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Biomedical subjects

Mizuki Nishino

Publications and source records attributed to Mizuki Nishino.

At least 19 recordsLinked to original sources

Cine MR imaging of uterine peristalsis in patients with endometriosis.

Endometriosis is one of the most important causes of infertility; however the precise mechanism by which it affects female fertility is unclear. The objective of this study was to study the functional aspects of the uterus by evaluating uterine contractility in patients with endometrial cysts of the ovary. The study population was recruited from two institutes and consisted of 26 women (periovulatory (10), luteal (13), and menstrual phase (3); age range: 19-51 years) with untreated endometriosis; the control group consisted of 12 healthy women (age range: 22-41 years). Cine MR imaging obtained by a 1.5T magnet was visually evaluated at 12x faster than real speed, focusing on the presence of uterine peristalsis, the direction and frequency of peristalsis, and the presence of sustained uterine contractions. Uterine peristalsis was identifiable in 3/10, 3/13, and 3/3 of the endometriosis patients in each menstrual cycle, respectively, and in 11/12, 3/12, and 5/12 of their control subjects. Peristaltic detection rate and frequency were significantly less for the endometriosis group than for the controls in the periovulatory phase only (p<0.05). Sustained contractions were recognized in 19/36 control subjects and in 13/26 endometriosis patients, but the difference was not significant. Uterine peristalsis appears to be suppressed during the periovulatory phase in patients with endometriosis, which may have an adverse effect on sperm transport.

Adult↗

Coronal reformations of the chest on 64-row multi-detector row CT: evaluation of image quality in comparison with 16-, 8- and 4-row multi-detector row CT.

PURPOSE: To evaluate image quality of coronal reformations of chest performed on 64-row MDCT in comparison with 16-, 8- and 4-row MDCT. MATERIALS AND METHODS: Consecutive patients who underwent pulmonary CT angiography using four different MDCT scanners were retrospectively studied with IRB approval: (1) n=30, 64-row MDCT; (2) n=30, 16-row MDCT; (3) n=30, 8-row MDCT; (4) n=30, 4-row MDCT. Coronal reformatted images (2 mm thickness and 2mm intervals for 64-row MDCT; 5 mm thickness and 5 mm intervals for 16-, 8- and 4-row MDCT) were evaluated by consensus reading of two board-certified radiologists who were blinded to scanner type. The image quality of overall chest appearance and individual thoracic structures including heart, aorta and pulmonary arteries was graded using five-point scale. Grades from four different scanners were compared using Kruskal-Wallis test. A second evaluation was performed in 48 randomly selected patients (12 patients for each scanner). Reproducibility was assessed using weighted-kappa analysis. RESULT: Significant reproducibility was observed between the first and second evaluations in 48 patients both for image quality of overall chest (weighted kappa=0.826) and each thoracic structure (mean weighted kappa=0.803; range, 0.729-0.858). Image quality of overall chest and individual thoracic structures differed significantly among four different MDCT groups, with 64-row MDCT having the highest grades, followed by 16-, 8- and 4-row MDCT (mean grades for overall chest in each scanner: 3.9, 3.0, 2.4 and 1.9, respectively) (P<0.0001 for overall chest and each thoracic structure). CONCLUSION: When comparing coronal reformations of chest using four different MDCT scanners, the 64-row MDCT had the highest image quality for overall chest appearance and individual thoracic structures, followed by 16-, 8- and finally 4-row MDCT.

Adult↗

Evaluation of thoracic abnormalities on 64-row multi-detector row CT: comparison between axial images versus coronal reformations.

