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Case history Acute chest pain – Triple rule out Diagnosis Subsegmental pulmonary embolism. Protocol Tube voltage 1 (kV) 120 Tube current 1 (mAs) 560 DLP 834 CTDI 29,0 mSv k.A. Siemens Scanner SOMATOM Definition This case has been submitted to the Siemens Image Quality Contest 2010. Read more

Case history DECT images of patients with known gout. Images of the right knee reveals uric acid (UA) deposits along the collateral & cruciate ligaments and in the prepatellar region. It is evident that with the material decomposition algorithm, UA can be clearly depicted in red thereby confirming the diagnosis of … Read more

Case history 64 year-old female presents with history of neck and chest pain. Diagnosis Thickened quadricuspid pulmonary valve. Aneurysmal dilatation and asymmetry of pulmonary arteries. Stenosis of mid LAD with a component of myocardial bridging. Description Had “Definition” not been available, patient would have been imaged using routine helical sequence at presumably larger … Read more

Case history: Child with nepphroblastoma before initiation of chemotherapy. Diagnosis: Exclusion of infiltrates Read more

History
49-year old male referred to CT for evaluation of aortic valve. Besides asthma and history of colonoscopy, the patient was in good health. Physical examination revealed a heart murmur. The baseline echocardiogram reported normal tricuspid aortic root with moderate aortic regurgitation (AI) and EF of 60 %.

Question
Detection of morphology of aortic root, and severity of aortic regurgitation for surgical planning.

Diagnosis/Differential diagnosis
Aortic valve disorder – moderately severe AI

Findings
The 3D and 4D assessment of aortic root demonstrates a bicuspid aortic valve with partial fusion between non- and right coronary cusps. There is a mild prolapse of the partially fused non- and right cusp with incomplete diastolic coaptation. The area of the diastolic opening measures 0.23 cm². The diastolic opening formed by thick raphe is likely associated with severe aortic insufficiency. The absence of aortic valve calcification is noted.

Comments
Cardiac MDCT proves to be reliable source for detection of morphology of aortic valve. 4D images of phases between 0-90 % enable functional assessment of aortic valve and identification of degree of severity of valvular disorders.

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Movie 1: Cross sectional image of aortic valve showing partial fusion of non- and right coronary cusps, and central diastolic opening.


Figure 2: Cross sectional image showing the measurement of diastolic opening area in planimetry.

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Movie 3: Image showing mild prolapse of aortic valve cusps and diastolic coaptation.

Authors: Sandra Halliburton and Paul Schoenhagen

Two interesting questions about CT in pediatrics have been asked on DSCT.com some time ago. As Dr. Hyun Woo Goo, who is an expert in pediatrics, recently joined the DSCT expert community, DSCT.com asked him to comment on these questions as well. Read his answers here. The following questions … Read more

The following question has been sent by Patrick, CT Tech: Our facilty is currently operating a siemens Definition Scanner. I was hoping you could recommend some reading material on Dual Source CT. Also some info on how to reduce radiation exposure. Ralf Bauer, MD, Clinic of the Goethe University, Frankfurt, Germany: Dear … Read more

Objective: In supraaortic vessels, bone subtracted maximum intensity projections make the evaluation of computed tomographic angiography (CTA) datasets easier and faster. Dual energy CT can be used for bone removal without user interaction. The purpose of this study was to compare the results of conventional and dual energy-based bone removal. Materials … Read more

This fourth article of our Dual Energy series gives an overview of the most important clinical applications of Dual Energy, including color coding of contrast material, perfusion imaging, angiography, and differentiation of renal stones and tendons/ligaments. Read more

This third article of our Dual Energy-series focuses on the technical implementation of Dual Energy technology. For Dual Energy scanning, the tube potentials are mostly set to 140 and 80 kVp to obtain the largest spectral difference. Weighted average images are calculated by the image reconstruction system to resemble normal 120 … Read more