Flash双源CT冠脉成像联合心肌灌注显像对猪急性心肌梗死模型的诊断价值

目的:探讨Flash双源CT(DSCT)冠脉成像联合心肌灌注显像对猪急性心肌梗死模型的诊断价值。方法:使用明胶海绵栓塞法建立5只猪急性心肌梗死模型,使用DSCT冠脉成像联合心肌灌注显像进行"一站式"扫描得到冠脉图像和心肌灌注图像,并与冠脉造影和病理染色相比较。结果:DSCT得到的心肌灌注图像结果与病理染色相比较,敏感性为93%,特异性为91%,阴性预测值为96%,阳性预测值为84%,Kappa值为0.82;DSCT得到的冠脉图像与冠脉造影相比较,敏感性为93%,特异性为81%,阴性预测值为95%,阳性预测值为75%,Kappa值为0.71。结论:DSCT冠脉成像联合心肌灌注显像与组织病理学及冠脉造影一致性较好,可以用于对猪急性心肌梗死模型的诊断。     

A novel concept for CT with fixed anodes (FACT): Medical imaging based on the feasibility of thermal load capacity

Focussing primarily on thermal load capacity, we describe the performance of a novel fixed anode CT (FACT) compared with a 100 kW reference CT. Being a fixed system, FACT has no focal spot blurring of the X-ray source during projection. Monte Carlo and finite element methods were used to determine the fluence proportional to thermal capacity. Studies of repeated short-time exposures showed that FACT could operate in pulsed mode for an unlimited period. A virtual model for FACT was constructed to analyse various temporal sequences for the X-ray source ring, representing a circular array of 1160 fixed anodes in the gantry. Assuming similar detector properties at a very small integration time, image quality was investigated using an image reconstruction library. Our model showed that approximately 60 gantry rounds per second, i.e. 60 sequential targetings of the 1160 anodes per second, were required to achieve a performance level equivalent to that of the reference CT (relative performance, RP = 1) at equivalent image quality. The optimal projection duration in each direction was about 10 μs. With a beam pause of 1 μs between projections, 78.4 gantry rounds per second with consecutive source activity were thermally possible at a given thermal focal spot. The settings allowed for a 1.3-fold (RP = 1.3) shorter scan time than conventional CT while maintaining radiation exposure and image quality. Based on the high number of rounds, FACT supports a high image frame rate at low doses, which would be beneficial in a wide range of diagnostic and technical applications.     

Helical differential X-ray phase-contrast computed tomography

We report on the first experimental results of helical differential phase-contrast computed tomography (helical DPC-CT) with a laboratory X-ray tube source and a Talbot–Lau grating interferometer. The results experimentally verify the feasibility of helical data acquisition and reconstruction in phase-contrast imaging, in analogy to its use in clinical CT systems. This allows fast and continuous volumetric scans for long objects with lengths exceeding the dimension of the detector. Since helical CT revolutionized the field of medical CT several years ago, we anticipate that this method will bring the same significant impact on the future medical and industrial applications of X-ray DPC-CT.     

Temporal resolution measurement of 128-slice dual source and 320-row area detector computed tomography scanners in helical acquisition mode using the impulse method

PurposeTo analyse the temporal resolution (TR) of modern computed tomography (CT) scanners using the impulse method, and assess the actual maximum TR at respective helical acquisition modes.MethodsTo assess the actual TR of helical acquisition modes of a 128-slice dual source CT (DSCT) scanner and a 320-row area detector CT (ADCT) scanner, we assessed the TRs of various acquisition combinations of a pitch factor (P) and gantry rotation time (R).ResultsThe TR of the helical acquisition modes for the 128-slice DSCT scanner continuously improved with a shorter gantry rotation time and greater pitch factor. However, for the 320-row ADCT scanner, the TR with a pitch factor of <1.0 was almost equal to the gantry rotation time, whereas with pitch factor of >1.0, it was approximately one half of the gantry rotation time. The maximum TR values of single- and dual-source helical acquisition modes for the 128-slice DSCT scanner were 0.138 (R/P = 0.285/1.5) and 0.074 s (R/P = 0.285/3.2), and the maximum TR values of the 64 × 0.5- and 160 × 0.5-mm detector configurations of the helical acquisition modes for the 320-row ADCT scanner were 0.120 (R/P = 0.275/1.375) and 0.195 s (R/P = 0.3/0.6), respectively.ConclusionBecause the TR of a CT scanner is not accurately depicted in the specifications of the individual scanner, appropriate acquisition conditions should be determined based on the actual TR measurement.     