PURPOSE: To evaluate the capability of coronal reformations of chest on 64-row MDCT in demonstrating thoracic abnormalities in comparison with axial images. MATERIALS AND METHODS: Thirty-eight consecutive patients who underwent pulmonary CTA on 64-row MDCT were retrospectively studied with institutional review board (IRB) approval. Contiguous 2 mm axial and coronal images were reviewed independently with a 1-week interval, by consensus reading of two board-certified radiologists. Overall image quality was graded using a five-point scale. Abnormalities in mediastinum, hilum, pulmonary vessels, aorta, heart, esophagus, pleura, chest wall, and lung parenchyma were scored: 1 = definitely absent, 2 = probably absent, 3 = equivocal, 4 = probably present, 5 = definitely present. Scores on axial and coronal images were compared using weighted kappa analysis. RESULTS: Overall image quality was not different with statistical relevance between axial and coronal images (mean/median scores; 3.7/4; 3.6/4, respectively, P = 0.286, Wilcoxon signed-rank test). Significant agreement was observed between axial and coronal scores (mean weighted kappa, 0.661; range, 0.362-1). Agreement was almost perfect for pneumothorax, lung and pleural mass, effusion and consolidation (weighted kappa=0.833-1); substantial for pulmonary embolism, trachea, mediastinal lymphadenopathy and non-skeletal chest wall lesion, heart, esophagus, and emphysema (weighted kappa, 0.618-0.799); moderate for atelectasis, mediastinum, hilar nodes, aorta, other lung lesions, skeletal chest wall lesions, linear scarring, nodules > 1 cm, pulmonary artery abnormalities and pleural thickening (weighted kappa, 0.405-0.592); and fair for nodules < 1 cm (weighted kappa = 0.362). CONCLUSION: Coronal reformations on 64-row MDCT had substantial agreement with axial images for evaluation of the majority of thoracic abnormalities.

Adult↗

Loss of anteroposterior intralobar attenuation gradient of the lung: Correlation with pulmonary function.

RATIONALE AND OBJECTIVES: Since the initial description of an intralobar attenuation gradient by Webb et al, it has been suggested that departure from the intralobar attenuation gradient could indicate early lung diseases. However, its significance has not been determined in detail. We aimed to quantify the anteroposterior intralobar attenuation gradient on volumetric end-inspiratory and end-expiratory high-resolution computed tomography (CT) in patients with emphysema and to correlate the gradient values with pulmonary function. MATERIALS AND METHODS: The study population consisted of 21 consecutive patients with emphysema evaluated with volumetric expiratory high-resolution CT and 6 patients with normal high-resolution CT findings. The anteroposterior intralobar attenuation gradient values were quantified on end-inspiratory and end-expiratory sagittal reformations using a lung analysis software program and were correlated with pulmonary function tests results. RESULTS: The intralobar attenuation gradient values in patients with forced expiratory volume in 1 second (FEV1) < or =70% were significantly smaller compared with those in patients with FEV1 >70% in bilateral lower lobes at end-expiration (P = .0061, P = .047, respectively, unpaired t-test). The FEV1 values in patients with attenuation gradient values < or =0.02 were significantly lower than in those with attenuation gradient values >0.02 (right lower lobe: P = .024; left lower lobe: P = .0034; chi-squared test). The intralobar attenuation gradient values in bilateral lower lobes at end-expiration were significantly correlated with FEV1 and FEV1/forced vital capacity (right: P = .031, P = .039, respectively; left: P = .036, P = .030, respectively, Pearson correlation). CONCLUSIONS: The quantitative measurement of the anteroposterior intralobar attenuation gradient values of the lung showed that these gradients at end-expiration in both lower lobes correlate with obstructive physiology.

Adult↗

Incidence of pulmonary embolism in younger versus older patients using CT.

