Science.gov

Sample records for abdominal enhanced ct

  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. 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 ...

  3. 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 ...

  4. 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.

  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. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. Contrast-enhanced ultrasound (CEUS) in blunt abdominal trauma.

    PubMed

    Miele, Vittorio; Piccolo, Claudia Lucia; Galluzzo, Michele; Ianniello, Stefania; Sessa, Barbara; Trinci, Margherita

    2016-01-01

    Baseline ultrasound is essential in the early assessment of patients with a huge haemoperitoneum undergoing an immediate abdominal surgery; nevertheless, even with a highly experienced operator, it is not sufficient to exclude parenchymal injuries. More recently, a new ultrasound technique using second generation contrast agents, named contrast-enhanced ultrasound (CEUS) has been developed. This technique allows all the vascular phase to be performed in real time, increasing ultrasound capability to detect parenchymal injuries, enhancing some qualitative findings, such as lesion extension, margins and its relationship with capsule and vessels. CEUS has been demonstrated to be almost as sensitive as contrast-enhanced CT in the detection of traumatic injuries in patients with low-energy isolated abdominal trauma, with levels of sensitivity and specificity up to 95%. Several studies demonstrated its ability to detect lesions occurring in the liver, spleen, pancreas and kidneys and also to recognize active bleeding as hyperechoic bands appearing as round or oval spots of variable size. Its role seems to be really relevant in paediatric patients, thus avoiding a routine exposure to ionizing radiation. Nevertheless, CEUS is strongly operator dependent, and it has some limitations, such as the cost of contrast media, lack of panoramicity, the difficulty to explore some deep regions and the poor ability to detect injuries to the urinary tract. On the other hand, it is timesaving, and it has several advantages, such as its portability, the safety of contrast agent, the lack to ionizing radiation exposure and therefore its repeatability, which allows follow-up of those traumas managed conservatively, especially in cases of fertile females and paediatric patients. PMID:26607647

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  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. 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

  10. Contrast-enhanced ultrasound for imaging blunt abdominal trauma - indications, description of the technique and imaging review.

    PubMed

    Cokkinos, D; Antypa, E; Stefanidis, K; Tserotas, P; Kostaras, V; Parlamenti, A; Tavernaraki, K; Piperopoulos, P N

    2012-02-01

    Patients with blunt abdominal trauma are initially imaged with ultrasound (US) for the evaluation of free abdominal fluid. However, lacerations of solid organs can be overlooked. Although computed tomography (CT) is the gold standard technique for abdominal trauma imaging, overutilization, ionizing radiation, need to transport the patient and potential artifacts are well known disadvantages. Contrast-enhanced US (CEUS) can be used as an imaging tool between the two methods. It can easily and reliably reveal solid abdominal organ injuries in patients with low-energy localized trauma and decrease the number of CT scans performed. It can be rapidly performed at the patient's bedside with no need for transportation. There are only very few contraindications and anaphylactoid reactions are extremely rare. Altogether, CEUS has proved to be very helpful for the initial imaging of traumatic lesions of the liver, kidney and spleen, as well as for patient follow-up. PMID:22274907

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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).

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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

  3. CT imaging of enhanced oil recovery experiments

    SciTech Connect

    Gall, B.L.

    1992-12-01

    X-ray computerized tomography (Cr) has been used to study fluid distributions during chemical enhanced oil recovery experiments. Four CT-monitored corefloods were conducted, and oil saturation distributions were calculated at various stages of the experiments. Results suggested that this technique could add significant information toward interpretation and evaluation of surfactant/polymer EOR recovery methods. CT-monitored tracer tests provided information about flow properties in the core samples. Nonuniform fluid advance could be observed, even in core that appeared uniform by visual inspection. Porosity distribution maps based on CT density calculations also showed the presence of different porosity layers that affected fluid movement through the cores. Several types of CT-monitored corefloods were conducted. Comparisons were made for CT-monitored corefloods using chemical systems that were highly successful in reducing residual oil saturations in laboratory experiments and less successful systems. Changes were made in surfactant formulation and in concentration of the mobility control polymer. Use of a poor mobility control agent failed to move oil that was not initially displaced by the injected surfactant solution; even when a good'' surfactant system was used. Use of a less favorable surfactant system with adequate mobility control could produce as much oil as the use of a good surfactant system with inadequate mobility control. The role of mobility control, therefore, becomes a critical parameter for successful application of chemical EOR. Continuation of efforts to use CT imaging in connection with chemical EOR evaluations is recommended.

  4. CT imaging of enhanced oil recovery experiments

    SciTech Connect

    Gall, B.L.

    1992-12-01

    X-ray computerized tomography (Cr) has been used to study fluid distributions during chemical enhanced oil recovery experiments. Four CT-monitored corefloods were conducted, and oil saturation distributions were calculated at various stages of the experiments. Results suggested that this technique could add significant information toward interpretation and evaluation of surfactant/polymer EOR recovery methods. CT-monitored tracer tests provided information about flow properties in the core samples. Nonuniform fluid advance could be observed, even in core that appeared uniform by visual inspection. Porosity distribution maps based on CT density calculations also showed the presence of different porosity layers that affected fluid movement through the cores. Several types of CT-monitored corefloods were conducted. Comparisons were made for CT-monitored corefloods using chemical systems that were highly successful in reducing residual oil saturations in laboratory experiments and less successful systems. Changes were made in surfactant formulation and in concentration of the mobility control polymer. Use of a poor mobility control agent failed to move oil that was not initially displaced by the injected surfactant solution; even when a ``good`` surfactant system was used. Use of a less favorable surfactant system with adequate mobility control could produce as much oil as the use of a good surfactant system with inadequate mobility control. The role of mobility control, therefore, becomes a critical parameter for successful application of chemical EOR. Continuation of efforts to use CT imaging in connection with chemical EOR evaluations is recommended.

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. Importance of extracolonic findings at IV contrast medium-enhanced CT colonography versus those at non-enhanced CT colonography.

    PubMed

    Spreng, Adrian; Netzer, Peter; Mattich, Joerg; Dinkel, Hans-Peter; Vock, Peter; Hoppe, Hanno

    2005-10-01

    To compare the clinical importance of extracolonic findings at intravenous (IV) contrast-enhanced CT colonography versus those at non-enhanced CT colonography. IV contrast medium-enhanced (n=72) and non-enhanced (n=30) multidetector CT colonography was performed in 102 symptomatic patients followed by conventional colonoscopy on the same day. The impact of extracolonic findings on further work up and treatment was assessed by a review of patient records. Extracolonic findings were divided into two groups: either leading to further work up respectively having an impact on therapy or not. A total of 303 extracolonic findings were detected. Of those, 71% (215/303) were found on IV contrast-enhanced CT, and 29% (88/303) were found on non-enhanced CT colonography. The extracolonic findings in 25% (26/102) of all patients led to further work up or had an impact on therapy. Twenty-two of these patients underwent CT colonography with IV contrast enhancement, and four without. The percentage of extracolonic findings leading to further work up or having an impact on therapy was higher for IV contrast-enhanced (31%; 22/72) than for non-enhanced (13%; 4/30) CT scans (P=0.12). IV contrast-enhanced CT colonography produced more extracolonic findings than non-enhanced CT colonography. A substantially greater proportion of findings on IV contrast-enhanced CT colonography led to further work up and treatment than did non-enhanced CT colonography. PMID:15965661

  14. 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.

  15. 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

  16. 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.

  17. ¹⁸F-FDG PET/CT and contrast enhanced CT in differential diagnosis between leiomyoma and gastrointestinal stromal tumor.

    PubMed

    Hirose, Yasumitus; Kaida, Hayato; Kawahara, Akihiko; Kurata, Seiji; Ishibashi, Masatoshi; Abe, Toshi

    2015-01-01

    In a 49 years old woman a large abdominal tumor was diagnosed by abdominal ultrasound. Dynamic contrast-enhanced computed tomography (CECT) showed a large tumor with minute calcification and poor contrast enhancement in the left abdominal cavity. The fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scan showed low ¹⁸F-FDG uptake in the tumor. The SUV max (early image) was 1.90, and that of the delayed image was 2.86. A gastrointestinal stromal tumor (GIST) was suspected. Tumor resection revealed that it was a leiomyoma originating in the major curvature of the stomach. In conclusion, the findings of low ¹⁸F-FDG uptake on ¹⁸F-FDG PET and poor contrast enhancement on CECT in a gastric submucosal tumor suggested of a gastric leiomyoma rather than GIST. PMID:26574696

  18. 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

  19. 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

  20. 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.

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. Could contrast-enhanced CT detect STEMI prior to electrocardiogram?

