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    HRCT Protocols & Artifacts: Leena. R. David M.SC - MIT

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    Nadeem Shah
    HRCT protocols and artifacts HRCT provides excellent spatial resolution for imaging lungs and temporal bones. Key modifications for HRCT include thin collimation, high-frequency reconstruction algorithms, and targeted reconstructions. HRCT is useful for evaluating conditions like emphysema, interstitial lung disease, fibrosis, and bronchiectasis using thin slices during suspended full inspiration. Motion, beam hardening, partial volume, and reconstruction artifacts can occur and be minimized by techniques like ECG gating and increased dose. Streaks and correlated noise arise from under sampling and photon starvation respectively.

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    HRCT Protocols & Artifacts: Leena. R. David M.SC - MIT

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    Nadeem Shah
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    HRCT protocols and artifacts HRCT provides excellent spatial resolution for imaging lungs and temporal bones. Key modifications for HRCT include thin collimation, high-frequency reconstruction algorithms, and targeted reconstructions. HRCT is useful for evaluating conditions like emphysema, interstitial lung disease, fibrosis, and bronchiectasis using thin slices during suspended full inspiration. Motion, beam hardening, partial volume, and reconstruction artifacts can occur and be minimized by techniques like ECG gating and increased dose. Streaks and correlated noise arise from under sampling and photon starvation respectively.

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    HRCT protocols and artifacts HRCT provides excellent spatial resolution for imaging lungs and temporal bones. Key modifications for HRCT include thin collimation, high-frequency reconstruction algorithms, and targeted reconstructions. HRCT is useful for evaluating conditions like emphysema, interstitial lung disease, fibrosis, and bronchiectasis using thin slices during suspended full inspiration. Motion, beam hardening, partial volume, and reconstruction artifacts can occur and be minimized by techniques like ECG gating and increased dose. Streaks and correlated noise arise from under sampling and photon starvation respectively.

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    56 views24 pages

    HRCT Protocols & Artifacts: Leena. R. David M.SC - MIT

    Uploaded by

    Nadeem Shah
    HRCT protocols and artifacts HRCT provides excellent spatial resolution for imaging lungs and temporal bones. Key modifications for HRCT include thin collimation, high-frequency reconstruction algorithms, and targeted reconstructions. HRCT is useful for evaluating conditions like emphysema, interstitial lung disease, fibrosis, and bronchiectasis using thin slices during suspended full inspiration. Motion, beam hardening, partial volume, and reconstruction artifacts can occur and be minimized by techniques like ECG gating and increased dose. Streaks and correlated noise arise from under sampling and photon starvation respectively.

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    of 24

    HRCT PROTOCOLS

    & ARTIFACTS
    Leena. R. David
    M.Sc.MIT
    HRCT
    • HRCT techniques are capable of imaging the
    ROI (lungs, temporal bone) with excellent
    spatial resolution.

    • Conventional radiography:
    – Superimposition of structures due to 2D
    projectional format.
    • MODIFICATION OF CT TECHNIQUE THAT
    MAKES IT HRCT ARE:

    – The use of thin collimation


    – Image reconstruction with a high
    spatial frequency (sharp) algorithm
    – Increased kVp or mA technique
    – Use of large matrix size
    – Targeted image reconstruction
    ESSENTIAL….
    • Collimation: thinnest available.
    • Reconstruction algorithm: high- spatial frequency
    or “sharp” algorithm.
    • Scan time: as short as possible (1 to 2 sec)
    • Windows: lung window
    • Soft tissue window- for mediastinum, hila and
    pleura.
    • Targeted reconstruction– to a single lung instead
    of a entire thorax.
    HRCT OF LUNGS
    • It is the technique used in the
    assessment of disorders of the lungs.
    • Uses thinner slices (1mm) spaced 10mm
    apart.
    • Thin sections – permits optimal
    evaluation of details.
    • No I/V contrast agent is used.
    HRCT LUNGS
    INDICATIONS
    Emphysema-Permanent, abnormal enlargement
    of air spaces distal to the terminal bronchiole,
    accompanied by the obstruction of the walls
    of the involved air spaces.
    • ILD
    • Fibrotic or restrictive disease
    • Hemoptysis
    • Bronchiectasis
    PROTOCOL
    PROTOCOL HRCT helical
    Scano 1800
    kV 120
    mA 30
    Patient position Feet first supine
    Resolution High
    Slice thickness 1.00 mm