Feasibility and accuracy of tissue characterization with dual source computed tomography

PurposeTo evaluate the feasibility and accuracy of a model for tissue characterization with dual source computed tomography (DSCT).Methods and MaterialsA model for tissue characterization in CT was used with a parameterization of linear attenuation coefficients. Sixteen chemical substances with effective atomic numbers between 5.21 and 13.08 and electron densities between 2.20 and 4.12 x10²³ electrons/cm³ were scanned at energies of 80 and 140 kV on a DSCT. From the reconstructed dual energy data sets, effective atomic numbers and electron densities of the substances were calculated.ResultsOur presented model using DSCT approximated the effective atomic numbers and effective electron densities of 16 substances very well. The measured effective atomic numbers deviated 3.4 ± 6.8% (R² = 0.994) from theoretical effective atomic numbers. In addition, measured effective electron densities deviated ?0.6 ± 2.2% (R² = 0.999) from theoretical effective electron densities.ConclusionEffective atomic numbers and effective electron densities can be determined with a high accuracy with DSCT. Therefore the model can be of potential benefit for clinical applications of quantitative tissue characterization with DSCT.     

Higher patient doses through X-ray imaging procedures

Medical imaging using X-rays has been one of the most popular imaging modalities ever since the discovery of X-rays 125 years ago. With unquestionable benefits, concerns about radiation risks have frequently been raised. Computed tomography (CT) and fluoroscopic guided interventional procedures have the potential to impart higher radiation exposure to patients than radiographic examinations. Despite technological advances, there have been instances of increased doses per procedure mainly because of better diagnostic information in images. However, cumulative dose from multiple procedures is creating new concerns as effective doses >100 mSv are not uncommon. There is a need for action at all levels. Manufacturers must produce equipment that can provide a quality diagnostic image at substantially lesser dose and better implementation of optimization strategies by users. There is an urgent need for the industry to develop CT scanners with sub-mSv radiation dose, a goal that has been lingering. It appears that a new monochromatic X-ray source will lead to replacement of X-ray tubes all over the world in coming years and will lead to a drastic reduction in radiation doses. This innovation will impact all X-ray imaging and will help dose reduction. For interventional procedures, the likely employment of robotic systems in practice may drastically reduce radiation exposures to operators- but patient exposure will still remain an issue. Training needs always need to be emphasized and practiced.     

宝石能谱CT的功能特点及心血管检查的临床应用

宝石能谱CT拥有一系列独特的技术,包括宝石探测器、高压发射器、ASIR重组技术、能谱栅技术等,使其具有低剂量高清成像、能谱成像和动态500排成像特点,实现了全身0.23mm的极限空间分辨率和类MRI的软组织低密度分辨率,为心脏能量成像、斑块性质的鉴别及金属伪影的消除提供了全新有效的手段。其特有的高纯度和高通透性的物理学特性,再加上影像链中采样率的增高,专有的高清算法,使得宝石能谱CT能够在更低的剂量下,获得更为清晰的图像质量,达到目前业内最高的空间分辨率和密度分辨率;同时,其独有的能谱栅成像技术,将CT诊断从形态学带入功能学领域,因此也被称为"显微CT,病理CT,绿色CT",宝石能谱CT代表了目前CT发展的趋势,它用准确的绝对CT值的单能量成像(keV)诊断和基物质成像诊断来取代传统的相对CT值的混合能量(kVp)成像诊断,用多参数CT成像诊断来代替传统的单参数CT成像诊断,而"三同"(同时、同源、同向)的物理基础保证了其能谱成像的准确性,使CT能谱成像真正走入了临床诊断的第一线,从而提高了心血管疾病诊断的准确性和安全性。为CT在心脏疾病的诊断方面开拓了新领域和新方法。     

