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Showing 1 - 200 of 2353 Journals sorted alphabetically
3D Research     Hybrid Journal   (Followers: 19, SJR: 0.214, h-index: 10)
4OR: A Quarterly J. of Operations Research     Hybrid Journal   (Followers: 9, SJR: 1.073, h-index: 25)
AAPS J.     Hybrid Journal   (Followers: 20, SJR: 1.192, h-index: 74)
AAPS PharmSciTech     Hybrid Journal   (Followers: 6, SJR: 0.718, h-index: 54)
Abdominal Imaging     Hybrid Journal   (Followers: 14, SJR: 0.723, h-index: 60)
Abhandlungen aus dem Mathematischen Seminar der Universitat Hamburg     Hybrid Journal   (Followers: 3, SJR: 0.447, h-index: 12)
Academic Psychiatry     Full-text available via subscription   (Followers: 22, SJR: 0.492, h-index: 32)
Academic Questions     Hybrid Journal   (Followers: 7, SJR: 0.135, h-index: 6)
Accreditation and Quality Assurance: J. for Quality, Comparability and Reliability in Chemical Measurement     Hybrid Journal   (Followers: 26, SJR: 0.378, h-index: 30)
Acoustical Physics     Hybrid Journal   (Followers: 11, SJR: 0.355, h-index: 20)
Acoustics Australia     Hybrid Journal  
Acta Analytica     Hybrid Journal   (Followers: 7, SJR: 0.387, h-index: 6)
Acta Applicandae Mathematicae     Hybrid Journal   (Followers: 1, SJR: 0.624, h-index: 34)
Acta Biotheoretica     Hybrid Journal   (Followers: 5, SJR: 0.419, h-index: 25)
Acta Diabetologica     Hybrid Journal   (Followers: 14, SJR: 1.318, h-index: 46)
Acta Endoscopica     Hybrid Journal   (Followers: 1, SJR: 0.113, h-index: 8)
acta ethologica     Hybrid Journal   (Followers: 4, SJR: 0.465, h-index: 23)
Acta Geochimica     Hybrid Journal   (Followers: 4)
Acta Geodaetica et Geophysica     Hybrid Journal   (Followers: 1, SJR: 0.294, h-index: 13)
Acta Geotechnica     Hybrid Journal   (Followers: 7, SJR: 1.818, h-index: 22)
Acta Informatica     Hybrid Journal   (Followers: 5, SJR: 0.524, h-index: 32)
Acta Mathematica     Hybrid Journal   (Followers: 11, SJR: 8.021, h-index: 47)
Acta Mathematica Hungarica     Hybrid Journal   (Followers: 2, SJR: 0.53, h-index: 29)
Acta Mathematica Sinica, English Series     Hybrid Journal   (Followers: 5, SJR: 0.406, h-index: 30)
Acta Mathematica Vietnamica     Hybrid Journal   (SJR: 0.451, h-index: 5)
Acta Mathematicae Applicatae Sinica, English Series     Hybrid Journal   (SJR: 0.22, h-index: 20)
Acta Mechanica     Hybrid Journal   (Followers: 19, SJR: 0.898, h-index: 52)
Acta Mechanica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.426, h-index: 29)
Acta Metallurgica Sinica (English Letters)     Hybrid Journal   (Followers: 5, SJR: 0.525, h-index: 18)
Acta Meteorologica Sinica     Hybrid Journal   (Followers: 3, SJR: 0.524, h-index: 14)
Acta Neurochirurgica     Hybrid Journal   (Followers: 6, SJR: 0.833, h-index: 73)
Acta Neurologica Belgica     Hybrid Journal   (SJR: 0.348, h-index: 27)
Acta Neuropathologica     Hybrid Journal   (Followers: 5, SJR: 6.61, h-index: 117)
Acta Oceanologica Sinica     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 17)
Acta Parasitologica     Hybrid Journal   (Followers: 9, SJR: 0.581, h-index: 28)
Acta Physiologiae Plantarum     Hybrid Journal   (Followers: 2, SJR: 0.551, h-index: 39)
Acta Politica     Hybrid Journal   (Followers: 13, SJR: 0.658, h-index: 20)
Activitas Nervosa Superior     Hybrid Journal  
adhäsion KLEBEN & DICHTEN     Hybrid Journal   (Followers: 5, SJR: 0.103, h-index: 4)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 21, SJR: 0.871, h-index: 15)
Adhesion Adhesives & Sealants     Hybrid Journal   (Followers: 7)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 15, SJR: 0.795, h-index: 40)
Adsorption     Hybrid Journal   (Followers: 4, SJR: 0.774, h-index: 52)
Advances in Applied Clifford Algebras     Hybrid Journal   (Followers: 3, SJR: 0.319, h-index: 15)
Advances in Atmospheric Sciences     Hybrid Journal   (Followers: 34, SJR: 0.959, h-index: 44)
Advances in Computational Mathematics     Hybrid Journal   (Followers: 15, SJR: 1.255, h-index: 44)
Advances in Contraception     Hybrid Journal   (Followers: 3)
Advances in Data Analysis and Classification     Hybrid Journal   (Followers: 53, SJR: 1.113, h-index: 14)
Advances in Gerontology     Partially Free   (Followers: 9, SJR: 0.141, h-index: 3)
Advances in Health Sciences Education     Hybrid Journal   (Followers: 22, SJR: 1.397, h-index: 42)
Advances in Manufacturing     Hybrid Journal   (Followers: 3, SJR: 0.2, h-index: 4)
Advances in Polymer Science     Hybrid Journal   (Followers: 41, SJR: 0.637, h-index: 89)
Advances in Therapy     Hybrid Journal   (Followers: 5, SJR: 0.79, h-index: 44)
Aegean Review of the Law of the Sea and Maritime Law     Hybrid Journal   (Followers: 7)
Aequationes Mathematicae     Hybrid Journal   (Followers: 2, SJR: 0.882, h-index: 23)
Aerobiologia     Hybrid Journal   (Followers: 1, SJR: 0.511, h-index: 36)
Aesthetic Plastic Surgery     Hybrid Journal   (Followers: 9, SJR: 0.821, h-index: 49)
African Archaeological Review     Hybrid Journal   (Followers: 15, SJR: 0.612, h-index: 24)
Afrika Matematika     Hybrid Journal   (Followers: 1, SJR: 0.248, h-index: 6)
AGE     Hybrid Journal   (Followers: 7, SJR: 1.358, h-index: 33)
Ageing Intl.     Hybrid Journal   (Followers: 7, SJR: 0.337, h-index: 10)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
Aging Clinical and Experimental Research     Hybrid Journal   (Followers: 3, SJR: 0.529, h-index: 55)
Agricultural Research     Hybrid Journal   (Followers: 3)
Agriculture and Human Values     Hybrid Journal   (Followers: 12, SJR: 1.197, h-index: 49)
Agroforestry Systems     Hybrid Journal   (Followers: 20, SJR: 0.64, h-index: 56)
Agronomy for Sustainable Development     Hybrid Journal   (Followers: 10, SJR: 1.732, h-index: 59)
AI & Society     Hybrid Journal   (Followers: 7, SJR: 0.171, h-index: 19)
AIDS and Behavior     Hybrid Journal   (Followers: 13, SJR: 2.006, h-index: 71)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3, SJR: 0.706, h-index: 19)
Akupunktur & Aurikulomedizin     Full-text available via subscription   (Followers: 1)
Algebra and Logic     Hybrid Journal   (Followers: 4, SJR: 0.566, h-index: 18)
Algebra Universalis     Hybrid Journal   (Followers: 2, SJR: 0.388, h-index: 22)
Algebras and Representation Theory     Hybrid Journal   (Followers: 1, SJR: 0.868, h-index: 20)
Algorithmica     Hybrid Journal   (Followers: 8, SJR: 0.898, h-index: 56)
Allergo J.     Full-text available via subscription   (Followers: 1, SJR: 0.183, h-index: 20)
Allergo J. Intl.     Hybrid Journal   (Followers: 2)
Alpine Botany     Hybrid Journal   (Followers: 4, SJR: 0.729, h-index: 20)
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 3, SJR: 1.392, h-index: 32)
