BackgroundThis study was performed to assess whether iterative reconstruction can reduce radiation dose while maintaining acceptable image quality, and to investigate whether perfusion parameters vary from conventional filtered back projection (FBP) at the low-tube-voltage (80-kVp) during whole-pancreas perfusion examination using a 256-slice CT.Methods76 patients with known or suspected pancreatic mass underwent whole-pancreas perfusion by a 256-slice CT. High- and low-tube-voltage CT images were acquired. 120-kVp image data (protocol A) and 80-kVp image data (protocol B) were reconstructed with conventional FBP, and 80-kVp image data were reconstructed with iDose4 (protocol C) iterative reconstruction. The image noise; contrast-to-noise ratio (CNR) relative to muscle for the pancreas, liver, and aorta; and radiation dose of each protocol were assessed quantitatively. Overall image quality was assessed qualitatively. Among 76 patients, 23 were eventually proven to have a normal pancreas. Perfusion parameters of normal pancreas in each protocol including blood volume, blood flow, and permeability-surface area product were measured.ResultsIn the quantitative study, protocol C reduced image noise by 36.8% compared to protocol B (P<0.001). Protocol C yielded significantly higher CNR relative to muscle for the aorta, pancreas and liver compared to protocol B (P<0.001), and offered no significant difference compared to protocol A. In the qualitative study, protocols C and A gained similar scores and protocol B gained the lowest score for overall image quality (P<0.001). Mean effective doses were 23.37 mSv for protocol A and 10.81 mSv for protocols B and C. There were no significant differences in the normal pancreas perfusion values among three different protocols.ConclusionLow-tube-voltage and iDose4 iterative reconstruction can dramatically decrease the radiation dose with acceptable image quality during whole-pancreas CT perfusion and have no significant impact on the perfusion parameters of normal pancreas compared to the conventional FBP reconstruction using a 256-slice CT scanner.
Synovial sarcoma (SS) is a high-grade malignant neoplasm. SS is a rare cancer type, which is primarily derived from the soft tissues of the lower extremities. The head and neck region is quite an extremely rare location, particularly the ventricle.The origin of SS remains a challenge, which along with its propensity to present clinical features mimicking other neoplasms within the common site, can result in significant diagnostic difficulty.Herein, we present a case of 40-year-old male SS located in the left ventricle with information including manifestation, imaging and histopathological features.On CT, approximately 30% of cases appear detectable calcification, which may be focal or dispersed throughout the tumor, often with a fine, stippled, or opaque appearance. MRI revealed a heterogeneous expansive and multi-lobular mass involving left ventricle, with intense and heterogeneous enhancement. Tentorium was thickened and enhanced. Small cystic changes were found in the peripheral part of the tumor with no enhancement. . Radiologically, discriminating SS from other types of cancer is very difficult. Nonetheless, they should be considered in the differential diagnosis. Owing to the rarity of SS in the ventricle, misdiagnosis is commonIn summary, we report one SS in the ventricle, the unusual location, to remind the radiologist to make it come to our mind for future work.
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