Evaluation of whole body Ultralow-Dose CT for the assessment of ventriculoperitoneal shunt complications: an experimental ex-vivo study in a swine model

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• 作者：Ahmed Othman ; Hussam A. Hamou ; Rastislav Pjontek ; Saif Afat…
• 关键词：Ventriculoperitoneal Shunt ; Multidetector Computed Tomography ; Low Dose CT ; Radiography ; Radiation Dosage
• 刊名：European Radiology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：25
• 期：8
• 页码：2199-2204
• 全文大小：529 KB
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• 作者单位：Ahmed Othman (1) (3)
  Hussam A. Hamou (2)
  Rastislav Pjontek (1)
  Saif Afat (1)
  Hans Clusmann (2)
  Martin Wiesmann (1)
  Marc A. Brockmann (1)
  
  1. Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
  3. Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, 72076, Tübingen, Germany
  2. Department of Neurosurgery, RWTH Aachen University, 52074, Aachen, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Diagnostic Radiology
  Interventional Radiology
  Neuroradiology
  Ultrasound
  Internal Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1084

文摘

Objective To evaluate the suitability of whole body Ultralow-dose CT (ULD-CT) as a diagnostic tool for the evaluation of ventriculoperitoneal shunt (VP-shunt) complications with special regards to radiation dose and image quality. Methods Fourteen VP-shunts were implanted in 7 swine cadavers (weight: 55-70?kg). Twenty-two mechanical complications (extracranial and extraperitoneal malpositioning, breakages, disconnections) were induced in nine VP-shunts. Ten ULD-CT scans with different parameters (tube voltage: 80, 100, 120?kV; tube current: 20 or 50 mAs; Pitch (P): 1 or 1.5) were acquired; the combination of 120?kV and 50 mAs was omitted. Radiation dose estimation, blinded readings, and quantitative and qualitative assessment of the CT-data were performed. Results Effective radiation doses varied between 0.44?±-.06 and 2.55?±-.35?mSv. ULD-CT protocols provided a mean sensitivity (i.e., correctly detected shunt complications) of 98.2?%. Unnoticed or incorrectly identified complications did not exceed one complication (4.5?%) in any ULD-CT protocol. Diagnostic confidence was sufficient for all ULD-CT protocols except for protocols with 80?kV and 20 mAs. Conclusions ULD-CT allows accurate detection of VP-shunt complications at radiation doses similar or lower than reported for a radiographic shunt series. At the tested radiation dose levels, ULD-CT thus provides an alternative to a radiographic shunt series. Key Points -Ultralow-dose CT accurately detects Ventriculoperitoneal Shunt complications. -Radiation dosage is similar or lower than reported for a radiographic shunt series. -Ultralow-dose CT potentially shortens the diagnostic process when shunt complications are suspected.