Dual Source CT Imaging PDF
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Dual Source CT Imaging Seidensticker Hofmann (Eds.) Dual Source CT Imaging Peter R. Seidensticker, MD Lars K. Hofmann, MD With 209 Figures and 52 Tables ISBN 978-3-540-77601-7 Springer Medizin Verlag Heidelberg Bibliografische Information der Deutschen Bibliothek The Deutsche Bibliothek lists this publication in Deutsche Nationalbibliographie; detailed bibliographic data is available in the internet at http://dnb.ddb.de. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned,specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. 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Druckzentrum GmbH, Heidelberg 18/5135 – 5 4 3 2 1 0 Content Foreword 7 The Dual Source CT Expert Panel 9 Authors 13 Dual Source CT Technology Bernhard Schmidt, Christiane Bredenhoeller, Thomas Flohr 19 Iodinated Contrast Media: New Perspectives with Dual Source CT Matthias Braeutigam, Ute Huebner-Steiner, Hubertus Pietsch, Ulrich Speck 35 Cardiovascular and Body Radiology DSCT Applications Cardiac: Coronary CT Angiography Stephan Achenbach, Axel Kuettner, Dieter Ropers – Erlangen-Nuremberg 50 Cardiac: Coronary Stents Stephan G. Ruehm, Cesar Arellano, Christoph Panknin – Los Angeles 60 Cardiac: Coronary CTA in Obese Patients Kavitha M. Chinnaiyan, Ralph Gentry, Gilbert L. Raff – Royal Oak 70 Cardiac: Valvular Function Hatem Alkadhi, Sebastian Leschka, Hans Scheffel, Paul Stolzmann – Zurich 80 Cardiac: Morphology Scott Harris, Cynthia McCollough, Eric Williamson – Rochester 90 Cardiac: Left / Right Ventricular Function Kai Uwe Juergens, Harald Seifarth, Michael Puesken, Roman Fischbach – Münster 100 Cardiac: Atrial Fibrillation / Arrhythmia Nico R. Mollet, Filippo Cademartiri, Gabriel P. Krestin – Rotterdam 110 Cardiac: Bypass Grafts Pal Suranyi, Christian Thilo, Heon Lee, U. Joseph Schoepf – Charleston 120 Vascular: Extended Chest Pain Protocol Thorsten R. C. Johnson, Konstantin Nikolaou, Christoph R. Becker – Munich-Grosshadern 130 Vascular: Pulmonary Veins Harald Brodoefel, Martin Heuschmid, Andreas F. Kopp – Tübingen 140 3 Vascular: Aortic Runoff, Abdominal CTA Andreas H. Mahnken, Joachim E. Wildberger, Marco Das – Aachen 150 Vascular: Renal CTA Robert P. Hartman, Terri J. Vrtiska, Cynthia McCollough – Rochester 160 Vascular: Peripheral Runoff Axel Kuettner, Katharina Anders, Michael Lell – Erlangen-Nuremberg 170 Vascular: Brain Perfusion Harald Seifarth, Tobias Fischer, Roman Fischbach, Stephan P. Kloska – Münster 180 Body: Obese Mode Elizabeth McDonald, Robert P. Hartman, Cynthia McCollough – Rochester 190 Dual Energy CT Applications Dual Energy: CTA of Head and Neck Dominik Morhard, Thorsten R. C. Johnson, Christoph R. Becker – Munich-Grosshadern 202 Dual Energy: CTA Aorta Marco Das, Andreas H. Mahnken, Joachim E. Wildberger – Aachen 212 Dual Energy: CTA Runoff Andrew Misselt, Cynthia McCollough, Eric Williamson – Rochester 222 Dual Energy: CTA Lung Perfusion (PE) Thorsten R. C. Johnson, Christian Fink, Christoph R. Becker – Munich-Grosshadern 232 Dual Energy: Virtual Non-Contrast Axel Kuettner, Katharina Anders, Michael Lell – Erlangen-Nuremberg 242 Dual Energy: Characterization of Kidney Stone Composition Andrew Primak, Terri J. Vrtiska, Cynthia McCollough – Rochester 252 Dual Energy: Urography Robert P. Hartman, Terri J. Vrtiska, Cynthia McCollough – Rochester 262 Dual Energy: Vascular Plaque Removal / Detection Christoph Thomas, Harald Brodoefel, Martin Heuschmid, Andreas F. Kopp – Tübingen 272 Dual Energy: Tendons and Cartilage Stephan G. Ruehm, Derek Lohan, Christoph Panknin – Los Angeles 282 Dual Energy: Gout Thorsten R. C. Johnson, Sabine Weckbach, Christoph R. Becker – Munich-Grosshadern 292 4 Abbreviations 301 Editors 303 CME Instructions inside back cover 5 Dear Colleagues The introduction of Dual Source Computed Tomography (DSCT) in 2005 represented a giant leap in the evolution of sectional imaging comparable to the introduction of spiral and later multi-detector CT. The scientific community has responded with great interest and DSCT has opened entirely new clinical fields to CT applications. Equipped with two x-ray sources and detectors mounted in one gantry, DSCT enables many new applications ranging from heart rate independent coronary CT angiography examinations to complete chest pain evaluation in one single scan. Because it is able to run both x-ray sources simultaneously at different energy settings, DSCT is also the