    PubMed

    Sabbagh, Chadi; Rahi, Mayda; Baz, Maria; Haddad, Fadi; Helwe, Omar; Aoun, Noel; Ibrahim, Tony; Abdo, Lynn

    2015-01-01

    We present here a case in which contrast-enhanced computed tomography (CT) was the first diagnostic tool to detect myocardial hypoperfusion in a patient with atypical symptoms and normal electrocardiogram (ECG) on admission. An ST-segment elevation was detected thereafter on a second ECG realized several minutes after CT with raised troponin levels. Percutaneous coronary intervention was performed after failure of thrombolysis and confirmed occlusion of the left anterior descending artery. Further studies are needed to evaluate the role of high-resolution contrast-enhanced CT with or without coronary angiography in the workup of suspected myocardial infarction in the setting of a normal ECG. PMID:25085282

  7. 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

  8. Model-based pancreas segmentation in portal venous phase contrast-enhanced CT images.

    PubMed

    Hammon, Matthias; Cavallaro, Alexander; Erdt, Marius; Dankerl, Peter; Kirschner, Matthias; Drechsler, Klaus; Wesarg, Stefan; Uder, Michael; Janka, Rolf

    2013-12-01

    This study aims to automatically detect and segment the pancreas in portal venous phase contrast-enhanced computed tomography (CT) images. The institutional review board of the University of Erlangen-Nuremberg approved this study and waived the need for informed consent. Discriminative learning is used to build a pancreas tissue classifier incorporating spatial relationships between the pancreas and surrounding organs and vessels. Furthermore, discrete cosine and wavelet transforms are used to build texture features to describe local tissue appearance. Classification is used to guide a constrained statistical shape model to fit the data. The algorithm to detect and segment the pancreas was evaluated on 40 consecutive CT data that were acquired in the portal venous contrast agent phase. Manual segmentation of the pancreas was carried out by experienced radiologists and served as reference standard. Threefold cross validation was performed. The algorithm-based detection and segmentation yielded an average surface distance of 1.7 mm and an average overlap of 61.2 % compared with the reference standard. The overall runtime of the system was 20.4 min. The presented novel approach enables automatic pancreas segmentation in portal venous phase contrast-enhanced CT images which are included in almost every clinical routine abdominal CT examination. Reliable pancreatic segmentation is crucial for computer-aided detection systems and an organ-specific decision support. PMID:23471751

  9. 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

  10. 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

  11. 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

  12. 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%.

  13. Non-contrast-enhanced renal and abdominal MR angiography using velocity-selective inversion preparation.

    PubMed

    Shin, Taehoon; Worters, Pauline W; Hu, Bob S; Nishimura, Dwight G

    2013-05-01

    Non-contrast-enhanced MR angiography is a promising alternative to the established contrast-enhanced approach as it reduces patient discomfort and examination costs and avoids the risk of nephrogenic systemic fibrosis. Inflow-sensitive slab-selective inversion recovery imaging has been used with great promise, particularly for abdominal applications, but has limited craniocaudal coverage due to inflow time constraints. In this work, a new non-contrast-enhanced MR angiography method using velocity-selective inversion preparation is developed and applied to renal and abdominal angiography. Based on the excitation k-space formalism and Shinnar-Le-Roux transform, a velocity-selective excitation pulse is designed that inverts stationary tissues and venous blood while preserving inferiorly flowing arterial blood. As the magnetization of the arterial blood in the abdominal aorta and iliac arteries is well preserved during the magnetization preparation, artery visualization over a large abdominal field of view is achievable with an inversion delay time that is chosen for optimal background suppression. Healthy volunteer tests demonstrate that the proposed method significantly increases the extent of visible arteries compared with the slab-selective approach, covering renal arteries through iliac arteries over a craniocaudal field of view of 340 mm. PMID:22711643

  14. Resolution-enhancing hybrid, spectral CT reconstruction

    NASA Astrophysics Data System (ADS)

    Clark, D. P.; Badea, C. T.

    2016-04-01

    Spectral x-ray imaging based on photon-counting x-ray detectors (PCXD) is an area of growing interest. By measuring the energy of x-ray photons, a spectral CT system can better differentiate elements using a single scan. However, the spatial resolution achievable with most PCXDs limits their application, particularly in preclinical CT imaging. Consequently, our group is developing a hybrid micro-CT scanner based on a high-resolution, energy-integrating (EID) detector and a lower-resolution, PCXD. To complement this system, we propose and demonstrate a hybrid, spectral CT reconstruction algorithm which robustly combines the spectral contrast of the PCXD with the spatial resolution of the EID. Specifically, the high-resolution, spectrally resolved data (X) is recovered as the sum of two matrices: one with low column rank (XL) determined from the EID data and one with intensity gradient sparse columns (XS) corresponding to the upsampled spectral contrast obtained from the PCXD data. We test the proposed algorithm in a feasibility study focused on molecular imaging of atherosclerotic plaque using activatable iodine and gold nanoparticles. The results show accurate estimation of material concentrations at increased spatial resolution for a voxel size ratio between the PCXD and the EID of 500 μm3:100 μm3. Specifically, regularized, iterative reconstruction of the MOBY mouse phantom around the K-edges of iodine (33.2 keV) and gold (80.7 keV) reduces the reconstruction error by more than a factor of three relative to least-squares, algebraic reconstruction. Likewise, the material decomposition accuracy into iodine, gold, calcium, and water improves by more than a factor of two.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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

  1. Temporal subtraction contrast-enhanced dedicated breast CT

    NASA Astrophysics Data System (ADS)

    Gazi, Peymon M.; Aminololama-Shakeri, Shadi; Yang, Kai; Boone, John M.

    2016-09-01

    The development of a framework of deformable image registration and segmentation for the purpose of temporal subtraction contrast-enhanced breast CT is described. An iterative histogram-based two-means clustering method was used for the segmentation. Dedicated breast CT images were segmented into background (air), adipose, fibroglandular and skin components. Fibroglandular tissue was classified as either normal or contrast-enhanced then divided into tiers for the purpose of categorizing degrees of contrast enhancement. A variant of the Demons deformable registration algorithm, intensity difference adaptive Demons (IDAD), was developed to correct for the large deformation forces that stemmed from contrast enhancement. In this application, the accuracy of the proposed method was evaluated in both mathematically-simulated and physically-acquired phantom images. Clinical usage and accuracy of the temporal subtraction framework was demonstrated using contrast-enhanced breast CT datasets from five patients. Registration performance was quantified using normalized cross correlation (NCC), symmetric uncertainty coefficient, normalized mutual information (NMI), mean square error (MSE) and target registration error (TRE). The proposed method outperformed conventional affine and other Demons variations in contrast enhanced breast CT image registration. In simulation studies, IDAD exhibited improvement in MSE (0–16%), NCC (0–6%), NMI (0–13%) and TRE (0–34%) compared to the conventional Demons approaches, depending on the size and intensity of the enhancing lesion. As lesion size and contrast enhancement levels increased, so did the improvement. The drop in the correlation between the pre- and post-contrast images for the largest enhancement levels in phantom studies is less than 1.2% (150 Hounsfield units). Registration error, measured by TRE, shows only submillimeter mismatches between the concordant anatomical target points in all patient studies. The algorithm was

  2. Temporal subtraction contrast-enhanced dedicated breast CT.

    PubMed

    Gazi, Peymon M; Aminololama-Shakeri, Shadi; Yang, Kai; Boone, John M

    2016-09-01

    The development of a framework of deformable image registration and segmentation for the purpose of temporal subtraction contrast-enhanced breast CT is described. An iterative histogram-based two-means clustering method was used for the segmentation. Dedicated breast CT images were segmented into background (air), adipose, fibroglandular and skin components. Fibroglandular tissue was classified as either normal or contrast-enhanced then divided into tiers for the purpose of categorizing degrees of contrast enhancement. A variant of the Demons deformable registration algorithm, intensity difference adaptive Demons (IDAD), was developed to correct for the large deformation forces that stemmed from contrast enhancement. In this application, the accuracy of the proposed method was evaluated in both mathematically-simulated and physically-acquired phantom images. Clinical usage and accuracy of the temporal subtraction framework was demonstrated using contrast-enhanced breast CT datasets from five patients. Registration performance was quantified using normalized cross correlation (NCC), symmetric uncertainty coefficient, normalized mutual information (NMI), mean square error (MSE) and target registration error (TRE). The proposed method outperformed conventional affine and other Demons variations in contrast enhanced breast CT image registration. In simulation studies, IDAD exhibited improvement in MSE (0-16%), NCC (0-6%), NMI (0-13%) and TRE (0-34%) compared to the conventional Demons approaches, depending on the size and intensity of the enhancing lesion. As lesion size and contrast enhancement levels increased, so did the improvement. The drop in the correlation between the pre- and post-contrast images for the largest enhancement levels in phantom studies is less than 1.2% (150 Hounsfield units). Registration error, measured by TRE, shows only submillimeter mismatches between the concordant anatomical target points in all patient studies. The algorithm was

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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

  9. 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.

  10. Development of contrast-enhanced rodent imaging using functional CT

    NASA Astrophysics Data System (ADS)

    Liang, Yun; Stantz, Keith M.; Krishnamurthi, Ganapathy; Steinmetz, Rosemary; Hutchins, Gary D.

    2003-05-01

    Micro-computed tomography (microCT) is capable of obtaining high-resolution images of skeletal tissues. However its image contrast among soft tissues remains inadequate for tumor detection. High speed functional computed tomography will be needed to image tumors by employing x-ray contrast medium. The functional microCT development will not only facilitate the image contrast enhancement among different tissues but also provide information of tumor physiology. To demonstrate the feasibility of functional CT in mouse imaging, sequential computed tomography is performed in mice after contrast material administration using a high-speed clinical CT scanner. Although the resolution of the clinical scanner is not sufficient to dissolve the anatomic details of rodents, bulky physiological parameters in major organs such as liver, kidney, pancreas, and ovaries (testicular) can be examined. For data analysis, a two-compartmental model is employed and implemented to characterize the tissue physiological parameters (regional blood flow, capillary permeability, and relative compartment volumes.) The measured contrast dynamics in kidneys are fitted with the compartmental model to derive the kidney tissue physiology. The study result suggests that it is feasible to extract mouse tissue physiology using functional CT imaging technology.