OBJECTIVE: The aim of this study is to compare the incidence of pulmonary embolism (PE) on computed tomography (CT) studies between younger and older patients to determine if there is an age-related bias for overutilization of CT pulmonary angiography (CTPA) in younger patients. MATERIAL AND METHODS: Six hundred thirty-one consecutive CTPA cases for suspected acute PE between 11/10/2003 and 3/19/2004 were retrospectively studied. Of these 631 cases, 59 patients were found to have clots in the pulmonary arteries (ranging from central to subsegmental PA). CTPA was performed using multidetector CT at 1.25-mm collimation, 120 kVp, 320 mA. Patients were categorized by gender and age: A, less than 20 (n = 11); B, 20 to 29 (n = 44); C, 30 to 39 (n = 59); D, 40 to 49 (n = 90); E, 50 to 59 (n = 120); F, 60 to 69 (n = 114); G, 70 to 79 (n = 104); H, 80 to 89 (n = 72); I, 90 or more (n = 21). The incidences of PE were calculated in each gender and age group. To compare the incidence of PE between younger and older groups, they were divided into 2 groups at the ages of 40 (<39 and > or = 40), 50 (<49 and > or = 50), and 60 (<59 and > or = 60). Statistical analysis was performed using the chi test. RESULTS: The incidences of PE were 11.9% in males (A, 0%; B, 17.6%; C, 10%; D, 8.3%; E, 13.3%; F, 6.9%; G, 17.5%; H, 23.5%; I, 0%), 7.7% in females (A, 0%; B, 7.4%; C, 5.1%; D, 12.5%; E, 4.2%; F, 14.5%; G, 7.8%; H, 5.5%; I, 0%), and 9.4% in total patients (A, 0%; B, 11.1%; C, 6.8%; D, 11.1%; E, 7.5%; F, 10.5%; G, 11.5%; H, 9.7%; I, 0%). No significant differences in the incidences of PE were observed when patients were divided at the age of 40 (male, female, total; P=1.0, 0.6252, 0.7220), at the age of 50 (male, female, total; P = 0.6748, 0.6879, 1.0), or at the age of 60 (male, female, total; P = 0.8458, 0.7046, 0.6820). CONCLUSION: No statistically significant difference in the incidence of PE was observed between younger and older patients. Our findings suggest that there is no age-related bias for overutilization of CT angiography (CTA) in younger patients.

Adolescent↗

Fetal lung volume measurements: determination with MR imaging--effect of various factors.

PURPOSE: To retrospectively determine the effect of gestational age (GA), imaging plane, section thickness, and inter- and intraobserver variability on fetal lung volume (FLV) measurements obtained with magnetic resonance (MR) imaging in a cohort of fetuses without thoracic abnormalities. MATERIALS AND METHODS: Institutional review board approval was obtained. Informed consent for this retrospective cohort study was waived, and the conduct of this study was HIPAA compliant. FLV was measured in 30 fetuses (GA, 17-36 weeks) referred for MR imaging for indications other than pulmonary abnormalities. Measurements were made on single-shot fast spin-echo images by tracing free-form regions of interest on individual consecutive sections in the transverse, sagittal, and coronal planes. Measurements were performed twice by two observers independently. Correlations between FLV and GA, imaging plane, and section thickness were assessed, as were intra- and interobserver variability. Time to perform FLV was assessed in a subset of fetuses. RESULTS: Total FLV ranged from 2 to 110 mL. Mixed-effects regression model showed significant quadratic trend in FLV with increasing GA, with comparable strength of correlation (r = 0.89-0.91) in the three imaging planes of measurement. Intraobserver agreement was good in all three planes (r = 0.65-0.83) and was highest in the transverse plane. Interobserver agreement was good in all three planes (r = 0.68-0.76). FLV showed no significant dependence on section thickness (P = .23) or imaging plane (P = .82). Mean time to obtain FLV measurements ranged from 48 seconds at GA of 21 weeks to 77 seconds at GA of 29-30 weeks. CONCLUSION: GA-based FLV measurements obtained with MR images are independent of section thickness and imaging plane and can be performed with good inter- and intraobserver agreement in less than 2 minutes.

Female↗

Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse.

PURPOSE: To compare dynamic expiratory and end-expiratory computed tomography (CT) for depicting central airway collapse in patients with acquired tracheobronchomalacia (TBM). MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was not needed. Retrospective review was performed of all patients with a CT diagnosis of TBM in a 10-month period (n = 34) who underwent evaluation of airway disease by means of three different sequences at multi-detector row CT: end inspiration, dynamic expiration, and end expiration (the latter was performed only at the levels of the aortic arch, carina, and bronchus intermedius). Fourteen patients (11 men, three women; age range, 19-79 years) who had comparable images obtained with all three sequences at any of these three levels were included in the study. The degree of airway collapse was measured by two thoracic radiologists in consensus by calculating the percentage change in the area of the airway between inspiratory and expiratory scanning. Statistical analysis was performed by using the paired t test. RESULTS: Dynamic expiratory CT elicited a significantly greater degree of airway collapse than end-expiratory CT at all three levels (P < .005). The mean percentages of airway collapse at each of the three levels were as follows: aortic arch, 53.9% with dynamic expiration versus 35.7% with end expiration (P = .0046); carina, 53.6% with dynamic expiration versus 30.9% with end expiration (P < .0001); and bronchus intermedius, 57.5% with dynamic expiration versus 28.6% with end expiration (P = .0022). CONCLUSION: Dynamic expiratory CT elicits a significantly greater degree of airway collapse than standard end-expiratory CT in patients with TBM.

