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Innominate Vein Turndown Procedure as Another Option for Lymphatic Abnormalities in Fontan Patients. 作为治疗丰坦患者淋巴异常的另一种选择的腹内静脉翻转术。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.240257
Pier Paolo Bassareo
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引用次数: 0
Noncontrast MR Lymphangiography to Identify Progression of Lymphatic Abnormalities over the Course of Fontan Completion. 通过非对比 MR 淋巴管造影确定丰坦手术完成过程中淋巴管异常的进展。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.240201
Jeremy D Collins, Scott M Thompson
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引用次数: 0
Association of Cardiac MRI-derived Aortic Stiffness with Early Stages and Progression of Heart Failure with Preserved Ejection Fraction. 心脏磁共振成像得出的主动脉僵硬度与射血分数保留型心力衰竭早期阶段和进展的关系
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230344
Alexander Schulz, Isabel N Schellinger, Sören J Backhaus, Ansgar S Adler, Torben Lange, Ruben Evertz, Johannes T Kowallick, Annett Hoffmann, Christian Matek, Philip S Tsao, Gerd Hasenfuß, Uwe Raaz, Andreas Schuster

Purpose To investigate if aortic stiffening as detected with cardiac MRI is an early phenomenon in the development and progression of heart failure with preserved ejection fraction (HFpEF). Materials and Methods Both clinical and preclinical studies were performed. The clinical study was a secondary analysis of the prospective HFpEF stress trial (August 2017 through September 2019) and included 48 participants (median age, 69 years [range, 65-73 years]; 33 female, 15 male) with noncardiac dyspnea (NCD, n = 21), overt HFpEF at rest (pulmonary capillary wedge pressure [PCWP] ≥ 15 mm Hg, n = 14), and masked HFpEF at rest diagnosed during exercise stress (PCWP ≥ 25 mm Hg, n = 13) according to right heart catheterization. Additionally, all participants underwent echocardiography and cardiac MRI at rest and during exercise stress. Aortic pulse wave velocity (PWV) was calculated. The mechanistic preclinical study characterized cardiac function and structure in transgenic mice with induced arterial stiffness (Runx2-smTg mice). Statistical analyses comprised nonparametric and parametric comparisons, Spearman correlations, and logistic regression models. Results Participants with HFpEF showed increased PWV (NCD vs masked HFpEF: 7.0 m/sec [IQR: 5.0-9.5 m/sec] vs 10.0 m/sec [IQR: 8.0-13.4 m/sec], P = .005; NCD vs overt HFpEF: 7.0 m/sec [IQR: 5.0-9.5 m/sec] vs 11.0 m/sec [IQR: 7.5-12.0 m/sec], P = .01). Increased PWV correlated with higher PCWP (P = .006), left atrial and left ventricular long-axis strain (all P < .02), and N-terminal pro-brain natriuretic peptide levels (P < .001). Participants with overt HFpEF had higher levels of myocardial fibrosis, as demonstrated by increased native T1 times (1199 msec [IQR: 1169-1228 msec] vs 1234 msec [IQR: 1208-1255 msec], P = .009). Aortic stiffness was independently associated with HFpEF on multivariable analyses (odds ratio, 1.31; P = .049). Runx2-smTG mice exhibited an "HFpEF" phenotype compared with wild-type controls, with preserved left ventricular fractional shortening but an early and late diastolic mitral annulus velocity less than 1 (mean, 0.67 ± 0.39 [standard error of the mean] vs 1.45 ± 0.47; P = .004), increased myocardial collagen deposition (mean, 11% ± 1 vs 2% ± 1; P < .001), and increased brain natriuretic peptide levels (mean, 171 pg/mL ± 23 vs 101 pg/mL ± 10; P < .001). Conclusion This study provides translational evidence that increased arterial stiffness might be associated with development and progression of HFpEF and may facilitate its early detection. Keywords: MR Functional Imaging, MR Imaging, Animal Studies, Cardiac, Aorta, Heart ClinicalTrials.gov identifier NCT03260621 Supplemental material is available for this article. © RSNA, 2024.

