Introduction: Computed tomography angiography (CTA) represents the gold standard as a method for the diagnosis of carotid artery diseases. The current topic is the use of CTA for the evaluation of carotid arteries with a reduction in the dose of contrast agent and dose of ionizing radiation, which, with adequate preparation, would enable the use of this method in some risk groups. The aim of this study was to evaluate the feasibility and image quality of a new low-dose CTA protocol in comparison with a standard protocol. Methods: Forty patients with recumbent ischemic stroke were included in the study, twenty of whom underwent lowdose CTA, and the remaining twenty underwent a standard CTA protocol of the carotid arteries. Results: No significant difference was found between the mean values of CT number (Hounsfield unit), signal-to-noise ratio, contrast-to-noise ratio, and subjective assessment of image quality in the comparison of the control and experimental groups. CT dose index, volume, and dose length product were significantly lower in patients who underwent lowdose carotid CTA. There was no significant difference in the degree of carotid stenosis between color Doppler and CTA. Conclusion: The use of the low-dose protocol for carotid CTA allows the application of this method in risk groups, in which it was previously not possible to perform, with the same image quality in comparison with the standard protocol.
In clinical practice, there is a very common discrepancy between the clinical findings of patients with lumboischialgia and the radiological findings. This research aimed to determine the degree of correlation between the ODI index and the VAS scale with degenerative changes in the lumbar spine found using MRI. The study included 100 patients, who were referred for an MRI of the lumbar spine and who had a clear clinical picture of lumboischialgia. Patients underwent MRI. Degenerative changes in the lumbar spine and discs were analysed. Patients were asked to answer the questions in the questionnaire about the subjective feeling of pain and functional status, and ODI and VAS scores were calculated. There has been a statistically significant correlation found between the answers to the survey questions and the VAS score (p < 0.001). There was a significant correlation obtained between the level of degeneration and the disability index (p = 0.022), while the correlation with the VAS score has not been found to be significant (p = 0.325). This study has demonstrated a significant correlation between the VAS pain score and the ODI, as well as a significant correlation between the level of degeneration on MRI scans and the disability index; however, the correlation of MRI scan results with VAS score has not been found to be significant.
Computed tomography (CT) is a diagnostic imaging process that uses ionising radiation to obtain information about the interior anatomic structure of the human body. Considering that the medical use of ionising radiation implies exposing patients to radiation that may lead to unwanted stochastic effects and that those effects are less probable at lower doses, optimising imaging protocols is of great importance. In this paper, we used an assembled 3D-printed infant head phantom and matched its image quality parameters with those obtained for a commercially available adult head phantom using the imaging protocol dedicated for adult patients. In accordance with the results, an optimised scanning protocol was designed which resulted in dose reductions for paediatric patients while keeping image quality at an adequate level.
Moždani udar ili cerebrovaskularni inzult (CVI) je u današnje vrijeme jedan od glavnih uzroka smrtnosti i invaliditeta u svijetu. Veoma značajnu ulogu u dijagnostici CVI-a zauzima magnetna rezonanca (MR), koja se ogleda u mogućnosti klasifikacije i otkrivanju patofiziologije kako bi se pravovremeno i brzo postupilo sa terapijskim tretmanom ukoliko je došlo do pojave CVI-a. Ciljevi: Uporediti kvalitet prikaza CVI-a između T2 FLAIR i T2 sekvence, utvrditi utjecaj lokalizacije CVI-a na intenzitet signala, utvrditi utjecaj vremena pojave CVI-a na intenzitet signala. Utvrditi smo kategorije pacijenata kod kojih najčešće nastaje CVI, kao i korelaciju između uputne i definitivne dijagnoze. Metode istraživanja: Istraživanje je dizajnirano kao retrospektivna deskriptivna studija. Rad je realiziran u Kliničkom centru Univerziteta u Sarajevu, na Klinici za radiologiju. U studiju je uključeno 50 pacijenata kod kojih MR nalaz ukazuje na prisustvo CVI-a. Ispitivanje je obavljeno na MRI jedinicama jačine 1.5 i 3.0 T. Rezultati: Od ukupnog broja pacijenata 50 (100%), 32 su muškog pola (64%), a 18 (36%) ženskog pola. CVI je najčešće bio prisutan kod pacijenata muškog pola u grupi od 61-70 godine, dok je kod pacijenata ženskog pola najčešće bio prisutan u grupi od 71-80 godine. 52% pacijenata je imalo jedan od faktora rizika za nastanka CVI-a, HTA je bila prisutna kod 28% pacijenata a DM kod 22% pacijenata. T2 FLAIR sekvenca je imala veće vrijednosti intenziteta signala na lateralnom rubu CVI-a, dok je T2 sekvenca imala veće vrijednosti u centru i prednjem rubu CVI-a. T2 FLAIR sekvenca je imala veći intenzitet signala na lokacijama: thalamus, mesencephalon, okcipitalno kortikalno subkortikalno i područje kapsule interne. T2 sekvenca je imala veći intenzitet signala lokacijama: medula oblongata, parieto okcipitalno kortikalno subkortikalno, frontoparietalno paraventrikularno, parietalno kortikalno subkortikalno, frontoparietalno kortikalno subkortikalno, cerebelum i pons. Najčešća uputna dijagnoza je bila CVI. Zaključak: T2 FLAIR sekvenca je senzitivnija kod prikaza akutnog i subakutnog CVI-a. T2 sekvenca je senzitivnija kod prikaza hroničnog CVI-a, čime radna hipoteza u ovom slučaju nije u potpunosti dokazana.
For more than two years, coronavirus disease 19 (COVID-19) has represented a threat to global health and lifestyles. Computed tomography (CT) imaging provides useful information in patients with COVID-19 pneumonia. However, this diagnostic modality is based on exposure to ionizing radiation, which is associated with an increased risk of radiation-induced cancer. In this study, we evaluated the common dose descriptors, CTDIvol and DLP, for 1180 adult patients. This data was used to estimate the effective dose, and risk of exposure-induced death (REID). Awareness of the extensive use of CT as a diagnostic tool in the management of COVID-19 during the pandemic is vital for the evaluation of radiation exposure parameters, dose reduction methods development and radiation protection.
Introduction: Axial-loaded magnetic resonance imaging (MRI), which can simulate an upright position of the patient may cause a significant reduction of the dural sac cross-sectional area (DCSA) compared with standard MRI, thus providing valuable information in the assessment of the lumbar spinal canal. The purpose of this study was to investigate excessiveness of the change in DCSA and depth of lateral recesses (DLRs) before and after axial-loaded imaging in relation to body mass index (BMI) of the subjects.Methods: Twenty patients were scanned to evaluate DCSA and DLR at three consecutive lumbar spine intervertebral disc levels (L3/4, L4/5, and L5/S1) on conventional-recumbent MRI, and after axial loading were applied.Results: Axial-loaded MRI demonstrates a significant difference of DSCA in comparison to conventional MRI. Furthermore, results show a significant correlation between the DCSA and BMI on level L3/L4, both before and after axial loading MRI. With axial loading, there is a reduction of DSCA of 12.2%, 12.1%, and 2.1% at the levels L3/L4, L4/L5, and L5/S1, respectively. After axial loading has been applied, the depth of the neural foramen has been reduced by an average of 10.1%.Conclusion: Axial-loaded MRI reduces DCSA and DLRs in comparison to standard MRI. Information obtained in this way may be useful to explain the patient’s symptomatology and may provide an additional insight that can influence the treatment decision plan accordingly.
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