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Image quality and dose comparison among screen-film, computed, and CT scanned projection radiography: applications to CT urography.

PURPOSE: To evaluate image quality and dose for abdominal imaging techniques that could be used as part of a computed tomographic (CT) urographic examination: screen-film (S-F) radiography or computed radiography (CR), performed with moving and stationary grids, and CT scanned projection radiography (CT SPR). MATERIALS AND METHODS: An image quality phantom underwent imaging with moving and stationary grids with both a clinical S-F combination and CR plate. CT SPR was performed with six CT scanners at various milliampere second and kilovolt peak settings. Entrance skin exposure (ESE); spatial, contrast, and temporal resolutions; geometric accuracy; and artifacts were assessed. RESULTS: S-F or CR images, with either grid, provided image quality equivalent to that with the clinical standard, S-F with a moving grid. ESE values for both S-F and CR were 435 mR (112.2 microC/kg [1 mR = 0.258 microC/kg]) with a moving grid and 226 mR (58.3 microC/kg) with a stationary grid. All CT SPR images provided inferior spatial resolution compared with S-F or CR images. High-contrast objects generated substantial artifacts on CT SPR images. Compared with S-F, CR and CT SPR provided improved resolution of small low-contrast objects. The contrast between iodine and soft-tissue-mimicking structures on CT SPR images acquired at 80 kVp was twice that at 120 kVp. CT SPR images with acceptable noise levels required a midline ESE value of approximately 300 mR (77.4 microC/kg) at 80 kVp. CONCLUSION: S-F and CR provided better spatial resolution than did CT SPR. However, CT SPR provided improved low-contrast resolution compared with S-F, at exposures comparable to those used for S-F or CR.

Equipment Design↗

Excretory urography in the emergency department: utility of teleradiology.

To test the feasibility of teleradiology for use with excretory urograms obtained in the emergency department in cases for suspected renal colic, radiographs from 43 patients were digitized, transmitted via standard phone lines, and viewed on a video monitor 2 miles distant. Diagnostic interpretations of the video image and the original radiograph were reviewed for degree of concordance. The video and film images of the 27 examinations showing obstruction were interpreted with 100% correlation. Agreement as to the site of obstruction was present in 93% of cases. Only two-thirds of renal and ureteral calculi seen on the radiographs were discerned on the video images, however. Teleradiology proved as useful for ongoing monitoring and modification of these examinations as for initial interpretation.

Colic↗

Excretion urography toxicity studies in experimental acute renal failure.

Studies have been carried out on the toxicity of large doses of contrast medium (Hypaque 45%) given to rats with acute renal failure induced both by mercuric chloride and by glycerol. No increase in the expected mortality of the experimental models was observed following infusion of twice the maximum clinical dose of contrast medium.

Acute Kidney Injury↗