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Sample records for abdominal ct studies

  1. Abdominal CT scan

    MedlinePlus

    ... results may also be due to: Abdominal aortic aneurysm Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal ... Livingstone; 2014:chap 4. Read More Abdominal aortic aneurysm Abdominal aortic aneurysm repair - open Abscess Acute cholecystitis ...

  2. Abdominal CT scan

    MedlinePlus

    ... tumors, including cancer Infections or injury Kidney stones Appendicitis ... also be due to: Abdominal aortic aneurysm Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal artery stenosis ...

  3. Interaction of expanding abdominal aortic aneurysm with surrounding tissue: Retrospective CT image studies

    PubMed Central

    Kwon, Sebastian T.; Burek, William; Dupay, Alexander C.; Farsad, Mehdi; Baek, Seungik; Park, Eun-Ah; Lee, Whal

    2015-01-01

    Objectives Abdominal aortic aneurysms (AAA) that rupture have a high mortality rate. Rupture occurs when local mechanical stress exceeds the local mechanical strength of an AAA, so stress profiles such as those from finite element analysis (FEA) are useful. The role and effect of surrounding tissues, like the vertebral column, which have not been extensively studied, are examined in this paper. Methods Longitudinal CT scans from ten patients with AAAs were studied to see the effect of surrounding tissues on AAAs. Segmentation was performed to distinguish the AAA from other tissues and we studied how these surrounding tissues affected the shape and curvature of the AAA. Previously established methods by Veldenz et al. were used to split the AAA into 8 sections and examine the specific effects of surrounding tissues on these sections [1]. Three-dimensional models were created to better examine these effects over time. Registration was done in order to compare AAAs longitudinally. Results The vertebral column and osteophytes were observed to have been affecting the shape and the curvature of the AAA. Interaction with the spine caused focal flattening in certain areas of the AAA. In 16 of the 41 CT scans, the right posterior dorsal section (section 5), had the highest radius of curvature, which was by far the section that had the maximum radius for a specified CT scan. Evolution of the growing AAA showed increased flattening in this section when comparing the last CT scan to the first scan. Conclusion Surrounding tissues have a clear influence on the geometry of an AAA, which may in turn affect the stress profile of AAA. Incorporating these structures in FEA and G&R models will provide a better estimate of stress. Clinical Relevance Currently, size is the only variable considered when deciding whether to undergo elective surgery to repair AAA since it is an easy enough measure for clinicians to utilize. However, this may not be the best indicator of rupture risk

  4. Three-Dimensional Ultrasound-Based Navigation Combined with Preoperative CT During Abdominal Interventions: A Feasibility Study

    SciTech Connect

    Kaspersen, J.H. Sjolie, E.; Wesche, J.; Asland, J.; Lundbom, J.; Odegard, A.; Lindseth, F.; Nagelhus Hernes, T.A.

    2003-08-15

    Purpose: Three-dimensional (3D)intraoperative ultrasound may be easier to interpret when used in combination with less noisy preoperative image data such as CT. The purpose of this study was to evaluate the use of preoperative image data in a 3D ultrasound-based navigation system specially designed for minimally invasive abdominal surgery. A prototype system has been tested in patients with aortic aneurysms undergoing clinical assessment before and after abdominal aortic stent-graft implantation. Methods: All patients were first imaged by spiral CT followed by 3D ultrasound scanning. The CT volume was registered to the patient using fiducial markers. This enabled us to compare corresponding slices from 3D ultrasound and CT volumes. The accuracy of the patient registration was evaluated both using the external fiducial markers (artificial landmarks glued on the patient's skin) and using intraoperative 3D ultrasound as a measure of the true positioning of anatomic landmarks inside the body. Results: The mean registration accuracy on the surface was found to be 7.1 mm, but increased to 13.0 mm for specific landmarks inside the body. CT and ultrasound gave supplementary information of surrounding structures and position of the patient's anatomy. Fine-tuning the initial patient registration of the CT data with a multimodal CT to intraoperative 3D ultrasound registration (e.g., mutual information), as well as ensuring no movements between this registration and image guidance, may improve the registration accuracy. Conclusion: Preoperative CT in combination with 3D ultrasound might be helpful for guiding minimal invasive abdominal interventions.

  5. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  6. Multidetector CT of blunt abdominal trauma.

    PubMed

    Soto, Jorge A; Anderson, Stephan W

    2012-12-01

    The morbidity, mortality, and economic costs resulting from trauma in general, and blunt abdominal trauma in particular, are substantial. The "panscan" (computed tomographic [CT] examination of the head, neck, chest, abdomen, and pelvis) has become an essential element in the early evaluation and decision-making algorithm for hemodynamically stable patients who sustained abdominal trauma. CT has virtually replaced diagnostic peritoneal lavage for the detection of important injuries. Over the past decade, substantial hardware and software developments in CT technology, especially the introduction and refinement of multidetector scanners, have expanded the versatility of CT for examination of the polytrauma patient in multiple facets: higher spatial resolution, faster image acquisition and reconstruction, and improved patient safety (optimization of radiation delivery methods). In this article, the authors review the elements of multidetector CT technique that are currently relevant for evaluating blunt abdominal trauma and describe the most important CT signs of trauma in the various organs. Because conservative nonsurgical therapy is preferred for all but the most severe injuries affecting the solid viscera, the authors emphasize the CT findings that are indications for direct therapeutic intervention. PMID:23175542

  7. CT of acute abdominal aortic disorders.

    PubMed

    Bhalla, Sanjeev; Menias, Christine O; Heiken, Jay P

    2003-11-01

    Aortic aneurysm rupture, aortic dissection, PAU, acute aortic occlusion, traumatic aortic injury, and aortic fistula represent acute abdominal aortic conditions. Because of its speed and proximity to the emergency department, helical CT is the imaging test of choice for these conditions. MR imaging also plays an important role in the imaging of aortic dissection and PAU, particularly when the patient is unable to receive intravenous contrast material. In this era of MDCT, conventional angiography is used as a secondary diagnostic tool to clarify equivocal findings on cross-sectional imaging. Ultrasound is helpful when CT is not readily available and the patient is unable or too unstable to undergo MR imaging. PMID:14661663

  8. Low kV settings CT angiography (CTA) with low dose contrast medium volume protocol in the assessment of thoracic and abdominal aorta disease: a feasibility study

    PubMed Central

    Talei Franzesi, C; Fior, D; Bonaffini, P A; Minutolo, O; Sironi, S

    2015-01-01

    Objective: To assess the diagnostic quality of low dose (100 kV) CT angiography (CTA), by using ultra-low contrast medium volume (30 ml), for thoracic and abdominal aorta evaluation. Methods: 67 patients with thoracic or abdominal vascular disease underwent multidetector CT study using a 256 slice scanner, with low dose radiation protocol (automated tube current modulation, 100 kV) and low contrast medium volume (30 ml; 4 ml s−1). Density measurements were performed on ascending, arch, descending thoracic aorta, anonymous branch, abdominal aorta, and renal and common iliac arteries. Radiation dose exposure [dose–length product (DLP)] was calculated. A control group of 35 patients with thoracic or abdominal vascular disease were evaluated with standard CTA protocol (automated tube current modulation, 120 kV; contrast medium, 80 ml). Results: In all patients, we correctly visualized and evaluated main branches of the thoracic and abdominal aorta. No difference in density measurements was achieved between low tube voltage protocol (mean attenuation value of thoracic aorta, 304 HU; abdominal, 343 HU; renal arteries, 331 HU) and control group (mean attenuation value of thoracic aorta, 320 HU; abdominal, 339; renal arteries, 303 HU). Radiation dose exposure in low tube voltage protocol was significantly different between thoracic and abdominal low tube voltage studies (490 and 324 DLP, respectively) and the control group (thoracic DLP, 1032; abdomen, DLP 1078). Conclusion: Low-tube-voltage protocol may provide a diagnostic performance comparable with that of the standard protocol, decreasing radiation dose exposure and contrast material volume amount. Advances in knowledge: Low-tube-voltage-setting protocol combined with ultra-low contrast agent volume (30 ml), by using new multidetector-row CT scanners, represents a feasible diagnostic tool to significantly reduce the radiation dose delivered to patients and to preserve renal function

  9. Pineal gland calcification, lumbar intervertebral disc degeneration and abdominal aorta calcifying atherosclerosis correlate in low back pain subjects: A cross-sectional observational CT study.

    PubMed

    Turgut, Ahmet Tuncay; Sönmez, Iclal; Cakıt, Burcu Duyur; Koşar, Pınar; Koşar, Uğur

    2008-06-01

    The goal of this cross-sectional observational study was to assess the possible impact of pineal gland calcification upon the intervertebral disc degeneration and abdominal aorta atherosclerosis in subjects with low back pain, and to investigate the course of these processes with aging. The study was carried out on 81 (66 women and 15 men) subjects: younger than 45 years (group X, n=22), 45-65 years of age (group Y, n=45), and older than 65 years (group Z, n=14). In addition to clinical data, computed tomography (CT) scan of the brain as well as X-ray and CT examination of the lumbar spine were recorded in this study. The degree of disc degeneration and calcification rates of aortic wall and pineal gland were independently determined by two radiologists. Both ratio of calcified pineal gland and density of pineal calcification increased progressively with aging. Also, both the degree of aortic wall calcification and disc degeneration score increased with advancing age. On CT scan, a positive correlation between degree of aortic wall calcification and disc degeneration score was found (r=0.306, p<0.01). Importantly, there was a positive association between calcification of the pineal gland and degenerative disc disease in X-ray or CT study (r=0.378 and r=0.295, p<0.005 and p<0.01, respectively), as well as between abdominal aorta atherosclerosis and pineal calcification (r=0.634, p<0.001). Our findings suggest that there is a significant interaction between pineal gland calcification and lumbar intervertebral disc degeneration and also abdominal aorta atherosclerosis. However, further studies with a larger subject cohorts are needed. PMID:18215511

  10. Spleen volume on CT and the effect of abdominal trauma.

    PubMed

    Cruz-Romero, Cinthia; Agarwal, Sheela; Abujudeh, Hani H; Thrall, James; Hahn, Peter F

    2016-08-01

    The aim of this study is to determine the magnitude of change in spleen volume on CT in subjects sustaining blunt abdominal trauma without hemorrhage relative to patients without disease and how the spleen volumes are distributed. Sixty-seven subjects with blunt abdominal trauma and 101 control subjects were included in this retrospective single-center, IRB-approved, and HIPAA-compliant study. Patients with an injured spleen were excluded. Using a semiautomatic segmentation program, two readers computed spleen volumes from CT. Spleen volume distribution in male and female trauma and control cohorts were compared nonparametrically. Spleen volume plotted against height, weight, and age were analyzed by linear regression. The number of females and males are, respectively, 35 and 32 in trauma subjects and 69 and 32 among controls. Female trauma patients (49.6 years) were older than males (39.8 years) (p = 0.02). Distributions of spleen volume were not normal, skewed above their means, requiring a nonparametric comparison. Spleen volumes in trauma patients were smaller than those in controls with medians of 230 vs 294 mL in males(p < 0.006) and 163 vs 191 mL in females(p < 0.04). Spleen volume correlated positively with weight in females and with height in male controls, and negatively with age in male controls (p < 0.01). Variation in reproducibility and repeatability was acceptable at 1.5 and 4.9 %, respectively. Reader variation was 1.7 and 4.6 % for readers 1 and 2, respectively. The mean spleen volume in controls was 245 mL, the largest ever reported. Spleen volume decreases in response to blunt abdominal trauma. Spleen volumes are not normally distributed. Our population has the largest spleen volume reported in the literature, perhaps a consequence of the obesity epidemic. PMID:27166964

  11. Intra-abdominal desmoplastic small round cell tumors: CT and FDG-PET/CT findings with histopathological association

    PubMed Central

    CHEN, JINGJING; WU, ZENGJIE; SUN, BINBIN; LI, DACHENG; WANG, ZHENGUANG; LIU, FANGJUN; HUA, HUI

    2016-01-01

    Desmoplastic small round cell tumors (DSRCTs) are rare and aggressive malignant tumors. The aim of the present study was to analyze computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT imaging features of intra-abdominal desmoplastic DSRCT, and investigate the association of these features with histopathological results. The present study was a retrospective investigation of 4 patients with DSRCT. All patients underwent CT and dynamic CT, and 1 additionally underwent FDG-PET/CT scanning. Following a tumor resection, routine hematoxylin and eosin staining, and immunostaining, were performed and evaluated. Multiple large abdominopelvic masses were identified in all 4 patients; however, no indications of their site of origin were demonstrated. CT revealed soft-tissue masses with patchy foci of hypodense lesions. Contrast-enhanced CT revealed slightly or moderately heterogeneous enhancement of the lesions. Other observations from these patients included calcification (n=2), peritoneal seeding (n=3), hepatic metastasis (n=3), retroperitoneal lymphadenopathy (n=3) and ascites (n=2). FDG-PET/CT revealed multiple nodular increased FDG uptake in the abdominopelvic masses, and in the liver and peritoneum in 1 case. Intra-abdominal DSRCT demonstrated significant diagnostic characteristics on plain and contrast-enhanced CT. Multiple, bulky soft-tissue masses inside the peritoneal cavity, particularly in male adolescents and young adults, should be considered as potential cases of DSRCT. FDG-PET/CT techniques may be utilized to aid the staging of tumors. PMID:27123106

  12. Fully automated adipose tissue measurement on abdominal CT

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Sussman, Daniel L.; Summers, Ronald M.

    2011-03-01

    Obesity has become widespread in America and has been associated as a risk factor for many illnesses. Adipose tissue (AT) content, especially visceral AT (VAT), is an important indicator for risks of many disorders, including heart disease and diabetes. Measuring adipose tissue (AT) with traditional means is often unreliable and inaccurate. CT provides a means to measure AT accurately and consistently. We present a fully automated method to segment and measure abdominal AT in CT. Our method integrates image preprocessing which attempts to correct for image artifacts and inhomogeneities. We use fuzzy cmeans to cluster AT regions and active contour models to separate subcutaneous and visceral AT. We tested our method on 50 abdominal CT scans and evaluated the correlations between several measurements.

  13. Effects of Dual-Energy CT with Non-Linear Blending on Abdominal CT Angiography

    PubMed Central

    Wang, Chaoqin; Jiang, Xiaochen; Xu, Ge

    2014-01-01

    Objective To determine whether non-linear blending technique for arterial-phase dual-energy abdominal CT angiography (CTA) could improve image quality compared to the linear blending technique and conventional 120 kVp imaging. Materials and Methods This study included 118 patients who had accepted dual-energy abdominal CTA in the arterial phase. They were assigned to Sn140/80 kVp protocol (protocol A, n = 40) if body mass index (BMI) < 25 or Sn140/100 kVp protocol (protocol B, n = 41) if BMI ≥ 25. Non-linear blending images and linear blending images with a weighting factor of 0.5 in each protocol were generated and compared with the conventional 120 kVp images (protocol C, n = 37). The abdominal vascular enhancements, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and radiation dose were assessed. Statistical analysis was performed using one-way analysis of variance test, independent t test, Mann-Whitney U test, and Kruskal-Wallis test. Results Mean vascular attenuation, CNR, SNR and subjective image quality score for the non-linear blending images in each protocol were all higher compared to the corresponding linear blending images and 120 kVp images (p values ranging from < 0.001 to 0.007) except for when compared to non-linear blending images for protocol B and 120 kVp images in CNR and SNR. No significant differences were found in image noise among the three kinds of images and the same kind of images in different protocols, but the lowest radiation dose was shown in protocol A. Conclusion Non-linear blending technique of dual-energy CT can improve the image quality of arterial-phase abdominal CTA, especially with the Sn140/80 kVp scanning. PMID:25053901

  14. Radiation dose reduction in pediatric abdominal CT scanning

    SciTech Connect

    Kamel, I.R.

    1993-01-01

    A clinical trial was designed to test whether a significantly lower radiation dose technique could be used for pediatric abdominal CT scanning without loss of diagnostic image quality. The study included pediatric patients referred to radiology from the Children's Hospital and clinics at The University of Michigan. Seventy-eight cases were included in the study, 36 cases in the experimental group and 42 in the control group. Patient characteristics in both groups were comparable in every respect except for the technical factors used to expose the pelvis. Patients in the experimental group were scanned with a technique using 80 mAs while those in the control group were scanned with the conventional technique of 240 mAs. Therefore, the radiation dose to the pelvis was three times higher in the control group than in the experimental group. Scans were evaluated by two experienced pediatric radiologists who assessed anatomical details, image resolution and the degree of confidence in reaching a diagnosis. The low-mAs technique did not result in reduction of diagnostic image quality or the confidence in reaching a diagnosis. In conclusion, the radiation dose resulting from pediatric CT of the pelvis may be reduced by a factor of three with equivalent medical benefit.

  15. Abdominal organ motion measured using 4D CT

    SciTech Connect

    Brandner, Edward D.; Wu, Andrew . E-mail: andrew.wu@jefferson.edu; Chen, Hungcheng; Heron, Dwight; Kalnicki, Shalom; Komanduri, Krishna; Gerszten, Kristina; Burton, Steve; Ahmed, Irfan; Shou, Zhenyu

    2006-06-01

    Purpose: To measure respiration-induced abdominal organ motion using four-dimensional computed tomography (4D CT) scanning and to examine the organ paths. Methods and Materials: During 4D CT scanning, consecutive CT images are acquired of the patient at each couch position. Simultaneously, the patient's respiratory pattern is recorded using an external marker block taped to the patient's abdomen. This pattern is used to retrospectively organize the CT images into multiple three-dimensional images, each representing one breathing phase. These images are analyzed to measure organ motion between each phase. The displacement from end expiration is compared to a displacement limit that represents acceptable dosimetric results (5 mm). Results: The organs measured in 13 patients were the liver, spleen, and left and right kidneys. Their average superior to inferior absolute displacements were 1.3 cm for the liver, 1.3 cm for the spleen, 1.1 cm for the left kidney, and 1.3 cm for the right kidney. Although the organ paths varied among patients, 5 mm of superior to inferior displacement from end expiration resulted in less than 5 mm of displacement in the other directions for 41 of 43 organs measured. Conclusions: Four-dimensional CT scanning can accurately measure abdominal organ motion throughout respiration. This information may result in greater organ sparing and planning target volume coverage.

  16. Immersive virtual reality for visualization of abdominal CT

    NASA Astrophysics Data System (ADS)

    Lin, Qiufeng; Xu, Zhoubing; Li, Bo; Baucom, Rebeccah; Poulose, Benjamin; Landman, Bennett A.; Bodenheimer, Robert E.

    2013-03-01

    Immersive virtual environments use a stereoscopic head-mounted display and data glove to create high fidelity virtual experiences in which users can interact with three-dimensional models and perceive relationships at their true scale. This stands in stark contrast to traditional PACS-based infrastructure in which images are viewed as stacks of two dimensional slices, or, at best, disembodied renderings. Although there has substantial innovation in immersive virtual environments for entertainment and consumer media, these technologies have not been widely applied in clinical applications. Here, we consider potential applications of immersive virtual environments for ventral hernia patients with abdominal computed tomography imaging data. Nearly a half million ventral hernias occur in the United States each year, and hernia repair is the most commonly performed general surgery operation worldwide. A significant problem in these conditions is communicating the urgency, degree of severity, and impact of a hernia (and potential repair) on patient quality of life. Hernias are defined by ruptures in the abdominal wall (i.e., the absence of healthy tissues) rather than a growth (e.g., cancer); therefore, understanding a hernia necessitates understanding the entire abdomen. Our environment allows surgeons and patients to view body scans at scale and interact with these virtual models using a data glove. This visualization and interaction allows users to perceive the relationship between physical structures and medical imaging data. The system provides close integration of PACS-based CT data with immersive virtual environments and creates opportunities to study and optimize interfaces for patient communication, operative planning, and medical education.

  17. Percutaneous Transhepatic Drainage of Inaccessible Abdominal Abscesses Following Abdominal Surgery Under Real-Time CT-Fluoroscopic Guidance

    SciTech Connect

    Yamakado, Koichiro Takaki, Haruyuki; Nakatsuka, Atsuhiro; Kashima, Masataka; Uraki, Junji; Yamanaka, Takashi; Takeda, Kan

    2010-02-15

    This study evaluated the safety, feasibility, and clinical utility of transhepatic drainage of inaccessible abdominal abscesses retrospectively under real-time computed tomographic (CT) guidance. For abdominal abscesses, 12 consecutive patients received percutaneous transhepatic drainage. Abscesses were considered inaccessible using the usual access route because they were surrounded by the liver and other organs. The maximum diameters of abscesses were 4.6-9.5 cm (mean, 6.7 {+-} 1.4 cm). An 8-Fr catheter was advanced into the abscess cavity through the liver parenchyma using real-time CT fluoroscopic guidance. Safety, feasibility, procedure time, and clinical utility were evaluated. Drainage catheters were placed with no complications in abscess cavities through the liver parenchyma in all patients. The mean procedure time was 18.8 {+-} 9.2 min (range, 12-41 min). All abscesses were drained. They shrank immediately after catheter placement. In conclusions, this transhepatic approach under real-time CT fluoroscopic guidance is a safe, feasible, and useful technique for use of drainage of inaccessible abdominal abscesses.

  18. Studies on the application of a low-voltage peak to the postsurgical follow-up CT scan in abdominal cancer patients in order to reduce the exposure of patients to radiation

    NASA Astrophysics Data System (ADS)

    Cho, J. H.; Lee, H. K.; Kim, H. J.; Dong, K. R.; Chung, W. K.

    2012-10-01

    This study examined the radiation dose, computed tomography (CT) number, contrast and image quality of patients requiring periodic follow-up abdominal CT examinations at various tube voltages. The subjects were divided into two groups. One group consisted of patients who underwent a clinical analysis and the other group was a phantom one. Somatom Sensation 16 (Siemens, Erlangen, Germany) was used. Twenty patients who underwent a periodic follow-up examination by CT were selected randomly. The tube current was fixed to 150 mA, and the tube voltage was adjusted according to the appropriate value of each examination. The computed tomography dose index (CTDI) values were measured. The CT number of each organ was measured by setting up a 1 cm diameter return on investment (ROI) in the abdominal organs at the same height of the first lumbar vertebra using images of the arterial phase. Two radiologists in consensus graded the quality of the abdominal images into three groups. An abdomen-shaped acrylic phantom was used in the phantom study. An ion chamber was inserted into the holes located at the center and periphery of the phantom, where the radiation dose was automatically displayed on the reader. Tube voltages of 80, 100, 120 and 140 kVp were applied to the phantom (diluted contrast medium with water at 1:10 ratio) and the phantom was scanned. The CT number was measured from a 1 cm diameter ROI at the center of the image. The CTDI value decreased by 36% at 100 kVp (7.50 mGy) compared with that at 120 kVp (11.70 mGy). According to the radiologists' evaluation, there were 17 equivalent, 3 acceptable and 0 unacceptable levels in the group of 20 subjects. The radiation dose in the phantom study decreased with increasing tube voltages from 80 to 140 kVp. The peripheral and central doses decreased by 38% and 41%, respectively. The CT numbers at 80, 100, 120 and 140 kVp were 1365.9±4.4, 1046.1±3.7, 862.8±3.2 and 737.5±3.0 HU, respectively. In conclusion, in a follow

  19. Preoperative CT angiography versus Doppler ultrasound mapping of abdominal perforator in DIEP breast reconstructions: A randomized prospective study.

    PubMed

    Klasson, S; Svensson, H; Malm, K; Wassélius, J; Velander, P

    2015-06-01

    Is there a difference in surgery time and complication rate when Doppler ultrasound (US) is used for the preoperative mapping of perforators in comparison with computer tomography angiography (CTA)? Women who were candidates for breast reconstruction using the deep inferior epigastric perforator (DIEP) free flap were enrolled in a prospective randomized study. The operating time was 249 ± 62 min (mean ± SD) in the CTA group (n = 32) and 255 min ± 75 in the US group (n = 31)--hence a difference of 6 min on average. No flaps were lost. Sixteen complications occurred in 15 patients: seven in the CTA group and nine in the US group. Complications were remedied without delay and all patients came through with a favorable reconstruction. Preoperative mapping of perforators with US is satisfactory enough provided the microsurgery team has proper experience in breast reconstruction with the DIEP flap. PMID:25824193

  20. COMPARISON OF ADAPTIVE STATISTICAL ITERATIVE RECONSTRUCTION (ASIR™) AND MODEL-BASED ITERATIVE RECONSTRUCTION (VEO™) FOR PAEDIATRIC ABDOMINAL CT EXAMINATIONS: AN OBSERVER PERFORMANCE STUDY OF DIAGNOSTIC IMAGE QUALITY.

    PubMed

    Hultenmo, Maria; Caisander, Håkan; Mack, Karsten; Thilander-Klang, Anne

    2016-06-01

    The diagnostic image quality of 75 paediatric abdominal computed tomography (CT) examinations reconstructed with two different iterative reconstruction (IR) algorithms-adaptive statistical IR (ASiR™) and model-based IR (Veo™)-was compared. Axial and coronal images were reconstructed with 70 % ASiR with the Soft™ convolution kernel and with the Veo algorithm. The thickness of the reconstructed images was 2.5 or 5 mm depending on the scanning protocol used. Four radiologists graded the delineation of six abdominal structures and the diagnostic usefulness of the image quality. The Veo reconstruction significantly improved the visibility of most of the structures compared with ASiR in all subgroups of images. For coronal images, the Veo reconstruction resulted in significantly improved ratings of the diagnostic use of the image quality compared with the ASiR reconstruction. This was not seen for the axial images. The greatest improvement using Veo reconstruction was observed for the 2.5 mm coronal slices. PMID:26873711

  1. Computer-aided kidney segmentation on abdominal CT images.

    PubMed

    Lin, Daw-Tung; Lei, Chung-Chih; Hung, Siu-Wan

    2006-01-01

    In this paper, an effective model-based approach for computer-aided kidney segmentation of abdominal CT images with anatomic structure consideration is presented. This automatic segmentation system is expected to assist physicians in both clinical diagnosis and educational training. The proposed method is a coarse to fine segmentation approach divided into two stages. First, the candidate kidney region is extracted according to the statistical geometric location of kidney within the abdomen. This approach is applicable to images of different sizes by using the relative distance of the kidney region to the spine. The second stage identifies the kidney by a series of image processing operations. The main elements of the proposed system are: 1) the location of the spine is used as the landmark for coordinate references; 2) elliptic candidate kidney region extraction with progressive positioning on the consecutive CT images; 3) novel directional model for a more reliable kidney region seed point identification; and 4) adaptive region growing controlled by the properties of image homogeneity. In addition, in order to provide different views for the physicians, we have implemented a visualization tool that will automatically show the renal contour through the method of second-order neighborhood edge detection. We considered segmentation of kidney regions from CT scans that contain pathologies in clinical practice. The results of a series of tests on 358 images from 30 patients indicate an average correlation coefficient of up to 88% between automatic and manual segmentation. PMID:16445250

  2. Kaposi sarcoma and lymphadenopathy syndrome: limitations of abdominal CT in acquired immunodeficiency syndrome

    SciTech Connect

    Moon, K.L. Jr.; Federle, M.P.; Abrams, D.I.; Volberding, P.; Lewis, B.J.

    1984-02-01

    Abdominal computed tomography (CT) was performed in 31 patients with Kaposi sarcoma (KS) related to acquired immunodeficiency syndrome (AIDS), three patients with classic KS, and 12 patients with the newly described lymphadenopathy syndrome (LNS). The frequency, distribution, and appearance of lymphadenopathy and splenomegaly were similar in the AIDS-related KS and LNS groups. Rectal and perirectal disease was identified in 86% of homosexual men studied; rectal KS could not be distinguished from proctitis on CT criteria alone. No CT abnormalities were seen in patients with classic KS. The CT demonstration of retroperitoneal, mesenteric, or pelvic adenopathy or of rectal or perirectal disease in patients with AIDS-related KS is not necessarily indicative of widespread involvement with the disease.

  3. Feasibility Study of Using Gemstone Spectral Imaging (GSI) and Adaptive Statistical Iterative Reconstruction (ASIR) for Reducing Radiation and Iodine Contrast Dose in Abdominal CT Patients with High BMI Values

    PubMed Central

    Zhu, Zheng; Zhao, Xin-ming; Zhao, Yan-feng; Wang, Xiao-yi; Zhou, Chun-wu

    2015-01-01

    Purpose To prospectively investigate the effect of using Gemstone Spectral Imaging (GSI) and adaptive statistical iterative reconstruction (ASIR) for reducing radiation and iodine contrast dose in abdominal CT patients with high BMI values. Materials and Methods 26 patients (weight > 65kg and BMI ≥ 22) underwent abdominal CT using GSI mode with 300mgI/kg contrast material as study group (group A). Another 21 patients (weight ≤ 65kg and BMI ≥ 22) were scanned with a conventional 120 kVp tube voltage for noise index (NI) of 11 with 450mgI/kg contrast material as control group (group B). GSI images were reconstructed at 60keV with 50%ASIR and the conventional 120kVp images were reconstructed with FBP reconstruction. The CT values, standard deviation (SD), signal-noise-ratio (SNR), contrast-noise-ratio (CNR) of 26 landmarks were quantitatively measured and image quality qualitatively assessed using statistical analysis. Results As for the quantitative analysis, the difference of CNR between groups A and B was all significant except for the mesenteric vein. The SNR in group A was higher than B except the mesenteric artery and splenic artery. As for the qualitative analysis, all images had diagnostic quality and the agreement for image quality assessment between the reviewers was substantial (kappa = 0.684). CT dose index (CTDI) values for non-enhanced, arterial phase and portal phase in group A were decreased by 49.04%, 40.51% and 40.54% compared with group B (P = 0.000), respectively. The total dose and the injection rate for the contrast material were reduced by 14.40% and 14.95% in A compared with B. Conclusion The use of GSI and ASIR provides similar enhancement in vessels and image quality with reduced radiation dose and contrast dose, compared with the use of conventional scan protocol. PMID:26079259

  4. Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis

    PubMed Central

    Miano, Danielle I.; Silvis, Renee M.; Popp, Jill M.; Culbertson, Marvin C.; Campbell, Brendan; Smith, Sharon R.

    2015-01-01

    Introduction Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US) or computed tomography (CT) studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation. The objective of the study was to compare the rate of appendiceal rupture and negative appendectomies between children with and without abdominal CTs; and to evaluate the same outcomes for children with and without USs to determine if there were any associations between imaging modalities and outcomes. Methods We conducted a retrospective chart review including emergency department (ED) and inpatient records from 1/1/2009–2/31/2010 and included patients with suspected acute appendicitis. Results 1,493 children, aged less than one year to 20 years, were identified in the ED with suspected appendicitis. These patients presented with abdominal pain who had either a surgical consult or an abdominal imaging study to evaluate for appendicitis, or were transferred from an outside hospital or primary care physician office with the stated suspicion of acute appendicitis. Of these patients, 739 were sent home following evaluation in the ED and did not return within the subsequent two weeks and were therefore presumed not to have appendicitis. A total of 754 were admitted and form the study population, of which 20% received a CT, 53% US, and 8% received both. Of these 57%, 95% CI [53.5,60.5] had pathology-proven appendicitis. Appendicitis rates were similar for children with a CT (57%, 95% CI [49.6,64.4]) compared to those without (57%, 95% CI [52.9,61.0]). Children with perforation were similar between those with a CT (18%, 95% CI [12.3,23.7]) and those without (13%, 95% CI [10.3,15.7]). The proportion of children with a

  5. Emerging Techniques for Dose Optimization in Abdominal CT

    PubMed Central

    Platt, Joel F.; Goodsitt, Mitchell M.; Al-Hawary, Mahmoud M.; Maturen, Katherine E.; Wasnik, Ashish P.; Pandya, Amit

    2014-01-01

    Recent advances in computed tomographic (CT) scanning technique such as automated tube current modulation (ATCM), optimized x-ray tube voltage, and better use of iterative image reconstruction have allowed maintenance of good CT image quality with reduced radiation dose. ATCM varies the tube current during scanning to account for differences in patient attenuation, ensuring a more homogeneous image quality, although selection of the appropriate image quality parameter is essential for achieving optimal dose reduction. Reducing the x-ray tube voltage is best suited for evaluating iodinated structures, since the effective energy of the x-ray beam will be closer to the k-edge of iodine, resulting in a higher attenuation for the iodine. The optimal kilovoltage for a CT study should be chosen on the basis of imaging task and patient habitus. The aim of iterative image reconstruction is to identify factors that contribute to noise on CT images with use of statistical models of noise (statistical iterative reconstruction) and selective removal of noise to improve image quality. The degree of noise suppression achieved with statistical iterative reconstruction can be customized to minimize the effect of altered image quality on CT images. Unlike with statistical iterative reconstruction, model-based iterative reconstruction algorithms model both the statistical noise and the physical acquisition process, allowing CT to be performed with further reduction in radiation dose without an increase in image noise or loss of spatial resolution. Understanding these recently developed scanning techniques is essential for optimization of imaging protocols designed to achieve the desired image quality with a reduced dose. © RSNA, 2014 PMID:24428277

  6. Radiation dose reduction with application of non-linear adaptive filters for abdominal CT

    PubMed Central

    Singh, Sarabjeet; Kalra, Mannudeep K; Sung, Mi Kim; Back, Anni; Blake, Michael A

    2012-01-01

    AIM: To evaluate the effect of non-linear adaptive filters (NLAF) on abdominal computed tomography (CT) images acquired at different radiation dose levels. METHODS: Nineteen patients (mean age 61.6 ± 7.9 years, M:F = 8:11) gave informed consent for an Institutional Review Board approved prospective study involving acquisition of 4 additional image series (200, 150, 100, 50 mAs and 120 kVp) on a 64 slice multidetector row CT scanner over an identical 10 cm length in the abdomen. The CT images acquired at 150, 100 and 50 mAs were processed with the NLAF. Two radiologists reviewed unprocessed and processed images for image quality in a blinded randomized manner. CT dose index volume, dose length product, patient weight, transverse diameters, objective noise and CT numbers were recorded. Data were analyzed using Analysis of Variance and Wilcoxon signed rank test. RESULTS: Of the 31 lesions detected in abdominal CT images, 28 lesions were less than 1 cm in size. Subjective image noise was graded as unacceptable in unprocessed images at 50 and 100 mAs, and in NLAF processed images at 50 mAs only. In NLAF processed images, objective image noise was decreased by 21% (14.4 ± 4/18.2 ± 4.9) at 150 mAs, 28.3% (15.7 ± 5.6/21.9 ± 4) at 100 mAs and by 39.4% (18.8 ± 9/30.4 ± 9.2) at 50 mAs compared to unprocessed images acquired at respective radiation dose levels. At 100 mAs the visibility of smaller structures improved from suboptimal in unprocessed images to excellent in NLAF processed images, whereas diagnostic confidence was respectively improved from probably confident to fully confident. CONCLUSION: NLAF lowers image noise, improves the visibility of small structures and maintains lesion conspicuity at down to 100 mAs for abdominal CT. PMID:22328968

  7. CT Hounsfield Numbers of Soft Tissues on Unenhanced Abdominal CT Scans: Variability Between Two Different Manufacturers’ MDCT Scanners

    PubMed Central

    Lamba, Ramit; McGahan, John P.; Corwin, Michael T.; Li, Chin-Shang; Tran, Tien; Seibert, J. Anthony; Boone, John M.

    2016-01-01

    OBJECTIVE The purpose of this study is to determine whether Hounsfield numbers of soft tissues on unenhanced abdominal CT of the same patient vary on repeat scans done on two different manufacturers’ MDCT scanners. MATERIALS AND METHODS A database search was performed to identify patients older than 18 years who underwent unenhanced CT of the abdomen and pelvis performed both on a Volume CT (GE Healthcare) and a Definition AS Plus (Siemens Healthcare) 64-MDCT scanner within 12 months of each other. After excluding those patients for whom Hounsfield unit measurements would be affected by mitigating factors, 48 patients (mean age, 58.8 years) were identified. Hounsfield unit measurements were obtained in nine different soft-tissue anatomic locations on each scan, and the location of these sites was kept identical on each scan pair. Data were analyzed to evaluate Hounsfield unit differences between these scanners. RESULTS In general, there was a low consistency in the Hounsfield unit measurements for each of these sites on scans obtained by the two scanners, with the subcutaneous fat in the left posterolateral flank showing the lowest correlation (intraclass correlation coefficient, 0.198). There were differences in the Hounsfield unit measurements obtained in all anatomic sites on scans obtained by both scanners. Mean Hounsfield unit measurements obtained on the Definition AS Plus scanner were lower than those obtained on the Volume CT scanner, with the intriguing exception of the anterior midline subcutaneous fat Hounsfield unit measurements, which were higher on the Definition AS Plus scanner. All differences were statistically significant (p < 0.05). CONCLUSION Hounsfield unit measurements for unenhanced abdominal soft tissues of the same patient vary between scanners of two common MDCT manufacturers. PMID:25341139

  8. Computed tomography (CT) of bowel and mesenteric injury in blunt abdominal trauma: a pictorial essay.

    PubMed

    Hassan, Radhiana; Abd Aziz, Azian; Mohamed, Siti Kamariah Che

    2012-08-01

    Computed tomography (CT) is currently the diagnostic modality of choice in the evaluation of clinically stable patients with blunt abdominal trauma, including the assessment of blunt bowel and mesenteric injuries. CT signs of bowel and/or mesenteric injuries are bowel wall defect, free air, oral contrast material extravasation, extravasation of contrast material from mesenteric vessels, mesenteric vascular beading, abrupt termination of mesenteric vessels, focal bowel wall thickening, mesenteric fat stranding, mesenteric haematoma and intraperitoneal or retroperitoneal fluid. This pictorial essay illustrates CT features of bowel and/or mesenteric injuries in patients with blunt abdominal trauma. Pitfalls in interpretation of images are emphasized in proven cases. PMID:23082464

  9. Incidentalomas associated with abdominal and pelvic CT angiograms for abdominal-based breast free flap reconstruction.

    PubMed

    Ho, Olivia A; Bagher, Shaghayegh; Jaskolka, Jeff; Tan, Marcus; Butler, Kate; O'Neill, Anne C; Zhong, Toni; Hofer, Stefan O

    2016-05-01

    Computed tomography angiography (CTA) is routinely performed prior to breast reconstruction using deep inferior epigastric perforator (DIEP) flaps to provide better surgical planning and improve preoperative decision making. These investigations occasionally result in unexpected findings in otherwise asymptomatic women. Unexpected findings on imaging in a population of women with previous breast cancer or strong breast cancer risk factors can lead to undue stress and anxiety. The aim of this study is to determine the incidence of unexpected findings in preoperative CT angiograms and to correlate these with patient and breast cancer characteristics. A retrospective chart review from May 2008 to December 2012 was performed reviewing all patients who underwent DIEP flap breast reconstruction. Radiology reports of their preoperative CT angiograms, details of unexpected findings, patients' past medical and cancer history, additional radiological investigations, outcomes, and interventions were reviewed. In total, 360 patients met the inclusion criteria for the study. Sixty-four percent of the patients who underwent CTA imaging had incidental findings. Further imaging was suggested in 48% of this group. The most common incidentalomas were hepatic (47%), bone (24%), and renal (20%). "Incidentalomas" were associated with patients' underlying comorbidities (p = 0.001) and age (p = 0.01). "Radiographically suspicious incidentalomas" were associated with the underlying comorbidities (p = 0.001). The radiologists most commonly suggested investigation methods such as ultrasound (41%), another CT (28%), bone scan (21%), and magnetic resonance imaging (MRI; 14%). No incidentalomas were found to be malignant on further recommended investigation in this study and no breast cancer reconstruction was delayed as a result of the discovery of incidentalomas or their subsequent investigations. It is important to counsel patients of the possibility of incidental findings and the

  10. Multidetector CT in emergency radiology: acute and generalized non-traumatic abdominal pain.

    PubMed

    Paolantonio, Pasquale; Rengo, Marco; Ferrari, Riccardo; Laghi, Andrea

    2016-05-01

    Multidetector CT (MDCT) is an imaging technique that provides otherwise unobtainable information in the diagnostic work-up of patients presenting with acute abdominal pain. A correct working diagnosis depends essentially on understanding the individual patient's clinical data and laboratory findings. In haemodynamically stable patients with acute severe and generalized abdominal pain, MDCT is now the preferred imaging test and gives invaluable diagnostic information, also in unstable patients after stabilization. In this descriptive review, we focus our attention on acute, severe and generalized or undifferentiated non-traumatic abdominal pain. The main differential diagnoses are acute pancreatitis, gastrointestinal perforation, ruptured abdominal aneurysm and acute mesenteric ischaemia. We will provide radiologist readers with a technical guide to optimize MDCT imaging protocols and list the major CT signs essential to reach a correct diagnosis and guide the best treatment. PMID:26689097

  11. New technique for treating abdominal surgical site infection using CT woundgraphy and NPWT: A case report

    PubMed Central

    Ito, Eisaku; Yoshida, Masashi; Nakashima, Keigo; Suzuki, Norihiko; Imakita, Tomonori; Tsutsui, Nobuhiro; Ohdaira, Hironori; Kitajima, Masaki; Suzuki, Yutaka

    2016-01-01

    Introduction Negative pressure wound therapy (NPWT) for abdominal surgical site infection (SSI) is becoming increasingly common, although enterocutaneous fistula (ECF) has been reported as a complication. To avoid ECF, we used computed tomography (CT) woundgraphy to evaluate the relationship between the wound and the intestine, and then safely treated the abdominal SSI with NPWT. Case presentation Following a laparoscopic intersphincteric resection for low rectal neuroendocrine tumor and covering ileostomy, a 59-year-old woman underwent stoma closure. Six days after surgery, we diagnosed SSI. We suspected ECF, because the wound was deep and the pus resembled enteric fluid. However, CT woundgraphy showed that the wound was separated from the abdominal cavity and the intestine by the abdominal rectus muscle. Accordingly, we performed NPWT. SSI was cured and the wound was well granulated. Twenty-three days after surgery, the patient was discharged. Eventually, the wound was completely epithelialized. Discussion Although successful NPWT has been reported for open abdominal wounds, ECF is a common complication. ECF can be prevented by separating the wound from the intestine by the omentum or muscle fascia, protecting the intestinal serosa during surgery, and applying low vacuum pressure. The relationships among the wound, the fascia, and the intestine must be evaluated before abdominal SSI treatment. One good method is CT woundgraphy, which evaluates wound extent and depth, closure of muscle fascia, and the relationship between the wound and the intestine. Conclusion We report a case of CT woundgraphy before NPWT for abdominal SSI. CT woundgraphy is a good candidate for evaluating wound condition. PMID:27002290

  12. Development of automated quantification of visceral and subcutaneous adipose tissue volumes from abdominal CT scans

    NASA Astrophysics Data System (ADS)

    Mensink, Sanne D.; Spliethoff, Jarich W.; Belder, Ruben; Klaase, Joost M.; Bezooijen, Roland; Slump, Cornelis H.

    2011-03-01

    This contribution describes a novel algorithm for the automated quantification of visceral and subcutaneous adipose tissue volumes from abdominal CT scans of patients referred for colorectal resection. Visceral and subcutaneous adipose tissue volumes can accurately be measured with errors of 1.2 and 0.5%, respectively. Also the reproducibility of CT measurements is good; a disadvantage is the amount of radiation. In this study the diagnostic CT scans in the work - up of (colorectal) cancer were used. This implied no extra radiation. For the purpose of segmentation alone, a low dose protocol can be applied. Obesity is a well known risk factor for complications in and after surgery. Body Mass Index (BMI) is a widely accepted indicator of obesity, but it is not specific for risk assessment of colorectal surgery. We report on an automated method to quantify visceral and subcutaneous adipose tissue volumes as a basic step in a clinical research project concerning preoperative risk assessment. The outcomes are to be correlated with the surgery results. The hypothesis is that the balance between visceral and subcutaneous adipose tissue together with the presence of calcifications in the major bloodvessels, is a predictive indicator for post - operatieve complications such as anastomotic leak. We start with four different computer simulated humanoid abdominal volumes with tissue values in the appropriate Hounsfield range at different dose levels. With satisfactory numerical results for this test, we have applied the algorithm on over a 100 patient scans and have compared results with manual segmentations by an expert for a smaller pilot group. The results are within a 5% difference. Compared to other studies reported in the literature, reliable values are obtained for visceral and subcutaneous adipose tissue areas.

  13. CT-SPECT fusion to correlate radiolabeled monoclonal antibody uptake with abdominal CT findings

    SciTech Connect

    Kramer, E.L.; Noz, M.E.; Sanger, J.J.; Megibow, A.J.; Maguire, G.Q. )

    1989-09-01

    To enhance the information provided by computed tomography (CT) and single photon emission computed tomography (SPECT) performed with radiolabeled, anti-carcinoembryonic antigen monoclonal antibody (MoAb), the authors performed fusion of these types of images from eight subjects with suspected colorectal adenocarcinoma. Section thickness and pixel size of the two studies were matched, coordinates of corresponding points from each study were identified, and CT sections were translated, rotated, and reprojected to match the corresponding SPECT scans. The CT-SPECT fusion enabled identification of anatomic sites of tumor-specific MoAb accumulation in four cases, showed non-specific MoAb accumulation in two, and helped confirm information only suggested by the two studies separately in one.

  14. Efficient Abdominal Segmentation on Clinically Acquired CT with SIMPLE Context Learning

    PubMed Central

    Xu, Zhoubing; Burke, Ryan P.; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-01-01

    Abdominal segmentation on clinically acquired computed tomography (CT) has been a challenging problem given the inter-subject variance of human abdomens and complex 3-D relationships among organs. Multi-atlas segmentation (MAS) provides a potentially robust solution by leveraging label atlases via image registration and statistical fusion. We posit that the efficiency of atlas selection requires further exploration in the context of substantial registration errors. The selective and iterative method for performance level estimation (SIMPLE) method is a MAS technique integrating atlas selection and label fusion that has proven effective for prostate radiotherapy planning. Herein, we revisit atlas selection and fusion techniques for segmenting 12 abdominal structures using clinically acquired CT. Using a re-derived SIMPLE algorithm, we show that performance on multi-organ classification can be improved by accounting for exogenous information through Bayesian priors (so called context learning). These innovations are integrated with the joint label fusion (JLF) approach to reduce the impact of correlated errors among selected atlases for each organ, and a graph cut technique is used to regularize the combined segmentation. In a study of 100 subjects, the proposed method outperformed other comparable MAS approaches, including majority vote, SIMPLE, JLF, and the Wolz locally weighted vote technique. The proposed technique provides consistent improvement over state-of-the-art approaches (median improvement of 7.0% and 16.2% in DSC over JLF and Wolz, respectively) and moves toward efficient segmentation of large-scale clinically acquired CT data for biomarker screening, surgical navigation, and data mining. PMID:25914506

  15. Efficient abdominal segmentation on clinically acquired CT with SIMPLE context learning

    NASA Astrophysics Data System (ADS)

    Xu, Zhoubing; Burke, Ryan P.; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-03-01

    Abdominal segmentation on clinically acquired computed tomography (CT) has been a challenging problem given the inter-subject variance of human abdomens and complex 3-D relationships among organs. Multi-atlas segmentation (MAS) provides a potentially robust solution by leveraging label atlases via image registration and statistical fusion. We posit that the efficiency of atlas selection requires further exploration in the context of substantial registration errors. The selective and iterative method for performance level estimation (SIMPLE) method is a MAS technique integrating atlas selection and label fusion that has proven effective for prostate radiotherapy planning. Herein, we revisit atlas selection and fusion techniques for segmenting 12 abdominal structures using clinically acquired CT. Using a re-derived SIMPLE algorithm, we show that performance on multi-organ classification can be improved by accounting for exogenous information through Bayesian priors (so called context learning). These innovations are integrated with the joint label fusion (JLF) approach to reduce the impact of correlated errors among selected atlases for each organ, and a graph cut technique is used to regularize the combined segmentation. In a study of 100 subjects, the proposed method outperformed other comparable MAS approaches, including majority vote, SIMPLE, JLF, and the Wolz locally weighted vote technique. The proposed technique provides consistent improvement over state-of-the-art approaches (median improvement of 7.0% and 16.2% in DSC over JLF and Wolz, respectively) and moves toward efficient segmentation of large-scale clinically acquired CT data for biomarker screening, surgical navigation, and data mining.

  16. FDG PET/CT Findings in Abdominal Fat Necrosis After Treatment for Lymphoma.

    PubMed

    Dubreuil, Julien; Moreau, Aurélie; Sarkozy, Clémentine; Traverse-Glehen, Alexandra; Skanjeti, Andrea; Salles, Gilles; Giammarile, Francesco

    2016-05-01

    FDG PET/CT is now validated in non-Hodgkin lymphoma for response assessment in interim and posttreatment lymphoma. We report the case of a 62-year-old man followed by FDG PET/CT for a diffuse large B-cell lymphoma, with initial stage III. The interim FDG PET/CT examination concluded in complete metabolic and morphological response of subdiaphragmatic lymphadenopathy but a persistent abnormal subdiaphragmatic uptake (SUVmax at 9 and Deauville 5-point scale at 5). Therefore, an abdominal biopsy of the corresponding nodules was conducted with a final diagnosis of diffuse fat necrosis. PMID:26825213

  17. CFD Modelling of Abdominal Aortic Aneurysm on Hemodynamic Loads Using a Realistic Geometry with CT

    PubMed Central

    Ng, E. Y. K.; Loong, T. H.; Bordone, Maurizio; Pua, Uei; Narayanan, Sriram

    2013-01-01

    The objective of this study is to find a correlation between the abdominal aortic aneurysm (AAA) geometric parameters, wall stress shear (WSS), abdominal flow patterns, intraluminal thrombus (ILT), and AAA arterial wall rupture using computational fluid dynamics (CFD). Real AAA 3D models were created by three-dimensional (3D) reconstruction of in vivo acquired computed tomography (CT) images from 5 patients. Based on 3D AAA models, high quality volume meshes were created using an optimal tetrahedral aspect ratio for the whole domain. In order to quantify the WSS and the recirculation inside the AAA, a 3D CFD using finite elements analysis was used. The CFD computation was performed assuming that the arterial wall is rigid and the blood is considered a homogeneous Newtonian fluid with a density of 1050 kg/m3 and a kinematic viscosity of 4 × 10−3 Pa·s. Parallelization procedures were used in order to increase the performance of the CFD calculations. A relation between AAA geometric parameters (asymmetry index (β), saccular index (γ), deformation diameter ratio (χ), and tortuosity index (ε)) and hemodynamic loads was observed, and it could be used as a potential predictor of AAA arterial wall rupture and potential ILT formation. PMID:23864906

  18. Comparative analysis of the radiation shield effect in an abdominal CT scan

    NASA Astrophysics Data System (ADS)

    Kim, Seon-Chil; Kim, Young-Jae; Lee, Joon-Seok; Dong, Kyung-Rae; Chung, Woon-Kwan; Lim, Chang-Seon

    2014-03-01

    This study measured and compared the dose on the eyeballs and the thyroid with and without the use of a shield by applying the abdominal examination protocol used in an actual examination to a 64-channel computed tomography (CT) scan. A dummy phantom manufactured from acryl was used to measure the dose to the eyeballs and the thyroid of a patient during a thoraco-abdominal CT scan. The dose was measured using three dosimeters (optically-stimulated luminescence dosimeter (OSLD), thermoluminescence dosimeter (TLD) and photoluminescence dosimeter (PLD)) attached to the surfaces of three parts (left and right eyeballs and thyroid) in a phantom with and without the use of a shield for the eyeballs and the thyroid. Two types of shields (1-mm barium shielding sheet and 1-mm tungsten shielding sheet) were used for the measurements. The goggles and the lead shield, which are normally used in clinical practice, were used to compare the shield ratios of the shields. According to the results of the measurements made by using the OSLD, the shield ratios of the barium and the tungsten sheets were in the range of 34-36%. The measurements made by using the TLD showed that the shield ratio of the barium sheet was 6.25% higher than that of the tungsten sheet. When the PLD was used for the measurement, the shield ratio of the barium sheet was 33.34%, which was equivalent to that of the tungsten sheet. These results confirmed that the cheap barium sheet had a better shielding effect than the expensive tungsten sheet.

  19. A reappraisal of adult thoracic and abdominal surface anatomy via CT scan in Chinese population.

    PubMed

    Shen, Xin-Hua; Su, Bai-Yan; Liu, Jing-Juan; Zhang, Gu-Muyang; Xue, Hua-Dan; Jin, Zheng-Yu; Mirjalili, S Ali; Ma, Chao

    2016-03-01

    Accurate surface anatomy is essential for safe clinical practice. There are numerous inconsistencies in clinically important surface markings among and within contemporary anatomical reference texts. The aim of this study was to investigate key thoracic and abdominal surface anatomy landmarks in living Chinese adults using computed tomography (CT). A total of 100 thoracic and 100 abdominal CT scans were examined. Our results indicated that the following key surface landmarks differed from current commonly-accepted descriptions: the positions of the tracheal bifurcation, azygos vein termination, and pulmonary trunk bifurcation (all below the plane of the sternal angle at vertebral level T5-T6 in most individuals); the superior vena cava formation and junction with the right atrium (most often behind the 1st and 4th intercostal spaces, respectively); and the level at which the inferior vena cava and esophagus traverse the diaphragm (T10 and T11, respectively). The renal arteries were most commonly at L1; the midpoint of the renal hila was most frequently at L2; the 11th rib was posterior to the left kidney in only 29% of scans; and the spleen was most frequently located between the 10th and 12th ribs. A number of significant sex- and age-related differences were noted. The Chinese population was also compared with western populations on the basis of published reports. Reappraisal of surface anatomy using modern imaging tools in vivo will provide both quantitative and qualitative evidence to facilitate the clinical application of these key surface landmarks. Clin. Anat. 29:165-174, 2016. © 2015 Wiley Periodicals, Inc. PMID:26032163

  20. Abdominal and pancreatic motion correlation using 4D CT, 4D transponders, and a gating belt.

    PubMed

    Betancourt, Ricardo; Zou, Wei; Plastaras, John P; Metz, James M; Teo, Boon-Keng; Kassaee, Alireza

    2013-01-01

    The correlation between the pancreatic and external abdominal motion due to respiration was investigated on two patients. These studies utilized four dimensional computer tomography (4D CT), a four dimensional (4D) electromagnetic transponder system, and a gating belt system. One 4D CT study was performed during simulation to quantify the pancreatic motion using computer tomography images at eight breathing phases. The motion under free breathing and breath-hold were analyzed for the 4D electromagnetic transponder system and the gating belt system during treatment. A linear curve was fitted for all data sets and correlation factors were evaluated between the 4D electromagnetic transponder system and the gating belt system data. The 4D CT study demonstrated a modest correlation between the external marker and the pancreatic motion with R-square values larger than 0.8 for the inferior-superior (inf-sup). Then, the relative pressure from the belt gating system correlated well with the 4D electromagnetic transponder system's motion in the anterior-posterior (ant-post) and the inf-post directions. These directions have a correlation value of -0.93 and 0.76, while the lateral only had a 0.03 correlation coefficient. Based on our limited study, external surrogates can be used as predictors of the pancreatic motion in the inf-sup and the ant-post directions. Although there is a low correlation on the lateral direction, its motion is significantly shorter. In conclusion, an appropriate treatment delivery can be used for pancreatic cancer when an internal tracking system, such as the 4D electromagnetic transponder system, is unavailable. PMID:23652242

  1. Abdominal Imaging with Contrast-enhanced Photon-counting CT: First Human Experience.

    PubMed

    Pourmorteza, Amir; Symons, Rolf; Sandfort, Veit; Mallek, Marissa; Fuld, Matthew K; Henderson, Gregory; Jones, Elizabeth C; Malayeri, Ashkan A; Folio, Les R; Bluemke, David A

    2016-04-01

    Purpose To evaluate the performance of a prototype photon-counting detector (PCD) computed tomography (CT) system for abdominal CT in humans and to compare the results with a conventional energy-integrating detector (EID). Materials and Methods The study was HIPAA-compliant and institutional review board-approved with informed consent. Fifteen asymptomatic volunteers (seven men; mean age, 58.2 years ± 9.8 [standard deviation]) were prospectively enrolled between September 2 and November 13, 2015. Radiation dose-matched delayed contrast agent-enhanced spiral and axial abdominal EID and PCD scans were acquired. Spiral images were scored for image quality (Wilcoxon signed-rank test) in five regions of interest by three radiologists blinded to the detector system, and the axial scans were used to assess Hounsfield unit accuracy in seven regions of interest (paired t test). Intraclass correlation coefficient (ICC) was used to assess reproducibility. PCD images were also used to calculate iodine concentration maps. Spatial resolution, noise-power spectrum, and Hounsfield unit accuracy of the systems were estimated by using a CT phantom. Results In both systems, scores were similar for image quality (median score, 4; P = .19), noise (median score, 3; P = .30), and artifact (median score, 1; P = .17), with good interrater agreement (image quality, noise, and artifact ICC: 0.84, 0.88, and 0.74, respectively). Hounsfield unit values, spatial resolution, and noise-power spectrum were also similar with the exception of mean Hounsfield unit value in the spinal canal, which was lower in the PCD than the EID images because of beam hardening (20 HU vs 36.5 HU; P < .001). Contrast-to-noise ratio of enhanced kidney tissue was improved with PCD iodine mapping compared with EID (5.2 ± 1.3 vs 4.0 ± 1.3; P < .001). Conclusion The performance of PCD showed no statistically significant difference compared with EID when the abdomen was evaluated in a conventional scan mode. PCD provides

  2. Can lab data be used to reduce abdominal computed tomography (CT) usage in young adults presenting to the emergency department with nontraumatic abdominal pain?

    PubMed

    Scheinfeld, Meir H; Mahadevia, Soham; Stein, Evan G; Freeman, Katherine; Rozenblit, Alla M

    2010-09-01

    We sought to determine whether laboratory parameters could be found, predictive of a negative abdominal CT scan in young adults with nontraumatic abdominal pain. Following institutional review board approval, we evaluated CT reports of 522 patients, aged 21-35 years old, who presented to the Emergency Department with nontraumatic abdominal pain. Bivariate analyses relating ten laboratory parameters to whether the CT detected a cause for abdominal pain were conducted. A multivariate logistic regression model was then derived, with all variables in the final model significant at p < 0.05. Variables were dichotomized to yield odds ratios and 95% confidence intervals. Of the 522 patients meeting inclusion criteria, 45% had a cause for pain demonstrated by CT. Predictors of a negative CT in men were normal hematocrit and negative urine blood (p = 0.045, p = 0.016, respectively), and in women normal hematocrit, granulocyte percent, and alkaline phosphatase (p = 0.023, p = 0.039, p < 0.0001, respectively). When standard normal values were used to calculate descriptive statistics, only granulocyte percent in women had a significant confidence interval (odds ratio 2.5, confidence interval 1.6-4.0). Among the 208 women with normal granulocyte percent, the final clinical diagnosis was appendicitis, cholecystitis, and diverticulitis, in three, three, and two cases, respectively (4% combined). In summary, no laboratory test was sufficient to offer reassurance that a CT is not necessary in a young adult patient with nontraumatic abdominal pain. Alternative strategies should be considered to decrease the use of CT, and its associated radiation exposure, in young adults with nontraumatic abdominal pain. PMID:20306104

  3. The Value of Restaging With Chest and Abdominal CT/MRI Scan After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer.

    PubMed

    Liu, Guo-Chen; Zhang, Xu; Xie, E; An, Xin; Cai, Pei-Qiang; Zhu, Ying; Tang, Jing-Hua; Kong, Ling-Heng; Lin, Jun-Zhong; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-11-01

    Little was known with regard to the value of preoperative systemic restaging for patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT). This study was designed to evaluate the role of chest and abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI) on preoperative restaging in LARC after neoadjuvant CRT and to assess the impact on treatment strategy.Between January 2007 and April 2013, 386 newly diagnosed consecutive patients with LARC who underwent neoadjuvant CRT and received restaging with chest and abdominal CT/MRI scan were included. Imaging results before and after CRT were analyzed.Twelve patients (3.1%) (6 liver lesions, 2 peritoneal lesions, 2 distant lymph node lesions, 1 lung lesions, 1 liver and lung lesions) were diagnosed as suspicious metastases on the restaging scan after radiotherapy. Seven patients (1.8%) were confirmed as metastases by pathology or long-term follow-up. The treatment strategy was changed in 5 of the 12 patients as a result of restaging CT/MRI findings. Another 10 patients (2.6%) who present with normal restaging imaging findings were diagnosed as metastases intra-operatively. The sensitivity, specificity accuracy, negative predictive value, and positive predictive values of restaging CT/MRI was 41.4%, 98.6%, 58.3%, and 97.3%, respectively.The low incidence of metastases and minimal consequences for the treatment plan question the clinical value of routine restaging of chest and abdomen after neoadjuvant CRT. Based on this study, a routine restaging CT/MRI of chest and abdomen in patients with rectal cancer after neoadjuvant CRT is not advocated, carcino-embryonic antigen (CEA) -guided CT/MRI restaging might be an alternative. PMID:26632714

  4. Evaluation of five image registration tools for abdominal CT: pitfalls and opportunities with soft anatomy

    NASA Astrophysics Data System (ADS)

    Lee, Christopher P.; Xu, Zhoubing; Burke, Ryan P.; Baucom, Rebeccah; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-03-01

    Image registration has become an essential image processing technique to compare data across time and individuals. With the successes in volumetric brain registration, general-purpose software tools are beginning to be applied to abdominal computed tomography (CT) scans. Herein, we evaluate five current tools for registering clinically acquired abdominal CT scans. Twelve abdominal organs were labeled on a set of 20 atlases to enable assessment of correspondence. The 20 atlases were pairwise registered based on only intensity information with five registration tools (affine IRTK, FNIRT, Non-Rigid IRTK, NiftyReg, and ANTs). Following the brain literature, the Dice similarity coefficient (DSC), mean surface distance, and Hausdorff distance were calculated on the registered organs individually. However, interpretation was confounded due to a significant proportion of outliers. Examining the retrospectively selected top 1 and 5 atlases for each target revealed that there was a substantive performance difference between methods. To further our understanding, we constructed majority vote segmentation with the top 5 DSC values for each organ and target. The results illustrated a median improvement of 85% in DSC between the raw results and majority vote. These experiments show that some images may be well registered to some targets using the available software tools, but there is significant room for improvement and reveals the need for innovation and research in the field of registration in abdominal CTs. If image registration is to be used for local interpretation of abdominal CT, great care must be taken to account for outliers (e.g., atlas selection in statistical fusion).

  5. Computer-aided diagnosis of splenic enlargement using wave pattern of spleen in abdominal CT images

    NASA Astrophysics Data System (ADS)

    Seong, Won; Cho, June-Sik; Noh, Seung-Moo; Park, Jong Won

    2006-03-01

    It is known that the spleen accompanied by liver cirrhosis is hypertrophied or enlarged. We have examined a wave pattern at the left boundary of spleen on the abdominal CT images having liver cirrhosis, and found that they are different from those on the images having a normal liver. It is noticed that the abdominal CT images of patient with liver cirrhosis shows strong bending in the wave pattern. In the case of normal liver, the images may also have a wave pattern, but its bends are not strong. Therefore, the total waving area of the spleen with liver cirrhosis is found to be greater than that of the spleen with a normal liver. Moreover, we found that the waves of the spleen from the image with liver cirrhosis have the higher degree of circularity compared to the normal liver case. Based on the two observations above, we propose an automatic method to diagnose splenic enlargement by using the wave pattern of the spleen in abdominal CT images. The proposed automatic method improves the diagnostic performance compared with the conventional process based on the size of spleen.

  6. On the relationship of minimum detectable contrast to dose and lesion size in abdominal CT.

    PubMed

    Zhou, Yifang; Scott, Alexander; Allahverdian, Janet; Lee, Christina; Kightlinger, Blake; Azizyan, Avetis; Miller, Joseph

    2015-10-01

    CT dose optimization is typically guided by pixel noise or contrast-to-noise ratio that does not delineate low contrast details adequately. We utilized the statistically defined low contrast detectability to study its relationship to dose and lesion size in abdominal CT. A realistically shaped medium sized abdomen phantom was customized to contain a cylindrical void of 4 cm diameter. The void was filled with a low contrast (1% and 2%) insert containing six groups of cylindrical targets ranging from 1.2 mm to 7 mm in size. Helical CT scans were performed using a Siemens 64-slice mCT and a GE Discovery 750 HD at various doses. After the subtractions between adjacent slices, the uniform sections of the filtered backprojection reconstructed images were partitioned to matrices of square elements matching the sizes of the targets. It was verified that the mean values from all the elements in each matrix follow a Gaussian distribution. The minimum detectable contrast (MDC), quantified by the mean signal to background difference equal to the distribution's standard deviation multiplied by 3.29, corresponding to 95% confidence level, was found to be related to the phantom specific dose and the element size by a power law (R^2  >  0.990). Independent readings on the 5 mm and 7 mm targets were compared to the measured contrast to the MDC ratios. The results showed that 93% of the cases were detectable when the measured contrast exceeds the MDC. The correlation of the MDC to the pixel noise and target size was also identified and the relationship was found to be the same for the scanners in the study. To quantify the impact of iterative reconstructions to the low contrast detectability, the noise structure was studied in a similar manner at different doses and with different ASIR blending fractions. The relationship of the dose to the blending fraction and low contrast detectability is presented. PMID:26389637

  7. On the relationship of minimum detectable contrast to dose and lesion size in abdominal CT

    NASA Astrophysics Data System (ADS)

    Zhou, Yifang; Scott, Alexander, II; Allahverdian, Janet; Lee, Christina; Kightlinger, Blake; Azizyan, Avetis; Miller, Joseph

    2015-10-01

    CT dose optimization is typically guided by pixel noise or contrast-to-noise ratio that does not delineate low contrast details adequately. We utilized the statistically defined low contrast detectability to study its relationship to dose and lesion size in abdominal CT. A realistically shaped medium sized abdomen phantom was customized to contain a cylindrical void of 4 cm diameter. The void was filled with a low contrast (1% and 2%) insert containing six groups of cylindrical targets ranging from 1.2 mm to 7 mm in size. Helical CT scans were performed using a Siemens 64-slice mCT and a GE Discovery 750 HD at various doses. After the subtractions between adjacent slices, the uniform sections of the filtered backprojection reconstructed images were partitioned to matrices of square elements matching the sizes of the targets. It was verified that the mean values from all the elements in each matrix follow a Gaussian distribution. The minimum detectable contrast (MDC), quantified by the mean signal to background difference equal to the distribution’s standard deviation multiplied by 3.29, corresponding to 95% confidence level, was found to be related to the phantom specific dose and the element size by a power law (R^2  >  0.990). Independent readings on the 5 mm and 7 mm targets were compared to the measured contrast to the MDC ratios. The results showed that 93% of the cases were detectable when the measured contrast exceeds the MDC. The correlation of the MDC to the pixel noise and target size was also identified and the relationship was found to be the same for the scanners in the study. To quantify the impact of iterative reconstructions to the low contrast detectability, the noise structure was studied in a similar manner at different doses and with different ASIR blending fractions. The relationship of the dose to the blending fraction and low contrast detectability is presented.

  8. Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility

    NASA Astrophysics Data System (ADS)

    Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

    2007-03-01

    Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

  9. Abdominal Lipectomy: A Prospective Outcomes Study

    PubMed Central

    Semer, Nadine B; Ho, Wan C; Mills, Sharrie; Rajashekara, BM; Taylor, Jason R; Trung, Nguyen B; Young, Henry; Kivuls, Juris

    2008-01-01

    Context/objective: Abdominal lipectomy is performed by plastic surgeons to provide symptomatic, functional, and cosmetic relief for patients with excess abdominal tissue. However, there are few clinical outcome studies looking at the utility of this procedure: this is the first prospective oucomes study. Design: Patients who underwent abdominal lipectomy at the Bellflower Medical Center during a 12-month period (September 2004 through September 2005) were prospectively studied. Data were collected at the preoperative visit, during surgery, and at the one-week, one-month, and six-month postoperative visits. Outcome measures: Complications, both major (requiring rehospitalization or reoperation) and minor (requiring local outpatient care) were identified. To evaluate the impact on our patients' perceived health and well-being as well as body image, we administered the Short Form–36 Health Survey (SF-36) and the Multidimensional Body-Self Relations Questionnaire (MBSRQ) to participants at their preoperative and six-month postoperative visits. Results: For the 72 patients enrolled in the study, the postoperative major complication rate was 5.6% (four patients) and the minor complication rate was 27.8% (20 patients); 98.3% were happy to have had the surgery. Two components of the MBSRQ, feelings of attractiveness and body area satisfaction, showed significant improvement (p < 0.0001 for each) at six-month postoperative testing. No component of the SF-36 reached statistical significance between pre- and postoperative testing. Conclusion: Because the complication rate for cosmetic abdominoplasty in our study did not significantly differ from rates reported for other studies, and given our data on perceived patient satisfaction and improvement in outcomes, our study validates the utility of abdominal lipectomy for patients with symptomatic lower abdominal pannus. PMID:21364808

  10. Assessing the prevalence and clinical relevance of positive abdominal and pelvic CT findings in senior patients presenting to the emergency department.

    PubMed

    Alabousi, Abdullah; Patlas, Michael N; Meshki, Malek; Monteiro, Sandra; Katz, Douglas S

    2016-04-01

    The purpose of our study was to retrospectively evaluate the prevalence and clinical relevance of positive abdominal and pelvic CT findings for patients 65 years of age and older, when compared with all other scanned adult Emergency Department (ED) patients, at a single tertiary care hospital. Our hypothesis was that there is an increased prevalence and clinical relevance of positive abdominal/pelvic CT findings in senior patients. A research ethics board-approved retrospective review of all adult patients who underwent an emergency CT of the abdomen and pelvis for acute nontraumatic abdominal and/or pelvic signs and symptoms was performed. Two thousand one hundred two patients between October 1, 2011, and September 30, 2013, were reviewed. Six hundred thirty-one patients were included in the <65 group (298 men and 333 women; mean age 46, age range 18-64), and 462 were included in the >65 group (209 men and 253 women; mean age 77.6, age range 65-99). Overall, there were more positive CT findings for patients <65 (389 positive cases, 61.6 %) compared with the >65 group (257 positive cases, 55.6 %), which was a statistically significant difference (p < 0.03). Moreover, with the exception of complicated appendicitis cases, which were more common in the >65 group, there were no statistically significant differences in the clinical/surgical relevance of the positive CT findings between the two groups. The findings of our retrospective study therefore refute our hypothesis that there is an increased prevalence of positive abdominal CT findings in patients >65. This may be related to ED physicians at our institution being more hesitant to order CT examinations for the younger population, presumably due to radiation concerns. However, older patients in our series were more likely to present with complicated appendicitis, and a lower threshold for ordering CT examinations of the abdomen and pelvis in this patient population should therefore be considered. PMID

  11. Contrast-Enhanced Abdominal Angiographic CT for Intra-abdominal Tumor Embolization: A New Tool for Vessel and Soft Tissue Visualization

    SciTech Connect

    Meyer, Bernhard Christian Frericks, Bernd Benedikt; Albrecht, Thomas; Wolf, Karl-Juergen; Wacker, Frank Klaus

    2007-07-15

    C-Arm cone-beam computed tomography (CACT), is a relatively new technique that uses data acquired with a flat-panel detector C-arm angiography system during an interventional procedure to reconstruct CT-like images. The purpose of this Technical Note is to present the technique, feasibility, and added value of CACT in five patients who underwent abdominal transarterial chemoembolization procedures. Target organs for the chemoembolizations were kidney, liver, and pancreas and a liposarcoma infiltrating the duodenum. The time for patient positioning, C-arm and system preparation, CACT raw data acquisition, and data reconstruction for a single CACT study ranged from 6 to 12 min. The volume data set produced by the workstation was interactively reformatted using maximum intensity projections and multiplanar reconstructions. As part of an angiography system CACT provided essential information on vascular anatomy, therapy endpoints, and immediate follow-up during and immediately after the abdominal interventions without patient transfer. The quality of CACT images was sufficient to influence the course of treatment. This technology has the potential to expedite any interventional procedure that requires three-dimensional information and navigation.

  12. ASSESSMENT OF CLINICAL IMAGE QUALITY IN PAEDIATRIC ABDOMINAL CT EXAMINATIONS: DEPENDENCY ON THE LEVEL OF ADAPTIVE STATISTICAL ITERATIVE RECONSTRUCTION (ASiR) AND THE TYPE OF CONVOLUTION KERNEL.

    PubMed

    Larsson, Joel; Båth, Magnus; Ledenius, Kerstin; Caisander, Håkan; Thilander-Klang, Anne

    2016-06-01

    The purpose of this study was to investigate the effect of different combinations of convolution kernel and the level of Adaptive Statistical iterative Reconstruction (ASiR™) on diagnostic image quality as well as visualisation of anatomical structures in paediatric abdominal computed tomography (CT) examinations. Thirty-five paediatric patients with abdominal pain with non-specified pathology undergoing abdominal CT were included in the study. Transaxial stacks of 5-mm-thick images were retrospectively reconstructed at various ASiR levels, in combination with three convolution kernels. Four paediatric radiologists rated the diagnostic image quality and the delineation of six anatomical structures in a blinded randomised visual grading study. Image quality at a given ASiR level was found to be dependent on the kernel, and a more edge-enhancing kernel benefitted from a higher ASiR level. An ASiR level of 70 % together with the Soft™ or Standard™ kernel was suggested to be the optimal combination for paediatric abdominal CT examinations. PMID:26922785

  13. Automated segmentation of upper digestive tract from abdominal contrast-enhanced CT data using hierarchical statistical modeling of organ interrelations

    NASA Astrophysics Data System (ADS)

    Hirayama, S.; Otake, Y.; Okada, T.; Hori, M.; Tomiyama, N.; Sato, Y.

    2016-03-01

    We have been studying the automatic segmentation of multi-organ region from abdominal CT images. In previous work, we proposed an approach using a hierarchical statistical modeling using a relationship between organs. In this paper, we have proposed automatic segmentation of the upper digestive tract from abdominal contrast-enhanced CT using previously segmented multiple organs. We compared segmentation accuracy of the esophagus, stomach and duodenum between our proposed method using hierarchical statistical modeling and a conventional statistical atlas method. Additionally, preliminary experiment was performed which added the region representing gas to the candidate region at the segmentation step. The segmentation results were evaluated quantitatively by Dice coefficient, Jaccard index and the average symmetric surface distance of the segmented region and correct region data. Percentage of the average of Dice coefficient of esophagus, stomach and duodenum were 58.7, 68.3, and 38.6 with prediction-based method and 23.7, 51.1, and 24.4 with conventional atlas method.

