MR urography: Anatomical and quantitative information on congenital malformations in children.

BACKGROUND AND AIM: Magnetic resonance urography (MRU) is considered to be the next step in uroradiology. This technique combines superb anatomical images and functional information in a single test. In this article, we aim to present the topic of MRU in children and how it has been implemented in Northern Greece so far. The purpose of this study is to demonstrate the potential of MRU in clinical practice. We focus both on the anatomical and the quantitative information this technique can offer. MATERIALS AND METHODS: MRU was applied in 25 children (ages from 3 to 11 years) diagnosed with different types of congenital malformations. T1 and T2 images were obtained for all patients. Dynamic, contrast-enhanced data were processed and signal intensity versus time curves were created for all patients from regions of interest (ROIs) selected around the kidneys in order to yield quantitative information regarding the kidneys function. RESULTS: From the slopes of these curves we were able to evaluate which kidneys were functional and from the corticomedullary cross-over point to determine whether the renal system was obstructed or not. CONCLUSION: In all 25 cases MRU was sufficient, if not superior to other imaging modalities, to establish a complete diagnosis.

The variation of intrinsic spatial resolution across the UFOV of scintillation cameras.

The aim of the present study was to investigate in detail the variation of the intrinsic spatial resolution across the useful field of view (UFOV) of gamma-cameras and to explore whether this variation could lead to observable effects in clinical images. Two gamma-cameras were used, without their collimators, to acquire 560 (99m)Tc point source images at different points across their UFOVs, in order to measure the intrinsic spatial resolution at each point. Possible clinical effects of the resolution variation were examined on images of a thyroid phantom using a LEHR collimator, acquired at different locations on the UFOV and at various distances from the collimator. The gamma-camera intrinsic resolution varied significantly across the UFOV, being generally lower at the central region and deteriorating at the edges. Pronounced local maxima and minima were found at points corresponding to the centers of the photomultiplier tubes (PMTs) and halfway in between. Maximum differences of more than 50% were observed between the points presenting the best and worst intrinsic resolution. Differences between neighboring points reached 17%. The effects of resolution variation were clearly observable on the thyroid phantom images. It was concluded that an appropriate correction algorithm might be necessary in order to correct for the variation of the intrinsic spatial resolution across the UFOV of gamma-cameras.

The dependence of patient dose on factors relating to the technique and complexity of Interventional Cardiology procedures.

Dose-area product (DAP) measurements were conducted for 168 coronary angiography (CA) and 89 single vessel percutaneous transluminal coronary angioplasty (PTCA) to examine the factors influencing patient dose beyond the X-ray exposure parameters. It was found that for CA, the DAP increases with the number of catheters used and with the number of vessels with stenosis. DAP values for patients with a prior bypass surgery, were higher compared to those without such a medical record to surgery. In PTCA, the use of coronary stents did not enhance the patient radiation dose significantly. Noticeable differences were found in the percentage contribution of each projection to the total DAP between the three types of single vessel PTCA. Finally low variations in DAP were found among the cardiologists performing both procedures.

Radiation exposure to cardiologists performing interventional cardiology procedures.

Medical doctors, who practice interventional cardiology, receive a noticeable radiation dose. In this study, we measured the radiation dose to 9 cardiologists during 144 procedures (72 coronary angiographies and 70 percutaneus translumined coronary angioplasties) in two Greek hospitals. Absorbed doses were measured with TLD placed underneath and over the lead apron at the thyroid protective collar. Based on these measurements, the effective dose was calculated using the Niklason method. In addition, dose area product (DAP) was registered. The effective doses, E, were normalised to the total DAP measured in each procedure, producing the E/DAP index. The mean effective dose values were found to be in the range of 1.2-2.7 microSv while the mean E/DAP values are in the range of 0.010-0.035 microSv/Gycm2. The dependence of dose to the X-ray equipment, the exposure parameters and the technique of the cardiologist were examined. Taking under consideration the laboratories' annual workload, the maximum annual dose was estimated to be 1.9 and 2.8 mSv in the two hospitals.