3D Pulmonary Perfusion Mapping Using 3D Ultrashort Echo-time Imaging
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Lung MRI is getting more interest as an alternative to CT because of no radiation exposure and expands its role of providing structural information to functional information such as ventilation and perfusion. In terms of 3D functional imaging, 3D ventilation mapping was already proposed, but few studies have been done on 3D perfusion mapping. Here, we propose a 3D pulmonary perfusion map using 3D UTE-MRI with retrospective respiratory and cardiac gating. The proposed method provides high-resolution 3D regional perfusion information of the lungs and will be useful for diagnosing diffusive lung diseases along with ventilation map (e.g., V/Q ratio).Objective To compare the application value of Single Photon Emission Computed Tomography(SPECT)lung perfusion imaging and CT in the diagnosis of radiation-induced pulmonary injury by animal experiment. Methods The right lungs of 16New Zealand white rabbits were exposed to 40Gy light for a single time to establish the radiation-induced lung injured rabbit models.2experimental rabbits were randomly chosen to undergo CT scanning and SPECT lung perfusion imaging before being radiated.In week 6and week 6after radiation,the lung CT and SPECT lung perfusion imaging were performed on them respectively.12weeks after radiation,pathological pulmonary characteristics of rabbits were observed.Results Before rabbits were radiated,the image effect of lung CT and SPECT lung perfusion imaging showed no significant difference.However,in week 6,CT showed that there was ground-glass-like image in the right lung of one experimental rabbit but no abnormality in its left lung and both lungs of other rabbits.SPECT lung perfusion imaging showed no radioactive sparse defects area in lungs of all the rabbits. In week 12,CT showed that the right lungs of 2rabbits had local patchy change and the texture of their left lungs increased.Other 14rabbits had also increased texture on both lungs.SPECT lung perfusion imaging showed that all of the rabbits' right lungs had radioactive sparse defects.The positive rate of SPECT lung perfusion imaging and CT were 100%(16/16)and 12.5%(2/16)respectively,so the difference between the two groups had statistical significance(P =0.0000).In week 12,pathology showed that there were large amount of inflammatory cell infiltration and fibroblast proliferation in the right lungs of all the experimental rabbits and a small amount of inflammatory cell infiltration and mild alveolar congestion in their left lungs.Conclusion SPECT lung perfusion imaging has a higher sensitivity than CT in diagnosing radiation-induced pulmonary injury.
Spect imaging
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Objective To investigate th e hemodynamic features of different cytopathological types of lung malignancies on multislice spiral CT perfusion imaging.Methods Forty-five patients with histologically proven lung cancers were involved in this study.A conventional thoracic CT was obtained as a routine to locate the lung lesions.Fifty milliliters of nonionic contrast(300 mgI/ml) were injected at 6 ml/s,then,followed by dynamic CT scans at the same location.Data postprocessing was performed on Siemens workstation using lung cancer analyzing software in the package of Body Perfusion.The perfusion measurements were calculated for each dynamic scan.The perfusion values of different types of lung malignancies were then compared using analysis of variance.Results The time to start perfusion of lung adenocarcinomas was later than the time of squamous cell carcinomas and small cell undifferentiated carcinomas.The time to peak perfusion of squamous cell carcinomas was earlier than lung adenocarcinomas and small cell undifferentiated carcinomas.No significant differences were noted on other perfusion values among different cytopathological types of lung malignancies.Conclusion The Significant differences were noted on the values of time to start and time to peak perfusion among different cytopathological types of lung malignancies,but further investigation is necessary for their significance of prediction the cytopathology of lung malignancies.No significant differences were noted on other perfusion values among different types of lung malignancies.They may be of little help on differentiation of different cytopathological types of lung malignancies.
Multislice
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Objective:To analyze the value of CT perfusion and mammography in the diagnosis of breast diseases.Methods:45 patients with pathology proved breast disease were examined by mammography and CT perfusion,the imaging results were analyzed and correlated with pathology.Results:The diagnostic accuracy of mammography was 77.28%,CT perfusion was 88.89% and the diagnostic accuracy of mammography in combination with CT perfusion was 95.56%,significant statistical differences were existed (P0.05).The mean value of blood flow (BF),blood volume (BV) and surface permeability (PS) of breast malignancy on CT perfusion were markedly higher than that of benignancy.CT perfusion was superior to mammography in the diagnosis of extent of lesion and existence of necrosis (P0.05). Mammography was superior to CT perfusion in the identification of micro-calcifications (P0.05).Conclusion:The diagnostic accuracy of breast carcinoma could be improved by mammography in combination with CT perfusion.
Breast carcinoma
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Neuroradiology
Stroke
Acute stroke
Interventional radiology
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To explore the relationship of the perfusion defects in the dual-energy CT lung perfusion image and the filling defects in the CT pulmonary angiography (CTPA) in patients with acute pulmonary embolism.The clinical data of 22 patients with acute pulmonary embolism were retrospectively analyzed. All of them underwent contrast CT scan in two phases using dual-energy CT: the first is pulmonary artery phase, and the second was performed immediately after the first phase using dual-energy scan covered the whole lung. Perfusion defects in the lung perfusion images were compared with the filling defects in the CTPA.Complete filling defects of segmental and subsegmental pulmonary arteries mostly showed correspondence perfusion defects in the CT perfusion map, accounting for 83% and 62% respectively. However, when there were partial or central filling defects, most of them were partial perfusion defects or normal in the CT perfusion map. Three segmental perfusion defects were depicted without the visualization of endoluminal thrombi within the corresponding arteries.The perfusion defects in the CT lung perfusion image are not completely corresponding to the filling defects in the CTPA. The combination of CTPA and CT lung perfusion map will offer more information for the acute pulmonary embolism.