Adult↗

Bronchomalacia in sarcoidosis: evaluation on volumetric expiratory high-resolution CT of the lung.

RATIONALE AND OBJECTIVES: The aim of this study is to investigate the frequency of bronchomalacia associated with sarcoidosis and compare the extent of air trapping in patients with sarcoidosis with and without bronchomalacia. MATERIALS AND METHODS: Eighteen consecutive patients (6 men, 12 women; age, 29-64 years; mean age, 47 years) with pathologically proven sarcoidosis who underwent clinical volumetric expiratory high-resolution computed tomography were studied. On contiguous end-expiratory images, the presence and severity of bronchomalacia and extent of air trapping were evaluated. The extent of air trapping was compared between patients with sarcoidosis with and without bronchomalacia. RESULTS: Bronchomalacia was noted in 11 of 18 patients (61%) with sarcoidosis (grade 1 [mild], n = 6; grade 2 [moderate], n = 4; and grade 3 [severe], n = 1). Air trapping was observed in 17 of 18 patients (94%; grade 1 [1%-25%], n = 8; grade 2 [26%-50%], n = 9). The extent of air trapping in patients with bronchomalacia was significantly greater than that in patients without bronchomalacia (P = .027, chi-squared test). CONCLUSION: Bronchomalacia frequently was associated with sarcoidosis, and the extent of air trapping was significantly greater in patients with sarcoidosis with bronchomalacia compared with those without bronchomalacia.

Adult↗

Comparison of artifacts on coronal reformation and axial CT pulmonary angiography images using single-detector and 4- and 8-detector multidetector-row helical CT scanners.

RATIONALE AND OBJECTIVES: The aim of this study is to compare the degree of stair-step artifact on coronal reformation computed tomographic (CT) pulmonary angiography images obtained using single-detector helical CT (SDCT), four-detector (4-MDCT), and eight-detector multidetector-row CT (8-MDCT) and compare the degree of motion artifact on the corresponding axial CT images. MATERIALS AND METHODS: Three groups of consecutive patients imaged by means of CT angiography for suspected pulmonary embolus were retrospectively identified by using CT records at our institution: (1) group A (n = 38), SDCT; (2) group B (n = 36), 4-MDCT; and (3) group C (n = 74), 8-MDCT. For each case, coronal multiplanar volume reformation maximal intensity projection images were created by using a standard technique. All images were reviewed in a randomized fashion by two thoracic radiologists who were blinded to the type of CT scanner. Stair-step artifact of pulmonary arteries on coronal reformation images was graded by consensus agreement using a four-point scale (0 = no artifact to 3 = severe artifact). Axial images were assessed for six parameters of motion artifact. The sum of these grades resulted in a total motion score, with a potential range of 0 (no motion) to 12 (severe motion). Statistical analysis was performed using the Mann-Whitney test. RESULTS: Stair-step artifacts were significantly higher for SDCT (mean, 2.9; median, 3) compared with 4-MDCT (mean, 2.2; median, 2; P < .0001) and 8-MDCT (mean, 1.5; median, 1; P < .0001). Total motion scores were significantly higher for SDCT (mean, 9.3) compared with 4-MDCT (mean, 8.4; P = .03) and 8-MDCT (mean, 6.8; P < .0001). CONCLUSION: Stair-step artifacts are significantly higher with SDCT compared with MDCT. For MDCT, eight-detector scanners produce images with significantly less artifact than four-detector scanners.

Adolescent↗

Effects of oral 5-fluorouracil drugs on hepatic fat content in patients with colon cancer.

