Pub Date : 2023-02-11DOI: 10.5812/iranjradiol-131641
N. Ghadimi, S. Mehralizadeh, E. Rahimian, L. Hafezi, Ahmadreza Talaiepour
Background: Temporomandibular joint disorders (TMDs) are the most common cause of non-odontogenic pain in the maxillofacial region. Internal derangement (ID) is one of the most prevalent causes of TMDs, and disc displacement is recognized as the most common ID. The masticatory muscles are among anatomical structures involved in TMDs that may be affected by ID. Objectives: This study aimed to evaluate the correlation between the masticatory muscle dimensions and ID of temporomandibular joints using magnetic resonance imaging (MRI). Patients and Methods: This cross-sectional study was conducted on the MRI images of 145 patients, retrieved from the archives of the MRI diagnostic and research center during 2020 - 2021. The patients were categorized into three main groups of normal disc position (NP) (n = 42), disc displacement with reduction (DDR) (n = 54), and disc displacement without reduction (DDWR) (n = 49). The maximum width and height of the masseter and medial pterygoid muscles and the maximum height and length of the superior and inferior heads of the lateral pterygoid muscle were measured on MRI images for each of the groups. Data were analyzed using t-test, Pearson’s correlation test, ANOVA test, and Tukey’s test (alpha < 0.05). Results: Significant differences were observed between the NP, DDR, and DDWR groups regarding the height (P < 0.001) and length (P < 0.001) of the superior head of the lateral pterygoid muscle; both parameters were significantly higher in the NP group, followed by the DDR and DDWR groups (P < 0.05). The dimensions of masticatory muscles were significantly greater in males than females (P < 0.05), except for the width of the medial pterygoid muscle (P = 0.064). The height of the masseter muscle (r = 0.190, P = 0.022) and the medial pterygoid muscle (r = 0.166, P = 0.046) was significantly correlated with age. Conclusion: Significant correlations were found between the height and length of the superior head of the lateral pterygoid muscle and ID of TMJ; the corresponding values were lower in the DDWR group compared to the DDR and NP groups, respectively.
{"title":"Correlation Between the Masticatory Muscle Dimensions and Internal Derangement of Temporomandibular Joints Based on Magnetic Resonance Imaging","authors":"N. Ghadimi, S. Mehralizadeh, E. Rahimian, L. Hafezi, Ahmadreza Talaiepour","doi":"10.5812/iranjradiol-131641","DOIUrl":"https://doi.org/10.5812/iranjradiol-131641","url":null,"abstract":"Background: Temporomandibular joint disorders (TMDs) are the most common cause of non-odontogenic pain in the maxillofacial region. Internal derangement (ID) is one of the most prevalent causes of TMDs, and disc displacement is recognized as the most common ID. The masticatory muscles are among anatomical structures involved in TMDs that may be affected by ID. Objectives: This study aimed to evaluate the correlation between the masticatory muscle dimensions and ID of temporomandibular joints using magnetic resonance imaging (MRI). Patients and Methods: This cross-sectional study was conducted on the MRI images of 145 patients, retrieved from the archives of the MRI diagnostic and research center during 2020 - 2021. The patients were categorized into three main groups of normal disc position (NP) (n = 42), disc displacement with reduction (DDR) (n = 54), and disc displacement without reduction (DDWR) (n = 49). The maximum width and height of the masseter and medial pterygoid muscles and the maximum height and length of the superior and inferior heads of the lateral pterygoid muscle were measured on MRI images for each of the groups. Data were analyzed using t-test, Pearson’s correlation test, ANOVA test, and Tukey’s test (alpha < 0.05). Results: Significant differences were observed between the NP, DDR, and DDWR groups regarding the height (P < 0.001) and length (P < 0.001) of the superior head of the lateral pterygoid muscle; both parameters were significantly higher in the NP group, followed by the DDR and DDWR groups (P < 0.05). The dimensions of masticatory muscles were significantly greater in males than females (P < 0.05), except for the width of the medial pterygoid muscle (P = 0.064). The height of the masseter muscle (r = 0.190, P = 0.022) and the medial pterygoid muscle (r = 0.166, P = 0.046) was significantly correlated with age. Conclusion: Significant correlations were found between the height and length of the superior head of the lateral pterygoid muscle and ID of TMJ; the corresponding values were lower in the DDWR group compared to the DDR and NP groups, respectively.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43715668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-10DOI: 10.5812/iranjradiol-129306
Samira Rezvani, Pardis Ghafarian, Mehrdad Bakhshayesh Karam, Mohammadreza Ay
Background: The quality of positron emission tomography/computed tomography (PET/CT) images plays an important role in tumor detection. This imaging method often yields poor-quality images of overweight patients due to the high level of noise, originating from scattering and photon attenuation. Objectives: The point spread function (PSF) is mostly used to enhance the spatial resolution and signal-to-noise ratio (SNR); however, it is known to increase the edge artifacts. The time-of-flight (TOF) principle can reduce edge artifacts in PSF modeling and improve lesion detection, especially in the thorax. The present study aimed to assess these two new techniques by applying different reconstruction parameters. Materials and Methods: An in-house phantom with an inner diameter of 35 cm was used for the simulation of overweight patients. Lesion-to-background ratios (LBRs) of 2: 1 and 8: 1, as well as background activity concentrations of 3 and 5 kBq/cc, were considered in this study. The list-mode data were reconstructed with various reconstruction protocols, numbers of subsets, and filter sizes. Quantitative analyses, including the coefficient of variation (COV), SNR, and recovery coefficient (RC), were also carried out. Moreover, box-and-whisker plots were performed. Results: At LBR of 2: 1, by changing the protocol from ordered subset expectation maximization (OSEM) to OSEM + PSF + TOF, the median value of SNR for 13-mm lesions (37 mm) increased by 39.25% and 53.45% (42.22% and 56.21%), at background activity concentrations of 3 and 5 kBq/cc respectively. However, at LBR of 8: 1, the corresponding values were 33.22% and 48.94% (40.22% and 52.15%) at background activity concentrations of 3 and 5 kBq/cc respectively. Conclusion: The TOF protocols were strongly recommended for both background activity concentrations at LBR of 2: 1 and for the low background activity concentration at LBR of 8: 1, especially when using smaller filter sizes. Moreover, subset numbers of 18 and 24 were appropriate for all protocols. However, a smaller subset number was suitable when a low background activity concentration and a smaller filter size were applied, especially at a lower LBR.
