Objective To review the principles and techniques of CT perfusion imaging and its applications in the imaging diagnosis of abdominal disorders. Methods All the relevant literatures were reviewed. The principles and techniques of CT perfusion imaging were described and summarized in detail. The functional information of a target abdominal organ (e.g. the liver and pancreas) revealed by CT perfusion imaging, such as hemodynamics and microcirculation status, was also evaluated. Results In addition to the morphologic information, CT perfusion imaging can also provide functional information about the circulation parameters of target abdominal organs. Moreover, such functional information can be generated for the neovasculature and microcirculation of tumor lesions of abdominal organs, which is very helpful for not only the diagnosis, but also the evaluation of tumor invasiveness and response to treatment. Conclusion CT perfusion imaging offers an effective method for studying abdominal disorders by providing functional information that is quite useful for the differential diagnosis and assessment of therapeutic response.
ObjectiveTo research on the effect of nursing intervention on CT scanning success rate and image quality in head CT perfusion imaging for cerebral ischemia patients. MethodBetween June 2013 and July 2014, we retrospectively analyzed the clinical data of 203 patients who underwent CT perfusion imaging for cerebral ischemia. All the patients received nursing intervention including the following aspects:body position, psychology, sedation, leakage of contrast medium, allergic reaction, etc. ResultsA total of 199 patients successfully underwent the examination, among whom there were 190 (93.6%) satisfactory and 9 (4.5%) qualified results. The other four patients (1.9%) stopped examination because of motion artifacts. So the success rate came to 98.1%, and the failure rate was 1.9%. ConclusionsWith nursing intervention before, during and after CT scanning, patients with acute cerebral ischemia can accept higher success rate in examining and satisfactory image quality. At the same time, the nursing service was also improved.
ObjectiveTo evaluate the comparative cost-effectiveness of thrombolysis treatment of ischemic stroke based on outcomes of CT perfusion (CTP). MethodsWe applied the methods of systematic review to evaluate the studies abroad about the cost effectiveness of CTP diagnosis outcomes used for selecting stroke patients for thrombolysis treatment. We also evaluated the domestic studies about the cost-effectiveness of CTP in China by establishing a decision tree model. ResultsA total of 2 economics studies were included. The results showed that, the cost-effectiveness ratios of CT, CTP and MRI for selecting stroke patients for thrombolysis treatment were 2 983.7 ￡/QALY, 2 951.4 ￡/QALY and 2 982.9 ￡/ QALY, respectively, in the UK; 100 483.5＄/QALY and 99 406.1＄/QALY just for CT and CTP, respectively, in the US; and the evaluation outcomes by establishing the decision tree model showed that, 113 492.4 ￥/QALY, 113 615￥/QALY and 120 831.9 ￥/QALY, respectively, in China. ConclusionAll international and domestic studies' results show that CTP is more cost-effective than CT/MRI in selecting stroke patients for thrombolysis treatment.
ObjectiveTo investigate the clinical value of multi-slice spiral CT perfusion imaging for blood supply of pulmonary mixed ground-glass nodules (mGGN). MethodsThe mGGN patients were retrospectively analyzed from March 2011 to May 2015 in Affiliated Hospital of Hebei University of Engineering, Handan First Hospital and Xingtai People's Hospital. Multi-slice spiral CT perfusion imaging for blood supply was applied to evaluate the blood supply of solid lesions in mGGN, and the diagnostic values of CT perfusion parameters were compared for differentiating the benigh mGGN from the malignant mGGN. ResultsTotally 97 mGGN patients were enrolled in this study, in which 80 were malignant mGGN and 17 were benigh mGGN. Blood volume (BV), peak enhancement image (PEI) and permeability surface (PS) in malignant mGGN lesions were higher than those of benign lesions, while the time to peak was less than that of benign lesions, and the differences were all statistically significant (P < 0.05). BV, PEI and PS in minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) patients were significantly higher than those in the patients with precancerous lesions (P < 0.05). BV and PS in IAC patients were significantly higher than those in MIA patients (P < 0.05). Logistic regression analysis showed that IAC, MIA and the precancerous lesions, BV, PEI and PS were positively correlated with mGGN. Receiver operating characteristic (ROC) curve showed that the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rates with BV+PS+PEI combined, were 95.28%, 86.65%, 91.10%, 87.52% and 91.76%, respectively, while the area under ROC curve was significantly higher than those with single parameter (P < 0.05). ConclusionMulti-slice spiral CT perfusion imaging can evaluate the blood supply of mGGN, and BV+PS+PEI combined can be used in differentiation of the benigh and malignant mGGN.
Objective To explore the feasibility of mean temporal phase images calculated from perfusion CT datasets by using CT perfusion (CTP) of liver on the third-generation dual-source CT. Methods Twenty-two consecutive patients with suspected hepatocellular carcinoma were enrolled, we retrospectively compared objective and subjective image quality, leson detectability, and radiation dose between mean temporal arterial (mTA) and mean temporal portal venous (mTPV) images which calculated from perfusion CT datasets with conventional enhanced arterial and portal venous datasets. Results ① Image quality: compared with the conventional enhancement image, the standard deviation (SD) values of CTP images on liver (arterial phase), portal vein (arterial phase), and liver (portal vein phase) were lower (P<0.05); the signal-to-noise ratio (SNR) values of CTP images on aorta (arterial phase), portal vein (arterial phase), aorta (portal vein phase), and portal vein (portal vein phase) were all higher (P<0.05), the contrast-to-noise ratio (CNR) value of CTP images on aorta (arterial phase) was higher (P<0.05). ② The subjective image quality: the subjective image quality scores of CTP images (mTA and mTPV images) were higher when compared to responding conventional enhanced arterial and portal venous datasets (P<0.05). ③ The diagnostic efficiency: the CTP images and conventional enhancement images showed all the lesions, but the diagnostic efficiency images of CTP images was better than the conventional enhancement images, both on lesions of blood supply and lack of blood supply (P<0.05). Conclusions The image quality of mTA and mTPV datasets calculated from CTP datasets are non-inferior when compared to conventional enhanced arterial and portal venous acquisitions in patients with suspected hepatic lesions. Thus, CTP could be used as a stand-alone imaging technique without additionally performed conventional arterial and portal venous CT acquisitions.