AMBIO     Hybrid Journal   (Followers: 15, SJR: 1.094, h-index: 87)
American J. of Cardiovascular Drugs     Hybrid Journal   (Followers: 13, SJR: 0.864, h-index: 39)
American J. of Community Psychology     Hybrid Journal   (Followers: 23, SJR: 1.237, h-index: 83)
American J. of Criminal Justice     Hybrid Journal   (Followers: 6, SJR: 0.634, h-index: 13)
American J. of Cultural Sociology     Hybrid Journal   (Followers: 11, SJR: 0.283, h-index: 3)
American J. of Dance Therapy     Hybrid Journal   (Followers: 4, SJR: 0.175, h-index: 13)
American J. of Potato Research     Hybrid Journal   (Followers: 2, SJR: 0.558, h-index: 35)
American J. of Psychoanalysis     Hybrid Journal   (Followers: 21, SJR: 0.293, h-index: 13)
American Sociologist     Hybrid Journal   (Followers: 12, SJR: 0.18, h-index: 13)
Amino Acids     Hybrid Journal   (Followers: 8, SJR: 1.362, h-index: 83)
AMS Review     Partially Free   (Followers: 4)
Analog Integrated Circuits and Signal Processing     Hybrid Journal   (Followers: 7, SJR: 0.21, h-index: 37)
Analysis and Mathematical Physics     Hybrid Journal   (Followers: 3, SJR: 0.665, h-index: 7)
Analysis in Theory and Applications     Hybrid Journal   (Followers: 1)
Analysis of Verbal Behavior     Hybrid Journal   (Followers: 5)
Analytical and Bioanalytical Chemistry     Hybrid Journal   (Followers: 29, SJR: 1.096, h-index: 123)
Anatomical Science Intl.     Hybrid Journal   (Followers: 2, SJR: 0.301, h-index: 26)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3, SJR: 2.212, h-index: 69)
Animal Cognition     Hybrid Journal   (Followers: 16, SJR: 1.122, h-index: 55)
Annales françaises de médecine d'urgence     Hybrid Journal   (Followers: 1, SJR: 0.156, h-index: 4)
Annales Henri Poincaré     Hybrid Journal   (Followers: 3, SJR: 1.377, h-index: 32)
Annales mathématiques du Québec     Hybrid Journal   (Followers: 4)
Annali dell'Universita di Ferrara     Hybrid Journal   (SJR: 0.504, h-index: 14)
Annali di Matematica Pura ed Applicata     Hybrid Journal   (Followers: 1, SJR: 1.167, h-index: 26)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 11, SJR: 2.112, h-index: 98)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18, SJR: 1.182, h-index: 94)
Annals of Combinatorics     Hybrid Journal   (Followers: 3, SJR: 0.849, h-index: 15)
Annals of Data Science     Hybrid Journal   (Followers: 9)
Annals of Dyslexia     Hybrid Journal   (Followers: 9, SJR: 0.857, h-index: 40)
Annals of Finance     Hybrid Journal   (Followers: 28, SJR: 0.686, h-index: 14)
Annals of Forest Science     Hybrid Journal   (Followers: 4, SJR: 0.929, h-index: 57)
Annals of Global Analysis and Geometry     Hybrid Journal   (Followers: 1, SJR: 1.136, h-index: 23)
Annals of Hematology     Hybrid Journal   (Followers: 14, SJR: 1.117, h-index: 62)
Annals of Mathematics and Artificial Intelligence     Hybrid Journal   (Followers: 6, SJR: 0.593, h-index: 42)
Annals of Microbiology     Hybrid Journal   (Followers: 10, SJR: 0.402, h-index: 26)
Annals of Nuclear Medicine     Hybrid Journal   (Followers: 5, SJR: 0.68, h-index: 45)
Annals of Operations Research     Hybrid Journal   (Followers: 8, SJR: 1.186, h-index: 78)
Annals of Ophthalmology     Hybrid Journal   (Followers: 11)
Annals of Regional Science     Hybrid Journal   (Followers: 7, SJR: 0.405, h-index: 42)
Annals of Software Engineering     Hybrid Journal   (Followers: 12)
Annals of Solid and Structural Mechanics     Hybrid Journal   (Followers: 10, SJR: 0.553, h-index: 8)
Annals of Surgical Oncology     Hybrid Journal   (Followers: 15, SJR: 1.902, h-index: 127)
Annals of Telecommunications     Hybrid Journal   (Followers: 7, SJR: 0.315, h-index: 25)
Annals of the Institute of Statistical Mathematics     Hybrid Journal   (Followers: 1, SJR: 0.931, h-index: 31)
Antonie van Leeuwenhoek     Hybrid Journal   (Followers: 5, SJR: 0.992, h-index: 87)
Apidologie     Hybrid Journal   (Followers: 4, SJR: 1.14, h-index: 57)
APOPTOSIS     Hybrid Journal   (Followers: 8, SJR: 1.554, h-index: 87)
Applicable Algebra in Engineering, Communication and Computing     Hybrid Journal   (Followers: 2, SJR: 0.354, h-index: 27)
Applications of Mathematics     Hybrid Journal   (Followers: 1, SJR: 0.274, h-index: 20)
Applied Biochemistry and Biotechnology     Hybrid Journal   (Followers: 44, SJR: 0.575, h-index: 80)
Applied Biochemistry and Microbiology     Hybrid Journal   (Followers: 17, SJR: 0.267, h-index: 26)
Applied Cancer Research     Open Access  
Applied Categorical Structures     Hybrid Journal   (Followers: 2, SJR: 0.361, h-index: 21)
Applied Composite Materials     Hybrid Journal   (Followers: 48, SJR: 0.705, h-index: 35)
Applied Entomology and Zoology     Partially Free   (Followers: 2, SJR: 0.554, h-index: 34)
Applied Geomatics     Hybrid Journal   (Followers: 3, SJR: 0.323, h-index: 9)
Applied Geophysics     Hybrid Journal   (Followers: 8, SJR: 0.541, h-index: 13)
Applied Intelligence     Hybrid Journal   (Followers: 11, SJR: 0.777, h-index: 43)
Applied Magnetic Resonance     Hybrid Journal   (Followers: 4, SJR: 0.358, h-index: 34)
Applied Mathematics & Optimization     Hybrid Journal   (Followers: 4, SJR: 0.955, h-index: 33)
Applied Mathematics - A J. of Chinese Universities     Hybrid Journal   (SJR: 0.275, h-index: 8)
Applied Mathematics and Mechanics     Hybrid Journal   (Followers: 4, SJR: 0.37, h-index: 26)
Applied Microbiology and Biotechnology     Hybrid Journal   (Followers: 62, SJR: 1.262, h-index: 161)
Applied Physics A     Hybrid Journal   (Followers: 7, SJR: 0.535, h-index: 121)
Applied Physics B: Lasers and Optics     Hybrid Journal   (Followers: 23, SJR: 0.983, h-index: 104)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 8, SJR: 0.677, h-index: 47)
Applied Research in Quality of Life     Hybrid Journal   (Followers: 10, SJR: 0.288, h-index: 15)
Applied Solar Energy     Hybrid Journal   (Followers: 17, SJR: 0.251, h-index: 6)
Applied Spatial Analysis and Policy     Hybrid Journal   (Followers: 4, SJR: 0.351, h-index: 9)
Aquaculture Intl.     Hybrid Journal   (Followers: 22, SJR: 0.613, h-index: 40)
Aquarium Sciences and Conservation     Hybrid Journal   (Followers: 1)
Aquatic Ecology     Hybrid Journal   (Followers: 30, SJR: 0.646, h-index: 44)
Aquatic Geochemistry     Hybrid Journal   (Followers: 4, SJR: 0.764, h-index: 39)
Aquatic Sciences     Hybrid Journal   (Followers: 12, SJR: 1.172, h-index: 53)
Arabian J. for Science and Engineering     Hybrid Journal   (Followers: 5, SJR: 0.345, h-index: 20)
Arabian J. of Geosciences     Hybrid Journal   (Followers: 1, SJR: 0.417, h-index: 16)
Archaeological and Anthropological Sciences     Hybrid Journal   (Followers: 22, SJR: 1.056, h-index: 15)