  14. A 54-Year-Old Man Presenting With an Abnormal Abdominal CT Scan 8 Months After Double Lung Transplant.

    PubMed

    Mistrot, Daniel P; Gemma, Vincent A; Gagliano, Ronald A; Omar, Ashraf; Panchabhai, Tanmay S

    2016-05-01

    A 54-year-old man who had undergone bilateral sequential lung transplant for idiopathic pulmonary fibrosis was admitted to the hospital for further evaluation of an abnormal abdominal CT scan. Three months previously a gastrojejunostomy tube had been placed after he was found to have evidence of silent aspiration with oral intake. At a recent clinic visit, he denied abdominal pain or problems with the feeding tube. He described frequent diarrhea since placement of the feeding tube. PMID:27157231

  15. Pancreas segmentation from 3D abdominal CT images using patient-specific weighted subspatial probabilistic atlases

    NASA Astrophysics Data System (ADS)

    Karasawa, Kenichi; Oda, Masahiro; Hayashi, Yuichiro; Nimura, Yukitaka; Kitasaka, Takayuki; Misawa, Kazunari; Fujiwara, Michitaka; Rueckert, Daniel; Mori, Kensaku

    2015-03-01

    Abdominal organ segmentations from CT volumes are now widely used in the computer-aided diagnosis and surgery assistance systems. Among abdominal organs, the pancreas is especially difficult to segment because of its large individual differences of the shape and position. In this paper, we propose a new pancreas segmentation method from 3D abdominal CT volumes using patient-specific weighted-subspatial probabilistic atlases. First of all, we perform normalization of organ shapes in training volumes and an input volume. We extract the Volume Of Interest (VOI) of the pancreas from the training volumes and an input volume. We divide each training VOI and input VOI into some cubic regions. We use a nonrigid registration method to register these cubic regions of the training VOI to corresponding regions of the input VOI. Based on the registration results, we calculate similarities between each cubic region of the training VOI and corresponding region of the input VOI. We select cubic regions of training volumes having the top N similarities in each cubic region. We subspatially construct probabilistic atlases weighted by the similarities in each cubic region. After integrating these probabilistic atlases in cubic regions into one, we perform a rough-to-precise segmentation of the pancreas using the atlas. The results of the experiments showed that utilization of the training volumes having the top N similarities in each cubic region led good results of the pancreas segmentation. The Jaccard Index and the average surface distance of the result were 58.9% and 2.04mm on average, respectively.

  16. SU-F-18C-12: On the Relationship of the Weighted Dose to the Surface Dose In Abdominal CT - Patient Size Dependency

    SciTech Connect

    Zhou, Y; Scott, A; Allahverdian, J

    2014-06-15

    Purpose: It is possible to measure the patient surface dose non-invasively using radiolucent dosimeters. However, the patient size specific weighted dose remains unknown. We attempted to study the weighted dose to surface dose relationship as the patient size varies in abdominal CT. Methods: Seven abdomen phantoms (CIRS TE series) simulating patients from an infant to a large adult were used. Size specific doses were measured with a 100 mm CT chamber under axial scans using a Siemens Sensation 64 (mCT) and a GE 750 HD. The scanner settings were 120 kVp, 200 mAs with fully opened collimations. Additional kVps (80, 100, 140) were added depending on the phantom sizes. The ratios (r) of the weighted CT dose (Dw) to the surface dose (Ds) were related to the phantom size (L) defined as the diameter resulting the equivalent cross-sectional area. Results: The Dw versus Ds ratio (r) was fitted to a linear relationship: r = 1.083 − 0.007L (R square = 0.995), and r = 1.064 − 0.007L (R square = 0.953), for Siemens Sensation 64 and GE 750 HD, respectively. The relationship appears to be independent of the scanner specifics. Conclusion: The surface dose to the weighted dose ratio decreases linearly as the patient size increases. The result is independent of the scanner specifics. The result can be used to obtain in vivo CT dosimetry in abdominal CT.

  17. Pearls and pitfalls in interpretation of abdominal and pelvic PET-CT.

    PubMed

    Blake, Michael A; Singh, Ajay; Setty, Bindu N; Slattery, James; Kalra, Mannudeep; Maher, Michael M; Sahani, Dushyant V; Fischman, Alan J; Mueller, Peter R

    2006-01-01

    The interpretation of images obtained in the abdomen and pelvis can be challenging, and the coregistration of positron emission tomographic (PET) and computed tomographic (CT) scans may be especially valuable in the evaluation of these anatomic areas. PET-CT represents a major technologic advance, consisting of generally complementary modalities whose combined strength tends to overcome their respective weaknesses. However, this combined functional-structural imaging approach raises a number of controversial questions and presents some unique interpretative challenges. Accurate PET-CT scan interpretation requires awareness of the various pitfalls associated with the imaging components, both individually and in combination. The results of recent PET-CT studies have been very encouraging, but larger prospective studies will be needed to establish optimal hybrid scanning protocols. Applying sound imaging principles, paying attention to detail, and staying abreast of advances in this exciting new modality are necessary for harnessing the full diagnostic power of abdominopelvic PET-CT. PMID:16973768

  18. Familial aggregation of abdominal visceral fat level: results from the Quebec family study.

    PubMed

    Pérusse, L; Després, J P; Lemieux, S; Rice, T; Rao, D C; Bouchard, C

    1996-03-01

    The purpose of this study was to investigate the importance of familial aggregation in abdominal visceral fat (AVF) level as assessed by computed tomography (CT). Four measures of abdominal adipose tissue, obtained from an abdominal scan between the fourth and fifth Lumbar vertebrae (L4-L5) taken in 366 adult subjects from 100 French-Canadian nuclear families, were considered in this study. Total abdominal fat, AVF, subcutaneous abdominal fat, obtained by computing the difference between total and AVF tissue areas, and the visceral to total abdominal fat ratio were measured. Spouses, parent-offspring, and sibling correlations were computed by maximum likelihood methods after adjustment of the four phenotypes for age and for age and total fat mass (FM) derived from underwater weighing. Significant familial aggregation was found for all phenotypes, whether adjusted or not for body FM. However, after adjustment of data for body FM, in addition to age, all spouse correlations became nonsignificant, suggesting that the familial aggregation of abdominal fat is primarily genetic. Heritability estimates reached 42% and 56% for subcutaneous fat and AVF, respectively. These results suggest that genetic factors are major determinants of the familial aggregation observed in the amount of abdominal fat, irrespective of total body fat content, and that AVF seems more influenced by genetic factors than abdominal subcutaneous adipose tissue. These findings imply that some individuals are more at risk than others to exhibit the various metabolic complications associated with upper-body obesity because of their inherited tendency to store abdominal fat in the visceral depot rather than in the subcutaneous depot. PMID:8606647

  19. An Abdominal CT may be Safe in Selected Hypotensive Trauma Patients with Positive FAST Exam

    PubMed Central

    Cook, Mackenzie R.; Holcomb, John B.; Rahbar, Mohammad H.; Alarcon, Louis H.; Bulger, Eileen M.; Brasel, Karen J.; Schreiber, Martin A.

    2016-01-01

    Background Positive Focused Assessment with Sonography in Trauma (FAST) and hypotension often indicates urgent surgery. An abdomen/pelvis CT (apCT) may allow less invasive management but the delay may be associated with adverse outcomes. Methods Patients in the Prospective Observational Multicenter Major Trauma Transfusion study with hypotension and a positive FAST (HF+) who underwent a CT (apCT+) were compared to those who did not. Results Of the 92 HF+ identified, 32(35%) underwent apCT during initial evaluation and apCT was associated with decreased odds of an emergency operation, OR 0.11 95% CI (0.001–0.116) and increased odds of angiographic intervention, OR 14.3 95% CI (1.5–135). There was no significant difference in 30 day mortality or need for dialysis. Conclusion An apCt in HF+ patients is associated with reduced odds of emergency surgery, but not mortality. Select HF+ patients can safely undergo apCT to obtain clinically useful information. PMID:25805456

  20. Abdominal Kaposiform Hemangioendothelioma Associated With Lymphangiomatosis Involving Mesentery and Ileum: A Case Report of MRI, CT, and 18F-FDG PET/CT Findings.

    PubMed

    Dong, Aisheng; Zhang, Ling; Wang, Yang; He, Tianlin; Zuo, Changjing

    2016-02-01

    Kaposiform hemangioendothelioma (KH) is a rare vascular tumor of intermediate malignancy that occurs mainly in the childhood. Adult patients with KH are rare. Imaging findings of KH have rarely been reported before. We present magnetic resonance imaging (MRI), computed tomography (CT), and fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/CT findings in an adult patient with KH associated with lymphangiomatosis involving mesentery and ileum.A 22-year-old female complained of a 9-month history of intermittent melena, weakness, and palpitation. Laboratory tests revealed anemia and hypoproteinemia. Fecal occult blood test was positive. Abdominal enhanced MRI and CT showed a large abdominal mass involving mesentery and ileum. On enhanced MRI, there were many hypervascular nodules in the mass. On FDG PET/CT, the mass and the nodules showed slight FDG uptake. Small bowel capsule endoscopy showed numerous grape-shaped red nodules in the luminal wall of the involved ileum. The patient underwent resection of the abdominal mass and a segment of the ileum invaded by the abdominal mass. KH arising within lymphangiomatosis involving mesentery and ileum was confirmed by pathology. After surgery, the patient's symptoms improved.This is the first case of KH associated with lymphangiomatosis involving mesentery and ileum. In this case, the lymphangiomatosis overshadowed the small tumor nodules resulting in unusual imaging findings. Familiarity with these imaging findings is helpful for diagnosis and differential diagnosis of KH. PMID:26871848

  1. Maximizing Iodine Contrast-to-Noise Ratios in Abdominal CT Imaging through Use of Energy Domain Noise Reduction and Virtual Monoenergetic Dual-Energy CT1

    PubMed Central

    Leng, Shuai; Yu, Lifeng; Fletcher, Joel G.; McCollough, Cynthia H.

    2015-01-01

    Purpose To determine the iodine contrast-to-noise ratio (CNR) for abdominal computed tomography (CT) when using energy domain noise reduction and virtual monoenergetic dual-energy (DE) CT images and to compare the CNR to that attained with single-energy CT at 80, 100, 120, and 140 kV. Materials and Methods This HIPAA-compliant study was approved by the institutional review board with waiver of informed consent. A syringe filled with diluted iodine contrast material was placed into 30-, 35-, and 45-cm-wide water phantoms and scanned with a dual-source CT scanner in both DE and single-energy modes with matched scanner output. Virtual monoenergetic images were generated, with energies ranging from 40 to 110 keV in 10-keV steps. A previously developed energy domain noise reduction algorithm was applied to reduce image noise by exploiting information redundancies in the energy domain. Image noise and iodine CNR were calculated. To show the potential clinical benefit of this technique, it was retrospectively applied to a clinical DE CT study of the liver in a 59-year-old male patient by using conventional and iterative reconstruction techniques. Image noise and CNR were compared for virtual monoenergetic images with and without energy domain noise reduction at each virtual monoenergetic energy (in kiloelectron volts) and phantom size by using a paired t test. CNR of virtual monoenergetic images was also compared with that of single-energy images acquired with 80, 100, 120, and 140 kV. Results Noise reduction of up to 59% (28.7/65.7) was achieved for DE virtual monoenergetic images by using an energy domain noise reduction technique. For the commercial virtual monoenergetic images, the maximum iodine CNR was achieved at 70 keV and was 18.6, 16.6, and 10.8 for the 30-, 35-, and 45-cm phantoms. After energy domain noise reduction, maximum iodine CNR was achieved at 40 keV and increased to 30.6, 25.4, and 16.5. These CNRs represented improvement of up to 64% (12.0/18.6) with

  2. A new method for detecting colonic polyps based on local intensity structure analysis from 3D abdominal CT images

    NASA Astrophysics Data System (ADS)

    Oda, Masahiro; Nakada, Yuichi; Kitasaka, Takayuki; Mori, Kensaku; Suenaga, Yasuhito; Takayama, Tetsuji; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Nawano, Shigeru

    2007-03-01

    This paper presents a new method for detecting colonic polyps from abdominal CT images based on Hessian matrix analysis. Recently, virtual colonoscopy (VC) has widely received attention as a new and less-invasive colon diagnostic method. A physician diagnoses the inside of the colon using a virtual colonoscopy system. However, since the colon has many haustra and its shape is long and convoluted, a physician has to change viewpoints and viewing directions of the virtual camera many times while diagnosing. Lesions behind haustra may be overlooked. Thus this paper proposes an automated colonic polyp detection method from 3D abdominal CT images. Colonic polyps are located on the colonic wall, and their CT values are higher than colonic lumen regions. In addition, CT values inside polyps tend to gradually increase from outward to inward (blob-like structure). We employ a blob structure enhancement filter based on the eigenvalues of a Hessian matrix to detect polyps with the above blob-shaped characteristics. For reducing FPs, we eliminate polyp candidate regions in which the maximum output value of the blob structure enhancement filter is smaller than given threshold values. Also small regions are removed from candidates. We applied the proposed method to 23 cases of abdominal CT images. Overall, 74.4% of the polyps were detected with 3.8 FPs per case.

  3. Computerized organ localization in abdominal CT volume with context-driven generalized Hough transform

    NASA Astrophysics Data System (ADS)

    Liu, Jing; Li, Qiang

    2014-03-01

    Fast localization of organs is a key step in computer-aided detection of lesions and in image guided radiation therapy. We developed a context-driven Generalized Hough Transform (GHT) for robust localization of organ-of-interests (OOIs) in a CT volume. Conventional GHT locates the center of an organ by looking-up center locations of pre-learned organs with "matching" edges. It often suffers from mislocalization because "similar" edges in vicinity may attract the prelearned organs towards wrong places. The proposed method not only uses information from organ's own shape but also takes advantage of nearby "similar" edge structures. First, multiple GHT co-existing look-up tables (cLUT) were constructed from a set of training shapes of different organs. Each cLUT represented the spatial relationship between the center of the OOI and the shape of a co-existing organ. Second, the OOI center in a test image was determined using GHT with each cLUT separately. Third, the final localization of OOI was based on weighted combination of the centers obtained in the second stage. The training set consisted of 10 CT volumes with manually segmented OOIs including liver, spleen and kidneys. The method was tested on a set of 25 abdominal CT scans. Context-driven GHT correctly located all OOIs in the test image and gave localization errors of 19.5±9.0, 12.8±7.3, 9.4±4.6 and 8.6±4.1 mm for liver, spleen, left and right kidney respectively. Conventional GHT mis-located 8 out of 100 organs and its localization errors were 26.0±32.6, 14.1±10.6, 30.1±42.6 and 23.6±39.7mm for liver, spleen, left and right kidney respectively.

  4. Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group

    PubMed Central

    Servaes, Sabah; Naranjo, Arlene; Geller, James I.; Ehrlich, Peter F.; Gow, Kenneth W.; Perlman, Elizabeth J.; Dome, Jeffrey S.; Gratias, Eric; Mullen, Elizabeth A.

    2015-01-01

    Background CT and MRI are both used for abdominal staging of pediatric renal tumors. The diagnostic performance of the two modalities for local and regional staging of renal tumors has not been systematically evaluated. Objective To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumors. Materials and methods The study population was derived from the AREN03B2 study of the Children's Oncology Group. Baseline abdominal imaging performed with both CT and MRI within 30 days of nephrectomy was available for retrospective review in 82 renal tumor cases. Each case was evaluated for capsular penetration, lymph node metastasis, tumor thrombus, preoperative tumor rupture, and synchronous contralateral lesions. The surgical and pathological findings at central review were the reference standard. Results The sensitivity of CT and MRI for detecting capsular penetration was 68.6% and 62.9%, respectively (P=0.73), while specificity was 86.5% and 83.8% (P=1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 76.5% and 52.9% (P=0.22), and specificity was 90.4% and 92.3% (P=1.0). Synchronous contralateral lesions were identified by CT in 4/9 cases and by MRI in 7/9 cases. Conclusion CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MR detected more contralateral synchronous lesions; however these were present in a very small number of cases. Either modality can be used for initial loco–regional staging of pediatric renal tumors. PMID:25135711

  5. What is the preferred strength setting of the sinogram-affirmed iterative reconstruction algorithm in abdominal CT imaging?

    PubMed

    Hardie, Andrew D; Nelson, Rachel M; Egbert, Robert; Rieter, William J; Tipnis, Sameer V

    2015-01-01

    Our primary objective in this study was to determine the preferred strength setting for the sinogram-affirmed iterative reconstruction algorithm (SAFIRE) in abdominal computed tomography (CT) imaging. Sixteen consecutive clinical CT scans of the abdomen were reconstructed by use of traditional filtered back projection (FBP) and 5 SAFIRE strengths: S1-S5. Six readers of differing experience were asked to rank the images on preference for overall diagnostic quality. The contrast-to-noise ratio was not significantly different between SAFIRE S1 and FBP, but increased with increasing SAFIRE strength. For pooled data, S2 and S3 were preferred equally but both were preferred over all other reconstructions. S5 was the least preferred, with FBP the next least preferred. This represents a marked disparity between the image quality based on quantitative parameters and qualitative preference. Care should be taken to factor in qualitative in addition to quantitative aspects of image quality when one is optimizing iterative reconstruction images. PMID:25164978

  6. Segmentation of abdominal organs from CT using a multi-level, hierarchical neural network strategy.

    PubMed

    Selver, M Alper

    2014-03-01

    Precise measurements on abdominal organs are vital prior to the important clinical procedures. Such measurements require accurate segmentation of these organs, which is a very challenging task due to countless anatomical variations and technical difficulties. Although, several features with various classifiers have been designed to overcome these challenges, abdominal organ segmentation via classification is still an emerging field in order to reach desired precision. Recent studies on multiple feature-classifier combinations show that hierarchical systems outperform composite feature-single classifier models. In this study, how hierarchical formations can translate to improved accuracy, when large size feature spaces are involved, is explored for the problem of abdominal organ segmentation. As a result, a semi-automatic, slice-by-slice segmentation method is developed using a novel multi-level and hierarchical neural network (MHNN). MHNN is designed to collect complementary information about organs at each level of the hierarchy via different feature-classifier combinations. Moreover, each level of MHNN receives residual data from the previous level. The residual data is constructed to preserve zero false positive error until the last level of the hierarchy, where only most challenging samples remain. The algorithm mimics analysis behaviour of a radiologist by using the slice-by-slice iteration, which is supported with adjacent slice similarity features. This enables adaptive determination of system parameters and turns into the advantage of online training, which is done in parallel to the segmentation process. Proposed design can perform robust and accurate segmentation of abdominal organs as validated by using diverse data sets with various challenges. PMID:24480371

  7. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    SciTech Connect

    Park, Joon Young Kim, Shin Jung Kim, Hyoung Ook; Kim, Yong Tae; Lim, Nam Yeol Kim, Jae Kyu; Chung, Sang Young Choi, Soo Jin Na Lee, Ho Kyun

    2015-02-15

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

  8. The Use of CT Scan in Hemodynamically Stable Children with Blunt Abdominal Trauma: Look before You Leap.

    PubMed

    Nellensteijn, David R; Greuter, Marcel J; El Moumni, Moustafa; Hulscher, Jan B

    2016-08-01

    We set out to determine the diagnostic value of computed tomographic (CT) scans in relation to the radiation dose, tumor incidence, and tumor mortality by radiation for hemodynamically stable pediatric patients with blunt abdominal injury. We focused on the changes in management because of new information obtained by CT. CT scans for suspected pediatric abdominal injury performed in our accident and emergency department were retrieved from the radiology registry and analyzed for: injury and hemodynamic parameters, changes in therapy, and radiological interventions. The dose length product (DLP) was used to calculate the effective dose (ED) and with the BEIR VII report we calculated the estimated induced lifetime tumor and mortality risk. Seventy-two patients underwent abdominal CT scanning for suspicion of abdominal injury and eight patients were excluded for hemodynamic instability, leaving 64 hemodynamically stable patients. Four patients died (6%). On the remaining 60 patients, only one laparotomy was performed for suspicion of duodenal perforation. Only in three out of the 64 hemodynamically stable cases (5%), a CT scan brought forward an indication for intervention or change in management. One patient was suspected of a duodenal perforation and underwent a laparotomy. A grade II hepatic laceration, but no duodenal, injury was found. Two patients underwent embolization of the splenic artery. One for an arterial blush caused by splenic laceration as was observed on the contrast enhanced-CT. Patient remained stable and during the angiogram the blush had disappeared. The second patient underwent (prophylactic) selective arterial embolization for having sustained a grade V splenic injury. The median radiation dosage was 11.43 mSv (range 1.19-23.76 mSv) in our patients. The use of the BEIR VII methodology results in an estimated increase in the lifetime tumor incidence of 0.17% (range, 0.05-0.67%) and an estimated increase in lifetime tumor incidence of 0.08% (0

  9. Repeatability of Radiotracer Uptake in Normal Abdominal Organs with 111In-Pentetreotide Quantitative SPECT/CT

    PubMed Central

    Rowe, Steven P.; Vicente, Esther; Anizan, Nadège; Wang, Hao; Leal, Jeffrey P.; Lodge, Martin A.; Frey, Eric C.; Wahl, Richard L.

    2015-01-01

    With an increasing emphasis on quantitation of SPECT imaging and its use in dosimetry to guide therapies, it is desirable to understand the repeatability in normal-organ SPECT uptake values (SPECT-UVs). We investigated the variability of normal abdominal organ uptake in repeated 111In-pentetreotide SPECT studies. Methods Nine patients with multiple 111In-pentetreotide SPECT/CT studies for clinical purposes were evaluated. Volumes of interest were drawn for the abdominal organs and applied to SPECT-UVs. The variability of those values was assessed. Results The average SPECT-UV for the liver (1.7 ± 0.6) was much lower than for the kidneys (right, 8.0 ± 2.4; left, 7.5 ± 1.7). Interpatient and intrapatient variability was similar (intraclass correlation coefficients, 0.40–0.59) for all organs. The average coefficients of variation for each organ for each patient were obtained and averaged across all patients (0.26 for liver, 0.22 for right kidney, and 0.20 for left kidney). The coefficients of variation for the organs across all scans were 0.33 (liver), 0.30 (right kidney), and 0.22 (left kidney). Conclusion Variability across all patients and all scans for the liver was higher than reported with 18F-FDG PET, though left kidney variability was similar to PET liver variability and left kidney uptake may be able to serve as an internal metric for determining the quantifiability of an 111In-pentetreotide SPECT study. PMID:25977467

  10. Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

    SciTech Connect

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

    2014-06-15

    Purpose: The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? Methods: The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. Results: Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. Conclusions: The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed

  11. Abdominal injuries in a low trauma volume hospital - a descriptive study from northern Sweden

    PubMed Central

    2014-01-01

    Background Abdominal injuries occur relatively infrequently during trauma, and they rarely require surgical intervention. In this era of non-operative management of abdominal injuries, surgeons are seldom exposed to these patients. Consequently, surgeons may misinterpret the mechanism of injury, underestimate symptoms and radiologic findings, and delay definite treatment. Here, we determined the incidence, diagnosis, and treatment of traumatic abdominal injuries at our hospital to provide a basis for identifying potential hazards in non-operative management of patients with these injuries in a low trauma volume hospital. Methods This retrospective study included prehospital and in-hospital assessments of 110 patients that received 147 abdominal injuries from an isolated abdominal trauma (n = 70 patients) or during multiple trauma (n = 40 patients). Patients were primarily treated at the University Hospital of Umeå from January 2000 to December 2009. Results The median New Injury Severity Score was 9 (range: 1–57) for 147 abdominal injuries. Most patients (94%) received computed tomography (CT), but only 38% of patients with multiple trauma were diagnosed with CT < 60 min after emergency room arrival. Penetrating trauma caused injuries in seven patients. Solid organ injuries constituted 78% of abdominal injuries. Non-operative management succeeded in 82 patients. Surgery was performed for 28 patients, either immediately (n = 17) as result of operative management or later (n = 11), due to non-operative management failure; the latter mainly occurred with hollow viscus injuries. Patients with multiple abdominal injuries, whether associated with multiple trauma or an isolated abdominal trauma, had significantly more non-operative failures than patients with a single abdominal injury. One death occurred within 30 days. Conclusions Non-operative management of patients with abdominal injuries, except for hollow viscus injuries, was highly

  12. A Novel Multiinstance Learning Approach for Liver Cancer Recognition on Abdominal CT Images Based on CPSO-SVM and IO

    PubMed Central

    Yi, Dehui

    2013-01-01

    A novel multi-instance learning (MIL) method is proposed to recognize liver cancer with abdominal CT images based on instance optimization (IO) and support vector machine with parameters optimized by a combination algorithm of particle swarm optimization and local optimization (CPSO-SVM). Introducing MIL into liver cancer recognition can solve the problem of multiple regions of interest classification. The images we use in the experiments are liver CT images extracted from abdominal CT images. The proposed method consists of two main steps: (1) obtaining the key instances through IO by texture features and a classification threshold in classification of instances with CPSO-SVM and (2) predicting unknown samples with the key instances and the classification threshold. By extracting the instances equally based on the entire image, the proposed method can ignore the procedure of tumor region segmentation and lower the demand of segmentation accuracy of liver region. The normal SVM method and two MIL algorithms, Citation-kNN algorithm and WEMISVM algorithm, have been chosen as comparing algorithms. The experimental results show that the proposed method can effectively recognize liver cancer images from two kinds of cancer CT images and greatly improve the recognition accuracy. PMID:24368931

  13. Can Surgeons Assess CT Suitability for Endovascular Repair (EVAR) in Ruptured Abdominal Aortic Aneurysm? Implications for a Ruptured EVAR Trial

    SciTech Connect

    Rayt, Harjeet Lambert, Kelly; Bown, Matthew; Fishwick, Guy; Morgan, Robert; McCarthy, Mark; London, Nick; Sayers, Robert

    2008-09-15

    The purpose of this study was to determine whether surgeons without formal radiological training are able to assess suitability of patients with ruptured abdominal aortic aneurysms (AAA) for EVAR. The CT scans of 20 patients with AAA were reviewed under timed conditions by six vascular surgeons. Twenty minutes was allocated per scan. They were asked to determine if each aneurysm would be treatable by EVAR in the emergency setting and, if so, to measure for device selection. The results were then compared with those of a vascular radiologist. Six surgeons agreed on the suitability of endovascular repair in 45% of cases (95% CI, 23.1-68.5%; 9/20 scans; {kappa} = 0.41 [p = 0.01]) and concurred with the radiologist in eight of these. Individually, agreement ranged from 13 to 16 of the 20 scans, 65-80% between surgeons. The kappa value for agreement between all the surgeons and the radiologist was 0.47 (p = 0.01, moderate agreement). For the individual surgeons, this ranged from 0.3 to 0.6 (p = 0.01). In conclusion, while overall agreement was moderate between the surgeons and the radiologist, it is clear that if surgeons are to assess patients for ruptured EVAR in the future, focused training of surgical trainees is required.

  14. Whole-body CT in polytrauma patients: The effect of arm position on abdominal image quality when using a human phantom

    NASA Astrophysics Data System (ADS)

    Jeon, Pil-Hyun; Kim, Hee-Joung; Lee, Chang-Lae; Kim, Dae-Hong; Lee, Won-Hyung; Jeon, Sung-Su

    2012-06-01

    For a considerable number of emergency computed tomography (CT) scans, patients are unable to position their arms above their head due to traumatic injuries. The arms-down position has been shown to reduce image quality with beam-hardening artifacts in the dorsal regions of the liver, spleen, and kidneys, rendering these images non-diagnostic. The purpose of this study was to evaluate the effect of arm position on the image quality in patients undergoing whole-body CT. We acquired CT scans with various acquisition parameters at voltages of 80, 120, and 140 kVp and an increasing tube current from 200 to 400 mAs in 50 mAs increments. The image noise and the contrast assessment were considered for quantitative analyses of the CT images. The image noise (IN), the contrast-to-noise ratio (CNR), the signal-to-noise ratio (SNR), and the coefficient of variation (COV) were evaluated. Quantitative analyses of the experiments were performed with CT scans representative of five different arm positions. Results of the CT scans acquired at 120 kVp and 250 mAs showed high image quality in patients with both arms raised above the head (SNR: 12.4, CNR: 10.9, and COV: 8.1) and both arms flexed at the elbows on the chest (SNR: 11.5, CNR: 10.2, and COV: 8.8) while the image quality significantly decreased with both arms in the down position (SNR: 9.1, CNR: 7.6, and COV: 11). Both arms raised, one arm raised, and both arms flexed improved the image quality compared to arms in the down position by reducing beam-hardening and streak artifacts caused by the arms being at the side of body. This study provides optimal methods for achieving higher image quality and lower noise in abdominal CT for trauma patients.

  15. Abdominal multi-organ CT segmentation using organ correlation graph and prediction-based shape and location priors.

    PubMed

    Okada, Toshiyuki; Linguraru, Marius George; Hori, Masatoshi; Summers, Ronald M; Tomiyama, Noriyuki; Sato, Yoshinobu

    2013-01-01

    The paper addresses the automated segmentation of multiple organs in upper abdominal CT data. We propose a framework of multi-organ segmentation which is adaptable to any imaging conditions without using intensity information in manually traced training data. The features of the framework are as follows: (1) the organ correlation graph (OCG) is introduced, which encodes the spatial correlations among organs inherent in human anatomy; (2) the patient-specific organ shape and location priors obtained using OCG enable the estimation of intensity priors from only target data and optionally a number of untraced CT data of the same imaging condition as the target data. The proposed methods were evaluated through segmentation of eight abdominal organs (liver, spleen, left and right kidney, pancreas, gallbladder, aorta, and inferior vena cava) from 86 CT data obtained by four imaging conditions at two hospitals. The performance was comparable to the state-of-the-art method using intensity priors constructed from manually traced data. PMID:24505771

  16. SU-E-I-23: A General KV Constrained Optimization of CNR for CT Abdominal Imaging

    SciTech Connect

    Weir, V; Zhang, J

    2015-06-15

    Purpose: While Tube current modulation has been well accepted for CT dose reduction, kV adjusting in clinical settings is still at its early stage. This is mainly due to the limited kV options of most current CT scanners. kV adjusting can potentially reduce radiation dose and optimize image quality. This study is to optimize CT abdomen imaging acquisition based on the assumption of a continuous kV, with the goal to provide the best contrast to noise ratio (CNR). Methods: For a given dose (CTDIvol) level, the CNRs at different kV and pitches were measured with an ACR GAMMEX phantom. The phantom was scanned in a Siemens Sensation 64 scanner and a GE VCT 64 scanner. A constrained mathematical optimization was used to find the kV which led to the highest CNR for the anatomy and pitch setting. Parametric equations were obtained from polynomial fitting of plots of kVs vs CNRs. A suitable constraint region for optimization was chosen. Subsequent optimization yielded a peak CNR at a particular kV for different collimations and pitch setting. Results: The constrained mathematical optimization approach yields kV of 114.83 and 113.46, with CNRs of 1.27 and 1.11 at the pitch of 1.2 and 1.4, respectively, for the Siemens Sensation 64 scanner with the collimation of 32 x 0.625mm. An optimized kV of 134.25 and 1.51 CNR is obtained for a GE VCT 64 slice scanner with a collimation of 32 x 0.625mm and a pitch of 0.969. At 0.516 pitch and 32 x 0.625 mm an optimized kV of 133.75 and a CNR of 1.14 was found for the GE VCT 64 slice scanner. Conclusion: CNR in CT image acquisition can be further optimized with a continuous kV option instead of current discrete or fixed kV settings. A continuous kV option is a key for individualized CT protocols.

  17. Staging of Primary Abdominal Lymphomas: Comparison of Whole-Body MRI with Diffusion-Weighted Imaging and 18F-FDG-PET/CT

    PubMed Central

    Stecco, Alessandro; Buemi, Francesco; Quagliozzi, Martina; Lombardi, Mariangela; Santagostino, Alberto; Sacchetti, Gian Mauro; Carriero, Alessandro

    2015-01-01

    Background. The purpose of this study was to compare the accuracy of whole-body MRI with diffusion-weighted sequences (WB-DW-MRI) with that of 18F-FDG-PET/CT in the staging of patients with primary gastrointestinal lymphoma. Methods. This retrospective study involved 17 untreated patients with primary abdominal gastrointestinal lymphoma. All patients underwent 18F-FDG-PET/CT and WB-DW-MRI. Histopathology findings or at least 6 months of clinical and radiological follow-up was the gold standard. The Musshoff-modified Ann Arbor system was used for staging, and diagnostic accuracy was evaluated on a per-node basis. Results. WB-DW-MRI exhibited 100% sensitivity, 96.3% specificity, and 96.1% and 100% positive and negative predictive values (PPV and NPV), respectively. The sensitivity, specificity, and PPV and NPV of PET/CT were 95.9%, 100%, and 100% and 96.4%, respectively. There were no statistically significant differences between the two techniques (p = 0.05). The weighted kappa agreement statistics with a 95% confidence interval were 0.97 (0.95–0.99) between the two MRI readers and 0.87 (0.82–0.92) between the two methods. Conclusions. WB-DW-MRI appears to have a comparable diagnostic value to 18F-FDG-PET/CT in staging patients with gastrointestinal lymphoma. PMID:26798331

  18. Computer-Aided Diagnosis of Splenic Enlargement Using Wave Pattern of Spleen in Abdominal CT Images: Initial Observations

    NASA Astrophysics Data System (ADS)

    Seong, Won; Cho, June-Sik; Noh, Seung-Moo; Park, Jong-Won

    In general, the spleen accompanied by abnormal abdomen is hypertrophied. However, if the spleen size is originally small, it is hard to detect the splenic enlargement due to abnormal abdomen by simply measure the size. On the contrary, the spleen size of a person having a normal abdomen may be large by nature. Therefore, measuring the size of spleen is not a reliable diagnostic measure of its enlargement or the abdomen abnormality. This paper proposes an automatic method to diagnose the splenic enlargement due to abnormality, by examining the boundary pattern of spleen in abdominal CT images.

  19. Electromyography study of the portions of the abdominal rectus muscle.

    PubMed

    Negrao Filho, R de F; Bérzin, F; Souza, G da C

    1997-01-01

    This study objective was to verify the behavior of three portions of the abdominal rectus muscle through a quantitative analysis of the electromyographic signal in different types of abdominal exercises. Ten young male between 16 and 27 years old were studied and they had no previous history of muscle and joint illness. They were well-trained and did seven abdominal exercises chosen considering the types of contraction (isotonic and isometric) as well as the muscle fixation points. The electric activity of the superior, medium (above umbilicus) and inferior (below umbilicus) portions at the left side of the abdominal rectus muscle was taken using Beckman type surface mini-electrodes. The registers were collected from computerized 8-channel Nicholet electromyography equipment, model Viking II. The signals were quantified using the MVA (Maximum Volunteer Activity) software, being considered for analysis the values of RMS (Root Mean Square). The obtained data were submitted to a parametric analysis using the variance analysis (F test) and also the Tukey test, besides a descriptive graphic analysis starting from the average RMS values of each muscle portion. This study results suggest that for the majority of the subjects, the functional activities of the abdominal rectus muscle are performed with electric activity differences among their portions, showing a tendency of producing more electric activity in the superior portion than in the medium and inferior portions. The experiment also demonstrated an absence of a common behavior pattern in the three portions of the ten tested subjects. PMID:9444489

  20. CT in ovarian cancer staging: how to review and report with emphasis on abdominal and pelvic disease for surgical planning.

    PubMed

    Sahdev, Anju

    2016-01-01

    CT of the abdomen and pelvis is the first line imaging modality for staging, selecting treatment options and assessing disease response in ovarian cancer. The staging CT provides disease distribution, disease burden and is the imaging surrogate for surgico-pathological FIGO staging. Optimal cyto-reductive surgery offers patients' the best chance for disease control or cure, but sub-optimal resection confers no advantage over chemotherapy and adversely increases the risk of post surgical complications. Although there is extensive literature comparing performance of CT against laparoscopy and surgery, for the staging abdominal and pelvic CT, there are currently no accepted guidelines for interpretation or routinely used minimum data set templates for reporting these complex CT scans often with extensive radiological findings. This review provides a systematic approach for identifying the important radiological findings and highlighting important sites of disease within the abdomen and pelvis, which may alter or preclude surgery at presentation or after adjuvant chemotherapy. The distribution of sites and volume of disease can be used to categorize patients as suitable, probably suitable or not suitable for optimal cyto-reductive surgery. This categorization can potentially assist oncological surgeons and oncologists as a semi objective assessment tool useful for selecting patient treatment, streamlining multi disciplinary discussion and improving the reproducibility and correlation of CT with surgical findings. The review also highlights sites of disease and complications of ovarian cancer which should be included as part of the radiological report as these may require additional surgical input from non gynaecological surgeons or influence treatment selection. PMID:27484100

  1. The relevance of image quality indices for dose optimization in abdominal multi-detector row CT in children: experimental assessment with pediatric phantoms

    NASA Astrophysics Data System (ADS)

    Brisse, H. J.; Brenot, J.; Pierrat, N.; Gaboriaud, G.; Savignoni, A.; DeRycke, Y.; Neuenschwander, S.; Aubert, B.; Rosenwald, J.-C.

    2009-04-01

    This study assessed and compared various image quality indices in order to manage the dose of pediatric abdominal MDCT protocols and to provide guidance on dose reduction. PMMA phantoms representing average body diameters at birth, 1 year, 5 years, 10 years and 15 years of age were scanned in a four-channel MDCT with a standard pediatric abdominal CT protocol. Image noise (SD, standard deviation of CT number), noise derivative (ND, derivative of the function of noise with respect to dose) and contrast-to-noise ratio (CNR) were measured. The 'relative' low-contrast detectability (rLCD) was introduced as a new quantity to adjust LCD to the various phantom diameters on the basis of the LCD1% assessed in a Catphan® phantom and a constant central absorbed dose. The required variations of CTDIvol16 with respect to phantom size were analyzed in order to maintain each image quality index constant. The use of a fixed SD or CNR level leads to major dose ratios between extreme patient sizes (factor 22.7 to 44 for SD, 31.7 to 51.5 for CNR2.8%), whereas fixed ND and rLCD result in acceptable dose ratios ranging between factors of 2.9 and 3.9 between extreme phantom diameters. For a 5-9 mm rLCD1%, adjusted ND values range between -0.84 and -0.11 HU mGy-1. Our data provide guidance on dose reduction on the basis of patient dimensions and the required rLCD (e.g., to get a constant 7 mm rLCD1% for abdominal diameters of 10, 13, 16, 20 and 25 cm, tube current-time product should be adjusted in order to obtain CTDIvol16 values of 6.2, 7.2, 8.8, 11.6 and 17.7 mGy, respectively).

  2. Association of Intraluminal Thrombus, Hemodynamic Forces, and Abdominal Aortic Aneurysm Expansion Using Longitudinal CT Images.

    PubMed

    Zambrano, Byron A; Gharahi, Hamidreza; Lim, ChaeYoung; Jaberi, Farhad A; Choi, Jongeun; Lee, Whal; Baek, Seungik

    2016-05-01

    While hemodynamic forces and intraluminal thrombus (ILT) are believed to play important roles on abdominal aortic aneurysm (AAA), it has been suggested that hemodynamic forces and ILT also interact with each other, making it a complex problem. There is, however, a pressing need to understand relationships among three factors: hemodynamics, ILT accumulation, and AAA expansion for AAA prognosis. Hence this study used longitudinal computer tomography scans from 14 patients and analyzed the relationship between them. Hemodynamic forces, represented by wall shear stress (WSS), were obtained from computational fluid dynamics; ILT accumulation was described by ILT thickness distribution changes between consecutives scans, and ILT accumulation and AAA expansion rates were estimated from changes in ILT and AAA volume. Results showed that, while low WSS was observed at regions where ILT accumulated, the rate at which ILT accumulated occurred at the same rate as the aneurysm expansion. Comparison between AAAs with and without thrombus showed that aneurysm with ILT recorded lower values of WSS and higher values of AAA expansion than those without thrombus. Findings suggest that low WSS may promote ILT accumulation and submit the idea that by increasing WSS levels ILT accumulation may be prevented. PMID:26429788

  3. Effect of Reducing Abdominal Compression during Prone CT Colonography on Ascending Colonic Rotation during Supine-to-Prone Positional Change

    PubMed Central

    Jang, Jong Keon; Lee, Jong Seok; Kim, Hyun Jin; Kim, Ah Young; Ha, Hyun Kwon

    2016-01-01

    Objective To determine the effect of reduced abdominal compression in prone position on ascending colonic movement during supine-to-prone positional change during CT colonography (CTC). Materials and Methods Eighteen consecutive patients who had undergone prone CTC scanning with cushion blocks placed under the chest and hip/thigh to reduce abdominal compression and had confirmed sessile polyps ≥ 6 mm in the well-distended, straight, mid-ascending colon, were included. Radial location along the ascending colonic luminal circumference (°) was measured for 24 polyps and 54 colonic teniae on supine and prone CTC images. The supine-to-prone change ranging between -180° and +180° (- and + for internal and external colonic rotations, respectively), was determined. In addition, possible causes of any ascending colonic rotations were explored. Results Abdominal compression during prone CTC scanning completely disappeared with the use of cushion blocks in 17 of 18 patients. However, some degrees of ascending colonic rotation were still observed, with the radial location changes of -22° to 61° (median, 13.9°) for the polyps and similar degrees for teniae. Fifty-four percent and 56% of polyps and teniae, respectively, showed changes > 10°. The radial location change of the polyps was significantly associated with the degree of anterior shift of the small bowel and mesentery (r = 0.722, p < 0.001) and the degree of posterior displacement of the ascending colon (r = 0.566, p = 0.004) during supine-to-prone positional change. Conclusion Ascending colonic rotation upon supine-to-prone positional change during CTC, mostly in the form of external rotation, is not eliminated by removing abdominal compression in prone position. PMID:26798215

  4. Segmenting the thoracic, abdominal and pelvic musculature on CT scans combining atlas-based model and active contour model

    NASA Astrophysics Data System (ADS)

    Zhang, Weidong; Liu, Jiamin; Yao, Jianhua; Summers, Ronald M.

    2013-03-01

    Segmentation of the musculature is very important for accurate organ segmentation, analysis of body composition, and localization of tumors in the muscle. In research fields of computer assisted surgery and computer-aided diagnosis (CAD), muscle segmentation in CT images is a necessary pre-processing step. This task is particularly challenging due to the large variability in muscle structure and the overlap in intensity between muscle and internal organs. This problem has not been solved completely, especially for all of thoracic, abdominal and pelvic regions. We propose an automated system to segment the musculature on CT scans. The method combines an atlas-based model, an active contour model and prior segmentation of fat and bones. First, body contour, fat and bones are segmented using existing methods. Second, atlas-based models are pre-defined using anatomic knowledge at multiple key positions in the body to handle the large variability in muscle shape. Third, the atlas model is refined using active contour models (ACM) that are constrained using the pre-segmented bone and fat. Before refining using ACM, the initialized atlas model of next slice is updated using previous atlas. The muscle is segmented using threshold and smoothed in 3D volume space. Thoracic, abdominal and pelvic CT scans were used to evaluate our method, and five key position slices for each case were selected and manually labeled as the reference. Compared with the reference ground truth, the overlap ratio of true positives is 91.1%+/-3.5%, and that of false positives is 5.5%+/-4.2%.

  5. Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports

    PubMed Central

    Andersen, Jack Gunnar; Stokke, Mali Victoria; Tennstrand, Anne Lise; Aamodt, Rolf; Heggelund, Thomas; Dahl, Fredrik A; Sandbæk, Gunnar; Hurlen, Petter

    2016-01-01

    Background Misinterpretation of radiological examinations is an important contributing factor to diagnostic errors. Consultant radiologists in Norwegian hospitals frequently request second reads by colleagues in real time. Our objective was to estimate the frequency of clinically important changes to radiology reports produced by these prospectively obtained double readings. Methods We retrospectively compared the preliminary and final reports from 1071 consecutive double-read abdominal CT examinations of surgical patients at five public hospitals in Norway. Experienced gastrointestinal surgeons rated the clinical importance of changes from the preliminary to final report. The severity of the radiological findings in clinically important changes was classified as increased, unchanged or decreased. Results Changes were classified as clinically important in 146 of 1071 reports (14%). Changes to 3 reports (0.3%) were critical (demanding immediate action), 35 (3%) were major (implying a change in treatment) and 108 (10%) were intermediate (requiring further investigations). The severity of the radiological findings was increased in 118 (81%) of the clinically important changes. Important changes were made less frequently when abdominal radiologists were first readers, more frequently when they were second readers, and more frequently to urgent examinations. Conclusion A 14% rate of clinically important changes made during double reading may justify quality assurance of radiological interpretation. Using expert second readers and a targeted selection of urgent cases and radiologists reading outside their specialty may increase the yield of discrepant cases. PMID:27013638

  6. Detection of abdominal aortic graft infection: comparison of CT and In-labeled white blood cell scans

    SciTech Connect

    Mark, A.S.; McCarthy, S.M.; Moss, A.A.; Price, D.

    1985-02-01

    Aortic graft infections are a rare but potentially lethal complication of aortic graft surgery. The diagnosis and assessment of the extent of a graft infection is difficult on clinical grounds. A prospective study compared CT and indium-labeled white blood cell (In-WBC) scans in the diagnosis of aortic graft infection. Five patients with aortic graft infection and three patients without aortic graft infection were studied by both methods. CT correctly detected the retroperitoneal extension of the infection in three patients with groin infection; In-WBC scans diagnosed the extension only in one patient. Both CT and In-WBC were positive in two patients with aortic graft infection but no groin infection. Both studies were negative in the three patients without evidence of aortic graft infection. The study suggests that CT is more sensitive than In-WBC in evaluating the extent of aortic graft infection and should be the imaging method of choice.

  7. Estimation of CT-Derived Abdominal Visceral and Subcutaneous Adipose Tissue Depots from Anthropometry in Europeans, South Asians and African Caribbeans

    PubMed Central

    Eastwood, Sophie V.; Tillin, Therese; Wright, Andrew; Heasman, John; Willis, Joseph; Godsland, Ian F.; Forouhi, Nita; Whincup, Peter; Hughes, Alun D.; Chaturvedi, Nishi

    2013-01-01

    Background South Asians and African Caribbeans experience more cardiometabolic disease than Europeans. Risk factors include visceral (VAT) and subcutaneous abdominal (SAT) adipose tissue, which vary with ethnicity and are difficult to quantify using anthropometry. Objective We developed and cross-validated ethnicity and gender-specific equations using anthropometrics to predict VAT and SAT. Design 669 Europeans, 514 South Asians and 227 African Caribbeans (70±7 years) underwent anthropometric measurement and abdominal CT scanning. South Asian and African Caribbean participants were first-generation migrants living in London. Prediction equations were derived for CT-measured VAT and SAT using stepwise regression, then cross-validated by comparing actual and predicted means. Results South Asians had more and African Caribbeans less VAT than Europeans. For basic VAT prediction equations (age and waist circumference), model fit was better in men (R2 range 0.59-0.71) than women (range 0.35-0.59). Expanded equations (+ weight, height, hip and thigh circumference) improved fit for South Asian and African Caribbean women (R2 0.35 to 0.55, and 0.43 to 0.56 respectively). For basic SAT equations, R2 was 0.69-0.77, and for expanded equations it was 0.72-0.86. Cross-validation showed differences between actual and estimated VAT of <7%, and SAT of <8% in all groups, apart from VAT in South Asian women which disagreed by 16%. Conclusion We provide ethnicity- and gender-specific VAT and SAT prediction equations, derived from a large tri-ethnic sample. Model fit was reasonable for SAT and VAT in men, while basic VAT models should be used cautiously in South Asian and African Caribbean women. These equations will aid studies of mechanisms of cardiometabolic disease in later life, where imaging data are not available. PMID:24069381

  8. Both pelvic radiography and lateral abdominal radiography correlate well with coronary artery calcification measured by computed tomography in hemodialysis patients: A cross-sectional study.

    PubMed

    Hong, Daqing; Ruan, Yizhe; Pu, Lei; Zhong, Xiang; Zhang, Yuan; Zhang, Yue; Deng, Fei; Yang, Hongling; Li, Guisen; Wang, Li

    2016-07-01

    Introduction Lateral abdominal radiograph is suggested as an alternative to coronary artery computed tomography (CT) in evaluating vascular calcification. Simple scoring systems including pelvic radiograph scoring and abdominal scoring system were utilized to study their correlation with coronary artery calcification. Methods In 106 MHD patients, coronary artery CT, lateral abdominal, and pelvic radiograph were taken. The Agatston scoring system was applied to evaluate the degree of coronary artery calcification which was categorized according to Agatston coronary artery calcification score (CACS) ≥ 30, ≥100, ≥400, and ≥1000. Abdominal aortic calcification was scored by 4-scored and 24-scored systems. Pelvic artery calcification was scored by a 4-scored system. Sensitivities and specificities of abdominal aortic calcification scores and pelvic artery calcification scores to predict different categories of coronary artery calcification were analyzed. We studied the diagnostic capability of abdominal aorta calcification and pelvic artery calcification to predict different CACS categories by calculating likelihood ratios. Receiver operator characteristic curves were used to determine the area under the curve for each of these testing procedures. Findings The prevalence was 48(45.3%), 15 (14.2%), 11 (10.4%), 11 (10.4%), and 11 (10.4%) for CACs > 0, ≥30, ≥100, ≥400, and ≥1000, respectively. The degree of CACs was positively correlated with patient age, prevalence of diabetes, abdominal aorta scores, and pelvic calcification scores. The areas under the curves for different CACS by all X-ray scoring systems were above 0.70 except pelvic 4-scored system for diagnosing CACS ≥30, without significant difference (P > 0.05). Discussion Both lateral abdominal and pelvic plain radiographs were demonstrated as acceptable alternatives to CT in evaluating vascular calcification. PMID:26932162

  9. Detection of necrosis of the gastric fundus after blunt abdominal trauma by PET-CT.

    PubMed

    Hofer, A; Kratochwill, H; Pentsch, A; Gabriel, M

    2015-02-01

    Positron emission tomography with [(18)F]-fluorodeoxyglucose provides functional and anatomic information by visualising the uptake of radiolabelled glucose in tumour and inflammatory cells. We report delayed diagnosis of necrosis of the gastric fundus after blunt abdominal trauma in a 73-year-old man. After a car accident with head-on collision, the patient was stabilised in our emergency room. His femur was treated by internal fixation, his ellbow was stabilised by a fixateur externe. During surgery his status deteriorated. The patient was in need of high dosage of inotrops during the following days. He had a biventricular pacemaker implanted because of ischemic myocardiopathy, and he suffered from renal insufficiency. Over the next days, his haemodynamics improved. A central venous line had to be removed because of ensuing septic fever. The patient complained of upper abdominal pain and nausea. A sonography and computer tomography without contrast medium were performed with negative result. Because of contamination of the central venous line with Staphylococcus epidermidis the pacemaker was evaluated for infection by transoesophageal echocardiography, again without any findings. Because of ongoing fever and positive inflammatory markers a positron emission tomography was indicated, as a contrast examination and a magnetic resonance examination were not feasible because of the renal insufficiency and the pacemaker, respectively. Prophylactic removal of the pacemaker would have been a substantial risk for the patient due to his underlying myocardiopathy. Positron emission tomography showed an increased tracer uptake in the gastric fundus, which turned out to be necrotic by endoscopy. A laparoscopic resection followed, and drainage of an abscess, which had evolved subsequently between stomach and spleen stopped the inflammatory process. This case report demonstrates that positron emission tomography may be an alternative to computer tomography with contrast medium

  10. Helical CT Angiography of Abdominal Aortic Aneurysms Treated with Suprarenal Stent Grafting: A Pictorial Essay

    SciTech Connect

    Sun Zhonghua

    2003-06-15

    The endovascular repair of abdominal aorticaneurysm (AAA) with stent grafts is rapidly becoming an important alternative to open repair. Suprarenal stent grafting, recently modified from conventional infrarenal stent grafting, is a technique for the purpose of treating patients with inappropriate aneurysm necks.Unlike open repair, the success of endoluminal repair cannot be ascertained by means of direct examination and thus relies on imaging results. The use of conventional angiography for arterial imaging has become less dominant, while helical computed tomography angiography(CTA) has become the imaging modality of choice for both preoperative assessment and postoperative followup after treatment with stent graft implants. There is an increasing likelihood that radiologists will become more and more involved in the procedure of aortic stent grafting and in giving the radiological report on these patients treated with stent grafts. It is necessary for radiologists to be familiar with the imaging findings, including common and uncommon appearances following aortic stent grafting. The purpose of this pictorial essay is to describe and present normal and abnormal imaging appearances following aortic stent grafting based on helical CTA.

  11. Classification of visual signs in abdominal CT image figures in biomedical literature

    NASA Astrophysics Data System (ADS)

    Xue, Zhiyun; You, Daekeun; Antani, Sameer; Long, L. Rodney; Demner-Fushman, Dina; Thoma, George R.

    2014-03-01

    "Imaging signs" are a critical part of radiology's language. They not only are important for conveying diagnosis, but may also aid in indexing radiology literature and retrieving relevant cases and images. Here we report our work towards representing and categorizing imaging signs of abdominal abnormalities in figures in the radiology literature. Given a region-of-interest (ROI) from a figure, our goal was to assign a correct imaging sign label to that ROI from the following seven: accordion, comb, ring, sandwich, small bowel feces, target, or whirl. As training and test data, we created our own "gold standard" dataset of regions containing imaging signs. We computed 2997 feature attributes to represent imaging sign characteristics for each ROI in training and test sets. Following feature selection they were reduced to 70 attributes and were input to a Support Vector Machine classifier. We applied image-enhancement methods to compensate for variable quality of the images in radiology articles. In particular we developed a method for automatic detection and removal of pointers/markers (arrows, arrowheads, and asterisk symbols) on the images. These pointers/markers are valuable for approximately locating ROIs; however, they degrade the classification because they are often (partially) included in the training ROIs. On a test set of 283 ROIs, our method achieved an overall accuracy of 70% in labeling the seven signs, which we believe is a promising result for using imaging signs to search/retrieve radiology literature. This work is also potentially valuable for the creation of a visual ontology of biomedical imaging entities.

  12. Extra-abdominal lumbar abscesses caused by retroperitoneal gastrointestinal perforations through the lumbar triangle of Petit: report of two cases diagnosed by CT.

    PubMed

    Coulier, Bruno; Gogoase, Monica; Ramboux, Adrien; Pierard, Frederic

    2012-12-01

    Extra-abdominal abscesses of gastrointestinal origin developing within the lumbar subcutaneous tissues are extremely rare. We report two cases of retroperitoneal bowel perforation presenting spontaneously at admission with a lumbar abscess trespassing the lumbar triangle of Petit, a classical "locus of minus resistencia" of the posterior abdominal wall. The first case was caused by perforation of a retrocecal appendicitis--being concomitantly responsible of a necrotizing fasciitis of the thigh--and in the second case perforation was caused by left colonic diverticulitis. In both cases, the full diagnosis was made with abdominal CT. The patients were threatened by a two-step surgical approach comprising a direct posterior percutaneous drainage of the abscess followed by classical laparotomy. PMID:22270582

  13. Value of a probabilistic atlas in medical image segmentation regarding non-rigid registration of abdominal CT scans

    NASA Astrophysics Data System (ADS)

    Park, Hyunjin; Meyer, Charles R.

    2012-10-01

    A probabilistic atlas provides important information to help segmentation and registration applications in medical image analysis. We construct a probabilistic atlas by picking a target geometry and mapping other training scans onto that target and then summing the results into one probabilistic atlas. By choosing an atlas space close to the desired target, we construct an atlas that represents the population well. Image registration used to map one image geometry onto another is a primary task in atlas building. One of the main parameters of registration is the choice of degrees of freedom (DOFs) of the geometric transform. Herein, we measure the effect of the registration's DOFs on the segmentation performance of the resulting probabilistic atlas. Twenty-three normal abdominal CT scans were used, and four organs (liver, spinal cord, left and right kidneys) were segmented for each scan. A well-known manifold learning method, ISOMAP, was used to find the best target space to build an atlas. In summary, segmentation performance was high for high DOF registrations regardless of the chosen target space, while segmentation performance was lowered for low DOF registrations if a target space was far from the best target space. At the 0.05 level of statistical significance, there were no significant differences at high DOF registrations while there were significant differences at low DOF registrations when choosing different targets.

  14. Measuring abdominal circumference and skeletal muscle from a single cross-sectional CT image: a step-by-step guide for clinicians using National Institutes of Health ImageJ

    PubMed Central

    Gomez-Perez, Sandra L.; Haus, Jacob M; Sheean, Patricia; Patel, Bimal; Mar, Winnie; Chaudhry, Vivek; McKeever, Liam; Braunschweig, Carol

    2015-01-01

    Diagnostic computed tomography (CT) scans provide numerous opportunities for body composition analysis including quantification of abdominal circumference, abdominal adipose tissues (subcutaneous, visceral and intermuscular) and skeletal muscle (SM). CT scans are commonly performed for diagnostic purposes in clinical settings and methods for estimating abdominal circumference and whole-body SM mass from them have been reported. A supine abdominal circumference is a valid measure of waist circumference (WC). The valid correlation between a single cross sectional CT image (slice) at third lumbar (L3) for abdominal SM and whole body SM is also well established. Sarcopenia refers to the age-associated decreased in muscle mass and function. A single dimensional definition of sarcopenia using CT images that includes only assessment of low whole body SM has been validated in clinical populations and significantly associated with negative outcomes. However, despite the availability and precision of SM data from CT scans and the relationship between these measurements and clinical outcomes, they have not become a routine component of clinical nutrition assessment. Lack of time, training, and expense are potential barriers that prevent clinicians from fully embracing this technique. This tutorial presents a systematic, step-by-step guide to quickly quantify abdominal circumference as a proxy for WC and SM using a cross-sectional CT image from a regional diagnostic CT scan for clinical identification of sarcopenia. Multiple software options are available, however this tutorial utilizes ImageJ, a free public domain software developed by the National Institutes of Health (NIH). PMID:26392166

  15. Cine CT technique for dynamic airway studies

    SciTech Connect

    Ell, S.R.; Jolles, H.; Keyes, W.D.; Galvin, J.R.

    1985-07-01

    The advent of cine CT scanning with its 50-msec data acquisition time promises a much wider range of dynamic CT studies. The authors describe a method for dynamic evaluation of the extrathoracic airway, which they believe has considerable potential application in nonfixed upper-airway disease, such as sleep apnea and stridor of unknown cause. Conventional CT is limited in such studies by long data acquisition time and can be used to study only prolonged maneuvers such as phonation. Fluoroscopy and digital subtraction studies are limited by relatively high radiation dose and inability to image all wall motions simultaneously.

  16. Diagnostic value of CT compared to ultrasound in the evaluation of acute abdominal pain in children younger than 10 years old.

    PubMed

    Simanovsky, Natalia; Dola, Tamar; Hiller, Nurith

    2016-02-01

    To assess the diagnostic value of ultrasound compared to CT in evaluating acute abdominal pain of different causes in children 10 years of age and under, hospital records and imaging files of 4052 patients under age of 10 who had imaging for abdominal pain were reviewed. One-hundred-thirty-two patients (3 %), (74 males/58 females) who underwent ultrasound and CT within 24 h were divided by age: group I, ages 0-48 months (25 patients); group II, 49-84 months (53 patients); and group III, 85-120 months (54 patients). Diagnoses at ultrasound, CT, and discharge were compared. Cases of a change in diagnosis following CT and impact of the changed diagnosis on patient management were assessed. Non-diagnostic ultrasound or a diagnostic conundrum was present in a small percentage (3 %) of our patients. In the group of patients imaged with two modalities, CT changed the diagnosis in 73/132 patients (55.3 %). Patient management changed in 63/132 patients (47.7 %). CT changed the diagnosis in 46/64 patients with surgical conditions (71.8 %, p < 0.001). Among patients with surgical conditions, the difference between ultrasonography (US) and CT diagnoses was significant in groups 2 (p = 0.046) and 3 (p =  .001). The impact of the change in diagnosis in surgical patients imaged with two modalities was significant in the group as a whole and in each age group separately. Non-diagnostic or equivocal US in a small percentage of patients is probably sufficient to justify the additional radiation burden. PMID:26453370

  17. Potential for Adult-Based Epidemiological Studies to Characterize Overall Cancer Risks Associated with a Lifetime of CT Scans

    PubMed Central

    Shuryak, Igor; Lubin, Jay H.; Brenner, David J.

    2014-01-01

    Recent epidemiological studies have suggested that radiation exposure from pediatric CT scanning is associated with small excess cancer risks. However, the majority of CT scans are performed on adults, and most radiation-induced cancers appear during middle or old age, in the same age range as background cancers. Consequently, a logical next step is to investigate the effects of CT scanning in adulthood on lifetime cancer risks by conducting adult-based, appropriately designed epidemiological studies. Here we estimate the sample size required for such studies to detect CT-associated risks. This was achieved by incorporating different age-, sex-, time- and cancer type-dependent models of radiation carcinogenesis into an in silico simulation of a population-based cohort study. This approach simulated individual histories of chest and abdominal CT exposures, deaths and cancer diagnoses. The resultant sample sizes suggest that epidemiological studies of realistically sized cohorts can detect excess lifetime cancer risks from adult CT exposures. For example, retrospective analysis of CT exposure and cancer incidence data from a population-based cohort of 0.4 to 1.3 million (depending on the carcinogenic model) CT-exposed UK adults, aged 25–65 in 1980 and followed until 2015, provides 80% power for detecting cancer risks from chest and abdominal CT scans. PMID:24828111

  18. Prospective Evaluation of Prior Image Constrained Compressed Sensing (PICCS) Algorithm in Abdominal CT: A comparison of reduced dose with standard dose imaging

    PubMed Central

    Lubner, Meghan G.; Pickhardt, Perry J.; Kim, David H.; Tang, Jie; Munoz del Rio, Alejandro; Chen, Guang-Hong

    2014-01-01

    Purpose To prospectively study CT dose reduction using the “prior image constrained compressed sensing” (PICCS) reconstruction technique. Methods Immediately following routine standard dose (SD) abdominal MDCT, 50 patients (mean age, 57.7 years; mean BMI, 28.8) underwent a second reduced-dose (RD) scan (targeted dose reduction, 70-90%). DLP, CTDIvol and SSDE were compared. Several reconstruction algorithms (FBP, ASIR, and PICCS) were applied to the RD series. SD images with FBP served as reference standard. Two blinded readers evaluated each series for subjective image quality and focal lesion detection. Results Mean DLP, CTDIvol, and SSDE for RD series was 140.3 mGy*cm (median 79.4), 3.7 mGy (median 1.8), and 4.2 mGy (median 2.3) compared with 493.7 mGy*cm (median 345.8), 12.9 mGy (median 7.9 mGy) and 14.6 mGy (median 10.1) for SD series, respectively. Mean effective patient diameter was 30.1 cm (median 30), which translates to a mean SSDE reduction of 72% (p<0.001). RD-PICCS image quality score was 2.8±0.5, improved over the RD-FBP (1.7±0.7) and RD-ASIR(1.9±0.8)(p<0.001), but lower than SD (3.5±0.5)(p<0.001). Readers detected 81% (184/228) of focal lesions on RD-PICCS series, versus 67% (153/228) and 65% (149/228) for RD-FBP and RD-ASIR, respectively. Mean image noise was significantly reduced on RD-PICCS series (13.9 HU) compared with RD-FBP (57.2) and RD-ASIR (44.1) (p<0.001). Conclusion PICCS allows for marked dose reduction at abdominal CT with improved image quality and diagnostic performance over reduced-dose FBP and ASIR. Further study is needed to determine indication-specific dose reduction levels that preserve acceptable diagnostic accuracy relative to higher-dose protocols. PMID:24943136

  19. Pediatric Computed Tomography. Radiation Dose in Abdominal Studies

    NASA Astrophysics Data System (ADS)

    López, X.; Ruiz-Trejo, C.; Buenfil, A. E.; Gamboa-deBuen, I.; Dies, P.

    2008-08-01

    Computed tomography is one of the most popular medical imaging modalities used in the last years. However, because is one of the techniques that delivered a considerable radiation dose, precautions should be taken into account. Pediatric patients are more radiosensitive than adults, and the probability that no desirable biological effects can occur is greater. To this, also it adds the probability that they will need more radiological studies in the future. The work consisted in determining the received dose by the pediatric patients undergoing abdominal studies in a multislice computed tomograph, according to the dosimetric quantities established by a Code of Practice published by the International Atomic Energy Agency; using a ionization chamber and a phantom that simulates the abdomen of a pediatric patient. The weighted air kerma index (Cw) was 14.3±0.4 mGy, this value is lower than the published by the American College of Radiology, 25 mGy. The multiple scan average dose (MSAD), which is a quantity established by the NOM-229-SSA1-2002 was determined, finding a value of 14.2±0.1 mGy, it is also below the value established, 25 mGy for an adult study.

  20. Pediatric Computed Tomography. Radiation Dose in Abdominal Studies

    SciTech Connect

    Lopez, X.; Ruiz-Trejo, C.; Buenfil, A. E.; Gamboa-deBuen, I.; Dies, P

    2008-08-11

    Computed tomography is one of the most popular medical imaging modalities used in the last years. However, because is one of the techniques that delivered a considerable radiation dose, precautions should be taken into account. Pediatric patients are more radiosensitive than adults, and the probability that no desirable biological effects can occur is greater. To this, also it adds the probability that they will need more radiological studies in the future. The work consisted in determining the received dose by the pediatric patients undergoing abdominal studies in a multislice computed tomograph, according to the dosimetric quantities established by a Code of Practice published by the International Atomic Energy Agency; using a ionization chamber and a phantom that simulates the abdomen of a pediatric patient. The weighted air kerma index (C{sub w}) was 14.3{+-}0.4 mGy, this value is lower than the published by the American College of Radiology, 25 mGy. The multiple scan average dose (MSAD), which is a quantity established by the NOM-229-SSA1-2002 was determined, finding a value of 14.2{+-}0.1 mGy, it is also below the value established, 25 mGy for an adult study.

  1. Intraoperative DynaCT Detection and Immediate Correction of a Type 1a Endoleak Following Endovascular Repair of Abdominal Aortic Aneurysm

    SciTech Connect

    Biasi, Lukla; Ali, Tahir; Hinchliffe, Robert; Morgan, Rob; Loftus, Ian; Thompson, Matt

    2009-05-15

    Reintervention following endovascular aneurysm repair (EVAR) is required in up to 10% of patients at 30 days and is associated with a demonstrable risk of increased mortality. Completion angiography cannot detect all graft-related anomalies and computed tomographic angiography is therefore mandatory to ensure clinical success. Intraoperative angiographic computed tomography (DynaCT; Siemens, Germany) utilizes cone beam reconstruction software and flat-panel detectors to generate CT-like images from rotational angiographic acquisitions. We report the intraoperative use of this novel technology in detecting and immediately treating a proximal anterior type Ia endoleak, following an endovascular abdominal aortic repair, which was not seen on completion angiography. Immediate evaluation of cross-sectional imaging following endograft deployment may allow for on-table correction of clinically significant stent-related complications. This should both improve technical success and minimize the need for early secondary intervention following EVAR.

  2. Educational inequality in the occurrence of abdominal obesity: Pró-Saúde Study

    PubMed Central

    Alves, Ronaldo Fernandes Santos; Faerstein, Eduardo

    2015-01-01

    OBJECTIVE To estimate the degree of educational inequality in the occurrence of abdominal obesity in a population of non-faculty civil servants at university campi. METHODS In this cross-sectional study, we used data from 3,117 subjects of both genders aged 24 to 65-years old, regarding the baseline of Pró-Saúde Study, 1999-2001. Abdominal obesity was defined according to abdominal circumference thresholds of 88 cm for women and 102 cm for men. A multi-dimensional, self-administered questionnaire was used to evaluate education levels and demographic variables. Slope and relative indices of inequality, and Chi-squared test for linear trend were used in the data analysis. All analyses were stratified by genders, and the indices of inequality were standardized by age. RESULTS Abdominal obesity was the most prevalent among women (43.5%; 95%CI 41.2;45.9), as compared to men (24.3%; 95%CI 22.1;26.7), in all educational strata and age ranges. The association between education levels and abdominal obesity was an inverse one among women (p < 0.001); it was not statistically significant among men (p = 0.436). The educational inequality regarding abdominal obesity in the female population, in absolute terms (slope index of inequality), was 24.0% (95%CI 15.5;32.6). In relative terms (relative index of inequality), it was 2.8 (95%CI 1.9;4.1), after the age adjustment. CONCLUSIONS Gender inequality in the prevalence of abdominal obesity increases with older age and lower education. The slope and relative indices of inequality summarize the strictly monotonous trend between education levels and abdominal obesity, and it described educational inequality regarding abdominal obesity among women. Such indices provide relevant quantitative estimates for monitoring abdominal obesity and dealing with health inequalities. PMID:26465669

  3. Mechanical Intestinal Obstruction in a Porcine Model: Effects of Intra-Abdominal Hypertension. A Preliminary Study

    PubMed Central

    Sánchez-Margallo, F. M.; Latorre, R.; López-Albors, O.; Wise, R.; Malbrain, M. L. N. G.; Castellanos, G.

    2016-01-01

    Introduction Mechanical intestinal obstruction is a disorder associated with intra-abdominal hypertension and abdominal compartment syndrome. As the large intestine intraluminal and intra-abdominal pressures are increased, so the patient’s risk for intestinal ischaemia. Previous studies have focused on hypoperfusion and bacterial translocation without considering the concomitant effect of intra-abdominal hypertension. The objective of this study was to design and evaluate a mechanical intestinal obstruction model in pigs similar to the human pathophysiology. Materials and Methods Fifteen pigs were divided into three groups: a control group (n = 5) and two groups of 5 pigs with intra-abdominal hypertension induced by mechanical intestinal obstruction. The intra-abdominal pressures of 20 mmHg were maintained for 2 and 5 hours respectively. Hemodynamic, respiratory and gastric intramucosal pH values, as well as blood tests were recorded every 30 min. Results Significant differences between the control and mechanical intestinal obstruction groups were noted. The mean arterial pressure, cardiac index, dynamic pulmonary compliance and abdominal perfusion pressure decreased. The systemic vascular resistance index, central venous pressure, pulse pressure variation, airway resistance and lactate increased within 2 hours from starting intra-abdominal hypertension (p<0.05). In addition, we observed increased values for the peak and plateau airway pressures, and low values of gastric intramucosal pH in the mechanical intestinal obstruction groups that were significant after 3 hours. Conclusion The mechanical intestinal obstruction model appears to adequately simulate the pathophysiology of intestinal obstruction that occurs in humans. Monitoring abdominal perfusion pressure, dynamic pulmonary compliance, gastric intramucosal pH and lactate values may provide insight in predicting the effects on endorgan function in patients with mechanical intestinal obstruction. PMID

  4. An In-depth Study of Abdominal Injuries Sustained by Car Occupants in Frontal Crashes

    PubMed Central

    Frampton, Richard; Lenard, James; Compigne, Sabine

    2012-01-01

    Currently, neither abdominal injury risk nor rear seat passenger safety is assessed in European frontal crash testing. The objective of this study was to provide real world in-depth analysis of the factors related to abdominal injury for belted front and rear seat occupants in frontal crashes. Rear occupants were significantly more at risk of AIS 2+ and 3+ abdominal injury, followed by front seat passengers and then drivers. This was still the case even after controlling for occupant age. Increasing age was separately identified as a factor related to increased abdominal injury risk in all seating positions. One exception to this trend concerned rear seated 15 to 19 year olds who sustained moderate to serious abdominal injury at almost the same rate as rear occupants aged 65+.No strong association was seen between AIS 2+ abdominal injury rates and gender. The majority of occupant body mass indices ranged from underweight to obese. Across that range, the AIS 2+ abdominal injury rates were very similar but a small number of very obese and extremely obese occupants outside of the range did exhibit noticeably higher rates. An analysis of variance in the rate of AIS 2+ abdominal injury with different restraint systems showed that simple belt systems, as used by most rear seat passengers, were the least protective. Increasing sophistication of the restraint system was related to lower rates of injury. The ANOVA also confirmed occupant age and crash severity as highly associated with abdominal injury risk. The most frequently injured abdominal organs for front seat occupants were the liver and spleen. Abdominal injury patterns for rear seat passengers were very different. While they also sustained significant injuries to solid organs, their rates of injury to the hollow organs (jejunum-ileum, mesentary, colon) were far higher even though the rate of fracture of two or more ribs did not differ significantly between seat positions. These results have implications for the

  5. Functional abdominal pain in childhood: background studies and recent research trends.

    PubMed

    Levy, Rona L; van Tilburg, Miranda A L

    2012-01-01

    The present review summarizes many of the major research trends investigated in the past five years regarding pediatric functional abdominal pain, and also summarizes the primary related findings from the authors' research program. Specific areas discussed based on work within the authors' group include familial illness patterns, genetics, traits, and mechanisms or processes related to abdominal pain. Topics covered from research published in the past five years include prevalence and cost, longitudinal follow-up, overlap with other disorders, etiology and mechanisms behind functional abdominal pain and treatment studies. It is hoped that findings from this work in abdominal pain will be interpreted as a framework for understanding the processes by which other pain phenomena and, more broadly, reactions to any physical state, can be developed and maintained in children. The present article concludes with recommendations for clinical practice and research. PMID:23248815

  6. Intra-abdominal hypertension in the ICU – a prospective epidemiological study

    PubMed Central

    ARABADZHIEV, GEORGI M.; TZANEVA, VALENTINA G.; PEEVA, KATYA G.

