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The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Abstract The number of computed tomography CT systems in operation in Japan is approximately 4.
However, CT systems are expensive, and thus, a heavy financial burden for hospital management. We also analyze the factors that affect CT profitability. First, the annual income per CT in operation is estimated for Second, the annual costs per CT are calculated as the sum of depreciation, maintenance, and labor costs. A correlation analysis between the annual net profits, population, and number of physicians per CT equipment is used to determine the determinants of the net CT profits by prefecture.
Thus, choosing high-performance MSCT is advantageous in terms of profitability in facilities with at least beds. Additionally, CT profitability presumably affects the balance between the number of introduced CTs, population per CT, and number of physicians per CT. It now provides immeasurable benefits in the field of medical care. As CT has superior spatial resolution than other examinations, it is excellent for stroke, acute abdominal disorder, and cancer screening, among other disorders 1 — 4.
Additionally, with the advent of multi-slice CT MSCT that uses multi-row detectors, it has become possible to photograph thin slices of tissue during a short time period, making, for example, coronary arteries and the colon subject to CT examinations 5 — 8.
Moreover, applying iterative reconstruction has made it possible to obtain high quality images at low doses, that is, screening for lung cancer at a low dose is also possible 4 , 9 , Consequently, CT has rapidly spread worldwide because of its rapid progress and high diagnostic capability.
Because of the speed of acquisition 0. One exception is during lung scans because the risk of motion artifact is slightly higher. The cost of this is typically relayed directly to pet owners as a line item on their bill. For Cone Beam systems, general anesthesia is required for virtually all scans to prevent motion artifact from rendering the entire scan non-diagnostic.
This is principally due to the longer acquisition times seconds per rotation during which any movement of the patient would require a re-scan. However, for soft tissue pathologies and brain, lung, and abdominal conditions, a radiologist over-read is sometimes necessary.
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Helical CT is a continuous volume acquisition that ensures that no lesions are lost due to respiration or after motion-related artifact Disadvantage: Radiation hazard is a major issue. Due to radiation, it can not be performed during early pregnancy. The soft tissue discrimination is poor. Although CT scan and MRI can provide valuable information about the anatomy and pathology of internal organs and tissues, greater details can be obtained by adding contrast. It may help visualize the pathology more clearly and indicate the nature of the lesion by the amount and distribution of contrast uptake.
Iodine-based contrast agents such as lopamiro are used with CT scans. It is given intravenously prior to scanning. Owing to the high atomic number of these agents, it can attenuate the X-ray beams and appear brighter or radio-opaque in the film. Blood containing this contrast agent flows through the vessels of the area to be scanned. In the film, the agent increases the contrast between blood and surrounding tissues.
This facilitates visualization of the arteries, veins and ultimately the internal structures. Highly vascularized areas will become brighter in the film. Different tissues interact with X-rays in different ways. The extent to which a material can be penetrated by an x-ray is expressed as Hounsfield Units HU. Subarachnoid haemorrhage 5 Intracerebral haemorrhage Intracerebral haemorrhage involves bleeding within the brain secondary to a ruptured blood vessel.
Intracerebral haemorrhage intraventricular and intraparenchymal Cisterns There are four key cisterns that which should be assessed for effacement, the presence of blood and asymmetry: Ambient cistern: surrounding the midbrain. Suprasellar cistern: superior to the sella turcica. Quadrigeminal cistern: adjacent to the corpora quadrigemina. Sylvian cistern: across the insular surface and within the Sylvian fissure.
An example of some of the subarachnoid cisterns made more visible due to the presence of blood from subarachnoid haemorrhage 5 Brain Sulcal effacement Sulcal effacement is the term used to describe the loss of the normal gyral-sulcal pattern of the brain, which is typically associated with raised intracranial pressure.
Grey-white matter differentiation On a normal CT head scan, the grey and white matter should be clearly differentiated. Loss of this differentiation suggests the presence of oedema which may develop secondary to a hypoxic brain injury, infarction e. Pneumocephalus air within the cranial vault may be noted after neurosurgery or adjacent to the inner table in cases of calvarial fractures. Pneumocephalus 7 Cerebral metastases with oedema 8 Hyperdense foci Hyperdensity on a CT head may be due to the presence of blood, thrombus or calcification: A hyperdense middle cerebral artery MCA is sometimes noted in total anterior circulation strokes TACS and indicates the presence of a large thrombus within the vessel.
Hyperdense right middle cerebral artery MCA 9 Tumour The radiological features of a tumour will vary depending on the histological diagnosis. Any of the following may be noted in our around a tumour: Surrounding haemorrhage: may be hyperdense, isodense or hypodense depending on the maturity of the bleed. Calcification: hyperdense on CT and typically associated with meningiomas. Oedema hypodense : may be present in the brain tissue surrounding the tumour. Contrast administration Following intravenous administration of a contrast medium, lesions may show no change, or demonstrate some form of contrast enhancement e.
Ring-enhancement is typically associated with cerebral abscesses and some types of cerebral metastases e.