容积减影成像计算机自动化技术与实现

探讨在PC机上对容积CT灌注（CTP）源影像全自动生成减影CTP源影像的方法。首先在WindowsXP操作系统中使用Matlab,对4层螺旋CTP源影像进行DICOM文件格式解析,获得CT成像设备的球管每转一周扫描层数及容积减影方法需要的其它参数信息,然后经过容积的CT值集合读、容积的CT值集合减以及容积的CT值集合写等几个步骤,生成减影CTP源影像的DICOM文件序列。使用该容积减影方法得到的减影CTP源影像,在定性肉眼观察和定量CT值矩阵比对上,与使用CT影像工作站上的减影软件手工逐层半自动减影得到的结果类同。容积减影方法实现了容积CTP源影像的自动化减影处理与成像,为最终形成一个一站式的减影CTP软件奠定了基础。     

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging

X-ray fluoroscopy is widely used for image guidance during cardiac intervention. However, radiation dose in these procedures can be high, and this is a significant concern, particularly in pediatric applications. Pediatrics procedures are in general much more complex than those performed on adults and thus are on average four to eight times longer¹. Furthermore, children can undergo up to 10 fluoroscopic procedures by the age of 10, and have been shown to have a three-fold higher risk of developing fatal cancer throughout their life than the general population^2,3.We have shown that radiation dose can be significantly reduced in adult cardiac procedures by using our scanning beam digital x-ray (SBDX) system⁴-- a fluoroscopic imaging system that employs an inverse imaging geometry^5,6 (Figure 1, Movie 1 and Figure 2). Instead of a single focal spot and an extended detector as used in conventional systems, our approach utilizes an extended X-ray source with multiple focal spots focused on a small detector. Our X-ray source consists of a scanning electron beam sequentially illuminating up to 9,000 focal spot positions. Each focal spot projects a small portion of the imaging volume onto the detector. In contrast to a conventional system where the final image is directly projected onto the detector, the SBDX uses a dedicated algorithm to reconstruct the final image from the 9,000 detector images.For pediatric applications, dose savings with the SBDX system are expected to be smaller than in adult procedures. However, the SBDX system allows for additional dose savings by implementing an electronic adaptive exposure technique. Key to this method is the multi-beam scanning technique of the SBDX system: rather than exposing every part of the image with the same radiation dose, we can dynamically vary the exposure depending on the opacity of the region exposed. Therefore, we can significantly reduce exposure in radiolucent areas and maintain exposure in more opaque regions. In our current implementation, the adaptive exposure requires user interaction (Figure 3). However, in the future, the adaptive exposure will be real time and fully automatic.We have performed experiments with an anthropomorphic phantom and compared measured radiation dose with and without adaptive exposure using a dose area product (DAP) meter. In the experiment presented here, we find a dose reduction of 30%.     

复杂型先天性心脏病诊断：低剂量大螺距双源CT 成像与超声心动图的对比研究

目的:探讨和比较双源CT和超声心动图对于复杂型先天性心脏病的诊断价值。方法:入选先心病患者47例,均使用SOMA TOM Flash CT扫描仪和超声心动图行心血管检查。所有入选患者均由外科手术或心血管造影证实。比较双源CT与超声心动图的诊断准确率。结果:经手术或心血管造影证实心内结构异常共38处,双源CT诊断34处,诊断准确率89.47%,超声心动图诊断37处,诊断准确率97.37%。两种方法比较无统计学差异;证实心外结构异常69处,双源CT诊断66处,诊断准确率95.65%,超声心电图诊断56处,诊断准确率85.51%,双源CT诊断准确率高于超声心动图(X2=7.07,P=0.008)。结论:双源CT诊断心外结构异常的诊断准确率高于超声心动图,两者结合有利于全面、准确的诊断复杂型先天性心脏病。     