    2015-01-01

    The aim of this prospective study is to examine the frequency and the severity of intra-abdominal hypertension in a mixed ICU of the University hospital. Methods A closed system for intravesical intermittent measurement of IAP was constructed. Results The frequency and the severity of IAH were examined in the period from June 2009 to December 2012 in 240 ICU patients divided into 3 groups (patients submitted to elective surgery, emergency surgery, and medical patients) in the University Hospital. In the elective surgery group there was 12.5% IAH, while in the emergency group IAH was 43.75%, and in the medical patients it was 42.5%. There was no statistical significant difference in the frequency of IAH among the mixed population of patients we examined and those studied by other authors with the same type of population. Conclusions The standardized measurement of intra-abdominal pressure is fundamental for defining intra-abdominal hypertension and abdominal compartment syndrome. The measurement of intra-abdominal pressure should be a part of the basic monitoring of patients at risk of intra-abdominal hypertension. Our point of view is that before there are indications for a surgical decompression, less invasive treatment options should be optimized. PMID:26528070

  7. Automatic abdominal lymph node detection method based on local intensity structure analysis from 3D x-ray CT images

    NASA Astrophysics Data System (ADS)

    Nakamura, Yoshihiko; Nimura, Yukitaka; Kitasaka, Takayuki; Mizuno, Shinji; Furukawa, Kazuhiro; Goto, Hidemi; Fujiwara, Michitaka; Misawa, Kazunari; Ito, Masaaki; Nawano, Shigeru; Mori, Kensaku

    2013-03-01

    This paper presents an automated method of abdominal lymph node detection to aid the preoperative diagnosis of abdominal cancer surgery. In abdominal cancer surgery, surgeons must resect not only tumors and metastases but also lymph nodes that might have a metastasis. This procedure is called lymphadenectomy or lymph node dissection. Insufficient lymphadenectomy carries a high risk for relapse. However, excessive resection decreases a patient's quality of life. Therefore, it is important to identify the location and the structure of lymph nodes to make a suitable surgical plan. The proposed method consists of candidate lymph node detection and false positive reduction. Candidate lymph nodes are detected using a multi-scale blob-like enhancement filter based on local intensity structure analysis. To reduce false positives, the proposed method uses a classifier based on support vector machine with the texture and shape information. The experimental results reveal that it detects 70.5% of the lymph nodes with 13.0 false positives per case.

  8. Multislice CT Angiography of Fenestrated Endovascular Stent Grafting for Treating Abdominal Aortic Aneurysms: a Pictorial Review of the 2D/3D Visualizations

    PubMed Central

    Mwipatayi, Bibombe P; Allen, Yvonne B; Hartley, David E; Lawrence-Brown, Michael M

    2009-01-01

    Fenestrated endovascular repair of an abdominal aortic aneurysm has been developed to treat patients with a short or complicated aneurysm neck. Fenestration involves creating an opening in the graft fabric to accommodate the orifice of the vessel that is targeted for preservation. Fixation of the fenestration to the renal arteries and the other visceral arteries can be done by implanting bare or covered stents across the graft-artery ostia interfaces so that a portion of the stent protrudes into the aortic lumen. Accurate alignment of the targeted vessels in a longitudinal aspect is hard to achieve during stent deployment because rotation of the stent graft may take place during delivery from the sheath. Understanding the 3D relationship of the aortic branches and the fenestrated vessel stents following fenestration will aid endovascular specialists to evaluate how the stent graft is situated within the aorta after placement of fenestrations. The aim of this article is to provide the 2D and 3D imaging appearances of the fenestrated endovascular grafts that were implanted in a group of patients with abdominal aortic aneurysms, based on the multislice CT angiography. The potential applications of each visualization technique were explored and compared with the 2D axial images. PMID:19412517

  9. Familial clustering of abdominal visceral fat and total fat mass: the Québec Family Study.

    PubMed

    Rice, T; Pérusse, L; Bouchard, C; Rao, D C

    1996-05-01

    The evidence for common familial factors underlying total fat mass (estimated from underwater weighing) and abdominal visceral fat (assessed from CT scan) was examined in families participating in phase 2 of the Québec Family Study (QFS) using a bivariate familial correlation model. Previous QFS investigations suggest that both genetic (major and polygenic) and familial environmental factors influence each phenotype, accounting for between 55% to 71% of the phenotypic variance in fat mass, and between 55% to 72% for abdominal visceral fat. The current study suggests that the bivariate familial effect ranges from 29% to 50%. This pattern suggests that there may be common familial determinants for abdominal visceral fat and total fat mass, as well as additional familial factors which are specific to each. The relatively high spouse cross-trait correlations usually suggest that a large percent of the bivariate familial effect may be environmental in origin. However, if mating is not random, then the spouse resemblance may reflect either genetic or environmental causes, depending on the source [i.e., through similar genes or cohabitation (environmental) effects]. Finally, there are significant sex differences in the magnitude of the familial cross-trait correlations involving parents, but not offspring, suggesting complex generation (i.e., age) and sex effects. For example, genes may turn on or off as a function of age and sex, and/or there may be an accumulation over time of effects due to the environment which may vary by sex. Whether the common familial factors are genetic (major and/or polygenic), environmental, or some combination of both, and whether the familial expression depends on sex and/or age warrants further investigation using more complex models. PMID:8732959

  10. Automatic segmentation of the liver using multi-planar anatomy and deformable surface model in abdominal contrast-enhanced CT images

    NASA Astrophysics Data System (ADS)

    Jang, Yujin; Hong, Helen; Chung, Jin Wook; Yoon, Young Ho

    2012-02-01

    We propose an effective technique for the extraction of liver boundary based on multi-planar anatomy and deformable surface model in abdominal contrast-enhanced CT images. Our method is composed of four main steps. First, for extracting an optimal volume circumscribing a liver, lower and side boundaries are defined by positional information of pelvis and rib. An upper boundary is defined by separating the lungs and heart from CT images. Second, for extracting an initial liver volume, optimal liver volume is smoothed by anisotropic diffusion filtering and is segmented using adaptively selected threshold value. Third, for removing neighbor organs from initial liver volume, morphological opening and connected component labeling are applied to multiple planes. Finally, for refining the liver boundaries, deformable surface model is applied to a posterior liver surface and missing left robe in previous step. Then, probability summation map is generated by calculating regional information of the segmented liver in coronal plane, which is used for restoring the inaccurate liver boundaries. Experimental results show that our segmentation method can accurately extract liver boundaries without leakage to neighbor organs in spite of various liver shape and ambiguous boundary.

  11. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  12. Abdominal Aortic Intimal Flap Motion Characterization in Acute Aortic Dissection: Assessed with Retrospective ECG-Gated Thoracoabdominal Aorta Dual-Source CT Angiography

    PubMed Central

    Yang, Shifeng; Li, Xia; Chao, Baoting; Wu, Lebin; Cheng, Zhaoping; Duan, Yanhua; Wu, Dawei; Zhan, Yiqiang; Chen, Jiuhong; Liu, Bo; Ji, Xiaopeng; Nie, Pei; Wang, Ximing

    2014-01-01

    Objectives To evaluate the feasibility of dose-modulated retrospective ECG-gated thoracoabdominal aorta CT angiography (CTA) assessing abdominal aortic intimal flap motion and investigate the motion characteristics of intimal flap in acute aortic dissection (AAD). Materials and Methods 49 patients who had thoracoabdominal aorta retrospective ECG-gated CTA scan were enrolled. 20 datasets were reconstructed in 5% steps between 0 and 95% of the R-R interval in each case. The aortic intimal flap motion was assessed by measuring the short axis diameters of the true lumen and false lumen 2 cm above of celiac trunk ostium in different R-R intervals. Intimal flap motion and configuration was assessed by two independent observers. Results In these 49 patients, 37 had AAD, 7 had intramural hematoma, and 5 had negative result for acute aortic disorder. 620 datasets of 31 patients who showed double lumens in abdominal aorta were enrolled in evaluating intimal flap motion. The maximum and minimum true lumen diameter were 12.2±4.1 mm (range 2.6∼17.4) and 6.7±4.1 mm (range 0∼15.3) respectively. The range of intimal flap motion in all patients was 5.5±2.6 mm (range 1.8∼10.2). The extent of maximum true lumen diameter decreased during a cardiac cycle was 49.5%±23.5% (range 12%∼100%). The maximum motion phase of true lumen diameter was in systolic phase (5%∼40% of R-R interval). Maximum and minimum intimal flap motion was at 15% and 75% of the R-R interval respectively. Intimal flap configuration had correlation with the phase of cardiac cycle. Conclusions Abdominal intimal flap position and configuration varied greatly during a cardiac cycle. Retrospective ECG-gated thoracoabdominal aorta CTA can reflect the actual status of the true lumen and provide more information about true lumen collapse. This information may be helpful to diagnosis and differential diagnosis of dynamic abstraction. PMID:24503676

  13. Detection and visualization of endoleaks in CT data for monitoring of thoracic and abdominal aortic aneurysm stents

    NASA Astrophysics Data System (ADS)

    Lu, J.; Egger, J.; Wimmer, A.; Großkopf, S.; Freisleben, B.

    2008-03-01

    In this paper we present an efficient algorithm for the segmentation of the inner and outer boundary of thoratic and abdominal aortic aneurysms (TAA & AAA) in computed tomography angiography (CTA) acquisitions. The aneurysm segmentation includes two steps: first, the inner boundary is segmented based on a grey level model with two thresholds; then, an adapted active contour model approach is applied to the more complicated outer boundary segmentation, with its initialization based on the available inner boundary segmentation. An opacity image, which aims at enhancing important features while reducing spurious structures, is calculated from the CTA images and employed to guide the deformation of the model. In addition, the active contour model is extended by a constraint force that prevents intersections of the inner and outer boundary and keeps the outer boundary at a distance, given by the thrombus thickness, to the inner boundary. Based upon the segmentation results, we can measure the aneurysm size at each centerline point on the centerline orthogonal multiplanar reformatting (MPR) plane. Furthermore, a 3D TAA or AAA model is reconstructed from the set of segmented contours, and the presence of endoleaks is detected and highlighted. The implemented method has been evaluated on nine clinical CTA data sets with variations in anatomy and location of the pathology and has shown promising results.

  14. Abdominal Adhesions

    MedlinePlus

    ... Abdominal Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91– ... are abdominal adhesions and intestinal obstructions ... generally do not require treatment. Surgery is the only way to treat abdominal ...

  15. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group).

    PubMed

    Meyers, W C; Foley, D P; Garrett, W E; Lohnes, J H; Mandlebaum, B R

    2000-01-01

    The purpose of this study was to gain insight into the pathophysiologic processes of severe lower-abdominal or inguinal pain in high-performance athletes. We evaluated 276 patients; 175 underwent pelvic floor repairs. Of the 157 athletes who had not undergone previous surgery, 124 (79%) participated at a professional or other highly competitive level, and 138 patients (88%) had adductor pain that accompanied the lower-abdominal or inguinal pain. More patients underwent related adductor releases during the later operative period in the series. Evaluation revealed 38 other abnormalities, including severe hip problems and malignancies. There were 152 athletes (97%) who returned to previous levels of performance. The syndrome was uncommon in women and the results were less predictable in nonathletes. A distinct syndrome of lower-abdominal/adductor pain in male athletes appears correctable by a procedure designed to strengthen the anterior pelvic floor. The location and pattern of pain and the operative success suggest the cause to be a combination of abdominal hyperextension and thigh hyperabduction, with the pivot point being the pubic symphysis. Diagnosis of "athletic pubalgia" and surgery should be limited to a select group of high-performance athletes. The consideration of other causes of groin pain in the patient is critical. PMID:10653536

  16. Excess weight and abdominal obesity in postmenopausal Brazilian women: a population-based study

    PubMed Central

    2013-01-01

    Background The menopause is associated with a tendency to gain weight. Several alterations in fat deposits occur, leading to changes in the distribution of body fat. There are strong indications that, in middle age, obesity is associated with increased mortality. This study set out to determine the factors associated with the prevalence of overweight and abdominal obesity in postmenopausal women in a population-based study in Brazil. Methods The sample included 456 women, aged 45–69 years, residing in the urban area of Maringa, Parana. Systematic sampling, with a probability proportional to the size of the census sector, was performed. Behavioral, economic, and sociodemographic data were collected, and body mass index (BMI) and waist circumference (WC) were determined. Results According to BMI criteria (≥25.0 kg/m2), 72.6% of the women were overweight, and according to WC (≥88 cm), 63.6% had abdominal obesity. Based on logistic regression analysis, the factors that were most closely associated with overweight were: having three or more children (odds ratio (OR): 1.78; 95% confidence interval (CI): 1.06–3.00); and not taking hormone replacement therapy (OR: 1.69; 95% CI: 1.06–2.63). The prevalence of abdominal obesity was positively associated with greater parity (OR: 1.34, 95% CI: 1.05–1.72) and age older than 65 years (OR: 1.50; 95% CI: 1.03–2.19). Conclusions This study found that the prevalences of overweight and abdominal obesity were higher for postmenopausal women who had three or more children. Age over 65 years was also a risk factor for abdominal obesity and no use of hormonal replacement therapy was a risk factor for overweight. PMID:24228934

  17. Focused Ultrasound Lipolysis in the Treatment of Abdominal Cellulite: An Open-Label Study

    PubMed Central

    Moravvej, Hamideh; Akbari, Zahra; Mohammadian, Shahrzad; Razzaghi, Zahra

    2015-01-01

    Introduction: Despite a growing popularity of noninvasive ultrasonic lipolysis procedure, there is a lack of evidence about the efficacy of this method. This study was performed to evaluate the efficacy of focused ultrasonic lipolysis on abdominal cellulite treatment. Methods: Twenty-eight consecutive subjects (age: 37.8 ± 8 years) underwent weekly transdermal focused ultrasonic lipolysis (Med Contour, General Project Ltd., Florence, Italy) and vacuum drainage for a maximum of eight sessions. Largest abdominal girth and 2 lines at 4 cm to 7 cm distance above and under it were located as fixed points of measurements. The mean value of the three fixed lines was considered as the abdominal circumference. Subjects were evaluated using measurements of circumference, immediately after and 3 weeks after the final treatment and compared using paired t test. Results: One hundred ninety-four ultrasonic lipolysis procedures were performed on 28 subjects. A statistically significant (P < .001) average of 1.89 cm (95% CI: 1.63-2.02 cm) decrease of circumference value was observed in each session of ultrasonic lipolysis. The mean pretreatment to posttreatment circumference reduction was 8.21 cm (95% CI: 6.38-10.04, P < .001) that declined to 7 cm (95% CI: 3.2-10.8, P < .001) at the 3-month follow-up visit. Conclusion: Focused ultrasonic lipolysis appears to be an effective method for reduction of abdominal cellulite, although some amount of circumference reduction reversal may be observed in long term follow-up visit. PMID:26464776

  18. Neck after total laryngectomy: CT study

    SciTech Connect

    DiSantis, D.J.; Balfe, D.M.; Hayden, R.E.; Sagel, S.S.; Sessions, D.; Lee, J.K.T.

    1984-12-01

    Computed tomographic scans in 23 patients who had undergone total laryngectomy were analyzed retrospectively to determine normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Nine patients without clinical evidence of recurrence illustrated the normal postoperative changes: a round or ovoid neopharynx connecting the base of the tongue with the cervical esophagus and intact fat planes surrounding the neopharynx, neurovascular bundles, and sternocleidomastoid muscles. In the 12 patients with recurrent neoplasm, the CT manifestations included masses involving the internal jugular lymph node chain, tracheostomy site, or paratracheal region. CT supplemented physical examination and indirect mirror examination, providing data regarding presence and extent of recurrent tumor and aiding in planning the mode and scope of therapy.

  19. Radiation exposure of ovarian cancer patients: contribution of CT examinations performed on different MDCT (16 and 64 slices) scanners and image quality evaluation: an observational study.

    PubMed

    Rizzo, Stefania; Origgi, Daniela; Brambilla, Sarah; De Maria, Federica; Foà, Riccardo; Raimondi, Sara; Colombo, Nicoletta; Bellomi, Massimo

    2015-05-01

    The objective of this study is to compare radiation doses given to ovarian cancer patients by different computed tomographies (CTs) and to evaluate association between doses and subjective and objective image quality.CT examinations included were performed either on a 16-slice CT, equipped with automatic z-axis tube current modulation, or on a 64-slice CT, equipped with z-axis, xy-axis modulation, and adaptive statistical iterative algorithm (ASIR). Evaluation of dose included the following dose descriptors: volumetric CT dose index (CTDIvol), dose length product (DLP), and effective dose (E). Objective image noise was evaluated in abdominal aorta and liver. Subjective image quality was evaluated by assessment of image noise, spatial resolution and diagnostic acceptability.Mean and median CTDIvol, DLP, and E; correlation between CTDIvol and DLP and patients' weight; comparison of objective noise for the 2 scanners; association between dose descriptors and subjective image quality.The 64-slice CT delivered to patients 24.5% lower dose (P < 0.0001) than 16-slice CT. There was a significant correlation between all dose descriptors (CTDIvol, DLP, E) and weight (P < 0.0001). Objective noise was comparable for the 2 CT scanners. There was a significant correlation between dose descriptors and image noise for the 64-slice CT, and between dose descriptors and spatial resolution for the 16-slice CT.Current dose reduction systems may reduce radiation dose without significantly affecting image quality and diagnostic acceptability of CT exams. PMID:25929914

  20. [The different genotypes of MTHFR 1298A>C and PON1 -108C>T polymorphisms confer the increased risk of the abdominal aortic aneurysm in the smoking and nonsmoking persons].

    PubMed

    Strauss, Ewa; Waliszewski, Krzysztof; Pawlak, Andrzej L

    2005-01-01

    In abdominal aortic aneurysm (AAA) both the etiology and the pathogenesis are of the multifactorial character. The genetic component in the determination of this disease is proven by its familial occurrence. Smoking represents the best recognized risk factor of the AAA development. Increased concentrations of homocysteine (Hcy) in plasma are the common finding in these patients. It is assumed that the Hcy thiolactone, the most reactive metabolite of Hcy, may participate in the aortic wall destruction in AAA. The polymorphic variants of the methylenetetrahydrofolate reductase (MTHFR 677C>T and 1298A>C) influence tissue concentrations of the Hcy. Paraoxonase (PON1), the enzyme associated in plasma with the HDL fraction, as lactonase detoxicates the Hcy thiolactone. The promotor polymorphism of PON1 - 108C>T gene may determine the lower activity of this enzyme. In the case-control study of 106 patients with AAA and 97 healthy persons, the effects of selected genetic and nongenetic risk factors on development of AAA were assessed, considering the possibilities of interaction between them. It was found, that the arterial hypertension, cigarette smoking and the lower HDL fraction are independent risk factors of AAA. The arterial hypertension was a risk factor both in the smoking and the nonsmoking males, whereas the lower HDL fraction has been the risk factor only for the smoking men. By the multivariate analysis in the nonsmoking males the MTHFR 1298 AC and CC genotypes increased the risk of AAA development 4,8-fold in relation to the MTHFR 1298 AA nonsmoking males. In reference to the genotypes of the expected high impact on the metabolism of Hcy and of Hcy thiolactone, the genotypes of MTHFR 677TT and PON1 -108CT and TT were more frequent in smoking ones, but the difference was not significant. This observation fits with the assumption that the influence of smoking on the occurrence of AAA prevails over that of genetic variability. When the patients age was considered

  1. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

    PubMed Central

    2012-01-01

    The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012). Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152). According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe. PMID:23190741

  2. Negative predictive value of preoperative computed tomography in determining pathologic local invasion, nodal disease, and abdominal metastases in gastric cancer

    PubMed Central

    Kagedan, D.J.; Frankul, F.; El-Sedfy, A.; McGregor, C.; Elmi, M.; Zagorski, B.; Dixon, M.E.; Mahar, A.L.; Vasilevska-Ristovska, J.; Helyer, L.; Rowsell, C.; Swallow, C.J.; Law, C.H.; Coburn, N.G.

    2016-01-01

    Background Before undergoing curative-intent resection of gastric adenocarcinoma (ga), most patients undergo abdominal computed tomography (ct) imaging to determine contraindications to resection (local invasion, distant metastases). However, the ability to detect contraindications is variable, and the literature is limited to single-institution studies. We sought to assess, on a population level, the clinical relevance of preoperative ct in evaluating the resectability of ga tumours in patients undergoing surgery. Methods In a provincial cancer registry, 2414 patients with ga diagnosed during 2005–2008 at 116 institutions were identified, and a primary chart review of radiology, operative, and pathology reports was performed for all patients. Preoperative abdominal ct reports were compared with intraoperative findings and final pathology reports (reference standard) to determine the negative predictive value (npv) of ct in assessing local invasion, nodal involvement, and intra-abdominal metastases. Results Among patients undergoing gastrectomy, the npv of ct imaging in detecting local invasion was 86.9% (n = 536). For nodal metastasis, the npv of ct was 43.3% (n = 450). Among patients undergoing surgical exploration, the npv of ct for intra-abdominal metastases was 52.3% (n = 407). Conclusions Preoperative abdominal ct imaging reported as negative is most accurate in determining local invasion and least accurate in nodal assessment. The poor npv of ct should be taken into account when selecting patients for staging laparoscopy. PMID:27536178

  3. Increasing utilization of abdominal CT in the Emergency Department of a secondary care center: does it produce better outcomes in caring for pediatric surgical patients?

    PubMed Central

    Kim, Younglim; Kang, Gu

    2014-01-01

    Purpose The use of abdominal computed tomography (ACT) utilization is increasing to a remarkable extent in the pediatric Emergency Department (ED), but the clinical benefit of increased use of ACT for pediatric surgical patients remains uncertain. Methods A retrospective review was conducted to investigate if, for patients who had visited pediatric ED during the last 5 years, increasing utilization of ACT would increase the detection rate of acute appendicitis, increase the detection rate of surgical conditions other than appendicitis, and decrease the hospital admission rate for surgical conditions. Results During the study period, there were 37,918 ED visits; of these, 3,274 (8.6%) were for abdominal pain, 844 (2.2%) had ACT performed. The annual proportional increase of the ACT was statistically significant (1.56% to 2.46%, P = 0.00), but the detection rate of acute appendicitis (3.3% to 5.1%) or other surgical conditions (1.7% to 2.8%) showed no statistically significant changes. Hospital admission rates (5.6% to 6.8%) also showed no significant changes during the study period. Conclusion Increasing utilization of ACT does not lead to the improved outcomes in caring for pediatric surgical patients visiting the pediatric ED. Careful evaluation for the indication for ACT is needed in the pediatric ED. PMID:25368849

  4. Value of fecal calprotectin in the evaluation of patients with abdominal discomfort: an observational study

    PubMed Central

    2012-01-01

    Background The evaluation of patients with abdominal discomfort is challenging and patient selection for endoscopy based on symptoms is not reliable. We evaluated the diagnostic value of fecal calprotectin in patients with abdominal discomfort. Methods In an observational study, 575 consecutive patients with abdominal discomfort referred for endoscopy to the Department of Gastroenterology & Hepatology at the University Hospital Basel in Switzerland, were enrolled in the study. Calprotectin was measured in stool samples collected within 24 hours before the investigation using an enzyme-linked immunosorbent assay. The presence of a clinically significant finding in the gastrointestinal tract was the primary endpoint of the study. Final diagnoses were adjudicated blinded to calprotectin values. Results Median calprotectin levels were higher in patients with significant findings (N = 212, median 97 μg/g, IQR 43-185) than in patients without (N = 326, 10 μg/g, IQR 10-23, P < 0.001). The area under the receiver operating characteristics curve (AUC) to identify a significant finding was 0.877 (95% CI, 0.85-0.90). Using 50 μg/g as cut off yielded a sensitivity of 73% and a specificity of 93% with good positive and negative likelihood ratios (10.8 and 0.29, respectively). Fecal calprotectin was useful as a diagnostic parameter both for findings in the upper intestinal tract (AUC 0.730, 0.66-0.79) and for the colon (AUC 0.912, 0.88-0.94) with higher diagnostic precision for the latter (P < 0.001). In patients > 50 years, the diagnostic precision remained unchanged (AUC 0.889 vs. 0.832, P = 0.165). Conclusion In patients with abdominal discomfort, fecal calprotectin is a useful non-invasive marker to identify clinically significant findings of the gastrointestinal tract, irrespective of age. PMID:22233279

  5. Abdominal mass

    MedlinePlus

    Several conditions can cause an abdominal mass: Abdominal aortic aneurysm can cause a pulsating mass around the navel. ... This could be a sign of a ruptured aortic aneurysm, which is an emergency condition. Contact your health ...

  6. Abdominal mass

    MedlinePlus

    ... Several conditions can cause an abdominal mass: Abdominal aortic aneurysm can cause a pulsating mass around the navel. ... This could be a sign of a ruptured aortic aneurysm, which is an emergency condition. Contact your health ...

  7. The effect of abdominal radiation on spleen function: A study in children with Wilms' tumor

    SciTech Connect

    Stevens, M.; Brown, E.; Zipursky, A. )

    1986-01-01

    Reports of splenic dysfunction in patients with Hodgkin's disease who received radiation therapy to the spleen raise questions concerning impairment of splenic function and the long-term risk of bacterial sepsis in children who receive abdominal radiation for other diseases. Splenic function was studied in 20 children with Wilms' tumor using a quantitative assessment of vacuolated (pitted) red cells as a measure of reticuloendothelial function. Fourteen children had received abdominal radiation to a field involving the spleen at a median dose of 2000 rads. Their pitted red cells counts were no different from those of 6 children who received therapy without radiation to the spleen or to those of a group of normal children and adults. We conclude that there is no demonstrable long-term impairment of spleen function with radiation doses at or below 2200 rads.

  8. A Retrospective Study of 51 Cases of Abdominal Problems in the Calf: Etiology, Diagnosis and Prognosis

    PubMed Central

    Naylor, Jonathan M.; Bailey, Jerry V.

    1987-01-01

    A retrospective study of 51 calves less than two months of age showing signs of abdominal pain or presented because of abdominal distension was carried out to evaluate the relationship between etiological, diagnostic, and prognostic characteristics. We found that the age of the calf differed with the type of lesion present. Calves under eight days of age had a 73% incidence of lesions which required surgical therapy. Atresia of part of the intestinal tract was the most frequently diagnosed problem, In eight-day to two-month-old calves, medical causes of colic were more common; only 26% of cases had lesions that required surgical correction. Gaseous distension of the abomasum and intestine was the most frequent cause of colic in older calves. Other abdominal problems observed in this study included abomasal ulceration and abomasal torsion. Mortality was more common in calves with surgical problems. Of the 21 calves with surgical problems, 76% died compared with a 20% mortality rate in the 30 calves with medical problems. Because of the high incidence of surgical problems in young calves, mortality was 69% in calves under eight days of age and only 33% in older calves. The chance of recovery decreased with the severity of hypothermia and dehydration. Most calves (75%) which were recumbent at presentation died, whereas only 29% of calves which were alert and able to stand at presentation died. Hematological findings indicative of severe inflammation were poor prognostic signs. Heart rate and the apparent severity of abdominal pain were not useful prognostic indicators. PMID:17422908

  9. Pathological calcifications studied with micro-CT

    NASA Astrophysics Data System (ADS)

    Stock, Stuart R.; Rajamannan, Nalini M.; Brooks, Ellen R.; Langman, Craig B.; Pachman, Lauren M.

    2004-10-01

    The microstructure of pathological biomineral deposits has received relatively little attention, perhaps, in part because of the difficulty preparing samples for microscopy. MicroCT avoids these difficulties, and laboratory microCT results are reviewed for aortic valve calcification (human as well as a rabbit model), for human renal calculi (stones) and for calcinoses formed in juvenile dermatomyositis (JDM). In calcified aortic valves of rabbits, numerical analysis of the data shows statistically significant correlation with diet. In a large kidney stone the pattern of mineralization is clearly revealed and may provide a temporal blueprint for stone growth. In JDM calcified deposits, very different microstructures are observed and may be related to processes unique to this disease.

  10. Correlative CT and anatomic study of the sciatic nerve

    SciTech Connect

    Pech, P.; Haughton, V.

    1985-05-01

    Sciatica can be caused by numerous processes affecting the sciatic nerve or its components within the pelvis including tumors, infectious diseases, aneurysms, fractures, and endometriosis. The CT diagnosis of these causes of sciatica has not been emphasized. This study identified the course and appearance of the normal sciatic nerve in the pelvis by correlating CT and anatomic slices in cadavers. For purposes of discussion, the sciatic nerve complex is conveniently divided into three parts: presacral, muscular, and ischial. Each part is illustrated here by two cryosections with corresponding CT images.

  11. A study evaluating the dependence of the patient dose on the CT dose change in a SPECT/CT scan

    NASA Astrophysics Data System (ADS)

    Kim, Woo-Hyun; Kim, Ho-Sung; Dong, Kyung-Rae; Chung, Woon-Kwan; Cho, Jae-Hwan; Shin, Jae-Woo

    2012-07-01

    This study assessed ways of reducing the patient dose by examining the dependence of the patient dose on the CT (computed tomography) dose in a SPECT (single-photon emission computed tomography)/CT scan. To measure the patient dose, we used Precedence 16 SPECT/CT along with a phantom for the CT dose measurement (CT dose phantom kit for adult's head and body, Model 76-414-4150), a 100-mm ionization chamber (CT Ion Chamber) and an X-ray detector (Victoreen Model 4000M+). In addition, the patient dose was evaluated under conditions similar to those for an actual examination using an ImPACT (imaging performance assessment of CT scanners) dosimetry calculator in the Monte Carlo simulation method. The experimental method involved the use of a CT dose phantom to measure the patient dose under different CT conditions (kVp and mAs) to determine the CTDI (CT dose index) under each condition. An ImPACT dosimetry calculator was also used to measure CTDIw (CT dose index water ), CTDIv (CT dose index volume ), DLP (dose-length product), and effective dose. According to the patient dose measurements using the CT dose phantom, the CTDI showed an approximately 54 fold difference between when the maximum (140 kVp and 250 mAs) and the minimum dose (90 kVp and 25 mAs) was used. The CTDI showed a 4.2 fold difference between the conditions (120 kVp and 200 mAs) used mainly in a common CT scan and the conditions (120 kVp and 50 mAs) used mainly in a SPECT/CT scan. According to the measurement results using the dosimetry calculator, the effective dose showed an approximately 35 fold difference between the conditions for the maximum and the minimum doses, as in the case with the CT dose phantom. The effective dose showed a 4.1 fold difference between the conditions used mainly in a common CT scan and those used mainly in a SPECT/CT scan. This study examined the patient dose by reducing the CT dose in a SPECT/CT scan. As various examinations can be conducted due to the development of

  12. Genome-wide association studies suggest sex-specific loci associated with abdominal and visceral fat

    PubMed Central

    Sung, Yun Ju; Pérusse, Louis; Sarzynski, Mark A.; Fornage, Myriam; Sidney, Steve; Sternfeld, Barbara; Rice, Treva; Terry, Gregg; Jacobs, David R.; Katzmarzyk, Peter; Curran, Joanne E; Carr, John Jeffrey; Blangero, John; Ghosh, Sujoy; Després, Jean-Pierre; Rankinen, Tuomo; Rao, D.C.; Bouchard, Claude

    2015-01-01

    Background To identify loci associated with abdominal fat and replicate prior findings, we performed genome-wide association (GWA) studies of abdominal fat traits: subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), total adipose tissue (TAT) and visceral to subcutaneous adipose tissue ratio (VSR). Subjects and Methods Sex-combined and sex-stratified analyses were performed on each trait with (TRAIT-BMI) or without (TRAIT) adjustment for BMI, and cohort-specific results were combined via a fixed effects meta-analysis. A total of 2,513 subjects of European descent were available for the discovery phase. For replication, 2,171 European Americans and 772 African Americans were available. Results A total of 52 SNPs encompassing 7 loci showed suggestive evidence of association (p < 1.0 × 10−6) with abdominal fat in the sex-combined analyses. The strongest evidence was found on chromosome 7p14.3 between a SNP near BBS9 gene and VAT (rs12374818; p= 1.10 × 10−7), an association that was replicated (p = 0.02). For the BMI-adjusted trait, the strongest evidence of association was found between a SNP near CYCSP30 and VAT-BMI (rs10506943; p= 2.42 × 10−7). Our sex-specific analyses identified one genome-wide significant (p < 5.0 × 10−8) locus for SAT in women with 11 SNPs encompassing the MLLT10, DNAJC1 and EBLN1 genes on chromosome 10p12.31 (p = 3.97 × 10−8 to 1.13 × 10−8). The THNSL2 gene previously associated with VAT in women was also replicated (p= 0.006). The six gene/loci showing the strongest evidence of association with VAT or VAT-BMI were interrogated for their functional links with obesity and inflammation using the Biograph knowledge-mining software. Genes showing the closest functional links with obesity and inflammation were ADCY8 and KCNK9, respectively. Conclusions Our results provide evidence for new loci influencing abdominal visceral (BBS9, ADCY8, KCNK9) and subcutaneous (MLLT10/DNAJC1/EBLN1) fat, and confirmed a locus (THNSL2

  13. Abdominal computed tomographic scan-merits and demerits over ultrasonography: evaluation of 70 cases.

    PubMed

    Obajimi, M O; Ogunseyinde, A O; Agunloye, A M

    2002-06-01

    Computed tomography (CT) and Ultrasonography (USS) are commonly used to ascertain the cause of abdominal symptoms. In a retrospective study of 70 Nigerian patients who had abdominal ultrasonography prior to abdominal CT scans, the most frequent clinical feature was abdominal pain, which was reported in 20.8% of the patients. The prevalent ultrasonographic finding was hepatomegaly (12.2%) while bowel displacement was the most frequently reported CT finding (18.3%). There was no correlation between USS and CT findings in 11 patients (15.7%). There was some agreement in the findings of both tests in 75.7% of cases. Additional findings were noted in 38 (54.3%) of the latter group of patients on CT scans. Hundred percent agreement was reported in both imaging techniques in 5 radiological findings namely: dilated gall bladder, renal cysts, ascites, adrenal mass and utero-cervical mass. These findings suggest a high yield of diagnostic accuracy from abdominal sonography and increased diagnostic details provided by CT imaging. Our overall impression is that the diagnostic information provided by the two techniques are complimentary. PMID:12518911

  14. The Incidence, Clinical Outcomes, and Risk Factors of Thrombocytopenia in Intra-Abdominal Infection Patients: A Retrospective Cohort Study

    PubMed Central

    Wu, Qin; Ren, Jianan; Wang, Gefei; Li, Guanwei; Gu, Guosheng; Wu, Xiuwen; Li, Yuan; Chen, Jun; Zhao, Yunzhao; Li, Jieshou

    2016-01-01

    Background Studies on the incidence and risk factors of thrombocytopenia among intra-abdominal infection patients remain absent, hindering efficacy assessments regarding thrombocytopenia prevention strategies. Methods We retrospectively studied 267 consecutively enrolled patients with intra-abdominal infections. Occurrence of thrombocytopenia was scanned for all patients. All-cause 28-day mortality was recorded. Variables from univariate analyses that were associated with occurrence of hospital-acquired thrombocytopenia were included in a multivariable logistic regression analysis to determine thrombocytopenia predictors. Results Median APACHE II score and SOFA score of the whole cohort was 12 and 3 respectively. The overall ICU mortality was 7.87% and the 28-day mortality was 8.98%. The incidence of thrombocytopenia among intra-abdominal infection patients was 21.73%. Regardless of preexisting or hospital-acquired one, thrombocytopenia is associated with an increased ICU mortality and 28-day mortality as well as length of ICU or hospital stay. A higher SOFA and ISTH score at admission were significant hospital-acquired thrombocytopenia risk factors. Conclusions This is the first study to identify a high incidence of thrombocytopenia in patients with intra-abdominal infections. Our findings suggest that the inflammatory milieu of intra-abdominal infections may uniquely predispose those patients to thrombocytopenia. More effective thrombocytopenia prevention strategies are necessary in intra-abdominal infection patients. PMID:26808492

  15. CT of Gastric Emergencies.

    PubMed

    Guniganti, Preethi; Bradenham, Courtney H; Raptis, Constantine; Menias, Christine O; Mellnick, Vincent M

    2015-01-01

    Abdominal pain, nausea, and vomiting are common presenting symptoms among adult patients seeking care in the emergency department, and, with the increased use of computed tomography (CT) to image patients with these complaints, radiologists will more frequently encounter a variety of emergent gastric pathologic conditions on CT studies. Familiarity with the CT appearance of emergent gastric conditions is important, as the clinical presentation is often nonspecific and the radiologist may be the first to recognize gastric disease as the cause of a patient's symptoms. Although endoscopy and barium fluoroscopy remain important tools for evaluating patients with suspected gastric disease in the outpatient setting, compared with CT these modalities enable less comprehensive evaluation of patients with nonspecific complaints and are less readily available in the acute setting. Endoscopy is also more invasive than CT and has greater potential risks. Although the mucosal detail of CT is relatively poor compared with barium fluoroscopy or endoscopy, CT can be used with the appropriate imaging protocols to identify inflammatory conditions of the stomach ranging from gastritis to peptic ulcer disease. In addition, CT can readily demonstrate the various complications of gastric disease, including perforation, obstruction, and hemorrhage, which may direct further clinical, endoscopic, or surgical management. We will review the normal anatomy of the stomach and discuss emergent gastric disease with a focus on the usual clinical presentation, typical imaging appearance, and differentiating features, as well as potential imaging pitfalls. PMID:26562229

  16. Abdominal wall competence after free transverse rectus abdominis musculocutaneous flap harvest: a prospective study.

    PubMed

    Suominen, S; Asko-Seljavaara, S; Kinnunen, J; Sainio, P; Alaranta, H

    1997-09-01

    A prospective study was designed to evaluate the possible changes in abdominal wall strength following free transverse rectus abdominis musculocutaneous (TRAM) flap surgery for breast reconstruction. Twenty-two patients were examined 1 day before surgery, and at 3, 6, and 12 months postoperatively. Trunk muscle strength was measured by the same physiotherapist using an isokinetic dynamometer (Lido Multi Joint II, Loredan Biomedical Inc., Davies, CA). The peak torque and average torque for both flexion and extension at 60 degrees per second angular velocity were recorded from the curves obtained. There was a significant reduction in trunk flexion strength at 3 months postoperatively (peak torque mean, 92% of the preoperative value; p = 0.04), but this was corrected by 6 months (mean, 96%), and improved to 98% by 12 months. The patient's ability to do curled trunk sit-ups was evaluated by the same physiotherapist and graded on a scale from 1 to 6. In 9 of 19 patients the operation had no effect on sit-up performance during follow-up. In 10 of 19 patients there was a reduction of one or two grades at 3 months that did not improve by 12 months. Magnetic resonance imaging of the abdominal wall was performed on 9 patients. The mean area of the upper third of both rectus muscles was measured on the axial images. At 3 months postoperatively the mean area of the upper third of the donor muscle was significantly larger than the contralateral (p = 0.03). There was no difference in size at 6 months, and by 12 months the donor side was smaller. This prospective study shows that harvesting of a free TRAM flap can cause a subclinical reduction in abdominal strength, although this was not noticed by the patients themselves. PMID:9326701

  17. Splenic trauma during abdominal wall liposuction: a case report

    PubMed Central

    Harnett, Paul; Koak, Yashwant; Baker, Daryl

    2008-01-01

    Summary A 35-year-old woman collapsed 18 hours after undergoing abdominal wall liposuction. Abdominal CT scan revealed a punctured spleen. She underwent an emergency splenectomy and made an uneventful recovery. PMID:18387911

  18. Radiochromic films for dental CT dosimetry: a feasibility study.

    PubMed

    Rampado, O; Bianchi, S D; Peruzzo Cornetto, A; Rossetti, V; Ropolo, R

    2014-02-01

    Dental CT dose evaluations are commonly performed using thermoluminescent dosimeters (TLD) inside anthropomorphic phantoms. Radiochromic films with good sensitivity in the X-ray diagnostic field have recently been developed and are commercially available as GAFCHROMIC XR-QA. There are potential advantages in the use of radiochromic films such as a more comprehensive dosimetry thanks to the adjustable size of the film samples. The purpose of this study was to investigate the feasibility of using radiochromic films for dental CT dose evaluations. Film samples were cut with a width of 5mm and a length of 25 mm (strips), the same size as the Alderson Rando anthropomorphic phantom holes used in this study. Dental CT dose measurements were performed using simultaneously both TLD and radiochromic strips in the same phantom sites. Two equipment types were considered for dental CT examinations: a 16 slice CT and a cone beam CT. Organ equivalent doses were then obtained averaging the measurements from the sites of the same organ and effective doses were calculated using ICRP 103 weighting factors. The entire procedure was repeated four times for each CT in order to compare also the repeatability of the two dosimeter types. A linear correlation was found between the absorbed dose evaluated with radiochromic films and with TLD, with slopes of 0.930 and 0.944 (correlation r>0.99). The maximum difference between the two dosimeter's measurements was 25%, whereas the average difference was 7%. The measurement repeatability was comparable for the two dosimeters at cumulative doses above 15 mGy (estimated uncertainty at 1 sigma level of about 5%), whereas below this threshold radiochromic films show a greater dispersion of data, of about 10% at 1 sigma level. We obtained, using respectively Gafchromic and TLD measurements, effective dose values of 107 μSv and 117 μSv (i.e. difference of 8.6%) for the cone beam CT and of 523 μSv and 562 μSv (i.e. difference of 7%) for the

  19. [Abdominal pregnancy, institutional experience].

    PubMed

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy. PMID:9737070

  20. A Study of Physicochemical Properties of Subcutaneous Fat of the Abdomen and its Implication in Abdominal Obesity

    PubMed Central

    Kumar, Pramod; Kodavoor, Srinivas Aithal; Kotian, Sushma Rama; Yathdaka, Sudhakar Narahari; Nayak, Dayanand; Souza, Anne D; Souza, Antony Sylvan D

    2016-01-01

    Introduction The lower abdominal obesity is more resistant to absorption as compared to that of upper abdomen. Differences in the physicochemical properties of the subcutaneous fat of the upper and lower abdomen may be responsible for this variation. There is paucity of the scientific literature on the physicochemical properties of the subcutaneous fat of abdomen. Aim The present study was undertaken to create a database of physicochemical properties of abdominal subcutaneous fat. Materials and Methods The samples of subcutaneous fat from upper and lower abdomen were collected from 40 fresh autopsied bodies (males 33, females 7). The samples were prepared for physicochemical analysis using organic and inorganic solvents. Various physicochemical properties of the fat samples analysed were surface tension, viscosity, specific gravity, specific conductivity, iodine value and thermal properties. Data was analysed by paired and independent sample t-tests. Results There was a statistically significant difference in all the physicochemical parameters between males and females except surface tension (organic) and surface tension (inorganic) of upper abdominal fat, and surface tension (organic) of lower abdominal fat. In males, viscosity of upper abdominal fat was more compared to that of lower abdomen (both organic and inorganic) unlike the specific conductivity that was higher for the lower abdominal fat as compared to that of the upper abdomen. In females there were statistically significant higher values of surface tension (inorganic) and specific gravity (organic) of the upper abdomen fat as compared to that of lower abdomen. The initial and final weight loss of the lower abdominal fat as indicated by Thermo Gravimetric Analysis was significantly more in males than in female Conclusion The difference in the physicochemical properties of subcutaneous fat between upper and lower abdomen and between males and females could be responsible for the variant behaviour of

  1. New Insights in Abdominal Pain in Paroxysmal Nocturnal Hemoglobinuria (PNH): A MRI Study

    PubMed Central

    De Cobelli, Francesco; Pezzetti, Giulio; Margari, Sergio; Esposito, Antonio; Giganti, Francesco; Agostini, Giulia; Del Maschio, Alessandro

    2015-01-01

    Introduction Abdominal pain in PNH has never been investigated by in-vivo imaging studies. With MRI, we aimed to assess mesenteric vessels flow and small bowel wall perfusion to investigate the ischemic origin of abdominal pain. Materials and Methods Six PNH patients with (AP) and six without (NOP) abdominal pain underwent MRI. In a blinded fashion, mean flow (MF, quantity of blood moving through a vessel within a second, in mL·s-1) and stroke volume (SV, volume of blood pumped out at each heart contraction, in mL) of Superior Mesenteric Vein (SMV) and Artery (SMA), areas under the curve at 60 (AUC60) and 90 seconds (AUC90) and Ktrans were assessed by two operators. Results Mean total perfusion and flow parameters were lower in AP than in NOP group. AUC60: 84.81 ± 11.75 vs. 131.73 ± 18.89 (P < 0.001); AUC90: 102.33 ± 14.16 vs. 152.58 ± 22.70 (P < 0.001); Ktrans: 0.0346 min-1 ± 0.0019 vs. 0.0521 ± 0.0015 (P = 0.093 duodenum, 0.009 jejunum/ileum). SMV: MF 4.67 ml/s ± 0.85 vs. 8.32 ± 2.14 (P = 0.002); SV 3.85 ml ± 0.76 vs. 6.55 ± 1.57 (P = 0.02). SMA: MF 6.95 ± 2.61 vs. 11.2 ± 2.32 (P = 0.07); SV 6.52 ± 2.19 vs. 8.78 ± 1.63 (P = 0.07). We found a significant correlation between MF and SV of SMV and AUC60 (MF:ρ = 0.88, P < 0.001; SV: ρ = 0.644, P = 0.024), AUC90 (MF: ρ = 0.874, P < 0.001; SV:ρ = 0.774, P = 0.003) and Ktrans (MF:ρ = 0.734, P = 0.007; SV:ρ = 0.581, P = 0.047). Conclusions Perfusion and flow MRI findings suggest that the impairment of small bowel blood supply is significantly associated with abdominal pain in PNH. PMID:25897796

  2. Multi-Atlas Segmentation for Abdominal Organs with Gaussian Mixture Models

    PubMed Central

    Burke, Ryan P.; Xu, Zhoubing; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-01-01

    Abdominal organ segmentation with clinically acquired computed tomography (CT) is drawing increasing interest in the medical imaging community. Gaussian mixture models (GMM) have been extensively used through medical segmentation, most notably in the brain for cerebrospinal fluid/gray matter/white matter differentiation. Because abdominal CT exhibit strong localized intensity characteristics, GMM have recently been incorporated in multi-stage abdominal segmentation algorithms. In the context of variable abdominal anatomy and rich algorithms, it is difficult to assess the marginal contribution of GMM. Herein, we characterize the efficacy of an a posteriori framework that integrates GMM of organ-wise intensity likelihood with spatial priors from multiple target-specific registered labels. In our study, we first manually labeled 100 CT images. Then, we assigned 40 images to use as training data for constructing target-specific spatial priors and intensity likelihoods. The remaining 60 images were evaluated as test targets for segmenting 12 abdominal organs. The overlap between the true and the automatic segmentations was measured by Dice similarity coefficient (DSC). A median improvement of 145% was achieved by integrating the GMM intensity likelihood against the specific spatial prior. The proposed framework opens the opportunities for abdominal organ segmentation by efficiently using both the spatial and appearance information from the atlases, and creates a benchmark for large-scale automatic abdominal segmentation. PMID:25914508

  3. Multi-atlas segmentation for abdominal organs with Gaussian mixture models

    NASA Astrophysics Data System (ADS)

    Burke, Ryan P.; Xu, Zhoubing; Lee, Christopher P.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.

    2015-03-01

    Abdominal organ segmentation with clinically acquired computed tomography (CT) is drawing increasing interest in the medical imaging community. Gaussian mixture models (GMM) have been extensively used through medical segmentation, most notably in the brain for cerebrospinal fluid / gray matter / white matter differentiation. Because abdominal CT exhibit strong localized intensity characteristics, GMM have recently been incorporated in multi-stage abdominal segmentation algorithms. In the context of variable abdominal anatomy and rich algorithms, it is difficult to assess the marginal contribution of GMM. Herein, we characterize the efficacy of an a posteriori framework that integrates GMM of organ-wise intensity likelihood with spatial priors from multiple target-specific registered labels. In our study, we first manually labeled 100 CT images. Then, we assigned 40 images to use as training data for constructing target-specific spatial priors and intensity likelihoods. The remaining 60 images were evaluated as test targets for segmenting 12 abdominal organs. The overlap between the true and the automatic segmentations was measured by Dice similarity coefficient (DSC). A median improvement of 145% was achieved by integrating the GMM intensity likelihood against the specific spatial prior. The proposed framework opens the opportunities for abdominal organ segmentation by efficiently using both the spatial and appearance information from the atlases, and creates a benchmark for large-scale automatic abdominal segmentation.

  4. Optical pathology study of human abdominal aorta tissues using confocal micro resonance Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Liu, Cheng-hui; Boydston-White, Susie; Wang, Wubao; Sordillo, Laura A.; Shi, Lingyan; Weisberg, Arel; Tomaselli, Vincent P.; Sordillo, Peter P.; Alfano, Robert R.

    2016-03-01

    Resonance Raman (RR) spectroscopic technique has a high potential for label-free and in-situ detection of biomedical lesions in vivo. This study evaluates the ability of RR spectroscopy method as an optical histopathology tool to detect the atherosclerotic plaque states of abdominal aorta in vitro. This part demonstrates the RR spectral molecular fingerprint features from different sites of the atherosclerotic abdominal aortic wall tissues. Total 57 sites of five pieces aortic samples in intimal and adventitial wall from an autopsy specimen were examined using confocal micro Raman system of WITec 300R with excitation wavelength of 532nm. The preliminary RR spectral biomarkers of molecular fingerprints indicated that typical calcified atherosclerotic plaque (RR peak at 964cm-1) tissue; fibrolipid plaque (RR peaks at 1007, 1161, 1517 and 2888cm-1) tissue, lipid pool with the fatty precipitation cholesterol) with collagen type I (RR peaks at 864, 1452, 1658, 2888 and 2948cm-1) in the soft tissue were observed and investigated.

  5. CT maxillary sinus evaluation-A retrospective cohort study

    PubMed Central

    Vaz, Paula; Faria-Almeida, Ricardo; Braga, Ana-Cristina; Felino, António

    2015-01-01

    Background Proximity of the dental roots to the sinus floor makes dental disease a probable cause of maxillary sinusitis. The aim of this study was to find out if maxillary sinus pathologic changes were more prevalent in patients with dental disease and to evaluate the performance of computed tomography (CT) in analyzing and detecting apical periodontitis and other odontogenic causes on the maxillary sinusitis etiology in a Portuguese Caucasian population. Material and Methods Retrospective cohort study. The total sample of 504 patients and their CT was included in this study. The patients were from a private dental clinic, specializing in oral surgery, where the first complaint was not directly related to sinus disease, but with dental pathology. For each patient, the etiological factors of maxillary sinusitis and the imaging CT findings were analyzed. All the axial, coronal and sagittal CT slices were evaluated and general data were registered. The latter was selected based on the maxillary sinus CT published literature. Results 32.40% of patients presented normal sinus (without any etiological factor associated), 29.00% showed presence of etiological and imaging findings in the maxillary sinus, 20.60% had only imaging changes in the maxillary sinus and 18.00% of patients presented only etiological factors and no change in the maxillary sinus. Conclusions Radiological imaging is an important tool for establishing the diagnosis of maxillary sinus pathology. These results indicate that the CT scan should be an excellent tool for complement the odontogenic sinusitis diagnosis. Key words: Maxillary sinusitis/etiology, odontogenic, computed tomography, maxillary sinus. PMID:25858084

  6. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study

    PubMed Central

    2014-01-01

    The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients. 827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses. The overall mortality rate was 10.5% (199/1898). According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p < 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p < 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p < 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p < 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p < 0.0001). PMID:24883079

  7. Citalopram Treatment of Pediatric Recurrent Abdominal Pain and Comorbid Internalizing Disorders: An Exploratory Study

    ERIC Educational Resources Information Center

    Campo, John V.; Perel, James; Lucas, Amanda; Bridge, Jeff; Ehmann, Mary; Kalas, Catherine; Monk, Kelly; Axelson, David; Birmaher, Boris; Ryan, Neal; Di Lorenzo, Carlo; Brent, David A.

    2004-01-01

    Objective: To assess the potential efficacy, tolerability, and safety of citalopram in the treatment of functional pediatric recurrent abdominal pain and comorbid internalizing disorders. Method: Twenty-five clinically referred children and adolescents with recurrent abdominal pain aged 7 to 18 years, inclusive, participated in a 12-week,…

  8. Abdominal sounds

    MedlinePlus

    ... during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation. Increased ( hyperactive ) bowel sounds ...

  9. Abdominal MRI

    MedlinePlus

    ... provider if you have: Artificial heart valves Brain aneurysm clips Heart defibrillator or pacemaker Inner ear (cochlear) ... which the test may be performed: Abdominal aortic aneurysm Atheroembolic renal disease Carcinoma of the renal pelvis ...

  10. Abdominal pain

    MedlinePlus

    ... threatening conditions, such as colon cancer or early appendicitis , may only cause mild pain or no pain. ... Food poisoning Stomach flu Other possible causes include: Appendicitis Abdominal aortic aneurysm (bulging and weakening of the ...

  11. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  12. Magnetic Resonance Elastography of the in vivo Abdominal Aorta: A Feasibility Study for Comparing Aortic Stiffness between Hypertensives and Normotensives

    PubMed Central

    Kolipaka, Arunark; Woodrum, David; Araoz, Philip A.; Ehman, Richard L.

    2011-01-01

    Purpose The purpose of this study is to demonstrate feasibility of using magnetic resonance elastography (MRE) to identify hypertensive changes in the abdominal aorta when compared to normotensives based on the stiffness measurements. Methods MRE was performed on 8 volunteers (4 normotensives and 4 hypertensives) to measure the effective stiffness of the abdominal aorta. MRE wave images are directionally filtered and phase gradient analysis was performed to determine the stiffness of the aorta. Student’s t-test was performed to determine significant difference in stiffness measurements between normotensives and hypertensives. Results The normotensive group demonstrated an average abdominal aortic stiffness of 3.7 ± 0.8 kPa, while the controlled-hypertensive demonstrated an average abdominal aortic stiffness of 9.3 ± 1.9kPa. MRE effective stiffness of abdominal aorta in hypertensives was significantly greater than that of normotensives with p=0.02. Conclusion Feasibility of in vivo aortic MRE is demonstrated. Hypertensives have significantly higher aortic stiffness assessed through MRE than normotensives. PMID:22045617

  13. Dynamic CT head phantom for perfusion and angiography studies

    NASA Astrophysics Data System (ADS)

    Russell, K.; Blazeski, A.; Dannecker, K.; Lee, Q. Y.; Holscher, C.; Donahue, C.; van Kampen, W.

    2010-03-01

    Contrast imaging is a compelling enhancement for the portable, flat panel-based brain CT scanner currently under development at Xoran. Due to the relative low temporal resolution of flat panel detectors, enabling tomographic imaging on such platform requires optimizing the imaging and injection protocols. A dynamic CT head phantom was designed to facilitate this task. The Dynamic Perfusion and Angiography Model (PAM), mimics tissue attenuation in CT images, provides physiological timing for angiography and perfusion studies, and moves fluid with properties similar to those of blood. The design consists of an arterial system, which contains bifurcating vessels that feed into perfusion chambers, mimicking blood flow through capillaries and smaller vessels, and a venous system, which is symmetrical to the arterial side and drains the perfusion chambers. The variation of geometry and flow rate in the phantom provides the physiological total time that fluid spends in the head, and the difference in material densities correlates to CT numbers for biological tissues. This paper discusses the design of Dynamic PAM and shows experimental results demonstrating its ability to realistically simulate blood flow. Results of dynamic imaging studies of the phantom are also presented.

  14. Anatomic Pathways of Peripancreatic Fluid Draining to Mediastinum in Recurrent Acute Pancreatitis: Visible Human Project and CT Study

    PubMed Central

    Xu, Haotong; Zhang, Xiaoming; Christe, Andreas; Ebner, Lukas; Zhang, Shaoxiang; Luo, Zhulin; Wu, Yi; Li, Yin; Tian, Fuzhou

    2013-01-01

    Background In past reports, researchers have seldom attached importance to achievements in transforming digital anatomy to radiological diagnosis. However, investigators have been able to illustrate communication relationships in the retroperitoneal space by drawing potential routes in computerized tomography (CT) images or a virtual anatomical atlas. We established a new imaging anatomy research method for comparisons of the communication relationships of the retroperitoneal space in combination with the Visible Human Project and CT images. Specifically, the anatomic pathways of peripancreatic fluid extension to the mediastinum that may potentially transform into fistulas were studied. Methods We explored potential pathways to the mediastinum based on American and Chinese Visible Human Project datasets. These drainage pathways to the mediastinum were confirmed or corrected in CT images of 51 patients with recurrent acute pancreatitis in 2011. We also investigated whether additional routes to the mediastinum were displayed in CT images that were not in Visible Human Project images. Principal Findings All hypothesized routes to the mediastinum displayed in Visible Human Project images, except for routes from the retromesenteric plane to the bilateral retrorenal plane across the bilateral fascial trifurcation and further to the retrocrural space via the aortic hiatus, were confirmed in CT images. In addition, route 13 via the narrow space between the left costal and crural diaphragm into the retrocrural space was demonstrated for the first time in CT images. Conclusion This type of exploration model related to imaging anatomy may be used to support research on the communication relationships of abdominal spaces, mediastinal spaces, cervical fascial spaces and other areas of the body. PMID:23614005

  15. Biomechanical and morphological study of a new elastic mesh (Ciberlastic) to repair abdominal wall defects.

    PubMed

    Calvo, B; Pascual, G; Peña, E; Pérez-Khöler, B; Rodríguez, M; Bellón, J M

    2016-06-01

    The aim of this study was to conduct a preclinical evaluation of the behaviour of a new type of abdominal LW prosthesis (Ciberlastic), which was designed with a non-absorbable elastic polyurethane monofilament (Assuplus, Assut Europe, Italy) to allow greater adaptability to mechanical area requirements and higher bio-mimicking with the newly formed surrounding tissues. Our hypothesis was that an increase in the elasticity of the mesh filament could improve the benefits of LW prostheses. To verify our hypothesis, we compared the short- and long-term behaviour of Ciberlastic and Optilene(®) elastic commercial meshes by repairing the partially herniated abdomen in New Zealand White rabbits. The implanted meshes were mechanically and histologically assessed at 14 and 180 days post-implant. We mechanically characterized the partially herniated repaired muscle tissue and also determined mesh shrinkage at different post-implant times. This was followed by a histological study in which the tissue incorporation process was analysed over time. The new prosthesis designed by our group achieved good behaviour that was similar to that of Optilene(®), one of the most popular LW prostheses on the market, with the added advantage of its elastic property. The mechanical properties are significantly lower than those of the polypropylene Optilene(®) mesh, and the new elastic mesh meets the basic mechanical requirements for positioning in the abdominal wall, which was also demonstrated by the absence of recurrences after implantation in the experimental model. We found that the growth of a connective tissue rich in collagen over the hernial defect and the proper deposit of the collagen fibres in the regenerated tissue substantially modified the original properties of the mesh, thereby increasing its biomechanical strength and making the whole tissue/mesh stiffer. PMID:26905037

  16. Early Parental and Child Predictors of Recurrent Abdominal Pain at School Age: Results of a Large Population-Based Study

    ERIC Educational Resources Information Center

    Ramchandani, Paul G.; Stein, Alan; Hotopf, Matthew; Wiles, Nicola J.

    2006-01-01

    Objective: To assess whether parental psychological and physical factors and child factors measured in the first year of life were associated with recurrent abdominal pain (RAP) in children at age 6 3/4 years. Method: A longitudinal cohort study (the Avon Longitudinal Study of Parents and Children), followed 8,272 children from pregnancy to age 6…

  17. Seat Belt Use and its Effect on Abdominal Trauma: A National Trauma Databank Study.

    PubMed

    Nash, Nick A; Okoye, Obi; Albuz, Ozgur; Vogt, Kelly N; Karamanos, Efstathios; Inaba, Kenji; Demetriades, Demetrios

    2016-02-01

    We sought to use the National Trauma Databank to determine the demographics, injury distribution, associated abdominal injuries, and outcomes of those patients who are restrained versus unrestrained. All victims of motor vehicle collisions (MVCs) were identified from the National Trauma Databank and stratified into subpopulations depending on the use of seat belts. A total of 150,161 MVC victims were included in this study, 72,394 (48%) were belted. Young, male passengers were the least likely to be wearing a seat belt. Restrained victims were less likely to have severe injury as measured by Injury Severity Score and Abbreviated Injury Score. Restrained victims were also less likely to suffer solid organ injuries (9.7% vs 12%, P < 0.001), but more likely to have hollow viscous injuries (1.9% vs 1.3%, P < 0.001). The hospital and intensive care unit length of stay were significantly shorter in belted victims with adjusted mean difference: -1.36 (-1.45, -1.27) and -0.96 (-1.02, -0.90), respectively. Seat belt use was associated with a significantly lower crude mortality than unrestrained victims (1.9% vs 3.3%, P < 0.001), and after adjusting for differences in age, gender, position in vehicle, and deployment of air bags, the protective effect remained (adjusted odds ratio for mortality 0.50, 95% confidence interval 0.47, 0.54). In conclusion, MVC victims wearing seat belts have a significant reduction in the severity of injuries in all body areas, lower mortality, a shorter hospital stay, and decreased length of stay in the intensive care unit. The nature of abdominal injuries, however, was significantly different, with a higher incidence of hollow viscous injury in those wearing seat belts. PMID:26874135

  18. A randomized controlled experimental study comparing chitosan coated polypropylene mesh and Proceed™ mesh for abdominal wall defect closure

    PubMed Central

    Jayanth, S.T.; Pulimood, Anna; Abraham, Deepak; Rajaram, A.; Paul, M.J.; Nair, Aravindan

    2015-01-01

    Background Abdominal wall defects and hernias are commonly repaired with synthetic or biological materials. Adhesions and recurrences are a common problem. A study was conducted to compare Chitosan coated polypropylene mesh and a polypropylene–polydioxanone composite with oxidized cellulose coating mesh (Proceed™) in repair of abdominal wall defect in a Rabbit hernia model. Methods A randomized controlled experimental study was done on twelve New Zealand white rabbits. A ventral abdominal defect was created in each of the rabbits. The rabbits were divided into two groups. In one group the defect was repaired with Chitosan coated polypropylene mesh and Proceed mesh™ in the other. The rabbits were operated in two phases. They were followed up at four weeks and twelve weeks respectively after which the rabbits were sacrificed. They were evaluated by open exploration and histopathological examination. Their efficacy in reducing adhesion and ability of remodeling and tissue integration were studied. Results There was no statistical significance in the area of adhesion, the force required to remove the adhesions, tissue integration and remodeling between Chitosan and Proceed™ group. Histological analysis revealed that the inflammatory response, fibrosis, material degradation and remodeling were similar in both the groups. There were no hernias, wound infection or dehiscence in any of the studied animals. Conclusion Chitosan coated polypropylene mesh was found to have similar efficacy to Proceed™ mesh. Chitosan coated polypropylene mesh, can act as an anti adhesive barrier when used in the repair of incisional hernias and abdominal wall defects. PMID:26594357

  19. Trajectories of Symptoms and Impairment for Pediatric Patients with Functional Abdominal Pain: A 5-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Mulvaney, Shelagh; Lambert, E. Warren; Garber, Judy; Walker, Lynn S.

    2006-01-01

    Objective: This prospective study characterizes trajectories of symptoms and impairment in pediatric patients with abdominal pain not associated with identifiable organic disease. Method: The Children's Somatization Inventory and the Functional Disability Inventory were administered four times over 5 years to 132 patients (6-18 years old) seen in…

  20. Newt limb regeneration studied with synchrotron micro-CT

    NASA Astrophysics Data System (ADS)

    Stock, Stuart R.; Ignatiev, Konstantin I.; Simon, Hans-Georg; De Carlo, Francesco

    2004-10-01

    Newts are the most developed vertebrates which retain the ability as adults to regenerate missing limbs; they are, therefore, of great interest in terms understanding how such regeneration could be triggered in mammals. In this study, synchrotron microCT was used to study bone microstructure in control forelimbs and in forelimbs regenerated for periods from 37 to 85 days. The bone microstructure in newts has been largely neglected, and interesting patterns within the original bone and in the regenerating arm and hand are described. Periosteal bone formation in the regenerating arm and finger bones, delayed ossification of carpal (but not metacarpal) bones and the complex microstructure of the original carpal bones are areas where microCT reveals detail of particular interest.

  1. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  2. Fruit Intake and Abdominal Aortic Calcification in Elderly Women: A Prospective Cohort Study

    PubMed Central

    Bondonno, Nicola P.; Lewis, Joshua R.; Prince, Richard L.; Lim, Wai H.; Wong, Germaine; Schousboe, John T.; Woodman, Richard J.; Kiel, Douglas P.; Bondonno, Catherine P.; Ward, Natalie C.; Croft, Kevin D.; Hodgson, Jonathan M.

    2016-01-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide. There is a consistent inverse relationship between fruit intake with CVD events and mortality in cross-sectional and prospective observational studies, but the relationship of fruit intake with measurements of atherosclerosis in humans is less clear. Nutritional effects on abdominal aortic calcification (AAC), a marker for subclinical intimal and medial atherosclerotic vascular disease, have not been studied previously. The aim of this study was to examine the cross-sectional relationship of total and individual fruit (apple, pear, orange and other citrus, and banana) intake with AAC, scored between 0 and 24. The current study assessed baseline data for a cohort of 1052 women over 70 years of age who completed both a food frequency questionnaire assessing fruit intake, and underwent AAC measurement using dual energy X-ray absorptiometry. AAC scores were significantly negatively correlated with total fruit and apple intakes (p < 0.05), but not with pear, orange or banana intakes (p > 0.25). In multivariable-adjusted logistic regression, each standard deviation (SD; 50 g/day) increase in apple intake was associated with a 24% lower odds of having severe AAC (AAC score >5) (odd ratio OR): 0.76 (0.62, 0.93), p = 0.009). Total and other individual fruit intake were not associated with increased odds of having severe AAC. Apple but not total or other fruit intake is independently negatively associated with AAC in older women. PMID:26978394

  3. Fruit Intake and Abdominal Aortic Calcification in Elderly Women: A Prospective Cohort Study.

    PubMed

    Bondonno, Nicola P; Lewis, Joshua R; Prince, Richard L; Lim, Wai H; Wong, Germaine; Schousboe, John T; Woodman, Richard J; Kiel, Douglas P; Bondonno, Catherine P; Ward, Natalie C; Croft, Kevin D; Hodgson, Jonathan M

    2016-03-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide. There is a consistent inverse relationship between fruit intake with CVD events and mortality in cross-sectional and prospective observational studies, but the relationship of fruit intake with measurements of atherosclerosis in humans is less clear. Nutritional effects on abdominal aortic calcification (AAC), a marker for subclinical intimal and medial atherosclerotic vascular disease, have not been studied previously. The aim of this study was to examine the cross-sectional relationship of total and individual fruit (apple, pear, orange and other citrus, and banana) intake with AAC, scored between 0 and 24. The current study assessed baseline data for a cohort of 1052 women over 70 years of age who completed both a food frequency questionnaire assessing fruit intake, and underwent AAC measurement using dual energy X-ray absorptiometry. AAC scores were significantly negatively correlated with total fruit and apple intakes (p < 0.05), but not with pear, orange or banana intakes (p > 0.25). In multivariable-adjusted logistic regression, each standard deviation (SD; 50 g/day) increase in apple intake was associated with a 24% lower odds of having severe AAC (AAC score >5) (odd ratio OR): 0.76 (0.62, 0.93), p = 0.009). Total and other individual fruit intake were not associated with increased odds of having severe AAC. Apple but not total or other fruit intake is independently negatively associated with AAC in older women. PMID:26978394

  4. Patient-specific CT dosimetry calculation: a feasibility study.

    PubMed

    Fearon, Thomas; Xie, Huchen; Cheng, Jason Y; Ning, Holly; Zhuge, Ying; Miller, Robert W

    2011-01-01

    Current estimation of radiation dose from computed tomography (CT) scans on patients has relied on the measurement of Computed Tomography Dose Index (CTDI) in standard cylindrical phantoms, and calculations based on mathematical representations of "standard man". Radiation dose to both adult and pediatric patients from a CT scan has been a concern, as noted in recent reports. The purpose of this study was to investigate the feasibility of adapting a radiation treatment planning system (RTPS) to provide patient-specific CT dosimetry. A radiation treatment planning system was modified to calculate patient-specific CT dose distributions, which can be represented by dose at specific points within an organ of interest, as well as organ dose-volumes (after image segmentation) for a GE Light Speed Ultra Plus CT scanner. The RTPS calculation algorithm is based on a semi-empirical, measured correction-based algorithm, which has been well established in the radiotherapy community. Digital representations of the physical phantoms (virtual phantom) were acquired with the GE CT scanner in axial mode. Thermoluminescent dosimeter (TLDs) measurements in pediatric anthropomorphic phantoms were utilized to validate the dose at specific points within organs of interest relative to RTPS calculations and Monte Carlo simulations of the same virtual phantoms (digital representation). Congruence of the calculated and measured point doses for the same physical anthropomorphic phantom geometry was used to verify the feasibility of the method. The RTPS algorithm can be extended to calculate the organ dose by calculating a dose distribution point-by-point for a designated volume. Electron Gamma Shower (EGSnrc) codes for radiation transport calculations developed by National Research Council of Canada (NRCC) were utilized to perform the Monte Carlo (MC) simulation. In general, the RTPS and MC dose calculations are within 10% of the TLD measurements for the infant and child chest scans. With

  5. Serial study of clinical and CT changes in tuberculous meningitis.

    PubMed

    Ranjan, P; Kalita, J; Misra, U K

    2003-05-01

    Clinical and radiological changes in tuberculous meningitis (TBM) have been reported but there is paucity of comprehensive serial clinicoradiological follow-up. In this prospective hospital based study, we investigated serial changes in the clinical and radiological findings and their relationships over 6 months in 31 consecutive patients with TBM, diagnosed on the basis of clinical, radiological and spinal fluid criteria. We graded the severity of the TBM as I-III. Detailed clinical examination, contrast-enhanced CT and activities of daily living (ADL) assessments were made on admission, and 3 and 6 months after therapy. Further CT was carried out as required. Patients received four-drug antituberculous therapy (RHZE) and underwent a ventriculoperitoneal shunt if necessary. Outcome was defined as poor, partial or complete recovery using the Barthel index score at 6 months. The age of the patients was 6-80 years, mean 35.2 years; four were children and 13 female. Meningitis was stage I in 5, stage II in six and stage III in 20 patients. Focal weakness was present in nine, papilloedema in six and ophthalmoplegia in ten. There were ten patients who deteriorated within first 6 weeks of therapy. Mean Glasgow coma score (GCS) deteriorated from 12.5 to 11.4; the grade of meningitis increased by two stages in one patient, one stage in another, and motor deficits appeared in four and optic atrophy in four; four patients required shunt surgery. By 3 months most patients were stable. At 6 months 17 patients had complete, four partial and nine poor recovery. Initial CT was abnormal in 28 patients, revealing hydrocephalus and exudates in 15 each, infarcts in ten and tuberculomas in 13. It was repeated in ten patients who deteriorated, showing new abnormalities such as hydrocephalus in two, infarcts in four, exudates in four and granulomas in two, with worsening of the previous findings. CT at 3 and 6 months was still abnormal in most patients. At 6 months hydrocephalus had

  6. Abdominal Obesity and Association With Atherosclerosis Risk Factors: The Uberlândia Heart Study.

    PubMed

    Roever, Leonardo S; Resende, Elmiro S; Diniz, Angélica L D; Penha-Silva, Nilson; Veloso, Fernando C; Casella-Filho, Antonio; Dourado, Paulo M M; Chagas, Antonio C P

    2016-03-01

    Ectopic visceral fat (VF) and subcutaneous fat (SCF) are associated with cardiovascular risk factors. Gender differences in the correlations of cardiovascular disease risk factors and ectopic fat in the Brazilian population still lacking. Cross-sectional study with 101 volunteers (50.49% men; mean age 56.5 ± 18, range 19-74 years) drawn from the Uberlândia Heart Study underwent ultrasonography assessment of abdominal visceral adipose tissue with convex transducer of 3.5 MHz of frequency. The thickness of VF was ultrasonographically measured by the distance between the inner face of the abdominal muscle and the posterior face of abdominal aorta, 1 cm above the umbilicus. The SCF thickness was measured with a 7.5 MHz linear transducer transversely positioned 1 cm above the umbilical scar. The exams were always performed by the same examiner. Ectopic fat volumes were examined in relation to waist circumference, blood pressure, and metabolic risk factors. The VF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.10), HDL cholesterol (P < 0.005, r = 0.15), total cholesterol (P < 0.01, r = 0.10), waist circumference (P < 0.0001, r = 0.43), systolic blood pressure (P < 0.001, r = 0.41), and diastolic blood pressure (P < 0.001, r = 0.32) in women, and with the levels of triglycerides (P < 0.002, r = 0,14), HDL cholesterol (P < 0.032, r = 0.07), glucose (P < 0.001, r = 0.15), alanine aminotransferase (ALT) (P < 0.008, r = 0.12), gamma-GT (P < 0.001, r = 0.30), waist circumference (P < 0.001, r = 0.52), systolic blood pressure (P < 0.001, r = 0.32), and diastolic blood pressure (P < 0.001, r = 0.26) in men. SCF was significantly associated with the levels of triglycerides (P < 0.01, r = 0.34), LDL cholesterol (P < 0.001, r = 0.36), total cholesterol (P < 0.05, r = 0.36), waist circumference (P

  7. A numerical study of fluid-structure coupled effect of abdominal aortic aneurysm.

    PubMed

    Cong, Yingbo; Wang, Liya; Liu, Xiao

    2015-01-01

    Three numerical models of an abdominal aortic aneurysm (AAA) with different geometric parameters are established in order to examine the coupled effect of the fluid-structure of AAA. The study is focused on examining the roles of the dilatation parameter and the aspect ratio of an AAA in the flow dynamic within a pulse period. The numerical results demonstrate that the vortex dominates the dynamic flow behavior within an AAA. During a pressure impulse cycle, an AAA is influenced by the entirety of the vortex, from its generation to its subsequent disappearance. As an indirect effect of the vortex dynamic acting on vessels, a series of alternate impulse responses of the wall shear stress (WSS) is generated in an AAA as eddies induced by the vortex move along the axis of the vessels, and the strength of the responses is proportional to the strength of the eddies. The alternated impulse of WSS may be one of the main influencing factors on AAA rupture. The results of this study aided in understanding the mechanisms underlying the evolutionary processes of AAAs. PMID:26406009

  8. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  9. Abdominal Adhesions

    MedlinePlus

    ... Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91–111. Seek Help for ... and how to participate, visit the NIH Clinical Research Trials and You website ... Foundation for Functional Gastrointestinal Disorders 700 West Virginia ...