Archaeologies     Hybrid Journal   (Followers: 12, SJR: 0.397, h-index: 13)
Archiv der Mathematik     Hybrid Journal   (Followers: 1, SJR: 0.597, h-index: 29)
Archival Science     Hybrid Journal   (Followers: 53, SJR: 0.804, h-index: 22)
Archive for History of Exact Sciences     Hybrid Journal   (Followers: 7, SJR: 0.28, h-index: 15)
Archive for Mathematical Logic     Hybrid Journal   (Followers: 1, SJR: 0.946, h-index: 23)
Archive for Rational Mechanics and Analysis     Hybrid Journal   (SJR: 4.091, h-index: 66)
Archive of Applied Mechanics     Hybrid Journal   (Followers: 5, SJR: 0.865, h-index: 40)
Archives and Museum Informatics     Hybrid Journal   (Followers: 124)
Archives of Computational Methods in Engineering     Hybrid Journal   (Followers: 4, SJR: 2.841, h-index: 40)
Archives of Dermatological Research     Hybrid Journal   (Followers: 6, SJR: 0.9, h-index: 65)
Archives of Environmental Contamination and Toxicology     Hybrid Journal   (Followers: 9, SJR: 0.846, h-index: 84)
Archives of Gynecology and Obstetrics     Hybrid Journal   (Followers: 17, SJR: 0.695, h-index: 47)
Archives of Microbiology     Hybrid Journal   (Followers: 8, SJR: 0.702, h-index: 85)
Archives of Orthopaedic and Trauma Surgery     Hybrid Journal   (Followers: 8, SJR: 1.039, h-index: 56)
Archives of Osteoporosis     Hybrid Journal   (Followers: 2, SJR: 1.092, h-index: 13)
Archives of Sexual Behavior     Hybrid Journal   (Followers: 9, SJR: 1.198, h-index: 74)
Archives of Toxicology     Hybrid Journal   (Followers: 16, SJR: 1.595, h-index: 76)
Archives of Virology     Hybrid Journal   (Followers: 5, SJR: 1.086, h-index: 90)
Archives of Women's Mental Health     Hybrid Journal   (Followers: 14, SJR: 1.264, h-index: 50)
Archivio di Ortopedia e Reumatologia     Hybrid Journal  
Archivum Immunologiae et Therapiae Experimentalis     Hybrid Journal   (Followers: 2, SJR: 1.2, h-index: 42)
ArgoSpine News & J.     Hybrid Journal   (SJR: 0.102, h-index: 3)
Argumentation     Hybrid Journal   (Followers: 5, SJR: 0.295, h-index: 18)
Arid Ecosystems     Hybrid Journal   (Followers: 3)
Arkiv för Matematik     Hybrid Journal   (Followers: 1, SJR: 0.948, h-index: 22)
Arnold Mathematical J.     Hybrid Journal   (Followers: 1)
Arthropod-Plant Interactions     Hybrid Journal   (Followers: 1, SJR: 0.797, h-index: 17)
Arthroskopie     Hybrid Journal   (Followers: 1, SJR: 0.145, h-index: 8)
Artificial Intelligence and Law     Hybrid Journal   (Followers: 10, SJR: 0.288, h-index: 25)
Artificial Intelligence Review     Hybrid Journal   (Followers: 14, SJR: 0.948, h-index: 48)
Artificial Life and Robotics     Hybrid Journal   (Followers: 8, SJR: 0.231, h-index: 14)
Asia Europe J.     Hybrid Journal   (Followers: 4, SJR: 0.247, h-index: 9)
Asia Pacific Education Review     Hybrid Journal   (Followers: 9, SJR: 0.371, h-index: 17)
Asia Pacific J. of Management     Hybrid Journal   (Followers: 14, SJR: 1.676, h-index: 50)
Asia-Pacific Education Researcher     Hybrid Journal   (Followers: 11, SJR: 0.353, h-index: 13)
Asia-Pacific Financial Markets     Hybrid Journal   (Followers: 2, SJR: 0.19, h-index: 15)
Asia-Pacific J. of Atmospheric Sciences     Hybrid Journal   (Followers: 20, SJR: 1.006, h-index: 14)
Asian Business & Management     Hybrid Journal   (Followers: 7, SJR: 0.41, h-index: 10)
Asian J. of Business Ethics     Hybrid Journal   (Followers: 7)
Asian J. of Criminology     Hybrid Journal   (Followers: 5, SJR: 0.263, h-index: 8)
AStA Advances in Statistical Analysis     Hybrid Journal   (Followers: 2, SJR: 0.681, h-index: 15)
AStA Wirtschafts- und Sozialstatistisches Archiv     Hybrid Journal   (Followers: 5, SJR: 0.195, h-index: 5)
ästhetische dermatologie & kosmetologie     Full-text available via subscription  

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Journal Cover Abdominal Imaging
  [SJR: 0.723]   [H-I: 60]   [14 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2366-004X - ISSN (Online) 2366-0058
   Published by Springer-Verlag Homepage  [2353 journals]
  • Transient severe motion in the arterial phase during gadoxetate
           disodium-enhanced MR imaging: evaluation of patients with multiple MR
    • Authors: Won Hyeong Im; Ji Soo Song; Eun Hae Park; Hyo Sung Kwak
      Pages: 2393 - 2401
      Abstract: Purpose To determine whether patients undergoing multiple gadoxetate disodium-enhanced magnetic resonance (MR) examinations who experienced transient severe motion (TSM) in the arterial phase were affected by the TSM noted in the first examination. Materials and methods 214 patients who underwent three or more repeated gadoxetate disodium-enhanced MR imaging were retrospectively analyzed. Three radiologists scored all of the examinations demonstrating a motion artifact using a five-point rating scale. Risk factor analysis and comparison of TSM recurrence rates were performed in the whole study population as well as in a subpopulation of patients with TSM. Results The overall incidence of TSM was 5.9% (54/922), which was observed in 40 patients. Thirty-two patients had one episode of TSM, and eight patients had recurrent TSM. Although TSM in the first examination increased the risk of recurrent TSM in the whole population (OR 24.45; P < 0.001), the incidence of recurrent TSM was low (2.4%, 22/922). On subpopulation analysis, TSM in the first examination did not influence recurrent TSM (OR 0.36; P = 0.250). Conclusion Patients undergoing multiple gadoxetate disodium-enhanced MR examinations who experienced recurrent TSM were not affected by TSM in the first examination. Therefore, a single episode of TSM should not be considered a risk factor of recurrent TSM.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1145-0
      Issue No: Vol. 42, No. 10 (2017)
  • CT features of hepatic metastases from hepatoid adenocarcinoma
    • Authors: Min-Yung Chang; Hye Jin Kim; Seung Hyun Park; Hyunki Kim; Dong Kyu Choi; Joon Seok Lim; Mi-Suk Park; Myeong-Jin Kim; Honsoul Kim
      Pages: 2402 - 2409