{"title":"Role of Lesion-to-Background Activity Ratio and Background Activity in Optimization of Reconstruction Protocols for FDG PET/CT Images of Overweight Patients: A Phantom Study","authors":"Samira Rezvani, Pardis Ghafarian, Mehrdad Bakhshayesh Karam, Mohammadreza Ay","doi":"10.5812/iranjradiol-129306","DOIUrl":"https://doi.org/10.5812/iranjradiol-129306","url":null,"abstract":"Background: The quality of positron emission tomography/computed tomography (PET/CT) images plays an important role in tumor detection. This imaging method often yields poor-quality images of overweight patients due to the high level of noise, originating from scattering and photon attenuation. Objectives: The point spread function (PSF) is mostly used to enhance the spatial resolution and signal-to-noise ratio (SNR); however, it is known to increase the edge artifacts. The time-of-flight (TOF) principle can reduce edge artifacts in PSF modeling and improve lesion detection, especially in the thorax. The present study aimed to assess these two new techniques by applying different reconstruction parameters. Materials and Methods: An in-house phantom with an inner diameter of 35 cm was used for the simulation of overweight patients. Lesion-to-background ratios (LBRs) of 2: 1 and 8: 1, as well as background activity concentrations of 3 and 5 kBq/cc, were considered in this study. The list-mode data were reconstructed with various reconstruction protocols, numbers of subsets, and filter sizes. Quantitative analyses, including the coefficient of variation (COV), SNR, and recovery coefficient (RC), were also carried out. Moreover, box-and-whisker plots were performed. Results: At LBR of 2: 1, by changing the protocol from ordered subset expectation maximization (OSEM) to OSEM + PSF + TOF, the median value of SNR for 13-mm lesions (37 mm) increased by 39.25% and 53.45% (42.22% and 56.21%), at background activity concentrations of 3 and 5 kBq/cc respectively. However, at LBR of 8: 1, the corresponding values were 33.22% and 48.94% (40.22% and 52.15%) at background activity concentrations of 3 and 5 kBq/cc respectively. Conclusion: The TOF protocols were strongly recommended for both background activity concentrations at LBR of 2: 1 and for the low background activity concentration at LBR of 8: 1, especially when using smaller filter sizes. Moreover, subset numbers of 18 and 24 were appropriate for all protocols. However, a smaller subset number was suitable when a low background activity concentration and a smaller filter size were applied, especially at a lower LBR.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"519 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136131707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Endometriosis is one of the most common gynecological diseases worldwide. Significant attention has been drawn to this multiorgan and often painful disorder. Objectives: This study aimed to examine the accuracy of transvaginal sonography (TVS) in the diagnosis of deeply infiltrating endometriosis (DIE) with respect to the presence or absence of ovarian endometrioma (OE). Patients and Methods: This cross-sectional study was performed on all patients undergoing TVS before gynecological laparoscopy. With pathological confirmation as the standard reference, the diagnostic accuracy of TVS for DIE and pouch of Douglas (POD) obliteration was compared with that of laparoscopy in the anterior and posterior pelvic compartments with respect to the presence or absence of OE. Agreement between TVS and laparoscopy was evaluated for each case, and Cohen’s kappa statistic was measured for each site of involvement. Moreover, sensitivity, specificity, negative and positive predictive values, and likelihood ratios of TVS were calculated, with laparoscopy as the reference test. Results: A total of 110 patients, with a mean age of 37.20 ± 7.16 years, were recruited in this study. The accuracy, sensitivity, and negative predictive value of TVS for the diagnosis of DIE and POD obliteration were estimated at 89.5%, 58.3%, and 88.9% in the anterior pelvic compartment and 93.3%, 92%, and 70.6% in the posterior pelvic compartment, respectively. Nevertheless, TVS showed lower sensitivity for detecting pelvic adhesions and peritoneal cysts compared to laparoscopy. The presence of OE did not significantly increase the accuracy of TVS for the diagnosis of DIE or POD obliteration (P > 0.05). Conclusion: The present study showed that TVS is an adequately accurate and non-invasive diagnostic tool for the detection and mapping of DIE and POD obliteration, regardless of the presence of OE. TVS may waive the need for exploratory laparoscopy in DIE or at least facilitate precise pre-procedural DIE mapping.
