AJR. American journal of roentgenology
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The purpose of this article is to give a brief overview of the technical background of dual-energy CT (DECT) imaging and to review various DECT applications in the abdomen that are currently available for clinical practice. In a review of the recent literature, specific DECT applications available for abdominal organs, liver, pancreas, kidneys including renal stones, and adrenal glands, will be discussed in light of reliability and clinical usefulness in replacing true unenhanced imaging, increased lesion conspicuity, iodine extraction, and improved tissue/material characterization (e.g., renal stone composition). Radiation dose considerations will be addressed in comparison with standard abdominal imaging protocols. ⋯ Modern DECT applications for the abdomen expand the use of CT and enable advanced quantitative methods in the clinical routine on the basis of differences in material attenuation observed by imaging at two different distinct photon energies.
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The introduction of dual-energy CT (DECT) has ushered in the ability of material differentiation and tissue characterization beyond the traditional CT attenuation scale. This quality has been exploited for visualizing and quantifying the specific tissue content using radiographic contrast agents, such as iodine-based contrast media or inhaled xenon gas. Applications of this paradigm in the thorax include characterization of the pulmonary blood pool in the setting of acute or chronic pulmonary embolism (PE) and characterization of diseases of the lung parenchyma. Selective xenon detection is being explored for imaging of lung ventilation. In addition, the usefulness of DECT-based selective iodine uptake measurements has been described for the diagnosis and surveillance of thoracic malignancies. This article reviews the current applications of DECT-based imaging techniques in the chest with an emphasis on the diagnosis and characterization of pulmonary thromboembolic disorders. ⋯ DECT can provide both anatomic and functional information about the lungs in a variety of pulmonary disease states based on a single contrast-enhanced CT examination. This quality has been shown to improve the diagnosis of acute and chronic PEs, other vascular disorders, lung malignancies, and parenchymal diseases. Further developments in DECT techniques and CT scanner technology will further foster and enhance the utility of this application and open new avenues in lung imaging.
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AJR Am J Roentgenol · Nov 2012
ReviewComprehensive MDCT evaluation of patients with suspected May-Thurner syndrome.
The purpose of this essay is to introduce the MDCT protocol and interpretation techniques for optimal evaluation of patients with suspected May-Thurner syndrome. ⋯ May-Thurner syndrome is always the working diagnosis when a patient presents with unilateral left lower limb swelling without signs of infection. MDCT is useful for fast, comprehensive evaluation of the vascular system to determine whether May-Thurner syndrome or an alternative condition is present.
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Various applications for dual-energy CT (DECT) have been investigated and have shown substantial clinical benefits. However, only limited data are available regarding the radiation dose associated with DECT imaging. The purpose of this article is to review the available literature regarding the radiation dose associated with DECT imaging applications in comparison with conventional single-energy CT techniques. ⋯ The rediscovery of DECT and the increasing availability of this technique on clinical CT systems have opened new dimensions for CT. The advanced spectral differentiation of materials within the human body as well as the selective visualization or subtraction of iodinated contrast material or xenon provides both advanced visualization of disease-specific molecular substrates as well as additional functional information within a single scan.
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AJR Am J Roentgenol · Sep 2012
ReviewThe novel oral anticoagulants: an update for the interventional radiologist.
Thromboembolic disorders are leading causes of morbidity and mortality, with treatment and prophylaxis a priority. There has been a heavy dependency upon warfarin and heparin for anticoagulation for 60 years. This is likely to change with the emergence of novel oral anticoagulants. ⋯ Interventional radiologists are increasingly encountering these medications, and a thorough knowledge of them is essential for appropriate periprocedural management. This article will review these novel agents, their uses, and their pharmacologic profiles and will propose guidelines for periprocedural management.