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Dual-Source Computed Tomography of the Chest in Blunt Thoracic Trauma

Reduced Aortic Motion Using a Novel Temporal Resolution Optimization Method

Liang, Teresa MD*; McLaughlin, Patrick D. MD, FRCPC*; Nugent, James P. BSc*; Rai, Shamir MD*; Schmiedeskamp, Heiko PhD; Louis, Luck MD, FRCPC*; Khosa, Faisal MD, MBA, FRCPC*; Nicolaou, Savvas MD, FRCPC*

doi: 10.1097/RTI.0000000000000412
Original Articles
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Purpose: The purpose of this study was to evaluate the clinical utility of temporal resolution optimization (TR-Opt), a computed tomography (CT) postprocessing technique, in reducing aortic motion artifacts in blunt thoracic trauma patients.

Materials and Methods: This was an IRB-approved study of 61 patients with blunt thoracic trauma carried out between February 18 and September 6, 2014; the patients had been imaged using a standardized dual-source high-pitch (DSHP) CT protocol. Image raw data were retrospectively postprocessed using the TR-Opt algorithm (DSHP-TR-Opt) and compared with conventional images (DSHP). Diagnostic ability to confidently identify and exclude potential injuries and qualitative aortic motion artifacts using a 5-point Likert scale (1=absence of motion artifacts; 5=severe motion artifact) was graded by 2 readers at multiple thoracic locations. Signal-to-noise and contrast-to-noise ratios were generated as quantitative indices of image quality.

Results: Motion artifacts degrading interpretation and limiting diagnosis of aortic injuries were present in 45% (442/976) of the assessed regions on DSHP. TR-Opt algorithm eliminated motion artifacts in 85% of the motion-degraded areas (375/442), leaving persistent motion artifacts in only 15% (67/442). Motion artifacts were most improved at the interventricular septum (1±1 vs. 3±1), aortic valve (2±1 vs. 4±1.5), and ascending aorta (1±1 vs. 3±2, P<0.005). Mean aorta noise (NAo) was 41.7% higher in the DSHP-TR-Opt images (26.5 vs. 18.7 HU, P<0.0001).

Conclusions: Temporal resolution optimized reconstruction is a raw data–based CT postprocessing technique that can be used to remove the majority of thoracic aortic motion artifacts that commonly degrade interpretation when imaging blunt thoracic trauma patients.

*Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada

Siemens Medical Solutions USA Inc., Mountain View, CA

H.S.: Senior Scientist with Siemens Medical Solutions. S.N.: UBC has a Masters research agreement with Siemens. The remaining authors declare no conflicts of interest.

Correspondence to: James P. Nugent, BSc, Department of Radiology, Vancouver General Hospital, 889 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9 (e-mail: jamespnugent@outlook.com).

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