{"title":"Diagnostic Accuracy of Transvaginal Sonography for Deeply Infiltrating Endometriosis and Pouch of Douglas Obliteration in the Presence or Absence of Ovarian Endometrioma","authors":"Nahid Sadighi, Behnaz Moradi, Masoumeh Gity, Behnaz Boroujerdirad, Fateme Davari-tanha, Reza Daneshvar, Javid Azadbakht","doi":"10.5812/iranjradiol-127068","DOIUrl":"https://doi.org/10.5812/iranjradiol-127068","url":null,"abstract":"Background: Endometriosis is one of the most common gynecological diseases worldwide. Significant attention has been drawn to this multiorgan and often painful disorder. Objectives: This study aimed to examine the accuracy of transvaginal sonography (TVS) in the diagnosis of deeply infiltrating endometriosis (DIE) with respect to the presence or absence of ovarian endometrioma (OE). Patients and Methods: This cross-sectional study was performed on all patients undergoing TVS before gynecological laparoscopy. With pathological confirmation as the standard reference, the diagnostic accuracy of TVS for DIE and pouch of Douglas (POD) obliteration was compared with that of laparoscopy in the anterior and posterior pelvic compartments with respect to the presence or absence of OE. Agreement between TVS and laparoscopy was evaluated for each case, and Cohen’s kappa statistic was measured for each site of involvement. Moreover, sensitivity, specificity, negative and positive predictive values, and likelihood ratios of TVS were calculated, with laparoscopy as the reference test. Results: A total of 110 patients, with a mean age of 37.20 ± 7.16 years, were recruited in this study. The accuracy, sensitivity, and negative predictive value of TVS for the diagnosis of DIE and POD obliteration were estimated at 89.5%, 58.3%, and 88.9% in the anterior pelvic compartment and 93.3%, 92%, and 70.6% in the posterior pelvic compartment, respectively. Nevertheless, TVS showed lower sensitivity for detecting pelvic adhesions and peritoneal cysts compared to laparoscopy. The presence of OE did not significantly increase the accuracy of TVS for the diagnosis of DIE or POD obliteration (P > 0.05). Conclusion: The present study showed that TVS is an adequately accurate and non-invasive diagnostic tool for the detection and mapping of DIE and POD obliteration, regardless of the presence of OE. TVS may waive the need for exploratory laparoscopy in DIE or at least facilitate precise pre-procedural DIE mapping.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134968589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-12DOI: 10.5812/iranjradiol-129295
E. Zarei, Nima Rakhshankhah, M. Khodadost, Abolfazl Abouie, Kosar Mohammadnejad, Mehdi Vafadar
Background: Differentiation of patients with central precocious puberty (CPP) from healthy individuals and patients with CPP-like conditions [isolated premature thelarche (IPT) and isolated premature adrenarche (IPA)] is important for selecting an appropriate treatment. The gonadotropin-releasing hormone stimulation test is used as the gold standard for differentiating CPP from other conditions. Despite its high specificity, this test has disadvantages, such as low sensitivity, time-consuming sampling, and need for multiple blood samples. Objectives: This study aimed to investigate the use of pelvic ultrasonography (US) and its parameters in distinguishing CPP patients from those with similar conditions and healthy individuals. Methods: In this case-control study, a total of 183 patients, who were referred to the endocrinology department of Ali Asghar Hospital in Tehran, Iran for the evaluation of CPP, were recruited cconsecutively from 2015 to 2019. All the participants were Iranians and classified based on the clinical and laboratory findings. Pelvic US parameters were evaluated in all groups. One-way analysis of variance (ANOVA) was used to compare the mean values of continuous variables between the groups. Moreover, a post-hoc test was performed for pairwise comparisons between the groups if the result of ANOVA test was statistically significant. Finally, the receiver-operating characteristic (ROC) curve analysis was performed to determine the best cutoff points for US parameters. Results: Of 183 children, 62 were allocated to the control group (33.87%), 93 to the CPP group (50.81%), 16 to the IPT group (8.74%), and 12 to the IPA group (6.55%). The results showed no significant difference between the groups regarding chronological age and body mass index, while the bone age (107.76 ± 19.81 months) (P < 0.001) and height (129.53 ± 8.97 cm) were significantly higher in the CPP group compared to the other groups (P = 0.003). All US parameters were significantly different between the CPP and control groups. There were also significant differences between CPP patients and those with IPT and IPA in terms of all parameters, except for the cervical anteroposterior diameter and ovarian volume. The best parameters for differentiating CPP from other conditions were the uterine volume (cutoff value, 1.40; 75.27% sensitivity; 75.56% specificity), uterine transverse diameter (cutoff value, 13.5 mm; 72.04% sensitivity; 71.11% specificity), and fundus/cervix (F/C) ratio (cutoff value, 0.98; 78.49% sensitivity; 70% specificity). Conclusions: The pelvic US parameters can improve the diagnosis of CPP and play an auxiliary role in distinguishing the treatment needed. Based on the findings, the best diagnostic parameter and its cutoff value can vary depending on ethnicity and type of study.
