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A new technique for visualisation of complex renal calculi using Dual Energy CT and image merging, in the preoperative work-up of patients undergoing Percutaneous Nephrolithotomy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Section of Medical Physics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
(English)Manuscript (preprint) (Other academic)
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:uu:diva-182092OAI: oai:DiVA.org:uu-182092DiVA: diva2:558472
Available from: 2012-10-03 Created: 2012-10-03 Last updated: 2013-01-23
In thesis
1. CT with 3D-Image Reconstructions in Preoperative Planning
Open this publication in new window or tab >>CT with 3D-Image Reconstructions in Preoperative Planning
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Computed tomography is one of the most evolving fields of modern radiology. The current CT applications permit among other things angiography, 3D image reconstructions, material decomposition and tissue characterization. CT is an important tool in the assessment of specific patient populations prior to an invasive or surgical procedure. The aim of this dissertation was to demonstrate the decisive role of CT with 3D-image reconstructions in haemodialysis patients scheduled to undergo fistulography, in patients undergoing surgical breast reconstructions with a perforator flap and in patients with complicated renal calculi scheduled to undergo percutaneous nephrolithotomy.

CT Angiography with 3D image reconstructions was performed in 31 patients with failing arteriovenous fistulas and grafts, illustrating the vascular anatomy in a comprehensive manner in 93.5% of the evaluated segments and demonstrating a sensitivity of 95% compared to fistulography.

In 59 mastectomy patients scheduled to undergo reconstructive breast surgery with a deep inferior epigastric perforator flap, the preoperative planning with CT Angiography with 3D image reconstructions of the anterior abdominal wall providing details of its vascular supply, reduced surgery time significantly (p< 0.001) and resulted in fewer complications.

Dual Energy CT Urography with advanced image reconstructions in 31 patients with complicated renal calculi scheduled to undergo PNL, resulted in a new method of material characterisation (depicting renal calculi within excreted contrast) and in the possibility of reducing radiation dose by 28% by omitting the nonenhanced scanning phase. Detailed analysis of the changes renal calculi undergo when virtually reconstructed was performed and a comparison of renal calculi number, volume, height and attenuation between virtual nonenhanced and true nonenhanced images was undertaken. All parameters were significantly underestimated in the virtual nonenhanced images.

CT with 3D-reconstructions is more than just “flashy images”. It is crucial in preoperative planning, optimizes various procedures and can reduce radiation dose. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 96 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 826
Keyword
CT Angiography, 3D-image reconstructions, haemodialysis, AVF/AVG, DIEP flap, surgery time, complicated renal calculi, PNL, true nonenhanced images, virtual nonenhanced images, CT Urography
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Radiology
Identifiers
urn:nbn:se:uu:diva-182080 (URN)978-91-554-8501-6 (ISBN)
Public defence
2012-11-23, Rosénsalen, Akademiska Sjukhuset, Ing 96, NBV, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2012-11-02 Created: 2012-10-03 Last updated: 2013-01-23Bibliographically approved

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Dimopoulou, AngelikiMagnusson, Anders

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