      Abstract: Purpose The purpose of this study was to report the imaging presentation of hepatic metastases from hepatoid adenocarcinoma (HAC). Methods We retrospectively identified 11 patients (10 men and 1 woman; median age 66) with HAC liver metastasis who underwent contrast-enhanced computed tomography (CT) which included arterial phase and portal venous phase. Two radiologists analyzed the imaging parameters, which included the enhancement pattern on arterial and portal phase images, necrosis, venous thrombi, and overall imaging diagnosis, and arrived at a consensus. Results On arterial phase, the liver lesions had global hyper-enhancement (n = 0), heterogeneous hyper-enhancement (63.6%; n = 7/11), peripheral hyper-enhancement (n = 0), iso-enhancement (n = 0/11), or hypo-enhancement (36.4%; n = 4/11). On portal venous phase, homogenous hypo-enhancement (18.2%; n = 2/11) and heterogenous hypo-enhancement (81.8%; n = 9/11) were observed. Venous thromboses occurred in four patients (36.4%; n = 4/11). The overall imaging diagnoses were “HCC-like” in seven patients (63.6%; n = 7/11), “indeterminable” in 1 patient (9.1%; n = 1/11), and “HCC-unlike” in three patients (27.3%; n = 3/11). Conclusions The imaging features of HAC liver metastasis were varied. Arterial phase enhancement coupled with venous phase washout (resembling HCC imaging features) was a major finding, but arterial phase hypo-enhancement (distinct from HCC imaging features) was also frequently encountered.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1150-3
      Issue No: Vol. 42, No. 10 (2017)
  • Periportal lymphatic system on post-hepatobiliary phase
           Gd-EOB-DTPA-enhanced MR imaging in normal subjects and patients with
           chronic hepatitis C
    • Authors: Yasunari Yamada; Shunro Matsumoto; Hiromu Mori; Ryo Takaji; Maki Kiyonaga; Naoki Hijiya; Rika Tanoue; Kenichiro Tomonari; Shuichi Tanoue; Norio Hongo; Masayuki Ohta; Masataka Seike; Masafumi Inomata; Kazunari Murakami; Masatsugu Moriyama
      Pages: 2410 - 2419
      Abstract: Purpose We sought to evaluate visualization of periportal lymphatics and lymph nodes (lymphatic system) on Gd-EOB-DTPA-enhanced magnetic resonance (MR) images using a fat-suppressed T2-weighted sequence with 3-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) at 3.0 T in normal subjects and patients with chronic hepatitis C. Methods MR imaging was performed in 254 subjects between June 2013 and May 2016. After applying inclusion and exclusion criteria, the final population was 31 normal subjects and 34 patients with chronic hepatitis C. Images were acquired after the hepatobiliary phase following intravenous administration of Gd-EOB-DTPA, which causes signal loss in the bile ducts, to facilitate the visualization of the periportal lymphatic system. Two radiologists assessed the visualization of the periportal lymphatic system in 31 normal subjects. The axial dimensions of the main periportal lymphatic system in normal subjects were measured and compared with those of 34 patients with chronic hepatitis C using the Mann–Whitney U-test, and their correlation with a hepatic fibrosis marker, the Fibrosis-4 (FIB-4), was assessed using Spearman’s rank correlation test. Results The periportal lymphatic system was detected as high signal intensity areas surrounding the portal vein up to the third branches by each reader in all normal subjects. The axial dimensions of the main periportal lymphatic system in patients with chronic hepatitis C were significantly larger than those in normal subjects (p < 0.0001), and showed a significantly positive correlation with the FIB-4 score (ρ = 0.73, p < 0.001). Conclusions Fat-suppressed T2-weighted MR imaging with 3D-VISTA acquired after the hepatobiliary phase on Gd-EOB-DTPA-enhanced imaging may be a useful noninvasive method for evaluating the periportal lymphatic system and the degree of hepatic fibrosis.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1155-y
      Issue No: Vol. 42, No. 10 (2017)
  • MDCT of the liver in obese patients: evaluation of a different method to
           optimize iodine dose
    • Authors: Marco Rengo; Davide Bellini; Rita Businaro; Damiano Caruso; Gabriella Azzara; Domenico De Santis; Simona Picchia; Tommaso Biondi; Marwen Eid; Dario Boschiero; Andrea Laghi
      Pages: 2420 - 2427
      Abstract: Purpose To prospectively compare two different approaches for estimating the amount of intravenous contrast media (CM) needed for multiphasic MDCT of the liver in obese patients. Materials and methods This single-center, HIPAA-compliant prospective study was approved by our Institutional Review Board. Ninety-six patients (55 men, 41 women), with a total of 42 hypovascular liver lesions, underwent MDCT of the liver. The amount of contrast medium injected was computed according to the patient’s lean body weight which was estimated using either a bioimpedance device (Group A) or the James formula (Group B). The following variables were compared between the two groups: the amount of contrast medium injected (in grams of Iodine, gI), the contrast enhancement index (CEI) and the lesion-to-liver contrast-to-noise ratio. Results Protocols A and B yielded significant differences in the amount of CM injected (mean values 41.9 ± 4.41 gI in Group A vs. 35.9 ± 5.75 gI in Group B; P = 0.021). The mean CEI value and lesion-to-liver contrast-to-noise ratio measured on the portal phase were significantly higher with protocol A than with protocol B (P < 0.05). Conclusions Our study shows that the adoption of a bioimpedance device in obese patients improves liver parenchymal enhancement and lesion conspicuity.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1156-x
      Issue No: Vol. 42, No. 10 (2017)
  • Evaluation of biliary ductal anatomy in potential living liver donors:
           comparison between MRCP and Gd-EOB-DTPA-enhanced MRI
    • Authors: D. Santosh; A. Goel; I. W. Birchall; A. Kumar; K. H. Lee; V. H. Patel; G. Low
      Pages: 2428 - 2435
      Abstract: Purpose To compare magnetic resonance cholangiopancreatography (MRCP) and Gd-EOB-DTPA-enhanced MRI in the evaluation of the biliary anatomy in potential living liver donors (LLDs). Methods A retrospective study was conducted in a tertiary care liver transplant center after obtaining ethics and institutional approvals. A total of 42 potential LLD MRI examinations were performed between November 2013 and March 2016. All patients underwent a standard MRI protocol which included MRCP and Gd-EOB-DTPA-enhanced MRI sequences in a single session. Three abdominal MR radiologists independently reviewed the studies and completed a customized data collection sheet for each MR sequence. The readers subjectively scored the bile duct visualization on each MR sequence on a Likert scale and classified the biliary anatomic configuration. Statistical analysis was performed using intraclass correlation coefficient and the McNemar Chi-square (χ 2) test. Results The 42 potential LLDs included 22 males and 20 females with an age range of 18–60 years. There was ‘good’ or ‘excellent’ inter-reader agreement on either MRI examination for the visualization of the first- and second-order ducts and the majority of third-order ducts. ‘Good’ inter-reader agreement on Gd-EOB-DTPA-enhanced MRI and ‘fair’ inter-reader agreement on MRCP was noted for the left third-order medial duct. There was significantly better visualization of the cystic duct, left hepatic duct, and right second-order ducts on Gd-EOB-DTPA-enhanced MRI compared with MRCP. A 12.6% improvement in classifying the biliary branch pattern was also observed on Gd-EOB-DTPA-enhanced MRI compared with MRCP (P = 0.03). Conclusion Gd-EOB-DTPA-enhanced MRI provides additional diagnostic confidence over MRCP in the evaluation of the biliary ductal anatomy in potential LLDs.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1157-9