{"title":"Effectiveness of Pelvic Ultrasonography in the Diagnosis of Central Precocious Puberty and its Differentiation from Similar Conditions","authors":"E. Zarei, Nima Rakhshankhah, M. Khodadost, Abolfazl Abouie, Kosar Mohammadnejad, Mehdi Vafadar","doi":"10.5812/iranjradiol-129295","DOIUrl":"https://doi.org/10.5812/iranjradiol-129295","url":null,"abstract":"Background: Differentiation of patients with central precocious puberty (CPP) from healthy individuals and patients with CPP-like conditions [isolated premature thelarche (IPT) and isolated premature adrenarche (IPA)] is important for selecting an appropriate treatment. The gonadotropin-releasing hormone stimulation test is used as the gold standard for differentiating CPP from other conditions. Despite its high specificity, this test has disadvantages, such as low sensitivity, time-consuming sampling, and need for multiple blood samples. Objectives: This study aimed to investigate the use of pelvic ultrasonography (US) and its parameters in distinguishing CPP patients from those with similar conditions and healthy individuals. Methods: In this case-control study, a total of 183 patients, who were referred to the endocrinology department of Ali Asghar Hospital in Tehran, Iran for the evaluation of CPP, were recruited cconsecutively from 2015 to 2019. All the participants were Iranians and classified based on the clinical and laboratory findings. Pelvic US parameters were evaluated in all groups. One-way analysis of variance (ANOVA) was used to compare the mean values of continuous variables between the groups. Moreover, a post-hoc test was performed for pairwise comparisons between the groups if the result of ANOVA test was statistically significant. Finally, the receiver-operating characteristic (ROC) curve analysis was performed to determine the best cutoff points for US parameters. Results: Of 183 children, 62 were allocated to the control group (33.87%), 93 to the CPP group (50.81%), 16 to the IPT group (8.74%), and 12 to the IPA group (6.55%). The results showed no significant difference between the groups regarding chronological age and body mass index, while the bone age (107.76 ± 19.81 months) (P < 0.001) and height (129.53 ± 8.97 cm) were significantly higher in the CPP group compared to the other groups (P = 0.003). All US parameters were significantly different between the CPP and control groups. There were also significant differences between CPP patients and those with IPT and IPA in terms of all parameters, except for the cervical anteroposterior diameter and ovarian volume. The best parameters for differentiating CPP from other conditions were the uterine volume (cutoff value, 1.40; 75.27% sensitivity; 75.56% specificity), uterine transverse diameter (cutoff value, 13.5 mm; 72.04% sensitivity; 71.11% specificity), and fundus/cervix (F/C) ratio (cutoff value, 0.98; 78.49% sensitivity; 70% specificity). Conclusions: The pelvic US parameters can improve the diagnosis of CPP and play an auxiliary role in distinguishing the treatment needed. Based on the findings, the best diagnostic parameter and its cutoff value can vary depending on ethnicity and type of study.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45558712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-25DOI: 10.5812/iranjradiol-118135
Jingtian Wu, Wanshu Peng, Taisong Peng, Zhigao Xu, Z. Ye
Background: Most brain gliomas are high-grade and likely to spread locally. Consequently, these patients commonly have a poor prognosis. Accurate identification of the malignancy grade of brain glioma before treatment is of great clinical significance. Objectives: This study aimed to explore the correlation of diffusion tensor imaging (DTI) parameters, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) with the pathological grade of brain glioma and expression of vascular endothelial growth factor (VEGF) and Ki-67. Patients and Methods: A total of 116 patients were selected for this study from January 2018 to December 2019. All the participants underwent magnetic resonance imaging (MRI) and DTI before surgery, and the FA and ADC values were measured for the regions of interest. Surgically resected tumor specimens were collected for immunohistochemical assay. Finally, the FA and ADC values and positive expression rates of VEGF and Ki-67 were compared. Results: A significantly higher FA, besides the positive expression of VEGF and Ki-67, was reported in the high-grade group, whereas a lower ADC was found in this group compared to the low-grade group (P < 0.05). Areas of normal white matter and peritumoral edema had higher FA values, whereas lower ADCs were measured in these areas compared to the cerebrospinal fluid (P < 0.05). The FA of tumor parenchymal area was positively correlated with the World Health Organization (WHO) WHO class of tumors (r = 0.588, P = 0.028), and the expression of VEGF and Ki-67 was positively correlated with the WHO grade (r = 0.843, P = 0.002 and r = 0.743, P = 0.006, respectively). The FA of tumor parenchymal area was positively correlated with the expression of VEGF and Ki-67 (r = 0.654, P = 0.008 and r = 0.567, P = 0.012, respectively). However, the ADC of tumor parenchymal area was not significantly correlated with the WHO grade, VEGF expression, or Ki-67 expression (r = 0.143, P = 0.156, r = 0.232, P = 0.116, and r = 0.054, P = 0.179, respectively). Conclusion: The FA value, as a DTI parameter, is valuable for assessing the malignancy grade of tumor cells and can provide a proper reference for formulating treatment regimens for brain gliomas.
{"title":"Correlation of Diffusion Tensor Imaging Parameters with the Pathological Grade of Brain Glioma and Expression of Vascular Endothelial Growth Factor and Ki-67","authors":"Jingtian Wu, Wanshu Peng, Taisong Peng, Zhigao Xu, Z. Ye","doi":"10.5812/iranjradiol-118135","DOIUrl":"https://doi.org/10.5812/iranjradiol-118135","url":null,"abstract":"Background: Most brain gliomas are high-grade and likely to spread locally. Consequently, these patients commonly have a poor prognosis. Accurate identification of the malignancy grade of brain glioma before treatment is of great clinical significance. Objectives: This study aimed to explore the correlation of diffusion tensor imaging (DTI) parameters, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) with the pathological grade of brain glioma and expression of vascular endothelial growth factor (VEGF) and Ki-67. Patients and Methods: A total of 116 patients were selected for this study from January 2018 to December 2019. All the participants underwent magnetic resonance imaging (MRI) and DTI before surgery, and the FA and ADC values were measured for the regions of interest. Surgically resected tumor specimens were collected for immunohistochemical assay. Finally, the FA and ADC values and positive expression rates of VEGF and Ki-67 were compared. Results: A significantly higher FA, besides the positive expression of VEGF and Ki-67, was reported in the high-grade group, whereas a lower ADC was found in this group compared to the low-grade group (P < 0.05). Areas of normal white matter and peritumoral edema had higher FA values, whereas lower ADCs were measured in these areas compared to the cerebrospinal fluid (P < 0.05). The FA of tumor parenchymal area was positively correlated with the World Health Organization (WHO) WHO class of tumors (r = 0.588, P = 0.028), and the expression of VEGF and Ki-67 was positively correlated with the WHO grade (r = 0.843, P = 0.002 and r = 0.743, P = 0.006, respectively). The FA of tumor parenchymal area was positively correlated with the expression of VEGF and Ki-67 (r = 0.654, P = 0.008 and r = 0.567, P = 0.012, respectively). However, the ADC of tumor parenchymal area was not significantly correlated with the WHO grade, VEGF expression, or Ki-67 expression (r = 0.143, P = 0.156, r = 0.232, P = 0.116, and r = 0.054, P = 0.179, respectively). Conclusion: The FA value, as a DTI parameter, is valuable for assessing the malignancy grade of tumor cells and can provide a proper reference for formulating treatment regimens for brain gliomas.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47216305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-19DOI: 10.5812/iranjradiol-128424
