Newsletter - April, 2013   send this newsletter to a colleague
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Focus on
New contribution focused on Anatomy

Chest CT Anatomy

J.F. Paul
The accurate interpretation of chest CT — the first-line modality in the diagnosis of thoracic pathology — requires a deep knowledge of anatomy. This Focus On illustrates the main anatomical features of the thorax through a series of high-resolution CT images in 2D, with multiplanar reconstruction, and in 3D with volume and surface rendering. Use this presentation to review the position and CT appearance of bones, vessels and organs in both physiological and pathological conditions.

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CT colonography
Dr. Perry J. Pickhardt, writing on the pages of Abdominal Imaging, reviews common errors in reading CT colonograms and offers advice on how to avoid diagnostic mistakes.
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Since the availability of 320-detector-row CT scanners, several studies have investigated the diagnostic performance of 320-slice CT coronary angiography. A new study on 118 patients with suspected coronary artery disease confirmed the high sensitivity and specificity of this examination and found that it exposed patients to lower doses of both radiation and contrast medium than did invasive angiography.
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Technical considerations/Cardiovascular
A paper published in the February issue of the International Journal of Cardiovascular Imaging examined how modifications to the scanning protocols for coronary CT angiography affect image quality and diagnostic accuracy. Researchers in the Netherlands determined the impact of scanning at low tube current (low radiation dose).
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Femoral bone mineral density is usually determined by dual-energy X-ray absorptiometry (DXA), but it can also be estimated from contrast-enhanced MDCT images of the abdomen when the proximal femur is included. In a retrospective study, researchers used archived radiographs from 40 patients who had undergone both exams to devise an equation to convert MDCT measures of bone mineral density into DXA-derived T-scores. They then showed how these calculated T-scores could be used to predict osteoporotic fractures in a larger group of patients who had only undergone MDCT.
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Optimizing image quality of cerebrovascular CT angiography
By V. Matarese

Multidetector CT angiography has high sensitivity and specificity for cerebral aneurysms, but the small possibility of false negatives (missed aneurysms) means that further improvements in this diagnostic test are needed. A new study found that the quality of intracranial artery images obtained with 16-slice CT angiography  is better when higher iodine doses are combined with scanning at lower voltage. This essay summarizes the strengths and weaknesses of the new study and points out areas for further research.
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Brain, head and neck
First generalized seizure
Man, 71 years old
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Acute onset of right-sided hemiparesis 
Woman, 84 years old
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Abdomen and Pelvis
Acute renal failure and hypertensive urgency
Woman, 23 years old
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Acute abdominal pain, leukocytosis and high CRP
Man, 57 years old
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CT staging of diffuse large B-cell lymphoma
Woman, 42 years old
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Restaging after chemotherapy for gastric cancer
Woman, 49 years old
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Sepsis in an intravenous drug user
Man, 39 years old
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Supported by an unrestricted educational grant from Bracco - Life from inside
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