Objective:To evaluate the sensitivity, specificity, and diagnostic odds ratio (DOR) of Doppler ultrasound, CT, and MRI in the diagnosis of Budd Chiari syndrome (BCS).Methods:We performed a literatu...

https://www.birpublications.org/doi/pdf/10.1259/bjr.20190847

Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari syndrome: systematic review and meta-analysis

BACKGROUND The aim of this study was to evaluate the image quality and radiation dose of CT coronary angiography (CTCA) with low kV, low concentration contrast agent, and iterative reconstruction. MATERIAL AND METHODS Ninety cases were randomly divided into 3 groups according to contrast agent concentration: group A 270 mg/ml (100 kV), group B 350 mg/ml (120 kV), and group C 370 mg/ml (120 kV), with 30 cases per group. Tube current was 200-250 mAs. Collimator width was 128×0.6 mm. Rotation speed was 0.27 s. The CT value of the left and right coronary arteries and the ascending aortic root was measured. The SNR and CNR of the images were calculated to evaluate the image quality objectively. The CTDI, DLP, and contrast injection were recorded. RESULTS There were no significant differences in sex, age, weight, height, and BMI among the 3 groups. There was no statistically significant difference between left and right coronary artery and ascending aortic root CT value, background noise, SNR, and CNR. Compared to B and C, the ED in group A decreased by about 27.58% and 28.21%, respectively. The total amount of iodine in group A was decreased by about 21.27% and 24.83%, respectively compared with groups B and C. CONCLUSIONS Low kV and low concentration contrast agent combined with iterative reconstruction for CTCA imaging produced image quality consistent with that of conventional CTCA and significantly reduced the dosage of the radiation and injected iodine.

Low kV and Low Concentration Contrast Agent with Iterative Reconstruction of Computed Tomography (CT) Coronary Angiography: A Preliminary Study.

Objective This study aimed to illustrate the magnetic resonance venography (MRV) manifestations of obstructed hepatic veins (HVs), the inferior vena cava (IVC), and accessory hepatic veins (AHVs) in patients with Budd-Chiari syndrome (BCS) and to evaluate the visualization capacity of MRV in the diagnosis of BCS. Materials and Methods Fifty-two patients with chronic BCS were included in this study. All patients were examined via MRV performed with a 3T system following injections of gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) or Gd-ethoxibenzyl-DTPA. HV and IVC lesions were classified, and their characteristics were described. HV cord-like occlusions detected via MRV were compared using ultrasonography (US). Digital subtraction angiography (DSA) was performed as a contrast in the MRV detection of IVC lesions. The HVs draining collaterals, mainly AHVs, were carefully observed. HV lesions were classified as segmental stenosis, segmental occlusion, membranous stenosis, membranous occlusion, cord-like occlusion, or non-visualized. Except for patent IVCs, IVC lesions were classified as segmental occlusion, segmental stenosis, membranous occlusion, membranous stenosis, and hepatomegaly-induced stenosis. Results All patients (52/52, 100%) showed HV lesions of different degrees. MRV was inferior to US in detecting cord-like occlusions (6 vs. 19, χ2 = 11.077, p < 0.001). Dilated AHVs, including 50 (50/52, 96.2%) caudate lobe veins and 37 (37/52, 71.2%) inferior HV and AHV lesions, were well-detected. There were no significant differences in detecting segmental lesions and thrombosis between MRV and DSA (χ2 = 0.000, p1 = 1.000, p2 = 1.000). The capacity of MRV to detect membranous lesions was inferior to that of DSA (7 vs. 15, χ2 = 6.125, p = 0.013). Conclusion In patients with BCS, MRV can clearly display the lesions in HVs and the IVC, as well as in AHVs, and it has diagnostic and therapeutic value.

/pdf/magnetic-resonance-venography-findings-of-obstructed-hepatic-4hbezi6j62.pdf

Magnetic Resonance Venography Findings of Obstructed Hepatic Veins and the Inferior Vena Cava in Patients with Budd-Chiari Syndrome.

