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The aim of this study was to examine attenuation values in the central vein and perivenous artefacts at the subclavian vein in cervical CT angiography (CTA) when using 40 ml contrast material (CM) followed by different volumes (25 ml vs 40 ml) of saline flush (SF).61 patients underwent CTA between the aortic arch (AA) and distal to the circle of Willis (cW). After calculating test-bolus time to peak enhancement at the cW (Tc), scanning delay was represented as [(Tc + 4) - scan duration between AA and cW] s. 28 patients (Group A) received 40 ml of 370 mg iodine (I) ml(-1) CM followed by 25 ml of SF, and 33 patients (Group B) received the same CM followed by 40 ml of SF, both administered through the right antecubital vein. Arterial attenuation was measured at seven points in the aorto-carotid artery and at three points in the vertebrobasilar artery. Venous attenuation in the central vein was measured at four points. Mean attenuation values were analysed quantitatively. Axial and post-processing three-dimensional images were assessed qualitatively.When Groups A and B were compared, there were no differences in the mean attenuation values in either the aorto-carotid artery (p=0.78) or the vertebrobasilar artery (p=0.82). Mean venous attenuation values were lower (p=0.002) in Group B than in Group A. Although the qualitative assessment of arterial images showed no differences between the two groups overall, perivenous artefacts at the subclavian vein were assessed as less prominent (p0.01) in Group B.When compared with CTA followed by 25 ml of SF, CTA followed by 40 ml of SF can reduce venous attenuation values and perivenous artefacts at the subclavian vein.

How the maintenance checks of the medical treatment system, including start of work check and the ending check, was effective for preventive maintenance and the safety improvement was verified. In this research, date on the failure of devices in multiple facilities was collected, and the data of the trouble repair record was analyzed by the technique of reliability engineering. An analysis of data on the system (8 general systems, 6 Angio systems, 11 CT systems, 8 MRI systems, 8 RI systems, and the radiation therapy system 9) used in eight hospitals was performed. The data collection period assumed nine months from April to December 2008. Seven items were analyzed. (1) Mean time between failures (MTBF) (2) Mean time to repair (MTTR) (3) Mean down time (MDT) (4) Number found by check in morning (5) Failure generation time according to modality. The classification of the breakdowns per device, the incidence, and the tendency could be understood by introducing reliability engineering. Analysis, evaluation, and feedback on the failure generation history are useful to keep downtime to a minimum and to ensure safety.

A catheterization study and treatment of coronary arteriopathy are performed by investigating the coronary artery from different angles to find the region to be treated. In doing so, our system always started from the initial value of the loading factor, using this only for the first time, and the system started from the last loading factor the second time and later, at all angles. Therefore, depending on the angle, the loading factor at the start of fluoroscopy sometimes became unstable, and it took time to stabilize. This made the starting image too dark (undershoot x-ray condition) or fogged by halation (overshoot x-ray condition). With the system manufacturer, we developed a tube voltage and tube current setting method for the initial value of the loading factor. We installed software which preset the loading factor at the start of fluoroscopy depending on the angle, and an auto memory function of the last loading factor for each angle. This function allows the system to control the tube voltage and tube current for any angle. As a result, the system can acquire a more stabilized image from the start of fluoroscopy. This method of determining the initial loading factor is an effective way to stabilize the fluoroscopy image quickly.

The development of MDCT enabled various high-quality 3D imaging and optimized scan timing with contrast injection in a multi-phase dynamic study. Since radiation dose tends to increase to yield such high-quality images, we have to make an effort to reduce radiation dose. A non-linear image filter (Neuro 3D filter: N3D filter) has been developed in order to improve image noise. The purpose of this study was to evaluate the physical performance and effectiveness of this non-linear image filter using phantoms, and show how we can reduce radiation dose in clinical use of this filter. This N3D filter reduced radiation dose by about 50%, with minimum deterioration of spatial reduction in phantom and clinical studies. This filter shows great potential for clinical application.

