title: Improved imaging of the cervico-thoracic junction in computed tomography.
abstract: OBJECTIVE
  To reduce beam hardening artifacts caused by the shoulder joint, we explored new and unique methods to improve the quality of images, such as varying the injection site and changing the position of patients (swimmers position).
  
  
  METHODS
  Fifth-four patients underwent neck CT examinations performed in routine and swimmers position and with a 64-slice MDCT scanner in spiral scanning. To examine the difference due to the injection sites of contrast material, subjects were divided into right- and left-side groups. For the evaluation of images, we carried out a subjective and objective assessment based on radiologists' ratings and noise measurement.
  
  
  RESULTS
  Images of the lower neck in the swimmers position exhibited less hardening and streak artifacts. The subjective and objective evaluations showed that the swimmers position received higher rating by radiologists and had lower noise level than that of routine position. The swimmers position was the most effective for the diagnosis of the cervico-thoracic junction area. As for the injection site, we obtained better images by an injection of contrast material in the right arm than in the left.
  
  
  CONCLUSIONS
  CT examination of the lower neck in the swimmers position may improve the quality of image and the effectiveness of diagnosis. The injection of a contrast material to the right side rather than the left side reduced foreign body artifacts.
authors.affiliation: Department of Radiology, Ansan Hospital, Korea University Medical Center, Ansan, Korea.
authors.forename: Pyong Kon
authors.initials: PK
authors.lastname: Cho
authors.forename: Young Hen
authors.initials: YH
authors.lastname: Lee
authors.forename: You Hyun
authors.initials: YH
authors.lastname: Kim
authors.forename: Jong Hak
authors.initials: JH
authors.lastname: Choi
authors.forename: Dong Chul
authors.initials: DC
authors.lastname: Shin
authors.forename: Tae Kyu
authors.initials: TK
authors.lastname: Choi
authors.forename: Jang Seob
authors.initials: JS
authors.lastname: Kim
authors.forename: Ki Hyun
authors.initials: KH
authors.lastname: Kim
authors.forename: Sun Ung
authors.initials: SU
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic / Q000379:methods*; D013909:Thorax; D014057:Tomography, X-Ray Computed / Q000379:methods*