  11. 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

  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. 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

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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

  1. Dynamic Contrast-Enhanced CT in Patients with Pancreatic Cancer.

    PubMed

    Eriksen, Rie Ø; Strauch, Louise S; Sandgaard, Michael; Kristensen, Thomas S; Nielsen, Michael B; Lauridsen, Carsten A

    2016-01-01

    The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases to identify all relevant publications. The QUADAS-2 tool was implemented to assess the risk of bias and applicability concerns of each included study. The initial literature search yielded 483 publications. Thirteen articles were included. Articles were categorized into three groups: nine articles concerning primary diagnosis or staging, one article about tumor response to treatment, and three articles regarding scan techniques. In exocrine pancreatic tumors, measurements of blood flow in eight studies and blood volume in seven studies were significantly lower in tumor tissue, compared with measurements in pancreatic tissue outside of tumor, or normal pancreatic tissue in control groups of healthy volunteers. The studies were heterogeneous in the number of patients enrolled and scan protocols. Perfusion parameters measured and analyzed by DCE-CT might be useful in the investigation of characteristic vascular patterns of exocrine pancreatic tumors. Further clinical studies are desired for investigating the potential of DCE-CT in pancreatic tumors. PMID:27608045

  2. Automated segmentation and quantification of liver and spleen from CT images using normalized probabilistic atlases and enhancement estimation

    PubMed Central

    Linguraru, Marius George; Sandberg, Jesse K.; Li, Zhixi; Shah, Furhawn; Summers, Ronald M.

    2010-01-01

    Purpose: To investigate the potential of the normalized probabilistic atlases and computer-aided medical image analysis to automatically segment and quantify livers and spleens for extracting imaging biomarkers (volume and height). Methods: A clinical tool was developed to segment livers and spleen from 257 abdominal contrast-enhanced CT studies. There were 51 normal livers, 44 normal spleens, 128 splenomegaly, 59 hepatomegaly, and 23 partial hepatectomy cases. 20 more contrast-enhanced CT scans from a public site with manual segmentations of mainly pathological livers were used to test the method. Data were acquired on a variety of scanners from different manufacturers and at varying resolution. Probabilistic atlases of livers and spleens were created using manually segmented data from ten noncontrast CT scans (five male and five female). The organ locations were modeled in the physical space and normalized to the position of an anatomical landmark, the xiphoid. The construction and exploitation of liver and spleen atlases enabled the automated quantifications of liver∕spleen volumes and heights (midhepatic liver height and cephalocaudal spleen height) from abdominal CT data. The quantification was improved incrementally by a geodesic active contour, patient specific contrast-enhancement characteristics passed to an adaptive convolution, and correction for shape and location errors. Results: The livers and spleens were robustly segmented from normal and pathological cases. For the liver, the Dice∕Tanimoto volume overlaps were 96.2%∕92.7%, the volume∕height errors were 2.2%∕2.8%, the root-mean-squared error (RMSE) was 2.3 mm, and the average surface distance (ASD) was 1.2 mm. The spleen quantification led to 95.2%∕91% Dice∕Tanimoto overlaps, 3.3%∕1.7% volume∕height errors, 1.1 mm RMSE, and 0.7 ASD. The correlations (R2) with clinical∕manual height measurements were 0.97 and 0.93 for the spleen and liver, respectively (p<0.0001). No significant

  3. Fuzzy pulmonary vessel segmentation in contrast enhanced CT data

    NASA Astrophysics Data System (ADS)

    Kaftan, Jens N.; Kiraly, Atilla P.; Bakai, Annemarie; Das, Marco; Novak, Carol L.; Aach, Til

    2008-03-01

    Pulmonary vascular tree segmentation has numerous applications in medical imaging and computer-aided diagnosis (CAD), including detection and visualization of pulmonary emboli (PE), improved lung nodule detection, and quantitative vessel analysis. We present a novel approach to pulmonary vessel segmentation based on a fuzzy segmentation concept, combining the strengths of both threshold and seed point based methods. The lungs of the original image are first segmented and a threshold-based approach identifies core vessel components with a high specificity. These components are then used to automatically identify reliable seed points for a fuzzy seed point based segmentation method, namely fuzzy connectedness. The output of the method consists of the probability of each voxel belonging to the vascular tree. Hence, our method provides the possibility to adjust the sensitivity/specificity of the segmentation result a posteriori according to application-specific requirements, through definition of a minimum vessel-probability required to classify a voxel as belonging to the vascular tree. The method has been evaluated on contrast-enhanced thoracic CT scans from clinical PE cases and demonstrates overall promising results. For quantitative validation we compare the segmentation results to randomly selected, semi-automatically segmented sub-volumes and present the resulting receiver operating characteristic (ROC) curves. Although we focus on contrast enhanced chest CT data, the method can be generalized to other regions of the body as well as to different imaging modalities.

  4. Optimal exposure techniques for iodinated contrast enhanced breast CT

    NASA Astrophysics Data System (ADS)

    Glick, Stephen J.; Makeev, Andrey

    2016-03-01

    Screening for breast cancer using mammography has been very successful in the effort to reduce breast cancer mortality, and its use has largely resulted in the 30% reduction in breast cancer mortality observed since 1990 [1]. However, diagnostic mammography remains an area of breast imaging that is in great need for improvement. One imaging modality proposed for improving the accuracy of diagnostic workup is iodinated contrast-enhanced breast CT [2]. In this study, a mathematical framework is used to evaluate optimal exposure techniques for contrast-enhanced breast CT. The ideal observer signal-to-noise ratio (i.e., d') figure-of-merit is used to provide a task performance based assessment of optimal acquisition parameters under the assumptions of a linear, shift-invariant imaging system. A parallel-cascade model was used to estimate signal and noise propagation through the detector, and a realistic lesion model with iodine uptake was embedded into a structured breast background. Ideal observer performance was investigated across kVp settings, filter materials, and filter thickness. Results indicated many kVp spectra/filter combinations can improve performance over currently used x-ray spectra.

  5. 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.

  6. 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.

  7. 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.

  8. Lipiodol enhanced CT scanning of malignant hepatic tumors.

    PubMed

    Eurvilaichit, C

    2000-04-01

    From August 1984 to March 1991, 41 patients with malignant liver tumors, 30 males and 11 females, aged 30-75 years were treated at Ramathibodi Hospital with injection of mitomycin-C lipiodol emulsion into the tumor via the feeding artery followed by embolization of the feeding artery with gelfoam particles. The patients comprised 30 cases of hepatocellular carcinoma, 4 cases of cholangiocarcinoma and 7 cases of metastatic tumors of which one was from CA stomach, three were from CA breast, and three from CA colon. The vascularity of the tumor was assessed in angiogram obtained prior to treatment and retention pattern of lipiodol in the tumor was evaluated in lipiodol-enhanced CT scan images taken 2-4 weeks following therapy. The results showed that lipiodol CT scan images exhibited four patterns of lipiodol retention in the tumor appearing as opacity as follows (1) homogenous (2) heterogeneous (3) ring-like and (4) none. Lipiodol retention pattern appeared to be somewhat related to vascularity of the tumor. Most of the hypervascular tumors such as hepatocellular carcinoma had homogeneous lipiodol accumulation pattern if the tumor size was less than 5 cm. Metastatic tumors and cholangiocarcinoma showed heterogeneous or ring-like pattern of lipiodol accumulation because they were relatively hypovascular. Hypervascular hepatocellular carcinoma may exhibit heterogeneous or ring-like pattern if they are larger than 5 cms, and have multiple feeding arteries, necrosis or AV shunting. Hepatocellular carcinoma with AV shunting may not show any lipiodol accumulation at all. PMID:10808700

  9. 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

  10. Xenon-enhanced CT imaging of local pulmonary ventilation

    NASA Astrophysics Data System (ADS)

    Tajik, Jehangir K.; Tran, Binh Q.; Hoffman, Eric A.

    1996-04-01

    We are using the unique features of electron beam CT (EBCT) in conjunction with respiratory and cardiac gating to explore the use of non-radioactive xenon gas as a pulmonary ventilation contrast agent. The goal is to construct accurate and quantitative high-resolution maps of local pulmonary ventilation in humans. We are evaluating xenon-enhanced computed tomography in the pig model with dynamic tracer washout/dilution and single breath inhalation imaging protocols. Scanning is done via an EBCT scanner which offers 50 msec scan aperture speeds. CT attenuation coefficients (image gray scale value) show a linear increase with xenon concentration (r equals 0.99). We measure a 1.55 Hounsfield Unit (HU) enhancement (kV equals 130, mA equals 623) per percentage increase in xenon gas concentration giving an approximately 155 HU enhancement with 100% xenon gas concentration as measured in a plexiglass super-syringe. Early results indicate that a single breath (from functional residual capacity to total lung capacity) of 100% xenon gas provides an average 32 +/- 1.85 (SE) HU enhancement in the lung parenchyma (maximum 50 HU) and should not encounter unwanted xenon side effects. However, changes in lung density occurring during even short breath holds (as short as 10 seconds) may limit using a single breath technique to synchronous volumetric scanning, currently possible only with EBCT. Preliminary results indicate close agreement between measured regional xenon concentration-time curves and theoretical predictions for the same sample. More than 10 breaths with inspirations to as high as 25 cmH2O airway pressure were needed to clear tracer from all lung regions and some regions had nearly linear rather than mono-exponential clearance curves. When regional parenchymal xenon concentration-time curves were analyzed, vertical gradients in ventilation and redistribution of ventilation at higher inspiratory flow rates were consistent with known pulmonary physiology. We present

  11. 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).