  10. Can nontriggered thoracic CT be used for coronary artery calcium scoring? A phantom study

    SciTech Connect

    Xie, Xueqian; Greuter, Marcel J. W.; Groen, Jaap M.; Bock, Geertruida H. de; Oudkerk, Matthijs; Jong, Pim A. de; Vliegenthart, Rozemarijn

    2013-08-15

    Purpose: Coronary artery calcium score, traditionally based on electrocardiography (ECG)-triggered computed tomography (CT), predicts cardiovascular risk. However, nontriggered CT is extensively utilized. The study-purpose is to evaluate the in vitro agreement in coronary calcium score between nontriggered thoracic CT and ECG-triggered cardiac CT.Methods: Three artificial coronary arteries containing calcifications of different densities (high, medium, and low), and sizes (large, medium, and small), were studied in a moving cardiac phantom. Two 64-detector CT systems were used. The phantom moved at 0–90 mm/s in nontriggered low-dose CT as index test, and at 0–30 mm/s in ECG-triggered CT as reference. Differences in calcium scores between nontriggered and ECG-triggered CT were analyzed by t-test and 95% confidence interval. The sensitivity to detect calcification was calculated as the percentage of positive calcium scores.Results: Overall, calcium scores in nontriggered CT were not significantly different to those in ECG-triggered CT (p > 0.05). Calcium scores in nontriggered CT were within the 95% confidence interval of calcium scores in ECG-triggered CT, except predominantly at higher velocities (≥50 mm/s) for the high-density and large-size calcifications. The sensitivity for a nonzero calcium score was 100% for large calcifications, but 46%± 11% for small calcifications in nontriggered CT.Conclusions: When performing multiple measurements, good agreement in positive calcium scores is found between nontriggered thoracic and ECG-triggered cardiac CT. Agreement decreases with increasing coronary velocity. From this phantom study, it can be concluded that a high calcium score can be detected by nontriggered CT, and thus, that nontriggered CT likely can identify individuals at high risk of cardiovascular disease. On the other hand, a zero calcium score in nontriggered CT does not reliably exclude coronary calcification.

  11. Hemodynamic Study of Flow Remodeling Stent Graft for the Treatment of Highly Angulated Abdominal Aortic Aneurysm

    PubMed Central

    Yeow, Siang Lin; Leo, Hwa Liang

    2016-01-01

    This study investigates the effect of a novel flow remodeling stent graft (FRSG) on the hemodynamic characteristics in highly angulated abdominal aortic aneurysm based on computational fluid dynamics (CFD) approach. An idealized aortic aneurysm with varying aortic neck angulations was constructed and CFD simulations were performed on nonstented models and stented models with FRSG. The influence of FRSG intervention on the hemodynamic performance is analyzed and compared in terms of flow patterns, wall shear stress (WSS), and pressure distribution in the aneurysm. The findings showed that aortic neck angulations significantly influence the velocity flow field in nonstented models, with larger angulations shifting the mainstream blood flow towards the center of the aorta. By introducing FRSG treatment into the aneurysm, erratic flow recirculation pattern in the aneurysm sac diminishes while the average velocity magnitude in the aneurysm sac was reduced in the range of 39% to 53%. FRSG intervention protects the aneurysm against the impacts of high velocity concentrated flow and decreases wall shear stress by more than 50%. The simulation results highlighted that FRSG may effectively treat aneurysm with high aortic neck angulations via the mechanism of promoting thrombus formation and subsequently led to the resorption of the aneurysm. PMID:27247612

  12. Radiation Doses of Various CT Protocols: a Multicenter Longitudinal Observation Study

    PubMed Central

    2016-01-01

    Emerging concerns regarding the hazard from medical radiation including CT examinations has been suggested. The purpose of this study was to observe the longitudinal changes of CT radiation doses of various CT protocols and to estimate the long-term efforts of supervising radiologists to reduce medical radiation. Radiation dose data from 11 representative CT protocols were collected from 12 hospitals. Attending radiologists had collected CT radiation dose data in two time points, 2007 and 2010. They collected the volume CT dose index (CTDIvol) of each phase, number of phases, dose length product (DLP) of each phase, and types of scanned CT machines. From the collected data, total DLP and effective dose (ED) were calculated. CTDIvol, total DLP, and ED of 2007 and 2010 were compared according to CT protocols, CT machine type, and hospital. During the three years, CTDIvol had significantly decreased, except for dynamic CT of the liver. Total DLP and ED were significantly decreased in all 11 protocols. The decrement was more evident in newer CT scanners. However, there was substantial variability of changes of ED during the three years according to hospitals. Although there was variability according to protocols, machines, and hospital, CT radiation doses were decreased during the 3 years. This study showed the effects of decreased CT radiation dose by efforts of radiologists and medical society. PMID:26908984

  13. Postherpetic pseudohernia: delayed onset of paresis of abdominal muscles due to herpes zoster causing an ipsilateral abdominal bulge.

    PubMed

    Ohno, Shunsuke; Togawa, Yasuhiro; Chiku, Tsuyoshi; Sano, Wataru

    2016-01-01

    Postherpetic pseudohernia causes an abdominal bulge as well as an abdominal wall herniation. This disease is one of the neurological complications of herpes zoster and essentially consists of paresis of ipsilateral abdominal muscles. Postherpetic pseudohernia may be mistaken for abdominal wall herniation because it is not well known. We describe two cases presenting an abdominal bulge. The ipsilateral abdominal bulge appeared after recovery from abdominal zoster. Abdominal CT showed no evidence of a herniation or mass. We diagnosed a postherpetic pseudohernia. One of the patients recovered spontaneously 4 months after the onset, and the other partially recovered after 2 months. This disease can be expected to disappear spontaneously, unlike abdominal herniation requiring surgery. It has been reported that 79.3% of patients eventually recovered spontaneously. For surgeons and general practitioners, it is beneficial to keep this disease in mind when examining a patient presenting an abdominal bulge. PMID:27229900

  14. Optimization of SPECT-CT Hybrid Imaging Using Iterative Image Reconstruction for Low-Dose CT: A Phantom Study

    PubMed Central

    Grosser, Oliver S.; Kupitz, Dennis; Ruf, Juri; Czuczwara, Damian; Steffen, Ingo G.; Furth, Christian; Thormann, Markus; Loewenthal, David; Ricke, Jens; Amthauer, Holger

    2015-01-01

    Background Hybrid imaging combines nuclear medicine imaging such as single photon emission computed tomography (SPECT) or positron emission tomography (PET) with computed tomography (CT). Through this hybrid design, scanned patients accumulate radiation exposure from both applications. Imaging modalities have been the subject of long-term optimization efforts, focusing on diagnostic applications. It was the aim of this study to investigate the influence of an iterative CT image reconstruction algorithm (ASIR) on the image quality of the low-dose CT images. Methodology/Principal Findings Examinations were performed with a SPECT-CT scanner with standardized CT and SPECT-phantom geometries and CT protocols with systematically reduced X-ray tube currents. Analyses included image quality with respect to photon flux. Results were compared to the standard FBP reconstructed images. The general impact of the CT-based attenuation maps used during SPECT reconstruction was examined for two SPECT phantoms. Using ASIR for image reconstructions, image noise was reduced compared to FBP reconstructions for the same X-ray tube current. The Hounsfield unit (HU) values reconstructed by ASIR were correlated to the FBP HU values(R2 ≥ 0.88) and the contrast-to-noise ratio (CNR) was improved by ASIR. However, for a phantom with increased attenuation, the HU values shifted for low X-ray tube currents I ≤ 60 mA (p ≤ 0.04). In addition, the shift of the HU values was observed within the attenuation corrected SPECT images for very low X-ray tube currents (I ≤ 20 mA, p ≤ 0.001). Conclusion/Significance In general, the decrease in X-ray tube current up to 30 mA in combination with ASIR led to a reduction of CT-related radiation exposure without a significant decrease in image quality. PMID:26390216

  15. A multicentre study of advanced abdominal pregnancy: a review of six cases in low resource settings.

    PubMed

    Aliyu, L D; Ashimi, A O

    2013-09-01

    Abdominal pregnancy has remained a big challenge worldwide especially in developing countries where there are limitations in diagnostic resources. The most important approach is to be vigilant for the unexpected as most patients present with no specific symptoms or clinical signs. It also poses great challenges in diagnosis and management, and is associated with a lot of morbidity and mortality. This series of six cases, each presenting in a peculiar way, typically illustrates these issues. The cases were managed in three different hospitals in the last 15 years. These series is aimed at highlighting the atypical presenting features of advanced abdominal pregnancy and the need for vigilance when there is suspicion of a case. It is also aimed at showing the difficulty of diagnosis and management of advanced abdominal pregnancy in low resource environment. PMID:23806448

  16. Abdominal exploration

    MedlinePlus

    ... these are aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), clopidogrel (Plavix), or ticlopidine (Ticlid). Ask your ... Biopsy Cancer Chronic pancreatitis CT scan Diverticulitis Ectopic pregnancy Endometriosis Hodgkin lymphoma Pelvic inflammatory disease (PID) Peritonitis - ...

  17. Renal flow studies after abdominal aortic aneurysmectomy and axillo-bifemoral bypass graft: case report

    SciTech Connect

    LaManna, M.M.; Yussen, P.S.

    1988-03-01

    Vascular disorders affecting the kidneys are either acquired or congenital. Included in this category are common multiplicity of renal arteries, the rare arteriovenous malformation, stresses due to fibromuscular disease or atherosclerosis including abdominal aortic aneurysms, arterial thrombosis, venous thrombosis, and infarction. In contrast to the group of cystic and neoplastic kidneys where scintigraphic or pathologic are not diagnostic, scintigraphic or pathologic anatomy in vascular disease is often diagnostic by nuclear medicine techniques. The authors present an interesting case of evaluation of acute renal failure in a patient abdominal aortic aneurysmectomy and axillo-bifemoral bypass graft.

  18. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  19. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  20. Abdominal Functional Electrical Stimulation to Assist Ventilator Weaning in Acute Tetraplegia: A Cohort Study

    PubMed Central

    McCaughey, Euan J.; Berry, Helen R.; McLean, Alan N.; Allan, David B.; Gollee, Henrik

    2015-01-01

    Background Severe impairment of the major respiratory muscles resulting from tetraplegia reduces respiratory function, causing many people with tetraplegia to require mechanical ventilation during the acute stage of injury. Abdominal Functional Electrical Stimulation (AFES) can improve respiratory function in non-ventilated patients with sub-acute and chronic tetraplegia. The aim of this study was to investigate the clinical feasibility of using an AFES training program to improve respiratory function and assist ventilator weaning in acute tetraplegia. Methods AFES was applied for between 20 and 40 minutes per day, five times per week on four alternate weeks, with 10 acute ventilator dependent tetraplegic participants. Each participant was matched retrospectively with a ventilator dependent tetraplegic control, based on injury level, age and sex. Tidal Volume (VT) and Vital Capacity (VC) were measured weekly, with weaning progress compared to the controls. Results Compliance to training sessions was 96.7%. Stimulated VT was significantly greater than unstimulated VT. VT and VC increased throughout the study, with mean VC increasing significantly (VT: 6.2 mL/kg to 7.8 mL/kg VC: 12.6 mL/kg to 18.7 mL/kg). Intervention participants weaned from mechanical ventilation on average 11 (sd: ± 23) days faster than their matched controls. Conclusion The results of this study indicate that AFES is a clinically feasible technique for acute ventilator dependent tetraplegic patients and that this intervention may improve respiratory function and enable faster weaning from mechanical ventilation. Trial Registration ClinicalTrials.gov NCT02200393 PMID:26047468

  1. Large Abdominal Wall Endometrioma Following Laparoscopic Hysterectomy

    PubMed Central

    Borncamp, Erik; Mehaffey, Philip; Rotman, Carlos

    2011-01-01

    Background: Endometriosis is a common condition in women that affects up to 45% of patients in the reproductive age group by causing pelvic pain. It is characterized by the presence of endometrial tissue outside the uterine cavity and is rarely found subcutaneously or in abdominal incisions, causing it to be overlooked in patients with abdominal pain. Methods: A 45-year-old woman presented with lower abdominal pain 2 years following a laparoscopic supracervical hysterectomy. She was found to have incidental cholelithiasis and a large abdominal mass suggestive of a significant ventral hernia on CT scan. Results: Due to the peculiar presentation, surgical intervention took place that revealed a large 9cm×7.6cm×6.2cm abdominal wall endometrioma. Conclusion: Although extrapelvic endometriosis is rare, it should be entertained in the differential diagnosis for the female patient who presents with an abdominal mass and pain and has a previous surgical history. PMID:21902990

  2. COMPARISON OF COMPUTED TOMOGRAPHY AND ABDOMINAL RADIOGRAPHY FOR DETECTION OF CANINE MECHANICAL INTESTINAL OBSTRUCTION.

    PubMed

    Drost, Wm Tod; Green, Eric M; Zekas, Lisa J; Aarnes, Turi K; Su, Lillian; Habing, Gregory G

    2016-07-01

    Vomiting, often caused by mechanical intestinal obstruction, is common in dogs. Equivocal radiographic signs often necessitate repeat radiographs or additional imaging procedures. For our prospective, case-controlled, accuracy study, we hypothesized the following: (1) using computed tomography (CT), radiologists will be more sensitive and specific for detecting mechanical intestinal obstruction and recommending surgery compared to using radiographs; and (2) using measurements, radiologists will be more sensitive and specific using radiographs or CT for detecting mechanical intestinal obstruction and recommending surgery. Twenty dogs had abdominal radiographs and abdominal CT. Seventeen dogs had abdominal surgery and three dogs were not obstructed based on clinical follow-up. Confidence levels (five-point scale) of three experienced radiologists for mechanical intestinal obstruction and recommending surgery were recorded before and after making selected measurements. Eight dogs had surgically confirmed mechanical intestinal obstruction, and 12 dogs did not have obstruction. For detecting mechanical intestinal obstruction, CT was more sensitive (95.8% vs. 79.2%) and specific (80.6% vs. 69.4%) compared to radiographs, but the difference was not statistically significant. For recommending surgery, radiography was more sensitive (91.7% vs. 83.3%) and specific (83.3% vs. 72.2%) than using CT, but differences were not statistically significant. We reported objective CT measurements for predicting small mechanical intestinal obstruction. By incorporating these objective data, the diagnosis of mechanical intestinal obstruction changed in five of 120 instances (radiographs and CT). In no instance (0/120), did the objective data change the recommendation for surgery. Using CT or abdominal radiographs for the detection of canine mechanical intestinal obstruction is sensitive and specific when evaluated by experienced veterinary radiologists. PMID:27038072

  3. Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings

    PubMed Central

    Behboodi, Firooz; Mohtasham-Amiri, Zahra; Masjedi, Navid; Shojaie, Reza; Sadri, Peyman

    2016-01-01

    Introduction: Focused assessment with sonography for trauma (FAST) is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. Methods: The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT) scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. Results: 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male). FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9%) cases. Finally, 12 (6.6%) patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006). Higher grading of spleen (p = 0.001) and hepatic (p = 0.038) ruptures increased the probability of need for laparotomy. Conclusion: 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy. PMID:27299142

  4. Thin-Section CT Characteristics and Longitudinal CT Follow-up of Chemotherapy Induced Interstitial Pneumonitis: A Retrospective Cohort Study.

    PubMed

    Lee, Han Na; Kim, Mi Young; Koo, Hyun Jung; Kim, Sung-Soo; Yoon, Dok Hyun; Lee, Jae Cheol; Song, Jin Woo

    2016-01-01

    To describe the computed tomography (CT) features of chemotherapy-induced interstitial pneumonitis (CIIP) with longitudinal follow-up.The study was approved by the local ethics committee. One hundred consecutive patients with CIIP between May 2005 and March 2015 were retrospectively enrolled. The initial CT was reviewed by 2 independent chest radiologists and categorized into 1 of 4 CT patterns in accordance with the 2013 guidelines for idiopathic interstitial pneumonia: nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), hypersensitivity pneumonitis (HP) mimicking desquamative interstitial pneumonitis, and diffuse alveolar damage (DAD). We assessed semiquantitative analysis on a 5% scale to assess the extent of parenchymal abnormalities (emphysema, reticulation, ground-glass opacity, consolidation, honeycombing cyst) and their distribution on initial (n = 100), subsequent (n = 87), and second follow-up CT (n = 48). Interval changes in extent on follow-up CT were compared using paired t test. The clinic-radiologic factors were compared between Group 1 (NSIP and OP patterns) and Group 2 (HP and DAD patterns) using χ and independent t tests.The most common pattern of CIIP on the initial CT was HP (51%), followed by NSIP (23%), OP (20%), and DAD (6%). Diffuse ground-glass opacity was the most common pulmonary abnormality. The predominant distribution was bilateral (99%) and symmetric (82%), with no craniocaudal (60%) or axial (79%) dominance. Subsequent and second follow-up CTs showed decreased extent of total pulmonary abnormalities (P < 0.001, respectively). In comparison with Group 1 CIIP, Group 2 CIIP was more likely to be caused by molecularly targeted drugs (P = 0.030), appeared earlier (P = 0.034), and underwent more complete resolution (P < 0.001). Use of a CT pattern-recognition approach to CIIP is appropriate and practical in interpreting radiological findings. PMID:26765442

  5. Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background General anesthesia usually requires mechanical ventilation, which is traditionally accomplished with constant tidal volumes in volume- or pressure-controlled modes. Experimental studies suggest that the use of variable tidal volumes (variable ventilation) recruits lung tissue, improves pulmonary function and reduces systemic inflammatory response. However, it is currently not known whether patients undergoing open abdominal surgery might benefit from intraoperative variable ventilation. Methods/Design The PROtective VARiable ventilation trial (‘PROVAR’) is a single center, randomized controlled trial enrolling 50 patients who are planning for open abdominal surgery expected to last longer than 3 hours. PROVAR compares conventional (non-variable) lung protective ventilation (CV) with variable lung protective ventilation (VV) regarding pulmonary function and inflammatory response. The primary endpoint of the study is the forced vital capacity on the first postoperative day. Secondary endpoints include further lung function tests, plasma cytokine levels, spatial distribution of ventilation assessed by means of electrical impedance tomography and postoperative pulmonary complications. Discussion We hypothesize that VV improves lung function and reduces systemic inflammatory response compared to CV in patients receiving mechanical ventilation during general anesthesia for open abdominal surgery longer than 3 hours. PROVAR is the first randomized controlled trial aiming at intra- and postoperative effects of VV on lung function. This study may help to define the role of VV during general anesthesia requiring mechanical ventilation. Trial registration Clinicaltrials.gov NCT01683578 (registered on September 3 3012). PMID:24885921

  6. Comparison of hetastarch to albumin for perioperative bleeding in patients undergoing abdominal aortic aneurysm surgery. A prospective, randomized study.

    PubMed Central

    Gold, M S; Russo, J; Tissot, M; Weinhouse, G; Riles, T

    1990-01-01

    The effects of hetastarch and human albumin solutions on perioperative bleeding and coagulation parameters during abdominal aortic aneurysm repair were compared. In two randomized groups of 20 patients, albumin 5% (group 1) or hetastarch 6% (group 2) 1 g/kg was given during surgery. The remaining perioperative fluids consisted of lactated ringers and packed red blood cells. Perioperative coagulation measurements included partial thromboplastin time, prothrombin time, activated clotting time, platelet count, and bleeding time. Estimated blood loss and the total amount of crystalloid and blood infused were also measured. The surgeon, blind to the colloid used, subjectively rated bleeding on a scale of 1 to 10. There was no significant difference between groups for any measured parameter at any time. Measurements of coagulation function were within normal limits for both groups. Hetastarch does not cause clotting disorders in patients undergoing abdominal aortic aneurysm repair, at least if the quantities used in this study are not exceeded. PMID:1690974

  7. Relevant incidental findings at abdominal multi-detector contrast-enhanced computed tomography: A collateral screening?

    PubMed Central

    Sconfienza, Luca Maria; Mauri, Giovanni; Muzzupappa, Claudia; Poloni, Alessandro; Bandirali, Michele; Esseridou, Anastassia; Tritella, Stefania; Secchi, Francesco; Di Leo, Giovanni; Sardanelli, Francesco

    2015-01-01

    AIM: To investigate the prevalence of relevant incidental findings (RIFs) detected during routine abdominal contrast-enhanced computed tomography (CeCT). METHODS: We retrospectively evaluated the reports of a consecutive series of abdominal CeCT studies performed between January and May 2013. For each report, patients’ age and sex, admission as inpatient or outpatient, clinical suspicion as indicated by the requesting physician, availability of a previous abdominal examination, and name of the reporting radiologist were recorded. Based on the clinical suspicion, the presence and features of any RIFs (if needing additional workup) was noted. RESULTS: One thousand forty abdominal CeCT were performed in 949 patients (528 males, mean age 66 ± 14 years). No significant difference was found between inpatients and outpatients age and sex distribution (P > 0.472). RIFs were found in 195/1040 (18.8%) CeCT [inpatients = 108/470 (23.0%); outpatients = 87/570 (15.2%); P = 0.002]. RIFs were found in 30/440 (6.8%) CeCT with a previous exam and in 165/600 (27.5%) without a previous exam (P < 0.001). Radiologists’ distribution between inpatients or outpatients was significantly different (P < 0.001). RIFs prevalence increased with aging, except for a peak in 40-49 year group. Most involved organs were kidneys, gallbladder, and lungs. CONCLUSION: A RIF is detected in 1/5 patients undergoing abdominal CeCT. Risk of overdiagnosis should be taken into account. PMID:26516432

  8. Abdominal aortic stiffness as a marker of atherosclerosis in childhood-onset asthma: a case–control study

    PubMed Central

    Ülger, Zülal; Gülen, Figen; Özyürek, Ruhi Arif

    2015-01-01

    Summary Background Asthma is one of the chronic inflammatory diseases. It is known that chronic inflammation accelerates atherosclerosis. Abdominal aortic stiffness parameters can be used to detect the early development of atherosclerosis. Aim In this study, we aimed to evaluate abdominal aortic stiffness parameters in childhood-onset asthma compared with a control group. Methods In this cross-sectional, case–control study, we evaluated 50 patients with childhood-onset asthma, and 57 healthy children as controls. Patients with a diagnosis of asthma of at least three years’ duration were included in the study. Children with hypertension, hyperlipidaemia, diabetes, a history of smoking contact, or systemic disease were excluded. The study and control groups were evaluated with transthoracic echocardiography, and abdominal aorta diameters were measured. Using the measured data, abdominal aortic stiffness parameters (aortic distensibility: DIS, aortic strain: S, pressure strain elastic modulus: Ep, and pressure strain normalised by diastolic pressure: Ep*) were calculated. Statistical evaluation was done with the Student’s t-test, chisquared test and Pearson’s correlation test. Results The study group consisted of 50 children (24 female, 26 male) with asthma. According to the GINA guidelines, 26 of the patients had mild intermittant asthma, six had mild persistent asthma and 18 had intermediate persistent asthma. None of the patients had severe asthma. In 37 of the asthma patients, spIgE was positive and these patients were accepted as having atopic asthma; 27 of these patients received immunotherapy. We did not detect any differences between the study and control groups in terms of gender, age and body mass index. No differences were evident between the groups with regard to systolic and diastolic blood pressure, heart rate, blood cholesterol levels and respiratory function test parameters. There was no difference between the asthma and control groups in the

  9. Sugar-Sweetened Beverage Consumption and Risk of General and Abdominal Obesity in Iranian Adults: Tehran Lipid and Glucose Study

    PubMed Central

    MIRMIRAN, Parvin; EJTAHED, Hanieh-Sadat; BAHADORAN, Zahra; BASTAN, Sara; AZIZI, Fereidoun

    2015-01-01

    Background: General and abdominal obesity are major global health problems. This cross-sectional study was conducted to evaluate the association between consumption of sugar-sweetened beverages (SSBs) and body mass index and waist circumference status in 5852 Iranian adults within the framework of the Tehran Lipid and Glucose Study (TLGS). Methods: Intakes of SSBs including carbonated drinks and synthetic fruit juices were measured using a validated food frequency questionnaire. The association between body mass index, waist circumference and body adiposity index in each quartile category of SSB consumption were determined using the multivariable linear regression models. The odds ratio (OR) of general and abdominal obesity in each quartile of SSB consumption was also determined using the multivariable logistic regression models. Results: Mean dietary intake of SSBs was 48.9 g/d or 0.25 servings/d. After adjustment for all potential confounding variables, significant associations were observed between SSB consumption and BMI (β: 0.49, 95% CI: 0.13–0.86), and waist circumference (β: 1.28, 95% CI: 0.40–2.16) in the fourth quartile. There was no significant association between SSB consumption and body adiposity index. Participants who consumed > 57.1 g/d of SSBs had 22% higher risk of general obesity (OR: 1.22, 95% CI: 1.00–1.48) and 35% higher risk of abdominal obesity (OR: 1.35, 95% CI: 1.12–1.61), compared with those in the lowest quartile of SSB consumption. Conclusion: Higher intakes of SSBs were associated with the higher risk of general and abdominal obesity in adults suggesting that limiting the consumption of SSBs may be a practical approach to prevent and manage obesity. PMID:26744712

  10. Smoking status and abdominal obesity among normal- and overweight/obese adults: Population-based FINRISK study.

    PubMed

    Tuovinen, Eeva-Liisa; Saarni, Suoma E; Männistö, Satu; Borodulin, Katja; Patja, Kristiina; Kinnunen, Taru H; Kaprio, Jaakko; Korhonen, Tellervo

    2016-12-01

    Several studies have reported direct associations of smoking with body mass index (BMI) and abdominal obesity. However, the interplay between them is poorly understood. Our first aim was to investigate the interaction between smoking status and BMI on abdominal obesity (waist circumference, WC). Our second aim was to examine how the association of smoking status with WC varies among normal and overweight/obese men and women. We examined 5833 participants from the National FINRISK 2007 Study. The interactions between smoking and BMI on WC were analyzed. Participants were categorized into eight groups according to BMI (normal weight vs. overweight/obese) and smoking status (never smoker, ex-smoker, occasional/light/moderate daily smoker, heavy daily smoker). The associations between each BMI/smoking status -group and WC were analyzed by multiple regressions, the normal-weight never smokers as the reference group. The smoking status by BMI-interaction on WC was significant for women, but not for men. Among the overweight/obese women, ex-smokers (β = 2.73; 1.99, 3.46) and heavy daily smokers (β = 4.90; 3.35, 6.44) had the highest estimates for WC when adjusted for age, BMI, alcohol consumption and physical activity. In comparison to never smoking overweight/obese women, the β-coefficients of ex-smokers and heavy daily smokers were significantly higher. Among men and normal weight women the β -coefficients did not significantly differ by smoking status. An interaction between smoking status and BMI on abdominal obesity was observed in women: overweight/obese heavy daily smokers were particularly vulnerable for abdominal obesity. This risk group should be targeted for cardiovascular disease prevention. PMID:27486563

  11. Imaging of abdominal aortic aneurysms.

    PubMed

    Sparks, Amy R; Johnson, Philip L; Meyer, Mark C

    2002-04-15

    Given the high rate of morbidity and mortality associated with abdominal aortic aneurysms (AAAs), accurate diagnosis and preoperative evaluation are essential for improved patient outcomes. Ultrasonography is the standard method of screening and monitoring AAAs that have not ruptured. In the past, aortography was commonly used for preoperative planning in the repair of AAAs. More recently, computed tomography (CT) has largely replaced older, more invasive methods. Recent advances in CT imaging technology, such as helical CT and CT angiography, offer significant advantages over traditional CT. These methods allow for more rapid scans and can produce three-dimensional images of the AAA and important adjacent vascular structures. Use of endovascular stent grafts has increased recently and is less invasive for the repair of AAAs in selected cases. Aortography and CT angiography can precisely determine the size and surrounding anatomy of the AAA to identify appropriate candidates for the use of endovascular stent grafts. Helical CT and CT angiography represent an exciting future in the preoperative evaluation of AAAs. However, this technology is not the standard of care because of the lack of widespread availability, the cost associated with obtaining new equipment, and the lack of universal protocols necessary for acquisition and reconstruction of these images. PMID:11989632

  12. Four- and Eight-Channel Aortoiliac CT Angiography: A Comparative Study

    SciTech Connect

    Karcaaltincaba, Musturay Foley, Dennis

    2005-04-15

    Purpose. To compare performance parameters, contrast material load and radiation dose in a patient cohort having aortoiliac CT angiography using 4- and 8-channel multidetector CT (MDCT) systems. Methods. Eighteen patients with abdominal aortic aneurysms underwent initial 4-channel and follow-up 8-channel MDCT angiography. Both the 4- and 8-channel MDCT systems utilized a matrix detector of 16 x 1.25 mm rows. Scan coverage included the abdominal aorta and iliac arteries to the level of the proximal femoral arteries. For 4-channel MDCT, nominal slice thickness and beam pitch were 1.25 mm and 1.5, respectively, and for 8-channel MDCT they were 1.25 mm and 1.35 or 1.65 respectively. Scan duration, iodinated contrast material load and mean aortoiliac attenuation were compared retrospectively. Comparative radiation dose measurements for 4- and 8-channel MDCT were obtained using a multiple scan average dose technique on an abdominal phantom. Results. Compared with 4-channel MDCT, 8-channel MDCT aortoiliac angiography was performed with equivalent collimation, decreased contrast load (mean 45% decrease: 144 ml versus 83 ml of 300 mg iodine/ml contrast material) and decreased acquisition time (mean 51% shorter: 34.4 sec versus 16.9 sec) without a significant change in mean aortic enhancement (299 HU versus 300 HU, p > 0.05). Radiation dose was 2 rad for the 4-channel system and 2/1.5 rad for the 8-channel system at 1.35/1.65 pitch respectively. Conclusion. Compared with 4-channel MDCT, aortoiliac CT angiography with 8-channel MDCT produces equivalent z-axis resolution with decreased contrast load and acquisition time without increased radiation exposure.

  13. Comparison of spirometry and abdominal height as four-dimensional computed tomography metrics in lung

    SciTech Connect

    Lu Wei; Low, Daniel A.; Parikh, Parag J.; Nystrom, Michelle M.; El Naqa, Issam M.; Wahab, Sasha H.; Handoko, Maureen; Fooshee, David; Bradley, Jeffrey D.

    2005-07-15

    An important consideration in four-dimensional CT scanning is the selection of a breathing metric for sorting the CT data and modeling internal motion. This study compared two noninvasive breathing metrics, spirometry and abdominal height, against internal air content, used as a surrogate for internal motion. Both metrics were shown to be accurate, but the spirometry showed a stronger and more reproducible relationship than the abdominal height in the lung. The abdominal height was known to be affected by sensor placement and patient positioning while the spirometer exhibited signal drift. By combining these two, a normalization of the drift-free metric to tidal volume may be generated and the overall metric precision may be improved.

  14. Benefits of immediate jejunostomy feeding after major abdominal trauma--a prospective, randomized study.

    PubMed

    Moore, E E; Jones, T N

    1986-10-01

    Benefits of immediate postinjury nutritional support remain ill defined. Seventy-five consecutive patients undergoing emergent celiotomy with an abdominal trauma index (A.T.I.) greater than 15 were randomized prospectively to a control group (no supplemental nutrition during first 5 days) or enteral-fed group. The enteral patients had a needle catheter jejunostomy (N.C.J.) placed at laparotomy with the constant infusion of an elemental diet (Vivonex HN) begun at 18 hours and advanced to 3,000 ml/day (3,000 kcal, 20 gm N2) within 72 hours. Control and enteral-fed groups were comparable with respect to demographic features, trauma mechanism, shock, colon injury, splenectomy, A.T.I., and initial nutritional assessment. Twenty (63%) of the enteral patients were maintained on the elemental diet greater than 5 days; four (12%) needed total parenteral nutrition (T.P.N.). Nine (29%) of the control patients required T.P.N. Nitrogen balance was markedly improved (p less than 0.001) in the enteral-fed group. Although visceral protein markers and overall complication rate were not significantly different, septic morbidity was greater (p less than 0.025) in the control group (abdominal infection in seven and pneumonia in two) compared to the enteral-fed patients (abdominal abscess in three). Analysis of patients with A.T.I. 15-40 disclosed sepsis in seven (26%) of the control versus one (4%) of the enteral-fed group (p less than 0.01). Our clinical experience demonstrates the feasibility of immediate postoperative enteral feeding via N.C.J. after major abdominal trauma, and suggests this early nutrition reduces septic complications in critically injured patients. PMID:3095557

  15. The effect of a low radiation CT protocol on accuracy of CT guided implant migration measurement: A cadaver study.

    PubMed

    Boettner, Friedrich; Sculco, Peter K; Lipman, Joseph; Saboeiro, Gregory; Renner, Lisa; Faschingbauer, Martin

    2016-04-01

    The current study compared the impact of low radiation CT protocols on the accuracy, repeatability, and inter- and intra-observer variability of implant migration studies in total hip arthroplasty. Two total hip replacements were performed in two human cadavers and six tantalum beads were inserted into the femur similar to radiostereometric analysis. Six different 28 mm heads (-3 mm, 0 mm, 2.5 mm, 5.0 mm, 7.5 mm, and 10 mm) were added to simulate five reproducible translations (maximum total point migration) of the center of the head. Three CT scans with varying levels of radiation were performed for each head position. The effective dose (mSv) was 3.8 mSv for Protocol A (standard protocol), 0.7 mSv for Protocol B and 1.6 mSv for Protocol C. Implant migration was measured in a 3-D analysis software (Geomagic Studio 7). The accuracy was 0.16 mm for CT Protocol A, 0.13 mm for Protocol B and 0.14 mm for Protocol C; The repeatability was 0.22 mm for CT Protocol A, 0.18 mm for Protocol B and 0.20 mm for Protocol C; ICC for inter observer reliability was 0.89, intra observer reliability was 0.95. The difference in accuracy between standard protocol A and the two low radiation protocols (B, C) was less than 0.05 mm. The accuracy, inter- and intra-observer reliability of all three CT protocols is comparable to radiostereometric analysis. Reducing the CT radiation exposure to numbers similar to an AP Pelvis radiograph (0.7 mSv protocol B) does not affect the accuracy of implant migration measurements. PMID:26425921

  16. The relationship between job enrichment and abdominal obesity: a longitudinal field study of apparently healthy individuals.

    PubMed

    Fried, Yitzhak; Laurence, Gregory A; Shirom, Arie; Melamed, Samuel; Toker, Sharon; Berliner, Shlomo; Shapira, Itzhak

    2013-10-01

    Obesity has become an epidemic in modern society. However, there is a paucity of research about how job context affects obesity. To enhance our knowledge we used a large, heterogeneous sample of apparently healthy employees (n = 1,949) across two time periods with an average of close to 3.5 years between measures. We tested a hypothesized curvilinear effect of job enrichment on changes in two stress related indicators of abdominal obesity over time: waist circumference (WC) and waist-hip ratio (WHR). Job enrichment consisted of the job dimensions of variety, identity, significance, autonomy, and feedback, and in our analysis we controlled for demographics and health related behaviors, including weekly sports activity, number of cigarettes smoked per day, and weekly alcohol consumption. The results supported the hypothesized U-shaped relationship between job enrichment and changes in both indicators of abdominal obesity over time, such that the level of abdominal obesity was reduced when job enrichment was moderate and was increased when job enrichment was either high or low. As expected, no such association was observed for the general obesity measure of body mass index (BMI). We discuss the theoretical and practical implications of these results. PMID:24001329

  17. Association of Abdominal Obesity with Lumbar Disc Degeneration – A Magnetic Resonance Imaging Study

    PubMed Central

    Takatalo, Jani; Karppinen, Jaro; Taimela, Simo; Niinimäki, Jaakko; Laitinen, Jaana; Sequeiros, Roberto Blanco; Samartzis, Dino; Korpelainen, Raija; Näyhä, Simo; Remes, Jouko; Tervonen, Osmo

    2013-01-01

    Purpose To evaluate whether midsagittal (abdominal) obesity in magnetic resonance imaging (MRI), waist circumference (WC) and body fat percentage are associated with lumbar disc degeneration in early adulthood. Methods We obtained the lumbar MRI (1.5-T scanner) of 325 females and 233 males at a mean age of 21 years. Lumbar disc degeneration was evaluated using Pfirrmann classification. We analysed the associations of MRI measures of obesity (abdominal diameter (AD), sagittal diameter (SAD), ventral subcutaneous thickness (VST), and dorsal subcutaneous thickness (DST)), WC and body fat percentage with disc degeneration sum scores using ordinal logistic regression. Results A total of 155 (48%) females and 147 (63%) males had disc degeneration. AD and SAD were associated with a disc degeneration sum score of ≥3 compared to disc degeneration sum score of 0–2 (OR 1.67; 95% confidence interval (CI) 1.20–2.33 and OR 1.40; 95% CI 1.12–1.75, respectively) among males, but we found no association among females. WC was also associated with disc degeneration among males (OR 1.03 per one cm; 95% CI 1.00–1.05), but not among females. Conclusion Measures of abdominal obesity in MRI and waist circumference were associated with disc degeneration among 21-year-old males. PMID:23418543

  18. Teaching Cost-Conscious Medicine: Impact of a Simple Educational Intervention on Appropriate Abdominal Imaging at a Community-Based Teaching Hospital

    PubMed Central

    Covington, Matthew F.; Agan, Donna L.; Liu, Yang; Johnson, John O.; Shaw, David J.

    2013-01-01

    Background Rising costs pose a major threat to US health care. Residency programs are being asked to teach residents how to provide cost-conscious medical care. Methods An educational intervention incorporating the American College of Radiology appropriateness criteria with lectures on cost-consciousness and on the actual hospital charges for abdominal imaging was implemented for residents at Scripps Mercy Hospital in San Diego, CA. We hypothesized that residents would order fewer abdominal imaging examinations for patients with complaints of abdominal pain after the intervention. We analyzed the type and number of abdominal imaging studies completed for patients admitted to the inpatient teaching service with primary abdominal complaints for 18 months before (738 patients) and 12 months following the intervention (632 patients). Results There was a significant reduction in mean abdominal computed tomography (CT) scans per patient (1.7–1.4 studies per patient, P < .001) and total abdominal radiology studies per patient (3.1–2.7 studies per patient, P  =  .02) following the intervention. The avoidance of charges solely due to the reduction in abdominal CT scans following the intervention was $129 per patient or $81,528 in total. Conclusions A simple educational intervention appeared to change the radiologic test-ordering behavior of internal medicine residents. Widespread adoption of similar interventions by residency programs could result in significant savings for the health care system. PMID:24404274

  19. Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

    PubMed Central

    Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

    2016-01-01

    Objectives To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. Setting A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Participants Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants. Main outcome measures For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. Results In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). Conclusions ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. PMID:27279477

  20. Texture analysis improves level set segmentation of the anterior abdominal wall

    SciTech Connect

    Xu, Zhoubing; Allen, Wade M.; Baucom, Rebeccah B.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-12-15

    Purpose: The treatment of ventral hernias (VH) has been a challenging problem for medical care. Repair of these hernias is fraught with failure; recurrence rates ranging from 24% to 43% have been reported, even with the use of biocompatible mesh. Currently, computed tomography (CT) is used to guide intervention through expert, but qualitative, clinical judgments, notably, quantitative metrics based on image-processing are not used. The authors propose that image segmentation methods to capture the three-dimensional structure of the abdominal wall and its abnormalities will provide a foundation on which to measure geometric properties of hernias and surrounding tissues and, therefore, to optimize intervention.Methods: In this study with 20 clinically acquired CT scans on postoperative patients, the authors demonstrated a novel approach to geometric classification of the abdominal. The authors’ approach uses a texture analysis based on Gabor filters to extract feature vectors and follows a fuzzy c-means clustering method to estimate voxelwise probability memberships for eight clusters. The memberships estimated from the texture analysis are helpful to identify anatomical structures with inhomogeneous intensities. The membership was used to guide the level set evolution, as well as to derive an initial start close to the abdominal wall.Results: Segmentation results on abdominal walls were both quantitatively and qualitatively validated with surface errors based on manually labeled ground truth. Using texture, mean surface errors for the outer surface of the abdominal wall were less than 2 mm, with 91% of the outer surface less than 5 mm away from the manual tracings; errors were significantly greater (2–5 mm) for methods that did not use the texture.Conclusions: The authors’ approach establishes a baseline for characterizing the abdominal wall for improving VH care. Inherent texture patterns in CT scans are helpful to the tissue classification, and texture

  1. A clinical pilot study of a modular video-CT augmentation system for image-guided skull base surgery

    NASA Astrophysics Data System (ADS)

    Liu, Wen P.; Mirota, Daniel J.; Uneri, Ali; Otake, Yoshito; Hager, Gregory; Reh, Douglas D.; Ishii, Masaru; Gallia, Gary L.; Siewerdsen, Jeffrey H.

    2012-02-01

    Augmentation of endoscopic video with preoperative or intraoperative image data [e.g., planning data and/or anatomical segmentations defined in computed tomography (CT) and magnetic resonance (MR)], can improve navigation, spatial orientation, confidence, and tissue resection in skull base surgery, especially with respect to critical neurovascular structures that may be difficult to visualize in the video scene. This paper presents the engineering and evaluation of a video augmentation system for endoscopic skull base surgery translated to use in a clinical study. Extension of previous research yielded a practical system with a modular design that can be applied to other endoscopic surgeries, including orthopedic, abdominal, and thoracic procedures. A clinical pilot study is underway to assess feasibility and benefit to surgical performance by overlaying CT or MR planning data in realtime, high-definition endoscopic video. Preoperative planning included segmentation of the carotid arteries, optic nerves, and surgical target volume (e.g., tumor). An automated camera calibration process was developed that demonstrates mean re-projection accuracy (0.7+/-0.3) pixels and mean target registration error of (2.3+/-1.5) mm. An IRB-approved clinical study involving fifteen patients undergoing skull base tumor surgery is underway in which each surgery includes the experimental video-CT system deployed in parallel to the standard-of-care (unaugmented) video display. Questionnaires distributed to one neurosurgeon and two otolaryngologists are used to assess primary outcome measures regarding the benefit to surgical confidence in localizing critical structures and targets by means of video overlay during surgical approach, resection, and reconstruction.

  2. The role of computed tomography in evaluating body composition and the influence of reduced muscle mass on clinical outcome in abdominal malignancy: a systematic review.

    PubMed

    Gibson, D J; Burden, S T; Strauss, B J; Todd, C; Lal, S

    2015-10-01

    It is estimated that there were 3.45 million new cases and 1.75 million deaths from cancer in Europe in 2012. Colorectal cancer was one of the most common cancers, accounting for 13% of new cases and 12.2% of all deaths. Conditions causing reduced muscle mass, such as sarcopenia, can increase the morbidity and mortality of people with cancer. Computed tomography (CT) scans can provide accurate, high-quality information on body composition, including muscle mass. To date, there has been no systematic review on the role of CT scans in identifying sarcopenia in abdominal cancer. This review aimed to examine the role of CT scans in determining the influence of reduced muscle mass on clinical outcome in abdominal cancer. A systematic review of English-language articles published in 2000 or later was conducted. Articles included cohort, randomised controlled trials and validation studies. Participants were people diagnosed with abdominal cancer who had undergone a CT scan. Data extraction and critical appraisal were undertaken. Ten cohort studies met the inclusion criteria. Seven studies demonstrated that low muscle mass was significantly associated with poor clinical outcome, with six specifically demonstrating reduced survival rates. Eight studies demonstrated that a greater number of patients (27.3-66.7%) were identified as sarcopenic using CT scans compared with numbers identified as malnourished using body mass index. CT scans can identify reduced muscle mass and predict negative cancer outcomes in people with abdominal malignancies, where traditional methods of assessment are less effective. PMID:25782424

  3. Dual resolution cone beam breast CT: A feasibility study

    PubMed Central

    Chen, Lingyun; Shen, Youtao; Lai, Chao-Jen; Han, Tao; Zhong, Yuncheng; Ge, Shuaiping; Liu, Xinming; Wang, Tianpeng; Yang, Wei T.; Whitman, Gary J.; Shaw, Chris C.

    2009-01-01

    Purpose: In this study, the authors investigated the feasibility of a dual resolution volume-of-interest (VOI) cone beam breast CT technique and compared two implementation approaches in terms of dose saving and scatter reduction. Methods: With this technique, a lead VOI mask with an opening is inserted between the x-ray source and the breast to deliver x-ray exposure to the VOI while blocking x rays outside the VOI. A CCD detector is used to collect the high resolution projection data of the VOI. Low resolution cone beam CT (CBCT) images of the entire breast, acquired with a flat panel (FP) detector, were used to calculate the projection data outside the VOI with the ray-tracing reprojection method. The Feldkamp–Davis–Kress filtered backprojection algorithm was used to reconstruct the dual resolution 3D images. Breast phantoms with 180 μm and smaller microcalcifications (MCs) were imaged with both FP and FP-CCD dual resolution CBCT systems, respectively. Two approaches of implementing the dual resolution technique, breast-centered approach and VOI-centered approach, were investigated and evaluated for dose saving and scatter reduction with Monte Carlo simulation using a GEANT4 package. Results: The results showed that the breast-centered approach saved more breast absorbed dose than did VOI-centered approach with similar scatter reduction. The MCs in fatty breast phantom, which were invisible with FP CBCT scan, became visible with the FP-CCD dual resolution CBCT scan. Conclusions: These results indicate potential improvement of the image quality inside the VOI with reduced breast dose both inside and outside the VOI. PMID:19810473

  4. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  5. Assessment of thermal sensitivity of CT during heating of liver: an ex vivo study

    PubMed Central

    Pandeya, G D; Greuter, M J W; Schmidt, B; Flohr, T; Oudkerk, M

    2012-01-01

    Objectives The purpose of this study was to assess the thermal sensitivity of CT during heating of ex-vivo animal liver. Methods Pig liver was indirectly heated from 20 to 90 °C by passage of hot air through a plastic tube. The temperature in the heated liver was measured using calibrated thermocouples. In addition, image acquisition was performed with a multislice CT scanner before and during heating of the liver sample. The reconstructed CT images were then analysed to assess the change of CT number as a function of temperature. Results During heating, a decrease in CT numbers was observed as a hypodense area on the CT images. In addition, the hypodense area extended outward from the heat source during heating. The analysis showed a linear decrease of CT number as a function of temperature. From this relationship, we derived a thermal sensitivity of CT for pig liver tissue of −0.54±0.03 HU °C−1 with an r2 value of 0.91. Conclusions The assessment of the thermal sensitivity of CT in ex-vivo pig liver tissue showed a linear dependency on temperature ≤90 °C. This result may be beneficial for the application of isotherms or thermal maps in CT images of liver tissue. PMID:22919016

  6. The effects of respiration motion in PET/CT studies

    NASA Astrophysics Data System (ADS)

    Wan, Lu; Wu, Zhijian; Zhou, Fengyin; Ye, Sheng; Zeng, Shaoqun; Kao, Chien-Min; Chen, Chin-Tu; Zhang, Yongxue; Xie, Qingguo

    2008-03-01

    In recent years, the clinical status of positron emission tomography(PET)/computed tomography(CT) in achieving more accurate staging of lung cancer has been established and the technology has been enthusiastically accepted by the medical community. However, its capability in chest imaging is still limited by several physical factors. As a result of typical PET/CT imaging protocol, respiration-averaged PET data and free of respiration-averaged CT data are collected in a PET/CT scanning. In this work, we investigate the effects of respiration motion. We employ mathematical and Monte-Carlo simulations for generating PET/CT data. We scale a Zubal phantom to generate 30 phantoms having various sizes in order to represent different torso anatomic states during respiration. Images reconstructed from selected scaling PET data using the respective scaling PET attenuation maps serve as baseline results. PET/CT imaging protocol is simulated by reconstruction from respiration-averaged PET data with the selected PET attenuation maps. We also reconstruct PET images from respiratory-averaged PET data with respiration-averaged PET attenuation maps, which simulates conventional PET imaging protocol. We will compare the resulting images reconstructed from the above-mentioned approaches to evaluate the effects of respiration motion in PET/CT.

  7. Structure and Protein-Protein Interaction Studies on Chlamydia trachomatis Protein CT670 (YscO Homolog)

    SciTech Connect

    Lorenzini, Emily; Singer, Alexander; Singh, Bhag; Lam, Robert; Skarina, Tatiana; Chirgadze, Nickolay Y.; Savchenko, Alexei; Gupta, Radhey S.

    2010-07-28

    Comparative genomic studies have identified many proteins that are found only in various Chlamydiae species and exhibit no significant sequence similarity to any protein in organisms that do not belong to this group. The CT670 protein of Chlamydia trachomatis is one of the proteins whose genes are in one of the type III secretion gene clusters but whose cellular functions are not known. CT670 shares several characteristics with the YscO protein of Yersinia pestis, including the neighboring genes, size, charge, and secondary structure, but the structures and/or functions of these proteins remain to be determined. Although a BLAST search with CT670 did not identify YscO as a related protein, our analysis indicated that these two proteins exhibit significant sequence similarity. In this paper, we report that the CT670 crystal, solved at a resolution of 2 {angstrom}, consists of a single coiled coil containing just two long helices. Gel filtration and analytical ultracentrifugation studies showed that in solution CT670 exists in both monomeric and dimeric forms and that the monomer predominates at lower protein concentrations. We examined the interaction of CT670 with many type III secretion system-related proteins (viz., CT091, CT665, CT666, CT667, CT668, CT669, CT671, CT672, and CT673) by performing bacterial two-hybrid assays. In these experiments, CT670 was found to interact only with the CT671 protein (YscP homolog), whose gene is immediately downstream of ct670. A specific interaction between CT670 and CT671 was also observed when affinity chromatography pull-down experiments were performed. These results suggest that CT670 and CT671 are putative homologs of the YcoO and YscP proteins, respectively, and that they likely form a chaperone-effector pair.

  8. Unenhanced Computed Tomography to Visualize Hollow Viscera and/or Mesenteric Injury After Blunt Abdominal Trauma

    PubMed Central

    Yang, Xu-Yang; Wei, Ming-Tian; Jin, Cheng-Wu; Wang, Meng; Wang, Zi-Qiang

    2016-01-01

    Abstract To identify and describe the major features of unenhanced computed tomography (CT) images of blunt hollow viscera and/or mesenteric injury (BHVI/MI) and to determine the value of unenhanced CT in the diagnosis of BHVI/MI. This retrospective study included 151 patients who underwent unenhanced CT before laparotomy for blunt abdominal trauma between January 2011 and December 2013. According to surgical observations, patients were classified as having BHVI/MI (n = 73) or not (n = 78). Sensitivity, specificity, P values, and likelihood ratios were calculated by comparing CT findings between the 2 groups. Six significant CT findings (P < 0.05) for BHVI/MI were identified and their sensitivity and specificity values determined, as follows: bowel wall thickening (39.7%, 96.2%), mesentery thickening (46.6%, 88.5%), mesenteric fat infiltration (12.3%, 98.7%), peritoneal fat infiltration (31.5%, 87.1%), parietal peritoneum thickening (30.1%, 85.9%), and intra- or retro-peritoneal air (34.2%, 96.2%). Unenhanced CT scan was useful as an initial assessment tool for BHVI/MI after blunt abdominal trauma. Six key features on CT were correlated with BHVI/MI. PMID:26945375

  9. Layer-dependent wall properties of abdominal aortic aneurysms: Experimental study and material characterization.

    PubMed

    Sassani, Sophia G; Kakisis, John; Tsangaris, Sokrates; Sokolis, Dimitrios P

    2015-09-01

    Mechanical testing and in-depth characterization of the abdominal aortic aneurysm wall from fifteen patients undergoing open surgery was performed to establish the layer-dependent tissue properties that are non-available in the literature. Quantitative microscopic evaluation was performed to identify the spatial organization of collagen-fiber network. Among a number of candidate models, the four-fiber family (microstructure-motivated) model, especially that including dispersions of fiber angles about the main directions, was superior to the Fung- and Gasser-type models in the fitting quality allowed, though it presented a practical difficulty in parameter estimation, so that an analysis was conducted aiding the identification of a more specific diagonal- and circumferential-fiber family model for all three layers. The adventitia was stiffer and stronger than the other layers, owing to its increased collagen content, and its contribution to the response of the intact wall was augmented being under greater residual tension than the media, whereas the intima was under residual compression. All layers were stiffer circumferentially than longitudinally, due to preferential collagen arrangement along that axis. The histologically-guided material characterization of layered wall presented herein is expected to assist clinical decision, by developing reliable criteria to predict the rupture risk of abdominal aortic aneurysms, and optimize endovascular interventions. PMID:26011656

  10. Diagnosis of abdominal abscesses in patients with major trauma: the use of computed tomography

    SciTech Connect

    Whitley, N.O.; Shatney, C.H.

    1983-04-01

    The usefulness of computed tomography (CT) in diagnosing abdominal abscesses was evaluated prospectively in 69 septic patients who had suffered massive trauma. For the 82 abdominal CT scans obtained, the accuracy rate was 84%, the sensitivity was 92%, and the specificity was 79%. With the use of abdominal CT, 32 patients were spared a ''blind'' laparotomy in the search for the focus of infection. It is concluded that CT is of significant value in the diagnosis of abdominal abscess in the septic trauma patient.

  11. Comparison Between Intraperitoneal and Intravenous Lidocaine for Postoperative Analgesia After Elective Abdominal Hysterectomy, a Double-Blind Placebo Controlled Study

    PubMed Central

    Samimi, Saghar; Taheri, Arman; Davari Tanha, Fatemeh

    2015-01-01

    Objective: To compare the efficacy of intravenous and intraperitoneal injection of lidocaine and normal saline in relieving postoperative pain after elective abdominal hysterectomy. Materials and methods: For this double-blind randomized controlled study 109 patients undergoing elective abdominal hysterectomy were randomly allocated to three groups :1) IV group (intravenous injection group) received intravenous lidocaine %2 bolus 1.5mg/kg 30 min before incision and then a continuous lidocaine infusion of 2mg/kg and before the wound closure an intraperitoneal injection of N/S , 2) IP group (intraperitoneal group) received intravenous N/S and intraperitoneal lidocaine 3mg/kg , 3) P group (placebo, N/S) received both intravenous and intraperitoneal N/S. The pain scores (VAS) at rest, total morphine consumption , the time to first need for rescue analgesic ,incidence of lidocaine related adverse effects and nausea and vomiting were recorded at 0,2,4,8,12 and 24 hrs postoperatively. Results: The VAS scores were significantly lower in IP and IV groups compared with placebo (p = 0.001). Total consumption of morphine (p = 0.001) and time to firs request of recue analgesic (p = 0.001) were lower too in IP and IV groups.Incidence of vomiting was comparable between groups (p < 0.05) but nausea was higher in control group (p > 0.05).There were not notable lidocaine-related adverse effects. IP and IV groups were not statistically different for all investigated variables. Conclusion: This study showed lidocaine administration both intravenously and intraperitoneally are effective in reducing the postoperative pain and also have opioid sparing effect and can be safely used in elective abdominal hysterectomy without any major adverse effects. PMID:27047566

  12. Quantitative cone-beam CT imaging in radiation therapy using planning CT as a prior: First patient studies

    SciTech Connect

    Niu Tianye; Al-Basheer, Ahmad; Zhu Lei

    2012-04-15

    the optional iterations and the gas pocket and couch matching. The image correction on the second patient is more challenging due to the effects of gas pockets and attenuating couch. The improved framework with all new components is used to fully evaluate the correction performance. The enhanced image quality has been evaluated using mean CT number and spatial nonuniformity (SNU) error as well as contrast improvement factor. If the pCT image is considered as the ground truth, on the four patients, the overall mean CT number error is reduced from over 300 HU to below 16 HU in the selected regions of interest (ROIs), and the SNU error is suppressed from over 18% to below 2%. The average soft-tissue contrast is improved by an average factor of 2.6. Conclusions: We further improve our pCT-based CBCT correction algorithm for clinical use. Superior correction performance has been demonstrated on four patient studies. By providing quantitative CBCT images, our approach significantly increases the accuracy of advanced CBCT-based clinical applications for IGRT.

  13. The role of routine post-natal abdominal ultrasound for newborns in a resource-poor setting: a longitudinal study

    PubMed Central

    2011-01-01

    Background- Neonatal abdominal ultrasound is usually performed in Nigeria to investigate neonatal symptoms rather than as a follow up to evaluate fetal abnormalities which were detected on prenatal ultrasound. The role of routine obstetric ultrasonography in the monitoring of pregnancy and identification of fetal malformations has partly contributed to lowering of fetal mortality rates. In Nigeria which has a high maternal and fetal mortality rate, many pregnant women do not have ante-natal care and not infrequently, women also deliver their babies at home and only bring the newborns to the clinics for immunization. Even when performed, most routine obstetric scans are not targeted towards the detection of fetal abnormalities. The aim of the present study is to evaluate the benefit of routinely performing abdominal scans on newborns with a view to detecting possible abnormalities which may have been missed ante-natally. Methods- This was a longitudinal study of 202 consecutive, apparently normal newborns. Routine clinical examination and abdominal ultrasound scans were performed on the babies by their mother's bedside, before discharge. Neonates with abnormal initial scans had follow-up scans. Results- There were 108 males and 94 females. There were 12 (5.9%) abnormal scans seen in five male and seven female neonates. Eleven of the twelve abnormalities were in the kidneys, six on the left and five on the right. Three of the four major renal anomalies- absent kidney, ectopic/pelvic kidney and two cases of severe hydronephrosis were however on the left side. There was one suprarenal abnormality on the right suspected to be a possible infected adrenal haemorrage. Nine of the abnormal cases reported for follow- up and of these, two cases had persistent severe abnormalities. Conclusions- This study demonstrated a 5.9% incidence of genito urinary anomalies on routine neonatal abdominal ultrasound in this small population. Routine obstetric USS is very useful but

  14. Takeaway food consumption and its associations with diet quality and abdominal obesity: a cross-sectional study of young adults

    PubMed Central

    Smith, Kylie J; McNaughton, Sarah A; Gall, Seana L; Blizzard, Leigh; Dwyer, Terence; Venn, Alison J

    2009-01-01

    Background Few studies have investigated the associations of takeaway food consumption with overall diet quality and abdominal obesity. Young adults are high consumers of takeaway food so we aimed to examine these associations in a national study of young Australian adults. Methods A national sample of 1,277 men and 1,585 women aged 26–36 completed a self-administered questionnaire on demographic and lifestyle factors, a 127 item food frequency questionnaire, usual daily frequency of fruit and vegetable consumption and usual weekly frequency of takeaway food consumption. Dietary intake was compared with the dietary recommendations from the Australian Guide to Healthy Eating. Waist circumference was measured for 1,065 men and 1,129 women. Moderate abdominal obesity was defined as ≥ 94 cm for men and ≥ 80 cm for women. Prevalence ratios (PR) were calculated using log binomial regression. Takeaway food consumption was dichotomised, with once a week or less as the reference group. Results Consumption of takeaway food twice a week or more was reported by more men (37.9%) than women (17.7%, P < 0.001). Compared with those eating takeaway once a week or less, men eating takeaway twice a week or more were significantly more likely to be single, younger, current smokers and spend more time watching TV and sitting, whereas women were more likely to be in the workforce and spend more time watching TV and sitting. Participants eating takeaway food at least twice a week were less likely (P < 0.05) to meet the dietary recommendation for vegetables, fruit, dairy, extra foods, breads and cereals (men only), lean meat and alternatives (women only) and overall met significantly fewer dietary recommendations (P < 0.001). After adjusting for confounding variables (age, leisure time physical activity, TV viewing and employment status), consuming takeaway food twice a week or more was associated with a 31% higher prevalence of moderate abdominal obesity in men (PR: 1.31; 95% CI: 1

  15. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study.

    PubMed

    López-Sobaler, Ana M; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18-64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415-2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045-1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m(2), WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m(2), WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future. PMID:27382572

  16. Ultrasonography and computed tomography of inflammatory abdominal wall lesions

    SciTech Connect

    Yeh, H.C.; Rabinowitz, J.G.

    1982-09-01

    Twenty-four patients with inflammatory lesions of the abdominal wall were examined by ultrasonography. Nine of these patients underwent computed tomographic (CT) scanning as well. Both ultrasonography and CT clearly delineated the exact location and extent of abdominal wall abscesses. Abscesses were easily differentiated from cellulitis or phlegmon with ultrasound. The peritoneal line was more clearly delineated on ultrasonograms than on CT scans; abscesses were also more distinct on the ultrasonograms because of their low echogenicity compared with the surrounding structures. Gas bubbles, fat density with specific low attenuation values, and underlying inflamed bowel loops in obese patients with Crohn's disease were better delineated by CT.

  17. A study of abdominal ultrasound therapy combined with complex exercise for effective obesity management among shift work employees

    PubMed Central

    Kim, Jin-Seop; Lee, Dong-Jin; Lee, Yeon-Seop; Lee, Byoung-Kwon

    2015-01-01

    [Purpose] This study aimed to examine the effects of abdominal ultrasound accompanied by complex exercise in shift work employees working in industry. [Subjects and Methods] Thirty shift work employees were randomly assigned to either a complex exercise group (control group) or a complex exercise and ultrasound treatment group (experimental group). The control group carried out complex exercise five times per week for 4 weeks, while the experimental group performed complex exercise twice per week and received deep ultrasound three times per week for 4 weeks. [Results] The results showed that there were no significant differences in body composition between the two groups. There were significant changes in weight, lean body mass, body fat mass, and body mass index in the control group; meanwhile, significant changes in weight and body fat mass were observed in the experimental group. There were no significant differences in blood lipids between the two groups. There was a significant decrease in high-density lipoprotein cholesterol (HDL-C) in the control group; furthermore, a significant decrease in total cholesterol was observed in the experimental group, along with significant increases in HDL-C and low-density lipoprotein cholesterol. [Conclusion] According to the results of this study concerning short-term obesity management programs, complex exercise was effective for improving of body composition and weight loss, while complex exercise combined with abdominal ultrasound had a good effect on blood lipids and secondary complication prevention. PMID:25642080

  18. Comparison of spectral CT imaging methods based a photon-counting detector: Experimental study

    NASA Astrophysics Data System (ADS)

    Lee, Youngjin; Lee, Seungwan; Kim, Hee-Joung

    2016-04-01

    Photon-counting detectors allow spectral computed tomography (CT) imaging using energy-resolved information from a polychromatic X-ray spectrum. The spectral CT images based on the photon-counting detectors are dependent on the energy ranges defined by energy bins for image acquisition. In this study, K-edge and energy weighting imaging methods were experimentally implemented by using a spectral CT system with a cadmium zinc telluride (CZT)-based photon-counting detector. The spectral CT images were obtained by various energy bins and compared in terms of CNR improvement for investigating the effect of energy bins and the efficiency of the spectral CT imaging methods. The results showed that the spectral CT image quality was improved by using the particular energy bins, which were optimized for each spectral CT imaging method and target material. The CNR improvement was different for the spectral CT imaging methods and target materials. It can be concluded that an appropriate selection of imaging method for each target material and the optimization of energy bin can maximize the quality of spectral CT images.

  19. Cross-sectional imaging of thoracic and abdominal complications of cerebrospinal fluid shunt catheters.

    PubMed

    Bolster, Ferdia; Fardanesh, Reza; Morgan, Tara; Katz, Douglas S; Daly, Barry

    2016-04-01

    This study aims to review the imaging findings of distal (thoracic and abdominal) complications related to ventriculo-peritoneal (VP), ventriculo-pleural (VPL), and ventriculo-atrial (VA) cerebrospinal fluid (CSF) shunt catheter placement. Institution review board-approved single-center study of patients with thoracic and abdominal CSF catheter-related complications on cross-sectional imaging examinations over a 14-year period was performed. Clinical presentation, patient demographics, prior medical history, and subsequent surgical treatment were recorded. The presence or absence of CSF catheter-related infection and/or acute hydrocephalus on cross-sectional imaging was also recorded. There were 81 distal CSF catheter-related complications identified on 47 thoracic or abdominal imaging examinations in 30 patients (age 5-80 years, mean 39.3 years), most often on CT (CT = 42, MRI = 1, US = 4). Complications included 38 intraperitoneal and 11 extraperitoneal fluid collections. Extraperitoneal collections included nine abdominal wall subcutaneous (SC) pseudocysts associated with shunt migration and obesity, an intrapleural pseudocyst, and a breast pseudocyst. There were also two large VPL-related pleural effusions, a fractured catheter in the SC tissues, and a large VA shunt thrombus within the right atrium. Ten patients (33.3 %) had culture-positive infection from CSF or shunt catheter samples. Ten patients (33.3 %) had features of temporally related acute or worsening hydrocephalus on neuroimaging. In four of these patients, the detection of thoracic and abdominal complications on CT preceded and predicted the findings of acute hydrocephalus on cranial imaging. Thoracic and abdominal complications of CSF shunts, as can be identified on CT,  include shunt infection and/or obstruction, may be both multiple and recurrent, and may be predictive of concurrent acute intracranial problems. PMID:26610766

  20. Patient doses from CT examinations in Turkey

    PubMed Central

    Ataç, Gökçe Kaan; Parmaksız, Aydın; İnal, Tolga; Bulur, Emine; Bulgurlu, Figen; Öncü, Tolga; Gündoğdu, Sadi

    2015-01-01

    PURPOSE We aimed to establish the first diagnostic reference levels (DRLs) for computed tomography (CT) examinations in adult and pediatric patients in Turkey and compare these with international DRLs. METHODS CT performance information and examination parameters (for head, chest, high-resolution CT of the chest [HRCT-chest], abdominal, and pelvic protocols) from 1607 hospitals were collected via a survey. Dose length products and effective doses for standard patient sizes were calculated from the reported volume CT dose index (CTDIvol). RESULTS The median number of protocols reported from the 167 responding hospitals (10% response rate) was 102 across five different age groups. Third quartile CTDIvol values for adult pelvic and all pediatric body protocols were higher than the European Commission standards but were comparable to studies conducted in other countries. CONCLUSION The radiation dose indicators for adult patients were similar to those reported in the literature, except for those associated with head protocols. CT protocol optimization is necessary for adult head and pediatric chest, HRCT-chest, abdominal, and pelvic protocols. The findings from this study are recommended for use as national DRLs in Turkey. PMID:26133189

  1. Performance benchmarking of liver CT image segmentation and volume estimation

    NASA Astrophysics Data System (ADS)

    Xiong, Wei; Zhou, Jiayin; Tian, Qi; Liu, Jimmy J.; Qi, Yingyi; Leow, Wee Kheng; Han, Thazin; Wang, Shih-chang

    2008-03-01

    In recent years more and more computer aided diagnosis (CAD) systems are being used routinely in hospitals. Image-based knowledge discovery plays important roles in many CAD applications, which have great potential to be integrated into the next-generation picture archiving and communication systems (PACS). Robust medical image segmentation tools are essentials for such discovery in many CAD applications. In this paper we present a platform with necessary tools for performance benchmarking for algorithms of liver segmentation and volume estimation used for liver transplantation planning. It includes an abdominal computer tomography (CT) image database (DB), annotation tools, a ground truth DB, and performance measure protocols. The proposed architecture is generic and can be used for other organs and imaging modalities. In the current study, approximately 70 sets of abdominal CT images with normal livers have been collected and a user-friendly annotation tool is developed to generate ground truth data for a variety of organs, including 2D contours of liver, two kidneys, spleen, aorta and spinal canal. Abdominal organ segmentation algorithms using 2D atlases and 3D probabilistic atlases can be evaluated on the platform. Preliminary benchmark results from the liver segmentation algorithms which make use of statistical knowledge extracted from the abdominal CT image DB are also reported. We target to increase the CT scans to about 300 sets in the near future and plan to make the DBs built available to medical imaging research community for performance benchmarking of liver segmentation algorithms.

  2. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study

    PubMed Central

    HONDA, Mitsuru; ICHIBAYASHI, Ryo; YOKOMURO, Hiroki; YOSHIHARA, Katsunori; MASUDA, Hiroyuki; HAGA, Daisuke; SEIKI, Yoshikatsu; KUDOH, Chiaki; KISHI, Taichi

    2016-01-01

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1–3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3–4, GCS5–6, and GCS7–8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients. PMID:27356957

  3. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study.

    PubMed

    Honda, Mitsuru; Ichibayashi, Ryo; Yokomuro, Hiroki; Yoshihara, Katsunori; Masuda, Hiroyuki; Haga, Daisuke; Seiki, Yoshikatsu; Kudoh, Chiaki; Kishi, Taichi

    2016-08-15

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1-3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3-4, GCS5-6, and GCS7-8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients. PMID:27356957

  4. Assessment of sub-milli-sievert abdominal computed tomography with iterative reconstruction techniques of different vendors

    PubMed Central

    Padole, Atul; Sainani, Nisha; Lira, Diego; Khawaja, Ranish Deedar Ali; Pourjabbar, Sarvenaz; Lo Gullo, Roberto; Otrakji, Alexi; Kalra, Mannudeep K

    2016-01-01

    AIM: To assess diagnostic image quality of reduced dose (RD) abdominal computed tomography (CT) with 9 iterative reconstruction techniques (IRTs) from 4 different vendors to the standard of care (SD) CT. METHODS: In an Institutional Review Board approved study, 66 patients (mean age 60 ± 13 years, 44 men, and 22 women) undergoing routine abdomen CT on multi-detector CT (MDCT) scanners from vendors A, B, and C (≥ 64 row CT scanners) (22 patients each) gave written informed consent for acquisition of an additional RD CT series. Sinogram data of RD CT was reconstructed with two vendor-specific and a vendor-neutral IRTs (A-1, A-2, A-3; B-1, B-2, B-3; and C-1, C-2, C-3) and SD CT series with filtered back projection. Subjective image evaluation was performed by two radiologists for each SD and RD CT series blinded and independently. All RD CT series (198) were assessed first followed by SD CT series (66). Objective image noise was measured for SD and RD CT series. Data were analyzed by Wilcoxon signed rank, kappa, and analysis of variance tests. RESULTS: There were 13/50, 18/57 and 9/40 missed lesions (size 2-7 mm) on RD CT for vendor A, B, and C, respectively. Missed lesions includes liver cysts, kidney cysts and stone, gall stone, fatty liver, and pancreatitis. There were also 5, 4, and 4 pseudo lesions (size 2-3 mm) on RD CT for vendor A, B, and C, respectively. Lesions conspicuity was sufficient for clinical diagnostic performance for 6/24 (RD-A-1), 10/24 (RD-A-2), and 7/24 (RD-A-3) lesions for vendor A; 5/26 (RD-B-1), 6/26 (RD-B-2), and 7/26 (RD-B-3) lesions for vendor B; and 4/20 (RD-C-1) 6/20 (RD-C-2), and 10/20 (RD-C-3) lesions for vendor C (P = 0.9). Mean objective image noise in liver was significantly lower for RD A-1 compared to both RD A-2 and RD A-3 images (P < 0.001). Similarly, mean objective image noise lower for RD B-2 (compared to RD B-1, RD B-3) and RD C-3 (compared to RD C-1 and C-2) (P = 0.016). CONCLUSION: Regardless of IRTs and MDCT vendors

  5. Histoplasmosis of the adrenal glands studied by CT

    SciTech Connect

    Wilson, D.A.; Muchmore, H.G.; Tisdal, R.G.; Fahmy, A.; Pitha, J.V.

    1984-03-01

    Computed tomography (CT) of the adrenal glands was performed on seven patients who had histologically proved disseminated histoplasmosis. All seven patients showed some degree of adrenal gland abnormality. The range of CT findings included minimal enlargement with faint flecks of calcium, moderate enlargement with focal low attenuation nodules, and massive enlargement with large areas of necrosis or dense calcification. The changes in each patient were bilateral and symmetrical. Adrenal gland shape was usually preserved. Finding of percutaneous adrenal biopsy, which was performed under CT guidance, made the diagnosis in one patient. Five of seven patients had adrenal insufficiency. It is concluded that the diagnosis of disseminated histoplasmosis should be considered in any patient who has bilateral adrenal gland enlargement and who resides in an endemic area, especially if there is evidence of adrenal insufficiency.