Eun Ju Kim, Chan-Keun Park, S. Cho, Hyun Kyung Ryu, Jong Eun Lee, H. Kim, Byung Chan Lee
Background: Postpartum hemorrhage (PPH), a serious labor-related complication, is the leading cause of maternal mortality, which requires an emergent intervention. Uterine arterial embolization (UAE) is an effective treatment for hemostasis of intractable PPH. Several risk factors have been reported for the failure of UAE. Objectives: To evaluate the clinical outcomes of UAE for the treatment of primary PPH following cesarean section (CS) and to determine the risk factors associated with the failure of this procedure. Methods: This retrospective, single-center study was approved by the institutional review board, and the requirement to obtain informed consent was waived. All patients referred to a tertiary care center, who underwent UAE for primary PPH between January 2018 and December 2020, were included. The patients’ medical records and radiological findings, including the patients’ characteristics, mode of delivery, initial vital signs and laboratory findings after hospitalization, procedure details, and embolization outcomes, were evaluated for data collection. Technical success was defined as appropriate embolization of target vessels on a completion angiogram. Clinical success was defined as adequate cessation of bleeding after the first embolization, without any need for subsequent embolization or surgical intervention. Statistical analysis was performed to determine factors related to the clinical failure of UAE in CS cases. Results: UAE was performed for 25 patients (mean age, 37.2 years; range, 25 - 45 years). The technical success rate was estimated at 100% (n = 25), and the clinical success rate was 76% (n = 19). There were no patients with permanent adverse sequelae or death. The univariate analyses showed that hemodynamic instability (P = 0.006), lower hemoglobin levels (P = 0.02), and prolonged activated partial thromboplastin time (aPTT) (P = 0.017) were related to clinical failure. The logistic regression analysis adjusted for age showed that the area under the curve (AUC) was 0.86 for hemoglobin (95% CI: 0.7 - 1; cutoff value: 0.667), 0.816 for aPTT (95% CI: 0.625 - 1; cutoff value: 0.411), and 0.868 for hemodynamic instability (95% CI: 0.661 - 1; cutoff value: 0.622). Conclusions: UAE is a safe and effective treatment for primary PPH following CS. Hemodynamic instability, low hemoglobin levels, and prolonged aPTT can be predictive factors for the poor outcomes of UAE in CS patients. These factors are rapid and straightforward criteria, which can be simply applied, even in emergency situations.
{"title":"Effectiveness of Uterine Arterial Embolization and Risk Factors Associated with Its Failure in Patients with Primary Postpartum Hemorrhage After Cesarean Section","authors":"Eun Ju Kim, Chan-Keun Park, S. Cho, Hyun Kyung Ryu, Jong Eun Lee, H. Kim, Byung Chan Lee","doi":"10.5812/iranjradiol-128424","DOIUrl":"https://doi.org/10.5812/iranjradiol-128424","url":null,"abstract":"Background: Postpartum hemorrhage (PPH), a serious labor-related complication, is the leading cause of maternal mortality, which requires an emergent intervention. Uterine arterial embolization (UAE) is an effective treatment for hemostasis of intractable PPH. Several risk factors have been reported for the failure of UAE. Objectives: To evaluate the clinical outcomes of UAE for the treatment of primary PPH following cesarean section (CS) and to determine the risk factors associated with the failure of this procedure. Methods: This retrospective, single-center study was approved by the institutional review board, and the requirement to obtain informed consent was waived. All patients referred to a tertiary care center, who underwent UAE for primary PPH between January 2018 and December 2020, were included. The patients’ medical records and radiological findings, including the patients’ characteristics, mode of delivery, initial vital signs and laboratory findings after hospitalization, procedure details, and embolization outcomes, were evaluated for data collection. Technical success was defined as appropriate embolization of target vessels on a completion angiogram. Clinical success was defined as adequate cessation of bleeding after the first embolization, without any need for subsequent embolization or surgical intervention. Statistical analysis was performed to determine factors related to the clinical failure of UAE in CS cases. Results: UAE was performed for 25 patients (mean age, 37.2 years; range, 25 - 45 years). The technical success rate was estimated at 100% (n = 25), and the clinical success rate was 76% (n = 19). There were no patients with permanent adverse sequelae or death. The univariate analyses showed that hemodynamic instability (P = 0.006), lower hemoglobin levels (P = 0.02), and prolonged activated partial thromboplastin time (aPTT) (P = 0.017) were related to clinical failure. The logistic regression analysis adjusted for age showed that the area under the curve (AUC) was 0.86 for hemoglobin (95% CI: 0.7 - 1; cutoff value: 0.667), 0.816 for aPTT (95% CI: 0.625 - 1; cutoff value: 0.411), and 0.868 for hemodynamic instability (95% CI: 0.661 - 1; cutoff value: 0.622). Conclusions: UAE is a safe and effective treatment for primary PPH following CS. Hemodynamic instability, low hemoglobin levels, and prolonged aPTT can be predictive factors for the poor outcomes of UAE in CS patients. These factors are rapid and straightforward criteria, which can be simply applied, even in emergency situations.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47616257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-18DOI: 10.5812/iranjradiol-129768
S. Song, Y. H. Lee, Youe Ree Kim
Introduction: Renomedullary interstitial cell tumors are benign tumors of renal medulla. They are usually asymptomatic, and preoperative diagnosis based on radiological findings is challenging. Therefore, in most clinical situations, nephrectomy is ultimately performed for differential diagnosis. Case Presentation: A 54-year-old woman presented to our hospital with hematuria. An incidental mass in the left kidney was detected on abdominal computed tomography (CT) scan. The mass showed iso-attenuation to renal parenchyma in the pre-contrast image and hypo-attenuation in the portal venous phase; however, some enhancement was observed in the central portion of the mass. Based on contrast-enhanced ultrasonography (CEUS) after one year, a slight septum-like enhancement was observed in the central portion of the mass in the venous phase. In dynamic contrast-enhanced T1- and T2-weighted magnetic resonance images (MRI), the mass showed a low signal intensity, and delayed persistent enhancement was observed in 10- and 15-minute delayed phases. The mass was finally diagnosed as a renomedullary interstitial cell tumor. Conclusion: The imaging findings of renomedullary interstitial tumors included a low-signal-intensity mass of renal medulla on T1- and T2-weighted MRI and delayed enhancement on CEUS and dynamic MRI.
