• Journal of the Korean Society of Radiology
• /
• v.85 no.2
• /
• pp.258-269
• /
• 2024

Treatment of patients with coronary artery disease commonly involves the use of balloon-expandable stent placements, currently recognized as the most prevalent approach for coronary artery revascularization. Nevertheless, the occurrence of restenosis remains a significant complication following percutaneous coronary interventions. The diagnostic role of coronary CT angiography (CCTA) in detecting stent restenosis has limitations primarily attributable to challenges in accurately discerning the lumen, due to issues such as blooming and motion artifacts. As a result, many cases often necessitate a transition to conventional coronary angiography. However, recent advancements in CT technology have led to notable improvements in both sensitivity and specificity, underscoring the growing significance of CCTA as a diagnostic tool. The consistent reporting of high negative predictive value is particularly noteworthy. This review aims to explore the historical context, current status, and recent trends in diagnosing coronary artery stent restenosis using CCTA.

• Korean Journal of Radiology
• /
• v.23 no.2
• /
• pp.256-263
• /
• 2022

Objective: This study aimed to evaluate the image quality and dose reduction of low-dose three-dimensional (3D) rotational angiography (RA) for evaluating intracranial aneurysms. Materials and Methods: We retrospectively evaluated the clinical data and 3D RA datasets obtained from 146 prospectively registered patients (male:female, 46:100; median age, 58 years; range, 19-81 years). The subjective image quality of 79 examinations obtained from a conventional method and 67 examinations obtained from a low-dose (5-seconds and 0.10-μGy/frame) method was assessed by two neurointerventionists using a 3-point scale for four evaluation criteria. The total image quality score was then obtained as the average of the four scores. The image quality scores were compared between the two methods using a noninferiority statistical testing, with a margin of -0.2 (i.e., score of low-dose group - score of conventional group). For the evaluation of dose reduction, dose-area product (DAP) and air kerma (AK) were analyzed and compared between the two groups. Results: The mean total image quality score ± standard deviation of the 3D RA was 2.97 ± 0.17 by reader 1 and 2.95 ± 0.20 by reader 2 for conventional group and 2.92 ± 0.30 and 2.95 ± 0.22, respectively, for low-dose group. The image quality of the 3D RA in the low-dose group was not inferior to that of the conventional group according to the total image quality score as well as individual scores for the four criteria in both readers. The mean DAP and AK per rotation were 5.87 Gy-cm² and 0.56 Gy, respectively, in the conventional group, and 1.32 Gy-cm² (p < 0.001) and 0.17 Gy (p < 0.001), respectively, in the low-dose group. Conclusion: Low-dose 3D RA was not inferior in image quality and reduced the radiation dose by 70%-77% compared to the conventional 3D RA in evaluating intracranial aneurysms.

• Investigative Magnetic Resonance Imaging
• /
• v.1 no.1
• /
• pp.75-78
• /
• 1997

A dual birdcage RF coil is proposed for MRI and MRA of the human leg. The proposed coil c can be used to cover the whole human leg by imaging upper and lower parts of the leg separately. In the conventional leg imaging scheme using a single RF coil, the leg has to be r relocated when changing the position of the RF coil thus causing problems in matching the i images from two sets of coils. When using the proposed dual RF coil, however, only the bed h has to be moved to select the imaging region while only one part of the dual coil is used each t time by using current switching and PIN diodes. The utility of proposed coil has been verified b by volunteer MRI and MRA and the imaging results show that the coil is useful for the clinical MRI and MRA of the leg.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.5
• /
• pp.471-475
• /
• 2015

Intracerebral hemorrhage (ICH) is common among various types of storkes; however, it is rare in young patients and patients who do not have any risk factors. In such cases, ICH is generally caused by vascular malformations, tumors, vasculitis, or drug abuse. Basal ganglia ICH is rarely related with distal lenticulostriate artery (LSA) aneurysm. Since the 1960s, a total of 29 distal LSA aneurysm cases causing ICH have been reported in the English literature. Despite of the small number of cases, various treatment methods have been attempted : surgical clipping, endovascular treatment, conservative treatment, superficial temporal artery-middle cerebral artery anastomosis, and gamma-knife radiosurgery. Here, we report two additional cases and review the literature. Thereupon, we discerned that young patients with deep ICH are in need of conventional cerebral angiography. Moreover, initial conservative treatment with follow-up cerebral angiography might be a good treatment option except for cases with a large amount of hematoma that necessitates emergency evacuation. If the LSA aneurysm still persists or enlarges on follow-up angiography, it should be treated surgically or endovascularly.

