AJR. American journal of roentgenology
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AJR Am J Roentgenol · May 2014
Multicenter StudyCT angiography (CTA) and diagnostic performance of noninvasive fractional flow reserve: results from the Determination of Fractional Flow Reserve by Anatomic CTA (DeFACTO) study.
Fractional flow reserve (FFR) computed from standard coronary CT scans (FFRCT) is a novel noninvasive method for determining the functional significance of coronary artery lesions. Compared with CT alone, FFRCT significantly improves diagnostic accuracy and discrimination for patients with and without hemodynamically significant coronary artery stenoses. To date, the impact of CT image quality on diagnostic performance of FFRCT is unknown. We evaluated the impact of patient preparation, CT scan protocol, and factors related to image quality on the diagnostic accuracy of FFRCT. ⋯ Use of β-blockade and nitroglycerin administration before CT improve diagnostic performance of FFRCT. Diagnostic accuracy of FFRCT is significantly reduced in the setting of misalignment artifacts.
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The objective of our study was to evaluate the CT characteristics of globe rupture. ⋯ Although CT is extremely useful in the evaluation of ocular trauma, it should not be solely relied on for the diagnosis of globe rupture because of the potentially catastrophic consequences of an undiagnosed injury. A difference in ACD can be diagnostic of globe rupture.
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Recent technologic advances in MDCT have led to the introduction of dual-energy CT (DECT). The basic principle of DECT is to acquire images at two different energy levels simultaneously and to use the attenuation differences at these different energy levels for deriving additional information, such as virtual monochromatic images, artifact suppression, and material composition of various tissues. ⋯ A variety of image reconstruction and postprocessing techniques are available for better demonstration and characterization of pathologic abnormalities. DECT can provide both anatomic and functional information of different organ systems. This article focuses on the main applications of DECT in emergency radiology.
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AJR Am J Roentgenol · Apr 2014
Is the new ACR-SPR practice guideline for addition of oblique views of the ribs to the skeletal survey for child abuse justified?
The purpose of our study was to determine whether adding oblique bilateral rib radiography to the skeletal survey for child abuse significantly increases detection of the number of rib fractures. ⋯ Adding bilateral oblique rib radiographs to the skeletal survey results in increased rib fracture detection and increased confidence of readers.
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AJR Am J Roentgenol · Apr 2014
Diagnostic performance of algorithm for computer-assisted detection of significant coronary artery disease in patients with acute chest pain: comparison with invasive coronary angiography.
The purpose of this study was to evaluate the performance of an automated computer-assisted detection (CAD) algorithm to detect coronary artery stenosis on coronary CT angiography (CTA). ⋯ The CAD algorithm yields a high NPV in detecting stenosis of at least 50% on coronary CTA. As a second "reader," the CAD algorithm may help to exclude significant coronary stenosis in patients with acute chest pain at an emergency department.