Segmentation and measurement of fat volumes in murine obesity models using X-ray computed tomography

Obesity is associated with increased morbidity and mortality as well as reduced metrics in quality of life. Both environmental and genetic factors are associated with obesity, though the precise underlying mechanisms that contribute to the disease are currently being delineated. Several small animal models of obesity have been developed and are employed in a variety of studies. A critical component to these experiments involves the collection of regional and/or total animal fat content data under varied conditions. Traditional experimental methods available for measuring fat content in small animal models of obesity include invasive (e.g. ex vivo measurement of fat deposits) and non-invasive (e.g. Dual Energy X-ray Absorptiometry (DEXA), or Magnetic Resonance (MR)) protocols, each of which presents relative trade-offs. Current invasive methods for measuring fat content may provide details for organ and region specific fat distribution, but sacrificing the subjects will preclude longitudinal assessments. Conversely, current non-invasive strategies provide limited details for organ and region specific fat distribution, but enable valuable longitudinal assessment. With the advent of dedicated small animal X-ray computed tomography (CT) systems and customized analytical procedures, both organ and region specific analysis of fat distribution and longitudinal profiling may be possible. Recent reports have validated the use of CT for in vivo longitudinal imaging of adiposity in living mice. Here we provide a modified method that allows for fat/total volume measurement, analysis and visualization utilizing the Carestream Molecular Imaging Albira CT system in conjunction with PMOD and Volview software packages.     

运用CT三维重建测量重度先天性脊柱侧凸Cobb角的临床应用

目的:评价在CT三维重建上测量重度先天性脊柱侧凸Cobb角度的可重复性和可靠性。方法:收集在我院诊治的重度先天性脊柱侧凸病人的CT三维重建和脊柱全长X线片,共计67例。由五名不同测量者对CT三维重建脊柱畸形冠状面主弯Cobb角测量两次,两次间隔在三周以上,并测量脊柱全长X线片脊柱畸形冠状面主弯Cobb角一次,运用组内相关系数分析测量结果之间的可重复性和可靠性。结果:同一测量者两次测量结果之间的差值平均为4.5°。同一测量者两次测量结果之间的组内相关系数为0.969,不同测量者之间测量结果的组内相关系数为0.913。取五名测量者在CT三维重建上第一次测量的Cobb角度,其平均值为(110.5±23.5)°,五名测量者在X线片上测量结果的平均值为(103.1±22.0)°,对两组数据进行Mann-Whitney非参数检验差异有统计学意义(Z=-2.86,P=0.004)。结论:在CT三维重建上测量重度先天性脊柱侧凸的Cobb角,可以减小测量的误差,提高测量的可重复性和可靠性,是一种相对准确的测量方法。     

Broadband Mid-Infrared Super-Resolution Imaging with Metallic Nanorod-Bridged Dimer Array

We propose a broadband mid-infrared super-resolution imaging system comprising a metallic nanorod-bridged dimer array. The imaging array enables super-resolution imaging of shaped dipole sources in the near field. A charge transfer plasmon (CTP) appears in a metallic nanorod-bridged dimer. By varying the radius of the junction, the plasmon resonance wavelength of CTP mode can be tuned into the mid-infrared region. Here, we investigate the broadband super-resolution imaging of the incoherent and coherent dipole sources at mid-infrared wavelengths. With the array pitch varying, we calculate the cross-sectional field intensity distributions at the source plane and the image plane by using the finite element method. The simulation results indicate that the broadband incoherent and coherent super-resolution imaging can be realized at mid-infrared wavelengths with the imaging array. The image quality is sensitively dependent on the source coherent, the array pitch, and the distance from the image plane to the array. In the same structural parameters, the image quality of coherent source of in-phase is lower than that of incoherent source. Increasing the array pitch improves the image quality but it also increases the size of the array. By reasonably choosing the array pitch of the array, the spatial resolution of ～λ/109 and ～λ/73 is obtained corresponding to the incoherent imaging case and coherent imaging case at the mid-infrared wavelength of 4390 nm. Moreover, the larger image-array distance results in the lower image quality.     