目的 研究心脏磁共振成像检测到的主动脉僵化是否是射血分数保留型心力衰竭(HFpEF)发生和发展的早期现象。材料和方法 进行了临床和临床前研究。临床研究是对前瞻性 HFpEF 压力试验(2017 年 8 月至 2019 年 9 月)的二次分析,包括 48 名参与者(中位年龄 69 岁[范围 65-73 岁];33 名女性,15 名男性),他们患有非心源性呼吸困难(NCD,n = 21)、静息时明显的 HFpEF(肺毛细血管楔压 [PCWP] ≥ 15 mm Hg,n = 14),以及根据右心导管检查在运动负荷时诊断出的静息时掩蔽性 HFpEF(PCWP ≥ 25 mm Hg,n = 13)。此外,所有参与者都在静息状态和运动负荷时接受了超声心动图和心脏核磁共振成像检查。计算了主动脉脉搏波速度(PWV)。机理临床前研究描述了具有诱导动脉僵化的转基因小鼠(Runx2-smTg 小鼠)的心脏功能和结构。统计分析包括非参数和参数比较、斯皮尔曼相关性和逻辑回归模型。结果 HFpEF 参与者的脉搏波速度增加(NCD vs masked HFpEF:7.0 米/秒[IQR:5.0-9.5 米/秒] vs 10.0 米/秒[IQR:8.0-13.4 米/秒],P = .005;NCD vs 明显 HFpEF:7.0 米/秒[IQR:5.0-9.5 米/秒] vs 10.0 米/秒[IQR:8.0-13.4 米/秒],P = .0057.0米/秒 [IQR:5.0-9.5米/秒] vs 11.0米/秒 [IQR:7.5-12.0米/秒],P = .01)。脉搏波速度增加与较高的 PCWP(P = .006)、左心房和左心室长轴应变(均 P < .02)以及 N 端前脑钠肽水平(P < .001)相关。显性 HFpEF 患者的心肌纤维化程度较高,表现为原生 T1 时间增加(1199 毫秒 [IQR: 1169-1228 毫秒] vs 1234 毫秒 [IQR: 1208-1255 毫秒],P = .009)。在多变量分析中,主动脉僵化与 HFpEF 独立相关(几率比为 1.31;P = .049)。与野生型对照组相比,Runx2-smTG 小鼠表现出 "HFpEF "表型,左心室折返缩短率保持不变,但舒张早期和舒张晚期二尖瓣环速度小于 1(平均值,0.67 ± 0.39 [平均值标准误差] vs 1.45 ± 0.47;P = .004),心肌胶原沉积增加(平均值,11% ± 1 vs 2% ± 1;P < .001),脑钠肽水平增加(平均值,171 pg/mL ± 23 vs 101 pg/mL ± 10;P < .001)。结论 本研究提供了转化证据,表明动脉僵化的增加可能与高频心衰的发生和发展有关,并有助于其早期检测。关键词磁共振功能成像 磁共振成像 动物研究 心脏 主动脉 心脏 ClinicalTrials.gov identifier NCT03260621 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Prognostic Value of Preoperative N Subcategories in Patients with Stage IIIA N2 Non-Small Cell Lung Cancer. IIIA N2 期非小细胞肺癌患者术前 N 子类别的预后价值
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230347
Na Eun Oh, Jooae Choe, Jae Kwang Yun, Wonjun Ji, Seonok Kim, Eun Jin Chae, Sang Min Lee, Joon Beom Seo

Purpose To evaluate the preoperative risk factors in patients with pathologic IIIA N2 non-small cell lung cancer (NSCLC) who underwent upfront surgery and to evaluate the prognostic value of new N subcategories. Materials and Methods Patients with pathologic stage IIIA N2 NSCLC who underwent upfront surgery in a single tertiary center from January 2015 to April 2021 were retrospectively reviewed. Each patient's clinical N (cN) was assigned to one of six subcategories (cN0, cN1a, cN1b, cN2a1, cN2a2, and cN2b) based on recently proposed N descriptors. Cox regression analysis was used to identify the significant prognostic factors for recurrence-free survival (RFS) and overall survival (OS). Results A total of 366 patients (mean age ± SD, 62.0 years ± 10.1; 202 male patients [55%]) were analyzed. The recurrence rate was 55% (203 of 366 patients) over a median follow-up of 37.3 months. Multivariable analysis demonstrated that cN (hazard ratios [HRs] for cN1 and cN2b compared with cN0, 1.66 [95% CI: 1.11, 2.48] and 2.11 [95% CI: 1.32, 3.38], respectively) and maximum lymph node (LN) size at N1 station (≥12 mm; HR, 1.62 [95% CI: 1.15, 2.29]), in addition to clinical T category (HR, 1.51 [95% CI: 1.14, 1.99]), were independent prognostic factors for RFS. For OS, clinical N subcategories (cN1, cN2a2, and cN2b vs cN0; HRs, 1.91 [95% CI: 1.11, 3.27], 1.89 [95% CI: 1.13, 2.18], and 2.02 [95% CI: 1.07, 3.80], respectively) and LN size at N1 station (HR, 1.75 [95% CI: 1.12, 2.71]) were independent prognostic factors. For clinical N1, OS was further stratified according to LN size (log-rank test, P < .001). Conclusion Assessing the proposed N subcategories by reporting single versus multistation involvement of N2 disease and maximum size of metastatic LN, reflecting metastatic burden, at preoperative CT may offer useful prognostic information for planning optimal treatment strategies. Keywords: CT, Lung, Staging, Non-Small Cell Lung Cancer Supplemental material is available for this article. ©RSNA, 2024.