{"title":"Imaging Findings of a Renomedullary Interstitial Cell Tumor: A Case Report","authors":"S. Song, Y. H. Lee, Youe Ree Kim","doi":"10.5812/iranjradiol-129768","DOIUrl":"https://doi.org/10.5812/iranjradiol-129768","url":null,"abstract":"Introduction: Renomedullary interstitial cell tumors are benign tumors of renal medulla. They are usually asymptomatic, and preoperative diagnosis based on radiological findings is challenging. Therefore, in most clinical situations, nephrectomy is ultimately performed for differential diagnosis. Case Presentation: A 54-year-old woman presented to our hospital with hematuria. An incidental mass in the left kidney was detected on abdominal computed tomography (CT) scan. The mass showed iso-attenuation to renal parenchyma in the pre-contrast image and hypo-attenuation in the portal venous phase; however, some enhancement was observed in the central portion of the mass. Based on contrast-enhanced ultrasonography (CEUS) after one year, a slight septum-like enhancement was observed in the central portion of the mass in the venous phase. In dynamic contrast-enhanced T1- and T2-weighted magnetic resonance images (MRI), the mass showed a low signal intensity, and delayed persistent enhancement was observed in 10- and 15-minute delayed phases. The mass was finally diagnosed as a renomedullary interstitial cell tumor. Conclusion: The imaging findings of renomedullary interstitial tumors included a low-signal-intensity mass of renal medulla on T1- and T2-weighted MRI and delayed enhancement on CEUS and dynamic MRI.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45939372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-13DOI: 10.5812/iranjradiol-128737
H. Ebrat Balkhkanlou, Abtin Doroudinia, Mehrdad Bakhshayesh karam, H. Emami
Background: Flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan is employed for initial staging and restaging of esophageal cancer patients. Objectives: The present study aimed to assess the value of a semi-quantitative parameter of 18F-FDG PET/CT scan, that is, maximum standardized uptake value (SUVmax), to determine its correlation with patient survival in two subtypes of esophageal cancer, including squamous cell carcinoma (SCC) and adenocarcinoma. Patients and Methods: This cross-sectional study was performed on patients with esophageal SCC and adenocarcinoma, undergoing 18F-FDG PET/CT scan for initial staging before any treatment. The 18F-FDG PET/CT semi-quantitative parameter (SUVmax) was determined by reviewing the PET/CT images. The patients were reevaluated using 18F-FDG PET/CT scan for restaging within 12 - 24 months. Results: No significant difference was observed in the SUVmax values of the primary tumor, metastatic lymph nodes, or distant metastasis between the adenocarcinoma and SCC groups, regardless of response to treatment. Similarly, no significant association was found between the short-term survival of patients with adenocarcinoma and the SUVmax values of the primary tumor, metastatic lymph nodes, or distant metastasis. Based on the survival curve, one- and two-year survival rates were estimated at 75% and 63.9% in patients with SCC and at 80% and 60% in patients with adenocarcinoma, respectively. In the SCC group, a significantly higher SUVmax was detected in deceased patients with distant metastatic lesions compared to cancer survivors. According to the area under the ROC curve, the SUVmax of metastatic lesions showed high potential for predicting the mortality of SCC patients. Conclusion: The assessment of SUVmax in distant metastatic lesions by 18F-FDG-PET/CT may help predict the survival of patients with esophageal SCC. However, 18F-FDG-PET/CT findings were not associated with the survival of esophageal adenocarcinoma; therefore, further evaluations on a larger sample size and a longer follow-up are required.