Background: Although fast acquisition of multidetector-row computed tomography (MDCT) can make it possible to acquire sufficient early vascular enhancement using small volumes and high concentrations of contrast material (CM), there are still some problems with nephrotoxicity and costs related to CM. Purpose: To compare the qualitative and quantitative performance in cervicocranial CT angiography (CTA) using two different iodine volumes and concentrations of CM. Material and Methods: CTA ranging from the aortic arch (AA) to distal to the circle of Willis (cW) was performed on a 32-MDCT system. Fifty-eight patients were randomly divided into two groups: group A (29 patients) received 60 ml of 300 mg I/ml CM, and group B (the other 29 patients) received 40 ml of 370 mg I/ml CM. Time to peak arterial enhancement at cW (Tc) was calculated. As scan speed was 96.9 mm/s and injection rate was 4.0 ml/s, scanning delay was individually decided according to Tc and scan duration between AA and cW. Arterial attenuation along the z-axis at eight points in the carotid-cerebral artery and venous attenuation of the internal jugular vein (IJV) at carotid bifurcation were measured. Mean attenuation values were then quantitatively analyzed. Postprocessing images were qualitatively assessed. Results: Arterial attenuation profiles revealed maximum attenuation at the distal common carotid artery in both groups. Although there were no significant differences in mean arterial attenuation in group A versus group B (402±70 HU vs. 407±67 HU; P=0.78), venous attenuation of the IJV was lower in group B than in group A (114±57 HU vs. 224±81 HU; P Conclusion: Although a different amount of CM was administered in both groups, quantitative and qualitative arterial images did not show significant differences between the two groups.

The clinical usefulness, as well as the advantages and limitations of DWI in the abdomen and pelvis, currently are under discussion. One of the limitations is the artifact from bowel fluid that may obscure lesion signals or make it difficult to detect them. The purpose of this study was to examine evidence as to whether an oral contrast agent of ferric ammonium citrate could eliminate this artifact from the bowel loop. The study consisted of a phantom study and clinical study. The density of the phantom compounded it to 1-6 times, 8 times and 12 times. We changed the density with ferric ammonium citrate to find the best density. The pulse sequence used SE-PEI and, variable parameter changed TE and b value. The signal intensity of the phantoms was visually analyzed. We took the results to an outside observer as a clinical study and confirmed the effect visually. When a signal of ferric ammonium citrate extended TE time and increased b value, it fell. As it thickened the density of phantom, it was the result that the signal deteriorated, and was good. However, an artifact from ferric ammonium citrate appeared when we exceeded 5x density. The signal of the bowel fluid artifact disappeared by having a normal person take the 4x density as in the clinical study. Elimination of bowel fluid artifact on abdominal DWI was able to suggest the possibility of taking the ferric ammonium citrate solution at 4x density.

An interventional-radiology computed-tomography (IVR-CT)/angio system is a combination of an angiographic unit and a CT scanner. This system allows patient's movement in and out of the two imaging units, on the same table. Since June 2003, we have applied our conventional protocol for evaluation of cerebral blood perfusion during interventional radiology (IVR) procedures. We reviewed our experience using the IVR-CT/angio system and investigated the efficacy and limitations of this technique. No complications relating to radiation exposure, contrast medium use, or IVR procedures were observed. CT perfusion was useful for detecting cerebral perfusion impairment during IVR procedures. This was helpful in deciding the postoperative management. Because patients do not need to be transported to another radiographic suite to evaluate cerebral blood perfusion, the IVR-CT/angio system is ideal for safely and simply detecting cerebral perfusion defects during IVR procedures. However, it is important to consider whether there is sufficient indication for the procedure, because radiation exposure and the amount of contrast medium use are increased if the IVR procedures become difficult.

The clinical efficacy, dose-response relationship, and safety of TRH-T (thyrotropin releasing hormone tartrate) were assessed in 290 patients with spinocerebellar degeneration (SCD) in a 2-week, double-blind study using placebo as control. 254 patients satisfied the criteria for inclusion in evaluation of the drug efficacy. The patients were treated with TRH-T in an intramuscular dose of 2 mg, 0.5 mg or 0 mg (placebo) as TRH once a day for 2 weeks. Clinical responses to these treatments were evaluated 3 times: at the end of weeks 1 and 2 of treatment and a week after the end of treatment. The results of "global improvement rating" as well as those of "ataxia improvement rating" showed that both 2 mg and 0.5 mg TRH-T treatments were significantly superior to placebo treatment in patients with predominantly cerebellar form of SCD. The effect was well maintained a week after the end of the 2-week treatment in the patients who were given TRH-T in daily dose of 2 mg and showed improvement at the end of treatment. The results of "improvement rating of each symptom" revealed that 2 mg treatment was significantly more effective than placebo for disorders of standing, gait, speech and writing. In the patients who had no pyramidal involvement or disorder of deep sensation, the drug efficacy and dose-response relationship were evident. Adverse reactions to the drug such as headache, feeling febrile and nausea were observed in 50% of the patients on 2 mg treatment, in 38% of those on 0.5 mg treatment and in 21% of those on placebo patient, however, discontinued treatment because of adverse reactions.