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Body Pushers: Low-Dose CT, Always the Best Choice? A Study of the Diagnostic Performance of CT Scout View

Open Journal of Radiology 2017年第2期7卷 112-120页

作者： Robin Fabian Gohmann Frauke Heckner Diane Uschner christiane Katharina kuhl Sebastian Daniel Reinartz Department of Diagnostic and Interventional Radiology University Hospital RWTH Aachen University Aachen Germany University Hospital RWTH Aachen University Aachen Germany Department of Medical Statistics University Hospital RWTH Aachen University Aachen Germany

Purpose: The purpose of this study has been to evaluate the diagnostic information contained in the CT scout view in the detection of body packing. Materials and methods: Retrospect analysis of 43 CT scans between July 2011 and June 2013 in asymptomatic suspects of body packing (29 men, 14 females, mean age 38 ± 9 years). Results: A total of 11 positive cases of body packing were identified. In 10 (91%) of the cases packets were relatively large and spares in number (3 or less);in 7 (64%) a single packet has been identified. 6 (55%) of the packets were located rectally, 4 (36%) vaginally and in 1 (9%) case multiple small packets of approximately 1 cm in size were found to have been ingested orally. Maximum and minimum diameters were 5.9 ± 3 cm and 2.9 ± 1.4 cm, respectively. The mean weight of packets was 7.5 ± 4.2 g (range 2 - 54 g). In 73% (n = 8) heroin had been detected;other drugs such as cocaine (n = 1) and cannabis (n = 1) were encountered once, respectively. One packet was identified retrospectively and its content could therefore not be identified. The average effective dose was 3.8 ± 2.1 mSv for CT, of that 0.12 ± 0.01 mSv was required for the CT scout view. Conclusion: If CT scout view were treated as a diagnostic image, some CT scans may be omitted, thereby maintaining streamlined operations and achieving further dose reduction jointly in the workup of body packing.

关键词： Body Packing CT Scout View CT Dose Reduction X-Ray

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Evaluation of a Reduced Contrast Media Protocol in Thoracoabdominal Aortic High Pitch CT-Angiography

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Open Journal of Radiology 2015年第4期5卷 177-188页

作者： Sebastian D. Reinartz Darius Karnitzschky christiane K. kuhl Andreas H. Mahnken Department of Diagnostic and Interventional Radiology University Hospital Aachen Germany Department of Diagnostic and Interventional Radiology University Hospital Marburg Germany

Objectives: The aim is to evaluate contrast enhancement and density distribution in non-ECG-synchronized high-pitch aortoiliacal CT-angiography. Methods: 84 patients underwent clinically indicated thoracoabdominal CTA between February 2011 and May 2012 using high-pitch technique for arterial phase and an individually tailored contrast-media protocol depending on weight-class and scan duration. Standardized measurement of intravascular density is performed and accessed by multi plane reformations (MPR) orthogradly to vessels centerline. Results for 1.5 cm slices are statistically evaluated on per slice, per vessel segment ascending aortic, aortic arch, descending and abdominal aorta, right and left iliacal artery (common and external) and per patient level, regarding left-ventricular function and renal impairment. Results: In mean 53.1 ± 7.4 ml contrast-medium is administered for aortoiliacal examination. 4841 slices with mean density 280.0 ± 63 HU are analyzed. In 84.2% (n = 4074), diagnostic quality is delivered. Regarding vessel segments, mean enhancement scored ≥ 255.5 except weight-class 5. Adjusted to homogeneity of bolus by excluding examinations with failed bolus triggering (14%), weight-class 1 to 3 provides 100% to 75% entirely diagnostic datasets, where amount is inadequate in weight-classes 4 (62%) and 5 (2%). Conclusions: CM protocol produces moderate but diagnostic vessel enhancement with little CM (mean = 50.7 ± 6 ml) in patients smaller than 86 kg (weight-class 1 to 3) independently to left ventricular or renal function. Failure rate requires precise bolus triggering.

关键词： Aortic Computed Tomography Angiography Radiologic Technology

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Y90-radioembolization via variant hepatic arteries: Is there a relevant risk for non-target embolization?

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World Journal of Radiology 2019年第7期11卷 102-109页

作者： Markus Zimmermann Maximilian Schulze-Hagen Federico Pedersoli Peter Isfort Alexander Heinzel christiane kuhl Philipp Bruners Department of Diagnostic and Interventional Radiology RWTH Aachen University HospitalAachen 52074Germany Department of Nuclear Medicine RWTH Aachen University HospitalPauwelsstrasse 30Aachen 52074Germany

BACKGROUND The hepatic arterial anatomy is highly variable, with the two most common variants being a replaced right hepatic artery(RHA) originating from the superior mesenteric artery(SMA) and a left hepatic artery(LHA) originating from the left gastric artery(LGA). These anatomical variants could potentially increase the risk for non-target embolization during Y90-Radioembolization due to the close proximity between hepatic and enteric vessel *** To evaluate the safety of Yttrium-90radioembolization(90Y-RE) with resin microspheres in patients with a variant hepatic arterial *** In this retrospective single-center observational study, 11 patients who underwent RE with 90Y-resin microspheres via a LHA originating from the LGA,and 13 patients via a RHA originating from the SMA were included. Patient and treatment data were reviewed regarding clinical and imaging evidence of nontarget embolization of 90Y-resin microspheres to the GI tract. Positioning of the tip of the microcatheter in relationship to the last hepatoenteric side branch was retrospectively analyzed using angiographic images, cone-beam CT and preinterventional *** None of the 24 patients developed clinical symptoms indicating a potential nontarget embolization to the GI tract within the first month after 90Y-RE. On thepostinterventional 90Y-bremsstrahlung images and/or 90Y-positron emission tomographies, no evidence of extrahepatic 90Y-activity in the GI tract was noted in any of the patients. The mean distance between the tip of the microcatheter and the last enteric side branch during delivery of the 90Y microspheres was 3.2 cm(range: 1.9-5 cm) in patients with an aberrant LHA originating from a LGA. This was substantially shorter than the mean distance of 5.2 cm(range: 2.9-7.7 cm) in patients with an aberrant right hepatic originating from the ***90Y-RE via aberrant hepatic arteries appears to be safe;at least with positioning of the microcatheter tip

关键词： Radioembolization Yttrium 90 Aberrant hepatic arteries Hepatic arterial variants Safety

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