RATIONALE AND OBJECTIVES: The association between hepatic steatosis and oral 5-fluorouracil (5-FU) agents is clinically recognized but has not been systematically studied. The aim of this study was to determine the effects of 5-FU on hepatic fat content in patients undergoing oral 5-FU therapy and to compare the effects in three subgroups of 5-FU drugs. MATERIALS AND METHODS: Fifty-one patients with postoperative colon cancer (mean 61.1 years) were retrospectively studied. Forty-three patients were given adjuvant oral 5-FU therapy for a mean 3.3 years (5-FU group), and eight patients were not (control group). All patients underwent preoperative and postoperative abdominal computed tomography (CT) studies. The liver/spleen ratio was calculated from the CT attenuation values for the liver and spleen. We also compared the effects on hepatic appearance under CT of three 5-FU drugs: fluorouracil (n = 13), doxifluridine (n = 14), or UFT (a mixture of tegafur and uracil; n = 9). RESULTS: In the 5-FU group, the mean CT values for the liver were significantly reduced relative to values before therapy (P < .01) and to those of the control group (P < .0001). Fifteen of 43 patients (34.9%) developed steatosis. Of the three 5-FU drugs, fluorouracil and doxifluridine caused a significant decrease in hepatic CT values. CONCLUSION: 5-FU caused a significant decrease in CT attenuation, indicating an increase in hepatic fat content, and was associated with very frequent hepatic steatosis. UFT seemed less likely to cause hepatic fatty infiltration. CT examination was useful for early detection of drug-induced side effects on liver even before lab abnormality or clinical manifestation is observed.

Adult↗

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas.

PURPOSE: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. MATERIALS AND METHODS: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. RESULTS: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. CONCLUSIONS: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

Adult↗

Functional evaluation of the postoperative gastrointestinal tract using kinematic MR imaging: Quantitative assessment of peristaltic activity.

The purpose of this study is to demonstrate the feasibility of kinematic MR imaging in visualizing peristaltic activity in the reconstructed gastrointestinal tract with quantitative measurements. Sixteen patients with gastrointestinal reconstruction were studied with kinematic MR imaging using HASTE and/or true FISP. Peristaltic waves were noted in the retrosternal gastric segment after gastric pull through (frequency = 3.0 +/- 0.5 times/min, velocity = 2.6 +/- 0.6 mm/s) and in the residual antrum after cardiectomy (frequency = 3 times/min, velocity = 4.0 mm/s). Peristaltic waves were not apparent in the residual fundus after distal gastrectomy and in the reconstructed jejunum after pancreatoduodenectomy and gastrojejunostomy.

Aged↗

Volumetric expiratory HRCT imaging with MSCT.

Expiratory HRCT is a powerful adjunct to inspiratory HRCT for detecting various small airway diseases. Current standard expiratory HRCT protocol consists of a limited number of non-contiguous scans at selected levels. We have developed a new volumetric expiratory HRCT protocol that allows volumetric data acquisition of lungs both at end-inspiration and end-expiration. By reducing the x-ray tube current, the radiation dose of this new protocol is equivalent to the standard expiratory HRCT protocol at our institution. This volumetric expiratory HRCT has been applied in patients with diffuse lung disease with small airway abnormalities. In this review, we describe: (1) technical considerations of VEHRCT including dose reduction, (2) the advantages of contiguous scans and multiplanar reformations, (3) clinical application of volumetric expiratory HRCT in various diffuse lung diseases, and (4) future directions including computational qualitative assessment of lung biomechanics.

Exhalation↗

A simple method for displaying cine images on web-based teaching files.

OBJECTIVE: Our objective was to develop a simple method for displaying dynamic cine images on Web-based teaching files. CONCLUSION: We developed a simple method for displaying cine images on Web-based teaching files using an open-source utility, the Java applet. This interactive utility offers improved 3D visualizations compared with the traditional approach using thumbnail and static images. Because Java is a built-in component of common Web browsers and computer systems, no other software was required. We have used this applet successfully for more than 2 years in our Web-based teaching system, including in our teaching files and on our case-of-the-week page.

Computer-Assisted Instruction↗

Use of personal digital assistants in diagnostic radiology resident education.

RATIONALE AND OBJECTIVES: Personal digital assistants (PDAs) are gaining widespread use in the medical community. We introduced a PDA-based mobile system that provides departmental and educational information with a seamless connection to the intranet. The objective of this study is to determine the impact a PDA has on educational resources (learning or data reference) brought to work and used at home by a radiology resident based on user surveys. MATERIALS AND METHODS: Survey was performed on 32 radiology residents in our department before and 6 months after the release of the PDA-based system. We assessed the changes in (1) sources of learning at home and at work, and in (2) data reference. The second survey also evaluated the usefulness of each component of the system. RESULTS: After the release of the PDA-based mobile system, the use of "digital books and references" as data references and educational resources that were brought to work every day significantly increased (P = .016, P < .0001, respectively). "Traditional books and references" remained the "most useful source in learning radiology"; however, "digital books and references" increased as the residents' first choice from 0% to 16% within 6 months of introducing the package (P = .125). CONCLUSION: The introduction of a PDA-based system consisting of educational and departmental information had a statistically significant impact in increasing the use of digitized information in radiology resident education.