Pulmonary angiography
Dual energy
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To test the feasibility of ultra-short echo time (UTE) MRI for assessment of regional pulmonary ventilation/perfusion in a standard 3 Tesla clinical MRI system.MRI of the lungs was conducted with an optimized three-dimensional UTE sequence in normal rats and in a rat model of pulmonary embolism (PE) induced by a blood clot. Changes in signal intensities (SIs) due to inhalation of molecular oxygen or intravenous (i.v.) injection of Gd, which represents the distribution of ventilation and perfusion, respectively, were assessed in the lung parenchyma.The UTE MRI with a TE of 100 μs could detect and map the changes in SI of the lung parenchyma due to the inhalation of 100% oxygen or i.v. injection of Gd in normal rats. Reduced T1 resulting from oxygen inhalation was also quantified. These changes were not observed on the images that were obtained simultaneously with a conventional range of TE (2.3 ms). Furthermore, the method could delineate the embolized lesions where the lung ventilation and perfusion were mismatched in a rat model with PE.These results show the feasibility and diagnostic potential of UTE MRI for the assessment of pulmonary ventilation and perfusion which is essential for the evaluation of a variety of lung diseases.
Parenchyma
Ventilation perfusion mismatch
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RATIONALE AND OBJECTIVES The authors evaluate the use of magnetic resonance (MR) to image pulmonary perfusion in healthy controls and to detect pulmonary defects in patients with unilateral lung transplantation, using dynamic images after contrast administration. METHODS Five patients with right lung transplantation and nine healthy volunteers underwent MR imaging. Twenty-five subsecond contrast-enhanced MR images (turbo-fast low-angle shot [FLASH]) were obtained at the level of the pulmonary arteries after a single injection of gadopentetate dimeglumine(0.1 mmol/kg) in an antecubital vein. Perfusion lung scintigraphy was done within 24 hours after the MR imaging examination in the transplanted patients. RESULTS Before administration of contrast material, MR images showed both lungs to be homogeneous and of low signal intensity in healthy controls and in patients with lung transplantation. After contrast administration in controls, the mean signal intensity of the dependent lung increased markedly to 171 ± 24% above baseline, whereas the nondependent signal intensity lung increased by only 105 ± 17%; these changes were significantly different. In all patients with lung transplantation, a clear perfusion defect was demonstrated in the native lung. This defect was confirmed in all cases by perfusion nuclear scintigraphy, which showed that the majority of lung perfusion is directed to the transplanted allograft, compared with the native contralateral lung. CONCLUSIONS Our results suggest that dynamic contrast-enhanced MR imaging is a potential method for detecting pulmonary perfusion defects in patients with lung transplantation.
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Dynamic Contrast-Enhanced MRI
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Summary Background. Introduction of helical computed tomography (CT) scanning has enabled rapid imaging of the vascular status by means of CT angiography and perfusion CT. By virtue of recent multi-detector technology, helical CT has the ability to perform both CT angiography and multi-section perfusion CT simultaneously. This study investigated the clinical feasibility of simultaneous assessment of perfusion CT and CT angiography in patients with acute ischemic stroke. Method. Perfusion CT and CT angiography were performed simultaneously in a series of consecutive 31 acute ischemic stroke patients. The time required for the entire processing was about 15 minutes. Contrast agent was used in a total dose of 100 ml (35 ml for perfusion CT and 65 ml for CT angiography). Findings. Simultaneous perfusion CT scans and CT angiographies were of diagnostic quality for 29 patients (94%). In large territorial infarct patients, perfusion CT could predict all perfusion deficits of the final lesions (10 out of 10 lesions) and CT angiography could detect 9 of 10 occlusions of major cerebral arteries (90%). In patients with small lacunar or subcortical infarcts, perfusion CT could predict 9 out of 19 lesions (47.4%), and false-negative were encountered in small lesions (three patients) or in inadequate coverage of data acquisition (seven patients). Acute stage thrombolytic intervention could be carried out based on the findings, and the success of thrombolytic therapy could be demonstrated by follow-up study. Conclusions. Simultaneous perfusion CT and CT angiography is the very useful tool for the rapid and adequate diagnosis of almost all of the large territorial infarcts and some of non-territorial lacunar infarcts. It is an easy-to-perform and safe imaging technique to assess acute ischemic stroke.
Stroke
Acute stroke
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Observation of serial pulmonary scintigraphies after the treatment in the patients with pulmonary thromboembolism revealed altered perfusion in the lung area unaffected by embolism in 2 cases. Also, showed that recovered perfusion of the embolized lung area influenced the perfusion of contralateral embolic lung area in 1 patient. These findings were detected and confirmed by comparison of the serial scintigraphies mutually. These results indicate that the serial scintigraphy is useful not only for assessing perfusion recovery but also for detecting altered perfusion in the lung area unaffected by the embolism.
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Stroke
Digital subtraction angiography
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