programma & abstracts - Nederlandse Vereniging voor Radiologie

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programma abstracts & abstracts
E06
LUNG PERFUSION DEFECTS ON DUAL-
ENERGY COMPUTED TOMOGRAPHY
(DECT): REVIEW OF MORPHOLOGY AND
DIFFERENTIAL DIAGNOSIS?
A.E. Odink 1 , M. Rossius 1 , R. Booij 1 , C.M. Schaefer-Prokop 2 ,
I.J.C. Hartmann 1
1
Erasmus Medisch Centrum, Rotterdam
2
Meander Medisch Centrum, Amersfoort
Purpose: To present insight on the basic principles of DECT
and provide a pictorial review of the range of morphology
of lung perfusion with diagnostic clues for differentiating
pulmonary embolism from other underlying diseases.
Content organization: The classic presentation on a
DECT perfusion map of acute pulmonary embolism (PE) is a
peripheral, wedge shaped defect. However, other underlying
parenchymal diseases such as emphysema, lung cysts, fibrosis
or pneumonia also cause perfusion defects. Location,
distribution and configuration of perfusion defects together
with findings in lung window settings provide the necessary
information for correct differential diagnosis. Also artifacts
caused by beam hardening or pulsation cause perfusion
inhomogeneities that occur in typical locations and are
mostly easy to dismiss.
The exhibit provides an overview of the spectrum of perfusion
map findings to be encountered in a group of unselected
patients undergoing evaluation for suspected PE and
with known or unknown concomitant lung diseases. Typical
and atypical perfusion defects caused by artifacts, focal or
diffuse lung parenchymal diseases will be presented together
with some guidelines for correct interpretation.
Conclusion: Especially in an unselected group of patients
with accompanying lung disease, knowledge of pitfalls and
artifacts is important for correct interpretation of the spectrum
of lung perfusion defects seen in DECT.
E07
VALUE OF COMPUTED TOMOGRAPHY
CORONARY ANGIOGRAPHY IN
FAILED CONVENTIONAL CORONARY
ANGIOGRAPHY
A.S. Thijssen 1 , R.N. de Visser 2 , G.F.A.J.B van Tilborg 2 ,
A.C. Weustink 1 , G.P. Krestin 1 , N.R.A. Mollet 1
1
Erasmus Medisch Centrum, Rotterdam
2
St. Elisabeth Ziekenhuis, Tilburg
Purpose/aim: If conventional X-ray coronary angiography
(CCA) fails, computed tomography coronary angiography
(CTCA) has the potential to provide the desired diagnostical
information concerning coronary patency but may also
demonstrate the cause of failing CCA exams.
Content organization: CTCA has proved its usefulness in
ruling out significant coronary artery stenosis in patients
with an intermediate risk of having coronary artery disease.
Although CCA is superior for this purpose, the exam cannot
always be successfully completed.
We will present a series of cases in which CCA could not be
successfully completed and where CTCA revealed the cause
of the failed exam. The presentation will feature several
images from CTCA studies (multiplanar reformations and 3D
renderings).
Summary: Although CTCA is primarily reserved for patients
with an intermediate risk of coronary artery disease, it can
be employed to image the coronary tree in cases where CCA
fails. In several instances, CTCA will reveal the cause of
failed CCA. CTCA data may also provide useful information
for planning interventional procedures or surgery in patients
with a failed CCA exam.
Figure 1 Figure 2 Figure 3
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