目的 评估接受前期手术的病理分期为 IIIA N2 非小细胞肺癌(NSCLC)患者的术前风险因素,并评估新 N 亚类的预后价值。材料与方法 对 2015 年 1 月至 2021 年 4 月期间在一家三级中心接受前期手术的病理 IIIA N2 期 NSCLC 患者进行了回顾性研究。根据最近提出的N描述符,将每位患者的临床N(cN)归入六个子类别(cN0、cN1a、cN1b、cN2a1、cN2a2和cN2b)之一。采用 Cox 回归分析确定无复发生存率(RFS)和总生存率(OS)的重要预后因素。结果 共分析了 366 例患者(平均年龄 ± SD,62.0 岁 ± 10.1;男性患者 202 例 [55%])。中位随访时间为 37.3 个月,复发率为 55%(366 例患者中有 203 例复发)。多变量分析表明,cN(与 cN0 相比,cN1 和 cN2b 的危险比 [HRs] 分别为 1.66 [95% CI: 1.11, 2.48] 和 2.11 [95% CI: 1.32, 3.38])和N1站最大淋巴结(LN)大小(≥12 mm; HR, 1.62 [95% CI: 1.15, 2.29])是RFS的独立预后因素,此外,临床T分类(HR, 1.51 [95% CI: 1.14, 1.99])也是RFS的独立预后因素。对于 OS,临床 N 亚类(cN1、cN2a2 和 cN2b vs cN0;HRs 分别为 1.91 [95% CI: 1.11, 3.27]、1.89 [95% CI: 1.13, 2.18] 和 2.02 [95% CI: 1.07, 3.80])和 N1 站的 LN 大小(HRs 为 1.75 [95% CI: 1.12, 2.71])是独立的预后因素。对于临床 N1,OS 根据 LN 大小进一步分层(对数秩检验,P < .001)。结论 在术前 CT 上报告 N2 病变的单个或多个分区受累情况以及反映转移负荷的转移 LN 的最大大小来评估所提出的 N 亚类,可为规划最佳治疗策略提供有用的预后信息。关键词: CTCT、肺、分期、非小细胞肺癌 本文有补充材料。©RSNA, 2024.
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引用次数: 0
SPECT/CT with 99mTc-DTPA in a Patient with Persistent Complex Pneumothorax after Endobronchial Valve Placement. 使用 99mTc-DTPA 的 SPECT/CT 用于一名支气管内瓣膜置入术后持续性复杂气胸患者。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230377
Tina Phan, Caroline Ricard, Linda Lee, Susannah Kay, Joan Rastegar, Dustin M Walters

Ventilation-perfusion SPECT with or without CT using technetium 99m (99mTc)-diethylenetriaminepentaacetic acid (DTPA) has been used to identify patterns typical of cardiopulmonary diseases, such as pulmonary embolism, pneumonia, heart failure, and obstructive lung disease. This case demonstrates the utility of a ventilation scan with SPECT/CT using 99mTc-DTPA for investigating the cause of a persistent complex pneumothorax in a patient with severe chronic obstructive pulmonary disease who recently underwent endobronchial valve placement. Keywords: CT-Spectral Imaging (Multienergy), SPECT/CT, Thorax, Lung Supplemental material is available for this article. © RSNA, 2024.

使用锝 99m (99mTc)- 二乙烯三胺五乙酸 (DTPA) 的通气-灌注 SPECT 扫描与或不使用 CT 扫描已被用于识别典型的心肺疾病模式,如肺栓塞、肺炎、心力衰竭和阻塞性肺病。本病例展示了使用99m锝-DTPA进行SPECT/CT通气扫描的实用性,可用于调查最近接受支气管内瓣膜置入术的严重慢性阻塞性肺病患者持续性复杂气胸的原因。关键词CT-光谱成像(多能) SPECT/CT 胸腔 肺部 本文有补充材料。© RSNA, 2024.