Photon-counting CT review

Photon-counting detectors are a promising new technology for computed tomography (CT) systems. They provide energy-resolved CT data at very high spatial resolution without electronic noise and with improved tissue contrasts. This review article gives an overview of the principles of photon-counting detector CT, of potential clinical benefits and limitations, and of the experience gained so far in pre-clinical installations.     

Detection of Airway Anomalies in?Pediatric?Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT

Objectives

To assess the feasibility of low-dose prospective ECG-gated dual-source CT (DSCT) in detecting airway anomalies in pediatric patients with cardiovascular anomalies compared with flexible tracheobronchoscopy (FTB).

Methods

33 pediatrics with respiratory symptoms who had been revealed cardiovascular anomalies by transthoracic echocardiography underwent FTB and contrast material–enhanced prospective ECG-triggering CT were enrolled. The study was approved by our institution review board and written informed consent was obtained from all patients’ guardian. DSCT examinations were performed to detect cardiovascular abnormalities using weight-adjusted low–dose protocol. Two radiologists independently performed CT image analysis. The FTB reports were reviewed by an experienced pulmonologist. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of DSCT in the detection of airway anomalies were assessed. The tracheobronchial stenoses revealed on FTB were graded. Effective radiation dose was calculated.

Results

Thirty cases were diagnosed with tracheobronchial narrowing and/or abnormality in 33 patients by FTB, while 3 patients had normal FTB findings. Twenty-eight cases were diagnosed with airway anomalies by CT, of which 27 were correct positive. 3 patients with normal findings at CT had findings of tracheobronchial narrowing due to tracheobronchomalacia at inspiration at FTB. Sensitivity and specificity of CT were 90.0% (95% CI: 72.3%, 97.4%) and 66.7% (95% CI: 12.5 %, 98.2 %), respectively. PPV and NPV were 96.4% (95% CI: 79.8 %, 99.8%) and 40.0% (95% CI: 7.3%, 83.0%), respectively. Overall accuracy of DSCT in detecting airway anomalies in pediatrics with cardiovascular anomalies was 87.9% (95% CI: 74.5%, 97.6%). In grading of tracheobronchial stenosis, images from CT correlated closely (r = 0.89) with those of FTB. Mean effective dose was 0.60±0.20 mSv.

Conclusion

In pediatric patients, ECG-triggered CT to evaluate congenital cardiovascular anomalies can also be used to diagnose and characterize fixed airway involvement in relation to the vascular structures.     

同步辐射在显微CT中的应用

计算机X射线断层成像技术（CT）是利用X射线的穿透能力对物体进行扫描,所得信号经过反投影的算法而得到物体二维分布的一种成像方法,已经在医学诊断、工业探伤等领域广泛应用。但是由于实验室光源的低通量,光源点大小及其单色性等限制了其向高分辨发展,通常其分辨率在0．5mm左右。利用微焦点X射线源作为光源的显微CT分辨率可以达到微米量级,但是由于其光通量低且为非单色光,对不同样品有不同程度的束线硬化,影响了其真实分辨率。同步辐射作为一种新兴的光源有高亮度、高光子通量、高准直性、高极化性、高相干性及宽的频谱范围的特点,配合高分辨的X射线探测器,可以发展同步辐射显微CT,其分辨率可达10μm以下。利用同步辐射的高空间相干性开展位相衬度显微CT的研究,对低吸收物质也可以清晰三维成像。新建的上海光源的X射线成像及生物医学应用线站开展了三维显微CT方面的研究,经过初步试验,得到了较好的结果。     