{"title":"Value of a 18F-FDG PET/CT Semi-quantitative Parameter (SUVmax) in Predicting the Survival of Patients with Esophageal Cancer Subtypes","authors":"H. Ebrat Balkhkanlou, Abtin Doroudinia, Mehrdad Bakhshayesh karam, H. Emami","doi":"10.5812/iranjradiol-128737","DOIUrl":"https://doi.org/10.5812/iranjradiol-128737","url":null,"abstract":"Background: Flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan is employed for initial staging and restaging of esophageal cancer patients. Objectives: The present study aimed to assess the value of a semi-quantitative parameter of 18F-FDG PET/CT scan, that is, maximum standardized uptake value (SUVmax), to determine its correlation with patient survival in two subtypes of esophageal cancer, including squamous cell carcinoma (SCC) and adenocarcinoma. Patients and Methods: This cross-sectional study was performed on patients with esophageal SCC and adenocarcinoma, undergoing 18F-FDG PET/CT scan for initial staging before any treatment. The 18F-FDG PET/CT semi-quantitative parameter (SUVmax) was determined by reviewing the PET/CT images. The patients were reevaluated using 18F-FDG PET/CT scan for restaging within 12 - 24 months. Results: No significant difference was observed in the SUVmax values of the primary tumor, metastatic lymph nodes, or distant metastasis between the adenocarcinoma and SCC groups, regardless of response to treatment. Similarly, no significant association was found between the short-term survival of patients with adenocarcinoma and the SUVmax values of the primary tumor, metastatic lymph nodes, or distant metastasis. Based on the survival curve, one- and two-year survival rates were estimated at 75% and 63.9% in patients with SCC and at 80% and 60% in patients with adenocarcinoma, respectively. In the SCC group, a significantly higher SUVmax was detected in deceased patients with distant metastatic lesions compared to cancer survivors. According to the area under the ROC curve, the SUVmax of metastatic lesions showed high potential for predicting the mortality of SCC patients. Conclusion: The assessment of SUVmax in distant metastatic lesions by 18F-FDG-PET/CT may help predict the survival of patients with esophageal SCC. However, 18F-FDG-PET/CT findings were not associated with the survival of esophageal adenocarcinoma; therefore, further evaluations on a larger sample size and a longer follow-up are required.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44162487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-10DOI: 10.5812/iranjradiol-132950
Mahboube Zarei, Mahbod Issaiy, M. Asadabadi, Morteza Heidari
Background: Ataxia is a symptom of a wide range of disorders, which manifests as a lack of coordinated movements. It is commonly associated with cerebellar disorders. Objectives: To evaluate the neuroimaging findings of children with acute ataxia (AA) and to identify the association between these findings and clinical results. Patients and Methods: This cross-sectional study was conducted using the electronic medical records of patients, presenting to a major pediatric referral center over 10 years from March 2009 to February 2020. Patients were included in the study if they were younger than 18 years, were diagnosed with AA (< 30 days), and underwent magnetic resonance imaging (MRI), computed tomography (CT) scan, or both. The exclusion criteria were as follows: A history of neurological or medical disorders, explaining ataxia; pseudo-ataxia; a traumatic brain injury; severe loss of consciousness; and missing key information in the medical records (e.g., no brain imaging findings). Patient data, including the demographic data, clinical history, laboratory findings, imaging results, and in-hospital outcomes, were collected. A P-value less than 0.05 was considered statistically significant, and the confidence interval was set at 95%. Results: A total of 119 patients were included in this study (51% female; mean age, 4.9 years). Clinically urgent neurological pathology (CUNP) was detected in 37 (31.09%) patients. The most common pathologies on images were tumors, acute disseminated encephalomyelitis (ADEM), and stroke. However, the most common diagnosis was acute post-infectious cerebellar ataxia (APCA) (24.4%), followed by brain tumors (16.8%) and Guillain-Barre syndrome (GBS) (15.1%), respectively. Overall, 11 variables were significantly different between patients with and without CUNP. Most notably, the duration of symptoms (P < 0.01), ophthalmoplegia (odds ratio [OR] = 13.93; 95% confidence interval [CI]: 3.5 - 54.7), focal neurologic deficit (OR = 7.26; 95% CI: 2.6 - 20.5), and fever (OR = 3.33; 95% CI: 1.1 - 9.8) were associated with a higher risk of CUNP. On the other hand, some features, such as a recent history of febrile illness (presence of fever or body temperature above 38°C in the last month) (OR = 0.36; 95% CI: 0.16 - 0.8) and hyporeflexia (P < 0.01), were associated with a lower risk of CUNP. Conclusion: Acute post-infectious cerebellar ataxia was the most common diagnosis of AA in children, undergoing neuroimaging studies in our center. Nevertheless, tumor was the most common pathology detected on the images of patients with CUNP. Some pathologies might not be detected by some imaging modalities. Considering the associations identified in this study, patients with risk factors, such as a longer duration of symptoms, ophthalmoplegia, focal neurologic deficit, and fever, need to undergo another imaging modality with higher sensitivity if there are no positive findings in the initial imaging study. On the other hand, patients with pr
{"title":"Clinical and Brain Imaging Findings of Children with Acute Ataxia: Ten Years of Experience at a Major Pediatric Referral Center","authors":"Mahboube Zarei, Mahbod Issaiy, M. Asadabadi, Morteza Heidari","doi":"10.5812/iranjradiol-132950","DOIUrl":"https://doi.org/10.5812/iranjradiol-132950","url":null,"abstract":"Background: Ataxia is a symptom of a wide range of disorders, which manifests as a lack of coordinated movements. It is commonly associated with cerebellar disorders. Objectives: To evaluate the neuroimaging findings of children with acute ataxia (AA) and to identify the association between these findings and clinical results. Patients and Methods: This cross-sectional study was conducted using the electronic medical records of patients, presenting to a major pediatric referral center over 10 years from March 2009 to February 2020. Patients were included in the study if they were younger than 18 years, were diagnosed with AA (< 30 days), and underwent magnetic resonance imaging (MRI), computed tomography (CT) scan, or both. The exclusion criteria were as follows: A history of neurological or medical disorders, explaining ataxia; pseudo-ataxia; a traumatic brain injury; severe loss of consciousness; and missing key information in the medical records (e.g., no brain imaging findings). Patient data, including the demographic data, clinical history, laboratory