  12. Enhanced transbuccal salmon calcitonin (sCT) delivery: effect of chemical enhancers and electrical assistance on in vitro sCT buccal permeation.

    PubMed

    Oh, Dong-Ho; Chun, Kyeung-Hwa; Jeon, Sang-Ok; Kang, Jeong-Won; Lee, Sangkil

    2011-10-01

    This study investigates the combined effect of absorption enhancers and electrical assistance on transbuccal salmon calcitonin (sCT) delivery, using fresh swine buccal tissue. We placed 200 IU (40 μg/mL) of each sCT formulation--containing various concentrations of ethanol, N-acetyl-L-cysteine (NAC), and sodium deoxyglycocholate (SDGC)--onto the donor part of a Franz diffusion cell. Then, 0.5 mA/cm(2) of fixed anodal current was applied alone or combined with chemical enhancers. The amount of permeated sCT was analyzed using an ELISA kit, and biophysical changes of the buccal mucosa were investigated using FT-IR spectroscopy, and hematoxylin-eosin staining methods were used to evaluate histological alteration of the buccal tissues. The flux (J(s)) of sCT increased with the addition of absorption enhancer groups, but it was significantly enhanced by the application of anodal iontophoresis (ITP). FT-IR study revealed that all groups caused an increase in lipid fluidity but only the groups containing SDGC showed statistically significant difference. Although the histological data of SDGC groups showed a possibility for tissue damage, the present enhancing methods appear to be safe. In conclusion, the combination of absorption enhancers and electrical assistance is a potential strategy for the enhancement of transbuccal sCT delivery. PMID:21683790

  13. Non-contrast MRA using an inflow-enhanced, inversion recovery SSFP technique in pediatric abdominal imaging.

    PubMed

    Serai, Suraj; Towbin, Alexander J; Podberesky, Daniel J

    2012-03-01

    Abdominal contrast-enhanced MR angiography (CE-MRA) is routinely performed in children. CE-MRA is challenging in children because of patient motion, difficulty in obtaining intravenous access, and the inability of young patients to perform a breath-hold during imaging. The combination of pediatric-specific difficulties in imaging and the safety concerns regarding the risk of gadolinium-based contrast agents in patients with impaired renal function has renewed interest in the use of non-contrast (NC) MRA techniques. At our institution, we have optimized 3-D NC-MRA techniques for abdominal imaging. The purpose of this work is to demonstrate the utility of an inflow-enhanced, inversion recovery balanced steady-state free precession-based (b-SSFP) NC-MRA technique. PMID:22072071

  14. Initial staging of Hodgkin's disease: role of contrast-enhanced 18F FDG PET/CT.

    PubMed

    Chiaravalloti, Agostino; Danieli, Roberta; Caracciolo, Cristiana Ragano; Travascio, Laura; Cantonetti, Maria; Gallamini, Andrea; Guazzaroni, Manlio; Orlacchio, Antonio; Simonetti, Giovanni; Schillaci, Orazio

    2014-08-01

    The objective of this study was to compare the diagnostic accuracy of positron emission tomography/low-dose computed tomography (PET/ldCT) versus the same technique implemented by contrast-enhanced computed tomography (ceCT) in staging Hodgkin's disease (HD).Forty patients (18 men and 22 women, mean age 30 ± 9.6) with biopsy-proven HD underwent a PET/ldCT study for initial staging including an unenhanced low-dose computed tomography for attenuation correction with positron emission tomography acquisition and a ceCT, performed at the end of the PET/ldCT scan, in the same exam session. A detailed datasheet was generated for illness locations for separate imaging modality comparison and then merged in order to compare the separate imaging method results (PET/ldCT and ceCT) versus merged results positron emission tomography/contrast-enhanced computed tomography (PET/ceCT). The nodal and extranodal lesions detected by each technique were then compared with follow-up data that served as the reference standard.No significant differences were found at staging between PET/ldCT and PET/ceCT in our series. One hundred and eighty four stations of nodal involvement have been found with no differences in both modalities. Extranodal involvement was identified in 26 sites by PET/ldCT and in 28 by PET/ceCT. We did not find significant differences concerning the stage (Ann Arbor).Our study shows a good concordance and conjunction between PET/ldCT and ceCT in both nodal and extranodal sites in the initial staging of HD, suggesting that PET/ldCT could suffice in most of these patients. PMID:25121354

  15. 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.

  16. Dynamic contrast enhanced CT in nodule characterization: How we review and report.

    PubMed

    Qureshi, Nagmi R; Shah, Andrew; Eaton, Rosemary J; Miles, Ken; Gilbert, Fiona J

    2016-01-01

    Incidental indeterminate solitary pulmonary nodules (SPN) that measure less than 3 cm in size are an increasingly common finding on computed tomography (CT) worldwide. Once identified there are a number of imaging strategies that can be performed to help with nodule characterization. These include interval CT, dynamic contrast enhanced computed tomography (DCE-CT), (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG-PET-CT). To date the most cost effective and efficient non-invasive test or combination of tests for optimal nodule characterization has yet to be determined.DCE-CT is a functional test that involves the acquisition of a dynamic series of images of a nodule before and following the administration of intravenous iodinated contrast medium. This article provides an overview of the current indications and limitations of DCE- CT in nodule characterization and a systematic approach to how to perform, analyse and interpret a DCE-CT scan. PMID:27430260

  17. 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

  18. 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

  19. 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

  20. Coronary artery calcium quantification from contrast enhanced CT using gemstone spectral imaging and material decomposition.

    PubMed

    Fuchs, Tobias A; Stehli, Julia; Dougoud, Svetlana; Sah, Bert-Ram; Bull, Sacha; Clerc, Olivier F; Possner, Mathias; Buechel, Ronny R; Gaemperli, Oliver; Kaufmann, Philipp A

    2014-10-01

    To explore the feasibility of coronary artery calcium (CAC) measurement from low-dose contrast enhanced coronary CT angiography (CCTA) as this may obviate the need for an unenhanced CT scan. 52 patients underwent unenhanced cardiac CT and prospectively ECG triggered contrast enhanced CCTA (Discovery HD 750, GE Healthcare, Milwaukee, WI, USA). The latter was acquired in single-source dual-energy mode [gemstone spectral imaging (GSI)]. Virtual unenhanced images were generated from GSI CCTA by monochromatic image reconstruction of 70 keV allowing selective iodine material suppression. CAC scores from virtual unenhanced CT were compared to standard unenhanced CT including a linear regression model. After iodine subtraction from the contrast enhanced CCTA the attenuation in the ascending aorta decreased significantly from 359 ± 61 to 54 ± 8 HU (P < 0.001), the latter comparing well to the value of 64 ± 55 HU found in the standard unenhanced CT (P = ns) confirming successful iodine subtraction. After introducing linear regression formula the mean values for Agatston, Volume and Mass scores of virtual unenhanced CT were 187 ± 321, 72 ± 114 mm(3), and 27 ± 46 mg/cm(3), comparing well to the values from standard unenhanced CT (187 ± 309, 72 ± 110 mm(3), and 27 ± 45 mg/cm(3)) yielding an excellent correlation (r = 0.96, r = 0.96, r = 0.92; P < 0.001). Mean estimated radiation dose revealed 0.83 ± 0.02 mSv from the unenhanced CT and 1.70 ± 0.53 mSv from the contrast enhanced CCTA. Single-source dual-energy scanning with GSI allows CAC quantification from low dose contrast enhanced CCTA by virtual iodine contrast subtraction. PMID:24993390

  1. 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

  2. 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

  3. 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

  4. Assessment of Bowel Wall Enhancement for the Diagnosis of Intestinal Ischemia in Patients with Small Bowel Obstruction: Value of Adding Unenhanced CT to Contrast-enhanced CT.