  6. Metonymies in Medical Terminologies. A SNOMED CT Case Study

    PubMed Central

    Kreuzthaler, Markus; Schulz, Stefan

    2012-01-01

    Metonymies are language phenomena, in which one expression is used to refer to a related one. Whereas there are many examples in medical discourse, it has been controversially discussed to what extent metonymic phenomena also matter in medical terminologies like SNOMED CT, where they could hamper their proper use. We investigated this by analyzing all SNOMED CT single word fully specified names containing the suffixes “-itis” and “-ectomy”. Using a combination of string and concept matching, we harvested definitional phrases from the Web and contrasted them with the terms and their logical definitions as stated in SNOMED CT. Whereas metonymic phenomena are very rare in the collection of surgical terms (two out of 138), they were found in 16 terms (out of 251) in the collection of inflammation terms. Web mining retrieved useful phrases for 11 of these terms. Most metonymies found corresponded to the “whole for part” and “general for specific” pattern. PMID:23304317

  7. The Accuracy of Urinalysis in Predicting Intra-Abdominal Injury Following Blunt Traumas

    PubMed Central

    Sabzghabaei, Anita; Shojaee, Majid; Safari, Saeed; Hatamabadi, Hamid Reza; Shirvani, Reza

    2016-01-01

    Introduction: In cases of blunt abdominal traumas, predicting the possible intra-abdominal injuries is still a challenge for the physicians involved with these patients. Therefore, this study was designed, to evaluate the accuracy of urinalysis in predicting intra-abdominal injuries. Methods: Patients aged 15 to 65 years with blunt abdominal trauma who were admitted to emergency departments were enrolled. Abdominopelvic computed tomography (CT) scan with intravenous contrast and urinalysis were requested for all the included patients. Demographic data, trauma mechanism, the results of urinalysis, and the results of abdominopelvic CT scan were gathered. Finally, the correlation between the results of abdominopelvic CT scan, and urinalysis was determined. Urinalysis was considered positive in case of at least one positive value in gross appearance, blood in dipstick, or red blood cell count. Results: 325 patients with blunt abdominal trauma were admitted to the emergency departments (83% male with the mean age of 32.63±17.48 years). Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of urinalysis, were 77.9% (95% CI: 69.6-84.4), 58.5% (95% CI: 51.2-65.5), 56% (95% CI: 48.5-63.3), 79.6% (95% CI: 71.8-85.7), 1.27% (95% CI: 1.30-1.57), and 0.25% (95% CI: 0.18-0.36), respectively. Conclusion: The diagnostic value of urinalysis in prediction of blunt traumatic intra-abdominal injuries is low and it seems that it should be considered as an adjuvant diagnostic tool, in conjunction with other sources such as clinical findings and imaging. PMID:26862543

  8. Association of Smoking in Adolescence With Abdominal Obesity in Adulthood: A Follow-Up Study of 5 Birth Cohorts of Finnish Twins

    PubMed Central

    Pietiläinen, Kirsi; Kantonen, Suvi; Rissanen, Aila; Kaprio, Jaakko

    2009-01-01

    Objectives. We studied the association of adolescent smoking with overweight and abdominal obesity in adulthood. Methods. We used the FinnTwin16, a prospective, population-based questionnaire study of 5 consecutive and complete birth cohorts of Finnish twins born between 1975 and 1979 (N = 4296) and studied at four points between the ages of 16 and 27 years to analyze the effect of adolescent smoking on abdominal obesity and overweight in early adulthood. Results. Smoking at least 10 cigarettes daily when aged 16 to 18 years increased the risk of adult abdominal obesity (odds ratio [OR]=1.77; 95% confidence interval [CI] = 1.39, 2.26). After we adjusted for confounders, the OR was 1.44 (95% CI = 1.11, 1.88), and after further adjustment for current body mass index (BMI), the OR was 1.34 (95% CI = 0.95, 1.88). Adolescent smoking significantly increased the risk of becoming overweight among women even after adjustment for possible confounders, including baseline BMI (OR = 1.74; 95% CI = 1.06, 2.88). Conclusions. Smoking is a risk factor for abdominal obesity among both genders and for overweight in women. The prevention of smoking during adolescence may play an important role in promoting healthy weight and in decreasing the morbidity related to abdominal obesity. PMID:19059868

  9. Lifestyle Risk Factors of General and Abdominal Obesity in Students of the School of Medicine and Health Science of the University of Development Studies, Tamale, Ghana

    PubMed Central

    Aleyira, Samuel

    2014-01-01

    This study evaluated the prevalence of general and abdominal obesity among students of the University for Development Studies, School of Medicine and Health Sciences (UDS-SMHS), Tamale, Ghana. Also, lifestyle risk factors for the two obesity indices were investigated. This study was conducted among a sample of 646 students. Anthropometric measures of weight, height, and waist circumference were appropriately assessed. The prevalence of general and abdominal obesity was 1.9% and 4.2%, respectively. Risk factors of general obesity were being female (crude OR = 6.9, 95% CI = 1.85–25.80, P = 0.0021), engaging in light PA (OR = 12.45, 95% CI = 2.96–52.41, P = 0.0006), being aged 28–37 years (OR = 5.37, 95% CI = 1.39–20.68, P = 0.0329), nonintake of coffee (OR = 4.1, 95% CI = 1.10–15.28, P = 0.0357), being married (OR = 5.7, 95% CI = 1.48–22.02, P = 0.0286), and being abdominally obese (OR = 02.7, 95% CI = 25.61–11.60, P < 0.0001). Risk factors for abdominal obesity were being female, being married, having general obesity, and nonintake of coffee. Abdominal obesity was more prevalent than general obesity. Risk factors included being female, married, and generally obese and nonintake of coffee. PMID:24649393

  10. Plasma cytokine levels and risks of abdominal aortic aneurysms: A population-based prospective cohort study

    PubMed Central

    Liao, Mengyang; Liu, Cong-Lin; Lv, Bing-Jie; Zhang, Jin-Ying; Cheng, Longxian; Cheng, Xiang; Lindholt, Jes S.; Rasmussen, Lars M.; Shi, Guo-Ping

    2015-01-01

    Background Abdominal aortic aneurysm (AAA) is characterized by inflammatory cell accumulation in AAA lesions that produce inflammatory cytokines and advance its pathogenesis. Peripheral cytokines may predict the degree or risk of AAA. Methods and Results ELISA determined plasma interleukin-6 (IL6), IL10, IL17A, IFN-γ, and C-reactive protein (CRP) from 476 AAA patients and 200 controls. AAA patients had lower IL6, IFN-γ, IL10, IL17A, and higher CRP than controls. IL10 correlated positively with IFN-γ, IL17A, or IL6, but not CRP in control or AAA populations. IL10 associated negatively with systolic blood pressure, whereas CRP associated positively with diastolic blood pressure and body mass index. CRP was an independent AAA risk factor and correlated positively with aortic diameters before and after adjustments for other risk factors. IFN-γ, IL17A, and CRP correlated positively with cross-sectional AAA area after adjustment. IL10 correlated positively with AAA growth rate before and after adjustment. AAA patients with CRP levels above the median doubled the risk of death. Conclusions Reduced IFN-γ, IL10, and IL17A in AAA patients, positive correlations of IFN-γ and IL17A with cross-sectional AAA area, IL10 with AAA growth rate, and IL10 with IFN-γ and IL17A suggest combined Th1, Th2, and Th17 immune responses in human AAAs. PMID:25856542

  11. Applications of dual energy computed tomography in abdominal imaging.

    PubMed

    Lestra, T; Mulé, S; Millet, I; Carsin-Vu, A; Taourel, P; Hoeffel, C

    2016-06-01

    Dual energy computed tomography (CT) is an imaging technique based on data acquisition at two different energy settings. Recent advances in CT have allowed data acquisition and almost simultaneously analysis of two spectra of X-rays at different energy levels resulting in novel developments in the field of abdominal imaging. This technique is widely used in cardiovascular imaging, especially for pulmonary embolism work-up but is now also increasingly developed in the field of abdominal imaging. With dual-energy CT it is possible to obtain virtual unenhanced images from monochromatic reconstructions as well as attenuation maps of different elements, thereby improving detection and characterization of a variety of renal, adrenal, hepatic and pancreatic abnormalities. Also, dual-energy CT can provide information regarding urinary calculi composition. This article reviews and illustrates the different applications of dual-energy CT in routine abdominal imaging. PMID:26993967

  12. Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma

    PubMed Central

    2013-01-01

    In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children. PMID:23902930

  13. The use of gentamicin-PMMA chains in abdominal surgery: a pilot study of prophylaxis against wound infection.

    PubMed

    Aubrey, D A; Jenkins, N H; Morgan, W P; Thomas, M

    1986-01-01

    A prospective study was carried out to examine the effectiveness of gentamicin-impregnated polymethylmethacrylate beads in the prevention of wound sepsis after gastro-intestinal surgery. The beads were laid in the abdominal and perineal incisions (61 wounds) of 55 patients at the end of the operative procedures, and were withdrawn in stages from the fifth post-operative day. This method of administration results in a sustained high antibiotic concentration in the wound with low serum and urine concentrations, thus eliminating the dangers of gentamicin toxicity. Wound infection occurred in only 1 instance, a favourable result when compared to historical controls. It is suggested that further controlled studies of this method of topical prophylactic antibiotic administration are indicated. PMID:3714759

  14. The effect of Reiki on pain and anxiety in women with abdominal hysterectomies: a quasi-experimental pilot study.

    PubMed

    Vitale, Anne T; O'Connor, Priscilla C

    2006-01-01

    The purpose of this pilot study was to compare reports of pain and levels of state anxiety in 2 groups of women after abdominal hysterectomy. A quasi-experimental design was used in which the experimental group (n = 10) received traditional nursing care plus three 30-minute sessions of Reiki, while the control group (n = 12) received traditional nursing care. The results indicated that the experimental group reported less pain and requested fewer analgesics than the control group. Also, the experimental group reported less state anxiety than the control group on discharge at 72 hours postoperation. The authors recommend replication of this study with a similar population, such as women who require nonemergency cesarian section deliveries. PMID:17099413

  15. [CT pathologic correlative study of bronchiolitis obliterans organizing pneumonia].

    PubMed

    Nishimura, K; Kitaichi, M; Izumi, T; Kanaoka, M; Itoh, H

    1989-01-01

    Though bronchiolitis obliterans organizing pneumonia (BOOP) was proposed as a new infiltrative lung disease in 1985, we think it has two radiologic problems. First, in spite of interstitial pneumonia, about half of chest radiographs of BOOP has been reported to show alveolar opacities. Second, because radiologic features of both some cases of BOOP and of usual interstitial pneumonia (UIP) show reticular shadows on chest radiographs, it is sometimes difficult to differentiate between two diseases. We correlated CT images with open lung biopsy specimens and evaluated CT's ability to differentiate BOOP from UIP. CT findings of all cases of BOOP were: (1) markedly increased dense infiltrates of various sizes which demarcated sharply from normal lung field. Air bronchogram was always present. (2) less dense images were seen which also stood out against the normal lung field. The former corresponded to air space consolidation formed by organized exudates and inflammatory cells within alveolar ducts and alveoli, while the latter indicated luminal and mural alveolitis. Both findings were sharply delineated from each other probably because of intervening interlobular septa. Conglomerated small cystic shadows and air bronchography within areas of intense lung density were seen in CT images of most of 28 patients with UIP. Those findings proved to correspond to macroscopic or microscopic honey combing which were not seen in our cases of BOOP. These radiologic and pathologic features of UIP were different. PMID:2724593

  16. Spectroscopic study one thiosemicarbazone derivative with ctDNA using ethidium bromide as a fluorescence probe.

    PubMed

    Geng, Shaoguang; Wu, Qing; Shi, Lei; Cui, Fengling

    2013-09-01

    In this study, a thiosemicarbazone derivative (E)-2-((1,4-dihydroxy-9,10-anthraquinone-2-yl)methylene)-N-(4-fluorophenyl)hydrazinecarbothioamide (DAFPT) was synthesized, and the interaction of DAFPT with calf thymus DNA (ctDNA) was explored using ethidium bromide (EB) as a fluorescence probe. The binding mode between DAFPT and ctDNA was investigated by UV absorption spectroscopy, fluorescence spectroscopy and molecular docking. The fluorescence quenching mechanism of EB-ctDNA by DAFPT might be a combined quenching type. Thermodynamic parameters showed that the reaction was spontaneous. According to ionic strength, fluorescence polarization and melting temperature (T(m)) curve results, DAFPT-ctDNA interaction was groove binding. The molecular modeling results indicated that DAFPT could slide into the A-T rich region of ctDNA. PMID:23769721

  17. Correlates of Adverse Outcomes in Abdominally Obese Individuals: Findings from the Five-Year Followup of the Population-Based Study of Health in Pomerania

    PubMed Central

    Friedrich, Nele; Schneider, Harald J.; John, Ulrich; Dörr, Marcus; Baumeister, Sebastian E.; Völker, Uwe; Wallaschofski, Henri

    2013-01-01

    Background. Abdominal obesity is a major risk factor of cardiovascular disease (CVD), type 2 diabetes (T2DM), and premature death. However, it has not been resolved which factors predispose for the development of these adverse obesity-related outcomes in otherwise healthy individuals with abdominal obesity. Methods. We studied 1,506 abdominal obese individuals (waist-to-height ratio (WHtR) ≥ 0.5) free of CVD or T2DM from the population-based Study of Health in Pomerania and assessed the incidence of CVD or T2DM after a five-year followup. Logistic regression models were adjusted for major cardiovascular risk factors and liver, kidney diseases, and sociodemographic status. Results. During follow-up time, we observed 114 and 136 new T2DM and CVD cases, respectively. Regression models identified age, waist circumference, serum glucose, and liver disease as predictors of T2DM. Regarding CVD, only age, unemployment, and a divorced or widowed marital status were significantly associated with incident CVD. In this subgroup of obese individuals blood pressure, serum glucose, or lipids did not influence incidence of T2DM or CVD. Conclusion. We identified various factors associated with an increased risk of incident T2DM and CVD among abdominally obese individuals. These findings may improve the detection of high-risk individuals and help to advance prevention strategies in abdominal obesity. PMID:24191195

  18. Development and evaluation of a novel, real time mobile telesonography system in management of patients with abdominal trauma: study protocol

    PubMed Central

    2012-01-01

    Background Despite the use of e-FAST in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted. The goal of this study is to develop a novel portable telesonography (TS) system and evaluate the comparability of the quality of images obtained via this system among healthy volunteers who undergo e-FAST abdominal examination in a moving ambulance and at the ED. We hypothesize that: (1) real-time ultrasound images of acute trauma patients in the pre-hospital setting can be obtained and transmitted to the ED via the novel TS system; and (2) Ultrasound images transmitted to the hospital from the real-time TS system will be comparable in quality to those obtained in the ED. Methods Study participants are three healthy volunteers (one each with normal, overweight and obese BMI category). The ultrasound images will be obtained by two ultrasound-trained physicians The TS is a portable sonogram (by Sonosite) interfaced with a portable broadcast unit (by Live-U). Two UTPs will conduct e-FAST examinations on healthy volunteers in moving ambulances and transmit the images via cellular network to the hospital server, where they are stored. Upon arrival in the ED, the same UTPs will obtain another set of images from the volunteers, which are then compared to those obtained in the moving ambulances by another set of blinded UTPs (evaluators) using a validated image quality scale, the Questionnaire for User Interaction Satisfaction (QUIS). Discussion Findings from this study will provide needed data on the validity of the novel TS in transmitting live images from moving ambulances to images obtained in the ED thus providing opportunity to facilitate medical care of a patient located in a remote or austere setting. PMID:23249290

  19. Intensity-Modulated Whole Abdominal Radiotherapy After Surgery and Carboplatin/Taxane Chemotherapy for Advanced Ovarian Cancer: Phase I Study

    SciTech Connect

    Rochet, Nathalie; Sterzing, Florian; Jensen, Alexandra D.; Dinkel, Julien; Herfarth, Klaus K.; Schubert, Kai; Eichbaum, Michael H.; Schneeweiss, Andreas; Sohn, Christof; Debus, Juergen; Harms, Wolfgang

    2010-04-15

    Purpose: To assess the feasibility and toxicity of consolidative intensity-modulated whole abdominal radiotherapy (WAR) after surgery and chemotherapy in high-risk patients with advanced ovarian cancer. Methods and Materials: Ten patients with optimally debulked ovarian cancer International Federation of Gynecology and Obstetrics Stage IIIc were treated in a Phase I study with intensity-modulated WAR up to a total dose of 30 Gy in 1.5-Gy fractions as consolidation therapy after adjuvant carboplatin/taxane chemotherapy. Treatment was delivered using intensity-modulated radiotherapy in a step-and-shoot technique (n = 3) or a helical tomotherapy technique (n = 7). The planning target volume included the entire peritoneal cavity and the pelvic and para-aortal node regions. Organs at risk were kidneys, liver, heart, vertebral bodies, and pelvic bones. Results: Intensity-modulated WAR resulted in an excellent coverage of the planning target volume and an effective sparing of the organs at risk. The treatment was well tolerated, and no severe Grade 4 acute side effects occurred. Common Toxicity Criteria Grade III toxicities were as follows: diarrhea (n = 1), thrombocytopenia (n = 1), and leukopenia (n = 3). Radiotherapy could be completed by all the patients without any toxicity-related interruption. Median follow-up was 23 months, and 4 patients had tumor recurrence (intraperitoneal progression, n = 3; hepatic metastasis, n = 1). Small bowel obstruction caused by adhesions occurred in 3 patients. Conclusions: The results of this Phase I study showed for the first time, to our knowledge, the clinical feasibility of intensity-modulated whole abdominal radiotherapy, which could offer a new therapeutic option for consolidation treatment of advanced ovarian carcinoma after adjuvant chemotherapy in selected subgroups of patients. We initiated a Phase II study to further evaluate the toxicity of this intensive multimodal treatment.

  20. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study

    PubMed Central

    López-Sobaler, Ana M.; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M.

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18–64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415–2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045–1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m2, WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m2, WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future. PMID:27382572

  1. Synthesis of a novel water-soluble zinc phthalocyanine and its CT DNA-damaging studies

    NASA Astrophysics Data System (ADS)

    Wang, Tianhui; Wang, Ao; Zhou, Lin; Lu, Shan; Jiang, Weiwei; Lin, Yun; Zhou, Jiahong; Wei, Shaohua

    2013-11-01

    A novel 3-(4-methoxybenzylamino) propanoic acid substituted water-soluble zinc phthalocyanine (CNPcZn) was synthesized. The interaction between CNPcZn with calf thymus DNA (CT DNA) was studied using spectroscopic methods. The studies indicated that CNPcZn has strong affinity to CT DNA, and furthermore, CNZnPc showed excellent photodamaging activity to CT DNA. Above results indicated that such CNPcZn has great potential to be used as an effective photosensitizer in the field of photodynamic therapy.

  2. Comparison of the strain field of abdominal aortic aneurysm measured by magnetic resonance imaging and stereovision: a feasibility study for prediction of the risk of rupture of aortic abdominal aneurysm.

    PubMed

    Wang, Yufei; Joannic, David; Delassus, Patrick; Lalande, Alain; Juillion, Patrick; Fontaine, Jean-François

    2015-04-13

    The prediction of the risk of rupture of abdominal aortic aneurysm (AAA) is a complex problem. Currently the criteria to predict rupture of abdominal aortic aneurysms are aneurysm diameter and growth rates. It is generally believed that study of the wall strain distribution could be helpful to find a better decision criterion for surgery of aortic aneurysms before their rupture. The wall strain distribution depends on many biological and biomechanical factors such as elastic properties of the aorta, turbulent blood flow, anatomy of the aorta, presence of thrombus or not and so on. Recently, numerical simulations to estimate rupture-potential have received many attentions. However, none of the medical imaging tools for screening and monitoring of AAAs were studied in terms of mechanical behavior and experimentally to demonstrate their capability to measure relevant variables. The aim of this study was to develop a metrological approach for deployment testing of the ability of techniques for measuring local in-vitro deformations based on comparison of stereovision and MRI. In this paper, we present the implementation approach and results of the study based on cylindrical phantoms with or without AAA representing, respectively, healthy and unhealthy artery. Through this study, an experimental device was developed for the behavior study of AAA during a cardiac cycle. The results show that the stereovision techniques used in laboratory is well suited and is qualitatively and quantitatively equivalent with MRI measurements. PMID:25661521

  3. Feasibility study of small animal imaging using clinical PET/CT scanner

    NASA Astrophysics Data System (ADS)

    Hsu, Wen-Lin; Chen, Chia-Lin; Wang, Ze-Jing; Wu, Tung-Hsin; Liu, Dai-Wei; Lee, Jason J. S.

    2007-02-01

    The feasibility of small animal imaging using a clinical positron emission tomography/computed tomography (PET/CT) scanner with [F-18]-fluoro-2-deoxy- D-glucose (FDG) was evaluated. Two protocols in PET/CT system, single-mouse high-resolution mode (SHR) and multi-mouse high throughput mode (MHT) protocol were employed to investigate the ability of the scanner and also explored the performance differences between microPET and clinical PET/CT. In this study, we have found that even the clinical PET/CT scanner could not compete with the microPET scanner, especially in spatial resolution; the high-resolution CT image could advance the anatomical information to sub-millimeter level. Besides, CT-based attenuation correction can improve the image uniformity characteristics and quantification accuracy, and the large bore of a human whole-body scanner broadens the possibility of high throughput studies. Considering all the benefits, clinical PET/CT imaging might be a potential alternative for small animal study.

  4. Pre-operative inspiratory muscle training preserves postoperative inspiratory muscle strength following major abdominal surgery – a randomised pilot study

    PubMed Central

    Kulkarni, SR; Fletcher, E; McConnell, AK; Poskitt, KR; Whyman, MR

    2010-01-01

    INTRODUCTION The aim of this pilot study was to assess the effect of pre-operative inspiratory muscle training (IMT) on respiratory variables in patients undergoing major abdominal surgery. PATIENTS AND METHODS Respiratory muscle strength (maximum inspiratory [MIP] and expiratory [MEP] mouth pressure) and pulmonary functions were measured at least 2 weeks before surgery in 80 patients awaiting major abdominal surgery. Patients were then allocated randomly to one of four groups (Group A, control; Group B, deep breathing exercises; Group C, incentive spirometry; Group D, specific IMT). Patients in groups B, C and D were asked to train twice daily, each session lasting 15 min, for at least 2 weeks up to the day before surgery. Outcome measurements were made immediately pre-operatively and postop-eratively. RESULTS In groups A, B and C, MIP did not increase from baseline to pre-operative assessments. In group D, MIP increased from 51.5 cmH2O (median) pre-training to 68.5 cmH2O (median) post-training pre-operatively (P < 0.01). Postoperatively, groups A, B and C showed a fall in MIP from baseline (P < 0.01, P < 0.01) and P = 0.06, respectively). No such significant reduction in postoperative MIP was seen in group D (P = 0.36). CONCLUSIONS Pre-operative specific IMT improves MIP pre-operatively and preserves it postoperatively. Further studies are required to establish if this is associated with reduced pulmonary complications. PMID:20663275

  5. Diagnostic imaging of intra-abdominal cyst in heifer using the computed tomography

    PubMed Central

    OTOMARU, Konosuke; FUJIKAWA, Takuro; SAITO, Yasuo; ANDO, Takaaki; OBI, Takeshi; MIURA, Naoki; KUBOTA, Chikara

    2015-01-01

    A 10-month-old Japanese black heifer was diagnosed as having an intra-abdominal cyst using computed tomography (CT). Through a posterior ventral midline incision, the cyst was removed, and the heifer completely recovered after the surgery. CT scans enabled detection of the intra-abdominal cyst and measurements of the diameter of the cyst before the surgery. PMID:25924971

  6. Standardized anatomic space for abdominal fat quantification

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

    2014-03-01

    The ability to accurately measure subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from images is important for improved assessment and management of patients with various conditions such as obesity, diabetes mellitus, obstructive sleep apnea, cardiovascular disease, kidney disease, and degenerative disease. Although imaging and analysis methods to measure the volume of these tissue components have been developed [1, 2], in clinical practice, an estimate of the amount of fat is obtained from just one transverse abdominal CT slice typically acquired at the level of the L4-L5 vertebrae for various reasons including decreased radiation exposure and cost [3-5]. It is generally assumed that such an estimate reliably depicts the burden of fat in the body. This paper sets out to answer two questions related to this issue which have not been addressed in the literature. How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? At what anatomic location do the volumes of SAT and VAT correlate maximally with the corresponding single-slice area measures? To answer these questions, we propose two approaches for slice localization: linear mapping and non-linear mapping which is a novel learning based strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. We then study the volume-to-area correlations and determine where they become maximal. We demonstrate on 50 abdominal CT data sets that this mapping achieves significantly improved consistency of anatomic localization compared to current practice. Our results also indicate that maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized.

  7. 75 FR 29583 - Special Resource Study and Environmental Impact Statement, Coltsville, Hartford, CT

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Special Resource Study and Environmental Impact Statement, Coltsville, Hartford, CT AGENCY: National Park Service, Department of the Interior. ACTION: Notice of Termination of...

  8. Thermoluminescent Dosimetry: A Preliminary Study for microCT Applications

    SciTech Connect

    Montano Garcia, C.; Rodriguez-Villafuerte, M.; Martinez-Davalos, A.; Brandan, M. E.; Ruiz-Trejo, C.

    2006-09-08

    Preliminary measurements for microCT dosimetry are reported in this work, using TLD-100 crystals (1x1x1 mm3) within a solid water phantom specially designed with approximate dimensions of a mouse. A dose dependence as a function of radial distance and position along the axis of the phantom was found. Because of the smaller doses used in this work we can say that it is feasible to perform dosimetry measurements with high accuracy using TLD-100 microcubes.

  9. MITHRA – multiparametric MR/CT image adapted brachytherapy (MR/CT-IABT) in anal canal cancer: a feasibility study

    PubMed Central

    Manfrida, Stefania; Barbaro, Brunella; Colangione, Maria Maddalena; Masiello, Valeria; Mattiucci, Gian Carlo; Placidi, Elisa; Autorino, Rosa; Gambacorta, Maria Antonietta; Chiesa, Silvia; Mantini, Giovanna; Kovács, György; Valentini, Vincenzo

    2015-01-01

    Purpose The aim of this study is to test a novel multiparametric imaging guided procedure for high-dose-rate brachytherapy in anal canal cancer, in order to evaluate the feasibility and safety. Material and methods For this analysis, we considered all consecutive patients who underwent magnetic resonance/computed tomography image adapted brachytherapy (MR/CT-IABT) treated from February 2012 to July 2014. To conduct this project, we formed a working group that established the procedure and identified the indicators and benchmarks to evaluate the feasibility and safety. We considered the procedure acceptable if 90% of the indicators were consistent with the benchmarks. Magnetic resonance imaging with contrast and diffusion weighted imaging were performed with an MRI-compatible dummy applicator in the anus to define the position of the clinical target volume disease and biological information. A pre-implantation treatment planning was created in order to get information on the optimal position of the needles. Afterwards, the patient underwent a simulation CT and the definite post-implantation treatment planning was created. Results We treated 11 patients (4 men and 7 women) with MR/CT-IABT and we performed a total of 13 procedures. The analysis of indicators for procedure evaluation showed that all indicators were in agreement with the benchmark. The dosimetric analysis resulted in a median of V200, V150, V100, V90, V85, respectively of 24.6%, 53.4%, 93.5%, 97.6%, and 98.7%. The median coverage index (CI) was 0.94, the median dose homogeneity index (DHI) was 0.43, the median dose non-uniformity ratio (DNR) resulted 0.56, the median overdose volume index (ODI) was 0.27. We observed no episodes of common severe acute toxicities. Conclusions Brachytherapy is a possible option in anal cancer radiotherapy to perform the boost to complete external beam radiotherapy (EBRT). Magnetic resonance can also have biological advantages compared to the US. Our results suggest that

  10. Antibiotic Regimen after a Total Abdominal Colectomy with Ileostomy for Fulminant Clostridium difficile Colitis: A Multi-Institutional Study

    PubMed Central

    van der Wilden, Gwendolyn M.; Subramanian, Melanie P.; Chang, Yuchiao; Lottenberg, Lawrence; Sawyer, Robert; Davies, Stephen W.; Ferrada, Paula; Han, Jinfeng; Beekley, Alec; Velmahos, George C.

    2015-01-01

    Abstract Background: Fulminant Clostridium difficile colitis (fCDC) is a highly lethal disease with mortality rates ranging between 12% and 80%. Although often these patients require a total abdominal colectomy (TAC) with ileostomy, there is no established management protocol for post-operative antibiotics. In this study we aim to make some recommendations for post-operative antibiotic usage, while describing the practice across different institutions. Methods: Multi-institutional retrospective case series including fCDC patients who underwent a TAC between January 1, 2007, and June 30, 2012. We first analyzed the complete cohort and consecutively performed a survivor analysis, comparing different antibiotic regimens. Additionally we stratified by time interval (antibiotics for ≤7 d, or ≥8 d). Primary outcome was in-hospital mortality. Additional secondary outcomes included hospital length of stay (HLOS), ICU LOS, number of ventilator-free days, and occurrence of intra-abdominal complications (proctitis, abscess, sepsis, etc.). Results: A total of 100 fCDC patients that underwent a TAC were included across five institutions. Four different antibiotic regimens were compared; A (metronidazole IV+vancomycin PO), B (metronidazole IV), C (metronidazole IV+vanco PO and PR), and D (metronidazole IV+vancomycin PR). The combination of IV metronidazole with or without PO vancomycin showed superior outcomes in terms of a shorter ICU length of stay and more ventilator-free days. However, when comparing metronidazole alone vs. metronidazole and any combination of vancomycin, no significant differences were found. Neither the addition of vancomycin enema, nor the time interval changed outcomes. Conclusion: Patients, after a TAC for fCDC, may be placed on either IV metronidazole or PO vancomycin depending upon local antibiograms, and proctitis may be treated with the addition of a vancomycin enema (PR). There was no data to support routine treatment of more than 7

  11. Diclofenac is more effective for post-operative analgesia in patients undergoing lower abdominal gynecological surgeries: A comparative study

    PubMed Central

    Pal, Anirban; Biswas, Jhuma; Mukhopadhyay, Purnava; Sanyal, Poushali; Dasgupta, Shyamal; Das, Shyamashis

    2014-01-01

    Aim: The present study aimed to compare the efficacy of injectable diclofenac intramuscularly (IM), injection paracetamol intravenously (IV), or a combination of both to provide post-operative analgesia in patients undergoing lower abdominal gynecological surgeries. Materials and Methods: A total of 90 female patients (American Society of Anesthesiologists I and II), aged 20-50 years, scheduled for elective total abdominal hysterectomy with or without bilateral salpingo-oophorectomy were randomized to receive 75 mg diclofenac IM 8 hourly (Group D) or 1 g paracetamol IV 8 hourly (Group P) or a combination of both 8 hourly (Group PD) for 24 h post-operative period from the start of surgery. The primary outcome measured was the requirement of rescue analgesic (tramadol), the secondary outcomes measured included visual analog score (VAS) for pain, time until first rescue analgesic administration, patient satisfaction score and any side effects. Results: The requirement of rescue analgesic was significantly lower in Groups D and PD compared to Group P. Mean (standard deviation) tramadol requirement during 24 h was 56.67 (62.60) mg, 20.00 (40.68) mg and 20.00 (40.68) mg in the Groups P, D and PD respectively. Less number of patients in Groups D and PD (20% in both the groups) required rescue analgesic compared to Group P (50%). The VAS showed a significant decrease in Groups D and PD compared to Group P between 4 and 12 h post-operatively. However, Group PD showed no significant difference when compared to Group D alone. Conclusion: Injection diclofenac IM is more effective than paracetamol IV in terms of rescue analgesic requirement, but the combination of diclofenac IM and paracetamol IV provides no added advantage over diclofenac IM alone. PMID:25886225

  12. An epidemiological study on pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents of Bangalore: Autopsy-based study

    PubMed Central

    Reddy, N. Bayapa; Hanumantha; Madithati, Pallavi; Reddy, N. Nagarjuna; Reddy, C. Sainarasimha

    2014-01-01

    Background: The statistical profile reflects a global estimate of 5.1 million deaths in 2000, which was due to injuries that accounted for 10% of deaths due to all causes. Out of this, a quarter of injury-related deaths occurred in the South-East Asian region. Road Traffic Accident (RTA) is one among the top 5 causes of morbidity and mortality in South-East Asian countries. Most common cause of blunt abdominal trauma in India is road traffic accident followed by pedestrian accidents, abdominal blows, and fall from heights. Aims: To analyze the epidemiology and pattern of fatal thoraco-abdominal injuries in road traffic accidents. Materials and Methods: An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 100 post-mortems of road traffic accident between November 2008 and May 2010 subjected to medico-legal autopsy at the department of Forensic Medicine, KIMS Hospital Bangalore. Results: The majority of the victims were aged 21 to 40 years, 50 (50.0%), most of the victims were male 92 (92.0%); and male/female ratio was 11.5:1. Commonest offending agents in heavy motor vehicles were 54 (54.0%). Bony cage sustained injuries were observed in 71; out of this, fractures of ribs were observed in 45 (63.3%) victims, clavicle in 14 (19.7%), sternum was 6 (8.4%), and vertebrae 6 (8.4%) of fatal road traffic accidents. Internal thoracic injuries were observed in 26 cases. Among internal thoracic injuries, lungs were the most commonly involved organ 24 (92.3%) followed by the heart 2 (7.6%). Lung sustained more lacerations 19 (79.1%) than contusions 5 (20.8%). Internal abdominal injuries were observed in 49 cases. In road traffic accidents, the most commonly injured abdominal organs were solid organs such as liver 16 (32.6%) followed by spleen 9 (18.3%). Conclusions: Majority of the times in road traffic accidents, young and productive males were injured or lost their life. This study may help the planners to

  13. A comparative study on the CT effective dose for various positions of the patient's arm

    NASA Astrophysics Data System (ADS)

    Seong, Ji-Hye; Park, Soon-Ki; Kim, Jung-Sun; Jung, Woo-Young; Kim, Ho-Sung; Dong, Kyung-Rae; Chung, Woon-Kwan; Cho, Jae-Hwan; Cho, Young-Kuk

    2012-10-01

    In a whole body PET/CT (positron emission tomography/computed tomography) scan, lifting the patient's arm to improve the image quality is natural. On the other hand, the arms should be placed lower when the lesion is located in the head and neck. This study compared the CT effective dose for each arm position after applying AEC (automatic exposure control). Forty-five patients who had undergone an 18F-FDG (fluorine-18-fluoro deoxy glucose) whole body PET/CT scan were examined using Biograph Truepoint 40, Biograph Sensation 16, and Discovery STe 8 systems. The CT effective dose of 15 patients for each set of equipment was measured and analyzed comparatively in both the arm-lifted and arm-lowered positions. The ImPACT Ver. 1.0 program was used to measure the CT effective dose. A paired t-test (SPSS 18.0 statistic program) was applied for statistical analysis. In the case of the arm-lifted position, the CT effective dose measured for Biograph 40, Biograph 16, and DSTe 8 systems were 6.33 ± 0.93 mSv, 8.01 ± 1.34 mSv, and 9.69 ± 2.32 mSv, respectively. When the arms were located in the lower position, the respective CT effective doses were 6.97 ± 0.76 mSv, 8.95 ± 1.85 mSv, and 13.07 ± 2.87 mSv, respectively. These results revealed 9.2%, 10.5%, and 25.9% improvement in the CT effective doses for the Biograph 40, Biograph 16 and DSTe 8 systems, respectively, when the arms were raised compared to that when they were lowered (p < 0.05). For the whole body PET/CT case, the CT effective dose applying AEC showed a mean 15.2% decrease in the radiation exposure of the patients when the arm was lifted. The patient with no lesion in the head and neck would show fewer artifacts in the objective part and a lower CT effective dose. For a patient with a lesion in the head and neck, the artifacts in the objective part can be reduced by putting the arms down. The fact that the CT effective dose is increased in a whole-body PET/CT scan should be a concern.

  14. 3D dosimetry estimation for selective internal radiation therapy (SIRT) using SPECT/CT images: a phantom study

    NASA Astrophysics Data System (ADS)

    Debebe, Senait A.; Franquiz, Juan; McGoron, Anthony J.

    2015-03-01

    Selective Internal Radiation Therapy (SIRT) is a common way to treat liver cancer that cannot be treated surgically. SIRT involves administration of Yttrium - 90 (90Y) microspheres via the hepatic artery after a diagnostic procedure using 99mTechnetium (Tc)-macroaggregated albumin (MAA) to detect extrahepatic shunting to the lung or the gastrointestinal tract. Accurate quantification of radionuclide administered to patients and radiation dose absorbed by different organs is of importance in SIRT. Accurate dosimetry for SIRT allows optimization of dose delivery to the target tumor and may allow for the ability to assess the efficacy of the treatment. In this study, we proposed a method that can efficiently estimate radiation absorbed dose from 90Y bremsstrahlung SPECT/CT images of liver and the surrounding organs. Bremsstrahlung radiation from 90Y was simulated using the Compton window of 99mTc (78keV at 57%). 99mTc images acquired at the photopeak energy window were used as a standard to examine the accuracy of dosimetry prediction by the simulated bremsstrahlung images. A Liqui-Phil abdominal phantom with liver, stomach and two tumor inserts was imaged using a Philips SPECT/CT scanner. The Dose Point Kernel convolution method was used to find the radiation absorbed dose at a voxel level for a three dimensional dose distribution. This method will allow for a complete estimate of the distribution of radiation absorbed dose by tumors, liver, stomach and other surrounding organs at the voxel level. The method provides a quantitative predictive method for SIRT treatment outcome and administered dose response for patients who undergo the treatment.

  15. Abdominal aortic aneurysm

    MedlinePlus

    ... to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ... blood pressure Male gender Genetic factors An abdominal aortic aneurysm is most often seen in males over age ...

  16. Abdominal x-ray

    MedlinePlus

    ... More Abdominal aortic aneurysm Abdominal pain Acute cholecystitis Acute kidney failure Addison disease Adenomyosis Annular pancreas Aplastic anemia Appendicitis Ascariasis Atheroembolic renal disease Biliary atresia Blind loop syndrome Cholangitis Chronic ...

  17. Large abdominal photopenic area on 99mTc-sestamibi myocardial perfusion imaging.

    PubMed

    Lyon, Jennifer; Spaulding, John; Zack, Paul M

    2012-12-01

    (99m)Tc-sestamibi myocardial perfusion imaging is frequently performed in conjunction with exercise or pharmacologic stress testing for evaluation of coronary heart disease. Interpretation of these studies includes systematic review of unprocessed rotating projectional images for evaluation of cardiac size as well as the presence of motion or attenuation artifacts. Occasionally, incidental noncardiac findings are detected on review of the projectional images. We report a case of a patient with a history of autosomal dominant polycystic kidney disease who was found to have a large abdominal photopenic area on the projectional images. The photopenic area corresponded to the location of large intraabdominal cysts on abdominal CT and was consistent with hepatic cysts associated with the patient's known polycystic kidney disease. We review the differential diagnosis of large abdominal photopenic regions identified on myocardial projectional images and the importance of routinely analyzing these images for incidental noncardiac findings. PMID:22997275

  18. Abdominal imaging: An introduction

    SciTech Connect

    Frick, M.P.; Feinberg, S.B.

    1986-01-01

    This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures.

  19. Whole- and refined-grain intakes are differentially associated with abdominal visceral and subcutaneous adiposity in healthy adults: The Framingham Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Different aspects of diet may be differentially related to body fat distribution. The purpose of this study was to assess associations between whole- and refined- grain intake and abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). We examined the cross-sectional associati...

  20. Dosimetric Quantities for Computed Tomography Examinations of Paediatric Patients on the Thoracic and Abdominal Regions

    SciTech Connect

    Flores-M, E.; Gamboa de Buen, I.; Buenfil, A. E.; Ruiz-Trejo, C.; Dies, P.

    2010-12-07

    Computed Tomography (CT) is a high dose X ray imaging procedure and its use has rapidly increased in the last two decades fueled by the development of helical CT. The aim of this study is to present values of the dosimetric quantities for CT paediatric examinations of thoracic and abdominal regions. The protocols studied were those of chest, lung-mediastine, chest-abdomen, pulmonary high resolution and mediastine-abdomen, which are the more common examinations performed at ''Hospital Infantil de Mexico Federico Gomez'' in the thoracic-abdominal region. The measurements were performed on a Siemens SOMATOM Sensation 16 CT Scanner and the equipment used was a CT pencil ionization chamber, connected to an electrometer. This system was calibrated for RQT9 CT beam quality. A PMMA head phantom with diameter of 16 cm and length of 15 cm was also used. The dosimetric quantities measured were the weighted air kerma index (C{sub w}), the volumetric dose index (C{sub vol}) and the CT air kerma-length product. It was found that the pulmonary high resolution examination presented the highest values for the C{sub w}(31.1 mGy) and C{sub vol}(11.1 mGy). The examination with the lowest values of these two quantities was the chest-abdomen protocol with 10.5 mGy for C{sub w} and 5.5 mGy for C{sub vol}. However, this protocol presented the highest value for P{sub KL,CT}(282.2 mGy cm) when considering the average clinical length of the examinations.

  1. Dosimetric Quantities for Computed Tomography Examinations of Paediatric Patients on the Thoracic and Abdominal Regions

    NASA Astrophysics Data System (ADS)

    Flores-M, E.; Buenfil, A. E.; Dies, P.; Gamboa-deBuen, I.; Ruiz-Trejo, C.

    2010-12-01

    Computed Tomography (CT) is a high dose X ray imaging procedure and its use has rapidly increased in the last two decades fueled by the development of helical CT. The aim of this study is to present values of the dosimetric quantities for CT paediatric examinations of thoracic and abdominal regions. The protocols studied were those of chest, lung-mediastine, chest-abdomen, pulmonary high resolution and mediastine-abdomen, which are the more common examinations performed at "Hospital Infantil de México Federico Gómez" in the thoracic-abdominal region. The measurements were performed on a Siemens SOMATOM Sensation 16 CT Scanner and the equipment used was a CT pencil ionization chamber, connected to an electrometer. This system was calibrated for RQT9 CT beam quality. A PMMA head phantom with diameter of 16 cm and length of 15 cm was also used. The dosimetric quantities measured were the weighted air kerma index (Cw), the volumetric dose index (Cvol) and the CT air kerma-length product. It was found that the pulmonary high resolution examination presented the highest values for the Cw (31.1 mGy) and Cvol (11.1 mGy). The examination with the lowest values of these two quantities was the chest-abdomen protocol with 10.5 mGy for Cw and 5.5 mGy for Cvol. However, this protocol presented the highest value for PKL,CT (282.2 mGy cm) when considering the average clinical length of the examinations.

  2. EFFECT OF PROTEIN SOURCE DURING WEIGHT LOSS ON BODY COMPOSITION, CARDIOMETABOLIC RISK AND PHYSICAL PERFORMANCE IN ABDOMINALLY OBESE, OLDER ADULTS: A PILOT FEEDING STUDY

    PubMed Central

    BEAVERS, K.M.; GORDON, M.M.; EASTER, L.; BEAVERS, D.P.; HAIRSTON, K.G.; NICKLAS, B.J.; VITOLINS, M.Z.

    2016-01-01

    Objectives The purpose of this pilot study was to begin to examine the effect of dietary protein source (soy protein versus non-soy protein) during weight loss on body composition, and cardiometabolic and functional decline risk factors in older, abdominally obese adults. Design Two-arm, single-blind, randomized, controlled trial. Setting Wake Forest School of Medicine, Winston-Salem NC 27157, USA. Participants 25 older (68.4±5.5 years, 88% female), abdominally obese (BMI: 35.1±4.3 kg/m2; WC: 101.4±13.1 cm) men and women were randomized to participate in the study. Intervention A 12-week weight loss intervention, with participants randomized to consume soy protein-based meal replacements (S; n=12) or non-soy protein-based meal replacements (NS; n=12), in addition to prepared meals, and all participants targeted to receive an individualized caloric deficit of 500 kcal/day. Measurements Body weight and composition (assessed via DXA and CT), conventional biomarkers of cardiometabolic risk, and physical performance measures were assessed pre- and post-intervention. Additional endpoints of feasibility (accrual, participation, retention, compliance, and safety) are reported. Results A total of 24 participants (87% female) completed the study (96% retention) and lost an average of 7.8±3.0 kg over the 12-week period, with no difference seen between groups (p=0.83). Although nearly all measures of global and regional body composition were significantly reduced following the 12-week intervention, differences were not observed between groups. Among cardiometabolic risk factors and physical performance measures, only diastolic blood pressure was significantly lower in the NS group compared to the S group (66.7±2.7 mmHg vs 73.5±2.7 mmHg, respectively; p=0.04). Interestingly, in groups combined, despite significant reductions in body weight and lean mass, no significant changes in 400-meter walk time (+5.3±43.4 s), short physical performance battery score (+0.1±1

  3. [Ultrasound diagnosis of an abdominal aortic aneurysm in a 52 year old woman].

    PubMed

    Romero-Hernández, Juan José; Lozano-Corona, Marco Antonio; Díaz-Méndez, Macrina; Aspeitia-León, Jorge Alejandro; Hernández-Díaz, Víctor; Magaña-Cabrera, Daniel

    2012-01-01

    The abdominal aortic aneurysm (AAA) is defined as increasing the diameter of the aorta in more than 50 % of its original size and the infra-renal location is the most common (90 %). AAA disease mainly affects older men and white smokers, and has a male: female ratio of 4:1, as well the diagnosis is rare in women under age 55. Aneurysm rupture is the most common complication and cause of death in the general population, its etiology is unclear, but is commonly associated with atherosclerosis. The AAA do not exhibit rupture and it is usually asymptomatic diagnosed incidentally, however, as the aneurysm grows, appears symptoms such as back pain, abdominal or groin pain, well as palpation of a pulse mass on umbilical and supra-umbilical region. Imaging study such as ultrasound and CT scan are the mainstay of diagnosis. We present a case of 52 years old patient with no history related to the diagnosis, who presented sudden and severe abdominal pain. She was admitted to the emergency room with a diagnosis of acute cholecystitis vs. acute pancreatitis. After ultrasound and CT studies, the diagnosis was a complicated abdominal aortic aneurysm. PMID:22882988

  4. Multi-gamma-source CT imaging system: a feasibility study with the Poisson noise

    NASA Astrophysics Data System (ADS)

    Wi, Sunhee; Cho, Seungryong

    2016-03-01

    This study was performed to test the feasibility of multi-gamma-source CT imaging system. Gamma-source CT employs radioisotopes that emit monochromatic energy gamma-rays. The advantages of gamma-source CT include its immunity to beam hardening artifacts, its capacity of quantitative CT imaging, and its higher performance in low contrast imaging compared to the conventional x-ray CT. Radioisotope should be shielded by use of a pin-hole collimator so as to make a fine focal spot. Due to its low gamma-ray flux in general, the reconstructed image from a single gamma-source CT would suffer from high noise in data. To address this problem, we proposed a multi-gamma source CT imaging system and developed an iterative image reconstruction algorithm accordingly in this work. Conventional imaging model assumes a single linear imaging system typically represented by Mf = g. In a multi-gamma-source CT system however, the inversion problem is not any more based on a single linear system since one cannot separate a detector pixel value into multiple ones that are corresponding to each rays from the sources. Instead, the imaging model can be constructed by a set of linear system models each of which assumes an estimated measurement g. Based on this model, the proposed algorithm has a weighting step which distributes each projection data into multiple estimated measurements. We used two gamma sources at various positions and with varying intensities in this numerical study to demonstrate its feasibility. Therefore, the measured projection data(g) is separated into each estimated projection data(g1, g2) in this study. The proposed imaging protocol is believed to contribute to both medical and industrial applications.

  5. Prevalence of generalized & abdominal obesity in urban & rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3

    PubMed Central

    Pradeepa, Rajendra; Anjana, Ranjit Mohan; Joshi, Shashank R.; Bhansali, Anil; Deepa, Mohan; Joshi, Prashant P.; Dhandania, Vinay K.; Madhu, Sri Venkata; Rao, Paturi Vishnupriya; Geetha, Loganathan; Subashini, Radhakrishnan; Unnikrishnan, Ranjit; Shukla, Deepak Kumar; Kaur, Tanvir; Mohan, Viswanathan; Das, Ashok Kumar

    2015-01-01

    Background & objectives: Overweight and obesity are rapidly increasing in countries like India. This study was aimed at determining the prevalence of generalized, abdominal and combined obesity in urban and rural India. Methods: Phase I of the ICMR-INDIAB study was conducted in a representative population of three States [Tamil Nadu (TN), Maharashtra (MH) and Jharkhand (JH)] and one Union Territory (UT)[Chandigarh (CH)] of India. A stratified multi-stage sampling design was adopted and individuals ≥20 yr of age were included. WHO Asia Pacific guidelines were used to define overweight [body mass index (BMI) ≥23 kg/m2 but <25 kg/m2), generalized obesity (GO, BMI≥25kg/m2), abdominal obesity (AO, waist circumference ≥90 cm for men and ≥80cm for women) and combined obesity (CO, GO plus AO). Of the 14,277 participants, 13,800 subjects (response rate, 96.7%) were included for the analysis (urban: n=4,063; rural: n=9737). Results: The prevalence of GO was 24.6, 16.6, 11.8 and 31.3 per cent among residents of TN, MH, JH and CH, while the prevalence of AO was 26.6, 18.7, 16.9 and 36.1 per cent, respectively. CO was present in 19.3, 13.0, 9.8 and 26.6 per cent of the TN, MH, JH and CH population. The prevalence of GO, AO and CO were significantly higher among urban residents compared to rural residents in all the four regions studied. The prevalence of overweight was 15.2, 11.3, 7.8 and 15.9 per cent among residents of TN, MH, JH and CH, respectively. Multiple logistic regression analysis showed that female gender, hypertension, diabetes, higher socio-economic status, physical inactivity and urban residence were significantly associated with GO, AO and CO in all the four regions studied. Age was significantly associated with AO and CO, but not with GO. Interpretation & conclusions: Prevalence of AO as well as of GO were high in India. Extrapolated to the whole country, 135, 153 and 107 million individuals will have GO, AO and CO, respectively. However, these figures

  6. Dose reduction and image quality optimizations in CT of pediatric and adult patients: phantom studies

    NASA Astrophysics Data System (ADS)

    Jeon, P.-H.; Lee, C.-L.; Kim, D.-H.; Lee, Y.-J.; Jeon, S.-S.; Kim, H.-J.

    2014-03-01

    Multi-detector computed tomography (MDCT) can be used to easily and rapidly perform numerous acquisitions, possibly leading to a marked increase in the radiation dose to individual patients. Technical options dedicated to automatically adjusting the acquisition parameters according to the patient's size are of specific interest in pediatric radiology. A constant tube potential reduction can be achieved for adults and children, while maintaining a constant detector energy fluence. To evaluate radiation dose, the weighted CT dose index (CTDIw) was calculated based on the CT dose index (CTDI) measured using an ion chamber, and image noise and image contrast were measured from a scanned image to evaluate image quality. The dose-weighted contrast-to-noise ratio (CNRD) was calculated from the radiation dose, image noise, and image contrast measured from a scanned image. The noise derivative (ND) is a quality index for dose efficiency. X-ray spectra with tube voltages ranging from 80 to 140 kVp were used to compute the average photon energy. Image contrast and the corresponding contrast-to-noise ratio (CNR) were determined for lesions of soft tissue, muscle, bone, and iodine relative to a uniform water background, as the iodine contrast increases at lower energy (i.e., k-edge of iodine is 33 keV closer to the beam energy) using mixed water-iodine contrast normalization (water 0, iodine 25, 100, 200, and 1000 HU, respectively). The proposed values correspond to high quality images and can be reduced if only high-contrast organs are assessed. The potential benefit of lowering the tube voltage is an improved CNRD, resulting in a lower radiation dose and optimization of image quality. Adjusting the tube potential in abdominal CT would be useful in current pediatric radiography, where the choice of X-ray techniques generally takes into account the size of the patient as well as the need to balance the conflicting requirements of diagnostic image quality and radiation dose

  7. Abdominal Compartment Hypertension and Abdominal Compartment Syndrome.

    PubMed

    Maluso, Patrick; Olson, Jody; Sarani, Babak

    2016-04-01

    Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare but potentially morbid diagnoses. Clinical index of suspicion for these disorders should be raised following massive resuscitation, abdominal wall reconstruction/injury, and in those with space-occupying disorders in the abdomen. Gold standard for diagnosis involves measurement of bladder pressure, with a pressure greater than 12 mm Hg being consistent with IAH and greater than 25 mm Hg being consistent with ACS. Decompressive laparotomy is definitive therapy but paracentesis can be equally therapeutic in properly selected patients. Left untreated, ACS can lead to multisystem organ failure and death. PMID:27016163

  8. Reduction of iodinated contrast medium in CT: feasibility study

    NASA Astrophysics Data System (ADS)

    Nasirudin, Radin A.; Mei, Kai; Kopp, Felix K.; Penchev, Petar; Rummeny, Ernst J.; Fiebich, Martin; Noël, Peter B.

    2015-03-01

    In CT, the magnitude of enhancement is proportional to the amount of contrast medium (CM) injected. However, high doses of iodinated CM pose health risks, ranging from mild side effects to serious complications such as contrast-induced nephropathy (CIN). This work presents a method that enables the reduction of CM dosage, without affecting the diagnostic image quality. The technique proposed takes advantage of the additional spectral information provided by photon-counting CT systems. In the first step, we apply a material decomposition technique on the projection data to discriminate iodine from other materials. Then, we estimated the noise of the decomposed image by calculating the Cramér-Rao lower bound of the parameter estimator. Next, we iteratively reconstruct the iodine-only image by using the decomposed image and the estimation of noise as an input into a maximum-likelihood iterative reconstruction algorithm. Finally, we combine the iodine-only image with the original image to enhance the contrast of low iodine concentrations. The resulting reconstructions show a notably improved contrast in the final images. Quantitatively, the combined image has a significantly improved CNR, while the measured concentrations are closer to the actual concentrations of the iodine. The preliminary results from our technique show the possibility of reducing the clinical dosage of iodine, without affecting the diagnostic image quality.

  9. Sensitivity study for CT image use in Monte Carlo treatment planning

    NASA Astrophysics Data System (ADS)

    Verhaegen, Frank; Devic, Slobodan

    2005-03-01

    An important step in Monte Carlo treatment planning (MCTP), which is commonly performed uncritically, is segmentation of the patient CT data into a voxel phantom for dose calculation. In addition to assigning mass densities to voxels, as is done in conventional TP, this entails assigning media. Mis-assignment of media can potentially lead to significant dose errors in MCTP. In this work, a test phantom with exact-known composition was used to study CT segmentation errors and to quantify subsequent MCTP inaccuracies. For our test cases, we observed dose errors in some regions of up to 10% for 6 and 15 MV photons, more than 30% for an 18 MeV electron beam and more than 40% for 250 kVp photons. It is concluded that a careful CT calibration with a suitable phantom is essential. Generic calibrations and the use of commercial CT phantoms have to be critically assessed.

  10. Locating the kidneys on CT to guide nephrotomography.

    PubMed

    Chen, M Y; Gelfand, D W; Spangler, K; Dyer, R B; Zagoria, R J; Ott, D J

    1997-01-01

    Tomography of the kidneys is a routine procedure performed during intravenous urography. Precisely locating the kidneys, however, can be difficult. This article describes a study performed to determine a simple and accurate measurement for kidney location as a guide to obtaining initial nephrotomographic sections. The authors measured the distance from the midplane of the kidney to the posterior skin line on abdominal CT images in 26 patients. This distance averaged one-third the thickness of the abdominal region. The best depth for the nephrotomographic cut was found to be one-third the thickness of the abdomen plus the thickness of any table pad. PMID:9085416

  11. Whole Abdominal Wall Segmentation using Augmented Active Shape Models (AASM) with Multi-Atlas Label Fusion and Level Set

    PubMed Central

    Xu, Zhoubing; Baucom, Rebeccah B.; Abramson, Richard G.; Poulose, Benjamin K.; Landman, Bennett A.

    2016-01-01

    The abdominal wall is an important structure differentiating subcutaneous and visceral compartments and intimately involved with maintaining abdominal structure. Segmentation of the whole abdominal wall on routinely acquired computed tomography (CT) scans remains challenging due to variations and complexities of the wall and surrounding tissues. In this study, we propose a slice-wise augmented active shape model (AASM) approach to robustly segment both the outer and inner surfaces of the abdominal wall. Multi-atlas label fusion (MALF) and level set (LS) techniques are integrated into the traditional ASM framework. The AASM approach globally optimizes the landmark updates in the presence of complicated underlying local anatomical contexts. The proposed approach was validated on 184 axial slices of 20 CT scans. The Hausdorff distance against the manual segmentation was significantly reduced using proposed approach compared to that using ASM, MALF, and LS individually. Our segmentation of the whole abdominal wall enables the subcutaneous and visceral fat measurement, with high correlation to the measurement derived from manual segmentation. This study presents the first generic algorithm that combines ASM, MALF, and LS, and demonstrates practical application for automatically capturing visceral and subcutaneous fat volumes. PMID:27127333

  12. CRITICAL ANALYSIS OF EXPERIMENTAL MODEL FOR STUDY OF ADHESIONS AFTER INCISIONAL HERNIAS INDUCED IN RATS’ AND REPAIR OF ABDOMINAL WALL WITH DIFFERENT BIOMATERIALS

    PubMed Central

    SERIGIOLLE, Leonardo Carvalho; BARBIERI, Renato Lamounier; GOMES, Helbert Minuncio Pereira; RODRIGUES, Daren Athiê Boy; STUDART, Sarah do Valle; LEME, Pedro Luiz Squilacci

    2015-01-01

    Background: Adhesions induced by biomaterials experimentally implanted in the abdominal cavity are basically studied by primary repair of different abdominal wall defects or by the correction of incisional hernias previously performed with no precise definition of the most appropriate model. Aim: To describe the adhesions which occur after the development of incisional hernias, before the prosthesis implantation, in an experimental model to study the changes induced by different meshes. Methods: Incisional hernias were performed in 10 rats with hernia orifices of standardized dimensions, obtained by the median incision of the abdominal wall and eversion of the defect edges. Ten days after the procedure adhesions of abdominal structures were found when hernias were repaired with different meshes. Results: The results showed hernia sac well defined in all rats ten days after the initial procedure. Adhesions of the greater omentum occurred in five animals of which two also showed adhesions of small bowel loops besides the omentum, and another two showed liver adhesions as well as the greater omentum, numbers with statistical significance by Student's t test (p<0.05). Conclusion: Although it reproduces the real clinical situation, the choice of experimental model of incisional hernia repair previously induced implies important adhesions, with possible repercussions in the evaluation of the second operation, when different implants of synthetic materials are used. PMID:26537141

  13. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  14. [Extension study and evaluation of the therapeutic response in a patient with metastatic lung adenocarcinoma using sequential study with ¹⁸F-FDG PET-CT and ¹⁸F-fluoride PET-CT].

    PubMed

    Moragas, M; Soler, M; Riera, E; García, J R

    2015-01-01

    We report a case of a patient with lung adenocarcinoma and bone and extraosseus metastases studied with (18)F-FDG PET-CT, (99m)Tc-HMDP and (18)F-fluoride PET-CT. It assesses the usefulness of (18)F-FDG PET-CT for initial staging of the disease and monitoring response to therapy. For the study of the sclerotic bone metastases it shows the superiority of 99mTc-HMDP bone scintigraphy and (18)F-fluoride PET-CT over (18)F-FDG PET-CT, and (18)F-fluoride PET-CT over bone scintigraphy. It also shows the usefulness of (18)F-fluoride PET-CT for monitoring the bone metastases. PMID:24690280

  15. Leukemia and brain tumors among children after radiation exposure from CT scans: design and methodological opportunities of the Dutch Pediatric CT Study.

    PubMed

    Meulepas, Johanna M; Ronckers, Cécile M; Smets, Anne M J B; Nievelstein, Rutger A J; Jahnen, Andreas; Lee, Choonsik; Kieft, Mariëtte; Laméris, Johan S; van Herk, Marcel; Greuter, Marcel J W; Jeukens, Cécile R L P N; van Straten, Marcel; Visser, Otto; van Leeuwen, Flora E; Hauptmann, Michael

    2014-04-01

    Computed tomography (CT) scans are indispensable in modern medicine; however, the spectacular rise in global use coupled with relatively high doses of ionizing radiation per examination have raised radiation protection concerns. Children are of particular concern because they are more sensitive to radiation-induced cancer compared with adults and have a long lifespan to express harmful effects which may offset clinical benefits of performing a scan. This paper describes the design and methodology of a nationwide study, the Dutch Pediatric CT Study, regarding risk of leukemia and brain tumors in children after radiation exposure from CT scans. It is a retrospective record-linkage cohort study with an expected number of 100,000 children who received at least one electronically archived CT scan covering the calendar period since the introduction of digital archiving until 2012. Information on all archived CT scans of these children will be obtained, including date of examination, scanned body part and radiologist's report, as well as the machine settings required for organ dose estimation. We will obtain cancer incidence by record linkage with external databases. In this article, we describe several approaches to the collection of data on archived CT scans, the estimation of radiation doses and the assessment of confounding. The proposed approaches provide useful strategies for data collection and confounder assessment for general retrospective record-linkage studies, particular those using hospital databases on radiological procedures for the assessment of exposure to ionizing or non-ionizing radiation. PMID:24748424

  16. Motion artifacts in CT scans: a study by computer simulation and mechanical phantom

    NASA Astrophysics Data System (ADS)

    Tien, Der-Chi; Lung, Jen-Kuang; Liao, Chih-Yu; Yong, Tung-Che; Hsu, Chung-Hsien; Liao, Chih-Chiang; Wu, Ren-Hong; Tseng, Kuo-Hsiung; Tsung, Tsing-Tshih

    2008-11-01

    Computed tomography (CT) is one of the most important tools in the diagnosis of thoracic tumors. However, during the scanning process, respiratory motion causes changes in the position and shape of the tumor, creating motion artifacts in the CT scan. This can lead to misdiagnosis of the size and position of the tumor, and can affect the effectiveness of treatment. This study develops a computer model of the movement of the thorax, and simulates the movement of a lung tumor caused by breathing during a CT scan. We show that adjusting the CT slice thickness is sufficient to determine the center of displacement and maximum displacement of a tumor during normal breathing. This model can be applied in the clinical diagnostic use of CT equipment. It will assist in finding the position of lung tumors from motion artifacts in CT scans. The target margin for treatment can thus be defined more accurately, so that appropriate doses of radiation can be applied to the target area, and irradiation of healthy tissue avoided.

  17. Peritoneal Breach as an Indication for Exploratory Laparotomy in Penetrating Abdominal Stab Injury: Operative Findings in Haemodynamically Stable Patients

    PubMed Central

    Aguirre, Victor; Martin, Kate; Varma, Dinesh; Fitzgerald, Mark; Pilgrim, Charles

    2015-01-01

    Introduction. Management of haemodynamically stable patients with penetrating abdominal injuries varies from nonoperative to operative management. The aim was to investigate whether peritoneal breach when used as an indication for exploratory laparotomy appropriately identified patients with intra-abdominal visceral injury. Methods. We conducted retrospective cohort study of all patients presenting with PAI at a major trauma centre from January 2007 to December 2011. We measured the incidence of peritoneal breach and correlated this with intra-abdominal visceral injury diagnosed at surgery. Results. 252 patients were identified with PAI. Of the included patients, 71 were managed nonoperatively and 118 operatively. The operative diagnoses included nonperitoneal-breaching injuries, intraperitoneal penetration without organ damage, or intraperitoneal injury with organ damage. The presenting trauma CT scan was reported as normal in 63%, 34%, and 2% of these groups, respectively. The total negative laparotomy/laparoscopy rate for all patients presented with PAI was 21%, almost half of whom had a normal CT scan. Conclusion. We found that peritoneal breach on its own does not necessarily always equate to intra-abdominal visceral injury. Observation with sequential examination for PAI patients with a normal CT scan may be more important than exclusion of peritoneal breach via laparoscopy. PMID:26064688

  18. Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study

    PubMed Central

    2012-01-01

    The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012). This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 912 patients with a mean age of 54.4 years (range 4–98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified. The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality. White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality. PMID:22613202

  19. Interfraction variation in lung tumor position with abdominal compression during stereotactic body radiotherapy

    SciTech Connect

    Mampuya, Wambaka Ange; Nakamura, Mitsuhiro; Matsuo, Yukinori; Ueki, Nami; Iizuka, Yusuke; Monzen, Hajime; Mizowaki, Takashi; Hiraoka, Masahiro; Fujimoto, Takahiro; Yano, Shinsuke

    2013-09-15

    Purpose: To assess the effect of abdominal compression on the interfraction variation in tumor position in lung stereotactic body radiotherapy (SBRT) using cone-beam computed tomography (CBCT) in a larger series of patients with large tumor motion amplitude.Methods: Thirty patients with lung tumor motion exceeding 8 mm who underwent SBRT were included in this study. After translational and rotational initial setup error was corrected based on bone anatomy, CBCT images were acquired for each fraction. The residual interfraction variation was defined as the difference between the centroid position of the visualized target in three dimensions derived from CBCT scans and those derived from averaged intensity projection images. The authors compared the magnitude of the interfraction variation in tumor position between patients treated with [n= 16 (76 fractions)] and without [n= 14 (76 fractions)] abdominal compression.Results: The mean ± standard deviation (SD) of the motion amplitude in the longitudinal direction before abdominal compression was 19.9 ± 7.3 (range, 10–40) mm and was significantly (p < 0.01) reduced to 12.4 ± 5.8 (range, 5–30) mm with compression. The greatest variance of the interfraction variation with abdominal compression was observed in the longitudinal direction, with a mean ± SD of 0.79 ± 3.05 mm, compared to −0.60 ± 2.10 mm without abdominal compression. The absolute values of the 95th percentile of the interfraction variation for one side in each direction were 3.97/6.21 mm (posterior/anterior), 4.16/3.76 mm (caudal/cranial), and 2.90/2.32 mm (right/left) without abdominal compression, and 2.14/5.03 mm (posterior/anterior), 3.93/9.23 mm (caudal/cranial), and 2.37/5.45 mm (right/left) with abdominal compression. An absolute interfraction variation greater than 5 mm was observed in six (9.2%) fractions without and 13 (17.1%) fractions with abdominal compression.Conclusions: Abdominal compression was effective for reducing the amplitude

  20. Reconciling Differences in Pool-GWAS Between Populations: A Case Study of Female Abdominal Pigmentation in Drosophila melanogaster

    PubMed Central

    Endler, Lukas; Betancourt, Andrea J.; Nolte, Viola; Schlötterer, Christian

    2016-01-01

    The degree of concordance between populations in the genetic architecture of a given trait is an important issue in medical and evolutionary genetics. Here, we address this problem, using a replicated pooled genome-wide association study approach (Pool-GWAS) to compare the genetic basis of variation in abdominal pigmentation in female European and South African Drosophila melanogaster. We find that, in both the European and the South African flies, variants near the tan and bric-à-brac 1 (bab1) genes are most strongly associated with pigmentation. However, the relative contribution of these loci differs: in the European populations, tan outranks bab1, while the converse is true for the South African flies. Using simulations, we show that this result can be explained parsimoniously, without invoking different causal variants between the populations, by a combination of frequency differences between the two populations and dominance for the causal alleles at the bab1 locus. Our results demonstrate the power of cost-effective, replicated Pool-GWAS to shed light on differences in the genetic architecture of a given trait between populations. PMID:26715669

  1. Clinical characteristics and antimicrobial patterns in complicated intra-abdominal infections: a 6-year epidemiological study in southern China.

    PubMed

    Ouyang, Wenwei; Xue, Huiling; Chen, Yunqin; Gao, Weiguo; Li, Xiaoyan; Wei, Jia; Wen, Zehuai

    2016-03-01

    Complicated intra-abdominal infection (cIAIs) are a common and important cause of morbidity worldwide. In this study, the clinical features, microbiological profiles, antimicrobial patterns and treatments of 3233 cIAI patients (mean age, 47.6 years; 54.7% male) with 3531 hospitalisations from 2008-2013 were retrospectively investigated. The most commonly isolated bacteria were Escherichia coli (47.6%), Klebsiella pneumoniae (16.9%), Enterococcus faecalis (10.4%) and Pseudomonas aeruginosa (8.8%). Ciprofloxacin, aminoglycoside (gentamicin), piperacillin/tazobactam and carbapenems exhibited activity against 53%, 76%, 88% and 100% of extended-spectrum β-lactamase (ESBL)-positive Enterobacteriaceae isolates, respectively. Pseudomonas aeruginosa isolates exhibited 100%, 95%, 88%, 71% and 76% susceptibility to aminoglycoside (gentamicin), ciprofloxacin, meropenem, imipenem and ceftazidime, respectively, and Enterococcus remained 100% susceptible to vancomycin and linezolid. β-Lactam antibacterials other than penicillin (specifically third-generation cephalosporins) and imidazole derivatives (ornidazole and metronidazole) were the most common first-line treatments. Patients subjected to regimen change after initial antibiotic treatment had predisposing conditions (e.g. older age, more severe co-morbidities) and a higher incidence of P. aeruginosa infection; in addition, these patients encountered a higher average cost of care and worse clinical outcomes compared with those without medication modification. Taken together, these findings indicate the importance of appropriate initial empirical therapy and suggest the use of combination therapy comprising cephalosporins and metronidazole. PMID:26899413

  2. [Differential diagnosis of abdominal cysts in children].

    PubMed

    Józsa, Gergő; Mohay, Gabriella; Pintér, András; Vástyán, Attila

    2015-09-13

    19 children were diagnosed with abdominal cysts of different origin in the Surgical Unit of the Department of Pediatrics, Medical University of Pécs, Hungary between 2010 and 2013. The authors discuss the details of representative cases of a parovarial cyst, an intestinal duplication, and an omental cyst with emphasis on the clinical symptoms, diagnostic tools, and surgical interventions. The authors conclude that abdominal cysts often cause mild symptoms only, and they are discovered accidentally by ultrasound imaging performed for other reasons. In some cases, the cyst can cause severe complaints or even acute abdomen requiring emergency surgery. Laporoscopy may be a valuable method both in diagnosis and surgical therapy. Abdominal CT or MRI are not required in the majority of the patients. PMID:26552027

  3. [Abdominal aortic aneurysm and renovascular disease].

    PubMed

    Riambau, Vicente; Guerrero, Francisco; Montañá, Xavier; Gilabert, Rosa

    2007-06-01

    Recent technological advances in the diagnosis and therapy of abdominal aortic aneurysm and renovascular disease are continuing to bring about changes in the way patients suffering from these conditions are treated. The prevalence of both these conditions is increasing. This is due to greater life-expectancy in patients with arteriosclerosis, a pathogenetic factor underlying both conditions. The application of diagnostic imaging techniques to non-vascular conditions has led to the early diagnosis of abdominal aortic aneurysm. Clinical suspicion of reno-vascular disease can be confirmed easily using high-resolution diagnostic imaging modalities such as CT angiography and magnetic resonance angiography. Endovascular intervention is successfully replacing conventional surgical repair techniques, with the result that it may be possible to improve outcome in both conditions using effective and minimally invasive approaches. Future technological developments will enable these endovascular techniques to be applied in the large majority of patients with abdominal aortic aneurysm or renovascular disease. PMID:17580053

  4. Hepatic perfusion in a tumor model using DCE-CT: an accuracy and precision study

    NASA Astrophysics Data System (ADS)

    Stewart, Errol E.; Chen, Xiaogang; Hadway, Jennifer; Lee, Ting-Yim

    2008-08-01

    In the current study we investigate the accuracy and precision of hepatic perfusion measurements based on the Johnson and Wilson model with the adiabatic approximation. VX2 carcinoma cells were implanted into the livers of New Zealand white rabbits. Simultaneous dynamic contrast-enhanced computed tomography (DCE-CT) and radiolabeled microsphere studies were performed under steady-state normo-, hyper- and hypo-capnia. The hepatic arterial blood flows (HABF) obtained using both techniques were compared with ANOVA. The precision was assessed by the coefficient of variation (CV). Under normo-capnia the microsphere HABF were 51.9 ± 4.2, 40.7 ± 4.9 and 99.7 ± 6.0 ml min-1 (100 g)-1 while DCE-CT HABF were 50.0 ± 5.7, 37.1 ± 4.5 and 99.8 ± 6.8 ml min-1 (100 g)-1 in normal tissue, tumor core and rim, respectively. There were no significant differences between HABF measurements obtained with both techniques (P > 0.05). Furthermore, a strong correlation was observed between HABF values from both techniques: slope of 0.92 ± 0.05, intercept of 4.62 ± 2.69 ml min-1 (100 g)-1 and R2 = 0.81 ± 0.05 (P < 0.05). The Bland-Altman plot comparing DCE-CT and microsphere HABF measurements gives a mean difference of -0.13 ml min-1 (100 g)-1, which is not significantly different from zero. DCE-CT HABF is precise, with CV of 5.7, 24.9 and 1.4% in the normal tissue, tumor core and rim, respectively. Non-invasive measurement of HABF with DCE-CT is accurate and precise. DCE-CT can be an important extension of CT to assess hepatic function besides morphology in liver diseases.

  5. Predicting Arterial Injuries after Penetrating Brain Trauma Based on Scoring Signs from Emergency CT Studies

    PubMed Central

    Bodanapally, Uttam K; Krejza, Jaroslaw; Saksobhavivat, Nitima; Jaffray, Paul M; Sliker, Clint W; Miller, Lisa A; Shanmuganathan, Kathirkamanathan; Dreizin, David

    2014-01-01

    Summary The objective of this study was to determine the accuracy of individual radiologists in detection of vascular injury in patients after penetrating brain injury (PBI) based on head CT findings at admission. We retrospectively evaluated 54 PBI patients who underwent admission head CT and digital subtraction angiography (DSA), used here as a reference standard. Two readers reviewed the CT images to determine the presence or absence of the 29 CT variables of injury profile and quantified selected variables. Four experienced trauma radiologists and one neuroradiologist assigned their own specific scores for each CT variable, a high score indicative of a high probability of artery injury. A sixth set consisted of the average score obtained from the five sets, generated by five experts. Receiver operating characteristic (ROC) curves were constructed for each set to assess the diagnostic performance of an individual radiologist in predicting an underlying vascular injury. The area under ROC curve (AUC) was higher for CT scores obtained from the sixth set (average of five sets of scores) of variable rank score 0.75 (95% CI 0.62-0.88) and for the rest of the data sets, the value ranged from 0.70 (95% CI 0.56-0.84) to 0.74 (95% CI 0.6-0.88). In conclusion, radiologists may be able to recommend DSA with a fair accuracy rate in selected patients, deemed ‘high-risk' for developing intracranial vascular injuries after PBI based on admission CT studies. A better approach needs to be developed to reduce the false positive rate to avoid unnecessary emergency DSA. PMID:24750698

  6. Size-specific dose estimates: Localizer or transverse abdominal computed tomography images?

    PubMed Central

    Pourjabbar, Sarvenaz; Singh, Sarabjeet; Padole, Atul; Saini, Akshay; Blake, Michael A; Kalra, Mannudeep K

    2014-01-01

    AIM: To investigate effect of body dimensions obtained from localizer radiograph and transverse abdominal computed tomography (CT) images on Size Specific Dose Estimate. METHODS: This study was approved by Institutional Review Board and was compliant with Health Insurance Portability and Accountability Act. Fifty patients with abdominal CT examinations (58 ± 13 years, Male:Female 28:22) were included in this study. Anterior-posterior (AP) and lateral (Lat) diameters were measured at 5 cm intervals from the CT exam localizer radiograph (simple X-ray image acquired for planning the CT exam before starting the scan) and transverse CT images. Average of measured AP and Lat diameters, as well as maximum, minimum and mid location AP and Lat were measured on both image sets. In addition, off centering of patients from the gantry iso-center was calculated from the localizers. Conversion factors from American Association of Physicists in Medicine (AAPM) report 204 were obtained for AP, Lat, AP + Lat, and effective diameter (√ AP * Lat) to determine size specific dose estimate (SSDE) from the CT dose index volume (CTDIvol) recorded from the dose reports. Data were analyzed using SPSS v19. RESULTS: Total number of 5376 measurements was done. In some patients entire body circumference was not covered on either projection radiograph or transverse CT images; hence accurate measurement of AP and Lat diameters was not possible in 11% (278/2488) of locations. Forty one patients were off-centered with mean of 1.9 ± 1.8 cm (range: 0.4-7 cm). Conversion factors for attained diameters were not listed on AAPM look-up tables in 3% (80/2488) of measurements. SSDE values were significantly different compared to CTDIvol, ranging from 32% lower to 74% greater than CTDIvol. CONCLUSION: There is underestimation and overestimation of dose comparing SSDE values to CTDIvol. Localizer radiographs are associated with overestimation of patient size and therefore underestimation of SSDE. PMID

  7. Abdominal trauma. Emphasis on computed tomography.

    PubMed

    Raptopoulos, V

    1994-09-01

    CT scans have been the champion in the diagnosis and management of abdominal injuries, and their use has decreased the number of negative exploratory laparotomies. Traditional areas for the use of CT scans include the assessment of injuries to the spleen and the liver and to signs of organ rupture into the peritoneal cavity. New technologic advances and increased experience have expanded the value of this modality to less than hemodynamically stable patients as well as to less common and more difficult to diagnose injuries of the pancreas, bowel, and the mesentery. PMID:8085007

  8. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  9. Benign osseous and articular abnormalities of the pelvis: a review of CT imaging findings.