      Issue No: Vol. 42, No. 10 (2017)
  • Hepatic segmental atrophy and nodular elastosis: imaging features
    • Authors: Ishan Garg; Rondell P. Graham; Wendaline M. VanBuren; Ajit H. Goenka; Michael S. Torbenson; Sudhakar K. Venkatesh
      Pages: 2447 - 2453
      Abstract: Purpose To evaluate the imaging features of hepatic segmental atrophy and nodular elastosis. Materials and methods In this Institutional review board (IRB)-approved, HIPAA-compliant study, we reviewed imaging features in six cases of histologically confirmed hepatic segmental atrophy (HSA) and nodular elastosis (NE). Retrospective review of ultrasound (US) in 2 patients, computed tomography (CT) in 5 patients, magnetic resonance imaging (MRI) in 4 patients, and positron emission tomography (PET) in 2 patients was performed. Location, size, and attenuation/density/signal intensity of these lesions were evaluated. Clinical presentation and coexistent conditions were also recorded. Results All six patients were females. Mean age of presentation was 58.3 years (range 37–80). A single HSA and NE lesion in each patient was found. The mean size of the lesion was 18 mm (range: 3 mm to 36 mm). Most lesions were detected incidentally (5/6). On contrast-enhanced single-phase (portal venous) CT, most lesions were hypodense (4/5) and one lesion was hyperdense to fatty liver parenchyma. On MRI, the lesions were iso- to hyperintense on T2-weighted images, T1 hypointense, and hyperintense on diffusion-weighted images (DWI). Three lesions were hypointense on arterial, portal venous, and delayed phases. One lesion occurring in fatty liver appeared hyperintense on all three phases. Gd-EOB-DTPA-enhanced images were available in 2 patients and lesions were hypointense on the 20-min hepatobiliary phase. On PET, two lesions were isometabolic to the background hepatic parenchyma. On ultrasound, one lesion appeared hypoechoic and another lesion isoechoic to hepatic parenchyma. Conclusions Hepatic segmental atrophy and nodular elastosis is an uncommon benign lesion and can simulate metastases due to variable imaging features. Lack of FDG uptake on PET/CT may be a clue to the benign nature of the lesion and may suggest the possibility of HSA and NE.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1164-x
      Issue No: Vol. 42, No. 10 (2017)
  • Low-dose attenuation correction in diagnosis of non-alcoholic fatty liver
    • Authors: Amjad M. Ahmed; Mohamed E. Ebid; Amr M. Ajlan; Mouaz H. Al-Mallah
      Pages: 2454 - 2459
      Abstract: Background Non-enhanced computed tomography (CT) is a valuable modality in the diagnosis of non-alcoholic fatty liver disease (NAFLD). However, it is not clear if low-dose CT attenuation correction (CTAC) scans have the same accuracy to diagnose NAFLD. Our aim is to evaluate the diagnostic accuracy of low-dose CTAC in the diagnosis of NAFLD using non-enhanced CT as a gold standard. Methods A total of 864 patients who underwent a clinically indicated hybrid nuclear imaging scanning between May 2011 and April 2014 were included in the study. Diagnosis of fatty liver was established if an absolute liver attenuation was <40 Hounsfield units and/or a liver-to-spleen ratio was <1.1. The diagnostic accuracy parameters were calculated to detect NAFLD by low-dose CTAC using unenhanced CT as a gold standard. Results The prevalence of fatty liver by diagnostic CT and low-dose attenuation correction were 9.9 and 12.9% (using liver attenuation <40HU and liver-to-spleen ratio <1.1), respectively, with 32.9 and 34.9% (using absolute liver attenuation or ratio-to-spleen criteria), correspondingly. Low-dose CTAC had sensitivity (81.3%), specificity (94.0%), positive predictive value (60.2%), and negative predictive value (97.8%) using both diagnostic criteria. Using either of the diagnostic criteria resulted in sensitivity (76.8%), specificity (83.5%), PPV (66.3%), and NPV (89.5%). Conclusion Low-dose CT could be used as a tool to rule out the presence of fatty liver if neither liver attenuation of less than 40 HU nor liver-to-spleen below 1.1 is present.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1166-8
      Issue No: Vol. 42, No. 10 (2017)
  • Comparative radiological pathological study of biliary intraductal
           tubulopapillary neoplasm and biliary intraductal papillary mucinous
    • Authors: Chia-Hung Wu; Yi-Chen Yeh; Yu-Chuan Tsuei; Li-Kuo Huang; Chia-I Lin; Chien-An Liu; Hsiou-Shan Tseng; Yi-You Chiou; Nai-Chi Chiu
      Pages: 2460 - 2469
      Abstract: Purpose Biliary tract intraductal tubulopapillary neoplasms (BT-ITPNs) and intraductal papillary mucinous neoplasms (BT-IPMNs) are rare and poorly described. Herein, we examined the magnetic resonance imaging (MRI) features of BT-ITPNs and BT-IPMNs and correlated them with key gross and microscopic pathological findings. Methods We retrospectively identified five patients with definitive pathological findings of BT-ITPN and available diagnostic MRI findings. Key MRI features were correlated to the gross and microscopic pathology and compared to those of BT-IPMNs (19 patients). Results All BT-ITPNs showed ductal dilatation and visible intraductal soft tissue with peribiliary liver parenchyma enhancement. One BT-ITPN patient had synchronous lung metastases, and another showed rapid tumor growth rate. The intraductal soft tissue proportion of BT-ITPNs was significantly more than that of BT-IPMNs (p < 0.05). CA-199 level was elevated in 60% of BT-ITPN cases. The overall combined 1-year and 3-year survival rates in the BT-ITPN group was 100% and 40%, and in the BT-IPMN group was 100% and 58%, respectively. A high intraductal soft tissue proportion, a lack of intraluminal mucin, and immunohistochemical absence of MUC5AC are radiological and pathological characteristics that differentiate BT-ITPN from BT-IPMN. Conclusions Although rare, BT-ITPN should be suspected when solid intraductal soft tissue and peribiliary liver parenchyma enhancement are present, particularly if the bile duct upstream and downstream of the lesion have a normal diameter, without mucin. Owing to the aggressive nature of the tumor, recognition of these features may indicate the need for more aggressive treatment in selected patients.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1167-7