    PubMed

    Chuong, Anh Minh; Corno, Lucie; Beaussier, Hélène; Boulay-Coletta, Isabelle; Millet, Ingrid; Hodel, Jérôme; Taourel, Patrice; Chatellier, Gilles; Zins, Marc

    2016-07-01

    Purpose To determine whether adding unenhanced computed tomography (CT) to contrast material-enhanced CT improves the diagnostic performance of decreased bowel wall enhancement as a sign of ischemia complicating mechanical small bowel obstruction (SBO). Materials and Methods This retrospective study was approved by the institutional review board, which waived the requirement for informed consent. Two gastrointestinal radiologists independently performed retrospective assessments of 164 unenhanced and contrast-enhanced CT studies from 158 consecutive patients (mean age, 71.2 years) with mechanical SBO. The reference standard was the intraoperative and/or histologic diagnosis (in 80 cases) or results from clinical follow-up in patients who did not undergo surgery (84 cases). Decreased bowel wall enhancement was evaluated with contrast-enhanced images then and both unenhanced and contrast-enhanced images 1 month later. Diagnostic performance of decreased bowel wall enhancement and confidence in the diagnosis were compared between the two readings by using McNemar and Wilcoxon signed rank tests. Interobserver agreement was assessed by using κ statistics and compared with bootstrapping. Results Ischemia was diagnosed in 41 of 164 (25%) episodes of SBO. For both observers, adding unenhanced images improved decreased bowel wall enhancement sensitivity (observer 1: 46.3% [19 of 41] vs 65.8% [27 of 41], P = .02; observer 2: 56.1% [23 of 41] vs 63.4% [26 of 41], P = .45), Youden index (from 0.41 to 0.58 for observer 1 and from 0.42 to 0.61 for observer 2), and confidence score (P < .001 for both). Specificity significantly increased for observer 2 (84.5% [104 of 123] vs 94.3% [116 of 123], P = .002), and interobserver agreement significantly increased, from moderate (κ = 0.48) to excellent (κ = 0.89; P < .0001). Conclusion Adding unenhanced CT to contrast-enhanced CT improved the sensitivity, diagnostic confidence, and interobserver agreement of the diagnosis of ischemia

  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. SU-E-J-187: Individually Optimized Contrast-Enhancement 4D-CT for Pancreatic Adenocarcinoma in Radiotherapy Simulation

    SciTech Connect

    Xue, M; Patel, K; Regine, W; Lane, B; D'Souza, W; Lu, W; Klahr, P

    2014-06-01

    Purpose: To study the feasibility of individually optimized contrastenhancement (CE) 4D-CT for pancreatic adenocarcinoma (PDA) in radiotherapy simulation. To evaluate the image quality and contrast enhancement of tumor in the CE 4D-CT, compared to the clinical standard of CE 3D-CT and 4D-CT. Methods: In this IRB-approved study, each of the 7 PDA patients enrolled underwent 3 CT scans: a free-breathing 3D-CT with contrast (CE 3D-CT) followed by a 4D-CT without contrast (4D-CT) in the first study session, and a 4D-CT with individually synchronized contrast injection (CE 4D-CT) in the second study session. In CE 4D-CT, the time of full contrast injection was determined based on the time of peak enhancement for the test injection, injection rate, table speed, and longitudinal location and span of the pancreatic region. Physicians contoured both the tumor (T) and the normal pancreatic parenchyma (P) on the three CTs (end-of-exhalation for 4D-CT). The contrast between the tumor and normal pancreatic tissue was computed as the difference of the mean enhancement level of three 1 cm3 regions of interests in T and P, respectively. Wilcoxon rank sum test was used to statistically compare the scores and contrasts. Results: In qualitative evaluations, both CE 3D-CT and CE 4D-CT scored significantly better than 4D-CT (4.0 and 3.6 vs. 2.6). There was no significant difference between CE 3D-CT and CE 4D-CT. In quantitative evaluations, the contrasts between the tumor and the normal pancreatic parenchyma were 0.6±23.4, −2.1±8.0, and −19.6±28.8 HU, in CE 3D-CT, 4D-CT, and CE 4D-CT, respectively. Although not statistically significant, CE 4D-CT achieved better contrast enhancement between the tumor and the normal pancreatic parenchyma than both CE 3D-CT and 4DCT. Conclusion: CE 4D-CT achieved equivalent image quality and better contrast enhancement between tumor and normal pancreatic parenchyma than the clinical standard of CE 3D-CT and 4D-CT. This study was supported in part

  7. Chlorogenic Acid Enhances Abdominal Skin Flap Survival Based on Epigastric Artery in Nondiabetic and Diabetic Rats.

    PubMed

    Bagdas, Deniz; Etoz, Betul Cam; Gul, Zulfiye; Ozyigit, Musa Ozgur; Cinkilic, Nilufer; Inan, Sevda; Buyukcoskun, Naciye Isbil; Ozluk, Kasim; Gurun, Mine Sibel

    2016-08-01

    Previous studies showed that chlorogenic acid (CGA) accelerates wound healing via its antioxidant activity. We aimed to investigate the effect of CGA in an experimental epigastric abdominal skin flap model in nondiabetic and diabetic rats. Rats were firstly divided into 2 groups: nondiabetic and diabetic. Diabetes was induced by streptozotocin. Then, 4 subgroups were created for each group: vehicle as well as 0.2 mg/0.5 mL, 1 mg/0.5 mL, and 5 mg/0.5 mL CGA treatments. Right epigastric artery-based abdominal skin flaps were elevated and sutured back into their original position. Chlorogenic acid or vehicle was injected once into the femoral arteries by leaving the epigastric artery as the single artery feeding the flaps during the injection. On postoperative day 7, flap survivals were evaluated, and the rats were killed. Distal flap tissues were collected for histopathological and biochemical assays. Chlorogenic acid showed greater flap survival in both nondiabetic and diabetic rats. Capillary density was increased, and necrosis was reduced in the CGA-treated rats. Chlorogenic acid decreased malondialdehyde levels as well as increased reduced glutathione and superoxide dismutase levels in the flap tissues. This study showed that CGA significantly improved flap survival by its antioxidant activities with intra-arterial local injections. PMID:25356637

  8. 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 ...

  9. Low-Dose PET/CT and Full-Dose Contrast-Enhanced CT at the Initial Staging of Localized Diffuse Large B-Cell Lymphomas

    PubMed Central

    Sabaté-Llobera, Aida; Cortés-Romera, Montserrat; Mercadal, Santiago; Hernández-Gañán, Javier; Pomares, Helena; González-Barca, Eva; Gámez-Cenzano, Cristina

    2016-01-01

    Computed tomography (CT) has been used as the reference imaging technique for the initial staging of diffuse large B-cell lymphoma until recent days, when the introduction of positron emission tomography (PET)/CT imaging as a hybrid technique has become of routine use. However, the performance of both examinations is still common. The aim of this work was to compare the findings between low-dose 2-deoxy-2-(18F)fluoro-d-glucose (18F-FDG) PET/CT and full-dose contrast-enhanced CT (ceCT) in 28 patients with localized diffuse large B-cell lymphoma according to PET/CT findings, in order to avoid the performance of ceCT. For each technique, a comparison in the number of nodal and extranodal involved regions was performed. PET/CT showed more lesions than ceCT in both nodal (41 vs. 36) and extranodal localizations (16 vs. 15). Disease staging according to both techniques was concordant in 22 patients (79%) and discordant in 6 patients (21%), changing treatment management in 3 patients (11%). PET/CT determined a better staging and therapeutic approach, making the performance of an additional ceCT unnecessary. PMID:27559300

  10. Left vein of Labbé thrombosis associated with ipsilateral dural sinus thrombosis: non-enhanced CT and contrast-enhanced CT (CTV) findings.

    PubMed

    Stýblo-Sramek, D I; De Temmerman, G; Verbist, B M

    2012-01-01

    A rare case of aseptic thrombosis of the left vein of Labbé in a young woman is reported. Cerebral venous thrombosis was suggested by computed tomography and confirmed after intravenous administration of contrast by computed tomography venography. The combination of the clinical setting with the findings on the non-enhanced CT may favour the diagnosis of vein of Labbé thrombosis. The diagnosis can be confirmed on computed tomography venography. PMID:23019987

  11. 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

  12. TextWithSurgeryPatients - A Research Hypothesis in Enhancing Education and Physical Assessment for Abdominal Surgical Patients.

    PubMed

    Hansen, Margaret

    2016-01-01

    Medical surgical nurses may not have the time or resources to provide effective pre- and post-operative instructions for patients in today's healthcare system. And, making timely physical assessments following discharge from the hospital is not always straightforward. Therefore, the risk for readmission associated with post-surgical complications is a concern. At present, mobile healthcare technologies and patient care are precipitously evolving and may serve as a resource to enhance communication between the healthcare provider and patient. A mobile telephone text message (short message service [SMS]) intervention for abdominal surgical patients may foster effective education (communication) and timely self-reported physical assessment in the home environment hence preventing deleterious outcomes. The aim of this research proposal is to identify the feasibility of using a SMS intervention via smart phones to improve health outcomes via timely communication, reach large numbers of at-risk surgical patients and, establish and sustain uniform protocols in a cost-efficient manner. PMID:27332251

  13. 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 ...

  14. 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 ...