first scanner generation to enable routine spiral dual energy imaging. As today’s scanners become faster and more robust, contrast media delivery has become an increasingly critical element of the contrast enhanced CT procedure. It has been necessary over the years to significantly adapt injection protocols with each new scanner generation. This is particularly relevant in the case of DSCT. Siemens AG and Bayer Schering Pharma joined forces in early 2006 to provide you with a comprehensive overview of DSCT’s capabilities together with reliable protocol recommendations for scanner use and optimized contrast media injection parameters. Based on their extensive experience in CT imaging, physicians from 12 global luminary sites were selected to form the Dual Source CT Expert Panel. Over the course of 18 months and four panel meetings, 25 clinical scan and contrast media injection protocols were developed. All protocols were based on intense discussions among the panel members. To ensure the highest quality, the selected protocols were tested by numerous sites, individually adapted and finally approved during a panel consensus meeting. This book will provide an introduction into DSCT technology as well as into the basics of contrast media administration. You will find consensus protocols as well as individual considerations, such as tricks and pitfalls, complemented by clinical examples from several of the world’s best radiologists and cardiologists. We are confident it can help you to achieve consistently high image quality, optimal patient care, and perhaps a solid starting point for the development of your own unique protocols. Peter R. Seidensticker, MD Lars K. Hofmann, MD Berlin / Germany Erlangen / Germany 7 The Dual Source CT Expert Panel Stephan Achenbach, MD, FESC, FACC Roman Fischbach, MD Professor of Cardiology Associate Professor of Radiology University of Erlangen-Nuremberg University of Münster Departments of Cardiology and Radiology Department of Clinical Radiology Ulmenweg 18 Albert-Schweitzer-Str. 33 91054 Erlangen, Germany 48149 Münster, Germany Hatem Alkadhi, MD Martin Heuschmid, MD University Hospital Zurich Associate Professor Institute of Diagnostic Radiology Eberhard-Karls-University Tübingen Raemistr. 100 Department of Diagnostic and 8091 Zurich, Switzerland Interventional Radiology Hoppe-Seyler-Str. 3 Christoph R. Becker, MD 72076 Tübingen, Germany Associate Professor University of Munich-Grosshadern Thorsten R. C. Johnson, MD Department of Clinical Radiology University of Munich-Grosshadern Marchioninistr. 15 Department of Clinical Radiology 81377 Munich, Germany Marchioninistr. 15 81377 Munich, Germany Harald Brodoefel, MD Eberhard-Karls-University Tübingen Kai Uwe Juergens, MD Department of Diagnostic and Assistant Professor Interventional Radiology University of Münster Hoppe-Seyler-Str. 3 Department of Clinical Radiology 72076 Tübingen, Germany Albert-Schweitzer-Str. 33 48149 Münster, Germany 9 Andreas F. Kopp, MD Gilbert L. Raff, MD Professor of Radiology William Beaumont Hospital Eberhard-Karls-University Tübingen Department of Cardiology Department of Diagnostic and 3601 West Thirteen Mile Road Interventional Radiology Royal Oak, MI 48073, USA Hoppe-Seyler-Str. 3 72076 Tübingen, Germany Dieter Ropers, MD, FESC Professor of Cardiology Axel Kuettner, MD University of Erlangen-Nuremberg University of Erlangen-Nuremberg Departments of Cardiology and Radiology Department of Radiology Ulmenweg 18 Maximiliansplatz 1 91054 Erlangen, Germany 91054 Erlangen, Germany Stephan G. Ruehm, MD, PhD Andreas H. Mahnken, MD, MBA David Geffen School of Medicine at UCLA University Hospital, RWTH Aachen University Department of Radiology Department of Diagnostic Radiology Peter V Ueberroth Bldg., Suite 3371 Pauwelsstr. 30 10945 LeConte Avenue 52074 Aachen, Germany Los Angeles, CA 90095-7206, USA Cynthia McCollough, PhD U. Joseph Schoepf, MD Mayo Clinic College of Medicine Medical University of South Carolina Department of Radiology Departments of Radiology and Medicine 200 First Street SW 169 Ashley Ave., PO Box 250322 Rochester, MN 55905, USA 29425 Charleston, USA Nico R. Mollet, MD, PhD Harald Seifarth, MD Erasmus Medical Center Rotterdam University of Münster Department of Radiology Department of Clinical Radiology Room HS-207, Department of Radiology Albert-Schweitzer-Str. 33 PO Box 2040 48149 Münster, Germany 3000 CA Rotterdam, Netherlands 10
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