    PubMed

    Belfi, Lily M; Bartolotta, Roger J; Loftus, Michael L; Wladyka, Christopher; Hentel, Keith D

    2015-01-01

    Computed tomography (CT) has become the standard of care for evaluation and follow-up for a wide range of abdominal and pelvic pathology. Many incidental osseous and articular abnormalities of the pelvis are detected on these studies, most of which have a benign etiology. However, most of these studies are interpreted by nonmusculoskeletal radiologists, who may not be familiar with the CT appearances of these benign musculoskeletal abnormalities. Uncertainty often leads to mischaracterization or unnecessary follow-up, resulting in increased health care costs and patient anxiety. This article reviews the CT appearance of the benign musculoskeletal entities that occur in pelvis. PMID:25433854

  10. Hereditary angio-edema involving the gastrointestinal tract: CT findings.

    PubMed

    Sadeghi, N; Van Daele, D; Hainaux, B; Engelholm, L; Michel, O

    2001-01-01

    We report a case of hereditary angio-edema in a young man presenting with recurrent abdominal pain for many years. The diagnosis was suspected on the basis of abdominal CT performed during an abdominal attack and was then confirmed by the measurement of serum concentration of C1 esterase inhibitor (C1-INH). To our knowledge, this is the first case reported of the hereditary form of angio-edema with isolated abdominal pain and in which the diagnosis was suggested by abdominal CT findings. PMID:11194925

  11. SU-E-T-416: VMAT Dose Calculations Using Cone Beam CT Images: A Preliminary Study

    SciTech Connect

    Yu, S; Sehgal, V; Kuo, J; Daroui, P; Ramsinghani, N; Al-Ghazi, M

    2014-06-01

    Purpose: Cone beam CT (CBCT) images have been used routinely for patient positioning throughout the treatment course. However, use of CBCT for dose calculation is still investigational. The purpose of this study is to assess the utility of CBCT images for Volumetric Modulated Arc Therapy (VMAT) plan dose calculation. Methods: A CATPHAN 504 phantom (The Phantom Laboratory, Salem, NY) was used to compare the dosimetric and geometric accuracy between conventional CT and CBCT (in both full and half fan modes). Hounsfield units (HU) profiles at different density areas were evaluated. A C shape target that surrounds a central avoidance structure was created and a VMAT plan was generated on the CT images and copied to the CBCT phantom images. Patient studies included three brain patients, and one head and neck (H'N) patient. VMAT plans generated on the patients treatment planning CT was applied to CBCT images obtained during the first treatment. Isodose distributions and dosevolume- histograms (DVHs) were compared. Results: For the phantom study, the HU difference between CT and CBCT is within 100 (maximum 96 HU for Teflon CBCT images in full fan mode). The impact of these differences on the calculated dose distributions was clinically insignificant. In both phantom and patient studies, target DVHs based on CBCT images were in excellent agreement with those based on planning CT images. Mean, Median, near minimum (D98%), and near maximum (D2%) doses agreed within 0-2.5%. A slightly larger discrepancy is observed in the patient studies compared to that seen in the phantom study, (0-1% vs. 0 - 2.5%). Conclusion: CBCT images can be used to accurately predict dosimetric results, without any HU correction. It is feasible to use CBCT to evaluate the actual dose delivered at each fraction. The dosimetric consequences resulting from tumor response and patient geometry changes could be monitored.

  12. Recurrent abdominal pain in children.

    PubMed

    Buch, Niyaz A; Ahmad, Sheikh Mushtaq; Ahmed, S Zubair; Ali, Syed Wazid; Charoo, B A; Hassan, Masood Ul

    2002-09-01

    Eighty five children with recurrent abdominal pain(RAP) were studied. Organic cause was noticed in 70 cases and non-organic in 15 cases. Giardiasis was the commonest organic cause in 57 (67.0 percent), either alone or with other parasitic infestations. Other organic causes include gallstones (4.7 percent), urinary infections (4.7 percent), esophagitis/gastritis (3.5 percent) and abdominal tuberculosis (2.3 percent). Single parent, school phobia, sibling rivalry, RAP in other family members and nocturnal enuresis are significant factors associated with nonorganic causes PMID:12368527

  13. Endoluminal Treatment of Ruptured Abdominal Aortic Aneurysm with Small Intestinal Submucosa Sandwich Endografts: A Pilot Study in Sheep

    SciTech Connect

    Yamada, Katsuyuki; Pavcnik, Dusan; Uchida, Barry T.; Timmermans, Hans A.; Corless, Christopher L.; Yin, Qiang; Yamakado, Koichiro; Wha Park, Joong; Roesch, Josef; Keller, Frederick S.; Sato, Morio; Yamada, Ryusaku

    2001-03-15

    Purpose: To evaluate efficacy of small intestinal submucosa (SIS) Sandwich endografts for the treatment of acute rupture of abdominal aortic aneurysms (AAA) and to explore the short-term reaction of the aorta to this material.Methods: In eight adult sheep, an infrarenal AAA was created transluminally by dilation of a short Palmaz stent. In six sheep, the aneurysm was then ruptured by overdilation of the stent with a large angioplasty balloon. Two sheep with AAAs that were not ruptured served as controls. A SIS Sandwich endograft, consisting of a Z stent frame with 5 bodies and covered inside and out with SIS, was used to exclude the ruptured and non-ruptured AAAs. Follow-up aortography was done immediately after the procedure and before sacrifice at 4, 8, or 12 weeks. Autopsy and histologic studies followed.Results: Endograft placement was successful in all eight sheep. Both ruptured and non-ruptured AAAs were successfully excluded. Three animals with AAA rupture developed hind leg paralysis due to compromise of the arterial supply to the lower spinal cord and were sacrificed 1 day after the procedure. In five animals, three with rupture and two controls, follow-up aortograms revealed no aortic stenoses and no perigraft leaks. Gross and histologic studies revealed incorporation of the endografts into the aortic wall with replacement of SIS by dense neointima that was completely endothelialized in areas where the endograft was in direct contact with the aortic wall. In central portions of the endograft, in contact with the thrombosed aneurysm, endothelialization was incomplete even at 12 weeks.Conclusion: The SIS Sandwich endografts effectively excluded simple AAAs and ruptured AAAs. They were rapidly incorporated into the aortic wall. A detailed long-term study is warranted.

  14. Impact of low-dose CT scan in dual timepoint investigations: a phantom study

    NASA Astrophysics Data System (ADS)

    Micheelsen, M. A.; Jensen, M.

    2011-09-01

    Dual timepoint FDG takeup investigations have a potential for separating malignant lymph nodes from non-malignant in certain cases of suspected lung cancer. One hour seems to be the optimal time interval between the two scans (50-120 min). Many of the new PET scanners benefit from image fusion with a CT image and also use the CT for attenuation correction. In any practical hospital setting, 1 hour is too long to occupy the scanner bed and a second CT procedure thus becomes necessary. This study tries to validate to what extent the dose/quality of the second CT scan can be lowered, without compromising attenuation correction, lesion detection and quantification. Using a standard NEMA phantom with the GE Discovery PET/CT scanner, taken in and out between scan sessions, we have tried to find the minimal CT dose necessary for the second scan while still reaching tissue activity quantification within predetermined error limits. For a hot sphere to background activity concentration ratio of 1:5, the average uptake (normalised by the time corrected input activity concentration) in a sphere of 6 cm3 was found to be 0.90 ± 0.08 for the standard scan, yielding a dose of 5.5 mGy, and 0.90 ± 0.14 for a scan with lowest possible mAs product and lowest possible kV, yielding a dose of 0.65 mGy. With an insignificant increase in the uncertainty in the uptake measurement, we can get an order of magnitude reduction for the CT dose.

  15. Exploratory study into the effect of abdominal mass loading on airways resistance and ventilatory failure

    PubMed Central

    Dattani, Raj S; Swerner, Casey B; Stradling, John R; Manuel, Ari RG

    2016-01-01

    Objective We hypothesised that the airway resistance during tidal breathing would correlate with a particular pattern of increasing obesity, particularly when supine, and would differ between participants with and without ventilatory failure. Methods In our cross-sectional cohort study, 72 morbidly obese patients (40 males, 32 females, mean body mass index (BMI) 47.2) had measurements of both airways resistance (by impulse oscillometry (IOS)) and adiposity (by dual-energy X-ray absorptiometry (DXA)). Results All measures of airways resistance increased in the supine position: total airways resistance (R5) +37% (p<0.0005); large airways resistance (R20) +29% (p<0.0005); and small airways resistance (R5–R20) +52% (p<0.0005). BMI was correlated with seated R5, seated R5–R20, supine R5 and supine R5–R20 (r=0.33 p<0.006, r=0.32 p<0.004, r=0.30 p<0.02 and r=0.36 p<0.04, respectively). Visceral adipose tissue mass was correlated with supine R5–20 (r=0.46 p<0.05). Supine measures of total airways resistance (R5) and large airways resistance (R20) differed between those with and without ventilatory failure, as did mean weight and BMI. Conclusions Our study identifies a potentially detrimental effect of the supine posture on tidal breathing airways resistance in obese patients. This change is correlated most with visceral adipose tissue mass and the small airways. We were able to demonstrate that supine increases in airways resistance during tidal breathing, within obese patients, are different between those with and without ventilatory failure. Trial registration number NCT01380418; pre-results. PMID:27335651

  16. SU-E-J-72: Dosimetric Study of Cone-Beam CT-Based Radiation Treatment Planning Using a Patient-Specific Stepwise CT-Density Table

    SciTech Connect

    Chen, S; Le, Q; Mutaf, Y; Yi, B; D’Souza, W

    2015-06-15

    Purpose: To assess dose calculation accuracy of cone-beam CT (CBCT) based treatment plans using a patient-specific stepwise CT-density conversion table in comparison to conventional CT-based treatment plans. Methods: Unlike CT-based treatment planning which use fixed CT-density table, this study used patient-specific CT-density table to minimize the errors in reconstructed mass densities due to the effects of CBCT Hounsfield unit (HU) uncertainties. The patient-specific CT-density table was a stepwise function which maps HUs to only 6 classes of materials with different mass densities: air (0.00121g/cm3), lung (0.26g/cm3), adipose (0.95g/cm3), tissue (1.05 g/cm3), cartilage/bone (1.6g/cm3), and other (3g/cm3). HU thresholds to define different materials were adjusted for each CBCT via best match with the known tissue types in these images. Dose distributions were compared between CT-based plans and CBCT-based plans (IMRT/VMAT) for four types of treatment sites: head and neck (HN), lung, pancreas, and pelvis. For dosimetric comparison, PTV mean dose in both plans were compared. A gamma analysis was also performed to directly compare dosimetry in the two plans. Results: Compared to CT-based plans, the differences for PTV mean dose were 0.1% for pelvis, 1.1% for pancreas, 1.8% for lung, and −2.5% for HN in CBCT-based plans. The gamma passing rate was 99.8% for pelvis, 99.6% for pancreas, and 99.3% for lung with 3%/3mm criteria, and 80.5% for head and neck with 5%/3mm criteria. Different dosimetry accuracy level was observed: 1% for pelvis, 3% for lung and pancreas, and 5% for head and neck. Conclusion: By converting CBCT data to 6 classes of materials for dose calculation, 3% of dose calculation accuracy can be achieved for anatomical sites studied here, except HN which had a 5% accuracy. CBCT-based treatment planning using a patient-specific stepwise CT-density table can facilitate the evaluation of dosimetry changes resulting from variation in patient anatomy.

  17. Evaluation of tumor localization in respiration motion-corrected cone-beam CT: Prospective study in lung

    SciTech Connect

    Dzyubak, Oleksandr; Kincaid, Russell; Hertanto, Agung; Hu, Yu-Chi; Pham, Hai; Yorke, Ellen; Zhang, Qinghui; Mageras, Gig S.; Rimner, Andreas

    2014-10-15

    Purpose: Target localization accuracy of cone-beam CT (CBCT) images used in radiation treatment of respiratory disease sites is affected by motion artifacts (blurring and streaking). The authors have previously reported on a method of respiratory motion correction in thoracic CBCT at end expiration (EE). The previous retrospective study was limited to examination of reducing motion artifacts in a small number of patient cases. They report here on a prospective study in a larger group of lung cancer patients to evaluate respiratory motion-corrected (RMC)-CBCT ability to improve lung tumor localization accuracy and reduce motion artifacts in Linac-mounted CBCT images. A second study goal examines whether the motion correction derived from a respiration-correlated CT (RCCT) at simulation yields similar tumor localization accuracy at treatment. Methods: In an IRB-approved study, 19 lung cancer patients (22 tumors) received a RCCT at simulation, and on one treatment day received a RCCT, a respiratory-gated CBCT at end expiration, and a 1-min CBCT. A respiration monitor of abdominal displacement was used during all scans. In addition to a CBCT reconstruction without motion correction, the motion correction method was applied to the same 1-min scan. Projection images were sorted into ten bins based on abdominal displacement, and each bin was reconstructed to produce ten intermediate CBCT images. Each intermediate CBCT was deformed to the end expiration state using a motion model derived from RCCT. The deformed intermediate CBCT images were then added to produce a final RMC-CBCT. In order to evaluate the second study goal, the CBCT was corrected in two ways, one using a model derived from the RCCT at simulation [RMC-CBCT(sim)], the other from the RCCT at treatment [RMC-CBCT(tx)]. Image evaluation compared uncorrected CBCT, RMC-CBCT(sim), and RMC-CBCT(tx). The gated CBCT at end expiration served as the criterion standard for comparison. Using automatic rigid image

  18. Porcine acellular lung matrix for wound healing and abdominal wall reconstruction: A pilot study

    PubMed Central

    Fernandez-Moure, Joseph S; Van Eps, Jeffrey L; Rhudy, Jessica R; Cabrera, Fernando J; Acharya, Ghanashyam S; Tasciotti, Ennio; Sakamoto, Jason; Nichols, Joan E

    2016-01-01

    Surgical wound healing applications require bioprosthetics that promote cellular infiltration and vessel formation, metrics associated with increased mechanical strength and resistance to infection. Porcine acellular lung matrix is a novel tissue scaffold known to promote cell adherence while minimizing inflammatory reactions. In this study, we evaluate the capacity of porcine acellular lung matrix to sustain cellularization and neovascularization in a rat model of subcutaneous implantation and chronic hernia repair. We hypothesize that, compared to human acellular dermal matrix, porcine acellular lung matrix would promote greater cell infiltration and vessel formation. Following pneumonectomy, porcine lungs were processed and characterized histologically and by scanning electron microscopy to demonstrate efficacy of the decellularization. Using a rat model of subcutaneou implantation, porcine acellular lung matrices (n = 8) and human acellular dermal matrices (n = 8) were incubated in vivo for 6 weeks. To evaluate performance under mechanically stressed conditions, porcine acellular lung matrices (n = 7) and human acellular dermal matrices (n = 7) were implanted in a rat model of chronic ventral incisional hernia repair for 6 weeks. After 6 weeks, tissues were evaluated using hematoxylin and eosin and Masson’s trichrome staining to quantify cell infiltration and vessel formation. Porcine acellular lung matrices were shown to be successfully decellularized. Following subcutaneous implantation, macroscopic vessel formation was evident. Porcine acellular lung matrices demonstrated sufficient incorporation and showed no evidence of mechanical failure after ventral hernia repair. Porcine acellular lung matrices demonstrated significantly greater cellular density and vessel formation when compared to human acellular dermal matrix. Vessel sizes were similar across all groups. Cell infiltration and vessel formation are well-characterized metrics of incorporation

  19. Porcine acellular lung matrix for wound healing and abdominal wall reconstruction: A pilot study.

    PubMed

    Fernandez-Moure, Joseph S; Van Eps, Jeffrey L; Rhudy, Jessica R; Cabrera, Fernando J; Acharya, Ghanashyam S; Tasciotti, Ennio; Sakamoto, Jason; Nichols, Joan E

    2016-01-01

    Surgical wound healing applications require bioprosthetics that promote cellular infiltration and vessel formation, metrics associated with increased mechanical strength and resistance to infection. Porcine acellular lung matrix is a novel tissue scaffold known to promote cell adherence while minimizing inflammatory reactions. In this study, we evaluate the capacity of porcine acellular lung matrix to sustain cellularization and neovascularization in a rat model of subcutaneous implantation and chronic hernia repair. We hypothesize that, compared to human acellular dermal matrix, porcine acellular lung matrix would promote greater cell infiltration and vessel formation. Following pneumonectomy, porcine lungs were processed and characterized histologically and by scanning electron microscopy to demonstrate efficacy of the decellularization. Using a rat model of subcutaneou implantation, porcine acellular lung matrices (n = 8) and human acellular dermal matrices (n = 8) were incubated in vivo for 6 weeks. To evaluate performance under mechanically stressed conditions, porcine acellular lung matrices (n = 7) and human acellular dermal matrices (n = 7) were implanted in a rat model of chronic ventral incisional hernia repair for 6 weeks. After 6 weeks, tissues were evaluated using hematoxylin and eosin and Masson's trichrome staining to quantify cell infiltration and vessel formation. Porcine acellular lung matrices were shown to be successfully decellularized. Following subcutaneous implantation, macroscopic vessel formation was evident. Porcine acellular lung matrices demonstrated sufficient incorporation and showed no evidence of mechanical failure after ventral hernia repair. Porcine acellular lung matrices demonstrated significantly greater cellular density and vessel formation when compared to human acellular dermal matrix. Vessel sizes were similar across all groups. Cell infiltration and vessel formation are well-characterized metrics of incorporation

  20. Abdominal aortic calcification is not superior over other vascular calcification in predicting mortality in hemodialysis patients: a retrospective observational study

    PubMed Central

    2013-01-01

    Background KDIGO (Kidney Disease: Improving Global Outcomes) guidelines recommend that a lateral abdominal radiograph should be performed to assess vascular calcification (VC) in dialysis patients. However, abdominal aortic calcification is a prevalent finding, and it remains unclear whether other anatomical areas of VC can predict mortality more accurately. Methods A total of 217 maintenance hemodialysis patients were enrolled at the Sichuan Provincial People’s Hospital between July 2010 and March 2011. Radiographs of the abdomen, pelvis and hands were evaluated by a radiologist to evaluate the presence of VC. The correlation between different areas of VC and all-cause or cardiovascular mortality was analyzed using univariate and multivariate models. Results The prevalence of VC was 70.0% (152 patients), and most had abdominal aortic calcification (90.1%). During 26 ± 7 months of follow-up, 37 patients died. The VC score was independently associated with patient mortality. VC observed on abdominal radiographs (abdominal aortic calcification) was associated with all-cause mortality in models adjusted for cardiovascular risk factors (HR, 4.69; 95%CI, 1.60-13.69) and dialysis factors (HR, 3.38; 95%CI, 1.18-9.69). VC in the pelvis or hands was associated with all-cause mortality in the model adjusted for dialysis factors. When three combinations of VC in different radiographs were included in models, the presence of abdominal VC was only significantly associated with all-cause mortality in the integrated model. VC in the abdomen and pelvis was associated with all-cause mortality in the model adjusted for cardiovascular factors and the integrated model, but neither was significantly associated with cardiovascular mortality. VC in all radiographs was significantly associated with a more than 6-fold risk of all-cause mortality and a more than 5-fold risk of cardiovascular mortality compared to patients without VC. Conclusions VC in different arteries as shown on

  1. Maternal macronutrient intake during pregnancy is associated with neonatal abdominal adiposity: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study1-4

    PubMed Central

    Chen, Ling-Wei; Tint, Mya-Thway; Fortier, Marielle V.; Aris, Izzuddin M.; Bernard, Jonathan Y.; Colega, Marjorelee; Gluckman, Peter D.; Saw, Seang-Mei; Chong, Yap-Seng; Yap, Fabian; Godfrey, Keith M.; Kramer, Michael S.; van Dam, Rob M.; Chong, Mary Foong-Fong; Lee, Yung Seng

    2016-01-01

    Background Infant body composition has been associated with later metabolic risk, but few studies have examined the association between maternal macronutrient intake and neonatal body composition. Furthermore, most of those studies have used proxy measures of body composition that may not reflect body fat distribution, particularly abdominal internal adiposity. Objective We investigated the relation between maternal macronutrient intake and neonatal abdominal adiposity measured using magnetic resonance imaging (MRI) in a multi-ethnic Asian mother-offspring cohort. Methods Macronutrient intakes of mothers were ascertained using a 24-h dietary recall at 26-28 weeks gestation. Neonatal abdominal adiposity was assessed using MRI in the second week of life. Mother-offspring dyads with complete macronutrient intake and adiposity information (n= 320) were included in the analysis. Associations were assessed by both substitution and addition models using multivariable linear regressions. Results Mothers [mean age: 30 y; 44% Chinese, 38% Malay, 18% Indians] consumed 15.5 ± 4.3% (mean ± SD) of their energy intakes from protein, 32.4 ± 7.7% from fat, and 52.1 ± 9.0% from carbohydrate. A higher protein, lower carbohydrate/fat diet during pregnancy was associated with lower abdominal internal adipose tissue (IAT) in the neonates [β (95% CI): -0.18 (-0.35, -0.001) mL per 1% protein to carbohydrate substitution and -0.25 (-0.46, -0.04) mL per 1% protein to fat substitution]. These associations were stronger in boys than in girls (P-interactions <0.05). Higher maternal intake of animal protein [-0.26 (-0.47, -0.05) mL for fat substitution], but not plant protein, was associated with lower offspring IAT. In contrast, maternal macronutrient intake was not consistently associated with infant anthropometric measurements, including abdominal circumference and subscapular skinfold thickness. Conclusions Higher maternal protein intake (at the expense of carbohydrate or fat intake

  2. Preoperative Association of Abdominal Striae Gravidarum with Intraabdominal Adhesions in Pregnant Women with a History of Previous Cesarean Section: a Cross-sectional Study

    PubMed Central

    Dogan, A.; Ertas, I. E.; Uyar, I.; Karaca, I.; Bozgeyik, B.; Töz, E.; Ozeren, M.

    2016-01-01

    Introduction: Intraabdominal adhesions that develop because of prior abdominal or pelvic surgery may cause problems during surgery. Complications can include difficult intraabdominal entry; injury to the urinary bladder, uterus or small intestine; longer operation times, and increased blood loss. The goal of the present study was to evaluate the association between abdominal striae gravidarum and intraabdominal adhesions in the preoperative period in pregnant women with a history of cesarean section. Materials and Methods: The study included 247 pregnant women at ≥ 37 weeks of gestation admitted to the labor unit for delivery; all had undergone at least one previous cesarean section. Abdominal striae were assessed preoperatively using the Davey scoring system; the severity and intensity of adhesions were subsequently evaluated intraoperatively according to the modified Nair scoring system. Results: No striae were seen in 104 pregnant women; 41 had mild striae and 102 had severe striae. Overall, 113 cases had no adhesions (grade 0), 106 had grade 1–2 adhesions, and 28 had grade 3–4 adhesions. Among patients with grade 0 adhesions, 34 (13.7 %) had no striae, while 79 (31.9 %) had mild-to-severe striae (p < 0.001; sensitivity 55 %; specificity 67 %; positive predictive value 69 %; negative predictive value 52 %). Among women with grade 1–2 adhesions, 48 (19.4 %) had no striae, while 58 (23.4 %) had mild-to-severe striae. Finally, among women with grade 3–4 adhesions, 22 (8.9 %) had no striae, while 6 (2.4 %) had mild-to-severe striae (p < 0.001). A p-value < 0.05 was taken to indicate statistical significance. Conclusions: The abdominal adhesion score dropped as the abdominal striae gravidarum score rose during the preoperative period. Addition of this useful, easy-to-apply, inexpensive, adjunctive, observational, abdominal scoring method to the obstetrical work-up can provide important clues about the intraabdominal adhesion

  3. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  4. Development and prevalence of femoroacetabular impingement-associated morphology in a paediatric and adolescent population: a CT study of 225 patients.

    PubMed

    Monazzam, S; Bomar, J D; Dwek, J R; Hosalkar, H S; Pennock, A T

    2013-05-01

    We investigated the development of CT-based bony radiological parameters associated with femoroacetabular impingement (FAI) in a paediatric and adolescent population with no known orthopaedic hip complaints. We retrospectively reformatted and reoriented 225 abdominal CTs into standardised CT pelvic images with neutral pelvic tilt and inclination (244 female and 206 male hips) in patients ranging from two to 19 years of age (mean 10.4 years). The Tönnis angle, acetabular depth ratio, lateral centre-edge angle, acetabular version and α-angle were assessed. Acetabular measurements demonstrated increased acetabular coverage with age and/or progressive ossification of the acetabulum. The α-angle decreased with age and/or progressive cortical bone development and resultant narrowing of the femoral neck. Cam and pincer morphology occurred as early as ten and 12 years of age, respectively, and their prevalence in the adolescent patient population is similar to that reported in the adult literature. Future aetiological studies of FAI will need to focus on the early adolescent population. PMID:23632667

  5. Construction of mouse phantoms from segmented CT scan data for radiation dosimetry studies

    NASA Astrophysics Data System (ADS)

    Welch, D.; Harken, A. D.; Randers-Pehrson, G.; Brenner, D. J.

    2015-05-01

    We present the complete construction methodology for an anatomically accurate mouse phantom made using materials which mimic the characteristics of tissue, lung, and bone for radiation dosimetry studies. Phantoms were constructed using 2 mm thick slices of tissue equivalent material which was precision machined to clear regions for insertion of lung and bone equivalent material where appropriate. Images obtained using a 3D computed tomography (CT) scan clearly indicate regions of tissue, lung, and bone that match their position within the original mouse CT scan. Additionally, radiographic films are used with the phantom to demonstrate dose mapping capabilities. The construction methodology presented here can be quickly and easily adapted to create a phantom of any specific small animal given a segmented CT scan of the animal. These physical phantoms are a useful tool to examine individual organ dose and dosimetry within mouse systems that are complicated by density inhomogeneity due to bone and lung regions.

  6. Synthesis of nanoparticle CT contrast agents: in vitro and in vivo studies

    NASA Astrophysics Data System (ADS)

    Kim, Sung June; Xu, Wenlong; Wasi Ahmad, Md; Baeck, Jong Su; Chang, Yongmin; Bae, Ji Eun; Chae, Kwon Seok; Kim, Tae Jeong; Park, Ji Ae; Lee, Gang Ho

    2015-10-01

    Water-soluble and biocompatible D-glucuronic acid coated Na2WO4 and BaCO3 nanoparticles were synthesized for the first time to be used as x-ray computed tomography (CT) contrast agents. Their average particle diameters were 3.2 ± 0.1 and 2.8 ± 0.1 nm for D-glucuronic acid coated Na2WO4 and BaCO3 nanoparticles, respectively. All the nanoparticles exhibited a strong x-ray attenuation. In vivo CT images were obtained after intravenous injection of an aqueous sample suspension of D-glucuronic acid coated Na2WO4 nanoparticles, and positive contrast enhancements in the kidney were clearly shown. These findings indicate that the nanoparticles reported in this study may be promising CT contrast agents.

  7. Construction of mouse phantoms from segmented CT scan data for radiation dosimetry studies

    PubMed Central

    Welch, D; Harken, A D; Randers-Pehrson, G; Brenner, D J

    2015-01-01

    We present the complete construction methodology for an anatomically accurate mouse phantom made using materials which mimic the characteristics of tissue, lung, and bone for radiation dosimetry studies. Phantoms were constructed using 2 mm thick slices of tissue equivalent material which was precision machined to clear regions for insertion of lung and bone equivalent material where appropriate. Images obtained using a 3D computed tomography (CT) scan clearly indicate regions of tissue, lung, and bone that match their position within the original mouse CT scan. Additionally, radiographic films are used with the phantom to demonstrate dose mapping capabilities. The construction methodology presented here can be quickly and easily adapted to create a phantom of any specific small animal given a segmented CT scan of the animal. These physical phantoms are a useful tool to examine individual organ dose and dosimetry within mouse systems that are complicated by density inhomogeneity due to bone and lung regions. PMID:25860401

  8. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Abdominal pain is the most common indication for OGD in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. We conducted the current study to examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and ...

  9. The relationship between insulin resistance and vascular calcification in coronary arteries, and the thoracic and abdominal aorta: The Multi-Ethnic Study of Atherosclerosis

    PubMed Central

    Ong, Kwok-Leung; McClelland, Robyn L.; Rye, Kerry-Anne; Cheung, Bernard M.Y.; Post, Wendy S.; Vaidya, Dhananjay; Criqui, Michael H.; Cushman, Mary; Barter, Philip J.; Allison, Matthew A.

    2014-01-01

    Objective Insulin resistance may be related to vascular calcification as both are associated with abdominal obesity. We investigated the association of insulin resistance with abdominal aortic calcium (AAC), coronary artery calcium (CAC) and thoracic aortic calcium (TAC), and whether it differs according to different levels of subcutaneous fat area (SFA) and visceral fat area (VFA) in a cross-sectional study design. Methods We investigated 1632 participants without diabetes from the Multi-Ethnic Study of Atherosclerosis with valid data on homeostasis model assessment index (HOMA-IR), AAC, CAC, and TAC. Adipocytokines, SFA, and VFA were also determined. Results HOMA-IR was associated with the presence of CAC, but not AAC and TAC, and the association remained significant after adjusting for traditional risk factors, adipocytokines, abdominal muscle mass, SFA, and VFA (prevalence ratio=1.04 per one interquartile range [IQR] increase, P=0.01). As the strength of the association of HOMA-IR with vascular calcification may differ by abdominal fat composition, subgroup analysis was performed among participants with different tertiles of SFA and VFA. Significant interactions between HOMA-IR with SFA and VFA separately were observed for the presence of TAC, but not AAC and CAC, even after adjusting for confounding factors. The association of HOMA-IR with TAC tended to be stronger in participants with more SFA and VFA. Conclusions Atherosclerotic calcification, especially in the coronary arteries, is related to insulin resistance. Further studies are needed to delineate the mechanisms by which visceral obesity can lead to vascular calcification. PMID:25108074

  10. Recurrent Abdominal Pain

    ERIC Educational Resources Information Center

    Banez, Gerard A.; Gallagher, Heather M.

    2006-01-01

    The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

  11. Primary Liver Carcinosarcoma and 18F-FDG PET/CT.

    PubMed

    Li, Beilei; Zhang, Yiqiu; Hou, Jun; Yu, Haojun; Shi, Hongcheng

    2016-08-01

    Primary liver carcinosarcoma is a very rare, malignant neoplasm that is concomitantly composed of a mixture of sarcomatous and carcinomatous elements. In the present study, an initial staging FDG PET/CT showed intense FDG uptake in a patient with liver carcinosarcoma composed of hepatocellular carcinoma and rhabdomyosarcoma. Two months after surgical resection, a restaging PET/CT showed rapid progression of the disease with abdominal and lung metastases, indicating aggressive feature of the disease. The case shows the importance to repeat a restaging PET/CT at early time after surgery for a patient with liver carcinosarcoma to monitor disease progression. PMID:27280902

  12. Role of Computed Tomography in Pediatric Abdominal Conditions.

    PubMed

    Eapen, Anu; Gibikote, Sridhar

    2016-07-01

    In the pediatric patient, computed tomography (CT) scan as an imaging modality for evaluation of the abdomen is to be used judiciously. The use of correct scanning protocols, single phase scanning, scanning only when required are key factors to minimize radiation doses to the child, while providing diagnostic quality. CT is the preferred modality in the evaluation of trauma, to assess extent of solid organ or bowel injury. It is also useful in several inflammatory conditions such as inflammatory bowel diseases and acute pancreatitis. CT also has an important role in evaluating intra-abdominal tumors, although magnetic resonance imaging (MRI) can be used as an alternative to CT. PMID:26964550

  13. Epidural dexamethasone for post-operative analgesia in patients undergoing abdominal hysterectomy: A dose ranging and safety evaluation study

    PubMed Central

    Hefni, Amira Fathy; Mahmoud, Mohamed Sidky; Al Alim, Azza Atef Abd

    2014-01-01

    Aim: Number of studies revealed that epidural bupivacaine-dexamethasone has the same analgesic potency as bupivacaine-fentanyl with opioid sparing and antiemetic effects. Different doses of dexamethasone were used in different studies. This study was designed to evaluate the optimum dose of epidural dexamethasone for post-operative analgesia. Materials and Methods: In this double-blinded randomized controlled study, we evaluated the efficiency and safety of different doses of epidural dexamethasone for post-operative analgesia in 160 patients aged 45-60 years scheduled for total abdominal hysterectomy. Patient were randomly allocated into four groups to receive a total volume of 10 ml epidural plain bupivacaine 0.25% in the control group (Group D0) with either 4 mg dexamethasone in (Group D4) or 6 mg dexamethasone in (Group D6) or 8 mg dexamethasone in (Group D8). Patients then received general anesthesia. Sedation, satisfaction and visual analog pain scores (VAS) at rest and with effort were measured post-operatively. Meperidine was administered when VAS > or = 4. Intra-operative fentanyl dose, post-operative meperidine consumption and the time to first analgesic requirement were recorded by a blinded observer. Blood glucose was measured pre-operatively and at 4 h and 8 h after study drug administration. Wound healing and infection were assessed after 1 week. Results: Intraoperative fentanyl requirements were comparable among groups. The time to first analgesic requirement was significantly prolonged 5.5 times in D8 Group but only 1.5 times in D6 and D4 Groups more than the analgesic duration in the control Group D0, with a P < 0.01. There was a significant reduction in post-operative meperidine consumption during the first 24 h in the D8 (75%) in comparison with D6 and D4 Groups (50%), respectively, (P < 0.01) and the control Group D0 (0%) (P < 0.01). VAS scores were significantly lower and patient satisfaction score was significantly higher in the D8 and

  14. Influence of CT utilisation on patient flow in the emergency department: a retrospective 1-year cohort study

    PubMed Central

    Li, Chao-Jui; Syue, Yuan-Jhen; Lin, Yan-Ren; Cheng, Hsien-Hung; Cheng, Fu-Jen; Tsai, Tsung-Cheng; Chen, Kuan-Fu; Lee, Chien-Hung

    2016-01-01

    Objective CT, an important diagnostic tool in the emergency department (ED), might increase the ED length of stay (LOS). Considering the issue of ED overcrowding, it is important to evaluate whether CT use delays or facilitates patient disposition in the ED. Design A retrospective 1-year cohort study. Setting 5 EDs within the same healthcare system dispersed nationwide in Taiwan. Participants All adult non-trauma patients who visited the 5 EDs from 1 July 2011 to 30 June 2012. Interventions Patients were grouped by whether or not they underwent a CT scan (CT and non-CT groups, respectively). Primary and secondary outcome measures The ED LOS and hospital LOS between patients who had and had not undergone CT scans were compared by stratifying different dispositions and diagnoses. Results CT use prolonged patient ED LOS among those who were directly discharged from the ED. Among patients admitted to the observation unit and then discharged, patients diagnosed with nervous system disease had shorter ED LOS if they underwent a CT scan. CT use facilitated patient admission to the general ward. CT use also accelerated patients' admission to the intensive care unit (ICU) for patients with nervous system disease, neoplasm and digestive disease. Finally, patients admitted to the general wards had shorter hospital LOS if they underwent CT scans in the ED. Conclusions CT use did not seem to have delayed patient disposition in ED. While CT use facilitated patient disposition if they were finally hospitalised, it mildly prolonged ED LOS in cases of patients discharged from the ED. PMID:27147387

  15. Quality control of CT systems by automated monitoring of key performance indicators: a two-year study.

    PubMed

    Nowik, Patrik; Bujila, Robert; Poludniowski, Gavin; Fransson, Annette

    2015-01-01

    The purpose of this study was to develop a method of performing routine periodical quality controls (QC) of CT systems by automatically analyzing key performance indicators (KPIs), obtainable from images of manufacturers' quality assurance (QA) phantoms. A KPI pertains to a measurable or determinable QC parameter that is influenced by other underlying fundamental QC parameters. The established KPIs are based on relationships between existing QC parameters used in the annual testing program of CT scanners at the Karolinska University Hospital in Stockholm, Sweden. The KPIs include positioning, image noise, uniformity, homogeneity, the CT number of water, and the CT number of air. An application (MonitorCT) was developed to automatically evaluate phantom images in terms of the established KPIs. The developed methodology has been used for two years in clinical routine, where CT technologists perform daily scans of the manufacturer's QA phantom and automatically send the images to MonitorCT for KPI evaluation. In the cases where results were out of tolerance, actions could be initiated in less than 10 min. 900 QC scans from two CT scanners have been collected and analyzed over the two-year period that MonitorCT has been active. Two types of errors have been registered in this period: a ring artifact was discovered with the image noise test, and a calibration error was detected multiple times with the CT number test. In both cases, results were outside the tolerances defined for MonitorCT, as well as by the vendor. Automated monitoring of KPIs is a powerful tool that can be used to supplement established QC methodologies. Medical physicists and other professionals concerned with the performance of a CT system will, using such methods, have access to comprehensive data on the current and historical (trend) status of the system such that swift actions can be taken in order to ensure the quality of the CT examinations, patient safety, and minimal disruption of service

  16. Triplane fracture of the distal tibial epiphysis: radiographic and CT studies

    SciTech Connect

    Cone, R.O. III; Nguyen, V.; Flournoy, J.G.; Guerra, J. Jr.

    1984-12-01

    The authors analyzed six cases of triplane fracture of the ankle and reviewed the literature. A previously underscribed fracture pattern was identified in one patient. CT studies proved to be useful diagnostic tools in the evaluation of triplane fractures when operative reduction was contemplated.

  17. Study Finds Small Increase in Cancer Risk after Childhood CT Scans

    Cancer.gov

    A study published in the June 6, 2012, issue of The Lancet shows that radiation exposure from computed tomography (CT) scans in childhood results in very small but increased risks of leukemia and brain tumors in the first decade after exposure.

  18. Renal applications of dual-energy CT.

    PubMed

    Kaza, Ravi K; Platt, Joel F

    2016-06-01

    Dual-energy CT is being increasingly used for abdominal imaging due to its incremental benefit of material characterization without significant increase in radiation dose. Knowledge of the different dual-energy CT acquisition techniques and image processing algorithms is essential to optimize imaging protocols and understand potential limitations while using dual-energy CT renal imaging such as urinary calculi characterization, assessment of renal masses and in CT urography. This review article provides an overview of the current dual-energy CT techniques and use of dual-energy CT in renal imaging. PMID:27010938

  19. TU-A-12A-07: CT-Based Biomarkers to Characterize Lung Lesion: Effects of CT Dose, Slice Thickness and Reconstruction Algorithm Based Upon a Phantom Study

    SciTech Connect

    Zhao, B; Tan, Y; Tsai, W; Lu, L; Schwartz, L; So, J; Goldman, J; Lu, Z

    2014-06-15

    Purpose: Radiogenomics promises the ability to study cancer tumor genotype from the phenotype obtained through radiographic imaging. However, little attention has been paid to the sensitivity of image features, the image-based biomarkers, to imaging acquisition techniques. This study explores the impact of CT dose, slice thickness and reconstruction algorithm on measuring image features using a thorax phantom. Methods: Twentyfour phantom lesions of known volume (1 and 2mm), shape (spherical, elliptical, lobular and spicular) and density (-630, -10 and +100 HU) were scanned on a GE VCT at four doses (25, 50, 100, and 200 mAs). For each scan, six image series were reconstructed at three slice thicknesses of 5, 2.5 and 1.25mm with continuous intervals, using the lung and standard reconstruction algorithms. The lesions were segmented with an in-house 3D algorithm. Fifty (50) image features representing lesion size, shape, edge, and density distribution/texture were computed. Regression method was employed to analyze the effect of CT dose, slice of thickness and reconstruction algorithm on these features adjusting 3 confounding factors (size, density and shape of phantom lesions). Results: The coefficients of CT dose, slice thickness and reconstruction algorithm are presented in Table 1 in the supplementary material. No significant difference was found between the image features calculated on low dose CT scans (25mAs and 50mAs). About 50% texture features were found statistically different between low doses and high doses (100 and 200mAs). Significant differences were found for almost all features when calculated on 1.25mm, 2.5mm, and 5mm slice thickness images. Reconstruction algorithms significantly affected all density-based image features, but not morphological features. Conclusions: There is a great need to standardize the CT imaging protocols for radiogenomics study because CT dose, slice thickness and reconstruction algorithm impact quantitative image features to

  20. Role of radiological-assisted cytology in intra-abdominal lesions: A 3 years’ experience in a tertiary care center

    PubMed Central

    Dosi, Shilpi; Gupta, Garima; Kawatra, Mallika; Chakrabarti, Preeti Rihal; Agrawal, Purti; Jain, Mukul Raj

    2016-01-01

    Background: Fine needle aspiration (FNA) with assistance of radiological tools such as ultrasonography (USG) and computed tomography (CT) is an effective and safe technique for diagnosing intra-abdominal neoplastic and nonneoplastic lesions. Aims and Objectives: (1) To assess the utility of image-guided cytology in the diagnosis of intra-abdominal lesions. (2) To categorize various intra-abdominal lesions according to their site of occurrence and study their cytomorphological features. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology between January 2012 and January 2015. A total of 174 cases with intra-abdominal lesions were included in the study. Results: In our study, diagnostic yield was 84.5%. The mean age was found to be 52 years with M: F ratio 1.1:1. We found that 92 (52.87%) cases were in hepatobiliary region, 33 (18.96%) in adnexa, 13 (7.47%) in pancreatic-ampullary region, 14 (8.04%) in unknown abdominal lumps, 8 (4.6%) in lymph nodes, 6 (3.4%) in renal, 5 (2.87%) in retroperitoneum, 2 (1.1%) in omental nodules, and 1 (0.5%) in splenic mass. Of total 174 cases, 106 (61%) cases were malignant, 10 (5.7%) benign, 16 (9.1%) inflammatory, 27 (15.5%) inadequate, and 15 (8.7%) suspicious for malignancy. Conclusion: Ultrasound and CT-guided FNA cytology had a significant role in diagnosis of palpable and nonpalpable intra-abdominal lesions. Being a relatively quick and safe method, it also avoids invasive diagnostic procedures. PMID:27127738

  1. Stress and strain distribution in demineralized enamel: A micro-CT based finite element study.

    PubMed

    Neves, Aline Almeida; Coutinho, Eduardo; Alves, Haimon Diniz Lopes; de Assis, Joaquim Teixeira

    2015-10-01

    Physiological oral mechanical forces may play a role on the progression of enamel carious lesions to cavitation. Thus, the aim of this study was to describe, by 3D finite element analysis, stress, and strain patterns in sound and carious enamel after a simulated occlusal load. Micro-CT based models were created and meshed with tetrahedral elements (based on an extracted third molar), namely: a sound (ST) and a carious tooth (CT). For the CT, enamel material properties were assigned according to the micro-CT gray values. Below the threshold corresponding to the enamel lesion (2.5 g/cm(3) ) lower and isotropic elastic modulus was assigned (E = 18 GPa against E1  = 80 GPa, E2  = E3  = 20 GPa for sound enamel). Both models were imported into a FE solver where boundary conditions were assigned and a pressure load (500 MPa) was applied at the occlusal surface. A linear static analysis was performed, considering anisotropy in sound enamel. ST showed a more efficient transfer of maximum principal stress from enamel to the dentin layer, while for the CT, enamel layer was subjected to higher and concentrated loads. Maximum principal strain distributions were seen at the carious enamel surface, especially at the central fossa, correlating to the enamel cavity seen at the original micro-CT model. It is possible to conclude that demineralized enamel compromises appropriate stress transfer from enamel to dentin, contributing to the odds of fracture and cavitation. Enamel fracture over a dentin lesion may happen as one of the normal pathways to caries progression and may act as a confounding factor during clinical diagnostic decisions. PMID:26240030

  2. A study on the effects of an extended CT field of view (FOV) on the standardized uptake value (SUV) in a PET/CT scan using 18F-fluoro-2deoxy-D-glucose

    NASA Astrophysics Data System (ADS)

    Park, Soon-Ki; Nam, Ki-Pyo; Jung, Woo-Young; Kim, Kyeong-Sik; Shin, Sang-Ki; Cho, Shee-Man; Kim, Ho-Sung; Dong, Kyung-Rae; Park, Yong-Soon; Chung, Woon-Kwan; Cho, Jae-Hwan; Yeo, Hwa-Yeon

    2012-12-01

    This study examined the effect of an extended CT field of view (FOV) on the standardized uptake value (SUV) of positron emission tomography — computed tomography (PET/CT) when the image extended beyond the CT FOV. CT images were reconstructed at different FOV sizes (500 mm and 700 mm). Two sets of CT images were reconstructed from the CT projection data by using the two FOV sizes. Twenty patients were examined in this study. The PET images were reconstructed from attenuation maps with a 500 mm CT FOV and a 700 mm extended CT FOV images. The regions of interest (ROIs) were drawn on the PET images. In addition, in the twenty patients, the PET images reconstructed by using a 500-mm CT FOV and 700-mm extended CT FOV were compared with the standardized uptake value (SUVmax). When attenuation maps with the 700-mm extended CT FOV were used, the SUVmax analyses of the liver (p = 0.000), lung (p = 0.007) and mediastinum (p = 0.001) produced statistically significant result. A 700 mm extended CT FOV help recover the true activity distribution in the PET emission data and affected the SUV measurements of the liver, lung and mediastinum.

  3. Evaluation of radiation dose and image quality of CT scan for whole-body pediatric PET/CT: A phantom study

    SciTech Connect

    Yang, Ching-Ching; Liu, Shu-Hsin; Mok, Greta S. P.; Wu, Tung-Hsin

    2014-09-15

    Purpose: This study aimed to tailor the CT imaging protocols for pediatric patients undergoing whole-body PET/CT examinations with appropriate attention to radiation exposure while maintaining adequate image quality for anatomic delineation of PET findings and attenuation correction of PET emission data. Methods: The measurements were made by using three anthropomorphic phantoms representative of 1-, 5-, and 10-year-old children with tube voltages of 80, 100, and 120 kVp, tube currents of 10, 40, 80, and 120 mA, and exposure time of 0.5 s at 1.75:1 pitch. Radiation dose estimates were derived from the dose-length product and were used to calculate risk estimates for radiation-induced cancer. The influence of image noise on image contrast and attenuation map for CT scans were evaluated based on Pearson's correlation coefficient and covariance, respectively. Multiple linear regression methods were used to investigate the effects of patient age, tube voltage, and tube current on radiation-induced cancer risk and image noise for CT scans. Results: The effective dose obtained using three anthropomorphic phantoms and 12 combinations of kVp and mA ranged from 0.09 to 4.08 mSv. Based on our results, CT scans acquired with 80 kVp/60 mA, 80 kVp/80 mA, and 100 kVp/60 mA could be performed on 1-, 5-, and 10-year-old children, respectively, to minimize cancer risk due to CT scans while maintaining the accuracy of attenuation map and CT image contrast. The effective doses of the proposed protocols for 1-, 5- and 10-year-old children were 0.65, 0.86, and 1.065 mSv, respectively. Conclusions: Low-dose pediatric CT protocols were proposed to balance the tradeoff between radiation-induced cancer risk and image quality for patients ranging in age from 1 to 10 years old undergoing whole-body PET/CT examinations.

  4. Intraoperative Spillage of Favorable Histology Wilms Tumor Cells: Influence of Irradiation and Chemotherapy Regimens on Abdominal Recurrence. A Report From the National Wilms Tumor Study Group

    SciTech Connect

    Kalapurakal, John A.; Li, Sierra M.; Breslow, Norman E.; Beckwith, J. Bruce; Ritchey, Michael L.; Shamberger, Robert C.; Haase, Gerald M.; Thomas, Patrick R.M.; Grundy, Paul; Green, Daniel M.; D'Angio, Giulio J.

    2010-01-15

    Purpose: We undertook this study to determine (1) the frequency with which spilled tumor cells of favorable histology produced intra-abdominal disease in patients treated with differing chemotherapy regimens and abdominal radiation therapy (RT) and (2) the patterns of relapse and outcomes in such patients. Methods and Materials: The influence of RT dose (0, 10, and 20 Gy), RT fields (flank, whole abdomen), and chemotherapy with dactinomycin and vincristine (2 drugs) vs. added doxorubicin (three drugs) on intra-abdominal tumor recurrence rates was analyzed by logistic regression in 450 patients. Each patient was considered at risk for two types of failure: flank and subdiaphragmatic beyond-flank recurrence, with the correlation between the two outcomes accounted for in the analyses. Results: The crude odds ratio for the risk of recurrence relative to no RT was 0.35 (0.15-0.78) for 10Gy and 0.08 (0.01-0.58) for 20Gy. The odds ratio for the risk of recurrence for doxorubicin to two drugs after adjusting for RT was not significant. For Stage II patients (NWTS-4), the 8-year event rates with and without spillage, respectively, were 79% and 87% for relapse-free survival (p = 0.07) and 90% and 95% for overall survival (p = 0.04). Conclusions: Irradiation (10 Gy or 20 Gy) reduced abdominal tumor recurrence rates after tumor spillage. Tumor spillage in Stage II patients reduced relapse-free survival and overall survival, but only the latter was of statistical significance. These data provide a basis for assessing the risks vs. benefits when considering treatment for children with favorable histology Wilms tumor and surgical spillage.

  5. Prevention of postoperative nausea and vomiting with a subhypnotic dose of Propofol in patients undergoing lower abdominal surgery: A prospective, randomized, double-blind study

    PubMed Central

    Naghibi, Khosrou; Kashefi, Parviz; Azarnoush, Hamed; Zabihi, Parisa

    2015-01-01

    Background: Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia in patients undergoing elective lower abdominal surgery. We aimed to compare the effect of a sub hypnotic dose of Propofol in the prevention of PONV after lower abdominal surgery with that of the conventional antiemetic drug Metoclopramide. Materials and Methods: In this prospective, randomized, double-blind, placebo-controlled study, 104 patients with American Society of Anesthesiologists (ASA) class I or II status, aged 18–65 years, and undergoing elective lower abdominal surgery were randomized to one of four groups (n = 26 each). The patients in the four groups were administered intravenously Propofol 20 mg (G1), Propofol 30 mg (G2), Metoclopramide 10 mg (G3), and placebo (G4), 15 min before skin closure. All episodes of PONV during the first 24 h after anesthesia were recorded by an investigator who was blinded to treatment assignment. Results: There were no significant differences between the treatment groups with regard to their gender, age, ASA class, duration of surgery, duration of recovery time and hospital stay, and also body mass index (BMI) (P > 0.05). The prevalence of PONV 0-6 h after anesthesia was 23.08% with Propofol 20 mg (P = 0.005), 15.38% with Propofol 30 mg (P = 0.016), 15.38% with Metoclopramide 10 mg (P = 0.016), compared to 30.77% with placebo (P = 0.005). Conclusions: Administration of a subhypnotic dose of Propofol (30 mg) was found to be as effective as 10 mg Metoclopramide in reducing the incidence and severity of PONV in adult patients undergoing elective lower abdominal surgeries under Isoflurane-based anesthesia in the early postoperative period. PMID:25789261

  6. Does mechanical massage of the abdominal wall after colectomy reduce postoperative pain and shorten the duration of ileus? Results of a randomized study.

    PubMed

    Le Blanc-Louvry, Isabelle; Costaglioli, Bruno; Boulon, Catherine; Leroi, Anne-Marie; Ducrotte, Philippe

    2002-01-01

    The aim of this study was to determine the effectiveness of mechanical abdominal massage on postoperative pain and ileus after colectomy. We hypothesized that parietal abdominal stimulation could counteract induced pain and postoperative ileus, through common spinal-sensitive pathways, with nociceptive visceral messages. After preoperative randomization, 25 patients (age 52 +/- 5 years) underwent active mechanical massage by intermittent negative pressure on the abdominal wall resulting in aspiration (Cellu M50 device, LPG, Valence, France), and 25 patients (age 60 +/- 6 years) did not receive active mechanical massage (placebo group). Massage sessions began the first day after colectomy and were performed daily until the seventh postoperative day. In the active-massage group, amplitude and frequency were used, which have been shown to be effective in reducing muscular pain, whereas in the placebo group, ineffective parameters were used. Visual analogue scale (VAS) pain scores, doses of analgesics (propacetamol), and delay between surgery and the time to first passage of flatus were assessed. Types and dosages of the anesthetic drugs and the duration of the surgical procedure did not differ between groups. From the second and third postoperative days, respectively, VAS pain scores (P < 0.001) and doses of analgesics (P < 0.05) were significantly lower in patients receiving active massage compared to the placebo group. Time to first passage of flatus was also significantly shorter in the active-massage group (1.8 +/- 0.3 days vs. 3.6 +/- 0.4 days, P < 0.01). No adverse effects were observed. These results suggest that mechanical massage of the abdominal wall may decrease postoperative pain and ileus after colectomy. PMID:11986017

  7. Comparative Evaluation of Retrocrural versus Transaortic Neurolytic Celiac Plexus Block for Pain Relief in Patients with Upper Abdominal Malignancy: A Retrospective Observational Study

    PubMed Central

    Tewari, Saipriya; Agarwal, Anil; Dhiraaj, Sanjay; Gautam, Sujeet K; Khuba, Sandeep; Madabushi, Rajashree; Shamshery, Chetna; Kumar, Sanjay

    2016-01-01

    Aim: To compare retrocrural versus transaortic techniques for neurolytic celiac plexus block (NCPB) in patients suffering from upper abdominal malignancy. Methods: In this retrospective observational study between October 2013 and April 2015, 64 patients with inoperable upper abdominal malignancy received fluoroscopy-guided percutaneous NCPB in our institute. Their case files were reviewed and the patients were divided into two groups depending on the technique used to perform NCPB: retrocrural (Group R; n = 36) versus transaortic (Group T; n = 28). The primary outcome measure was pain as assessed with a numeric rating scale (NRS) from 0 to 10; the secondary outcome measures were morphine consumption per day (M), quality of life (QOL) as assessed by comparing the percent of positive responses in each group, and complications if any. These were noted and analyzed prior to intervention and then on day 1, weeks 1, 2, 3, and months 1, 2, 3, 6 following NCPB. Results: Patients in Group R had significantly reduced NRS pain scores at week 1, 2, 3, month 1 and 2 as compared to Group T (P < 0.05). Morphine consumption also reduced significantly in Group R at day 1, week 1, 2, and 3 (P < 0.05). QOL was found to be comparable between the groups, and no major complications were noted. Conclusion: Retrocrural NCPB provides superior pain relief along with a reduction in morphine consumption as compared to transaortic NCPB in patients with pain due to upper abdominal malignancy.

  8. Mesoesophagus and other fascial structures of the abdominal and lower thoracic esophagus: a histological study using human embryos and fetuses

    PubMed Central

    Hwang, Si Eun; Bae, Sang In; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2014-01-01

    A term "mesoesophagus" has been often used by surgeons, but the morphology was not described well. To better understand the structures attaching the human abdominal and lower thoracic esophagus to the body wall, we examined serial or semiserial sections from 10 embryos and 9 fetuses. The esophagus was initially embedded in a large posterior mesenchymal tissue, which included the vertebral column and aorta. Below the tracheal bifurcation at the fifth week, the esophagus formed a mesentery-like structure, which we call the "mesoesophagus," that was sculpted by the enlarging lungs and pleural cavity. The pneumatoenteric recess of the pleuroperitoneal canal was observed in the lowest part of the mesoesophagus. At the seventh week, the mesoesophagus was divided into the upper long and lower short parts by the diaphragm. Near the esophageal hiatus, the pleural cavity provided 1 or 2 recesses in the upper side, while the fetal adrenal gland in the left side was attached to the lower side of the mesoesophagus. At the 10th and 18th week, the mesoesophagus remained along the lower thoracic esophagus, but the abdominal esophagus attached to the diaphragm instead of to the left adrenal. The mesoesophagus did not contain any blood vessels from the aorta and to the azygos vein. The posterior attachment of the abdominal esophagus seemed to develop to the major part of the phrenoesophageal membrane with modification from the increased mass of the left fetal adrenal. After postnatal degeneration of the fetal adrenal, the abdominal esophagus might again obtain a mesentery. Consequently, the mesoesophagus seemed to correspond to a small area containing the pulmonary ligament and aorta in adults. PMID:25548720

  9. Visualizing Typical Features of Breast Fibroadenomas Using Phase-Contrast CT: An Ex-Vivo Study

    PubMed Central

    Grandl, Susanne; Willner, Marian; Herzen, Julia; Sztrókay-Gaul, Anikó; Mayr, Doris; Auweter, Sigrid D.; Hipp, Alexander; Birnbacher, Lorenz; Marschner, Mathias; Chabior, Michael; Reiser, Maximilian; Pfeiffer, Franz; Bamberg, Fabian; Hellerhoff, Karin

    2014-01-01

    Background Fibroadenoma is the most common benign solid breast lesion type and a very common cause for histologic assessment. To justify a conservative therapy, a highly specific discrimination between fibroadenomas and other breast lesions is crucial. Phase-contrast imaging offers improved soft-tissue contrast and differentiability of fine structures combined with the potential of 3-dimensional imaging. In this study we assessed the potential of grating-based phase-contrast CT imaging for visualizing diagnostically relevant features of fibroadenomas. Materials and Methods Grating-based phase-contrast CT was performed on six ex-vivo formalin-fixed breast specimens containing a fibroadenoma and three samples containing benign changes that resemble fibroadenomas using Talbot Lau interferometry and a polychromatic X-ray source. Phase-contrast and simultaneously acquired absorption-based 3D-datasets were manually matched with corresponding histological slices. The visibility of diagnostically valuable features was assessed in comparison with histology as the gold-standard. Results In all cases, matching of grating-based phase-contrast CT images and histology was successfully completed. Grating-based phase-contrast CT showed greatly improved differentiation of fine structures and provided accurate depiction of strands of fibrous tissue within the fibroadenomas as well as of the diagnostically valuable dilated, branched ductuli of the fibroadenomas. A clear demarcation of tumor boundaries in all cases was provided by phase- but not absorption-contrast CT. Conclusions Pending successful translation of the technology to a clinical setting and considerable reduction of the required dose, the data presented here suggest that grating-based phase-contrast CT may be used as a supplementary non-invasive diagnostic tool in breast diagnostics. Phase-contrast CT may thus contribute to the reduction of false positive findings and reduce the recall and core biopsy rate in population

  10. Complications in CT-guided Procedures: Do We Really Need Postinterventional CT Control Scans?

    SciTech Connect

    Nattenmüller, Johanna Filsinger, Matthias Bryant, Mark Stiller, Wolfram Radeleff, Boris Grenacher, Lars Kauczor, Hans-Ullrich Hosch, Waldemar

    2013-06-19

    PurposeThe aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.MethodsRetrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.ResultsThe complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).ConclusionComplications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only.

  11. [Performance evaluation for CT-AEC(CT automatic exposure control)systems].

    PubMed

    Muramatsu, Yoshihisa; Ikeda, Shu; Osawa, Kazuaki; Sekine, Ryo; Niwa, Nobuyuki; Terada, Masami; Keat, Nicholas; Miyazaki, Shigeru

    2007-05-20

    Although many current CT scanners incorporate CT-AEC, performance evaluation is not standardized. This study evaluates the performance of the latest CT-AEC of each manufacturer with the aim of establishing a standard CT-AEC performance evaluation method. The design of the phantoms was based upon the operation characteristics of different CT-AECs. A cone, an ellipse, a variable-shaped ellipse, stepped phantoms, and their analysis software were devised and carried out the field test. The targets were LightSpeed VCT 64 with 2D and 3D Auto mA(GE), Aquilion 64M with Real-EC and Volume-EC(Toshiba), Sensation 64 with CARE Dose and CARE Dose 4D(Siemens), and Bulliance 16P with Dose Right(Philips). Data was acquired while varying the typical abdominal CT(with CT-AEC)scanning conditions (120 kV, 5 mm slice, standard function for abdomen, scanning range 200 mm). The acquired images were converted to the DICOM format and image noise(SD) was calculated using dedicated software. All 4 CT-AECs reduced exposure dose. For GE and Toshiba, image noise was constant and met the target. For Siemens, noise was independent of phantom shape but varied uniformly with phantom size. For Philips, noise varied with phantom size and shape, and variation degree depended on phantom thickness in scanogram direction. The results reflect the basic concept and performance characteristics of the methods. Standardization of CT-AEC performance evaluation is possible using these phantoms. PMID:17538218

  12. A Pilot Study of 18F-FLT PET/CT in Pediatric Lymphoma

    PubMed Central

    Costantini, Danny L.; Vali, Reza; McQuattie, Susan; Chan, Jeffrey; Punnett, Angela; Weitzman, Shiela; Shammas, Amer; Charron, Martin

    2016-01-01

    We performed an observational pilot study of 18F-FLT PET/CT in pediatric lymphoma. Eight patients with equivocal 18F-FDG PET/CT underwent imaging with 18F-FLT PET/CT. No immediate adverse reactions to 18F-FLT were observed. Compared to 18F-FDG, 18F-FLT uptake was significantly higher in bone marrow and liver (18F-FLT SUV 8.6 ± 0.6 and 5.0 ± 0.3, versus 18F-FDG SUV 1.9 ± 0.1 and 3.4 ± 0.7, resp., p < 0.05). In total, 15 lesions were evaluated with average 18F-FDG and 18F-FLT SUVs of 2.6 ± 0.1 and 2.0 ± 0.4, respectively. Nonspecific uptake in reactive lymph nodes and thymus was observed. Future studies to assess the clinical utility of 18F-FLT PET/CT in pediatric lymphoma are planned. PMID:27313888

  13. A Pilot Study of 18F-FLT PET/CT in Pediatric Lymphoma.

    PubMed

    Costantini, Danny L; Vali, Reza; McQuattie, Susan; Chan, Jeffrey; Punnett, Angela; Weitzman, Shiela; Shammas, Amer; Charron, Martin

    2016-01-01

    We performed an observational pilot study of 18F-FLT PET/CT in pediatric lymphoma. Eight patients with equivocal 18F-FDG PET/CT underwent imaging with 18F-FLT PET/CT. No immediate adverse reactions to 18F-FLT were observed. Compared to 18F-FDG, 18F-FLT uptake was significantly higher in bone marrow and liver (18F-FLT SUV 8.6 ± 0.6 and 5.0 ± 0.3, versus 18F-FDG SUV 1.9 ± 0.1 and 3.4 ± 0.7, resp., p < 0.05). In total, 15 lesions were evaluated with average 18F-FDG and 18F-FLT SUVs of 2.6 ± 0.1 and 2.0 ± 0.4, respectively. Nonspecific uptake in reactive lymph nodes and thymus was observed. Future studies to assess the clinical utility of 18F-FLT PET/CT in pediatric lymphoma are planned. PMID:27313888

  14. Comparative Study of Diagnostic Nasal Endoscopy and CT Paranasal Sinuses in Diagnosing Chronic Rhinosinusitis.

    PubMed

    Lohiya, Sweta S; Patel, Seema V; Pawde, Apurva M; Bokare, Bhagyashree D; Sakhare, Prafulla T

    2016-06-01

    Evaluation of the accuracy of objective diagnostic modalities for chronic rhinosinusitis and their comparison to each other to reach the correct diagnosis with minimum cost and highest accuracy. Prospective diagnostic cohort study. Academic medical center. Subjects more than 10 years of age presenting for evaluation of chronic rhinosinusitis, not responding to 12 weeks of medical treatment, suffering from at least 2 or more of the following symptoms- nasal obstruction, anterior and or posterior nasal discharge, headache or facial pains, and abnormalities of smell were prospectively studied. All selected patients were subjected to nasal endoscopy and CT paranasal sinuses. Endoscopic findings were scored according to Lund Kennedy scoring system. Sinus CT scans were scored with the Lund Mackay scoring system. The clinical diagnosis of CRS was determined on the basis of the published adult sinusitis guideline criteria and nasal endoscopic findings were compared with the diagnostic gold standard CT. A total of 100 patients were studied. Endoscopy was able to diagnose 87 % as CRS based on Lund-Kennedy score ≥2. 93 % patients could be labeled as CRS based on Lund-Mackey score ≥4. On correlating endoscopy and CT PNS it was found that sensitivity was 88.04 %, specificity was 28.57 %, PPV was 94.19 %, NPV was 15.38 %. Positive likelihood ratio of 1.23 and negative likelihood ratio of 0.42 was found p value was found to be 0.10565, thereby confirming that there is no significant difference in diagnosing CRS by either modality. The addition of nasal endoscopy helps reduce the use of CT, reducing costs and radiation exposure. PMID:27340642

  15. Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

    PubMed Central

    de Cleva, Roberto; de Assumpção, Marianna Siqueira; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C.; Filho, Wilson Jacob

    2014-01-01

    OBJECTIVE: Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). METHODS: We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. RESULTS: The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L) and FVC (2.0±0.7 L) with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p = 0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. CONCLUSIONS: Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery. PMID:25029580

  16. PET-CT for staging and early response: results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study.

    PubMed

    Barrington, Sally F; Kirkwood, Amy A; Franceschetto, Antonella; Fulham, Michael J; Roberts, Thomas H; Almquist, Helén; Brun, Eva; Hjorthaug, Karin; Viney, Zaid N; Pike, Lucy C; Federico, Massimo; Luminari, Stefano; Radford, John; Trotman, Judith; Fosså, Alexander; Berkahn, Leanne; Molin, Daniel; D'Amore, Francesco; Sinclair, Donald A; Smith, Paul; O'Doherty, Michael J; Stevens, Lindsey; Johnson, Peter W

    2016-03-24

    International guidelines recommend that positron emission tomography-computed tomography (PET-CT) should replace CT in Hodgkin lymphoma (HL). The aims of this study were to compare PET-CT with CT for staging and measure agreement between expert and local readers, using a 5-point scale (Deauville criteria), to adapt treatment in a clinical trial: Response-Adapted Therapy in Advanced Hodgkin Lymphoma (RATHL). Patients were staged using clinical assessment, CT, and bone marrow biopsy (RATHL stage). PET-CT was performed at baseline (PET0) and after 2 chemotherapy cycles (PET2) in a response-adapted design. PET-CT was reported centrally by experts at 5 national core laboratories. Local readers optionally scored PET2 scans. The RATHL and PET-CT stages were compared. Agreement among experts and between expert and local readers was measured. RATHL and PET0 stage were concordant in 938 (80%) patients. PET-CT upstaged 159 (14%) and downstaged 74 (6%) patients. Upstaging by extranodal disease in bone marrow (92), lung (11), or multiple sites (12) on PET-CT accounted for most discrepancies. Follow-up of discrepant findings confirmed the PET characterization of lesions in the vast majority. Five patients were upstaged by marrow biopsy and 7 by contrast-enhanced CT in the bowel and/or liver or spleen. PET2 agreement among experts (140 scans) with a κ (95% confidence interval) of 0.84 (0.76-0.91) was very good and between experts and local readers (300 scans) at 0.77 (0.68-0.86) was good. These results confirm PET-CT as the modern standard for staging HL and that response assessment using Deauville criteria is robust, enabling translation of RATHL results into clinical practice. PMID:26747247

  17. A navigation system for flexible endoscopes using abdominal 3D ultrasound.

    PubMed

    Hoffmann, R; Kaar, M; Bathia, Amon; Bathia, Amar; Lampret, A; Birkfellner, W; Hummel, J; Figl, M

    2014-09-21

    A navigation system for flexible endoscopes equipped with ultrasound (US) scan heads is presented. In contrast to similar systems, abdominal 3D-US is used for image fusion of the pre-interventional computed tomography (CT) to the endoscopic US. A 3D-US scan, tracked with an optical tracking system (OTS), is taken pre-operatively together with the CT scan. The CT is calibrated using the OTS, providing the transformation from CT to 3D-US. Immediately before intervention a 3D-US tracked with an electromagnetic tracking system (EMTS) is acquired and registered intra-modal to the preoperative 3D-US. The endoscopic US is calibrated using the EMTS and registered to the pre-operative CT by an intra-modal 3D-US/3D-US registration. Phantom studies showed a registration error for the US to CT registration of 5.1 mm±2.8 mm. 3D-US/3D-US registration of patient data gave an error of 4.1 mm compared to 2.8 mm with the phantom. From this we estimate an error on patient experiments of 5.6 mm. PMID:25170913

  18. Molecular Imaging of Experimental Abdominal Aortic Aneurysms

    PubMed Central

    Ramaswamy, Aneesh K.; Hamilton, Mark; Joshi, Rucha V.; Kline, Benjamin P.; Li, Rui; Wang, Pu; Goergen, Craig J.

    2013-01-01

    Current laboratory research in the field of abdominal aortic aneurysm (AAA) disease often utilizes small animal experimental models induced by genetic manipulation or chemical application. This has led to the use and development of multiple high-resolution molecular imaging modalities capable of tracking disease progression, quantifying the role of inflammation, and evaluating the effects of potential therapeutics. In vivo imaging reduces the number of research animals used, provides molecular and cellular information, and allows for longitudinal studies, a necessity when tracking vessel expansion in a single animal. This review outlines developments of both established and emerging molecular imaging techniques used to study AAA disease. Beyond the typical modalities used for anatomical imaging, which include ultrasound (US) and computed tomography (CT), previous molecular imaging efforts have used magnetic resonance (MR), near-infrared fluorescence (NIRF), bioluminescence, single-photon emission computed tomography (SPECT), and positron emission tomography (PET). Mouse and rat AAA models will hopefully provide insight into potential disease mechanisms, and the development of advanced molecular imaging techniques, if clinically useful, may have translational potential. These efforts could help improve the management of aneurysms and better evaluate the therapeutic potential of new treatments for human AAA disease. PMID:23737735

  19. CT imaging signs of surgically proven bowel trauma.

    PubMed

    LeBedis, Christina A; Anderson, Stephan W; Bates, David D B; Khalil, Ramy; Matherly, David; Wing, Heidi; Burke, Peter A; Soto, Jorge A

    2016-06-01

    The objective of this study was to determine the incidence and interobserver agreement of individual CT findings as well as the bowel injury prediction score (BIPS) in surgically proven bowel injury after blunt abdominal trauma. This HIPAA-compliant retrospective study was IRB approved and consent was waived. All patients 14 years or older who sustained surgically proven bowel injury after blunt abdominal trauma between 1/1/2004 and 6/30/2015 were included. Admission trauma MDCT scans were independently interpreted by two abdominal fellowship-trained radiologists who recorded the following CT findings: intraperitoneal fluid, mesenteric hematoma/fat stranding, bowel wall thickening/hematoma, active intravenous contrast extravasation, free intraperitoneal air, bowel wall discontinuity, and focal bowel hypoenhancement. Subsequently, the electronic medical records of the included patients, admission abdominal physical exam results, admission white blood cell count, and findings at exploratory laparotomy of the included patients were recorded. Thirty-three patients met the inclusion criteria. The incidence and interobserver agreement of the CT findings were as follows: intraperitoneal fluid 93.9 %, kappa = 0.784 (good); mesenteric hematoma/fat stranding 84.8 %, kappa = 0.718 (good); bowel wall thickening/hematoma 42.4 %, kappa = 0.491 (moderate); active IV contrast extravasation 36.3 %, kappa = 1.00 (perfect); free intraperitoneal air 21.2 %, kappa = 0.904 (very good), bowel wall discontinuity 6.1 %, kappa = 1.00 (perfect); and focal bowel hypoenhancement 6.1 %, kappa = 0.468 (moderate). An absence of the specified CT findings was encountered in 9.1 % with surgically proven bowel injuries (kappa = 1.00, perfect). In our study, 9/16 patients or 56.3 % had a bowel injury prediction score (BIPS) of 2 or more as defined by McNutt et al. (J Trauma Acute Care Surg 78(1):105-111, 2014). The presence of intraperitoneal fluid and

  20. Treatment options for traumatic pseudoaneurysms of the paravisceral abdominal aorta.

    PubMed

    Tucker, Sonny; Rowe, Vincent L; Rao, Rajeev; Hood, Douglas B; Harrell, Donald; Weaver, Fred A

    2005-09-01

    Penetrating gunshot wounds (GSWs) to the abdominal aorta are frequently lethal. Alternative management options for treatment of traumatic pseudoaneurysms of the abdominal aorta are illustrated by three patient case histories. Patient A sustained two GSWs to the abdomen (midepigastrium, right subcostal region). He was hypotensive in the field. Emergent laparotomy was undertaken with suture ligature of a celiac injury and distal pancreatectomy/splenectomy for a pancreatic injury. Postoperative abdominal CT for an intraabdominal infection with leukocytosis revealed a 4 cm traumatic pseudoaneurysm of the abdominal aorta that extended from the suprarenal aorta to the level of the renal arteries. Six weeks later, he underwent an open repair. Patient B sustained multiple GSWs to his right arm and right upper quadrant. He was hemodynamically stable. He underwent abdominal exploration for a grade 3 liver laceration. Postoperative abdominal CT revealed a supraceliac abdominal aortic pseudoaneurysm. An aortogram demonstrated a 1.5 cm defect in the aortic wall above the celiac trunk communicating with the inferior vena cava (IVC). He underwent endovascular repair with covered aortic stent graft. Patient C sustained multiple thoracoabdominal GSWs. He was hemodynamically stable. Emergent laparotomy revealed multiple left colonic perforations, two duodenal lacerations, and an unsalvageable left kidney laceration. Postoperatively, he developed a duodenal-cutaneous fistula with multiple intraabdominal abscesses. Serial CT scans revealed an enlarging infrarenal aortic pseudoaneurysm. He underwent angiographic coil embolization and intraarterial injection of thrombin into the pseudoaneurysm sac. The average time from injury to surgical treatment was 46 days (range 29-67). Postoperatively, none of the patients developed paraplegia. Advances in endovascular techniques have provided options to deal with traumatic pseudoaneurysms of the abdominal aorta. In a hemodynamically stable

  1. Intra-abdominal textiloma. A retained surgical sponge mimicking a gastric gastrointestinal stromal tumor: report of a case.

