Dual-Source Computed Tomography of the Chest in Blunt Thoracic Trauma: Reduced Aortic Motion Using a Novel Temporal Resolution Optimization Method

J Thorac Imaging. 2019 Nov;34(6):387-392. doi: 10.1097/RTI.0000000000000412.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Algorithms
  • Aorta, Thoracic / diagnostic imaging*
  • Artifacts
  • Female
  • Humans
  • Male
  • Middle Aged
  • Movement*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Retrospective Studies
  • Signal-To-Noise Ratio
  • Thoracic Injuries / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*
  • Wounds, Nonpenetrating / diagnostic imaging*