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Biomedical subjects

Thorsten R C Johnson

Publications and source records attributed to Thorsten R C Johnson.

7 recordsLinked to original sources

ECG-gated 64-MDCT angiography in the differential diagnosis of acute chest pain.

OBJECTIVE: The most important differential diagnoses of acute chest pain include myocardial infarction, aortic dissection, and pulmonary embolism. The purpose of this study was to evaluate the diagnostic value of an ECG-gated 64-MDCT angiography protocol for simultaneous assessment of the pulmonary arteries, coronary arteries, and aorta within a single breath-hold. SUBJECTS AND METHODS: In 55 patients with acute chest pain, ECG-gated CT angiography was performed with a CT system in which 64 slices per gantry rotation were acquired. Density measurement and visual assessment of motion artifacts were performed to evaluate image quality. CT findings were correlated with results of laboratory tests and clinical follow-up. For 20 patients, two independent blinded reviewers compared findings on CT angiography with those on X-ray coronary angiography. RESULTS: Adequate contrast enhancement of the pulmonary vessels, coronary arteries, and aorta was achieved in all cases. Regarding image quality of the coronary arteries, there was minor blurring in seven patients, and in one examination the images did not provide enough information for diagnosis. The average image quality rating was 1.2 on a scale in which 1 indicated no artifacts; 2, minor motion artifacts; and 3, image insufficient for diagnosis. The cause of chest pain was correctly identified with MDCT in 37 patients. The diagnoses included pulmonary embolism (n = 10), coronary stenosis (n = 9), and aortic dissection (n = 1). In four patients, additional diagnoses were found with other examinations. CONCLUSION: With current techniques, ECG-gated CT angiography of the entire chest has very good image quality. The protocol proved helpful in the differential diagnosis of acute chest pain.

Acute Disease↗

Visual and automatic grading of coronary artery stenoses with 64-slice CT angiography in reference to invasive angiography.

The aim of this study was to assess the performance of a software tool for quantitative coronary artery analysis of computed tomography coronary angiography (CT-QCA) in comparison with invasive coronary angiography with quantitative analysis (CAG-QCA) as standard of reference. Two radiologists reviewed the CT angiography data sets (Siemens Sensation 64) of 25 patients, grading coronary artery stenoses visually and with a software tool (Circulation, Siemens). Twenty-three data sets with sufficient image quality were included in the final analysis. CAG revealed a total of 30 wall irregularities and 28 stenoses, of which 17 were graded as moderate and nine as hemodynamically significant. CT-QCA showed a better agreement to CAG-QCA, with a systematic overestimation of the degree of stenosis of 6.1% and limits of agreement of +36.1% and -23.9; the correlation coefficient was 0.82 (p < 0.0001). Using CT-QCA, sensitivity, specificity, and positive and negative predictive value were 89%, 100%, 89%, and 100%, respectively, for significant area stenoses greater than 75%. The positive predictive value for the visual assessment amounted to 53%. Interobserver variability between CT-QCA and visual assessment showed a kappa value of 0.72. In conclusion, software-supported CT-QCA makes it possible to quantify significant coronary artery stenoses automatically, with good agreement to CAG-QCA.

Contrast Media↗

Material differentiation by dual energy CT: initial experience.

The aim of this study was to assess the feasibility of a differentiation of iodine from other materials and of different body tissues using dual energy CT. Ten patients were scanned on a SOMATOM Definition Dual Source CT (DSCT; Siemens, Forchheim, Germany) system in dual energy mode at tube voltages of 140 and 80 kVp and a ratio of 1:3 between tube currents. Weighted CT Dose Index ranged between 7 and 8 mGy, remaining markedly below reference dose values for the respective body regions. Image post-processing with three-material decomposition was applied to differentiate iodine or collagen from other tissue. The results showed that a differentiation and depiction of contrast material distribution is possible in the brain, the lung, the liver and the kidneys with or without the underlying tissue of the organ. In angiographies, bone structures can be removed from the dataset to ease the evaluation of the vessels. The differentiation of collagen makes it possible to depict tendons and ligaments. Dual energy CT offers a more specific tissue characterization in CT and can improve the assessment of vascular disease. Further studies are required to draw conclusions on the diagnostic value of the individual applications.

Algorithms↗

Obstetrical and gynecological writing and publishing in Europe.

OBJECTIVE: To assess the number and quality of scientific articles published by authors from the European Union (EU) and Germany in the field of obstetrics and gynecology. STUDY DESIGN: Scientific articles published during the years 1980-2003 covered by the Journal Citation Report (JCR) were considered, with a focus on the impact factor (IF), authors' origin, journal country and publishing language. RESULTS: In 2003, there are 53 journals listed by the JCR for the field category 'obstetrics and gynecology', with altogether 3201 publications listed in the Science Citation Index (SCI). From the year 1980, the total number of publications increased persistently. Looking at the top 20 journals in the field of obstetrics and gynecology, there are 12 journals from the US, 8 from Europe. None of these journals has an IF>10 but 30 journals show an IF>1. Over the last 25 years, a growing importance of the English language as scientific language can be observed. CONCLUSION: These data indicate an important role of European research in the field of obstetrics and gynecology comparable to that of US-American research. The English language is gaining importance as scientific language, displacing other languages and contributing to a loss of impact of non-English journals.

Bibliometrics↗

Dual-source CT cardiac imaging: initial experience.

The relation of heart rate and image quality in the depiction of coronary arteries, heart valves and myocardium was assessed on a dual-source computed tomography system (DSCT). Coronary CT angiography was performed on a DSCT (Somatom Definition, Siemens) with high concentration contrast media (Iopromide, Ultravist 370, Schering) in 24 patients with heart rates between 44 and 92 beats per minute. Images were reconstructed over the whole cardiac cycle in 10% steps. Two readers independently assessed the image quality with regard to the diagnostic evaluation of right and left coronary artery, heart valves and left ventricular myocardium for the assessment of vessel wall changes, coronary stenoses, valve morphology and function and ventricular function on a three point grading scale. The image quality ratings at the optimal reconstruction interval were 1.24+/-0.42 for the right and 1.09+/-0.27 for the left coronary artery. A reconstruction of diagnostic systolic and diastolic images is possible for a wide range of heart rates, allowing also a functional evaluation of valves and myocardium. Dual-source CT offers very robust diagnostic image quality in a wide range of heart rates. The high temporal resolution now also makes a functional evaluation of the heart valves and myocardium possible.

Algorithms↗

Magnetic resonance imaging findings in solitary fibrous tumor of the kidney.

The magnetic resonance imaging findings in a patient with a large solitary fibrous tumor (SFT) of the kidney originating in the renal capsule are presented. SFT of the kidney is a rare, usually benign tumor with indolent clinical behavior. MRI revealed a diffusely hypointense mass on T2-weighted images without central necrosis despite the large size of the lesion. These imaging features, atypical for renal cell carcinoma, can suggest the diagnosis of SFT and may be an indication for attempting nephron-sparing surgery.

Female↗