      Issue No: Vol. 42, No. 10 (2017)
  • The capability of inflow inversion recovery magnetic resonance compared to
           contrast-enhanced magnetic resonance in renal artery angiography
    • Authors: Xueqin Xu; Xiaozhu Lin; Juan Huang; Zhaocheng Pan; Xiaolei Zhu; Kemin Chen; Chi-Shing Zee; Fuhua Yan
      Pages: 2479 - 2487
      Abstract: Purpose To assess the capability of inflow inversion recovery (IFIR) magnetic resonance angiography (MRA), compared with contrast-enhanced MRA (CE-MRA) as reference standard, in evaluating renal artery stenosis (RAS). Methods Seventy-two subjects were examined by IFIR MRA with respiratory-gated, prior to CE-MRA with a 1.5-T scanner. Two readers evaluated the quality of IFIR MRA images and renal artery depiction on artery-by-artery basis. The agreement of two methods to assess RAS was analyzed using the Kappa test. The relationship between image quality of IFIR MRA and respiratory rate was analyzed by ANOVA test. Results The visibility of renal artery branch vessels was significantly higher using IFIR MRA than CE-MRA (p < 0.05). A good agreement of two methods in evaluating stenosis grade, and a near-perfect inter-observer agreement for IFIR MRA (Kappa value 0.98) and CE-MRA (Kappa value 0.93), were demonstrated. As RAS ≥50%, the sensitivity and specificity of IFIR MRA were 92 and 98% in reader 1, 93 and 98% in reader 2, respectively. The image quality was significantly better in patients with stable respiration (p < 0.01). Conclusions IFIR MRA in patients with stable respiration has higher visibility of renal artery branch vessels than CE-MRA, and a good agreement with CE-MRA in evaluating stenosis grade. It could be used to evaluate RAS for screening, and monitoring treatment.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1161-0
      Issue No: Vol. 42, No. 10 (2017)
  • Prognostic significance of supradiaphragmatic lymph nodes at initial
           presentation in patients with stage III high-grade serous ovarian cancer
    • Authors: L. J. McIntosh; A. C. O’Neill; S. Bhanusupriya; S. A. Matalon; A. D. Van den Abbeele; N. H. Ramaiya; A. B. Shinagare
      Pages: 2513 - 2520
      Abstract: Purpose To identify the optimal size threshold and to assess the prognostic significance of supradiaphragmatic lymph nodes at initial presentation of patients with high-grade serous ovarian cancer (HGSC). Methods This IRB-approved, HIPAA-compliant retrospective study included baseline pretreatment staging abdominal CTs of 88 women (mean age 62 years, SD 10.4, range 29–85) with FIGO stage III HGSC. Patients with stage IV disease were excluded due to worse prognosis and management guided by distant metastases. Two fellowship-trained radiologists independently reviewed abdominal CTs to record the presence of supradiaphragmatic nodes, abdominal lymphadenopathy, peritoneal carcinomatosis, and ovarian mass. Progression-free survival (PFS) and overall survival (OS) were recorded after median 79 months follow-up (IQR 58–115, range 13–144). The optimal short-axis size threshold for supradiaphragmatic lymphadenopathy was determined by correlating 3, 4, 5, 6, 7, and 10 mm thresholds with PFS and OS using Log-rank test. Prognostic significance of supradiaphragmatic lymphadenopathy was assessed using Cox proportional hazards models. Results There was good interobserver agreement for presence (κ = 0.65, 95%CI 0.51–0.79) and size (ICC = 0.77, 95%CI 0.66–0.86) of supradiaphragmatic nodes. 5 mm short-axis size threshold was associated with significantly shorter PFS (median 14 months, IQR 11–17 vs. 23 months, IQR 12–59; p = 0.02) and OS (median 44 months, IQR 27–69 vs. 65 months, IQR 45–96; p = 0.03). Total 38/88 (43%) patients had supradiaphragmatic lymphadenopathy. On Cox proportion hazards analysis, supradiaphragmatic lymphadenopathy was significantly associated with shorter PFS (p = 0.02; HR 1.81, 95%CI 1.11–2.96) and OS (p = 0.008; HR 2.11, 95%CI 1.21–3.65). Conclusion In patients with stage III HGSC, supradiaphragmatic lymphadenopathy is associated with shorter PFS and OS. Further studies would help determine its implications on staging, decision regarding neoadjuvant therapy, and surgical technique.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1158-8
      Issue No: Vol. 42, No. 10 (2017)
  • The utility of CT and MRI in detecting male urethral recurrence after
           radical cystectomy
    • Authors: Jung Jae Park; Byung Kwan Park
      Pages: 2521 - 2526
      Abstract: Purpose To evaluate the utility of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting male urethral recurrence (UR). Materials and methods Between December 2008 and March 2016, 12 men (age range 61–85 years; median, 74 years) with urethral bloody discharge or pain were histologically confirmed as UR after radical cystectomy due to urothelial carcinoma. Of these patients, eight underwent both CT and MRI. The remaining four patients underwent CT only. CT and MRI were compared regarding UR detection rate. CT and MRI were also evaluated to determine which modality was more accurate for depicting UR. UR detection rate of each MRI sequence were recorded. Standard reference was biopsy or urethrectomy in 11 patients and size change in one patient after treatment. Results UR detection rate with CT was 41.7% (5/12), while that with MRI was 100% (8/8) (p = 0.0147). Of the eight patients who were diagnosed UR with MRI, six were detected with MRI alone and two with both MRI and CT (p = 0.0313). UR detection rates of T2-weighted, T1-weighted, diffusion-weighted, and contrast-enhanced MRI were 87.5% (7/8), 62.5% (5/8), 100% (5/5), and 87.5% (7/8), respectively. Conclusion MRI is superior to CT in detecting male URs in symptomatic patients after radical cystectomy. T2-weighted, diffusion-weighted, and contrast-enhanced MRI sequences are useful for detecting male UR.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1159-7
      Issue No: Vol. 42, No. 10 (2017)
  • Thirty-day emergency room visits and hospital admissions after outpatient
           non-vascular image-guided procedures
    • Authors: Quang Nguyen; Sahil V. Mehta; Jieming Fang; Robert Sheiman; Robert Kane; Muneeb Ahmed; Ammar Sarwar; Bettina Siewert; Olga R. Brook
      Pages: 2538 - 2543