  15. Resolution enhancement of lung 4D-CT data using multiscale interphase iterative nonlocal means

    SciTech Connect

    Zhang Yu; Yap, Pew-Thian; Wu Guorong; Feng Qianjin; Chen Wufan; Lian Jun; Shen Dinggang

    2013-05-15

    Purpose: Four-dimensional computer tomography (4D-CT) has been widely used in lung cancer radiotherapy due to its capability in providing important tumor motion information. However, the prolonged scanning duration required by 4D-CT causes considerable increase in radiation dose. To minimize the radiation-related health risk, radiation dose is often reduced at the expense of interslice spatial resolution. However, inadequate resolution in 4D-CT causes artifacts and increases uncertainty in tumor localization, which eventually results in extra damages of healthy tissues during radiotherapy. In this paper, the authors propose a novel postprocessing algorithm to enhance the resolution of lung 4D-CT data. Methods: The authors' premise is that anatomical information missing in one phase can be recovered from the complementary information embedded in other phases. The authors employ a patch-based mechanism to propagate information across phases for the reconstruction of intermediate slices in the longitudinal direction, where resolution is normally the lowest. Specifically, the structurally matching and spatially nearby patches are combined for reconstruction of each patch. For greater sensitivity to anatomical details, the authors employ a quad-tree technique to adaptively partition the image for more fine-grained refinement. The authors further devise an iterative strategy for significant enhancement of anatomical details. Results: The authors evaluated their algorithm using a publicly available lung data that consist of 10 4D-CT cases. The authors' algorithm gives very promising results with significantly enhanced image structures and much less artifacts. Quantitative analysis shows that the authors' algorithm increases peak signal-to-noise ratio by 3-4 dB and the structural similarity index by 3%-5% when compared with the standard interpolation-based algorithms. Conclusions: The authors have developed a new algorithm to improve the resolution of 4D-CT. It outperforms

  16. Feasibility of iodine contrast enhanced CT-scan during a 18F-fluorodeoxyglucose Positron Emission Tomography

    NASA Astrophysics Data System (ADS)

    Houzard, C.; Tychyj, C.; Morelec, I.; Ricard, F.; Got, P.; Cotton, F.; Giammarile, F.; Maintas, D.

    2009-06-01

    OBJECTIVE: this prospective study evaluates the feasibility in current clinical practice of contrast enhanced CT-scan for diagnosis purpose, performed during 18FDG PET-CT study with a PET/CT tomography. METHOD: 25 patients underwent FDG imaging for lymphoma staging. The PET scan was done immediately after the usual low dose CT (lCT). A second CT scan was consequently acquired, by using classical diagnosis CT parameters (dCT) and iodinated contrast. For each patient, all CT attenuation correction (CTAC) PET images were visually compared. Density in Hounsfield units (HU) and maximum Standardized Uptake Value (SUVmax) were then measured on different organs and up to 5 specific lymphoma localizations (total of 294 measurements). RESULTS: Visual analysis was similar for the 2 modalities, without discordant interpretation for the pathologic sites. SUVmax means and standard deviation of each organ for lCTAC and dCTAC were comparable. The equation of the fitted multiple linear regression model was: dCT=0.0748191 + 1.17024*lCT (98.71%; p < 0.01). CONCLUSION: These first results allow the use of injected CT scan, before the PET scan acquisition for lymphoma staging with this PET-CT scan, not affected by the height atomic number and elevated density. A great benefit is therefore obtained on diagnostic, logistic and radioprotection purposes.

  17. Solid organ abdominal ischemia, part I: clinical features, etiology, imaging findings, and management.

    PubMed

    Ricci, Zina J; Oh, Sarah K; Stein, Marjorie W; Kaul, Bindu; Flusberg, Milana; Chernyak, Victoria; Rozenblit, Alla M; Mazzariol, Fernanda A

    2016-01-01

    Solid organ abdominal ischemia commonly presents with acute pain prompting radiologic evaluation and often requires urgent treatment. Despite different risk factors and anatomic differences, most solid organ ischemia is due to arterial or venous occlusion and, less frequently, a low-flow state. Radiologic diagnosis is critical, as clinical presentations are often nonspecific. Contrast-enhanced computed tomography (CT) is the modality of choice (except in adnexal torsion) with magnetic resonance imaging (MRI) useful in equivocal cases or follow-up of ischemic disease. This article will provide a pictorial review of the CT and MRI features of solid abdominal organ ischemia while highlighting key clinical features, etiology, and management. PMID:27317217

  18. Determination of contrast media administration to achieve a targeted contrast enhancement in CT

    NASA Astrophysics Data System (ADS)

    Sahbaee, Pooyan; Li, Yuan; Segars, Paul; Marin, Daniele; Nelson, Rendon; Samei, Ehsan

    2015-03-01

    Contrast enhancement is a key component of CT imaging and offer opportunities for optimization. The design and optimization of new techniques however requires orchestration with the scan parameters and further a methodology to relate contrast enhancement and injection function. In this study, we used such a methodology to develop a method, analytical inverse method, to predict the required injection function to achieve a desired contrast enhancement in a given organ by incorporation of a physiologically based compartmental model. The method was evaluated across 32 different target contrast enhancement functions for aorta, kidney, stomach, small intestine, and liver. The results exhibited that the analytical inverse method offers accurate performance with error in the range of 10% deviation between the predicted and desired organ enhancement curves. However, this method is incapable of predicting the injection function based on the liver enhancement. The findings of this study can be useful in optimizing contrast medium injection function as well as the scan timing to provide more consistency in the way that the contrast enhanced CT examinations are performed. To our knowledge, this work is one of the first attempts to predict the contrast material injection function for a desired organ enhancement curve.

  19. Contrast-enhanced ultrasonography: advance and current status in abdominal imaging

    PubMed Central

    2015-01-01

    In the field of contrast-enhanced ultrasonography (US), contrast agents are classified as either first- or second-generation agents depending on the gas within the microbubbles. In the case of first-generation contrast agents, a high-mechanical-index technique is used and only intermittent scanning is possible due to the early destruction of the microbubbles during the scanning. The use of second-generation contrast agents in a low-mechanical-index technique enables continuous scanning. Besides the detection and characterization of focal liver lesions, contrastenhanced US is helpful in the monitoring of radiofrequency ablation therapy and in the targeting step of an US-guided biopsy. Recently, there has been a demand for new criteria to evaluate the treatment response obtained using anti-angiogenic agents because morphologic criteria alone may not reflect the treatment response of the tumor and contrast-enhanced US can provide quantitative markers of tissue perfusion. In spite of the concerns related to its cost-effectiveness, contrast-enhanced US has the potential to be more widely used as a complimentary tool or to substitute the current imaging modalities in some occasions. PMID:25342120

  20. Resolution enhancement of lung 4D-CT via group-sparsity

    SciTech Connect

    Bhavsar, Arnav; Wu, Guorong; Shen, Dinggang; Lian, Jun

    2013-12-15

    Purpose: 4D-CT typically delivers more accurate information about anatomical structures in the lung, over 3D-CT, due to its ability to capture visual information of the lung motion across different respiratory phases. This helps to better determine the dose during radiation therapy for lung cancer. However, a critical concern with 4D-CT that substantially compromises this advantage is the low superior-inferior resolution due to less number of acquired slices, in order to control the CT radiation dose. To address this limitation, the authors propose an approach to reconstruct missing intermediate slices, so as to improve the superior-inferior resolution.Methods: In this method the authors exploit the observation that sampling information across respiratory phases in 4D-CT can be complimentary due to lung motion. The authors’ approach uses this locally complimentary information across phases in a patch-based sparse-representation framework. Moreover, unlike some recent approaches that treat local patches independently, the authors’ approach employs the group-sparsity framework that imposes neighborhood and similarity constraints between patches. This helps in mitigating the trade-off between noise robustness and structure preservation, which is an important consideration in resolution enhancement. The authors discuss the regularizing ability of group-sparsity, which helps in reducing the effect of noise and enables better structural localization and enhancement.Results: The authors perform extensive experiments on the publicly available DIR-Lab Lung 4D-CT dataset [R. Castillo, E. Castillo, R. Guerra, V. Johnson, T. McPhail, A. Garg, and T. Guerrero, “A framework for evaluation of deformable image registration spatial accuracy using large landmark point sets,” Phys. Med. Biol. 54, 1849–1870 (2009)]. First, the authors carry out empirical parametric analysis of some important parameters in their approach. The authors then demonstrate, qualitatively as well as

  1. Evaluation of the potential utility of flat panel CT for quantifying relative contrast enhancement

    SciTech Connect

    Jones, A. Kyle; Mahvash, Armeen

    2012-07-15

    Purpose: Certain directed oncologic therapies seek to take advantage of the fact that tumors are typically more susceptible to directed therapeutic agents than normal tissue owing to their extensive networks of poorly formed, leaky vasculature. If differences between the vascularity of normal and tumor tissues could be quantified, patients could be selected for or excluded from directed treatments on the basis of this difference. However, angiographic imaging techniques such as digital subtraction angiography (DSA) yield two-dimensional data that may be inadequate for this task. As a first step, the authors evaluated the feasibility of using a commercial implementation of flat panel computed tomography (FPCT) to quantify differences in enhancement of a simulated tumor compared with normal tissue based on differences in CT number measured in precontrast and postcontrast scans. Methods: To evaluate the FPCT scanner studied, the authors scanned several phantoms containing simulated normal and tumor tissues. In the first experiment, the authors used an anthropomorphic phantom containing inclusions representing normal, tumor, and bone tissue to evaluate the constancy of CT numbers in scans repeated at clinically relevant intervals of 1 and 3 min. The authors then scanned gelatin phantoms containing dilutions of iodinated contrast to evaluate the accuracy of relative contrast enhancement measurements for a clinical FPCT system. Data were analyzed using widely available software. Results: CT numbers measured in identical locations were constant over both scan intervals evaluated. Measured relative contrast enhancement values were accurate compared with known relative contrast enhancement values. Care must be taken to avoid artifacts in reconstructed images when placing regions of interest. Conclusions: Despite its limitations, FPCT in the interventional laboratory can be used to quantify relative contrast enhancement in phantoms. This is accomplished by measuring CT