X线、CT、SPECT、PET在评估小鼠的骨成像中的作用

目的利用各种影像诊断设备对正常小鼠的骨进行成像,观察其在小鼠骨成像中最佳成像参数。方法分别使用X线、CT、SPECT、PET对小鼠的骨进行拍摄成像。结果X线和CT均可以清楚地对小鼠的骨组织成像,而SPECT、PET由于其分辨率和特异性不高,成像较模糊。结论X线和CT检查对小鼠的骨成像明显,对小鼠疾病的观察有重要意义。而SPECT、PET对诊断小鼠的骨疾病意义不是很大。     

A role for magnetic susceptibility in synthetic computed tomography

PurposeRadiotherapy treatment planning based on magnetic resonance imaging (MRI) benefits from increased soft-tissue contrast and functional imaging. MRI-only planning is attractive but limited by the lack of electron density information required for dose calculation, and the difficulty to differentiate air and bone. MRI can map magnetic susceptibility to separate bone from air. A method is introduced to produce synthetic CT (sCT) through automatic voxel-wise assignment of CT numbers from an MRI dataset processed that includes magnetic susceptibility mapping.MethodsVolumetric multi-echo gradient echo datasets were acquired in the heads of five healthy volunteers and fourteen patients with cancer using a 3 T MRI system. An algorithm for CT synthesis was designed using the volunteer data, based on fuzzy c-means clustering and adaptive thresholding of the MR data (magnitude, fat, water, and magnetic susceptibility). Susceptibility mapping was performed using a modified version of the iterative phase replacement algorithm. On patient data, the algorithm was assessed by direct comparison to X-ray computed tomography (CT) scans.ResultsThe skull, spine, teeth, and major sinuses were clearly distinguished in all sCT, from healthy volunteers and patients. The mean absolute CT number error between X-ray CT and sCT in patients ranged from 78 and 134 HU.ConclusionSusceptibility mapping using MRI can differentiate air and bone for CT synthesis. The proposed method is automated, fast, and based on a commercially available MRI pulse sequence. The method avoids registration errors and does not rely on a priori information, making it suitable for nonstandard anatomy.     

VCTDSA联合CT灌注成像在急性缺血性卒中诊断运用探究

目的：探讨64层容积CT数字减影血管造影（Volume computed tomography digital subtraction angiography, VCTDSA）联合CT灌注成像在急性缺血性卒中诊断价值。方法：回顾性分析45例临床确诊为急性缺血性卒中患者的临床资料,分别给予VCTDSA与CT灌注成像处理,分析这两种技术对急性缺血性卒中患者的诊断敏感性和特异性。结果：45例患者检查有颅内有不同部位出血灶,多见于脑室,均伴有不同程度的异常血管网形成,其中VCTDSA图像质量优于CT灌注成像,VCTDSA较DSA可准确显示和测量动静脉瘘口大小,VCTDSA与MRA在瘤体长轴、瘤颈的比较中无显著性差异。结论：与其他减影CTA比较,VCTDSA联合CT灌注成像在急性缺血性卒中患者的诊断中具有优势。     

Targeted molecular imaging of angiogenesis in PET and SPECT: a review

Over the past few decades, there have been significant advancements in the imaging techniques of positron emission tomography (PET) and single photon emission tomography (SPECT). These changes have allowed for the targeted imaging of cellular processes and the development of hybrid imaging systems (e.g., SPECT/CT and PET/CT), which provide both functional and structural images of biological systems. One area that has garnered particular attention is angiogenesis as it relates to ischemic heart disease and limb ischemia. Though the aforementioned techniques have benefits and consequences, they enable scientists and clinicians to identify regions that are vulnerable to or have been exposed to ischemic injury via non-invasive means. This literature review highlights the advancements in molecular imaging techniques and specific probes as they pertain to the process of angiogenesis in cardiovascular disease.