• Proceedings of the KOSOMBE Conference
• /
• v.1989 no.05
• /
• pp.35-37
• /
• 1989

A new MR angiography technique using a composite sequence for the suppression of static sample signals is proposed and verified with experiments. When the composite [$90^{\circ}-{\tau}-180^{\circ}-2{\tau}-180^{\circ}-{\tau}$] sequence is applied, the large signal from the static sample is sufficiently suppressed but the signal from fresh inflow sample of which amplitude. is observed without suppression. These properties are appropriate for angiographic applications. In this paper, a modified line scan method (Block line scan angiography) incorporated with the composite [$90^{\circ}-{\tau}-180^{\circ}-2{\tau}-180^{\circ}-{\tau}$] sequence is used to obtain flow-only images, i.e., angiograms. The block line scan method improves the resolution in the flow-direction at the expense of imaging time. With the composite sequence, there is no need for subtraction procedure as in the most conventional angiographic methods. Experimental results for a phantom and a normal volunteer with KAIS 2.0 Tesla MRI system are shown.

• Journal of radiological science and technology
• /
• v.44 no.5
• /
• pp.465-471
• /
• 2021

Dual-energy X-ray imaging (DEI) techniques can provide X-ray images that a certain material is suppressed or emphasized by combining two X-ray images obtained from two different x-ray spectrum. In this paper, a single-shot DEI, which uses stacked two detectors (i.e., multilayer detector), is proposed to reduce the patient dose and increase throughput in angiography. The polymethyl methacrylate (PMMA) and aluminum (Al) were selected as two basis materials for material decomposition, and material-specific images are reconstructed as a vector combination of these two materials. We investigate the contrast and noise performance of material-decomposed images using iodine phantoms with various concentrations and diameters. The single-shot DEI shows comparable performances to the conventional dual-shot DEI. In particular, the single-shot DEI shows edge enhancement in material-decomposed images due to the different spatial-resolution characteristics of upper and lower detectors. This study could be useful for designing the multilayer detector including scintillators and energy-separation filter for angiography purposes.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.4
• /
• pp.342-345
• /
• 2007

The azygos anterior cerebral artery, a rare anomaly in the circle of Willis in which only a single vessel supplies the medial aspects of both anterior cerebral hemispheres, is closely associated with saccular aneurysms. We present three cases of azygos anterior cerebral artery aneurysms among the 781 cerebral aneurysms surgically treated at our institution in an 11-year period. These three cases all involved elderly women who presented with subarachnoid hemorrhage. Conventional cerebral angiography and CT angiography revealed small saccular aneurysms at the distal ends of the azygos anterior cerebral arteries. These aneurysms were clipped successfully using a bifrontal interhemispheric approach. Hence, the pathogenesis of these particular aneurysms relating to hemodynamic change, associated anomalies, and surgical pitfalls is discussed with review of literature.

• Journal of the Korean Society of Radiology
• /
• v.13 no.5
• /
• pp.713-720
• /
• 2019

The purpose of this study was to propose a new measurement method for accurate measurement of vessel diameter in computed tomography angiography(CTA). CTA test was performed after non-ionic iodine contrast agent was flowed at a constant rate to self-maded perfusion phantom. After obtaining raw data, images were reconstructed with multi-planar reconstruction(MPR) and maximal intensity projection(MIP). Diameters of vascular models were measured for each technique. Relative and conventional measurements were then compared. The mean diameter of the vascular model was closer to the actual measurement when relative measurement was used compared to that when conventional measurement was used both in MPR and MIP. Relative measurements of MPR and MIP were closer to actual measurement than those of conventional measurement (34% VS, 24%, p<0.05). The relative measurement method proposed in this study was closer to the actual measurement than the conventional measurement method. However, both test methods were still larger than actual results. Therefore, further study of relative measurement method is needed using this study as basic data.

• Journal of the Korean Society of Radiology
• /
• v.81 no.1
• /
• pp.119-134
• /
• 2020

It is essential to identify the causative artery in case of active intra-abdominal or gastrointestinal bleeding. A thorough understanding of the basic arterial anatomy is required to identify the causative artery on contrast-enhanced CT angiography and conventional catheter angiography. If one is familiar with the basic arterial anatomy, obtaining access to the bleeding artery will be easier, despite the variations in the origin and course of the vessels. We describe the basic arterial anatomy that will help beginners in diagnostic radiology to identify the blood vessels that can cause active intra-abdominal or gastrointestinal bleeding.

• Korean Journal of Radiology
• /
• v.24 no.7
• /
• pp.681-689
• /
• 2023

Objective: Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. Materials and Methods: The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients' 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. Results: The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy (P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm², P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. Conclusion: The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.