      Abstract: Purpose To evaluate the rate of post-procedure emergency department (ED) visits and hospital admissions following outpatient non-vascular image-guided interventions performed under moderate sedation and to identify common and preventable causes of emergency department visits and hospital admissions. Materials and methods Institutional review board approval was acquired for this HIPAA-compliant retrospective study with waiver of informed consent. 1426 consecutive patients undergoing 1512 outpatient image-guided procedures under moderate sedation from November 2012 to August 2014 were included. The average patient age was 57.2 ± 15.2 years, and 602 (42%) patients were women. Major procedure categories included ultrasound-guided liver biopsies, ultrasound-guided kidney biopsies, and CT-guided lung biopsies/fiducial placement. Procedure details and medical follow-up within and after 30 days of the procedure were analyzed. Results A total of 168 (11.8%) patients were admitted to the hospital within 30 days of the procedure, with 29 of the admissions (17.3% of total admissions and 1.9% of total procedures) being procedure related. The most common procedure-related complication that required admission was hemorrhage (10/29, 34.5% of procedure-related admissions, 6.0% of total admissions, and 0.7% of total procedures), followed by pneumothorax (9/29, 31%, 5.4%, 0.6%), infection (4/29, 13.8%, 2.4%, 0.3%), and pain (3/29, 10.3%, 1.8%, 0.2%). Eighteen (62.1%) procedure-related admissions were immediately indicated. Thirty patients visited the ED and were subsequently discharged without admission with eight of the visits being procedure related (8/1512, 0.5%). All the procedure-related ED visits were due to pain. There were two deaths (2/1512, 0.1%) related to procedures, one from a thromboembolic event and another from post-biopsy hemorrhage. Conclusion Outpatient non-vascular image-guided procedures result in a 30-day 1.9% hospital admission, 30-day 0.5% emergency room visit, and 30-day 0.1% mortality rate.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1153-0
      Issue No: Vol. 42, No. 10 (2017)
  • Arterial injury during transcatheter arterial chemoembolization for
           hepatocellular carcinoma: predictors of risk and outcome
    • Authors: Hironori Onizuka; Eijun Sueyoshi; Hideki Ishimaru; Ichiro Sakamoto; Masataka Uetani
      Pages: 2544 - 2550
      Abstract: Purpose To investigate clinical features and results of follow-up in patients with arterial injury during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma. Methods From 2005 to 2015, 2219 TACE procedures were performed in 906 patients in our hospital. Iatrogenic arterial injury occurred during 38 TACE procedures (sessions) in 35 patients (24 men, 11 women; mean age 71.8 years). The incidence of arterial injury was 1.7%. We evaluated the characteristics of arterial injury, and evaluated the risk factors for incomplete recanalization of the injured artery at follow-up angiography conducted after 1–11 months (mean 102.5 days). Results Iatrogenic arterial injury was caused by the microcatheter in 34 of 38 cases (86.8%). There were 15 cases (39.5%) in which the replaced hepatic artery or the extrahepatic artery was the parasitic supply. Extravasation occurred in five cases. In 36 of 38 cases, follow-up angiography was performed. We divided 36 cases into two groups: complete reopening (n = 24) and non-complete reopening (n = 12). The two groups were compared regarding the factors associated with incomplete recanalization of the injured artery at follow-up. Injury length >3 cm (p = 0.0002) and proximal arterial injury (proximal to the segmental artery; p = 0.03) were significant risk factors for non-complete reopening of the injured artery. Conclusion Iatrogenic arterial injury frequently occurred in the extrahepatic artery or replaced hepatic artery. Recanalization rate of arterial injury was high; however, injury length >3 cm and proximal arterial injury were risk factors for non-complete reopening of the injured artery.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1168-6
      Issue No: Vol. 42, No. 10 (2017)
  • Split-bolus intravenous contrast material injection vs. single-bolus
           injection in patients following endovascular abdominal aortic repair
    • Authors: Johannes Boos; Vassilios Raptopoulos; Alexander Brook; Olga R. Brook
      Pages: 2551 - 2561
      Abstract: Purpose To investigate the feasibility and accuracy of a split-bolus contrast injection CTA (SB-CTA) compared to a single-bolus injection CTA (SI-CTA) protocol of post-EVAR patients. Materials and methods In this IRB-approved study, patients who underwent SB-CTA and SI-CTA after EVAR were evaluated. Attenuation and contrast-to-noise ratio (CNR) of vessels and parenchymal organs were assessed. Subjective enhancement of vessels, quality of 3D reconstructions, and enhancement phase of parenchymal organs were assessed by two independent readers. Endoleak visibility and incidental findings were evaluated. Results Fifty-six patients with SB-CTA and SI-CTA at two different time points after EVAR were included in the study (112 imaging studies, mean age 75 ± 9 years). There was no difference in attenuation and CNR for aorta between SB-CTA and SI-CTA (310 ± 87 vs. 311 ± 80 HU, p = 0.88; 31.1 ± 12.6 vs. 29.0 ± 12.2, p = 0.20), although both were improved in the venous structures and parenchymal organs with SB-CTA (portal vein: 149 ± 33 vs. 88 ± 32 HU, 11.6 ± 5.6 vs. 4.3 ± 3.4; liver: 91 ± 19 vs. 68 ± 20 HU, 4.4 ± 2.8 vs. 2.1 ± 2.0; pancreas: 108 ± 27 vs. 82 ± 23 HU, 6.4 ± 3.1 vs. 3.6 ± 2.4; p < 0.0001). Subjectively, enhancement of veins, liver, spleen, bowel, and kidneys was improved (p < 0.001), while there was no difference for the aorta (p = 0.46) and 3D reconstructions (p = 0.58). None of the 18/56 (32.1%) endoleaks was missed with the SB-CTA. More incidental findings were detected with SB-CTA (158/56) compared to SI-CTA (135/56), p < 0.001. SB-CTA was able to adequately characterize 7/15 (47%) of the findings that needed further evaluation in SI-CTA. 4/15 (26%) incidental findings that were missed with SI-CTA but seen with SB-CTA required further evaluation. Conclusion Split-bolus injection CTA in the follow-up of EVAR patients allows reliable visualization of endoleaks with improved subjective and objective image quality.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1154-z
      Issue No: Vol. 42, No. 10 (2017)
  • Systematic radiation dose optimization of abdominal dual-energy CT on a
           second-generation dual-source CT scanner: assessment of the accuracy of
           iodine uptake measurement and image quality in an in vitro and in vivo
    • Authors: Sebastian T. Schindera; Caroline Zaehringer; Luigia D’Errico; Fides Schwartz; Maka Kekelidze; Zsolt Szucs-Farkas; Matthias R. Benz