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引用次数: 0
Multimodality Imaging of Congenital Intrapericardial Diaphragmatic Hernia. 先天性心包内膈疝的多模态成像。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.240137
Yukun Cao, Lan Cheng, Cihao Xu, Heshui Shi
{"title":"Multimodality Imaging of Congenital Intrapericardial Diaphragmatic Hernia.","authors":"Yukun Cao, Lan Cheng, Cihao Xu, Heshui Shi","doi":"10.1148/ryct.240137","DOIUrl":"10.1148/ryct.240137","url":null,"abstract":"","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improved Detection of Small and Low-Density Plaques in Virtual Noncontrast Imaging-based Calcium Scoring at Photon-Counting Detector CT. 在光子计数探测器 CT 上基于虚拟非对比成像的钙化评分中改进对小斑块和低密度斑块的检测。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230328
Nicola Fink, Tilman Emrich, U Joseph Schoepf, Emese Zsarnoczay, Jim O'Doherty, Moritz C Halfmann, Joseph P Griffith, Daniel Pinos, Pal Suranyi, Dhiraj Baruah, Ismail M Kabakus, Jens Ricke, Akos Varga-Szemes

Purpose To investigate the impact of plaque size and density on virtual noncontrast (VNC)-based coronary artery calcium scoring (CACS) using photon-counting detector CT and to provide safety net reconstructions for improved detection of subtle plaques in patients whose VNC-based CACS would otherwise be erroneously zero when compared with true noncontrast (TNC)-based CACS. Materials and Methods In this prospective study, CACS was evaluated in a phantom containing calcifications with different diameters (5, 3, and 1 mm) and densities (800, 400, and 200 mg/cm3) and in participants who underwent TNC and contrast-enhanced cardiac photon-counting detector CT (July 2021-March 2022). VNC images were reconstructed at different virtual monoenergetic imaging (55-80 keV) and quantum iterative reconstruction (QIR) levels (QIR,1-4). TNC scans at 70 keV with QIR off served as the reference standard. In vitro CACS was analyzed using standard settings (3.0-mm sections, kernel Qr36, 130-HU threshold). Calcification detectability and CACS of small and low-density plaques were also evaluated using 1.0-mm sections, kernel Qr44, and 120- or 110-HU thresholds. Safety net reconstructions were defined based on background Agatston scores and evaluated in vivo in TNC plaques initially nondetectable using standard VNC reconstructions. Results The in vivo cohort included 63 participants (57.8 years ± 15.5 [SD]; 37 [59%] male, 26 [41%] female). Correlation and agreement between standard CACSVNC and CACSTNC were higher in large- and medium-sized and high- and medium-density than in low-density plaques (in vitro: intraclass correlation coefficient [ICC] ≥ 0.90; r > 0.9 vs ICC = 0.20-0.48; r = 0.5-0.6). Small plaques were not detectable using standard VNC reconstructions. Calcification detectability was highest using 1.0-mm sections, kernel Qr44, 120- and 110-HU thresholds, and QIR level of 2 or less VNC reconstructions. Compared with standard VNC, using safety net reconstructions (55 keV, QIR 2, 110-HU threshold) for in vivo subtle plaque detection led to higher detection (increased by 89% [50 of 56]) and improved correlation and agreement of CACSVNC with CACSTNC (in vivo: ICC = 0.51-0.61; r = 0.6). Conclusion Compared with TNC-based calcium scoring, VNC-based calcium scoring was limited for small and low-density plaques but improved using safety net reconstructions, which may be particularly useful in patients with low calcium scores who would otherwise be treated based on potentially false-negative results. Keywords: Coronary Artery Calcium CT, Photon-Counting Detector CT, Virtual Noncontrast, Plaque Size, Plaque Density Supplemental material is available for this article. © RSNA, 2024.