findings, imaging results, and in-hospital outcomes, were collected. A P-value less than 0.05 was considered statistically significant, and the confidence interval was set at 95%. Results: A total of 119 patients were included in this study (51% female; mean age, 4.9 years). Clinically urgent neurological pathology (CUNP) was detected in 37 (31.09%) patients. The most common pathologies on images were tumors, acute disseminated encephalomyelitis (ADEM), and stroke. However, the most common diagnosis was acute post-infectious cerebellar ataxia (APCA) (24.4%), followed by brain tumors (16.8%) and Guillain-Barre syndrome (GBS) (15.1%), respectively. Overall, 11 variables were significantly different between patients with and without CUNP. Most notably, the duration of symptoms (P < 0.01), ophthalmoplegia (odds ratio [OR] = 13.93; 95% confidence interval [CI]: 3.5 - 54.7), focal neurologic deficit (OR = 7.26; 95% CI: 2.6 - 20.5), and fever (OR = 3.33; 95% CI: 1.1 - 9.8) were associated with a higher risk of CUNP. On the other hand, some features, such as a recent history of febrile illness (presence of fever or body temperature above 38°C in the last month) (OR = 0.36; 95% CI: 0.16 - 0.8) and hyporeflexia (P < 0.01), were associated with a lower risk of CUNP. Conclusion: Acute post-infectious cerebellar ataxia was the most common diagnosis of AA in children, undergoing neuroimaging studies in our center. Nevertheless, tumor was the most common pathology detected on the images of patients with CUNP. Some pathologies might not be detected by some imaging modalities. Considering the associations identified in this study, patients with risk factors, such as a longer duration of symptoms, ophthalmoplegia, focal neurologic deficit, and fever, need to undergo another imaging modality with higher sensitivity if there are no positive findings in the initial imaging study. On the other hand, patients with pr","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41586231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-28DOI: 10.5812/iranjradiol-126572
Xili Li, S. Luo, Suping Chen, Du Wang, Yiqing Tan
Background: Contrast-enhanced chest computed tomography (CT) is useful for the detection and follow-up of patients with lung cancer. However, reaching balance between diagnostic image quality, radiation dose, and iodixanol dose is a cause of concern. Objectives: To investigate the clinical value of adaptive statistical iterative reconstruction (ASIR) in reducing the iodixanol content and radiation dose during contrast-enhanced chest CT scan for patients diagnosed with lung masses/nodules based on the analysis of image quality. Patients and Methods: This prospective study was conducted on 80 patients diagnosed with nodules or masses, who required contrast-enhanced chest CT scans. The experimental group (n = 40) was subjected to iohexol at a high concentration (350 mgI/L) with a tube voltage of 120 kVp and a filter back projection (FBP) reconstruction algorithm. The comparison group (n = 40) was subject to iodixanol at a lower concentration (270 mgI/L) with a tube voltage of 100 kVp and ASIR (blending ratio, 40%). The radiation dose and total iodixanol content, as well as subjective and objective evaluations of image quality, were analyzed and compared. Results: The two groups obtained non-significantly different subjective scores for five structures detected in the lung window and five structures detected in the mediastinal window, as well as the overall image (P > 0.05 for all). Both the two-group images obtained diagnosis-acceptable scores (≥ 3 points) on displays of 10 structures and overall image quality. The mean CT value of vessels (100 kVp vs. 120 kVp: 314.90 ± 23.42 vs. 308.93 ± 21.40; P > 0.05), standard deviation (13.03 ± 0.88 vs. 12.83 ± 0.90; P > 0.05), and contrast-to-noise ratio (20.77 ± 2.20 vs. 20.36 ± 1.94; P > 0.05) were not significantly different between two groups. However, the CT dose index, dose-length product, effective dose, and total iodine dose were reduced by 27.58%, 36.65%, 36.59%, and 22.86% in the 100-kVp group compared to the 120-kVp group. Conclusion: The ASIR showed great potential in reducing the radiation dose and iodine contrast dose, while maintaining good image quality and providing strong confidence for the diagnosis of lung cancer.
{"title":"Contrast-Enhanced Chest Computed Tomography (CT) Scan with Low Radiation and Total Iodine Dose for Lung Cancer Detection Using Adaptive Statistical Iterative Reconstruction","authors":"Xili Li, S. Luo, Suping Chen, Du Wang, Yiqing Tan","doi":"10.5812/iranjradiol-126572","DOIUrl":"https://doi.org/10.5812/iranjradiol-126572","url":null,"abstract":"Background: Contrast-enhanced chest computed tomography (CT) is useful for the detection and follow-up of patients with lung cancer. However, reaching balance between diagnostic image quality, radiation dose, and iodixanol dose is a cause of concern. Objectives: To investigate the clinical value of adaptive statistical iterative reconstruction (ASIR) in reducing the iodixanol content and radiation dose during contrast-enhanced chest CT scan for patients diagnosed with lung masses/nodules based on the analysis of image quality. Patients and Methods: This prospective study was conducted on 80 patients diagnosed with nodules or masses, who required contrast-enhanced chest CT scans. The experimental group (n = 40) was subjected to iohexol at a high concentration (350 mgI/L) with a tube voltage of 120 kVp and a filter back projection (FBP) reconstruction algorithm. The comparison group (n = 40) was subject to iodixanol at a lower concentration (270 mgI/L) with a tube voltage of 100 kVp and ASIR (blending ratio, 40%). The radiation dose and total iodixanol content, as well as subjective and objective evaluations of image quality, were analyzed and compared. Results: The two groups obtained non-significantly different subjective scores for five structures detected in the lung window and five structures detected in the mediastinal window, as well as the overall image (P > 0.05 for all). Both the two-group images obtained diagnosis-acceptable scores (≥ 3 points) on displays of 10 structures and overall image quality. The mean CT value of vessels (100 kVp vs. 120 kVp: 314.90 ± 23.42 vs. 308.93 ± 21.40; P > 0.05), standard deviation (13.03 ± 0.88 vs. 12.83 ± 0.90; P > 0.05), and contrast-to-noise ratio (20.77 ± 2.20 vs. 20.36 ± 1.94; P > 0.05) were not significantly different between two groups. However, the CT dose index, dose-length product, effective dose, and total iodine dose were reduced by 27.58%, 36.65%, 36.59%, and 22.86% in the 100-kVp group compared to the 120-kVp group. Conclusion: The ASIR showed great potential in reducing the radiation dose and iodine contrast dose, while maintaining good image quality and providing strong confidence for the diagnosis of lung cancer.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45886281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：