  2. Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain

    PubMed Central

    Hwang, In Kyeom; Lee, Yoon Suk; Kim, Jaihwan; Lee, Yoon Jin; Park, Ji Hoon; Hwang, Jin-Hyeok

    2015-01-01

    Abstract Enhanced computed tomography (CT) is widely used for evaluating acute biliary pain in the emergency department (ED). However, concern about radiation exposure from CT has also increased. We investigated the usefulness of pre-contrast CT for differential diagnosis in middle-aged subjects with suspected biliary pain. A total of 183 subjects, who visited the ED for suspected biliary pain from January 2011 to December 2012, were included. Retrospectively, pre-contrast phase and multiphase CT findings were reviewed and the detection rate of findings suggesting disease requiring significant treatment by noncontrast CT (NCCT) was compared with cases detected by multiphase CT. Approximately 70% of total subjects had a significant condition, including 1 case of gallbladder cancer and 126 (68.8%) cases requiring intervention (122 biliary stone-related diseases, 3 liver abscesses, and 1 liver hemangioma). The rate of overlooking malignancy without contrast enhancement was calculated to be 0% to 1.5%. Biliary stones and liver space-occupying lesions were found equally on NCCT and multiphase CT. Calculated probable rates of overlooking acute cholecystitis and biliary obstruction were maximally 6.8% and 4.2% respectively. Incidental significant finding unrelated with pain consisted of 1 case of adrenal incidentaloma, which was also observed in NCCT. NCCT might be sufficient to detect life-threatening or significant disease requiring early treatment in young adults with biliary pain. PMID:25700321

  3. Enhanced CT images by the wavelet transform improving diagnostic accuracy of chest nodules.

    PubMed

    Guo, Xiuhua; Liu, Xiangye; Wang, Huan; Liang, Zhigang; Wu, Wei; He, Qian; Li, Kuncheng; Wang, Wei

    2011-02-01

    The objective of this study was to compare the diagnostic accuracy in the interpretation of chest nodules using original CT images versus enhanced CT images based on the wavelet transform. The CT images of 118 patients with cancers and 60 with benign nodules were used in this study. All images were enhanced through an algorithm based on the wavelet transform. Two experienced radiologists interpreted all the images in two reading sessions. The reading sessions were separated by a minimum of 1 month in order to minimize the effect of observer's recall. The Mann-Whitney U nonparametric test was used to analyze the interpretation results between original and enhanced images. The Kruskal-Wallis H nonparametric test of K independent samples was used to investigate the related factors which could affect the diagnostic accuracy of observers. The area under the ROC curves for the original and enhanced images was 0.681 and 0.736, respectively. There is significant difference in diagnosing the malignant nodules between the original and enhanced images (z = 7.122, P < 0.001), whereas there is no significant difference in diagnosing the benign nodules (z = 0.894, P = 0.371). The results showed that there is significant difference between original and enhancement images when the size of nodules was larger than 2 cm (Z = -2.509, P = 0.012, indicating the size of the nodules is a critical evaluating factor of the diagnostic accuracy of observers). This study indicated that the image enhancement based on wavelet transform could improve the diagnostic accuracy of radiologists for the malignant chest nodules. PMID:19937084

  4. 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

  5. Pseudo-enhancement correction for computer-aided detection in fecal-tagging CT colonography

    NASA Astrophysics Data System (ADS)

    Näppi, Janne; Yoshida, Hiroyuki; Zalis, Michael; Cai, Wenli; Lefere, Philippe

    2007-03-01

    Fecal-tagging CT colonography (CTC) presents an opportunity to minimize colon cleansing while maintaining high diagnostic accuracy for the detection of colorectal lesions. However, the pseudo-enhancement introduced by tagging agents presents several problems for the application of computer-aided detection (CAD). We developed a correction method that minimizes pseudo-enhancement in CTC data by modeling of the pseudo-enhancement as a cumulative Gaussian energy distribution. The method was optimized by use of an anthropomorphic colon phantom, and its effect on our fully automated CAD scheme was tested by use of leave-one-patient-out evaluation on 23 clinical CTC cases with reduced colon cleansing based upon dietary fecal tagging. There were 28 colonoscopy-confirmed polyps >=6 mm. Visual evaluation indicated that the method reduced CT attenuation of pseudo-enhanced polyps to standard soft-tissue Hounsfield unit (HU) range without affecting untagged regions. At a 90% detection sensitivity for polyps >=6 mm, CAD yielded 8.5 false-positive (FP) detections and 3.9 FP detections per volumetric scan without and with the application of the pseudo-enhancement correction method. These results indicate that the pseudo-enhancement correction method is a potentially useful pre-processing step for automated detection of polyps in fecal-tagging CTC, and that CAD can yield a high detection sensitivity with a relatively low FP rate in CTC with patient-friendly reduced colon preparation.

  6. TGF-β Neutralization Enhances AngII-Induced Aortic Rupture and Aneurysm in Both Thoracic and Abdominal Regions

    PubMed Central

    Howatt, Deborah A.; Balakrishnan, Anju; Moorleghen, Jessica J.; Cassis, Lisa A.; Daugherty, Alan

    2016-01-01

    AngII and TGF-β interact in development of thoracic and abdominal aortic diseases, although there are many facets of this interaction that have not been clearly defined. The aim of the present study was to determine the effects of TGF-β neutralization on AngII induced-aortic pathologies. Male C57BL/6J mice were administered with either a rabbit or mouse TGF-β neutralizing antibody and then infused with AngII. The rabbit TGF-β antibody modestly reduced serum TGF-β concentrations, with no significant enhancements to AngII-induced aneurysm or rupture. Administration of this rabbit TGF-β antibody in mice led to high serum titers against rabbit IgG that may have attenuated the neutralization. In contrast, a mouse TGF-β antibody (1D11) significantly increased rupture in both the ascending and suprarenal aortic regions, but only at doses that markedly decreased serum TGF-β concentrations. High doses of 1D11 antibody significantly increased AngII-induced ascending and suprarenal aortic dilatation. To determine whether TGF-β neutralization had effects in mice previously infused with AngII, the 1D11 antibody was injected into mice that had been infused with AngII for 28 days and were observed during continued infusion for a further 28 days. Despite near ablations of serum TGF-β concentrations, the mouse TGF-β antibody had no effect on aortic rupture or dimensions in either ascending or suprarenal region. These data provide further evidence that AngII-induced aortic rupture is enhanced greatly by TGF-β neutralization when initiated before pathogenesis. PMID:27104863

  7. Respiratory Motion-Compensated Radial Dynamic Contrast-Enhanced (DCE)-MRI of Chest and Abdominal Lesions

    PubMed Central

    Lin, Wei; Guo, Junyu; Rosen, Mark A.; Song, Hee Kwon

    2016-01-01

    Dynamic contrast-enhanced (DCE)-MRI is becoming an increasingly important tool for evaluating tumor vascularity and assessing the effectiveness of emerging antiangiogenic and antivascular agents. In chest and abdominal regions, however, respiratory motion can seriously degrade the achievable image quality in DCE-MRI studies. The purpose of this work is to develop a respiratory motion-compensated DCE-MRI technique that combines the self-gating properties of radial imaging with the reconstruction flexibility afforded by the golden-angle view-order strategy. Following radial data acquisition, the signal at k-space center is first used to determine the respiratory cycle, and consecutive views during the expiratory phase of each respiratory period (34–55 views, depending on the breathing rate) are grouped into individual segments. Residual intra-segment translation of lesion is subsequently compensated for by an autofocusing technique that optimizes image entropy, while intersegment translation (among different respiratory cycles) is corrected using 3D image correlation. The resulting motion-compensated, undersampled dynamic image series is then processed to reduce image streaking and to enhance the signal-to-noise ratio (SNR) prior to perfusion analysis, using either the k-space-weighted image contrast (KWIC) radial filtering technique or principal component analysis (PCA). The proposed data acquisition scheme also allows for high framerate arterial input function (AIF) sampling and free-breathing baseline T1 mapping. The performance of the proposed radial DCE-MRI technique is evaluated in subjects with lung and liver lesions, and results demonstrate that excellent pixelwise perfusion maps can be obtained with the proposed methodology. PMID:18956465

  8. TGF-β Neutralization Enhances AngII-Induced Aortic Rupture and Aneurysm in Both Thoracic and Abdominal Regions.

    PubMed

    Chen, Xiaofeng; Rateri, Debra L; Howatt, Deborah A; Balakrishnan, Anju; Moorleghen, Jessica J; Cassis, Lisa A; Daugherty, Alan

    2016-01-01

    AngII and TGF-β interact in development of thoracic and abdominal aortic diseases, although there are many facets of this interaction that have not been clearly defined. The aim of the present study was to determine the effects of TGF-β neutralization on AngII induced-aortic pathologies. Male C57BL/6J mice were administered with either a rabbit or mouse TGF-β neutralizing antibody and then infused with AngII. The rabbit TGF-β antibody modestly reduced serum TGF-β concentrations, with no significant enhancements to AngII-induced aneurysm or rupture. Administration of this rabbit TGF-β antibody in mice led to high serum titers against rabbit IgG that may have attenuated the neutralization. In contrast, a mouse TGF-β antibody (1D11) significantly increased rupture in both the ascending and suprarenal aortic regions, but only at doses that markedly decreased serum TGF-β concentrations. High doses of 1D11 antibody significantly increased AngII-induced ascending and suprarenal aortic dilatation. To determine whether TGF-β neutralization had effects in mice previously infused with AngII, the 1D11 antibody was injected into mice that had been infused with AngII for 28 days and were observed during continued infusion for a further 28 days. Despite near ablations of serum TGF-β concentrations, the mouse TGF-β antibody had no effect on aortic rupture or dimensions in either ascending or suprarenal region. These data provide further evidence that AngII-induced aortic rupture is enhanced greatly by TGF-β neutralization when initiated before pathogenesis. PMID:27104863