目的 研究斑块大小和密度对使用光子计数探测器 CT 进行的基于虚拟非对比(VNC)的冠状动脉钙化评分(CACS)的影响,并提供安全网重建,以改进对患者微小斑块的检测,否则与基于真实非对比(TNC)的 CACS 相比,基于 VNC 的 CACS 将错误地为零。材料与方法 在这项前瞻性研究中,CACS 在一个包含不同直径(5、3 和 1 毫米)和密度(800、400 和 200 毫克/立方厘米)钙化的模型中进行了评估,并在接受 TNC 和对比度增强型心脏光子计数探测器 CT 的参与者中进行了评估(2021 年 7 月至 2022 年 3 月)。VNC 图像在不同的虚拟单能成像(55-80 keV)和量子迭代重建(QIR)级别(QIR,1-4)下重建。以关闭 QIR 的 70 keV TNC 扫描作为参考标准。体外 CACS 分析采用标准设置(3.0 毫米切片、Qr36 内核、130-HU 阈值)。此外,还使用 1.0 毫米切片、Qr44 内核、120 或 110-HU 阈值对小型和低密度斑块的钙化可探测性和 CACS 进行了评估。安全网重建是根据背景 Agatston 评分定义的,并在体内对最初使用标准 VNC 重建无法检测到的 TNC 斑块进行评估。结果 体内队列包括 63 名参与者(57.8 岁 ± 15.5 [SD];37 [59%] 男性,26 [41%] 女性)。与低密度斑块相比,标准 CACSVNC 与 CACSTNC 在大、中、高密度斑块中的相关性和一致性更高(体外:类内相关系数 [ICC] ≥ 0.90;r > 0.9 vs ICC = 0.20-0.48;r = 0.5-0.6)。使用标准 VNC 重建无法检测到小斑块。使用 1.0 毫米切片、内核 Qr44、120 和 110-HU 阈值以及 QIR 级别为 2 或更低的 VNC 重建,钙化的可检测性最高。与标准 VNC 相比,使用安全网重建(55 keV、QIR 2、110-HU 阈值)进行体内微小斑块检测可提高检测率(提高 89% [56 例中的 50 例]),并改善 CACSVNC 与 CACSTNC 的相关性和一致性(体内:ICC = 0.51-0.61; r = 0.6)。结论 与基于TNC的钙评分相比,基于VNC的钙评分对小斑块和低密度斑块的影响有限,但使用安全网重建后,情况有所改善,这对钙评分较低的患者可能特别有用,否则这些患者可能会根据潜在的假阴性结果接受治疗。关键词:冠状动脉钙化冠状动脉钙化 CT 光子计数探测器 CT 虚拟非对比斑块大小 斑块密度 本文有补充材料。© RSNA, 2024.
{"title":"Improved Detection of Small and Low-Density Plaques in Virtual Noncontrast Imaging-based Calcium Scoring at Photon-Counting Detector CT.","authors":"Nicola Fink, Tilman Emrich, U Joseph Schoepf, Emese Zsarnoczay, Jim O'Doherty, Moritz C Halfmann, Joseph P Griffith, Daniel Pinos, Pal Suranyi, Dhiraj Baruah, Ismail M Kabakus, Jens Ricke, Akos Varga-Szemes","doi":"10.1148/ryct.230328","DOIUrl":"10.1148/ryct.230328","url":null,"abstract":"<p><p>Purpose To investigate the impact of plaque size and density on virtual noncontrast (VNC)-based coronary artery calcium scoring (CACS) using photon-counting detector CT and to provide safety net reconstructions for improved detection of subtle plaques in patients whose VNC-based CACS would otherwise be erroneously zero when compared with true noncontrast (TNC)-based CACS. Materials and Methods In this prospective study, CACS was evaluated in a phantom containing calcifications with different diameters (5, 3, and 1 mm) and densities (800, 400, and 200 mg/cm<sup>3</sup>) and in participants who underwent TNC and contrast-enhanced cardiac photon-counting detector CT (July 2021-March 2022). VNC images were reconstructed at different virtual monoenergetic imaging (55-80 keV) and quantum iterative reconstruction (QIR) levels (QIR,1-4). TNC scans at 70 keV with QIR off served as the reference standard. In vitro CACS was analyzed using standard settings (3.0-mm sections, kernel Qr36, 130-HU threshold). Calcification detectability and CACS of small and low-density plaques were also evaluated using 1.0-mm sections, kernel Qr44, and 120- or 110-HU thresholds. Safety net reconstructions were defined based on background Agatston scores and evaluated in vivo in TNC plaques initially nondetectable using standard VNC reconstructions. Results The in vivo cohort included 63 participants (57.8 years ± 15.5 [SD]; 37 [59%] male, 26 [41%] female). Correlation and agreement between standard CACS<sub>VNC</sub> and CACS<sub>TNC</sub> were higher in large- and medium-sized and high- and medium-density than in low-density plaques (in vitro: intraclass correlation coefficient [ICC] ≥ 0.90; <i>r</i> > 0.9 vs ICC = 0.20-0.48; <i>r</i> = 0.5-0.6). Small plaques were not detectable using standard VNC reconstructions. Calcification detectability was highest using 1.0-mm sections, kernel Qr44, 120- and 110-HU thresholds, and QIR level of 2 or less VNC reconstructions. Compared with standard VNC, using safety net reconstructions (55 keV, QIR 2, 110-HU threshold) for in vivo subtle plaque detection led to higher detection (increased by 89% [50 of 56]) and improved correlation and agreement of CACS<sub>VNC</sub> with CACS<sub>TNC</sub> (in vivo: ICC = 0.51-0.61; <i>r</i> = 0.6). Conclusion Compared with TNC-based calcium scoring, VNC-based calcium scoring was limited for small and low-density plaques but improved using safety net reconstructions, which may be particularly useful in patients with low calcium scores who would otherwise be treated based on potentially false-negative results. <b>Keywords:</b> Coronary Artery Calcium CT, Photon-Counting Detector CT, Virtual Noncontrast, Plaque Size, Plaque Density <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterizing Lung Parenchymal Aeration via Standardized Signal Intensity from Free-breathing 4D Dynamic MRI in Phantoms, Healthy Children, and Pediatric Patients with Thoracic Insufficiency Syndrome. 通过模型、健康儿童和胸廓发育不全综合征儿科患者自由呼吸 4D 动态核磁共振成像的标准化信号强度描述肺实质通气情况。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230262
Yubing Tong, Jayaram K Udupa, Joseph M McDonough, Caiyun Wu, Lipeng Xie, Chamith S Rajapakse, Samantha Gogel, Sulagna Sarkar, Oscar H Mayer, Jason B Anari, Drew A Torigian, Patrick J Cahill

Purpose To investigate free-breathing thoracic bright-blood four-dimensional (4D) dynamic MRI (dMRI) to characterize aeration of parenchymal lung tissue in healthy children and patients with thoracic insufficiency syndrome (TIS). Materials and Methods All dMR images in patients with TIS were collected from July 2009 to June 2017. Standardized signal intensity (sSI) was investigated, first using a lung aeration phantom to establish feasibility and sensitivity and then in a retrospective research study of 40 healthy children (16 male, 24 female; mean age, 9.6 years ± 2.1 [SD]), 20 patients with TIS before and after surgery (11 male, nine female; mean age, 6.2 years ± 4.2), and another 10 healthy children who underwent repeated dMRI examinations (seven male, three female; mean age, 9 years ± 3.6). Individual lungs in 4D dMR images were segmented, and sSI was assessed for each lung at end expiration (EE), at end inspiration (EI), preoperatively, postoperatively, in comparison to normal lungs, and in repeated scans. Results Air content changes of approximately 6% were detectable in phantoms via sSI. sSI within phantoms significantly correlated with air occupation (Pearson correlation coefficient = -0.96 [P < .001]). For healthy children, right lung sSI was significantly lower than that of left lung sSI (at EE: 41 ± 6 vs 47 ± 6 and at EI: 39 ± 6 vs 43 ± 7, respectively; P < .001), lung sSI at EI was significantly lower than that at EE (P < .001), and left lung sSI at EE linearly decreased with age (r = -0.82). Lung sSI at EE and EI decreased after surgery for patients (although not statistically significantly, with P values of sSI before surgery vs sSI after surgery, left and right lung separately, in the range of 0.13-0.51). sSI varied within 1.6%-4.7% between repeated scans. Conclusion This study demonstrates the feasibility of detecting change in sSI in phantoms via bright-blood dMRI when air occupancy changes. The observed reduction in average lung sSI after surgery in pediatric patients with TIS may indicate postoperative improvement in parenchymal aeration. Keywords: MR Imaging, Thorax, Lung, Pediatrics, Thoracic Surgery, Lung Parenchymal Aeration, Free-breathing Dynamic MRI, MRI Intensity Standardization, Thoracic Insufficiency Syndrome Supplemental material is available for this article. © RSNA, 2024.