    PubMed

    Yamamura, Noriyuki; Nakajima, Kiyokazu; Takahashi, Tsuyoshi; Uemura, Mamoru; Nishitani, Akiko; Souma, Yoshihito; Nishida, Toshirou

    2008-01-01

    We describe a unique case of intra-abdominal textiloma (granuloma due to a retained foreign body), which mimicked a gastric tumor on preoperative imaging studies. A 78-year-old asymptomatic patient with a past history of a gastrectomy was referred for evaluation of an intra-abdominal mass lesion, which was incidentally observed on a computed tomography (CT) scan. Repeated CT with a higher resolution demonstrated a 5-cm heterogeneously enhanced mass with a distinct feeding artery. These findings were all compatible with a tumorous lesion originating in the gastric remnant, most likely gastric gastrointestinal stromal tumor. A diagnosis of textiloma was immediately made during surgery, and it was confirmed pathologically postoperatively. The feeding artery that appeared on CT images, which was a major reason for the false diagnosis, was considered to have resulted from a slow but continuous inflammation reaction around the retained surgical sponge. Surgeons should therefore always take the possibility of textilomas into consideration even with typical tumorous characteristics on preoperative imaging studies, especially in patients with a history of prior abdominal surgery. PMID:18516538

  2. Predicting gallstone composition with CT: in vivo and in vitro analysis.

    PubMed

    Brakel, K; Laméris, J S; Nijs, H G; Terpstra, O T; Steen, G; Blijenberg, B C

    1990-02-01

    Chemical composition of gallstones is of major importance in selecting patients for nonsurgical therapy. In a combined in vivo and in vitro study of predictive potential, 50 patients undergoing cholecystectomy were evaluated with computed tomography (CT) and either plain abdominal radiography or oral cholecystography (OCG). The largest stone surgically removed from each patient was subjected to in vitro CT and chemical analysis. The authors found an inverse relationship between CT attenuation numbers and cholesterol content and a good positive correlation between CT attenuation numbers and calcium content. In vivo CT analysis improved sensitivity, specificity, accuracy, and positive and negative predictive values compared to plain abdominal radiography and OCG in detection of cholesterol stones. Using their prediction rule (a CT number smaller than 140 HU indicates a pure cholesterol gallstone), the authors correctly classified gallstones in 17 (84%) of another 20 patients. In vivo CT analysis can enable reliable prediction of gallstone composition and should play an important role in the selection of patients for nonsurgical treatment. PMID:2296642

  3. In vivo 3D PIXE-micron-CT imaging of Drosophila melanogaster using a contrast agent

    NASA Astrophysics Data System (ADS)

    Matsuyama, Shigeo; Hamada, Naoki; Ishii, Keizo; Nozawa, Yuichiro; Ohkura, Satoru; Terakawa, Atsuki; Hatori, Yoshinobu; Fujiki, Kota; Fujiwara, Mitsuhiro; Toyama, Sho

    2015-04-01

    In this study, we developed a three-dimensional (3D) computed tomography (CT) in vivo imaging system for imaging small insects with micrometer resolution. The 3D CT imaging system, referred to as 3D PIXE-micron-CT (PIXEμCT), uses characteristic X-rays produced by ion microbeam bombardment of a metal target. PIXEμCT was used to observe the body organs and internal structure of a living Drosophila melanogaster. Although the organs of the thorax were clearly imaged, the digestive organs in the abdominal cavity could not be clearly discerned initially, with the exception of the rectum and the Malpighian tubule. To enhance the abdominal images, a barium sulfate powder radiocontrast agent was added. For the first time, 3D images of the ventriculus of a living D. melanogaster were obtained. Our results showed that PIXEμCT can provide in vivo 3D-CT images that reflect correctly the structure of individual living organs, which is expected to be very useful in biological research.

  4. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X- ... use high frequency sound waves to produce an image and do not expose the individual to radiation. ...

  5. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  6. Abdominal exploration - series (image)

    MedlinePlus

    ... surgical exploration of the abdomen, also called an exploratory laparotomy, may be recommended when there is abdominal ... blunt trauma"). Diseases that may be discovered by exploratory laparotomy include: inflammation of the appendix (acute appendicitis) ...

  7. Abdominal aortic aneurysm

    MedlinePlus

    ... main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs ... dissection). Symptoms of rupture include: Pain in the abdomen or back. The pain may be severe, sudden, ...

  8. Abdominal x-ray

    MedlinePlus

    An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the spleen, stomach, and intestines. When the test is done to look at the bladder and kidney structures, ...

  9. CT of schistosomal calcification of the intestine

    SciTech Connect

    Fataar, S.; Bassiony, H.; Satyanath, S.; Rudwan, M.; Hebbar, G.; Khalifa, A.; Cherian, M.J.

    1985-01-01

    The spectrum of schistosomal colonic calcification on abdominal radiographs has been described. The appearance on computed tomography (CT) is equally distinctive and occurs with varying degrees of genitourinary calcification. The authors have experience in three cases with the appearance on CT of intestinal calcification due to schistosomiasis.

  10. Myocardial Defect Detection Using PET-CT: Phantom Studies

    PubMed Central

    Mananga, Eugene S.; El Fakhri, Georges; Schaefferkoetter, Joshua; Bonab, Ali A.; Ouyang, Jinsong

    2014-01-01

    It is expected that both noise and activity distribution can have impact on the detectability of a myocardial defect in a cardiac PET study. In this work, we performed phantom studies to investigate the detectability of a defect in the myocardium for different noise levels and activity distributions. We evaluated the performance of three reconstruction schemes: Filtered Back-Projection (FBP), Ordinary Poisson Ordered Subset Expectation Maximization (OP–OSEM), and Point Spread Function corrected OSEM (PSF–OSEM). We used the Channelized Hotelling Observer (CHO) for the task of myocardial defect detection. We found that the detectability of a myocardial defect is almost entirely dependent on the noise level and the contrast between the defect and its surroundings. PMID:24505429

  11. Abdominal aortic aneurysm.

    PubMed

    Setacci, Francesco; Galzerano, Giuseppe; De Donato, Gianmarco; Benevento, Domenico; Guerrieri, Massimiliano W; Ruzzi, Umberto; Borrelli, Maria P; Setacci, Carlo

    2016-02-01

    Endovascular repair of abdominal aortic aneurysms has become a milestone in the treatment of patients with abdominal aortic aneurysm. Technological improvement allows treatment in more and more complex cases. This review summarizes all grafts available on the market. A complete review of most important trial on this topic is provided to the best of our knowledge, and technical tips and tricks for standard cases are also included. PMID:26771730

  12. ACCURACY AND PRECISION OF A METHOD TO STUDY KINEMATICS OF THE TEMPOROMANDIBULAR JOINT: COMBINATION OF MOTION DATA AND CT IMAGING

    PubMed Central

    Baltali, Evre; Zhao, Kristin D.; Koff, Matthew F.; Keller, Eugene E.; An, Kai-Nan

    2008-01-01

    The purpose of the study was to test the precision and accuracy of a method used to track selected landmarks during motion of the temporomandibular joint (TMJ). A precision phantom device was constructed and relative motions between two rigid bodies on the phantom device were measured using optoelectronic (OE) and electromagnetic (EM) motion tracking devices. The motion recordings were also combined with a 3D CT image for each type of motion tracking system (EM+CT and OE+CT) to mimic methods used in previous studies. In the OE and EM data collections, specific landmarks on the rigid bodies were determined using digitization. In the EM+CT and OE+CT data sets, the landmark locations were obtained from the CT images. 3D linear distances and 3D curvilinear path distances were calculated for the points. The accuracy and precision for all 4 methods were evaluated (EM, OE, EM+CT and OE+CT). In addition, results were compared with and without the CT imaging (EM vs. EM+CT, OE vs. OE+CT). All systems overestimated the actual 3D curvilinear path lengths. All systems also underestimated the actual rotation values. The accuracy of all methods was within 0.5 mm for 3D curvilinear path calculations, 0.05 mm for 3D linear distance calculations, and 0.2° for rotation calculations. In addition, Bland-Altman plots for each configuration of the systems suggest that measurements obtained from either system are repeatable and comparable. PMID:18617178

  13. 68Ga-PRGD2 PET/CT in the Evaluation of Glioma: A Prospective Study

    PubMed Central

    2015-01-01

    Integrin αvβ3 is overexpressed in both neovasculature and glioma cells. We aimed to evaluate 68gallium-BNOTA-PRGD2 (68Ga-PRGD2) as a new reagent for noninvasive integrin αvβ3 imaging in glioma patients. With informed consent, 12 patients with suspicious brain glioma, as diagnosed by enhanced magnetic resonance imaging (MRI) scanning, were enrolled to undergo 68Ga-PRGD2 PET/CT and 18F-FDG PET/CT scans before surgery. The preoperative images were compared and correlated with the pathologically determined WHO grade. Next, the expression of integrin αvβ3, CD34, and Ki-67 were determined by immunohistochemical staining of the resected brain tumor tissue. Our findings demonstrated that 68Ga-PRGD2 specifically accumulated in the brain tumors that were rich of integrin αvβ3 and other neovasculature markers, but not in the brain parenchyma other than the choroid plexus. Therefore, 68Ga-PRGD2 PET/CT was able to evaluate the glioma demarcation more specifically than 18F-FDG PET/CT. The maximum standardized uptake values (SUVmax) of 68Ga-PRGD2, rather than those of 18F-FDG, were significantly correlated with the glioma grading. The maximum tumor-to-brain ratios (TBRmax) of both tracers were significantly correlated with glioma grading, whereas 68Ga-PRGD2 seemed to be more superior to 18F-FDG in differentiating high-grade glioma (HGG) from low-grade glioma (LGG). Moreover, 68Ga-PRGD2 PET/CT showed different accumulation patterns for HGG of WHO grades III and IV. This is the first noninvasive integrin imaging study, to the best of our knowledge, conducted in preoperative patients with different grades of glioma, and it preliminarily indicated the effectiveness of this novel method for evaluating glioma grading and demarcation. PMID:25093246

  14. Readjustment of abdominal computed tomography protocols in a university hospital: impact on radiation dose*

    PubMed Central

    Romano, Ricardo Francisco Tavares; Salvadori, Priscila Silveira; Torres, Lucas Rios; Bretas, Elisa Almeida Sathler; Bekhor, Daniel; Caldana, Rogério Pedreschi; Medeiros, Regina Bitelli; D’Ippolito, Giuseppe

    2015-01-01

    Objective To assess the reduction of estimated radiation dose in abdominal computed tomography following the implementation of new scan protocols on the basis of clinical suspicion and of adjusted images acquisition parameters. Materials and Methods Retrospective and prospective review of reports on radiation dose from abdominal CT scans performed three months before (group A – 551 studies) and three months after (group B – 788 studies) implementation of new scan protocols proposed as a function of clinical indications. Also, the images acquisition parameters were adjusted to reduce the radiation dose at each scan phase. The groups were compared for mean number of acquisition phases, mean CTDIvol per phase, mean DLP per phase, and mean DLP per scan. Results A significant reduction was observed for group B as regards all the analyzed aspects, as follows: 33.9%, 25.0%, 27.0% and 52.5%, respectively for number of acquisition phases, CTDIvol per phase, DLP per phase and DLP per scan (p < 0.001). Conclusion The rational use of abdominal computed tomography scan phases based on the clinical suspicion in conjunction with the adjusted images acquisition parameters allows for a 50% reduction in the radiation dose from abdominal computed tomography scans. PMID:26543280

  15. Thermoacoustic CT of the breast: pilot study observations

    NASA Astrophysics Data System (ADS)

    Kruger, Robert A.; Kiser, William L., Jr.; Romilly, A. P.; Scmidt, Phyllis

    2001-06-01

    In order to assess the potential clinical utility of using thermoacoustic computer tomography (TCT) to image the breast, we conducted a retrospective pilot study of 78 patients. We recruited patients in three age groups (<40,40-50,>50 years). The study population was further segregated into normal and suspicious based on the results of the previous x-ray mammography and ultrasound. Image quality was evaluated qualitatively by consensus of two trained mammographers using a 4-point scale. The appearance of normal anatomy, cysts, benign disease and cancer was noted. Patients were also asked to rate the comfort of the TCT exam and to indicate a personal preference for x-ray mammography or TCT. Analysis of the data indicated that TCT image quality was dependent upon both patient age and breast density, improving with both increasing breast density and decreasing patient age. Fibrocystic disease was well seen, cysts appearing as areas of low RF absorption. Fibroadenomas did not demonstrate contrast enhancement with the exception of one patient with associated atypical hyperplasia. Cancer displayed higher RF absorption than surrounding tissues in 4/7 patients in whom cancer was confirmed, including one patient with a 7-mm ductal carcinoma in situ (DCIS).

  16. Refractory Epilepsy-MRI, EEG and CT scan, a Correlative Clinical Study

    PubMed Central

    Nikodijevic, Dijana; Baneva–Dolnenec, Natalija; Petrovska-Cvetkovska, Dragana; Caparoska, Daniela

    2016-01-01

    OBJECTIVES: Refractory epilepsies (RE), as well as, the surgically correctable syndromes, are of great interest, since they affect the very young population of children and adolescents. The early diagnosis and treatment are very important in preventing the psychosocial disability. Therefore MRI and EEG are highly sensitive methods in the diagnosis and localization of epileptogenic focus, but also in pre-surgical evaluation of these patients. The aim of our study is to correlate the imaging findings of EEG, MRI and CT scan in refractory symptomatic epilepsies, and to determine their specificity in detecting the epileptogenic focus. METHODS: The study was prospective with duration of over two years, open-labelled, and involved a group of 37 patients that had been evaluated and diagnosed as refractory epilepsy patients. In the evaluation the type and frequency of seizures were considered, together with the etiologic factors and their association, and finally the risk for developing refractory epilepsy was weighted. EEG and MRI findings and CT scan results were evaluated for their specificity and sensitivity in detecting the epileptogenic focus, and the correlation between them was analyzed. RESULTS: Regarding the type of seizures considered in our study, the patients with PCS (partial complex seizures) dominated, as opposed to those with generalized seizures (GS) (D=1.178, p < 0.05). Positive MRI findings were registered in 28 patients (75.7%). Most of them were patients with hippocampal sclerosis, 12 (42.8%), and also they were found to have the highest risk of developing refractory epilepsy (RE) (Odds ratio = 5.7), and the highest association between the etiologic factor and refractory epilepsy (p < 0.01). In detecting the epileptogenic focus, a significant difference was found (p < 0.01) between MRI and CT scan findings, especially in patients with hippocampal sclerosis and cerebral malformations. There was a strong correlation between the MRI findings and the

  17. Computed tomography in the evaluation of metastatic adenocarcinoma from an unknown primary site: a retrospective study

    SciTech Connect

    McMillan, J.H.; Levine, E.; Stephens, R.H.

    1982-04-01

    Abdominal computed tomography (CT) and other studies were evaluated retrospectively in 46 patients with metastatic adenocarconoma or undifferentiated carcinoma in whom the primary tumor site was not evident from the history, physical examination, or chest radiograph. The primary site was ultimately located in 21 patients (45.7%). CT of the abdomen in particular detected it in 16 patients (34.8%) and demonstrated additional and often unsuspected metastatic disease in 65%. CT proved superior to sonography in both diagnosis and assessment of the extent of disease and had a significantly higher diagnostic yield than contrast studies of the urinary and gastrointestinal tracts. Abdominal CT is recommended as the initial modality in patients with metastatic adenocarcinoma of unknown primary origin. If the abdominal scan is negative, it should be followed by pelvic sonography or CT, particularly in women. Contrast studies should be limited to patients with specific organic dysfunction.

  18. Imaging the pregnant patient with abdominal pain.

    PubMed

    Wallace, Graham W; Davis, Melissa A; Semelka, Richard C; Fielding, Julia R

    2012-10-01

    Imaging of pregnant patients with non-obstetric abdominal pain is reviewed, with an accompanying pictorial essay of cases with concentration on magnetic resonance imaging. Non-obstetric causes of abdominal pain during pregnancy are similar to those of non-pregnant patients. The most common causes are appendicitis and cholecystitis. Other causes are myriad and include biliary, gastrointestinal, infectious, inflammatory, and malignant etiologies, among others. The approach to imaging in pregnant patient is unique, as it is imperative to minimize potentially harmful radiation exposures to the fetus. Ultrasound and MRI are the primary modalities for evaluation of the pregnant patient with abdominal pain. The use of intravenous contrast is discouraged, except in highly-selected patients where there is no other way to obtain vital diagnostic information. CT is still used as the mainstay of evaluation of blunt abdominal trauma and is commonly used for diagnosis of small bowel obstruction, stone disease, and work-up of malignancy during pregnancy. A discussion of test selection and underlying rationale is presented. PMID:22160283

  19. A Kinect™ camera based navigation system for percutaneous abdominal puncture

    NASA Astrophysics Data System (ADS)

    Xiao, Deqiang; Luo, Huoling; Jia, Fucang; Zhang, Yanfang; Li, Yong; Guo, Xuejun; Cai, Wei; Fang, Chihua; Fan, Yingfang; Zheng, Huimin; Hu, Qingmao

    2016-08-01

    Percutaneous abdominal puncture is a popular interventional method for the management of abdominal tumors. Image-guided puncture can help interventional radiologists improve targeting accuracy. The second generation of Kinect™ was released recently, we developed an optical navigation system to investigate its feasibility for guiding percutaneous abdominal puncture, and compare its performance on needle insertion guidance with that of the first-generation Kinect™. For physical-to-image registration in this system, two surfaces extracted from preoperative CT and intraoperative Kinect™ depth images were matched using an iterative closest point (ICP) algorithm. A 2D shape image-based correspondence searching algorithm was proposed for generating a close initial position before ICP matching. Evaluation experiments were conducted on an abdominal phantom and six beagles in vivo. For phantom study, a two-factor experiment was designed to evaluate the effect of the operator’s skill and trajectory on target positioning error (TPE). A total of 36 needle punctures were tested on a Kinect™ for Windows version 2 (Kinect™ V2). The target registration error (TRE), user error, and TPE are 4.26  ±  1.94 mm, 2.92  ±  1.67 mm, and 5.23  ±  2.29 mm, respectively. No statistically significant differences in TPE regarding operator’s skill and trajectory are observed. Additionally, a Kinect™ for Windows version 1 (Kinect™ V1) was tested with 12 insertions, and the TRE evaluated with the Kinect™ V1 is statistically significantly larger than that with the Kinect™ V2. For the animal experiment, fifteen artificial liver tumors were inserted guided by the navigation system. The TPE was evaluated as 6.40  ±  2.72 mm, and its lateral and longitudinal component were 4.30  ±  2.51 mm and 3.80  ±  3.11 mm, respectively. This study demonstrates that the navigation accuracy of the proposed system is acceptable

  20. MRI, enhanced CT, and FDG PET/CT in primary retroperitoneal mucinous cystadenocarcinoma.

    PubMed

    Dong, Aisheng; Zhai, Zhijun; Wang, Yang; Zuo, Changjing

    2015-01-01

    Primary retroperitoneal mucinous cystadenocarcinoma (PRMC) is an extremely rare neoplasm. We present a case of PRMC with MRI, enhanced CT, and FDG PET/CT findings. Abdominal MRI showed a cystic lesion in the retroperitoneum with a mural nodule. The mural nodule showed progressive enhancement on enhanced CT and intense FDG uptake on early PET/CT with increased SUVmax on delayed PET/CT. Laparoscopy was performed. Retroperitoneal mucinous cystadenocarcinoma was confirmed histopathologically. Metastasis from gastrointestinal tract or ovary was excluded. This case indicates, although rare, PRMC should be considered when a hypermetabolic retroperitoneal cystic lesion with bilateral normal ovaries is found on FDG PET/CT. PMID:24445275

  1. Study of carbon-polymer composite samples using an area-array CT scanner

    SciTech Connect

    Savona, V.; Martz, H.E.

    1995-12-11

    The development of advanced materials and their improvement is strictly connected to the understanding of their properties and behavior as a function of both their macro- and micro-structures. The application of X-ray computed tomography (CT) to these materials allows for a better understanding of the materials properties and behavior on either macro- or micro-structure scales. We studied five Carbon-Polymer composite samples, static and fatigue tensile-tensile loading tested, characterized by different matrix composition (Epoxy and Peek), different fibers orientation and layer sequences. We considered both unnotched and notched (by a circular hole) samples too. We scanned these material with the Lawrence Livermore National Laboratory PCAT area array system, in order to investigate the feasibility of CT to study the defects and other features for such materials.

  2. Safety and Efficacy of Percutaneous CT-Guided Drainage in the Management of Abdominopelvic Abscess

    PubMed Central

    Shahnazi, Makhtoom; Khatami, Alireza; Jamzad, Abbas; Shohitavi, Shomal

    2014-01-01

    Background: Abdominopelvic fluid collection and abscess management and their outcomes have improved in the recent years due to innovation of the image-guided drainage technique and improvement of surgical procedures Objectives: This study was undertaken to evaluate the efficacy of CT-guided percutaneous drainage in treating abdominopelvic abscesses. Patients and Methods: In this study, the data of 41 patients who had abdominal abscess or fluid collections, and underwent treatment by percutaneous CT-guided drainage were analyzed. Treatment was assessed by reduction of collection size, relief of symptoms and signs including abdominal pain and fever and imaging findings. Any morbidity such as wound infection, sepsis, hematoma formation or peritonitis was followed up to six months after the procedure. Results: The average age of the patients was 54 years (range 12 to 79), including 21 (51%) men and 20 (49%) women. The common signs and symptoms were pain (83%) and fever (80.5%). The most prevalent abdominal abscess etiology was previous surgery in 31 cases (75.5%). Abscess diameter ranged between 5 and 12 cm (mean, 7.8 cm). The average hospital stay was 8 days (4-15). Thirty five cases (86%) were successfully treated. Only one case (2.5%) developed complication (peritonitis) after the procedure. Conclusions: According to our findings, CT-guided percutaneous drainage is a safe and effective procedure in the treatment of abdominal abscess and fluid collection. PMID:25763077

  3. Medical staff extremity dosimetry in CT fluoroscopy: an anthropomorphic hand voxel phantom study.

    PubMed

    Figueira, C; Becker, F; Blunck, C; DiMaria, S; Baptista, M; Esteves, B; Paulo, G; Santos, J; Teles, P; Vaz, P

    2013-08-21

    This work aims to contribute to the study of the radiation dose distribution delivered to the hands of medical staff members during a general computed tomographic (CT) fluoroscopic guided procedure. In this study, both Monte Carlo simulations and measurements were performed. For free-in-air and computed tomography dose index (CTDI) body phantom measurements, a standard pencil ionization chamber (IC) 100 mm long was used. The CT scanner model was implemented using MCNPX (Monte Carlo N-Particle eXtended) and was successfully validated by comparing the simulated results with measurements. Subsequently, CT images of a hand, together with an anthropomorphic phantom, were voxelized and used with the MCNPX code for dose calculations. The hand dose distribution study was performed both by using thermo-luminescent detector measurements and Monte Carlo simulations. The validated simulation tool provides a new perspective for detailed investigations of CT-irradiation scenarios. Simulations show that there is a strong dose gradient, namely the even zones of the hand that are in precise vicinity to the x-ray beam only receive about 4% of the maximum dose delivered to adjacent areas which are directly exposed to the primary x-ray beam. Finally, the scatter contribution of the patient was also studied through MC simulations. The results show that for directly exposed parts of the hand surface, the dose is reduced by the body of the patient (due to the shielding), whereas the dose is increased by scattered radiation from the patient for parts of the skin that receive scattered radiation only. PMID:23877320

  4. Medical staff extremity dosimetry in CT fluoroscopy: an anthropomorphic hand voxel phantom study

    NASA Astrophysics Data System (ADS)

    Figueira, C.; Becker, F.; Blunck, C.; DiMaria, S.; Baptista, M.; Esteves, B.; Paulo, G.; Santos, J.; Teles, P.; Vaz, P.

    2013-08-01

    This work aims to contribute to the study of the radiation dose distribution delivered to the hands of medical staff members during a general computed tomographic (CT) fluoroscopic guided procedure. In this study, both Monte Carlo simulations and measurements were performed. For free-in-air and computed tomography dose index (CTDI) body phantom measurements, a standard pencil ionization chamber (IC) 100 mm long was used. The CT scanner model was implemented using MCNPX (Monte Carlo N-Particle eXtended) and was successfully validated by comparing the simulated results with measurements. Subsequently, CT images of a hand, together with an anthropomorphic phantom, were voxelized and used with the MCNPX code for dose calculations. The hand dose distribution study was performed both by using thermo-luminescent detector measurements and Monte Carlo simulations. The validated simulation tool provides a new perspective for detailed investigations of CT-irradiation scenarios. Simulations show that there is a strong dose gradient, namely the even zones of the hand that are in precise vicinity to the x-ray beam only receive about 4% of the maximum dose delivered to adjacent areas which are directly exposed to the primary x-ray beam. Finally, the scatter contribution of the patient was also studied through MC simulations. The results show that for directly exposed parts of the hand surface, the dose is reduced by the body of the patient (due to the shielding), whereas the dose is increased by scattered radiation from the patient for parts of the skin that receive scattered radiation only.

  5. Abdominal Kaposiform Hemangioendothelioma Associated With Lymphangiomatosis Involving Mesentery and Ileum

    PubMed Central

    Dong, Aisheng; Zhang, Ling; Wang, Yang; He, Tianlin; Zuo, Changjing

    2016-01-01

    Abstract Kaposiform hemangioendothelioma (KH) is a rare vascular tumor of intermediate malignancy that occurs mainly in the childhood. Adult patients with KH are rare. Imaging findings of KH have rarely been reported before. We present magnetic resonance imaging (MRI), computed tomography (CT), and fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT findings in an adult patient with KH associated with lymphangiomatosis involving mesentery and ileum. A 22-year-old female complained of a 9-month history of intermittent melena, weakness, and palpitation. Laboratory tests revealed anemia and hypoproteinemia. Fecal occult blood test was positive. Abdominal enhanced MRI and CT showed a large abdominal mass involving mesentery and ileum. On enhanced MRI, there were many hypervascular nodules in the mass. On FDG PET/CT, the mass and the nodules showed slight FDG uptake. Small bowel capsule endoscopy showed numerous grape-shaped red nodules in the luminal wall of the involved ileum. The patient underwent resection of the abdominal mass and a segment of the ileum invaded by the abdominal mass. KH arising within lymphangiomatosis involving mesentery and ileum was confirmed by pathology. After surgery, the patient's symptoms improved. This is the first case of KH associated with lymphangiomatosis involving mesentery and ileum. In this case, the lymphangiomatosis overshadowed the small tumor nodules resulting in unusual imaging findings. Familiarity with these imaging findings is helpful for diagnosis and differential diagnosis of KH. PMID:26871848

  6. [The patient with intra-abdominal hypertension].

    PubMed

    Sakka, Samir G

    2016-01-01

    An intra-abdominal hypertension (IAH) defined as a pathological increase in intra-abdominal pressure (IAP) is commonly found on ICU admission or during the ICU stay. Several studies confirmed that an IAH is an independent predictor for mortality of critically ill patients. The abdominal compartment syndrome (ACS) which is defined as a sustained IAP>20 mmHg (with or without an abdominal perfusion pressure [APP]<60mmHg) that is associated with new organ dysfunction or failure has a mortality of up to 60%. In general, an IAH may be induced by several intra-abdominal as well as extra-abdominal conditions. Reduced abdominal wall compliance, intra-abdominal pathologies (either of the peritoneal space or parenchymateous organs) may lead to an IAH. Most commonly, intra-abdominal infections and/or sepsis and severe trauma or burns are predisposing for an IAH. An early sign may be a decrease in urinary output. The effects of an increased IAP on cardiovascular function are well recognized and include negative effects on preload, afterload and contractility. However, all other compartments of the body may be affected by an IAH. Thus, by an increase of the respective compartment pressure, e.g. intracranial pressure, a poly-compartment syndrome may result. Adequate prevention, a forward-looking strategy, and objective techniques for measurement of IAP are required to avoid or early detect an IAH or ACS. Finally, an immediate and consequent interdisciplinary management using conservative, interventional and operative options are necessary to solve an IAH or ACS. PMID:26863642

  7. Associations of birth weight, linear growth and relative weight gain throughout life with abdominal fat depots in adulthood: the 1982 Pelotas (Brazil) birth cohort study

    PubMed Central

    Araújo de França, G V; Lucia Rolfe, E De; Horta, B L; Gigante, D P; Yudkin, J S; Ong, K K; Victora, C G

    2016-01-01

    Background: Several studies have reported on associations of size at birth and early growth with general and central obesity; however, few have examined the potential effects of birth weight and postnatal growth on separate abdominal fat compartments. We investigated the effects of size at birth, linear growth and relative weight gain from birth to adulthood on visceral (VFT) and subcutaneous abdominal (SAFT) fat thicknesses at age 30 years. Methods: A total of 2663 participants from the 1982 Pelotas (Brazil) birth cohort study had complete information on ultrasound measures of abdominal fat at age 30 years, and anthropometric measurements for at least five visits (0/2/4/23/30 years). We estimated weight and height Z-score changes, conditional relative weight gain and conditional height at several ages. Results: In both men and women, VFT and SAFT showed positive associations with conditional relative weight gain during all age periods beyond 2 years and birth, respectively (all P⩽0.01). Women born with intrauterine growth restriction (IUGR) had greater VFT than other women (difference=0.15 s.d., 95% CI: 0.01–0.29), and they showed a stronger positive influence of infant weight gain 0–2 years on VFT (IUGR: β=0.17 s.d., 95% CI: 0.05–0.29; non-IUGR: β=0.01 s.d., 95% CI: −0.04 to 0.06; Pinteraction=0.02). Stunting at 2 years was associated with lower SAFT but not VFT, and it modified the influence of weight gain 2–4 years on SAFT in both sexes (both Pinteraction<0.05). Conclusions: Our findings reinforce the advantages of being born with an appropriate birth weight, and the hazards of rapid postnatal gains in weight relative to linear growth, particularly after the critical window of the first 1000 days. PMID:26395747

  8. Diagnostic Accuracy of Noncontrast CT in Detecting Acute Appendicitis: A Meta-analysis of Prospective Studies.

    PubMed

    Xiong, Bing; Zhong, Baishu; Li, Zhenwei; Zhou, Feng; Hu, Ruying; Feng, Zhan; Xu, Shunliang; Chen, Feng

    2015-06-01

    The aim of the study is to evaluate the diagnostic accuracy of noncontrast CT in detecting acute appendicitis. Prospective studies in which noncontrast CT was performed to evaluate acute appendicitis were found on PubMed, EMBASE, and Cochrane Library. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were assessed. The summary receiver-operating characteristic curve was conducted and the area under the curve was calculated. Seven original studies investigating a total of 845 patients were included in this meta-analysis. The pooled sensitivity and specificity were 0.90 (95% CI: 0.86-0.92) and 0.94 (95% CI: 0.92-0.97), respectively. The pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio was 12.90 (95% CI: 4.80-34.67), 0.09 (95% CI: 0.04-0.20), and 162.76 (95% CI: 31.05-853.26), respectively. The summary receiver-operating characteristic curve was symmetrical and the area under the curve was 0.97 (95% CI: 0.95-0.99). In conclusion, noncontrast CT has high diagnostic accuracy in detecting acute appendicitis, which is adequate for clinical decision making. PMID:26031278

  9. A Longitudinal Low Dose μCT Analysis of Bone Healing in Mice: A Pilot Study.

    PubMed

    Di, Lu-Zhao; Couture, Vanessa; Leblanc, Elisabeth; Alinejad, Yasaman; Beaudoin, Jean-François; Lecomte, Roger; Berthod, François; Faucheux, Nathalie; Balg, Frédéric; Grenier, Guillaume

    2014-01-01

    Low dose microcomputed tomography (μCT) is a recently matured technique that enables the study of longitudinal bone healing and the testing of experimental treatments for bone repair. This imaging technique has been used for studying craniofacial repair in mice but not in an orthopedic context. This is mainly due to the size of the defects (approximately 1.0 mm) in long bone, which heal rapidly and may thus negatively impact the assessment of the effectiveness of experimental treatments. We developed a longitudinal low dose μCT scan analysis method combined with a new image segmentation and extraction software using Hounsfield unit (HU) scores to quantitatively monitor bone healing in small femoral cortical defects in live mice. We were able to reproducibly quantify bone healing longitudinally over time with three observers. We used high speed intramedullary reaming to prolong healing in order to circumvent the rapid healing typical of small defects. Bone healing prolongation combined with μCT imaging to study small bone defects in live mice thus shows potential as a promising tool for future preclinical research on bone healing. PMID:25431676

  10. Derivation and Validation of Two Decision Instruments for Selective Chest CT in Blunt Trauma: A Multicenter Prospective Observational Study (NEXUS Chest CT)

    PubMed Central

    Rodriguez, Robert M.; Langdorf, Mark I.; Nishijima, Daniel; Baumann, Brigitte M.; Hendey, Gregory W.; Medak, Anthony J.; Raja, Ali S.; Allen, Isabel E.; Mower, William R.

    2015-01-01

    Background Unnecessary diagnostic imaging leads to higher costs, longer emergency department stays, and increased patient exposure to ionizing radiation. We sought to prospectively derive and validate two decision instruments (DIs) for selective chest computed tomography (CT) in adult blunt trauma patients. Methods and Findings From September 2011 to May 2014, we prospectively enrolled blunt trauma patients over 14 y of age presenting to eight US, urban level 1 trauma centers in this observational study. During the derivation phase, physicians recorded the presence or absence of 14 clinical criteria before viewing chest imaging results. We determined injury outcomes by CT radiology readings and categorized injuries as major or minor according to an expert-panel-derived clinical classification scheme. We then employed recursive partitioning to derive two DIs: Chest CT-All maximized sensitivity for all injuries, and Chest CT-Major maximized sensitivity for only major thoracic injuries (while increasing specificity). In the validation phase, we employed similar methodology to prospectively test the performance of both DIs. We enrolled 11,477 patients—6,002 patients in the derivation phase and 5,475 patients in the validation phase. The derived Chest CT-All DI consisted of (1) abnormal chest X-ray, (2) rapid deceleration mechanism, (3) distracting injury, (4) chest wall tenderness, (5) sternal tenderness, (6) thoracic spine tenderness, and (7) scapular tenderness. The Chest CT-Major DI had the same criteria without rapid deceleration mechanism. In the validation phase, Chest CT-All had a sensitivity of 99.2% (95% CI 95.4%–100%), a specificity of 20.8% (95% CI 19.2%–22.4%), and a negative predictive value (NPV) of 99.8% (95% CI 98.9%–100%) for major injury, and a sensitivity of 95.4% (95% CI 93.6%–96.9%), a specificity of 25.5% (95% CI 23.5%–27.5%), and a NPV of 93.9% (95% CI 91.5%–95.8%) for either major or minor injury. Chest CT-Major had a sensitivity

  11. Micro-CT of Carotid Arteries: A Tool for Experimental Studies

    SciTech Connect

    Mohr, Andreas; Wenke, Ruediger; Roemer, Frank W.; Lynch, John A.; Gatzka, Christian; Priebe, Markus; Guermazi, Ali; Grigorian, Mikayel; Heller, Martin; Mueller-Huelsbeck, Stefan

    2004-11-15

    Micro-computed tomography (micro-CT) is a high-resolution, nondestructive tool for two- and three-dimensional imaging and quantification. The ability of this technique to assess atherosclerosis of the carotid artery was evaluated in three human cadaver samples based on the original axial acquisitions, multiplanar reconstructions and volume rendering techniques. Quantitative analysis included the calculation of: (1) the original lumen perimeter, original lumen area, plaque area, residual lumen area, calcified area and gross sectional area reduction of the vascular lumen from two-dimensional slices; (2) the total tissue volume, soft tissue volume and calcified tissue volume from the three-dimensional data set. This preliminary study demonstrates the potential of micro-CT as a supplementary method for the two- and three-dimensional ex vivo evaluation of carotid atherosclerosis.

  12. Noise power spectrum studies of CT systems with off-centered image object and bowtie filter

    NASA Astrophysics Data System (ADS)

    Gomez-Cardona, Daniel; Cruz-Bastida, Juan P.; Li, Ke; Budde, Adam; Hsieh, Jiang; Chen, Guang-Hong

    2016-03-01

    In previous studies of the noise power spectrum (NPS) of multi-detector CT (MDCT) systems, the image object was usually placed at the iso-center of the CT system; therefore, the bowtie filter had negligible impact on the shape of the two-dimensional (2D) NPS of MDCT. This work characterized the NPS of off-centered objects when a bowtie filter is present. It was found that the interplay between the bowtie filter and object position has significant impact on the rotational symmetry of the 2D NPS. Depending on the size of the bowtie filter, the degree of object off-centering, and the location of the region of interest (ROI) used for the NPS measurements, the symmetry of the 2D NPS can be classified as circular, dumbbell, and a peculiar cloverleaf symmetry. An anisotropic NPS corresponds to structured noise texture, which may directly influence the detection performance of certain low contrast detection tasks.

  13. Sinonasal Anatomical Variants: CT and Endoscopy Study and Its Correlation with Extent of Disease.

    PubMed

    Mendiratta, Vandana; Baisakhiya, Nitish; Singh, Dalbir; Datta, Ginni; Mittal, Amit; Mendiratta, Parveen

    2016-09-01

    To evaluate the incidence of anatomical variations in sinonasal area by nasal endoscopy and CT scan paranasal sinuses and to correlate the anatomical variations in sinonasal area with extent of disease. The present study was conducted on 40 patients of chronic sinusitis. All the patients underwent CT scan paranasal sinus axial and coronal view and nasal endoscopy. The most common anatomical variations were agger nasi cells (80 %), deviated nasal septum (72.5 %) and concha bullosa (47.5 %). Other anatomical variations seen in sinonasal region were uncinate process variations, paradoxical middle turbinate, haller cells, accessory ostia of maxillary sinus, multiseptated sphenoid. Osteomeatal unit (87.5 %) and maxillary sinuses (87.5 %) were the most commonly involved which was followed by anterior ethmoids (70 %), posterior ethmoids (50 %), frontal sinuses (32.5 %) and the sphenoids (20 %). Considering the results obtained, we believe that anatomical variations may increase the risk of sinus mucosal disease. We therefore, emphasize the importance of a careful evaluation of CT study in patients with persistent symptoms of chronic rhinosinusitis. PMID:27508139

  14. Energy and dose considerations for diffraction enhanced CT in small animal studies

    NASA Astrophysics Data System (ADS)

    Connor, Dean; Dilmanian, F. Avraham; Parham, Christopher; Kao, Teresa; Zhong, Zhong

    2007-03-01

    Diffraction enhanced imaging (DEI) uses monochromatic x-rays coupled to an analyzer crystal to extract information about the refraction of x-rays within the object. Studies of excised biological tissues show that DEI has significant contrast-to-noise ratio (CNR) advantages for soft tissue when compared to standard radiography. DEI differs from conventional CT in that its refraction contrast depends on x-ray energy as 1/E, thus the energy and dose considerations for conventional CT will be inappropriate. The goal of this study was to assess the optimal energy for in vivo CT imaging of a mouse head to obtain the largest soft tissue refraction CNR. Through a theoretical model, optimum refraction CNR for mouse brain imaging was found to be about 20 keV. The findings were tested experimentally using the DEI system at the X15A beamline of the National Synchrotron Light Source. Using the parameters for optimized refraction CNR (20 keV, silicon [333] reflection), large image artifacts were caused by DEI's scatter-rejection properties. By increasing the x-ray energy and using a lower order diffraction, silicon [111], soft tissue features within the brain, including the hippocampus, could be resolved.

  15. A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone.

    PubMed

    Kim, Changsun; Kang, Bossng; Choi, Hyuk Joong; Park, Joon Bum

    2015-08-01

    We aimed to evaluate the feasibility of an iPhone-based remote control system as a real-time remote computed tomography (CT) reading tool for suspected appendicitis using a third-generation (3G) network under suboptimal illumination. One hundred twenty abdominal CT scans were selected; 60 had no signs of appendicitis, whereas the remaining 60 had signs of appendicitis. The 16 raters reviewed the images using the liquid crystal display (LCD) monitor of a picture archiving and communication system (PACS) workstation, as well as using an iPhone connected to the PACS workstation via a remote control system. We graded the probability of the presence of acute appendicitis for each examination using a five-point Likert scale. The overall sensitivity and specificity for the diagnosis of suspected appendicitis using the iPhone and the LCD monitor were high, and they were not significantly different (sensitivity P = 1.00, specificity P = 0.14). The average areas under the receiver operating characteristic curves for all CT readings with the iPhone and LCD monitor were 0.978 (confidence interval 0.965-0.991) and 0.974 (0.960-0.988), respectively, and the two devices did not have significantly different diagnostic performances (P = 0.55). The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-to-very good intra-observer agreement between the two devices. We verified the feasibility of an iPhone-based remote control system as a real-time remote CT reading tool for identifying suspected appendicitis using a 3G network and suboptimal illumination. PMID:25700617

  16. Distribution and length of osteophytes in the lumbar vertebrae and risk of rupture of abdominal aortic aneurysms: a study of dry bones from Chiang Mai, Thailand.

    PubMed

    Chanapa, Patcharin; Yoshiyuki, Tohno; Mahakkanukrauh, Pasuk

    2014-09-01

    Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. In the lumbar spinal region, the two major structures in close proximity anterior to the spine are the inferior vena cava and the abdominal aorta, both of which have been reported to be affected by osteophytes. The purpose of this study was to determine the distribution, classification and lengths of osteophytes in the lumbar vertebrae. One hundred and eighty lumbar columns of 90 males and 90 females from Chiang Mai, Thailand, in the age range 15 to 96 years (mean age, 63 years) were collected. The measuring length of osteophytes was assessed on vertebral body and articular facet. Statistical analysis was performed by descriptive analysis, chi-square and Pearson Correlation. Lumbar osteophytes were presented in 175 specimens (97.2%), 88 males and 87 females. The highest frequency was at L4, most were on the superior, inferior surface of body and articular facet (39.7%, 38.4%, and 22%), respectively. The greatest mean length was 3.47±2.21 mm at L5, and the longest length of anterior superior surface of body was 28.56 mm. The osteophyte length was significantly correlated directly with age (P<0.01), and males were significantly greater than females (P<0.05). The highest prevalence of osteophytes was on the anterior side of superior surface of body (30.4%), and the classification was traction. It can be proposed that the abdominal aorta could be damaged, especially a risk of rupture of abdominal aortic aneurysm. PMID:25276474

  17. Lifetime cigarette smoking is associated with abdominal obesity in a community-based sample of Japanese men: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA).

    PubMed

    Fujiyoshi, Akira; Miura, Katsuyuki; Kadowaki, Sayaka; Azuma, Koichiro; Tanaka, Sachiko; Hisamatsu, Takashi; Arima, Hisatomi; Kadota, Aya; Miyagawa, Naoko; Takashima, Naoyuki; Ohkubo, Takayoshi; Saitoh, Yoshino; Torii, Sayuki; Miyazawa, Itsuko; Maegawa, Hiroshi; Murata, Kiyoshi; Ueshima, Hirotsugu

    2016-12-01

    Studies from Western countries suggest that smokers tend to display greater abdominal obesity than non-smokers, despite showing lower weight. Whether this holds true in a leaner population requires clarification. Using indices of abdominal obesity including visceral adipose tissue, we examined whether lifetime cigarette smoking is associated with unfavorable fat distribution among Japanese men. From 2006 to 2008, we conducted a cross-sectional investigation of a community-based sample of Japanese men at 40-64 years old, free of cardiovascular diseases and cancer. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography. We divided participants into four groups: never-smokers; and tertiles of pack-years of smoking among ever-smokers. Using multivariable linear regression, we calculated adjusted means of obesity indices (VAT, SAT, VAT-SAT ratio [VSR], and waist-hip ratio [WHR]) for each group, and mean differences between consecutive groups. We analyzed 513 men (median age, 58.2 years; current smokers, 40.1%). Two-thirds showed body mass index (BMI) < 25 kg/m(2) (median, 23.5 kg/m(2)). Overall, greater lifetime smoking group was associated with greater WHR and VSR. On average, one higher smoking group was associated with 0.005 higher WHR (95% CI, 0.001-0.008; P = 0.005) and 0.041 greater VSR (95% CI, 0.009-0.073; P = 0.012) after adjustment for potential confounders, including BMI. In this sample of relatively lean Japanese men, greater lifetime smoking was associated with a metabolically more adverse fat distribution. Although smoking is commonly associated with lower BMI, minimizing the amount of lifetime smoking should be advocated. PMID:27413686

  18. Micromanaging abdominal aortic aneurysms.

    PubMed

    Maegdefessel, Lars; Spin, Joshua M; Adam, Matti; Raaz, Uwe; Toh, Ryuji; Nakagami, Futoshi; Tsao, Philip S

    2013-01-01

    The contribution of abdominal aortic aneurysm (AAA) disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to "fine tune" the translational output of their target messenger RNAs (mRNAs) by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility. PMID:23852016

  19. The Efficacy of Functional Electrical Stimulation of the Abdominal Muscles in the Treatment of Chronic Constipation in Patients with Multiple Sclerosis: A Pilot Study

    PubMed Central

    Peace, Carla

    2016-01-01

    Chronic constipation in patients with multiple sclerosis (MS) is common and the current methods of treatment are ineffective in some patients. Anecdotal observations suggest that functional electrical stimulation (FES) of the abdominal muscles may be effective in the management of constipation in these patients. Patients and Methods. In this exploratory investigation we studied the effects of FES on the whole gut transit time (WGTT) and the colonic transit time (CTT). In addition, we evaluated the treatment effect on the patients' constipation-related quality of life and on the use of laxatives and the use of manual bowel evacuation. FES was given for 30 minutes twice a day for a period of six weeks. Four female patients were studied. Results. The WGTT and CTT and constipation-related quality of life improved in all patients. The patients' use of laxatives was reduced. No adverse effects of FES treatment were reported. Conclusion. The findings of this pilot study suggest that FES applied to the abdominal muscles may be an effective treatment modality for severe chronic constipation in patients with MS. PMID:27200190

  20. Multicentre aneurysm screening study (MASS): cost effectiveness analysis of screening for abdominal aortic aneurysms based on four year results from randomised controlled trial

    PubMed Central

    2002-01-01

    have suggested that an ultrasound screening programme to detect abdominal aortic aneurysms in older men may be effectiveThere is uncertainty about the cost effectiveness of routine screening, with widely varying estimatesWhat this study addsA cost effectiveness analysis of data from a large randomised trial with follow up over four years showed 47 fewer deaths and additional costs of £2.2m in the group invited to screeningThe adjusted net cost per patient was £63.39 and per life year gained was £28 400The projected cost per life year gained after 10 years was £8000, which is substantially lower than the perceived NHS threshold value PMID:12433761

  1. Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

    PubMed Central

    Rehim, S. A.; Dagash, H.; Godbole, P. P.; Raghavan, A.; Murthi, G. V.

    2010-01-01

    Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM). Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable bleeding and necessitates an emergency laparotomy and splenectomy. We report two cases of children requiring splenectomy following severe blunt abdominal injury. In both instances emergency laparotomy was undertaken for uncontrollable bleeding despite resuscitation. The operating team was unaware of the precise source of bleeding preoperatively. Retrospective review of the computed tomography (CT) scans revealed subtle radiological features that indicate splenic avulsion. We wish to highlight these radiological features of splenic avulsion as they can help to focus management decisions regarding the need/timing for a laparotomy following blunt abdominal trauma in children. PMID:21209813

  2. A preliminary study of the measurement of slice-width dose profiles (SWDP) on diagnostic x-ray CT scanners using PAGAT polymer gel dosimeters with optical CT read-out

    NASA Astrophysics Data System (ADS)

    Sarabipour, Sarvenaz; Bosi, Stephen; Hill, Brendan; Baldock, Clive

    2006-12-01

    The slice-width dose profile (SWDP) is a measurement undertaken during acceptance testing and subsequent quality assurance measurements of diagnostic x-ray CT scanners for the determination, of patient dose. In a previous study (Hill B, Venning A J and Baldock C 2005 Med. Phys. 32 1589-1597) normoxic polymer gel dosimeters were used to measure dose, the SWDP and subsequently calculate computer tomography dose index (CTDI) during acceptance testing of a CT scanner. In the current study, a preliminary investigation was undertaken to determine the SWDP of a diagnostic x-ray CT scanner using the PAGAT polymer gel dosimeters with optical CT read-out.

  3. Pilot Study to Confirm that Fat and Liver can be Distinguished by Spectroscopic Tissue Response on a Medipix-All-Resolution System-CT (MARS-CT)

    NASA Astrophysics Data System (ADS)

    Berg, Kyra B.; Carr, James M.; Clark, Michael J.; Cook, Nick J.; Anderson, Nigel G.; Scott, Nicola J.; Butler, Alexandra P.; Butler, Philip H.; Butler, Anthony P.

    2009-07-01

    NAFLD, liver component of the "metabolic" syndrome, has become the most common liver disease in western nations. Non-invasive imaging techniques exist, but have limitations, especially in detection and quantification of mild to moderate fatty liver. In this pilot study, we produced attenuation curves from biomedical-quality projection images of liver and fat using the MARS spectroscopic-CT scanner. Difficulties obtaining attenuation spectra after reconstruction demonstrated that standard reconstruction programs do not preserve spectral information.

  4. Pilot Study to Confirm that Fat and Liver can be Distinguished by Spectroscopic Tissue Response on a Medipix-All-Resolution System-CT (MARS-CT)

    SciTech Connect

    Berg, Kyra B.; Anderson, Nigel G.; Butler, Alexandra P.; Carr, James M.; Clark, Michael J.; Cook, Nick J.; Scott, Nicola J.; Butler, Philip H.; Butler, Anthony P.

    2009-07-23

    NAFLD, liver component of the 'metabolic' syndrome, has become the most common liver disease in western nations. Non-invasive imaging techniques exist, but have limitations, especially in detection and quantification of mild to moderate fatty liver. In this pilot study, we produced attenuation curves from biomedical-quality projection images of liver and fat using the MARS spectroscopic-CT scanner. Difficulties obtaining attenuation spectra after reconstruction demonstrated that standard reconstruction programs do not preserve spectral information.

  5. Lab-Based Nanofocus X-ray CT as a Supplemental Analysis Tool in Studies of Earth Materials

    NASA Astrophysics Data System (ADS)

    Santillan, J. D.; Maher, K.; O'Henley, G.; Zacher, G.; Brunke, O.

    2009-12-01

    In recent years, lab-based X-ray CT has become a viable alternative to the use of a synchrotron beamline for Earth Science researchers. CT for geological research purposes can lead to a new dimension of understanding of the distribution of rock properties. Because it has only been a few years since lab-based nano-CT has been applied to such problems, the breadth of these studies in quickly expanding. Results of studies we have performed show data consistent with those obtained using synchrotron radiation. Our presentation will focus on studies where CT is not the primary investigative technique, but where the information gained can strongly inform the approach taken using other methods, such as XRD. Using CT to bolster other techniques will be of great interest as X-ray CT is applied to solving a greater variety of geological problems. We have examined several samples using X-ray CT in sizes up to 120 mm in diameter and weighing up to 1 kg with voxel-resolutions down to <500 nm (<0.5 microns). This ability to resolve pores of increasingly smaller size has increased the diversity of systems that can be analyzed with non-synchrotron based radiation. Additional studies that will be discussed include microcrystalline materials with a focus on samples where very little material is available and handling or processing of the materials must therefore be very limited. Our work will also describe recent advances in the hardware and software that is being used for high-resolution non-synchrotron based X-ray CT. X-ray CT (positive image)

  6. Enamel and dentin mineralization in familial hypophosphatemic rickets: a micro-CT study

    PubMed Central

    Costa, F W G; Soares, E C S; Williams, J R; Fonteles, C S R

    2015-01-01

    Objectives: The aim of the present study was to analyse the mineralization pattern of enamel and dentin in patients affected by X-linked hypophosphatemic rickets (XLHR) using micro-CTCT), and to associate enamel and dentin mineralization in primary and permanent teeth with tooth position, gender and the presence/absence of this disease. Methods: 19 teeth were collected from 5 individuals from the same family, 1 non-affected by XLHR and 4 affected by XLHR. Gender, age, tooth position (anterior/posterior) and tooth type (deciduous/permanent) were recorded for each patient. Following collection, teeth were placed in 0.1% thymol solution until µCT scan. Projection images were reconstructed and analysed. A plot profile describing the greyscale distance relationship in µCT images was achieved through a line bisecting each tooth in a region with the presence of enamel and dentin. The enamel and dentin mineralization densities were measured and compared. Univariate ANOVA and post hoc Tukey tests were used for all comparisons. Results: Teeth of all affected patients presented dentin with a different mineralization pattern compared with the teeth of healthy patients with dentin defects observed next to the pulp chambers. Highly significant differences were found for gray values between anterior and posterior teeth (p < 0.05), affected and non-affected (p < 0.05), as well as when position and disease status were considered (p < 0.05). Conclusions: In conclusion, the mineralization patterns of dentin differed when comparing teeth from patients with and without FHR, mainly next to pulp chambers where areas with porosity and consequently lower mineral density and dentin defects were found. PMID:25651274

  7. Evaluation of side effects of radiofrequency capacitive hyperthermia with magnetite on the blood vessel walls of tumor metastatic lesion surrounding the abdominal large vessels: an agar phantom study

    PubMed Central

    2014-01-01

    Background Magnetite used in an 8-MHz radiofrequency (RF) capacitive heating device can increase the temperature of a specific site up to 45°C. When treating a metastatic lesion around large abdominal vessels via hyperthermia with magnetite, heating-induced adverse effects on these vessels need to be considered. Therefore, this study examined hyperthermia-induced damage to blood vessel walls in vitro. Methods A large agar phantom with a circulatory system consisting of a swine artery and vein connected to a peristaltic pump was prepared. The blood vessels were placed on the magnetite-containing agar piece. Heating was continued for 30 min at 45°C. After heating, a histological study for injury to the blood vessels was performed. Results The inner membrane temperature did not reach 45°C due to the cooling effect of the blood flow. In the heated vessels, vascular wall collagen degenerated and smooth muscle cells were narrowed; however, no serious changes were noted in the vascular endothelial cells or vascular wall elastic fibers. The heated vessel wall was not severely damaged; this was attributed to cooling by the blood flow. Conclusions Our findings indicate that RF capacitive heating therapy with magnetite may be used for metastatic lesions without injuring the surrounding large abdominal vessels. PMID:25114787

  8. Peripheral embolisation after an abdominal massage.

    PubMed

    Tak, Sandeep; Tak, Shubhanjali; Gupta, Alok

    2014-01-01

    A 65-year-old man presented with a history of acute onset pain in toes of the right foot immediately after an abdominal massage by a 'local healer'. General physical examination and systemic examination were normal except for discolouration of the fourth and fifth toes and cold toes. Investigations including complete blood count, erythrocyte sedimentation rate, renal function tests, liver profile, lipid profile, antinuclear antibody, antineutrophil cytoplasmic antibody, ECG, chest X-ray, ultrasound abdomen, cardiac echocardiography, lower limb Doppler and CT scan of the abdomen were normal. The patient was treated with regular heparin infusion, aspirin and tramadol. Recovery was complete in 5 days. PMID:24928926

  9. Abdominal Dual Energy Imaging

    NASA Astrophysics Data System (ADS)

    Sommer, F. Graham; Brody, William R.; Cassel, Douglas M.; Macovski, Albert

    1981-11-01

    Dual energy scanned projection radiography of the abdomen has been performed using an experimental line-scanned radiographic system. Digital images simultaneously obtained at 85 and 135 kVp are combined, using photoelectric/Compton decomposition algorithms to create images from which selected materials are cancelled. Soft tissue cancellation images have proved most useful in various abdominal imaging applications, largely due to the elimination of obscuring high-contrast bowel gas shadows. These techniques have been successfully applied to intravenous pyelography, oral cholecystography, intravenous abdominal arteriog-raphy and the imaging of renal calculi.

  10. Abdominal Vascular Catastrophes.

    PubMed

    Singh, Manpreet; Koyfman, Alex; Martinez, Joseph P

    2016-05-01

    Abdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained. A multidisciplinary approach is required to have a positive impact on mortality rates. Ruptured abdominal aortic aneurysm likewise may present in a cryptic fashion. A specific type of ruptured aneurysm, the aortoenteric fistula, often masquerades as the more common routine gastrointestinal bleed. The astute clinician recognizes that this is a more lethal variant of gastrointestinal hemorrhage. PMID:27133247

  11. Abdominal Aortic Aneurysms

    PubMed Central

    Fortner, George; Johansen, Kaj

    1984-01-01

    Aneurysms are common in our increasingly elderly population, and are a major threat to life and limb. Until the advent of vascular reconstructive techniques, aneurysm patients were subject to an overwhelming risk of death from exsanguination. The first successful repair of an abdominal aortic aneurysm using an interposed arterial homograft was reported by Dubost in 1952. A milestone in the evolution of vascular surgery, this event and subsequent diagnostic, operative and prosthetic graft refinements have permitted patients with an unruptured abdominal aortic aneurysm to enjoy a better prognosis than patients with almost any other form of major systemic illness. Images PMID:6702193

  12. Diagnostic Imaging of Fetal and Neonatal Abdominal and Soft Tissue Tumors.

    PubMed

    Nagaraj, Usha D; Kline-Fath, Beth M

    2015-01-01

    Imaging plays a key role in the diagnosis and staging of prenatal and neonatal tumors, and is essential in treatment planning. Though obstetrical ultrasound is the first choice prenatally, fetal MRI continues to play an increasing role as experience with this imaging modality increases. In the neonate, in addition to ultrasound and MRI, CT and nuclear medicine studies can also play an important role. We describe the prenatal and neonatal imaging findings of some of the most common congenital abdominal and soft tissue neoplasms including neuroblastoma, renal, liver and soft tissue tumors. PMID:26168940

  13. Functional dissection of the Hox protein Abdominal-B in Drosophila cell culture

    SciTech Connect

    Zhai, Zongzhao; Yang, Xingke; Lohmann, Ingrid

    2011-11-04

    Highlights: Black-Right-Pointing-Pointer ct340 CRM was identified to be the posterior spiracle enhancer of gene cut. Black-Right-Pointing-Pointer ct340 is under the direct transcriptional control of Hox protein Abd-B. Black-Right-Pointing-Pointer An efficient cloning system was developed to assay protein-DNA interaction. Black-Right-Pointing-Pointer New features of Abd-B dependent target gene regulation were detected. -- Abstract: Hox transcription factors regulate the morphogenesis along the anterior-posterior (A/P) body axis through the interaction with small cis-regulatory modules (CRMs) of their target gene, however so far very few Hox CRMs are known and have been analyzed in detail. In this study we have identified a new Hox CRM, ct340, which guides the expression of the cell type specification gene cut (ct) in the posterior spiracle under the direct control of the Hox protein Abdominal-B (Abd-B). Using the ct340 enhancer activity as readout, an efficient cloning system to generate VP16 activation domain fusion protein was developed to unambiguously test protein-DNA interaction in Drosophila cell culture. By functionally dissecting the Abd-B protein, new features of Abd-B dependent target gene regulation were detected. Due to its easy adaptability, this system can be generally used to map functional domains within sequence-specific transcriptional factors in Drosophila cell culture, and thus provide preliminary knowledge of the protein functional domain structure for further in vivo analysis.

  14. Do Patients with Penetrating Abdominal Stab Wounds Require Laparotomy?

    PubMed Central

    Sanei, Behnam; Mahmoudieh, Mohsen; Talebzadeh, Hamid; Shahabi Shahmiri, Shahab; Aghaei, Zahra

    2013-01-01

    Background The optimal management of hemodynamically stable asymptomatic patients with anterior abdominal stab wounds (AASWs) remains controversial. The goal is to identify and treat injuries in a safe cost-effective manner. Common evaluation strategies are local wound exploration (LWE), diagnostic peritoneal lavage (DPL), serial clinical assessment (SCAs) and computed tomography (CT) imaging. Making a decision about the right time to operate on a patient with a penetrating abdominal stab wound, especially those who have visceral evisceration, is a continuing challenge. Objectives Until the year 2010, our strategy was emergency laparotomy in patients with penetrating anterior fascia and those with visceral evisceration. This survey was conducted towards evaluating the results of emergency laparotomy. So, better management can be done in patients with penetrating abdominal stab wounds. Patients and Methods This retrospective cross-sectional study was performed on patients with abdominal penetrating trauma who referred to Al- Zahra hospital in Isfahan, Iran from October 2000 to October 2010. It should be noted that patients with abdominal blunt trauma, patients under 14 years old, those with lateral abdomen penetrating trauma and patients who had unstable hemodynamic status were excluded from the study. Medical records of patients were reviewed and demographic and clinical data were collected for all patients including: age, sex, mechanism of trauma and the results of LWE and laparotomy. Data were analyzed with PASW v.20 software. All data were expressed as mean ± SD. The distribution of nominal variables was compared using the Chi-squared test. Also, diagnostic index for LWE were calculated. A two-sided P value less than 0.05 was considered to be statistically significant. Results During the 10 year period of the study, 1100 consecutive patients with stab wounds were admitted to Al-Zahra hospital Isfahan, Iran. In total, about 150 cases had penetrating traumas in

  15. Comprehensive study of LASL Well C/T-2 Roosevelt Hot Springs KGRA, Utah, and applications to geothermal well logging

    SciTech Connect

    Glenn, W.E.; Hulen, J.B.; Nielson, D.L.

    1981-02-01

    Utah State Geothermal Well 9-1 in the Roosevelt Hot Springs KGRA, Beaver County, Utah, has been donated by Phillips Petroleum Company for calibration and testing of well-logging equipment in the hot, corrosive, geothermal environment. It is the second Calibration/Test Well (C/T-2) in the Geothermal Log Interpretation Program. A study of cuttings and well logs from Well C/T-2 was completed. This synthesis and data presentation contains most of the subsurface geologic information needed to effect the total evaluation of geophysical logs acquired in this geothermal calibration/test well, C/T-2.

  16. Evaluation of Clinical Alvarado Scoring System and CT Criteria in the Diagnosis of Acute Appendicitis

    PubMed Central

    Gunes Tatar, Idil; Yilmaz, Kerim Bora; Sahin, Alpaslan; Aydin, Hasan; Akinci, Melih; Hekimoglu, Baki

    2016-01-01

    Aim. The aim was to evaluate the clinical Alvarado scoring system and computed tomography (CT) criteria for the diagnosis of acute appendicitis. Material and Methods. 117 patients with acute abdominal pain who underwent abdominal CT were enrolled in this retrospective study. Patient demographics, clinical Alvarado scoring, CT images, and pathologic results of the patients were evaluated. Results. 39 of the 53 patients who were operated on had pathologically proven acute appendicitis. CT criteria of appendiceal diameter, presence of periappendiceal inflammation, fluid, appendicolith, and white blood cell (WBC) count were significantly correlated with the inflammation of the appendix. The best cut-off value for appendiceal diameter was 6.5 mm. The correlation between appendiceal diameter and WBC count was 80% (P = 0.01 < 0.05). The correlation between appendiceal diameter and Alvarado score was 78.7% (P = 0.01 < 0.05). Conclusion. Presence of CT criteria of appendiceal diameter above 6.5 mm, periappendiceal inflammation, fluid, and appendicolith should prompt the diagnosis of acute appendicitis. Since patients with acute appendicitis may not always show the typical signs and symptoms, CT is a helpful imaging modality for patients with relatively low Alvarado score and leukocytosis and when physical examination is confusing. PMID:27242926

  17. Evaluation of organ doses in CT examinations with an infant anthropomorphic phantom.

    PubMed

    Fujii, K; Akahane, K; Miyazaki, O; Horiuchi, T; Shimada, A; Nagmatsu, H; Yamauchi, M; Yamauchi-Kawaura, C; Kawasaki, T

    2011-09-01

    The aim of this study is to evaluate organ doses in infant CT examinations with multi-detector row CT scanners. Radiation doses were measured with radiophotoluminescence glass dosemeters set in various organ positions within a 1-y-old child anthropomorphic phantom and organ doses were evaluated from the measurement values. Doses for tissues or organs within the scan range were 28-36 mGy in an infant head CT, 3-11 mGy in a chest CT, 5-11 mGy in an abdominal-pelvic CT and 2-14 mGy in a cardiac CT. The doses varied by the differences in the types of CT scanners and scan parameters used at each medical facility. Compared with those for children of various ages, the doses in an infant CT protocol were found to be similar to or slightly smaller than those in a paediatric CT for 5- or 6-y-old children. PMID:21743079

  18. C-arm CT for histomorphometric evaluation of lumbar spine trabecular microarchitecture: a study on anorexia nervosa patients.

    PubMed

    Phan, C M; Khalilzadeh, O; Dinkel, J; Wang, I S; Bredella, M A; Misra, M; Miller, K K; Klibanski, A; Gupta, R

    2013-07-01

    Bone histomorphometry measurements require high spatial resolution that may not be feasible using multidetector CT (MDCT). This study evaluated the trabecular microarchitecture of lumbar spine using MDCT and C-arm CT in a series of young adult patients with anorexia nervosa (AN). 11 young females with AN underwent MDCT (anisotropic resolution with a slice thickness of ~626 μm) and C-arm CT (isotropic resolution of ~200 µm). Standard histomorphometric parameters the of L1 vertebral body, namely the apparent trabecular bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular number (TbN) and trabecular separation (TbSp), were analysed using MicroView software (GE Healthcare, Piscataway, NJ). Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Trabecular parameters derived from MDCT and C-arm CT were compared, and their association with BMD parameters was evaluated. Histomorphometric parameters derived from C-arm CT, namely TbTh, TbN and TbSp, were significantly different from the corresponding MDCT parameters. There were no significant correlations between C-arm CT-derived parameters and the corresponding MDCT-derived parameters. C-arm CT-derived parameters were significantly (p<0.001) correlated with anteroposterior L1 spine BMD and Z-scores: TbTh (r=0.723, r=0.744, respectively), TbN (r=-0.720, r=-0.712, respectively) and TbSp (r=0.656, r=0.648, respectively). BV/TV, derived from C-arm CT, was significantly associated with body mass index (r=0.636) and ideal body weight (r=0.730) (p<0.05). These associations were not present in MDCT-derived parameters. This study suggests that the spatial resolution offered by C-arm CT more accurately captures the histomorphometric parameters of trabecular morphology than MDCT in patients with AN. PMID:23640801

  19. A study of the short- to long-phantom dose ratios for CT scanning without table translation

    SciTech Connect

    Li, Xinhua; Zhang, Da; Liu, Bob; Yang, Jie

    2014-09-15

    Purpose: For CT scanning in the stationary-table modes, AAPM Task Group 111 proposed to measure the midpoint dose on the central and peripheral axes of sufficiently long phantoms. Currently, a long cylindrical phantom is usually not available in many clinical facilities. The use of a long phantom is also challenging because of the heavy weight. In order to shed light on assessing the midpoint dose in CT scanning without table movement, the authors present a study of the short- to long-phantom dose ratios, and perform a cross-comparison of CT dose ratios on different scanner models. Methods: The authors performed Geant4-based Monte Carlo simulations with a clinical CT scanner (Somatom Definition dual source CT, Siemens Healthcare), and modeled dosimetry measurements using a 0.6 cm{sup 3} Farmer type chamber and a 10-cm long pencil ion chamber. The short (15 cm) to long (90 cm) phantom dose ratios were computed for two PMMA diameters (16 and 32 cm), two phantom axes (the center and the periphery), and a range of beam apertures (3–25 cm). The results were compared with the published data of previous studies with other multiple detector CT (MDCT) scanners and cone beam CT (CBCT) scanners. Results: The short- to long-phantom dose ratios changed with beam apertures but were insensitive to beam qualities (80–140 kV, the head and body bowtie filters) and MDCT and CBCT scanner models. Conclusions: The short- to long-phantom dose ratios enable medical physicists to make dosimetry measurements using the standard CT dosimetry phantoms and a Farmer chamber or a 10 cm long pencil chamber, and to assess the midpoint dose in long phantoms. This method provides an effective approach for the dosimetry of CBCT scanning in the stationary-table modes, and is useful for perfusion and interventional CT.

  20. The mechanism of diarrhoea resulting from pelvic and abdominal radiotherapy; a prospective study using selenium-75 labelled conjugated bile acid and cobalt-58 labelled cyanocobalamin.

    PubMed

    Yeoh, E K; Lui, D; Lee, N Y

    1984-12-01

    An attempt was made to elucidate the mechanism of diarrhoea resulting from pelvic and abdominal radiotherapy in a prospective study of 10 patients undergoing treatment for curable pelvic malignant tumours using the synthetic trihydroxy 75Se-labelled conjugated bile acid, SeHcat and 58Co-labelled cyanocobalamin (58Co Vit B12). Evidence of malabsorption of vitamin B12 measured as a significant fall in whole body percentage retention of 58Co Vit B12 from baseline levels was found in all nine patients who developed diarrhoea during radiotherapy. Only four out of these nine patients also had malabsorption of the trihydroxy conjugated bile acid, cholic acid, measured as a significant fall in SeHcat whole body percentage retention and these patients had the most severe diarrhoea. The findings are discussed in the light of what is known about the pathophysiology of diarrhoea during pelvic and abdominal radiotherapy and lend support to previous work which implicated increased bowel motility in the pathogenesis of radiation-induced diarrhoea. The hypothesis that local neuroendocrine mechanisms in the gut may be involved is put forward, with possible implications for treatment. PMID:6509291

  1. 18F-FDG PET/CT for the assessment of gastrointestinal GVHD: results of a pilot study.

    PubMed

    Bodet-Milin, C; Lacombe, M; Malard, F; Lestang, E; Cahu, X; Chevallier, P; Guillaume, T; Delaunay, J; Brissot, E; Moreau, P; Kraeber-Bodere, F; Mohty, M

    2014-01-01

    This prospective pilot study aimed to evaluate the predictive value of (18)F-FDG PET/CT for early diagnosis of acute gastrointestinal GVHD (GI-GVHD). In all, 42 consecutive patients who received allo-SCT were included. (18)F-FDG PET/CT was systematically performed at a median of 28 (range, 24-38) days after allo-SCT. (18)F-FDG PET/CT data review was positive in 15 cases (36%) (9 true positive (TP) cases and 6 false positive (FP) cases) and negative in 27 cases (64%; 26 true negative (TN) cases and 1 false negative (FN) case) at visual analysis. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (18)F-FDG PET/CT for the diagnosis of acute GI-GVHD were, respectively, 81%, 90%, 60%, 96% and 83%. There were no significant differences of SUVmax values between grade 1-2 GI-GVHD and severe grade 3-4 GI-GVHD. Overall, these preliminary findings suggested that the inflammatory activity of the gastrointestinal tract associated with acute GI-GVHD could be assessed by (18)F-FDG PET/CT suggesting that noninvasive (18)F-FDG PET/CT could become a valuable examination to be performed shortly before endoscopy to map acute GI-GVHD lesions, guide the biopsy sites and choose the appropriate endoscopic procedure, especially in those asymptomatic patients with a positive (18)F-FDG PET/CT. PMID:24076550

  2. The pros and cons of intraoperative CT scan in evaluation of deep brain stimulation lead implantation: A retrospective study

    PubMed Central

    Servello, Domenico; Zekaj, Edvin; Saleh, Christian; Pacchetti, Claudio; Porta, Mauro

    2016-01-01

    Background: Deep brain stimulation (DBS) is an established therapy for movement disorders, such as Parkinson's disease (PD), dystonia, and tremor. The efficacy of DBS depends on the correct lead positioning. The commonly adopted postoperative radiological evaluation is performed with computed tomography (CT) scan and/or magnetic resonance imaging (MRI). Methods: We conducted a retrospective study on 202 patients who underwent DBS from January 2009 to October 2013. DBS indications were PD, progressive supranuclear palsy, tremor, dystonia, Tourette syndrome, obsessive compulsive disorder, depression, and Huntington's disease. Preoperatively, all patients underwent brain MRI and brain CT scan with the stereotactic frame positioned. The lead location was confirmed intraoperatively with CT. The CT images were subsequently transferred to the Stealth Station Medtronic and merged with the preoperative planning. On the first or second day after, implantation we performed a brain MRI to confirm the correct position of the lead. Results: In 14 patients, leads were in suboptimal position after intraoperative CT scan positioning. The cases with alteration in the Z-axis were corrected immediately under fluoroscopic guidance. In all the 14 patients, an immediate repositioning was done. Conclusions: Based on our data, intraoperative CT scan is fast, safe, and a useful tool in the evaluation of the position of the implanted lead. It also reduces the patient's discomfort derived from the transfer of the patient from the operating room to the radiological department. However, intraoperative CT should not be considered as a substitute for postoperative MRI. PMID:27583182

  3. Preliminary Study on Appearance-Based Detection of Anatomical Point Landmarks in Body Trunk CT Images

    NASA Astrophysics Data System (ADS)

    Nemoto, Mitsutaka; Nomura, Yukihiro; Hanaoka, Shohei; Masutani, Yoshitaka; Yoshikawa, Takeharu; Hayashi, Naoto; Yoshioka, Naoki; Ohtomo, Kuni

    Anatomical point landmarks as most primitive anatomical knowledge are useful for medical image understanding. In this study, we propose a detection method for anatomical point landmark based on appearance models, which include gray-level statistical variations at point landmarks and their surrounding area. The models are built based on results of Principal Component Analysis (PCA) of sample data sets. In addition, we employed generative learning method by transforming ROI of sample data. In this study, we evaluated our method with 24 data sets of body trunk CT images and obtained 95.8 ± 7.3 % of the average sensitivity in 28 landmarks.