    Slice increment 10.0mm

    KV 120

    mAs 300 mAs/ Slice

    Matrix 768 x 768


    • INSPIRATORY LEVEL:
    – Routine HRCT during suspended full inspiration.
    – Normal lung attenuation in HRCT is -700 to -900 HU
    • PATIENT POSITION:
    – Routine : supine
    – Prone positions – Atelectasis (lack of gas exchange
    within the alveoli)
    • Normal findings can closely mimic the appearance of
    early lung fibrosis.
    • “ a true abnormality remains unchanged
    regardless of whether it is dependent or
    nondependent. Normal dependent density
    disappears in prone position”
    ILD
    • Diffuse parenchymal lung disease, Restrictive lung disease.
    • refers to a group of lung diseases affecting the interstitium
    (the tissue and space around the air sacs of the lungs).
    • characterized by a loss of lung compliance causing
    incomplete lung expansion and increased lung stiffness. E.g.
    in infant respiratory distress syndrome (IRDS)

    • Obstructive lung diseases- diseases of the lung where the


    bronchial tubes become narrowed making it hard to move
    air in and especially out of the lung.
    HONEY COMBING

    • Interstitial fibrosis ,
    alveolar disruption,
    dilation of alveolar
    ducts and
    bronchiolar dilatation
    can result in the
    formation of honey
    comb cysts.
    BRONCHIECTASIS
    • defined by localized,
    irreversible dilation of part
    of the bronchial tree. It is
    classified as an obstructive
    lung disease.
    • Involved bronchi are
    dilated, inflamed, and
    easily collapsible, resulting
    in airflow obstruction and
    impaired clearance of
    secretions
    EXPIRATORY HRCT
    • To detect air tapping
    in patients with
    small airway
    obstruction.
    • Lung parenchyma
    normally increases in
    CT attenuation as
    lung volume is
    reduced during
    expiration
    HRCT TEMPORAL BONE
    • TBF – longitudinal, transverse, complex, atypical.
    • Longitudinal are common due to the blows to
    the temporal bone or parietal areas.
    – It starts from the posterior aspect of the squamous
    temporal bone & continues anterio-medially.
    • Transverse fracture– blows to the occipital bone.
    – Fracture line passes through the vestibule & cochlea
    (total hearing loss)
    • Intraneural hematoma – most common cause of
    facial nerve palsy.
    SCAN PROTOCOL
    SCAN PROTOCOL IAC VOLUME

    SCANO 900

    kV 140

    mAs 349

    Filter D

    IMAGE MATRIX 768 X 768


    (a) the internal auditory
    canal
    (b) facial nerve turns
    anteriorly
    (c) ends at the
    geniculate ganglion
    anteriorly
    (d) posteriorly as the
    tympanic segment
    ARTIFACTS ON HRCT
    • Streak artifact: radiate from the edges of a
    sharply marginated, high contrast structures
    (bronchial walls, ribs or vertebral bodies)

    • Visible as : fine, linear or net- like opacities.

    • Streak artifacts can result from 2 separate


    mechanisms – aliasing, correlated noise.
    • Aliasing: geometric phenomenon that occurs
    because of under sampling of spatial
    information
    – related to detector spacing and scan collimation.

    • Correlated noise (photon starvation): seen in


    the paravertebral regions, adjacent to highly
    attenuating vertebral bodies.
    – Related to- radiation dose and can be minimized
    by increasing kVp and mAs.
    – Automatic tube current modulation may be used.
    DOUBLE FISSURE ARTIFACT
    BRONCHIECTASIS ARTIFACT
    PARTIAL VOLUME
    ARTIFACT:
    • Occurs when a
    dense object is
    located off- center
    and is
    incompletely
    scanned by the X-
    ray beam.

    • Minimized by thin
    collimation or high
    pitch
    MOTION ARTIFACTS
    • Pulsation or “ star” artifacts are commonly
    visible at the left lung base.
    • Can be reduced by ECG gating.
    ARTIFACTS DUE TO RECONSTRUCTION
    • ZEBRA ARTIFACT:
    results in the presence of horizontal stripes of varying
    density in the reconstructed image.
    • Due to the thickness of the detectors used, because
    of the noise inhomogeneity in the Z- axis.

    • STAIR- STEP ARTIFACT:


    – occurs when using scan data obtained with thick
    collimation and non- overlapping reconstructions. (not
    common because of thin detectors are used)
    – In MDCT artifacts in the images reconstructed in the sag &
    coronal is due to cardiac pulsation.
    THANK YOU

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