M Teufel

Comparison between High-Resolution CT and MRI Using a Very Short Echo Time in Patients with Cystic Fibrosis with Extra Focus on Mosaic Attenuation

Background: It would be beneficial to establish pulmonary MRI as a complementary approach to CT for direct visualization of mosaic perfusion, bullae, and emphysema in patients with cystic fibrosis. Objectives: The purpose of this study was to compare both modalities, CT and MRI, using the Helbich-Bhalla score with a special focus on reliable detection of a mosaic pattern. Methods: Out of 51 patients examined by MRI on a 1.5-Tesla system during a period of 2 years, 19 patients were scheduled for additional low-dose CT in a clinical context. The MRI protocol comprised a gradient echo (GRE) sequence with a very short echo time (TE = 0.8 ms) in inspiration and expiration, a 3-D GRE sequence in breath hold, and a fast spin echo sequence with respiration and ECG triggering. MDCT was carried out in inspiration and adapted to body weight using 100 or 120 kV, 30-60 mA, 1- and 3-mm slice thicknesses, as well as low and high kernels. Additionally incremental slices in 3 positions were recorded in expiration for distinct detection of air trapping. CT and MRI analyses were performed by two radiologic readers in consensus unaware of the clinical parameters. The Helbich-Bhalla score of both examinations was correlated. Mean difference and accordance were assessed in each category. Results: There was a strong correlation between CT and MRI (R = 0.87, p < 0.01). The mean Helbich-Bhalla score for CT was 12.2 (range 1-18) and for MRI it was 11.7 (range 2-19). The mean difference was 0.5 points. Besides this strong correlation for findings (bronchiectasis, mucus plugging, peribronchial thickening, and consolidation) with a prolonged T2 TE in MRI, we could also state a qualitative agreement of 95-100% in the categories with short T2 and low signal intensity in MRI as emphysema, bullae, and mosaic perfusion. Conclusions: These results suggest that in our patient group none of the relevant findings were missed by MR imaging and reading.

Contrast-Enhanced High-Pitch Computed Tomography in Pediatric Patients Without Electrocardiography Triggering and Sedation: Comparison of Cardiac Image Quality With Conventional Multidetector Computed Tomography.

Objective The aim of this study was to compare image quality of anatomical cardiac details without electrocardiography triggering, sedation, or heart rate–regulating drugs in contrast-enhanced pediatric chest computed tomography (CT), using high-pitch CT (HPCT) versus conventional pitch-mode technique (multidetector CT [MDCT]). Methods After written informed consent, 55 patients (median age, 11 years; range, 3–17 years) were prospectively included in this institutional review board–approved study. Patients underwent clinically indicated, contrast-enhanced MDCT or HPCT of the chest. Image quality was assessed evaluating morphological criteria on a 3-point scale (from 1, high, to 3, low detail) and summed up in a global score (from 4, best, to 12, poor image quality). Artifacts were analyzed correspondingly (from 3, low, to 9, severe artifacts). Effective dose and size-specific dose estimate were calculated for all scans. Results Cardiac image quality was higher in HPCT than in MDCT (7.1 [1.6] vs 8.8 [1.9], P < 0.001). Nevertheless, HPCT showed limitations in image quality, especially concerning the heart valves (2.5 [0.6] and 1.7 [0.5]) and coronary arteries (1.8 [0.6). Artifact score (3.4 [0.6 vs 5.1 [0.9, P < 0.001), effective dose (1.6 [1.3] vs 2.3 [1.6] mSv, P = 0.047), and size-specific dose estimate (2.5 [1.7] vs 4.1 [2.3] mGy, P = 0.002) were lower in HPCT compared with those in MDCT. Conclusions In pediatric patients, contrast-enhanced HPCT of the chest provides high image quality without electrocardiography triggering or sedation, although image quality is somewhat limited for a detailed depiction of cardiac anatomy.

Prognostic value of significant and non-significant coronary artery stenosis detection using MDCT for major adverse cardiac events

using MDCT for major adverse cardiac events Anja J. Reimann ⁎, Ilias Tsiflikas , Simon Pecha , Gunnar Blumenstock , Matthias Teufel , Tanja Drosch , Martin Heuschmid , Steffen Schroder , Claus D. Claussen , Christof Burgstahler e a Department of Diagnostic and Interventional Radiology, University of Tuebingen, Germany b Department of Cardiovascular Surgery, University Heart Center Hamburg, Germany c Institute for Medical Biometry of the University of Tuebingen, Germany d Klinikum am Eichert, Goeppingen, Germany e Department of Sports Medicine, University of Tuebingen, Germany