  4. Intra-Abdominal Hematoma Following Enoxaparin Injection

    PubMed Central

    Chung, Kin Tong

    2016-01-01

    An elderly patient, who was being treated for therapeutic enoxaparin for a couple of days due to suspected deep vein thrombosis, was admitted to hospital following a collapse and severe abdominal pain. She was in hypovolemic shock and was fluid resuscitated. Ultrasound scan and computed tomography (CT) scan showed a large pelvic hematoma. Radiologists also suspected a possibility of bleeding from inferior epigastric artery following a CT angiogram. The patient was stabilized and transferred to intensive care unit (ICU) for further hemodynamic supports and close monitoring. The patient was then transferred back to the general ward when she was stable. She was managed conservatively as there were no more signs of active bleeding. Unfortunately, she died of recurrent bleeding three days after ICU discharge. PMID:27158226

  5. Intra-Abdominal Hematoma Following Enoxaparin Injection.

    PubMed

    Chung, Kin Tong

    2016-01-01

    An elderly patient, who was being treated for therapeutic enoxaparin for a couple of days due to suspected deep vein thrombosis, was admitted to hospital following a collapse and severe abdominal pain. She was in hypovolemic shock and was fluid resuscitated. Ultrasound scan and computed tomography (CT) scan showed a large pelvic hematoma. Radiologists also suspected a possibility of bleeding from inferior epigastric artery following a CT angiogram. The patient was stabilized and transferred to intensive care unit (ICU) for further hemodynamic supports and close monitoring. The patient was then transferred back to the general ward when she was stable. She was managed conservatively as there were no more signs of active bleeding. Unfortunately, she died of recurrent bleeding three days after ICU discharge. PMID:27158226

  6. Reliability of vertebral fracture assessment using multidetector CT lateral scout views: the Framingham Osteoporosis Study

    PubMed Central

    Samelson, E. J.; Christiansen, B. A.; Demissie, S.; Broe, K. E.; Zhou, Y.; Meng, C. A.; Yu, W.; Cheng, X.; O’Donnell, C. J.; Hoffmann, U.; Genant, H. K.; Kiel, D. P.; Bouxsein, M. L.

    2010-01-01

    Summary Two radiologists evaluated images of the spine from computed tomography (CT) scans on two occasions to diagnose vertebral fracture in 100 individuals. Agreement was fair to good for mild fractures, and agreement was good to excellent for more severe fractures. CT scout views are useful to assess vertebral fracture. Introduction We investigated inter-reader agreement between two radiologists and intra-reader agreement between duplicate readings for each radiologist, in assessment of vertebral fracture using a semi-quantitative method from lateral scout views obtained by CT. Methods Participants included 50 women and 50 men (age 50-87 years, mean 70 years) in the Framingham Study. T4-L4 vertebrae were assessed independently by two radiologists on two occasions using a semi-quantitative scale as normal, mild, moderate, or severe fracture. Results Vertebra-specific prevalence of grade ≥1 (mild) fracture ranged from 3% to 5%. We found fair (κ=56-59%) inter-reader agreement for grade ≥1 vertebral fractures and good (κ=68-72%) inter-reader agreement for grade ≥2 fractures. Intra-reader agreement for grade ≥1 vertebral fracture was fair (κ=55%) for one reader and excellent for another reader (κ=77%), whereas intra-reader agreement for grade ≥2 vertebral fracture was excellent for both readers (κ=76% and 98%). Thoracic vertebrae were more difficult to evaluate than the lumbar region, and agreement was lowest (inter-reader κ=43%) for fracture at the upper (T4-T9) thoracic levels and highest (inter-reader κ=76-78%) for the lumbar spine (L1-L4). Conclusions Based on a semi-quantitative method to classify vertebral fractures using CT scout views, agreement within and between readers was fair to good, with the greatest source of variation occurring for fractures of mild severity and for the upper thoracic region. Agreement was good to excellent for fractures of at least moderate severity. Lateral CT scout views can be useful in clinical research settings

  7. Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting.

    PubMed

    Coronado-Malagón, Martin; Tauffer-Carrion, Luis Tomas

    2012-01-01

    A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction. PMID:23997589

  8. Jejunal perforation after abdominal liposuction, bilateral breast augmentation and facial fat grafting

    PubMed Central

    Coronado-Malagón, Martin; Tauffer-Carrion, Luis Tomas

    2012-01-01

    A 54-year-old woman presented to the emergency department 24 h after undergoing abdominal liposuction, bilateral breast augmentation and facial fat grafting at a private plastic surgery clinic. She presented with the classic evolution of a bowel perforation secondary to abdominal liposuction. A computed tomography (CT) scan found free air in her abdominal cavity. Based on the CT scan and the persistent pain experienced by the patient, an abdominal laparatomy was urgently performed. A jejunum perforation was found and was treated with a resection of the affected segment followed by intestinal anastomosis. The patient had a successful recovery and was discharged seven days later. The present article also reviews the classical presentation of a bowel perforation following abdominal liposuction. PMID:23997589

  9. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  10. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  11. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  12. Quantitative anatomical labeling of the anterior abdominal wall

    NASA Astrophysics Data System (ADS)

    Allen, Wade M.; Xu, Zhoubing; Asman, Andrew J.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-03-01

    Ventral hernias (VHs) are abnormal openings in the anterior abdominal wall that are common side effects of surgical intervention. Repair of VHs is the most commonly performed procedure by general surgeons worldwide, but VH repair outcomes are not particularly encouraging (with recurrence rates up to 43%). A variety of open and laparoscopic techniques are available for hernia repair, and the specific technique used is ultimately driven by surgeon preference and experience. Despite routine acquisition of computed tomography (CT) for VH patients, little quantitative information is available on which to guide selection of a particular approach and/or optimize patient-specific treatment. From anecdotal interviews, the success of VH repair procedures correlates with hernia size, location, and involvement of secondary structures. Herein, we propose an image labeling protocol to segment the anterior abdominal area to provide a geometric basis with which to derive biomarkers and evaluate treatment efficacy. Based on routine clinical CT data, we are able to identify inner and outer surfaces of the abdominal walls and the herniated volume. This is the first formal presentation of a protocol to quantify these structures on abdominal CT. The intra- and inter rater reproducibilities of this protocol are evaluated on 4 patients with suspected VH (3 patients were ultimately diagnosed with VH while 1 was not). Mean surfaces distances of less than 2mm were achieved for all structures.

  13. [Exposure to CT scans in childhood and long-term cancer risk: A review of epidemiological studies].

    PubMed

    Baysson, Hélène; Journy, Neige; Roué, Tristan; Ducou-Lepointe, Hubert; Etard, Cécile; Bernier, Marie-Odile

    2016-02-01

    Amongst medical exams requiring ionizing radiation, computed tomography (CT) scans are used more frequently, including in children. These CT examinations are associated with absorbed doses that are much higher than those associated with conventional radiology. In comparison to adults, children have a greater sensitivity to radiation and a longer life span with more years at cancer risks. Five epidemiological studies on cancer risks after CT scan exposure during childhood were published between 2012 and 2015. The results of these studies are consistent and show an increase of cancer risks in children who have been exposed to several CT scans. However, methodological limits due to indication bias, retrospective assessment of radiation exposure from CT scans and lack of statistical power are to be taken into consideration. International projects such as EPI-CT (Epidemiological study to quantify risks for pediatric computerized tomography and to optimize dose), with a focus on dosimetric reconstruction and minimization of bias will provide more precise results. In the meantime, available results reinforce the necessity of justification and optimization of doses. PMID:26782078

  14. Single-photon emission computed tomography/computed tomography in abdominal diseases.

    PubMed

    Schillaci, Orazio; Filippi, Luca; Danieli, Roberta; Simonetti, Giovanni

    2007-01-01

    Single-photon emission computed tomography (SPECT) studies of the abdominal region are established in conventional nuclear medicine because of their easy and large availability, even in the most peripheral hospitals. It is well known that SPECT imaging demonstrates function, rather than anatomy. It is useful in the diagnosis of various disorders because of its ability to detect changes caused by disease before identifiable anatomic correlates and clinical manifestations exist. However, SPECT data frequently need anatomic landmarks to precisely depict the site of a focus of abnormal tracer uptake and the structures containing normal activity; the fusion with morphological studies can furnish an anatomical map to scintigraphic findings. In the past, software-based fusion of independently performed SPECT and CT or magnetic resonance images have been demonstrated to be time consuming and not useful for routine clinical employment. The recent development of dual-modality integrated imaging systems, which provide SPECT and CT images in the same scanning session, with the acquired images co-registered by means of the hardware, has created a new scenario. The first data have been mainly reported in oncology patients and indicate that SPECT/CT is very useful because it is able to provide further information of clinical value in several cases. In SPECT studies of abdominal diseases, hybrid SPECT/CT can play a role in the differential diagnosis of hepatic hemangiomas located near vascular structures, in precisely detecting and localizing active splenic tissue caused by splenosis in splenectomy patients, in providing important information for therapy optimization in patients submitted to hepatic arterial perfusion scintigraphy, in accurately identifying the involved bowel segments in patients with inflammatory bowel diseases, and in correctly localizing the bleeding sites in patients with gastrointestinal bleeding. PMID:17161039

  15. [Review of pre- and post-treatment multidetector computed tomography findings in abdominal aortic aneurysms].

    PubMed

    Casula, E; Lonjedo, E; Cerverón, M J; Ruiz, A; Gómez, J

    2014-01-01

    The increase in the frequency of abdominal aortic aneurysms (AAA) and the widely accepted use of endovascular aneurysm repair (EVAR) as a first-line treatment or as an alternative to conventional surgery make it necessary for radiologists to have thorough knowledge of the pre- and post-treatment findings. The high image quality provided by multidetector computed tomography (MDCT) enables CT angiography to play a fundamental role in the study of AAA and in planning treatment. The objective of this article is to review the cases of AAA in which CT angiography was the main imaging technique, so that radiologists will be able to detect the signs related to this disease, to diagnose it, to plan treatment, and to detect complications in the postoperative period. PMID:23489768

  16. Predominance of Abdominal Visceral Adipose Tissue Reflects the Presence of Aortic Valve Calcification

    PubMed Central

    Oikawa, Masayoshi; Owada, Takashi; Yamauchi, Hiroyuki; Misaka, Tomofumi; Machii, Hirofumi; Yamaki, Takayoshi; Sugimoto, Koichi; Kunii, Hiroyuki; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu-ichi; Takeishi, Yasuchika

    2016-01-01

    Background. Aortic valve calcification (AVC) is a common feature of aging and is related to coronary artery disease. Although abdominal visceral adipose tissue (VAT) plays fundamental roles in coronary artery disease, the relationship between abdominal VAT and AVC is not fully understood. Methods. We investigated 259 patients who underwent cardiac and abdominal computed tomography (CT). AVC was defined as calcified lesion on the aortic valve by CT. %abdominal VAT was calculated as abdominal VAT area/total adipose tissue area. Results. AVC was detected in 75 patients, and these patients showed higher %abdominal VAT (44% versus 38%, p < 0.05) compared to those without AVC. When the cutoff value of %abdominal VAT was set at 40.9%, the area under the curve to diagnose AVC was 0.626. Multivariable logistic regression analysis showed that age (OR 1.120, 95% CI 1.078–1.168, p < 0.01), diabetes (OR 2.587, 95% CI 1.323–5.130, p < 0.01), and %abdominal VAT (OR 1.032, 95% CI 1.003–1.065, p < 0.05) were independent risk factors for AVC. The net reclassification improvement value for detecting AVC was increased when %abdominal VAT was added to the model: 0.5093 (95% CI 0.2489–0.7697, p < 0.01). Conclusion. We determined that predominance of VAT is associated with AVC. PMID:26904670

  17. Serial CT Findings of Paragonimus Infested Dogs and the Micro-CT Findings of the Worm Cysts

    PubMed Central

    Lee, Chang Hyun; Goo, Jin Mo; Lee, Hyun Ju; Hong, Sung-Tae; Shen, Cheng Hua; Chung, Doo Hyun; Son, Kyu Ri; Chang, Jung Min; Eo, Hong

    2007-01-01

    Objective To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. Materials and Methods This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. Results The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. Conclusion The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus. PMID:17923779

  18. Thin soil layer of green roof systems studied by X-Ray CT

    NASA Astrophysics Data System (ADS)

    Šácha, Jan; Jelínková, Vladimíra; Dohnal, Michal

    2016-04-01

    The popular non-invasive visualization technique of X-ray computed tomography (CT) has been used for 3D examination of thin soil layer of vegetated roof systems. The two categories of anthropogenic soils, usually used for green roof systems, were scanned during the first months after green roof system construction. First was represented by stripped topsoil with admixed crushed bricks and was well graded in terms of particle size distribution. The other category represented a commercial lightweight technogenic substrate. The undisturbed soil samples of total volume of 62.8 ccm were studied be means of X-ray Computed Tomography using X-ray Inspection System GE Phoenix Nanomex 180T with resulting spatial resolution about 57 μm in all directions. For both soil categories visible macroporosity, connectivity (described by the Euler characteristic), dimensionless connectivity and critical cross section of pore network were determined. Moreover, the temporal structural changes of studied soils were discussed together with heat and water regime of the green roof system. The analysis of CT images of anthropogenic soils was problematic due to the different X-ray attenuation of individual constituents. The correct determination of the threshold image intensity differentiating the soil constituents from the air phase had substantial importance for soil pore network analyses. However, X-ray CT derived macroporosity profiles reveal significant temporal changes notably in the soil comprised the stripped topsoil with admixed crushed bricks. The results implies that the technogenic substrate is structurally more stable over time compared to the stripped topsoil. The research was realized as a part of the University Centre for Energy Efficient Buildings supported by the EU and with financial support from the Czech Science Foundation under project number 14-10455P.

  19. Evaluation of chemotherapy response in ovarian cancer treatment using quantitative CT image biomarkers: a preliminary study

    NASA Astrophysics Data System (ADS)

    Qiu, Yuchen; Tan, Maxine; McMeekin, Scott; Thai, Theresa; Moore, Kathleen; Ding, Kai; Liu, Hong; Zheng, Bin

    2015-03-01

    The purpose of this study is to identify and apply quantitative image biomarkers for early prediction of the tumor response to the chemotherapy among the ovarian cancer patients participated in the clinical trials of testing new drugs. In the experiment, we retrospectively selected 30 cases from the patients who participated in Phase I clinical trials of new drug or drug agents for ovarian cancer treatment. Each case is composed of two sets of CT images acquired pre- and post-treatment (4-6 weeks after starting treatment). A computer-aided detection (CAD) scheme was developed to extract and analyze the quantitative image features of the metastatic tumors previously tracked by the radiologists using the standard Response Evaluation Criteria in Solid Tumors (RECIST) guideline. The CAD scheme first segmented 3-D tumor volumes from the background using a hybrid tumor segmentation scheme. Then, for each segmented tumor, CAD computed three quantitative image features including the change of tumor volume, tumor CT number (density) and density variance. The feature changes were calculated between the matched tumors tracked on the CT images acquired pre- and post-treatments. Finally, CAD predicted patient's 6-month progression-free survival (PFS) using a decision-tree based classifier. The performance of the CAD scheme was compared with the RECIST category. The result shows that the CAD scheme achieved a prediction accuracy of 76.7% (23/30 cases) with a Kappa coefficient of 0.493, which is significantly higher than the performance of RECIST prediction with a prediction accuracy and Kappa coefficient of 60% (17/30) and 0.062, respectively. This study demonstrated the feasibility of analyzing quantitative image features to improve the early predicting accuracy of the tumor response to the new testing drugs or therapeutic methods for the ovarian cancer patients.

  20. Do obese but metabolically normal women differ in intra-abdominal fat and physical activity levels from those with the expected metabolic abnormalities? A cross-sectional study

    PubMed Central

    2010-01-01

    Background Obesity remains a major public health problem, associated with a cluster of metabolic abnormalities. However, individuals exist who are very obese but have normal metabolic parameters. The aim of this study was to determine to what extent differences in metabolic health in very obese women are explained by differences in body fat distribution, insulin resistance and level of physical activity. Methods This was a cross-sectional pilot study of 39 obese women (age: 28-64 yrs, BMI: 31-67 kg/m2) recruited from community settings. Women were defined as 'metabolically normal' on the basis of blood glucose, lipids and blood pressure. Magnetic Resonance Imaging was used to determine body fat distribution. Detailed lifestyle and metabolic profiles of participants were obtained. Results Women with a healthy metabolic profile had lower intra-abdominal fat volume (geometric mean 4.78 l [95% CIs 3.99-5.73] vs 6.96 l [5.82-8.32]) and less insulin resistance (HOMA 3.41 [2.62-4.44] vs 6.67 [5.02-8.86]) than those with an abnormality. The groups did not differ in abdominal subcutaneous fat volume (19.6 l [16.9-22.7] vs 20.6 [17.6-23.9]). A higher proportion of those with a healthy compared to a less healthy metabolic profile met current physical activity guidelines (70% [95% CIs 55.8-84.2] vs 25% [11.6-38.4]). Intra-abdominal fat, insulin resistance and physical activity make independent contributions to metabolic status in very obese women, but explain only around a third of the variance. Conclusion A sub-group of women exists who are metabolically normal despite being very obese. Differences in fat distribution, insulin resistance, and physical activity level are associated with metabolic differences in these women, but account only partially for these differences. Future work should focus on strategies to identify those obese individuals most at risk of the negative metabolic consequences of obesity and on identifying other factors that contribute to metabolic status

  1. Is there a trans-abdominal testicular descent during the second gestational trimester? Study in human fetuses between 13 and 23 weeks post conception

    PubMed Central

    Favorito, Luciano A.; Bernardo, Fabio O.; Costa, Suelen F.; Sampaio, Francisco J. B.

    2016-01-01

    ABSTRACT Objectives To confirm if a real inner descend of testis occurs, correlating the testicular position with fetal parameters and analyzing the position of the testes relative to the internal ring. Material and Methods Twenty nine human fetuses between 13 and 23 weeks post conception (WPC) were studied. The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25X magnification and testicular position observed. With the aid of a digital pachymeter the distance between the lower pole of the kidney and the upper extremity of the testis (DK-T) was measured to show the position of the testis. During the dissection we also indicated the position of the testes relative to the internal ring. Means were statistically compared using simple linear regression and the paired T-test. Results The 58 testes had abdominal position. The DK-T in the right side measured between 0.17 and 1.82cm (mean=0.79cm) and in the left side it was between 0.12 and 1.84cm (mean=0.87cm), without statistically differences (p=0.0557). The linear regression analysis indicated that DK-T in both sides correlated significantly and positively with fetal age. All fetuses with more than 20 WPC, heavier than 350g and with CRL over 22cm had a greater distance than the average DK-T. We xobserved that the 58 testis remains adjacent to the internal ring throughout the period studied. Conclusions The testes remains adjacent to the internal ring throughout the period studied, indicating that there is no real trans-abdominal testicular descent during the second gestational trimester. PMID:27286121

  2. Registration of Real-Time 3-D Ultrasound to Tomographic Images of the Abdominal Aorta.

    PubMed

    Brekken, Reidar; Iversen, Daniel Høyer; Tangen, Geir Arne; Dahl, Torbjørn

    2016-08-01

    The purpose of this study was to develop an image-based method for registration of real-time 3-D ultrasound to computed tomography (CT) of the abdominal aorta, targeting future use in ultrasound-guided endovascular intervention. We proposed a method in which a surface model of the aortic wall was segmented from CT, and the approximate initial location of this model relative to the ultrasound volume was manually indicated. The model was iteratively transformed to automatically optimize correspondence to the ultrasound data. Feasibility was studied using data from a silicon phantom and in vivo data from a volunteer with previously acquired CT. Through visual evaluation, the ultrasound and CT data were seen to correspond well after registration. Both aortic lumen and branching arteries were well aligned. The processing was done offline, and the registration took approximately 0.2 s per ultrasound volume. The results encourage further patient studies to investigate accuracy, robustness and clinical value of the approach. PMID:27156015

  3. Sensitivity study of an image processing workflow on synchrotron μ-CT images of Berea sandstone

    NASA Astrophysics Data System (ADS)

    Leu, Leon; Berg, Steffen; Ott, Holger; Armstrong, Ryan T.; Enzmann, Frieder; Kersten, Michael

    2014-05-01

    For the present study, the sensitivity of the threshold value for watershed-based segmentation and global threshold segmentation was assessed on μ-CT images of fine grained Berea sandstone. The sensitivities were assessed in terms of porosity, permeability, single-phase flow simulations and capillary pressure curves that were calculated from the segmented data. The μ-CT images of fine grained Berea sandstone with a resolution of 3 μm/pixel was segmented using different threshold values that were systematically varied, which resulted in slightly different structures for the pore space. The results show, that watershed-based segmentation is more robust than global threshold segmentation and that the measured permeability showed a stronger sensitivity to threshold variation than porosity, indicating that it is a more sensitive parameter to image segmentation settings. Calculated permeability and capillary pressure curves matched well with experimental data revealing that the average pores and pore throats of the watershed-based segmented structure were segmented accurately. In contrast, capillary pressure curves indicated that pore sizes near the resolution limit of 3 μm, located in kaolinite rich areas of the rock, were not segmented correctly and thus caused the disagreement between the experimental measured porosity and that measured from the digital rock image. We conclude that capillary pressure curves and permeability values that result from the digital rock data is more indicative of the flow relevant fraction of the pore structure and are therefore better suited as validation criterion than porosity data. Numerical modeling of two-phase flow on segmented data from high resolution μ-CT images enhances our understanding of the dynamics of multiphase-flow of immiscible fluids at the pore-scale. To be confident about simulated data it is therefore important to identify meaningful properties, e.g. permeability, that can be used as benchmark parameters for

  4. Appearance of bony lesions on 3-D CT reconstructions: a case study in variable renderings

    NASA Astrophysics Data System (ADS)

    Mankovich, Nicholas J.; White, Stuart C.

    1992-05-01

    This paper discusses conventional 3-D reconstruction for bone visualization and presents a case study to demonstrate the dangers of performing 3-D reconstructions without careful selection of the bone threshold. The visualization of midface bone lesions directly from axial CT images is difficult because of the complex anatomic relationships. Three-dimensional reconstructions made from the CT to provide graphic images showing lesions in relation to adjacent facial bones. Most commercially available 3-D image reconstruction requires that the radiologist or technologist identify a threshold image intensity value that can be used to distinguish bone from other tissues. Much has been made of the many disadvantages of this technique, but it continues as the predominant method in producing 3-D pictures for clinical use. This paper is intended to provide a clear demonstration for the physician of the caveats that should accompany 3-D reconstructions. We present a case of recurrent odontogenic keratocyst in the anterior maxilla where the 3-D reconstructions, made with different bone thresholds (windows), are compared to the resected specimen. A DMI 3200 computer was used to convert the scan data from a GE 9800 CT into a 3-D shaded surface image. Threshold values were assigned to (1) generate the most clinically pleasing image, (2) produce maximum theoretical fidelity (using the midpoint image intensity between average cortical bone and average soft tissue), and (3) cover stepped threshold intensities between these two methods. We compared the computer lesions with the resected specimen and noted measurement errors of up to 44 percent introduced by inappropriate bone threshold levels. We suggest clinically applicable standardization techniques in the 3-D reconstruction as well as cautionary language that should accompany the 3-D images.

  5. Component separation in abdominal trauma.

    PubMed

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

  6. The use of biomaterials in the repair of abdominal wall defects: a comparative study between polypropylene meshes (Marlex) and a new polytetrafluoroethylene prosthesis (Dual Mesh).

    PubMed

    Bellón, J M; Contreras, L A; Buján, J; Carrera-San Martín, A

    1997-10-01

    In this study we compared the behaviour of the non-porous on one side ePTFE Dual Mesh prosthesis and the macroporous polypropylene mesh Marlex in the repair of abdominal wall defects in rabbits. We evaluated the degree of integration with recipient tissue, biological tolerance, adhesion formation with viscera and the biomechanical resistance of the repair zone. Our results showed good biological tolerance of both prostheses and a high degree of adhesion formation in Marlex implants. In animals with Dual Mesh implants, only loose adhesions were seen. Marlex implants induced the presence of disorganized scar tissue, while the Dual Mesh prostheses were encapsulated by organized tissue. The macrophage response was similar in both decreasing with time. The resistance to traction was higher when the reparation was done with polypropylene. We concluded that the structure of the prosthesis determines its degree of integration and the resistance to traction of the repaired zone. PMID:9399138

  7. BIOMECHANICS OF ABDOMINAL AORTIC ANEURYSM

    PubMed Central

    Vorp, David A.

    2009-01-01

    Abdominal aortic aneurysm (AAA) is a condition whereby the terminal aorta permanently dilates to dangerous proportions, risking rupture. The biomechanics of AAA has been studied with great interest since aneurysm rupture is a mechanical failure of the degenerated aortic wall and is a significant cause of death in developed countries. In this review article, the importance of considering the biomechanics of AAA is discussed, and then the history and the state-of-the-art of this field is reviewed - including investigations into the biomechanical behavior of AAA tissues, modeling AAA wall stress and factors which influence it, and the potential clinical utility of these estimates in predicting AAA rupture. PMID:17254589

  8. Quantitative evaluation of the memory bias effect in ROC studies with PET/CT

    NASA Astrophysics Data System (ADS)

    Kallergi, Maria; Pianou, Nicoletta; Georgakopoulos, Alexandros; Kafiri, Georgia; Pavlou, Spiros; Chatziioannou, Sofia

    2012-02-01

    PURPOSE. The purpose of the study was to evaluate the memory bias effect in ROC experiments with tomographic data and, specifically, in the evaluation of two different PET/CT protocols for the detection and diagnosis of recurrent thyroid cancer. MATERIALS AND METHODS. Two readers participated in an ROC experiment that evaluated tomographic images from 43 patients followed up for thyroid cancer recurrence. Readers evaluated first whole body PET/CT scans of the patients and then a combination of whole body and high-resolution head and neck scans of the same patients. The second set was read twice. Once within 48 hours of the first set and the second time at least a month later. The detection and diagnostic performances of the readers in the three reading sessions were assessed with the DBMMRMC and LABMRMC software using the area under the ROC curve as a performance index. Performances were also evaluated by comparing the number and the size of the detected abnormal foci among the three readings. RESULTS. There was no performance difference between first and second treatments. There were statistically significant differences between first and third, and second and third treatments showing that memory can seriously affect the outcome of ROC studies. CONCLUSION. Despite the fact that tomographic data involve numerous image slices per patient, the memory bias effect is present and substantial and should be carefully eliminated from analogous ROC experiments.

  9. Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study.

    PubMed

    Brodén, Cyrus; Olivecrona, Henrik; Maguire, Gerald Q; Noz, Marilyn E; Zeleznik, Michael P; Sköldenberg, Olof

    2016-01-01

    Background and Purpose. The gold standard for detection of implant wear and migration is currently radiostereometry (RSA). The purpose of this study is to compare a three-dimensional computed tomography technique (3D CT) to standard RSA as an alternative technique for measuring migration of acetabular cups in total hip arthroplasty. Materials and Methods. With tantalum beads, we marked one cemented and one uncemented cup and mounted these on a similarly marked pelvic model. A comparison was made between 3D CT and standard RSA for measuring migration. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated. Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv. Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting. PMID:27478832

  10. Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study

    PubMed Central

    Olivecrona, Henrik; Maguire, Gerald Q.; Noz, Marilyn E.; Zeleznik, Michael P.

    2016-01-01

    Background and Purpose. The gold standard for detection of implant wear and migration is currently radiostereometry (RSA). The purpose of this study is to compare a three-dimensional computed tomography technique (3D CT) to standard RSA as an alternative technique for measuring migration of acetabular cups in total hip arthroplasty. Materials and Methods. With tantalum beads, we marked one cemented and one uncemented cup and mounted these on a similarly marked pelvic model. A comparison was made between 3D CT and standard RSA for measuring migration. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated. Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv. Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting. PMID:27478832

  11. Ethnic-specific risks for atherosclerotic calcification of the thoracic and abdominal aorta (from the Multi-Ethnic Study of Atherosclerosis).

    PubMed

    Allison, Matthew A; Budoff, Matthew J; Nasir, Khurram; Wong, Nathan D; Detrano, Robert; Kronmal, Richard; Takasu, Junichiro; Criqui, Michael H

    2009-09-15

    The aims of this study were to (1) determine the association between ethnicity and thoracic aortic calcium (TAC) and abdominal aortic calcium (AAC) and (2) investigate associations between cardiovascular disease (CVD) risk factors and TAC and AAC. Participants were 1,957 men and women enrolled in the Multi-Ethnic Study of Atherosclerosis who had computed tomographic scans of the chest and abdomen. These scans were obtained at the same clinic visit and calcium scores were computed using the Agatston method. Regression analyses were conducted using relative risk regression. Mean age was 65 years and 50% were women. Forty percent were white, 26% Hispanic, 21% African-American, and 13% Chinese. Whites had the highest prevalence of AAC (80%), which was significantly higher than Hispanics (68%, p <0.001), African-Americans (63%, p <0.001), and Chinese (74%, p = 0.029). Similarly, whites had the highest prevalence of TAC (42%), which was significantly higher than in Hispanics (30%, p <0.01) and African-Americans (27%, p <0.001) but was not significantly different from that in Chinese (38%). Compared to whites and after adjustment for age, gender, body mass index, hypertension, diabetes, dyslipidemia, smoking, and family history of CVD, Hispanics and African-Americans, but not Chinese-Americans, had a significantly lower risk for the presence of any AAC or any TAC. In these models, diabetes, smoking, and dyslipidemia had stronger associations with AAC, whereas hypertension was stronger for TAC. In conclusion, compared to whites, African-Americans and Hispanics, but not Chinese, have evidence of less atherosclerosis in the thoracic and abdominal aortas, which does not appear to be accounted for by traditional CVD risk factors. PMID:19733716

  12. CT Evaluation of Acute Pancreatitis and its Prognostic Correlation with CT Severity Index

    PubMed Central

    Gupta, Rajesh; Vyas, Mahendra Mohan; Sharma, Rakesh

    2016-01-01

    Introduction Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal CT are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagnosing as well as demonstrating the extent. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease. CT is the imaging method of choice for assessing the extent of acute pancreatitis and for evaluating complications. Aim To assess prognostic correlation and clinical outcome of acute pancreatitis on the basis of CT severity index. Materials and Methods A prospective study of 50 cases was carried out in the Department of Radio Diagnosis, with complaint suggestive of acute pancreatitis on the basis of clinical/laboratory/ultrasonography findings were evaluated in Siemens somatom 40 slice CT. The severity of pancreatitis was scored using CT severity index, modified severity index and revised Atlanta classification and classified into mild, moderate, severe categories. Clinical follow-up of the patients was done in terms of the following parameters: Length of hospital stay, Need for surgery or percutaneous intervention, Evidence of infection in any organ system, Occurrence of organ failure- respiratory, cardiovascular, renal, hepatic and haematological system, death. The clinical outcome was compared with the currently accepted Balthazar’s CTSI and Modified Mortele’s CTSI and revised Atlanta classification in all the cases. Results Gall stone disease was most common aetiological factor seen in 40% cases, it was more common in females than males. Alcohol was second most common aetiological factor seen in 38% cases and was noted only in males. Pleural effusion was the most common extra-pancreatic complication seen in 46% cases. Balthazar grade C was the most common (40

  13. Correlation between Dual-Energy and Perfusion CT in Patients with Hepatocellular Carcinoma.

    PubMed

    Gordic, Sonja; Puippe, Gilbert D; Krauss, Bernhard; Klotz, Ernst; Desbiolles, Lotus; Lesurtel, Mickaël; Müllhaupt, Beat; Pfammatter, Thomas; Alkadhi, Hatem

    2016-07-01

    Purpose To develop a dual-energy contrast media-enhanced computed tomographic (CT) protocol by using time-attenuation curves from previously acquired perfusion CT data and to evaluate prospectively the relationship between iodine enhancement metrics at dual-energy CT and perfusion CT parameters in patients with hepatocellular carcinoma (HCC). Materials and Methods Institutional review board and local ethics committee approval and written informed consent were obtained. The retrospective part of this study included the development of a dual-energy CT contrast-enhanced protocol to evaluate peak arterial enhancement of HCC in the liver on the basis of time-attenuation curves from previously acquired perfusion CT data in 20 patients. The prospective part of the study consisted of an intraindividual comparison of dual-energy CT and perfusion CT data in another 20 consecutive patients with HCC. Iodine density and iodine ratio (iodine attenuation of the lesion divided by iodine attenuation in the aorta) from dual-energy CT and arterial perfusion (AP), portal venous perfusion, and total perfusion (TP) from perfusion CT were compared. Pearson R and linear correlation coefficients were calculated for AP and iodine density, AP and iodine ratio, TP and iodine density, and TP and iodine ratio. Results The dual-energy CT protocol consisted of bolus tracking in the abdominal aorta (threshold, 150 HU; scan delay, 9 seconds). The strongest intraindividual correlations in HCCs were found between iodine density and AP (r = 0.75, P = .0001). Moderate correlations were found between iodine ratio and AP (r = 0.50, P = .023) and between iodine density and TP (r = 0.56, P = .011). No further significant correlations were found. The volume CT dose index (11.4 mGy) and dose-length product (228.0 mGy · cm) of dual-energy CT was lower than those of the arterial phase of perfusion CT (36.1 mGy and 682.3 mGy · cm, respectively). Conclusion A contrast-enhanced dual-energy CT protocol developed

  14. CT -- Body

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Body Computed tomography (CT) of the body uses special x-ray ... Body? What is CT Scanning of the Body? Computed tomography, more commonly known as a CT or CAT ...

  15. Spiral CT Quantification of Aorto-Renal Calcification and Its Use in the Detection of Atheromatous Renal Artery Stenosis: A Study in 42 Patients

    SciTech Connect

    Gayard, Pierre; Garcier, Jean-Marc; Boire, Jean-Yves; Ravel, Anne; Perez, Nessim; Privat, Christian; Lucien, Pascal; Viallet, Jean-Francois; Boyer, Louis

    2000-01-15

    Purpose: To investigate whether a correlation exists between aortic and renal arterial calcifications detected with spiral CT and significant angiographic renal artery stenosis (RAS).Methods: Forty-two patients (mean age 67 years, range 37-84 years), of whom 24 were hypertensive, prospectively underwent abdominal helical CT and aortic and renal arteriography. The 3-mm thickness CT scans (pitch = 1) were reconstructed each millimeter. A manual outline of the renal artery including its ostial portion was produced. Calcific hyperdensities were defined as areas of density more than 130 HU. CT data were compared with the presence or absence of RAS on angiography (24 cases); hypertension and age were taken into account (Mann-Whitney U-test).Results: CT detection and quantification appeared to be reliable and reproductible. We did not find any correlation between aortic and renal arterial calcifications and RAS, even for the patients above 65 years, with or without hypertension. There was no correlation either between calcifications and hypertension in patients without RAS. Conclusion: In this population, aortic and renal arterial calcifications have no predictive value for RAS.

  16. Sagittal Abdominal Diameter as a Surrogate Marker of Insulin Resistance in an Admixtured Population—Brazilian Metabolic Syndrome Study (BRAMS)

    PubMed Central

    Cassani, Roberta S. L.; Forti, Adriana C. e; Vilela, Brunna S.; Tambascia, Marcos Antonio

    2015-01-01

    Background Sagittal abdominal diameter (SAD) has been proposed as a surrogate marker of insulin resistance (IR). However, the utilization of SAD requires specific validation for each ethnicity. We aimed to investigate the potential use of SAD, compared with classical anthropometrical parameters, as a surrogate marker of IR and to establish the cutoff values of SAD for screening for IR. Methods A multicenter population survey on metabolic disorders was conducted. A race-admixtured sample of 824 adult women was assessed. The anthropometric parameters included: BMI, waist circumference (WC), waist-to-hip ratio and SAD. IR was determined by a hyperglycemic clamp and the HOMA-IR index. Results After adjustments for age and total body fat mass, SAD (r = 0.23 and r = -0.70) and BMI (r = 0.20 and r = -0.71) were strongly correlated with the IR measured by the HOMA-IR index and the clamp, respectively (p < 0.001). In the ROC analysis, the optimal cutoff for SAD in women was 21.0 cm. The women with an increased SAD presented 3.2 (CI 95%: 2.1-5.0) more likelihood of having IR, assessed by the HOMA-IR index compared with those with normal SAD (p < 0.001); whereas women with elevated BMI and WC were 2.1 (95% CI: 1.4-3.3) and 2.8 (95% CI: 1.7-4.5) more likely to have IR (p < 0.001), respectively. No statistically significant results were found for waist-to-hip ratio. Conclusions SAD can be a suitable surrogate marker of IR. Understanding and applying routine and simplified methods is essential because IR is associated with an increased risk of obesity-related diseases even in the presence of normal weight, slight overweight, as well as in obesity. Further prospective analysis will need to verify SAD as a determinant of clinical outcomes, such as type 2 diabetes and cardiovascular events, in the Brazilian population. PMID:25951458

  17. Quantifying the impact of respiratory-gated 4D CT acquisition on thoracic image quality: A digital phantom study

    SciTech Connect

    Bernatowicz, K. Knopf, A.; Lomax, A.; Keall, P.; Kipritidis, J.; Mishra, P.

    2015-01-15

    Purpose: Prospective respiratory-gated 4D CT has been shown to reduce tumor image artifacts by up to 50% compared to conventional 4D CT. However, to date no studies have quantified the impact of gated 4D CT on normal lung tissue imaging, which is important in performing dose calculations based on accurate estimates of lung volume and structure. To determine the impact of gated 4D CT on thoracic image quality, the authors developed a novel simulation framework incorporating a realistic deformable digital phantom driven by patient tumor motion patterns. Based on this framework, the authors test the hypothesis that respiratory-gated 4D CT can significantly reduce lung imaging artifacts. Methods: Our simulation framework synchronizes the 4D extended cardiac torso (XCAT) phantom with tumor motion data in a quasi real-time fashion, allowing simulation of three 4D CT acquisition modes featuring different levels of respiratory feedback: (i) “conventional” 4D CT that uses a constant imaging and couch-shift frequency, (ii) “beam paused” 4D CT that interrupts imaging to avoid oversampling at a given couch position and respiratory phase, and (iii) “respiratory-gated” 4D CT that triggers acquisition only when the respiratory motion fulfills phase-specific displacement gating windows based on prescan breathing data. Our framework generates a set of ground truth comparators, representing the average XCAT anatomy during beam-on for each of ten respiratory phase bins. Based on this framework, the authors simulated conventional, beam-paused, and respiratory-gated 4D CT images using tumor motion patterns from seven lung cancer patients across 13 treatment fractions, with a simulated 5.5 cm{sup 3} spherical lesion. Normal lung tissue image quality was quantified by comparing simulated and ground truth images in terms of overall mean square error (MSE) intensity difference, threshold-based lung volume error, and fractional false positive/false negative rates. Results

  18. IV Leiomyomatosis on FDG PET/CT.

    PubMed

    Jin, Xiaona; Li, Fang; Lu, Zhaohui; Cheng, Wuying

    2016-07-01

    A 48-year-old woman presented with a 2-month history of right lower extremity edema. Clinical examination only showed right lower limb swelling. Routine laboratory examination revealed no abnormal results. Abdominal ultrasonography identified uterine leiomyoma and soft tissue masses. An abdominal CT demonstrated a continuous mass extending from the right internal and external iliac vein into the common iliac vein and inferior vena cava. To distinguish the mass from malignancy, the patient underwent PET/CT scan which showed increased FDG activity in the mass. However, histopathological examination proved the mass to be IV leiomyomatosis. PMID:26914578

  19. Weakness of the Pelvic Floor Muscle and Bladder Neck Is Predicted by a Slight Rise in Abdominal Pressure During Bladder Filling: A Video Urodynamic Study in Children

    PubMed Central

    2016-01-01

    Purpose: To investigate the significance of slowly rising abdominal pressure (SRAP), which is often observed in nonneurogenic children during bladder filling in video urodynamic studies (VUDSs). Methods: The records of patients who underwent VUDS from July 2011 to June 2013 were reviewed. SRAP was defined as a rising curve over 5 cm H2O from the baseline abdominal pressure during the filling phase in VUDS. Bladder descent was defined when the base of the bladder was below the upper line of the pubic symphysis. An open bladder neck was defined as the opening of the bladder neck during the filling phase. Results: Of the 488 patients, 285 were male patients. The mean age at VUDS was 3.7 years (range, 0.2–17.6 years). The VUDS findings were as follows: SRAP, 20.7% (101 of 488); descending bladder, 14.8% (72 of 488); and bladder neck opening, 4.3% (21 of 488). Of the 72 patients with a descending bladder, 84.7% had SRAP. A significant difference in the presence of SRAP was found between the descending bladder and the normal bladder (P<0.001). Of the 101 patients with SRAP, 40 (39.6%) did not have a descending bladder. Of the 40 patients, 14 (35.0%) had a bladder neck opening, which was a high incidence compared with the 4.3% in all subjects (P<0.001). Conclusions: SRAP was associated with a descending bladder or a bladder neck opening, suggesting that SRAP is a compensatory response to urinary incontinence. SRAP may also predict decreased function of the bladder neck or pelvic floor muscle. PMID:27032558

  20. Cardiovascular risk factors in middle age obese Indians: a cross-sectional study on association of per cent body fat and intra-abdominal fat mass

    PubMed Central

    Sandhu, Jaspal Singh; Esht, Vandana; Shenoy, Shweta

    2012-01-01

    Objectives To determine the association of per cent total body fat (TBF), intra-abdominal fat (IAF) mass and subcutaneous abdominal fat with cardiovascular risk factors in middle age obese Indians. Design Cross-sectional study. Setting Hydrostatic Laboratory, Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, India. Participants: 51 subjects aged 30–55 years with a body mass index value 23 and above. Methodology In all the participants, TBF was estimated by underwater weighing machine and IAF and subcutaneous fat were measured by ultrasonography. Lipid profile was determined by a semiautomated analyser. Main outcome measures were: IAF, per cent body fat to TBF ratio, lipid profile and risk of developing cardiovascular diseases. Results IAF was found to be significantly associated with lipid variables (95% CI, p<0.01) and risk of developing cardiovascular diseases (95% CI, p≤0.05) in both male and female subjects. TBF and subcutaneous fat thickness showed no significant results (95% CI, p>0.05) with either lipid variables or risk of developing cardiovascular diseases (tables 1 and 2). IAF mass showed significant association with age (95% CI, p<0.01) and significant negative association with physical activity (95% CI, p<0.05) in male subjects (tables 3 and 4). Conclusion An ultrasonic measurement of IAF is a better predictor of the risk of developing cardiovascular diseases in middle aged Indian population. In male subjects, physical activity of 5 or more days a week showed lesser amount of IAF as compared with those with physical activity <5 days a week. PMID:27326015

  1. Vomiting and Hyponatremia Are Risk Factors for Worse Clinical Outcomes Among Patients Hospitalized Due to Nonsurgical Abdominal Pain: A Retrospective Cohort Study.

    PubMed

    Goren, Idan; Israel, Ariel; Carmel-Neiderman, Narin N; Kliers, Iris; Gringauz, Irina; Dagan, Amir; Lavi, Bruno; Segal, Omer; Segal, Gad

    2016-04-01

    After initial evaluation in the Emergency Department (ED), many patients complaining of abdominal pain are classified as suffering from nonsurgical abdominal pain (NSAP). Clinical characteristics and risk factors for worse prognosis were not published elsewhere.Characterizing the clinical profile of patients hospitalized due to NSAP and identifying predictor variables for worse clinical outcomes.We made a retrospective cohort analysis of patients hospitalized due to NSAP compared to matched control patients (for age, gender, and Charlson comorbidity index) hospitalized due to other, nonsurgical reasons in a ratio of 1 to 10. We further performed in-group analysis of patients admitted due to NSAP in order to appreciate variables (clinical and laboratory parameters) potentially associated with worse clinical outcomes.Overall 23,584 patients were included, of which 2144 were admitted due to NSAP and 21,440 were matched controls. Patients admitted due to NSAP had overall better clinical outcomes: they had lower rates of in-hospital and 30-days mortality (2.8% vs 5.5% and 7.9% vs 10.4% respectively, P < 0.001 for both comparisons). They also had a significantly shorter length of hospital stay (3.9 vs 6.2 days, P < 0.001). Rates of re-hospitalization within 30-days were not significantly different between study groups. Among patients hospitalized due to NSAP, we found that vomiting or hyponatremia at presentation or during hospital stay were associated with worse clinical outcomes.Compared to patients hospitalized due to other, nonsurgical reasons, the overall prognosis of patients admitted due to NSAP is favorable. The combination of NSAP with vomiting and hyponatremia is associated with worse clinical outcomes. PMID:27057886

  2. Low dose abdominal radiation as a docetaxel chemosensitizer for recurrent epithelial ovarian cancer: A phase I study of the Gynecologic Oncology Group

    PubMed Central

    Kunos, Charles A.; Sill, Michael W.; Buekers, Thomas E.; Walker, Joan L.; Schilder, Jeanne M.; Yamada, S. Diane; Waggoner, Steven E.; Mohiuddin, Mohammed; Fracasso, Paula M.

    2010-01-01

    Objectives To determine the maximum tolerated dose and dose-limiting toxicity (DLT) of whole abdomen radiation as a chemosensitizer of weekly docetaxel for women with recurrent epithelial ovarian fallopian tube, or peritoneal cancers. Patients and methods Women were enrolled on one of three dose levels of docetaxel (20, 25, or 30 mg/m2) administered weekly with concurrent low dose whole abdominal radiation given as 60 cGy bid two days weekly for a total of 6 weeks. Results Thirteen women were enrolled and received 70 weekly treatments of docetaxel in combination with radiation therapy. At the first dose level, docetaxel 25 mg/m2, grade 3 fatigue and thrombocytopenia were observed. At the next dose level, docetaxel 30 mg/m2, grade 3 febrile neutropenia, grade 4 thrombocytopenia with epistaxis and grade 3 diarrhea were observed. Given these dose-limiting toxicities, a lower dose of docetaxel 20 mg/m2 was administered and found to be tolerable. No objective responses were observed among the 10 patients with measurable disease; however, the median progression-free survival (PFS) in all patients was 3.3 months, and 3 of the patients with measurable disease were free of tumor progression after 6 months (30%; 90% Confidence Interval 8.7–61%). Conclusions Twice weekly low dose whole abdomen radiation during weekly docetaxel 20 mg/m2 was well-tolerated. Given the PFS demonstrated in these women with resistant ovarian cancer, further study of whole abdominal radiation and concurrent chemotherapy may be warranted. PMID:21075438

  3. Ultrasound-guided rectus sheath and transversus abdominis plane blocks for perioperative analgesia in upper abdominal surgery: A randomized controlled study

    PubMed Central

    Abdelsalam, Khaled; Mohamdin, OW

    2016-01-01

    Background: Regional anesthetic techniques can be used to alleviate postoperative pain in patients undergoing major upper abdominal surgery. Our aim was to evaluate the efficacy of bilateral ultrasound (US)-guided rectus sheath (RS) and transversus abdominis plane (TAP) blocks for better perioperative analgesia. Patients and Methods: It is a prospective, observer-blinded, randomized clinical study. 40 eligible patients undergoing elective liver resection or Whipple procedure were included. All patients received a standardized anesthetic technique. Group 1 (n = 20) received preincisional US-guided bilateral RS and TAP blocks using 20 ml volume of bupivacaine 0.25% for each, and group 2 (n = 20) received local wound infiltration at end of surgery with 40 ml of bupivacaine 0.25%. A standardized postoperative analgesic regimen composed of intravenous paracetamol and a morphine patient-controlled analgesia (PCA). The use of intraoperative fentanyl and recovery room morphine boluses, PCA-administered morphine, pain scores as well as number of patients’ experienced postoperative nausea and vomiting in the ward at 6 and 24 h were recorded. Results: Group 1 patients received a significantly lower cumulative intraoperative fentanyl, significantly lesser boluses of morphine in postanesthesia care unit, as well, significantly lower cumulative 24 h postoperative morphine dosage than the group 2 patients. Pain visual analog scale scores were significantly lower at both 6 and 24 h postoperatively in TAP group when compared with the no-TAP group. There were no complications related to the TAP block procedures. No signs or symptoms of local anesthetic systemic toxicity were detected. Conclusion: The combination of bilateral US-guided RS and TAP blocks provides excellent perioperative analgesia for major upper abdominal surgery. PMID:26955306

  4. The Effects of Combined Exercise on Health-Related Fitness, Endotoxin, and Immune Function of Postmenopausal Women with Abdominal Obesity

    PubMed Central

    Park, Sung-Mo; Kwak, Yi-Sub; Ji, Jin-Goo

    2015-01-01

    This study was conducted to examine the effects of combined exercise on health-related fitness, endotoxin concentrations, and immune functions of postmenopausal women with abdominal obesity. 20 voluntary participants were recruited and they were randomly allocated to the combined exercise group (n = 10) or the control group (n = 10). Visceral obesity was defined as a visceral-to-subcutaneous fat ratio ≥0.4 based on computed tomography (CT) results. Body composition, exercise stress testing, fitness measurement, CT scan, and blood variables were analyzed to elucidate the effects of combined exercise. The SPSS Statistics 18.0 program was used to calculate means and standard deviations for all variables. Significant differences between the exercise group and control group were determined with 2-way ANOVA and paired t-tests. The exercise group's abdominal obesity was mitigated due to visceral fat reduction; grip strength, push-ups, and oxygen uptake per weight improved; and HDL-C and IgA level also increased, while TNF-α, CD14, and endotoxin levels decreased. Lowered TNF-α after exercise might have an important role in the obesity reduction. Therefore, we can conclude that combined exercise is effective in mitigating abdominal obesity, preventing metabolic diseases, and enhancing immune function. PMID:26075288

  5. Role of dynamic CT perfusion study in evaluating various intracranial space-occupying lesions

    PubMed Central

    Kamble, Ravindra B; Jayakumar, Peruvumba N; Shivashankar, Ravishankar

    2015-01-01

    Aims: Differentiating intracranial mass lesions on CT scan is challenging. The purpose of our study was to determine the perfusion parameters in various intracranial space-occupying lesions (ICSOL), differentiate benign and malignant lesions, and differentiate between grades of gliomas. Materials and Methods: We performed CT perfusion (CTP) in 64 patients, with age ranging from 17 to 68 years, having space-occupying lesions in brain and calculated relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV). Results: We found significantly lower perfusion in low-grade gliomas as compared to high-grade tumors, lymphoma, and metastases. Similarly in infective lesions, TWT and abscesses showed significantly lower perfusion compared to TOT. In ring enhancing lesions, capsule of TWT showed significantly lower perfusion as compared to abscesses, TOT, and metastases. Conclusion: Thus, in conclusion, infective lesions can be differentiated from tumors like lymphomas, high-grade gliomas, or metastases based on perfusion parameters. The cut off value of rCBV 1.64 can be used to differentiate between low grade and high grade gliomas. However, depending only on perfusion parameters, differentiation between the tumors like lymphomas, high-grade gliomas, and metastases may not be possible. PMID:25969639

  6. Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats.

    PubMed

    Bosch, L; Rivera del Álamo, M M; Andaluz, A; Monreal, L; Torrente, C; García-Arnas, F; Fresno, L

    2012-12-15

    Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (P<0.05) and male (P<0.05) values, and returned to initial perioperative readings four hours after surgery. Tomcats and pregnant females (P<0.05) showed an increase in MAP and APP immediately after surgery decreasing back to initial perioperative values four hours later. A significant decrease in RT was appreciated immediately after laparotomy in both pregnant and non-pregnant queens. IAP was affected by abdominal surgery in this study, due likely to factors, such as postoperative pain and hypothermia. Pregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy. PMID:23118052

  7. Patient-specific radiation dose and cancer risk estimation in pediatric chest CT: a study in 30 patients

    NASA Astrophysics Data System (ADS)

    Li, Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

    2010-04-01

    Radiation-dose awareness and optimization in CT can greatly benefit from a dosereporting system that provides radiation dose and cancer risk estimates specific to each patient and each CT examination. Recently, we reported a method for estimating patientspecific dose from pediatric chest CT. The purpose of this study is to extend that effort to patient-specific risk estimation and to a population of pediatric CT patients. Our study included thirty pediatric CT patients (16 males and 14 females; 0-16 years old), for whom full-body computer models were recently created based on the patients' clinical CT data. Using a validated Monte Carlo program, organ dose received by the thirty patients from a chest scan protocol (LightSpeed VCT, 120 kVp, 1.375 pitch, 40-mm collimation, pediatric body scan field-of-view) was simulated and used to estimate patient-specific effective dose. Risks of cancer incidence were calculated for radiosensitive organs using gender-, age-, and tissue-specific risk coefficients and were used to derive patientspecific effective risk. The thirty patients had normalized effective dose of 3.7-10.4 mSv/100 mAs and normalized effective risk of 0.5-5.8 cases/1000 exposed persons/100 mAs. Normalized lung dose and risk of lung cancer correlated strongly with average chest diameter (correlation coefficient: r = -0.98 to -0.99). Normalized effective risk also correlated strongly with average chest diameter (r = -0.97 to -0.98). These strong correlations can be used to estimate patient-specific dose and risk prior to or after an imaging study to potentially guide healthcare providers in justifying CT examinations and to guide individualized protocol design and optimization.

  8. Construction of an anthropopathic abdominal phantom for accuracy validation of deformable image registration.

    PubMed

    Liao, Y L; Chen, H B; Zhou, L H; Zhen, X

    2016-04-29

    The purpose of this study is to design and fabricate an anthropopathic abdominal phantom for accuracy evaluation of deformable image registration (DIR) algorithms in adaptive radiation therapy. The constructed deformable organs, including the liver, kidney, spleen and stomach, are made of mixture of polyvinyl chloride (PVC) and softener dioctyl terephthalate, while the rigid structures, i.e. vertebrae, are made of white cement. Relation between the PVC-softener blending ratio and organ CT number is studied, and three-dimensional printing technic is employed to create highly anthropopathic organs in terms of organ shape and density. Detailed steps for phantom construction, landmark point placement and choice of phantom ingredients and construction recipe are introduced. Preliminary results of the mechanical properties of the fabricated organs are also presented. The experimental results indicate that the constructed phantom has satisfactory elastic characteristics and close CT number with corporal organs, and can potentially be applied to simulate real abdominal organ deformation in geometric accuracy validation of DIR algorithms. PMID:27177102

  9. Effect of lateral target motion on image registration accuracy in CT-guided helical tomotherapy: a phantom study.

    PubMed

    Medwig, J; Gaede, S; Battista, J J; Yartsev, S

    2010-06-01

    Optimisation of imaging modes for kilovoltage CT (kVCT) used for treatment planning and megavoltage CT (MVCT) image guidance used in ungated helical tomotherapy was investigated for laterally moving targets. Computed tomography images of the QUASAR Respiratory Motion Phantom were acquired without target motion and for lateral motion of the target, with 2-cm peak-to-peak amplitude and a period of 4 s. Reference kVCT images were obtained using a 16-slice CT scanner in standard fast helical CT mode, untagged average CT mode and various post-processed 4D-CT modes (0% phase, average and maximum intensity projection). Three sets of MVCT images with different inter-slice spacings of were obtained on a Hi-Art tomotherapy system with the phantom displaced by a known offset position. Eight radiation therapists performed co-registration of MVCT obtained with 2-, 4- and 6-mm slice spacing and kVCT studies independently for all 15 CT imaging combinations. In the investigated case, the untagged average kVCT and 4-mm slice spacing for the MVCT yielded more accurate registration in the transverse plane. The average residual uncertainty of this combination of imaging procedures was 0.61 +/- 0.16 mm in the longitudinal direction, 0.45 +/- 0.14 mm in the anterior-posterior direction and insignificant in the lateral direction. Manual registration of MVCT-kVCT study pairs is necessary to account for a target in significant lateral motion with respect to bony structures. PMID:20598016

  10. Indications for computed tomography (CT-) diagnostics in proximal humeral fractures: a comparative study of plain radiography and computed tomography

    PubMed Central

    Bahrs, Christian; Rolauffs, Bernd; Südkamp, Norbert P; Schmal, Hagen; Eingartner, Christoph; Dietz, Klaus; Pereira, Philippe L; Weise, Kuno; Lingenfelter, Erich; Helwig, Peter

    2009-01-01

    Background Precise indications for computed tomography (CT) in proximal humeral fractures are not established. The purpose of this study was a comparison of conventional radiographic views with different CT reconstructions with 2 D and 3 D imaging to establish indications for additional CT diagnostics depending on the fractured parts. Methods In a prospective diagnostic study in two level 1 trauma centers, 44 patients with proximal humeral fractures were diagnosed with conventional X-rays (22 AP + axillary views, 22 AP + scapular Y-views) and CT (multi-planar reconstruction (MPR) and maximum intensity projection (MIP)) with 2 D and 3 D imaging. 3 observers assessed the technical image quality, the assessment of the relevant anatomical structures (2-sample-t-test) and the percentage of the osseous overlap of the proximal humerus (Welch-test) using a scoring system. The quality of the different diagnostic methods was assessed according to the number of fractured parts (Bonferroni-Holm adjustment). Results There was significantly more overlap of the fractured region on the scapular Y-views (mean 71.5%, range 45–90%) than on axillary views (mean 56.2%, range 10.5–100%). CT-diagnostics allowed a significantly better assessment of the relevant structures than conventional diagnostics (p < 0.05) independently of the fracture severity (two-, three-, and four-part fractures). Conclusion Conventional X-rays with AP view and a high-quality axillary view are useful for primary diagnostics of the fracture and often but not always show a clear presentation of the relevant bony structures such as both tuberosities, the glenoid and humeral head. CT with thin slices technology and additional 3 D imaging provides always a clear presentation of the fractured region. Clinically, a CT should be performed – independently of the number of fractured parts – when the proximal humerus and the shoulder joint are not presented with sufficient X-ray-quality to establish a treatment

  11. [Abdominal splenosis: an often underdiagnosed entity].

    PubMed

    Vercher-Conejero, J L; Bello-Arqués, P; Pelegrí-Martínez, L; Hervás-Benito, I; Loaiza-Góngora, J L; Falgas-Lacueva, M; Ruiz-Llorca, C; Pérez-Velasco, R; Mateo-Navarro, A

    2011-01-01

    Splenosis is defined as the heterotopic autotransplantation of splenic tissue because of a ruptured spleen due to trauma or surgery. It is a benign and incidental finding, although imaging tests may sometimes orient toward malignancy simulating renal tumors, abdominal lymphomas, endometriosis, among other. We report the case of a 42-year old male in whom a MRI was performed after a study due to abdominal pain. Multiple enlarged lymph nodes were observed in the abdomen, suggestive of lymphoproliferative disease. As an important background, splenectomy was carried out due to abdominal trauma at age 9. After several studies, it was decided to perform a (99m)Tc-labeled heat-damaged red blood cell scintigraphy that showed multiple pathological deposits distributed throughout the abdomen, and even the pelvis, being consistent with splenosis. PMID:20570413

  12. The Different Volume Effects of Small-Bowel Toxicity During Pelvic Irradiation Between Gynecologic Patients With and Without Abdominal Surgery: A Prospective Study With Computed Tomography-Based Dosimetry

    SciTech Connect

    Huang, E.-Y.; Sung, C.-C.; Ko, S.-F.; Wang, C.-J.; Yang, Kuender D.

    2007-11-01

    Purpose: To evaluate the effect of abdominal surgery on the volume effects of small-bowel toxicity during whole-pelvic irradiation in patients with gynecologic malignancies. Methods and Materials: From May 2003 through November 2006, 80 gynecologic patients without (Group I) or with (Group II) prior abdominal surgery were analyzed. We used a computed tomography (CT) planning system to measure the small-bowel volume and dosimetry. We acquired the range of small-bowel volume in 10% (V10) to 100% (V100) of dose, at 10% intervals. The onset and grade of diarrhea during whole-pelvic irradiation were recorded as small-bowel toxicity up to 39.6 Gy in 22 fractions. Results: The volume effect of Grade 2-3 diarrhea existed from V10 to V100 in Group I patients and from V60 to V100 in Group II patients on univariate analyses. The V40 of Group I and the V100 of Group II achieved most statistical significance. The mean V40 was 281 {+-} 27 cm{sup 3} and 489 {+-} 34 cm{sup 3} (p < 0.001) in Group I patients with Grade 0-1 and Grade 2-3 diarrhea, respectively. The corresponding mean V100 of Group II patients was 56 {+-} 14 cm{sup 3} and 132 {+-} 19 cm{sup 3} (p = 0.003). Multivariate analyses revealed that V40 (p = 0.001) and V100 (p = 0.027) were independent factors for the development of Grade 2-3 diarrhea in Groups I and II, respectively. Conclusions: Gynecologic patients without and with abdominal surgery have different volume effects on small-bowel toxicity during whole-pelvic irradiation. Low-dose volume can be used as a predictive index of Grade 2 or greater diarrhea in patients without abdominal surgery. Full-dose volume is more important than low-dose volume for Grade 2 or greater diarrhea in patients with abdominal surgery.

  13. Texture Analysis of Preoperative CT Images for Prediction of Postoperative Hepatic Insufficiency: A Preliminary Study

    PubMed Central

    Simpson, Amber L; Adams, Lauryn B; Allen, Peter J; D’Angelica, Michael I; DeMatteo, Ronald P; Fong, Yuman; Kingham, T Peter; Leung, Universe; Miga, Michael I; Parada, E Patricia; Jarnagin, William R; Do, Richard K G

    2015-01-01

    Background Texture analysis is a promising method of analyzing imaging data to potentially enhance diagnostic capability. This approach involves automated measurement of pixel intensity variation that may offer further insight into disease progression than standard imaging techniques alone. We postulate that postoperative liver insufficiency, a major source of morbidity and mortality, correlates with preoperative heterogeneous parenchymal enhancement that can be quantified with texture analysis of cross-sectional imaging. Study Design A retrospective case-matched study (waiver of informed consent and HIPAA authorization, approved by the institutional review board) was performed comparing patients who underwent major hepatic resection and developed liver insufficiency (n=12) to a matched group of patients with no postoperative liver insufficiency (n=24) by procedure, remnant volume, and year of procedure. Texture analysis (with gray-level co-occurrence matrices) was used to quantify the heterogeneity of liver parenchyma on preoperative computed tomography (CT) scans. Statistical significance was evaluated using Wilcoxon’s signed rank and Pearson’s chi-squared tests. Results No statistically significant differences were found between study groups for preoperative patient demographics and clinical characteristics, with the exception of gender (p<0.05). Two texture features differed significantly between the groups: correlation (linear dependency of gray levels on neighboring pixels) and entropy (randomness of brightness variation) (p<0.05). Conclusions In this preliminary study, the texture of liver parenchyma on preoperative CT, was significantly more varied, less symmetric, and less homogeneous in patients with postoperative liver insufficiency; thus texture analysis has the potential to provide an additional means of preoperative risk stratification. PMID:25537305

  14. Genome-wide association study of coronary and aortic calcification in lung cancer screening CT

    NASA Astrophysics Data System (ADS)

    de Vos, Bob D.; van Setten, Jessica; de Jong, Pim A.; Mali, Willem P.; Oudkerk, Matthijs; Viergever, Max A.; Išgum, Ivana

    2016-03-01

    Arterial calcification has been related to cardiovascular disease (CVD) and osteoporosis. However, little is known about the role of genetics and exact pathways leading to arterial calcification and its relation to bone density changes indicating osteoporosis. In this study, we conducted a genome-wide association study of arterial calcification burden, followed by a look-up of known single nucleotide polymorphisms (SNPs) for coronary artery disease (CAD) and myocardial infarction (MI), and bone mineral density (BMD) to test for a shared genetic basis between the traits. The study included a subcohort of the Dutch-Belgian lung cancer screening trial comprised of 2,561 participants. Participants underwent baseline CT screening in one of two hospitals participating in the trial. Low-dose chest CT images were acquired without contrast enhancement and without ECG-synchronization. In these images coronary and aortic calcifications were identified automatically. Subsequently, the detected calcifications were quantified using coronary artery calcium Agatston and volume scores. Genotype data was available for these participants. A genome-wide association study was conducted on 10,220,814 SNPs using a linear regression model. To reduce multiple testing burden, known CAD/MI and BMD SNPs were specifically tested (45 SNPs from the CARDIoGRAMplusC4D consortium and 60 SNPS from the GEFOS consortium). No novel significant SNPs were found. Significant enrichment for CAD/MI SNPs was observed in testing Agatston and coronary artery calcium volume scores. Moreover, a significant enrichment of BMD SNPs was shown in aortic calcium volume scores. This may indicate genetic relation of BMD SNPs and arterial calcification burden.

  15. Early Postoperative Pain After Keyless Abdominal Rope-Lifting Surgery

    PubMed Central

    Hüseyınoğlu, Ürfettin; Çıçek, Melek

    2015-01-01

    Background and Objectives: Keyless abdominal rope-lifting surgery is a novel, gasless, single-incision laparoscopic surgical technique. In this study we aimed to compare the postoperative pain from keyless abdominal rope-lifting surgery with carbon dioxide laparoscopy performed for benign ovarian cysts. Methods: During a 20-month period, 77 women underwent surgery for a benign ovarian cyst. Keyless abdominal rope-lifting surgery and conventional carbon dioxide laparoscopy techniques were used for the operations in 32 women and 45 women, respectively. The 2 operative techniques were compared with regard to demographic characteristics; preoperative, intraoperative, and postoperative data including early postoperative pain scores; and frequency of shoulder pain and analgesic requirements. Results: Data regarding demographic characteristics, preoperative findings, cyst diameters and rupture rates, intra-abdominal adhesions, intraoperative blood loss, and postoperative hospital stay did not differ between groups (P > .05). However, the mean operative and abdominal access times were significantly longer in the keyless abdominal rope-lifting surgery group (P < .05). Visual analog scale pain scores at initially and at the second, fourth, and 24th hours of the postoperative period were significantly lower in the keyless abdominal rope-lifting surgery group (P < .05). Similarly, keyless abdominal rope-lifting surgery caused significantly less shoulder pain and additional analgesic use (P < .05). Conclusion: Keyless abdominal rope-lifting surgery seems to cause less pain in the management of benign ovarian cysts in comparison with conventional carbon dioxide laparoscopy. PMID:25848177

  16. Imaging of abdominal and pelvic injuries from the Boston Marathon bombing.

    PubMed

    Singh, Ajay K; Sodickson, Aaron; Abujudeh, Hani

    2016-02-01

    The aim of this study is to describe the imaging findings of abdominal and pelvic injuries in victims of the Boston Marathon bombing. A retrospective review of 87 patients following the Boston Marathon bombing was performed to evaluate for abdominal and pelvic injuries on plain radiography or CT scans of the abdomen and pelvis. Imaging exams were evaluated for shrapnel, soft tissue injury, visceral damage, vascular disruption, and fractures. The injuries were classified as primary, secondary, tertiary, and quaternary blast injuries. Eleven of the 87 patients had positive findings in the abdomen or pelvis (M:F = 7:4, average age 34.6 years). There were 22 ball bearings, two nails, one screw, and two irregular metal fragments in the 11 patients with secondary blast (shrapnel) injuries. There was no peritoneal penetration or visceral injury seen in any of the patients. One patient had multiple transverse process fractures, representing tertiary blast injury. All but one patient had superficial penetrating abdominal or pelvic injuries secondary to shrapnel. There were no cases of bowel or solid visceral organ injuries due to the lack of peritoneal violation from the relatively low-powered explosions. Absence of peritoneal penetration by shrapnel indicates no need for laparotomy following low-powered explosions. PMID:26445949

  17. PET/CT-guided treatment planning for paediatric cancer patients: a simulation study of proton and conventional photon therapy

    PubMed Central

    Brodin, N P; Björk-Eriksson, T; Birk Christensen, C; Kiil-Berthelsen, A; Aznar, M C; Hollensen, C; Markova, E; Munck af Rosenschöld, P

    2015-01-01

    Objective: To investigate the impact of including fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) scanning in the planning of paediatric radiotherapy (RT). Methods: Target volumes were first delineated without and subsequently re-delineated with access to 18F-FDG PET scan information, on duplicate CT sets. RT plans were generated for three-dimensional conformal photon RT (3DCRT) and intensity-modulated proton therapy (IMPT). The results were evaluated by comparison of target volumes, target dose coverage parameters, normal tissue complication probability (NTCP) and estimated risk of secondary cancer (SC). Results: Considerable deviations between CT- and PET/CT-guided target volumes were seen in 3 out of the 11 patients studied. However, averaging over the whole cohort, CT or PET/CT guidance introduced no significant difference in the shape or size of the target volumes, target dose coverage, irradiated volumes, estimated NTCP or SC risk, neither for IMPT nor 3DCRT. Conclusion: Our results imply that the inclusion of PET/CT scans in the RT planning process could have considerable impact for individual patients. There were no general trends of increasing or decreasing irradiated volumes, suggesting that the long-term morbidity of RT in childhood would on average remain largely unaffected. Advances in knowledge: 18F-FDG PET-based RT planning does not systematically change NTCP or SC risk for paediatric cancer patients compared with CT only. 3 out of 11 patients had a distinct change of target volumes when PET-guided planning was introduced. Dice and mismatch metrics are not sufficient to assess the consequences of target volume differences in the context of RT. PMID:25494657

  18. Predictive value of low tube voltage and dual-energy CT for successful shock wave lithotripsy: an in vitro study.

    PubMed

    Largo, Remo; Stolzmann, Paul; Fankhauser, Christian D; Poyet, Cédric; Wolfsgruber, Pirmin; Sulser, Tullio; Alkadhi, Hatem; Winklhofer, Sebastian

    2016-06-01

    This study investigates the capabilities of low tube voltage computed tomography (CT) and dual-energy CT (DECT) for predicting successful shock wave lithotripsy (SWL) of urinary stones in vitro. A total of 33 urinary calculi (six different chemical compositions; mean size 6 ± 3 mm) were scanned using a dual-source CT machine with single- (120 kVp) and dual-energy settings (80/150, 100/150 Sn kVp) resulting in six different datasets. The attenuation (Hounsfield Units) of calculi was measured on single-energy CT images and the dual-energy indices (DEIs) were calculated from DECT acquisitions. Calculi underwent SWL and the number of shock waves for successful disintegration was recorded. The prediction of required shock waves regarding stone attenuation/DEI was calculated using regression analysis (adjusted for stone size and composition) and the correlation between CT attenuation/DEI and the number of shock waves was assessed for all datasets. The median number of shock waves for successful stone disintegration was 72 (interquartile range 30-361). CT attenuation/DEI of stones was a significant, independent predictor (P < 0.01) for the number of required shock waves with the best prediction at 80 kVp (β estimate 0.576) (P < 0.05). Correlation coefficients between attenuation/DEI and the number of required shock waves ranged between ρ = 0.31 and 0.68 showing the best correlation at 80 kVp (P < 0.001). The attenuation of urinary stones at low tube voltage CT is the best predictor for successful stone disintegration, being independent of stone composition and size. DECT shows no added value for predicting the success of SWL. PMID:26391614

  19. Reconstruction of difference in sequential CT studies using penalized likelihood estimation.

    PubMed

    Pourmorteza, A; Dang, H; Siewerdsen, J H; Stayman, J W

    2016-03-01

    Characterization of anatomical change and other differences is important in sequential computed tomography (CT) imaging, where a high-fidelity patient-specific prior image is typically present, but is not used, in the reconstruction of subsequent anatomical states. Here, we introduce a penalized likelihood (PL) method called reconstruction of difference (RoD) to directly reconstruct a difference image volume using both the current projection data and the (unregistered) prior image integrated into the forward model for the measurement data. The algorithm utilizes an alternating minimization to find both the registration and reconstruction estimates. This formulation allows direct control over the image properties of the difference image, permitting regularization strategies that inhibit noise and structural differences due to inconsistencies between the prior image and the current data. Additionally, if the change is known to be local, RoD allows local acquisition and reconstruction, as opposed to traditional model-based approaches that require a full support field of view (or other modifications). We compared the performance of RoD to a standard PL algorithm, in simulation studies and using test-bench cone-beam CT data. The performances of local and global RoD approaches were similar, with local RoD providing a significant computational speedup. In comparison across a range of data with differing fidelity, the local RoD approach consistently showed lower error (with respect to a truth image) than PL in both noisy data and sparsely sampled projection scenarios. In a study of the prior image registration performance of RoD, a clinically reasonable capture ranges were demonstrated. Lastly, the registration algorithm had a broad capture range and the error for reconstruction of CT data was 35% and 20% less than filtered back-projection for RoD and PL, respectively. The RoD has potential for delivering high-quality difference images in a range of sequential clinical

  20. Reconstruction of difference in sequential CT studies using penalized likelihood estimation

    NASA Astrophysics Data System (ADS)

    Pourmorteza, A.; Dang, H.; Siewerdsen, J. H.; Stayman, J. W.

    2016-03-01

    Characterization of anatomical change and other differences is important in sequential computed tomography (CT) imaging, where a high-fidelity patient-specific prior image is typically present, but is not used, in the reconstruction of subsequent anatomical states. Here, we introduce a penalized likelihood (PL) method called reconstruction of difference (RoD) to directly reconstruct a difference image volume using both the current projection data and the (unregistered) prior image integrated into the forward model for the measurement data. The algorithm utilizes an alternating minimization to find both the registration and reconstruction estimates. This formulation allows direct control over the image properties of the difference image, permitting regularization strategies that inhibit noise and structural differences due to inconsistencies between the prior image and the current data. Additionally, if the change is known to be local, RoD allows local acquisition and reconstruction, as opposed to traditional model-based approaches that require a full support field of view (or other modifications). We compared the performance of RoD to a standard PL algorithm, in simulation studies and using test-bench cone-beam CT data. The performances of local and global RoD approaches were similar, with local RoD providing a significant computational speedup. In comparison across a range of data with differing fidelity, the local RoD approach consistently showed lower error (with respect to a truth image) than PL in both noisy data and sparsely sampled projection scenarios. In a study of the prior image registration performance of RoD, a clinically reasonable capture ranges were demonstrated. Lastly, the registration algorithm had a broad capture range and the error for reconstruction of CT data was 35% and 20% less than filtered back-projection for RoD and PL, respectively. The RoD has potential for delivering high-quality difference images in a range of sequential clinical

  1. Reconstruction of difference in sequential CT studies using penalized likelihood estimation

    PubMed Central

    Pourmorteza, A; Dang, H; Siewerdsen, J H; Stayman, J W

    2016-01-01

    Characterization of anatomical change and other differences is important in sequential computed tomography (CT) imaging, where a high-fidelity patient-specific prior image is typically present, but is not used, in the reconstruction of subsequent anatomical states. Here, we introduce a penalized likelihood (PL) method called reconstruction of difference (RoD) to directly reconstruct a difference image volume using both the current projection data and the (unregistered) prior image integrated into the forward model for the measurement data. The algorithm utilizes an alternating minimization to find both the registration and reconstruction estimates. This formulation allows direct control over the image properties of the difference image, permitting regularization strategies that inhibit noise and structural differences due to inconsistencies between the prior image and the current data.Additionally, if the change is known to be local, RoD allows local acquisition and reconstruction, as opposed to traditional model-based approaches that require a full support field of view (or other modifications). We compared the performance of RoD to a standard PL algorithm, in simulation studies and using test-bench cone-beam CT data. The performances of local and global RoD approaches were similar, with local RoD providing a significant