      Pages: 2562 - 2570
      Abstract: Purpose To assess the accuracy of iodine quantification in a phantom study at different radiation dose levels with dual-energy dual-source CT and to evaluate image quality and radiation doses in patients undergoing a single-energy and two dual-energy abdominal CT protocols. Methods In a phantom study, the accuracy of iodine quantification (4.5–23.5 mgI/mL) was evaluated using the manufacturer-recommended and three dose-optimized dual-energy protocols. In a patient study, 75 abdomino-pelvic CT examinations were acquired as follows: 25 CT scans with the manufacturer-recommended dual-energy protocol (protocol A); 25 CT scans with a dose-optimized dual-energy protocol (protocol B); and 25 CT scans with a single-energy CT protocol (protocol C). CTDIvol and objective noise were measured. Five readers scored each scan according to six subjective image quality parameters (noise, contrast, artifacts, visibility of small structures, sharpness, overall diagnostic confidence). Results In the phantom study, differences between the real and measured iodine concentrations ranged from −8.8% to 17.0% for the manufacturer-recommended protocol and from −1.6% to 20.5% for three dose-optimized protocols. In the patient study, the CTDIvol of protocol A, B, and C were 12.5 ± 1.9, 7.5 ± 1.2, and 6.5 ± 1.7 mGycm, respectively (p < 0.001), and the average image noise values were 6.6 ± 1.2, 7.8 ± 1.4, and 9.6 ± 2.2 HU, respectively (p < 0.001). No significant differences in the six subjective image quality parameters were observed between the dose-optimized dual-energy and the single-energy protocol. Conclusion A dose reduction of 41% is feasible for the manufacturer-recommended, abdominal dual-energy CT protocol, as it maintained the accuracy of iodine measurements and subjective image quality compared to a single-energy protocol.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1160-1
      Issue No: Vol. 42, No. 10 (2017)
  • Novel contrast-injection protocol for high-resolution abdominal
           CT-angiography: vascular visualization improvement with vasodilator
    • Authors: Minori Hoshika; Kotaro Yasui; Takefumi Niguma; Toru Kojima; Norimi Nishiyama; Daisuke Suzuki; Izumi Togami
      Pages: 2571 - 2578
      Abstract: Purpose To evaluate the usefulness of a novel contrast-injection protocol for high-resolution abdominal computed tomography angiography (CTA) using nitroglycerin (NTG). Methods Abdominal CTA was performed in 80 patients using two 64-detector-row CT scanners. Forty patients were examined after administration of sublingual NTG (NTG group), while 40 were examined without NTG administration (non-NTG group). Arterial phase images were acquired with maximum intensity projection and volume rendering. Reduction rates: vessel cross-sectional areas ratio of 10 cm distal to origin at the superior mesenteric artery, contrast enhancements, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were assessed. Three reviewers evaluated degree of depiction of the peripancreatic vasculature using a four-point scale (1 = poor, 4 = excellent). Results Reduction rates were significantly lower in the NTG group (P < 0.001), while there were no significant differences in contrast enhancements, SNR, or CNR between groups. Visual evaluation results of the NTG group were significantly better than those of the non-NTG group (P < 0.01). Conclusion Abdominal CTA using NTG improved visualization of the abdominal peripheral vessels. This improved arterial view may be beneficial for preoperative evaluation of the arterial anatomy.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1163-y
      Issue No: Vol. 42, No. 10 (2017)
  • Assessment of 70-keV virtual monoenergetic spectral images in abdominal CT
           imaging: A comparison study to conventional polychromatic 120-kVp images
    • Authors: Negin Rassouli; Hamid Chalian; Prabhakar Rajiah; Amar Dhanantwari; Luis Landeras
      Pages: 2579 - 2586
      Abstract: Purpose To evaluate the image quality of 70-keV virtual monoenergetic (monoE) abdominal CT images compared to 120-kVp polychromatic images generated from a spectral detector CT (SDCT) scanner. Methods This prospective study included generation of a 120-kVp polychromatic dataset and a 70-keV virtual monoE dataset after a single contrast-enhanced CT acquisition on a SDCT scanner (Philips Healthcare) during portal venous phase. The attenuation values (HU), noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured in the liver, spleen, pancreas, kidney, aorta, portal vein, and muscle. The subjective image quality including noise, soft tissue contrast, sharpness, and overall image quality were graded on a 5-point Likert scale by two radiologists independently (1-worst image quality, 5-best image quality). Statistical analysis was performed using paired sample t test and Fleiss’s Kappa. Results Fifty-five patients (54.3 ± 16.8 y/o; 28 M, 27 F) were recruited. The noise of target organs was significantly lower in virtual monoE images in comparison to polychromatic images (p < 0.001). The SNR and CNR were significantly higher in virtual monoE images (p < 0.001 for both). Subjective image quality of 70-keV virtual monoE images was significantly better (p < 0.001) for all evaluated parameters. Median scores for all subjective parameters were 3.0 versus 4.0 for polychromatic vs virtual monoE images, respectively. The inter-reader agreement for overall image quality was good (Kappa were 0.767 and 0.762 for polychromatic and virtual monoE images, respectively). Conclusion In abdominal imaging, 70-keV virtual monoE CT images demonstrated significantly better noise, SNR, CNR, and subjective score compared to conventional 120-kVp polychromatic images.
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1151-2
      Issue No: Vol. 42, No. 10 (2017)
  • ‘Frosted liver’ appearance
    • Authors: Venkatraman Indiran; R. Vinoth Kumar
      Pages: 2587 - 2587
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1148-x
      Issue No: Vol. 42, No. 10 (2017)
  • Rigler sign
    • Authors: Venkatraman Indiran; V. Sivakumar
      Pages: 2588 - 2588
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1149-9
      Issue No: Vol. 42, No. 10 (2017)
  • The patent track sign
    • Authors: Saravana Kumar Swaminathan; Richard Hoau Gong Lo; Nanda Venkatanarasimha
      Pages: 2589 - 2590
      PubDate: 2017-10-01
      DOI: 10.1007/s00261-017-1152-1
      Issue No: Vol. 42, No. 10 (2017)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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