目的 研究自由呼吸胸腔亮血四维(4D)动态磁共振成像(dMRI),以描述健康儿童和胸廓发育不全综合征(TIS)患者肺实质组织的通气情况。材料与方法 收集了 2009 年 7 月至 2017 年 6 月期间 TIS 患者的所有 dMR 图像。首先使用肺通气模型确定可行性和灵敏度,然后对 40 名健康儿童(16 名男性,24 名女性;平均年龄为 9.6 岁 ± 2.1 [SD])、20 名手术前后的 TIS 患者(11 名男性,9 名女性;平均年龄为 6.2 岁 ± 4.2)以及另外 10 名接受重复 dMRI 检查的健康儿童(7 名男性,3 名女性;平均年龄为 9 岁 ± 3.6)进行了标准化信号强度(sSI)调查。对 4D dMR 图像中的单个肺进行分割,并在呼气末 (EE)、吸气末 (EI)、术前、术后、与正常肺的比较以及重复扫描中对每个肺的 sSI 进行评估。结果 通过 sSI 在模型中可检测到约 6% 的空气含量变化。模型中的 sSI 与空气占位有显著相关性(皮尔逊相关系数 = -0.96 [P < .001])。对于健康儿童,右肺 sSI 明显低于左肺 sSI(EE:41 ± 6 vs 47 ± 6,EI:39 ± 6 vs 43 ± 7,P < .001),EI 的肺 sSI 明显低于 EE(P < .001),EE 的左肺 sSI 随年龄呈线性下降(r = -0.82)。患者手术后,EE 和 EI 处的肺 sSI 均有所下降(但无统计学意义,左肺和右肺手术前 sSI 与手术后 sSI 的 P 值分别在 0.13-0.51 之间)。结论 本研究证明了通过亮血 dMRI 在空气占用率发生变化时检测模型中 sSI 变化的可行性。所观察到的 TIS 儿童患者术后肺部平均 sSI 的减少可能表明术后肺实质通气情况有所改善。关键词磁共振成像,胸腔,肺,儿科,胸外科,肺实质通气,自由呼吸动态磁共振成像,磁共振成像强度标准化,胸廓供血不足综合征 本文有补充材料。© RSNA, 2024.
{"title":"Characterizing Lung Parenchymal Aeration via Standardized Signal Intensity from Free-breathing 4D Dynamic MRI in Phantoms, Healthy Children, and Pediatric Patients with Thoracic Insufficiency Syndrome.","authors":"Yubing Tong, Jayaram K Udupa, Joseph M McDonough, Caiyun Wu, Lipeng Xie, Chamith S Rajapakse, Samantha Gogel, Sulagna Sarkar, Oscar H Mayer, Jason B Anari, Drew A Torigian, Patrick J Cahill","doi":"10.1148/ryct.230262","DOIUrl":"10.1148/ryct.230262","url":null,"abstract":"<p><p>Purpose To investigate free-breathing thoracic bright-blood four-dimensional (4D) dynamic MRI (dMRI) to characterize aeration of parenchymal lung tissue in healthy children and patients with thoracic insufficiency syndrome (TIS). Materials and Methods All dMR images in patients with TIS were collected from July 2009 to June 2017. Standardized signal intensity (sSI) was investigated, first using a lung aeration phantom to establish feasibility and sensitivity and then in a retrospective research study of 40 healthy children (16 male, 24 female; mean age, 9.6 years ± 2.1 [SD]), 20 patients with TIS before and after surgery (11 male, nine female; mean age, 6.2 years ± 4.2), and another 10 healthy children who underwent repeated dMRI examinations (seven male, three female; mean age, 9 years ± 3.6). Individual lungs in 4D dMR images were segmented, and sSI was assessed for each lung at end expiration (EE), at end inspiration (EI), preoperatively, postoperatively, in comparison to normal lungs, and in repeated scans. Results Air content changes of approximately 6% were detectable in phantoms via sSI. sSI within phantoms significantly correlated with air occupation (Pearson correlation coefficient = -0.96 [<i>P</i> < .001]). For healthy children, right lung sSI was significantly lower than that of left lung sSI (at EE: 41 ± 6 vs 47 ± 6 and at EI: 39 ± 6 vs 43 ± 7, respectively; <i>P</i> < .001), lung sSI at EI was significantly lower than that at EE (<i>P</i> < .001), and left lung sSI at EE linearly decreased with age (<i>r</i> = -0.82). Lung sSI at EE and EI decreased after surgery for patients (although not statistically significantly, with <i>P</i> values of sSI before surgery vs sSI after surgery, left and right lung separately, in the range of 0.13-0.51). sSI varied within 1.6%-4.7% between repeated scans. Conclusion This study demonstrates the feasibility of detecting change in sSI in phantoms via bright-blood dMRI when air occupancy changes. The observed reduction in average lung sSI after surgery in pediatric patients with TIS may indicate postoperative improvement in parenchymal aeration. <b>Keywords:</b> MR Imaging, Thorax, Lung, Pediatrics, Thoracic Surgery, Lung Parenchymal Aeration, Free-breathing Dynamic MRI, MRI Intensity Standardization, Thoracic Insufficiency Syndrome <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety Net Reconstruction to Catch Low-Density and Low-Volume Calcifications at Photon-Counting Detector CT Using Virtual Noncontrast Imaging. 利用虚拟非对比成像进行安全网重建,捕捉光子计数探测器 CT 上的低密度和低容积钙化。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.240266