Computers, Handheld↗

Comprehensive innovative solution for resident education using the Intranet Journal of Chest Radiology.

RATIONALE AND OBJECTIVES: Because of the rapid increase in clinical workload in academic radiology departments, time for teaching rotating residents is getting more and more limited. As a solution to this problem, we introduced the Intranet Journal of Chest Radiology as a comprehensive innovative tool for assisting resident education. MATERIALS AND METHODS: The Intranet Journal of Chest Radiology is constructed using Microsoft FrontPage version 2002 (Microsoft Corp, Redmond, WA) and is hosted in our departmental web server (Beth Israel Deaconess Medical Center, Boston, MA). The home page of the intranet journal provides access to the main features, "Cases of the Month," "Teaching File," "Selected Articles for Residents," "Lecture Series," and "Current Publications." These features provide quick access to the selected radiology articles, the interesting chest cases, and the lecture series and current publication from the chest section. RESULTS: Our intranet journal has been well utilized for 6 months after its introduction. It enhances residents' interest and motivation to work on case collections, to search and read articles, and to generate interest in research. Frequent updating is necessary for the journal to be kept current, relevant, and well-utilized. CONCLUSION: The intranet journal serves as a comprehensive innovative solution for resident education, providing basic educational resources and opportunities of interactive participation by residents.

Computer Communication Networks↗

Sagittal reformations of volumetric inspiratory and expiratory high-resolution CT of the lung.

RATIONALE AND OBJECTIVES: The purpose of this study is to determine whether sagittal reformations of volumetric high-resolution computed tomography (CT) provide additional information in evaluating lung abnormalities compared to axial high-resolution CT images. MATERIALS AND METHODS: Twenty-two consecutive patients who underwent combined inspiratory and expiratory volumetric high-resolution CT from May to July 2003 were studied. Using end-inspiratory and end-expiratory sagittal reformatted images, respiratory motion artifacts were evaluated at upper, middle, and lower lung areas bilaterally. Diaphragmatic motion artifacts were evaluated bilaterally. The detection of major and minor fissures was assessed. Additional findings on sagittal reformations were graded using a three-point scale: grade 1 = no additional findings; grade 2 = additional findings of no diagnostic significance; grade 3 = additional findings of diagnostic significance. RESULTS: Respiratory motion artifacts were either imperceptible or present but not diagnostically limiting except for one case, in which diagnostically limiting image degradation was noted in the bilateral lower lung areas. Diaphragmatic motion artifacts were frequently present: 95% (21/22) at end-inspiration, and 86% (19/22) at end-expiration; however, diagnostically limiting artifacts were observed in only two cases. The grading of additional findings on sagittal reformatted images was statistically significant (grade 1, n = 13; grade 2, n = 7; grade 3, n = 2; median, 1; P = .004) compared to axial images. Additional findings included relationship between mass/nodules and fissure/pleura/pericardium (grade 2, n = 4; grade 3, n = 2), distribution of interstitial abnormalities of the lung (grade 2, n = 2), and diaphragmatic eventration (grade 2, n = 1). CONCLUSION: Sagittal reformatted images of volumetric high-resolution CT provided additional information compared to volumetric axial images alone with statistical significance.

Adult↗

Volumetric expiratory high-resolution CT of the lung.

We developed a volumetric expiratory high-resolution CT (HRCT) protocol that provides combined inspiratory and expiratory volumetric imaging of the lung without increasing radiation exposure, and conducted a preliminary feasibility assessment of this protocol to evaluate diffuse lung disease with small airway abnormalities. The volumetric expiratory high-resolution CT increased the detectability of the conducting airway to the areas of air trapping (P<0.0001), and added significant information about extent and distribution of air trapping (P<0.0001).

Adult↗