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Home > Comparison of Image Quality in High Pitch Free Breathing Versus Standard Pitch Breath-Holding Computed Tomographic Pulmonary Angiography.

Comparison of Image Quality in High Pitch Free Breathing Versus Standard Pitch Breath-Holding Computed Tomographic Pulmonary Angiography.

Thesis Info

Author

Ombati, Kevin Onyinkwa

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2017

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728040433

Similar


Background: Pulmonary embolism (PE) is the third most common acute cardiovascular disease. Missed diagnosis is responsible for most preventable deaths associated with PE. Artefacts from cardiac and breathing motion are a main pitfall. Advances in Computed Tomographic imaging have enabled rapid imaging in an attempt to overcome these pitfalls. Objective: To compare image quality when using high pitch free breathing versus standard pitch breath holding Computed Tomographic Pulmonary Angiography (CTPA) using a dual source scanner. Methods: This was a randomised control trial whereby patients referred to the radiology department for CTPA examination for suspected pulmonary embolism were randomly selected into two arms: Arm A underwent the standard CTPA protocol using a pitch of 1.2 with breath-holding instructions while those in arm B underwent the examination using a pitch of 3.2 with quiet free breathing. Two blinded reviewers subjectively assessed the image quality while a single blinded reviewer recorded objective image parameters. The primary endpoint was to demonstrate non-inferiority of high pitch free breathing CTPA. Continuous variables were expressed as mean ± SD. Categorical variables were expressed as frequency (percentage). For calculation of statistically significant differences between both groups, Chi-square test was performed to assess categorical variables and t test for continuous variables. P-values of ≤0.05 were considered statistically significant. Cohen kappa testing was used to assess the degree of agreement between the 2 independent readings, with results expressed in terms of kappa statistics and proportional agreement. Results: A total of 112 patients were randomly selected into the two arms of the study. The patients in the high pitch group received a lower mean radiation dose compared to those in the standard pitch group (P<0.001). There was no statistically significant difference in the mean main pulmonary artery attenuation between the two groups (P=0.215). There was no significant difference in the qualitative analysis of the images between the two groups. Inter reader agreement for the subjective measurements ranged from moderate to almost perfect agreement between the 2 independent readers. Conclusion: Main pulmonary artery contrast opacification in high pitch CTPA is non-inferior to standard pitch CTPA using a dual source 256 slice scanner. High pitch dual source CTPA can be performed on all patients with no compromise on the image quality and with the added advantage of reduction in the radiation dose.
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ہماری دعا میں اثر ہی کہاں تھا

ہماری دُعا میں اثر ہی کہاں تھا
بھلا بے وفا وہ بشر ہی کہاں تھا

میں گھر کیوں نہیں جاتا سب پوچھتے ہیں
کہوں اب میں کیا میرا گھر ہی کہاں تھا

تجھے مانگنے کے سوا دشمنِ جاں
گرا اپنا سجدے میں سر ہی کہاں تھا

جو آباد تھا کس قدر اُس کے دم سے
بغیر اُس کے ویسا نگر ہی کہاں تھا

زمانے کی حدت سے مجھ کو بچاتا
رہِ عشق میں وہ شجر ہی کہاں تھا

حضور انورﷺ کی رحمت کی امتیازی خصوصیات

The many aspects of the Holy Prophet’s (PBUH) personality has been defined by Allah himself in Quran many times, keeping in view the all angles of the Holy Prophet (PBUH) Character blessings for all worlds and times. The Rehmatul-il-Almeen is infinite. The Holy Prophet (PBUH) has proved such a huge chain by his character. The blessing of the Holy Prophet (PBUH) is such a supreme that, it could not be defined in such an article, but here it has been tried to throw light on some features of Holy Prophet (PBUH) blessing. As Quran says that the secret of man on the path of the Holy Prophet (PBUH). Today same way, man regardless of color, race and religious should know that the wounds of humanity could be headed by following the route of the Holy Prophet (PBUH) Sunnah. All the other ways will lead to cul-de-sac.

Socio-Economic Impact of Overseas Workers Remittances on the Recipient Households in District Swabi, Pakistan

The main objective of this study was to analyze the impact of foreign remittances on the socio- economic development of the District Swabi, NWFP, Pakistan. For this purpose eleven villages were selected where 360 respondents were interviewed in the year 2008. Several important conclusions emerge from this study in the context of: determinants of emigration, the foreign earnings, the mode of utilization and socio-economic impact on recipients in Pakistan. These conclusions are summed up below. The study reveals that both “Pull” and ‘Push’ factors have propelled the emigration process but the “Pull” factors are more dominant. The study also distinctly substantiates the “Age Selectivity” character of emigration stream; 63% of the emigrants under study belong to the 21-30 years age group. The study reveals that the literacy level of the emigrants’ households positively impacted the incidence of emigration. Regression results of the study also clearly establish a positive and significant correlation between the level of ‘formal education’ and ‘formal training’ of emigrants with their income level abroad. These findings discount the commonplace views on this subject in the study universe and thus, should, further strengthen the urge, among the area’s people and also elsewhere, to go for formal education and formal training, more and more. An unexpected finding of the study is the negative and insignificant correlation between emigrants’ non-formal skills and their income level abroad. The emigrants’ remittances have substantially improved their left behind households’ income level, which compares very favorably with income of the in-country workers; being three times higher than the latter. The emigrants’ households were, generally speaking, found to be making a rational allocation of their enhanced income over consumption and productive uses. Some 14% households acquired agricultural land which significantly increased their holdings (22%) over the pre-emigration period; 12% purchased plots of land for residential/commercial construction; 32% invested in livestock that raised their livestock holdings by 83%; 49% bought vehicles, mostly for both personal and commercial use; and 79% constructed or improved their residences, thus creating an asset of growing value by the current trend. Expenditure on health and education is universally regarded a productive outlay, and the emigrants households prominently excel in this respect. These items claimed 11% and 14% respectively of their total current expenditure. The outcomes are manifested in improvement in health situation as well as literacy and education level of the population under study. Both men and women have had their share in this respect. The growing popularity of education among women is, especially noteworthy and is a break away from the social rigidity of the past. Thus, emigration and the resulting inflow of remittances from abroad have set in the much welcome process of socio-economic change and emigration should accordingly be encouraged and facilitated by providing appropriate financial, legal, and