Background: Currently, there is an increasing interest in noninvasive imaging of cardiovascular system such as computed tomography coronary angiography (CCTA). The risks of radiation-induced cancer and contrast-induced nephropathy (CIN) have always been regarded as concerns which increased demand for CCTA using reduced radiation dose and iodine intake. We aimed to evaluate the image quality and radiation dose of CCTA by modifying tube voltage and concentration of contrast media. Methods: The present study includes 105 patients who underwent CCTA for clinical indications. Specific inclusion and exclusion criteria in terms of patient's weight, body mass index, calcium score, and stenting were used. First group of patients scanned by 120Â kV and 370Â mg I/mL contrast medium, compared with second and third groups for which scanning was performed using 100Â kV and 370Â mg I/mL and 100Â kV and 300Â mg I/mL, respectively. Image quality was evaluated both subjectively and objectively. The effective dose and iodine intake were also measured. Results: Using low kV protocols led to radiation dose reduction up to 38 and applying low contrast medium concentration with consequent reduced iodine intake up to 21. Moreover, there were significant differences in image quality of new scanning protocols. Conclusion: Reduction in tube voltage with lowering of contrast medium concentration can reduce radiation dose and iodine intake with acceptable image quality. Â© 2019 Wiley Periodicals, Inc.

Coronary CT angiography by modifying tube voltage and contrast medium concentration: Evaluation of image quality and radiation dose

The purpose of this study was to analyze inferior vena cava (IVC) obstruction in Budd-Chiari syndrome (BCS) using rapid quantitative phase-contrast (PC) magnetic resonance (MR) imaging and compare the diagnostic efficacy of PC and MR venography (MRV) to explore the clinical prospects of applying PC quantitative diagnosis in IVC obstruction in BCS. PC quantitative data and MRV qualitative data obtained in 35 DSA-recognized inferior vena cava obstruction in BCS patients and 35 patients with liver focal lesions found in physical examination were analyzed and compared. The areas under the ROC curve for diagnostic parameters related to PC quantitative parameters, including stroke volume, forward flow volume, absolute stroke volume, mean flux, stroke distance, mean velocity (MV), and peak velocity, were 0.7767, 0.7788, 0.7747, 0.7665, 0.9143, 0.9159, and 0.8947, respectively. The sensitivity, specificity, and accuracy of MV in the diagnosis of IVC obstruction were 88.57%, 85.71%, and 87.14%, respectively. For IVC obstruction in BCS, there was no significant difference between the diagnostic efficacy of MV (one of the quantitative parameters of PC) and that of MRV (P = 0.0768). PC can be used to diagnose IVC obstruction in BCS and improve the understanding of hemodynamics of IVC obstruction in BCS.

Inferior vena cava obstruction in Budd-Chiari syndrome: a comparative study of rapid quantitative phase-contrast MRI and MRV

Objective
To evaluate image quality of low-voltage coronary artery computed tomographic (CT) angiography with low contrast agent in comparison with image quality.


Methods
Forty-five patients underwent coronary artery computed tomographic (CT) angiography. They were randomly assigned to 3 groups, group A(n=15)were scanned in 120 kVp with 350 mgI/ml iodinated contrast agent mode, group B(n=15)were scanned in 100 kVp with 350 mgI/ml iodinated contrast agent mode, group C(n=15)were scanned in 100 kVp with 270 mgI/ml iodinated contrast agent mode. Then measured CT attenuation value of three main branches(RCA, LAD and CX) of coronary artery, And compare the SNR, CNR, the effective radiation dose(ED) and iodine intake. The Kappa test were used to quantify inter- and intra-reader agreement in detecting quality of the images under different scanning solutions.


Results
Three groups of coronary artery CT image quality was no statistically significant differences (all P values >0.05), Good inter- and intra-reader agreement ( k= 0.754, P 0.05). There was significant difference in the ED among the 3 groups (P<0.05). The ED value of the group A was bigger than the value of the group B and C. There was no significant difference between the group B and C. Compared the group A and B, the iodine intake of the group C had fallen by 23%.


Conclusions
The coronary artery CT angiography using 100 kVp with 270 mgI/ml iodinated contrast agent provide similar objective or subjective image quality compared with the (350 mgI/ml)and the 100 kVp(350 mgI/ml), thus enabling effective dose and iodine intake reduction without loss of diagnostic information.


Key words: 
Coronary artery disease; Tomography, X-ray computed; Angiography

[Reduced-dose mode with low-voltage and low contrast agent in coronary artery CT angiography-a preliminary study]

Non-contrast-enhanced MR angiography in the diagnosis of Budd-Chiari syndrome (BCS) compared with digital subtraction angiography (DSA): Preliminary results

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[Reduced-dose mode with low-voltage and low contrast agent in coronary artery CT angiography-a preliminary study]

Non-contrast-enhanced MR angiography in the diagnosis of Budd-Chiari syndrome (BCS) compared with digital subtraction angiography (DSA): Preliminary results