Prabhakar Shantha Rajiah, Kishore Rajendran
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引用次数: 0
Enabling Reliable Visual Detection of Chronic Myocardial Infarction with Native T1 Cardiac MRI Using Data-Driven Native Contrast Mapping. 利用数据驱动的原位对比度映射,通过原位 T1 心脏 MRI 对慢性心肌梗死进行可靠的视觉检测。
IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1148/ryct.230338
Khalid Youssef, Xinheng Zhang, Ghazal Yoosefian, Yinyin Chen, Shing Fai Chan, Hsin-Jung Yang, Keyur Vora, Andrew Howarth, Andreas Kumar, Behzad Sharif, Rohan Dharmakumar

Purpose To investigate whether infarct-to-remote myocardial contrast can be optimized by replacing generic fitting algorithms used to obtain native T1 maps with a data-driven machine learning pixel-wise approach in chronic reperfused infarct in a canine model. Materials and Methods A controlled large animal model (24 canines, equal male and female animals) of chronic myocardial infarction with histologic evidence of heterogeneous infarct tissue composition was studied. Unsupervised clustering techniques using self-organizing maps and t-distributed stochastic neighbor embedding were used to analyze and visualize native T1-weighted pixel-intensity patterns. Deep neural network models were trained to map pixel-intensity patterns from native T1-weighted image series to corresponding pixels on late gadolinium enhancement (LGE) images, yielding visually enhanced noncontrast maps, a process referred to as data-driven native mapping (DNM). Pearson correlation coefficients and Bland-Altman analyses were used to compare findings from the DNM approach against standard T1 maps. Results Native T1-weighted images exhibited distinct pixel-intensity patterns between infarcted and remote territories. Granular pattern visualization revealed higher infarct-to-remote cluster separability with LGE labeling as compared with native T1 maps. Apparent contrast-to-noise ratio from DNM (mean, 15.01 ± 2.88 [SD]) was significantly different from native T1 maps (5.64 ± 1.58; P < .001) but similar to LGE contrast-to-noise ratio (15.51 ± 2.43; P = .40). Infarcted areas based on LGE were more strongly correlated with DNM compared with native T1 maps (R2 = 0.71 for native T1 maps vs LGE; R2 = 0.85 for DNM vs LGE; P < .001). Conclusion Native T1-weighted pixels carry information that can be extracted with the proposed DNM approach to maximize image contrast between infarct and remote territories for enhanced visualization of chronic infarct territories. Keywords: Chronic Myocardial Infarction, Cardiac MRI, Data-Driven Native Contrast Mapping Supplemental material is available for this article. © RSNA, 2024.

目的 研究在犬模型的慢性再灌注心肌梗死中,用数据驱动的机器学习像素法取代用于获得原始 T1 图的通用拟合算法,是否能优化梗死与远端心肌的对比度。材料与方法 研究了一种慢性心肌梗死的对照大型动物模型(24 只犬科动物,雌雄各半),其组织学证据表明梗死组织的组成不均匀。使用自组织图和 t 分布随机邻域嵌入的无监督聚类技术来分析和可视化原生 T1 加权像素强度模式。对深度神经网络模型进行了训练,以便将原生 T1 加权图像系列中的像素强度模式映射到晚期钆增强(LGE)图像上的相应像素上,从而生成视觉增强的非对比度映射图,这一过程被称为数据驱动的原生映射(DNM)。采用皮尔逊相关系数和布兰-阿尔特曼分析法将 DNM 方法的结果与标准 T1 地图进行比较。结果 原位 T1 加权图像在梗死区和偏远区之间显示出不同的像素强度模式。颗粒模式可视化显示,与原始 T1 图相比,LGE 标记的梗死区与偏远区的分离度更高。DNM 的表观对比噪声比(平均值为 15.01 ± 2.88 [标度])与原始 T1 地图(5.64 ± 1.58;P < .001)有显著差异,但与 LGE 对比噪声比(15.51 ± 2.43;P = .40)相似。与原始 T1 地图相比,基于 LGE 的梗死区域与 DNM 的相关性更强(原始 T1 地图与 LGE 相比,R2 = 0.71;DNM 与 LGE 相比,R2 = 0.85;P < .001)。结论 原位 T1 加权像素所携带的信息可通过建议的 DNM 方法提取出来,从而最大限度地提高梗死区和远端区域的图像对比度,增强慢性梗死区的可视化。关键词慢性心肌梗死 心脏 MRI 数据驱动的原位对比度映射 本文有补充材料。© RSNA, 2024.
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Radiology. Cardiothoracic imaging
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