  9. Size-Tuning Ionization To Optimize Gold Nanoparticles for Simultaneous Enhanced CT Imaging and Radiotherapy.

    PubMed

    Dou, Yan; Guo, Yanyan; Li, Xiaodong; Li, Xue; Wang, Sheng; Wang, Lin; Lv, Guoxian; Zhang, Xuening; Wang, Hanjie; Gong, Xiaoqun; Chang, Jin

    2016-02-23

    Computed tomography (CT) contrast and radiosensitization usually increase with particle sizes of gold nanoparticles (AuNPs), but there is a huge challenge to improve both by adjusting sizes under the requirements of in vivo application. Here, we report that AuNPs have great size-dependent enhancements on CT imaging as well as radiotherapy (RT) in the size range of 3-50 nm. It is demonstrated that AuNPs with a size of ∼13 nm could simultaneously possess superior CT contrast ability and significant radioactive disruption. The Monte Carlo method is further used to evaluate this phenomenon and indicates that the inhomogeneity of gold atom distributions caused by sizes may influence secondary ionization in whole X-ray interactions. In vivo studies further indicate that this optimally sized AuNP improves real-time CT imaging and radiotherapeutic inhibition of tumors in living mice by effective accumulation at tumors with prolonged in vivo circulation times compared to clinically used small-molecule agents. These results suggest that ∼13 nm AuNPs may serve as multifunctional adjuvants for clinical X-ray theranostic application. PMID:26815933

  10. Renal stones on portal venous phase contrast-enhanced CT: does intravenous contrast interfere with detection?

    PubMed Central

    Dym, R. Joshua; Duncan, Dameon R.; Spektor, Michael; Cohen, Hillel W.; Scheinfeld, Meir H.

    2015-01-01

    Purpose To determine the sensitivity of portal venous phase contrast-enhanced CT for the detection of renal stones. Methods This retrospective study included 97 CT examinations of the abdomen without and with intravenous contrast, including 85 (87.6%) examinations with at least one renal stone on the “gold standard” noncontrast images, as scored by a single radiologist. Three other radiologists each independently reviewed only the contrast-enhanced images from all 97 examinations and recorded all renal stones. Reviewer sensitivity for stones was categorized by stone diameter. Reviewer sensitivity and specificity for stone disease were also calculated on a per-kidney basis. Results The 97 cases included a total of 238 stones ≥1 mm, with a mean (±SD) of 1.2 ± 1.9 stones per kidney and a stone diameter of 3.5 ± 3.0 mm. Pooling data for the three reviewers, sensitivity for all stones was 81%; sensitivity for stones ≥2, ≥3, ≥4, and ≥5 mm was 88%, 95%, 99%, and 98%, respectively. Sensitivity for stone disease on a per-kidney basis was 94% when considering all stones; when considering only stones ≥2, ≥3, and ≥4 mm, sensitivity was 96%, 99%, and 100%, respectively. Specificity for stone disease on a per-kidney basis was 98% overall, 99% when considering only stones ≥2 mm, and 100% when considering only stones ≥3 mm. Conclusion: Contrast-enhanced CT is highly sensitive for the detection of renal stones ≥3 mm in diameter and less sensitive for smaller stones. In cases where the clinical diagnosis is uncertain and performance of a CT examination is being contemplated, intravenous contrast utilization would allow assessment for stone disease while also optimizing evaluation for other conditions. PMID:24504541

  11. Photon counting CT of the liver with dual-contrast enhancement

    NASA Astrophysics Data System (ADS)

    Muenzel, Daniela; Proksa, Roland; Daerr, Heiner; Fingerle, Alexander A.; Pfeiffer, Franz; Rummeny, Ernst J.; Noël, Peter B.

    2016-03-01

    The diagnostic quality of photon counting computed tomography (PCCT) is one the unexplored areas in medical imaging; at the same time, it seems to offer the opportunity as a fast and highly sensitive diagnostic tool. Today, conventional computed tomography (CT) is the standard imaging technique for diagnostic evaluation of the parenchyma of the liver. However, considerations on radiation dose are still an important factor in CT liver imaging, especially with regard to multi-phase contrast enhanced CT. In this work we report on a feasibility study for multi-contrast PCCT for simultaneous liver imaging at different contrast phases. PCCT images of the liver were simulated for a contrast-enhanced examination performed with two different contrast agents (CA), iodine (CA 1) and gadolinium (CA 2). PCCT image acquisition was performed at the time point with portal venous contrast distribution of CA 1 and arterial contrast phase for CA 2. Therefore, a contrast injection protocol was planned with sequential injection of CA 1 and CA 2 to provide a time dependent difference in contrast distribution of both CAs in the vessels and parenchyma of the liver. Native, arterial, and portal venous contrast enhanced images have been calculated based on the spectral separation of PCCT. In simulated PCCT images, we were able to differentiate between the tissue enhancement of CA 1 and CA 2. The distribution of both CA within the parenchyma of the liver was illustrated with perfusion maps for CA 1 and CA 2. In addition, virtual noncontrast enhanced image were calculated. In conclusion, multi-phase PCCT imaging of the liver based on a single scan is a novel approach for spectral PCCT imaging, offering detailed contrast information in a single scan volume and a significant reduction of radiation dose.

  12. Development of a dynamic flow imaging phantom for dynamic contrast-enhanced CT

    SciTech Connect

    Driscoll, B.; Keller, H.; Coolens, C.

    2011-08-15

    Purpose: Dynamic contrast enhanced CT (DCE-CT) studies with modeling of blood flow and tissue perfusion are becoming more prevalent in the clinic, with advances in wide volume CT scanners allowing the imaging of an entire organ with sub-second image frequency and sub-millimeter accuracy. Wide-spread implementation of perfusion DCE-CT, however, is pending fundamental validation of the quantitative parameters that result from dynamic contrast imaging and perfusion modeling. Therefore, the goal of this work was to design and construct a novel dynamic flow imaging phantom capable of producing typical clinical time-attenuation curves (TACs) with the purpose of developing a framework for the quantification and validation of DCE-CT measurements and kinetic modeling under realistic flow conditions. Methods: The phantom is based on a simple two-compartment model and was printed using a 3D printer. Initial analysis of the phantom involved simple flow measurements and progressed to DCE-CT experiments in order to test the phantoms range and reproducibility. The phantom was then utilized to generate realistic input TACs. A phantom prediction model was developed to compute the input and output TACs based on a given set of five experimental (control) parameters: pump flow rate, injection pump flow rate, injection contrast concentration, and both control valve positions. The prediction model is then inversely applied to determine the control parameters necessary to generate a set of desired input and output TACs. A protocol was developed and performed using the phantom to investigate image noise, partial volume effects and CT number accuracy under realistic flow conditionsResults: This phantom and its surrounding flow system are capable of creating a wide range of physiologically relevant TACs, which are reproducible with minimal error between experiments ({sigma}/{mu} < 5% for all metrics investigated). The dynamic flow phantom was capable of producing input and output TACs using

  13. Comparison of 68Ga-DOTANOC PET/CT and contrast-enhanced CT in localisation of tumours in ectopic ACTH syndrome

    PubMed Central

    Jadhav, Swati S; Lila, Anurag R; Kasaliwal, Rajeev; Khare, Shruti; Yerawar, Chaitanya G; Hira, Priya; Phadke, Uday; Shah, Hina; Lele, Vikram R; Malhotra, Gaurav; Bandgar, Tushar; Shah, Nalini S

    2016-01-01

    Background Localising ectopic adrenocorticotrophic hormone (ACTH) syndrome (EAS) tumour source is challenging. Somatostatin receptor-based PET imaging has shown promising results, but the data is limited to case reports and small case series. We reviewed here the performance of 68Ga-DOTANOC positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) in our cohort of 12 consecutive EAS patients. Materials and methods Retrospective data analysis of 12 consecutive patients of EAS presenting to a single tertiary care centre in a period between January 2013 and December 2014 was done. CECT and 68Ga-DOTANOC PET/CT were reported (blinded) by an experienced radiologist and a nuclear medicine physician, respectively. The performance of CECT and 68Ga-DOTANOC PET/CT was compared. Results Tumours could be localised in 11 out of 12 patients at initial presentation (overt cases), whereas in one patient, tumour remained occult. Thirteen lesions were identified in 11 patients as EAS source (true positives). CECT localised 12 out of these 13 lesions (sensitivity 92.3%) and identified five false-positive lesions (positive predictive value (PPV) 70.5%). Compared with false-positive lesions, true-positive lesions had greater mean contrast enhancement at 60s (33.2 vs 5.6 Hounsfield units (HU)). 68Ga-DOTANOC PET/CT was able to identify 9 out of 13 lesions (sensitivity 69.2%) and reported no false-positive lesions (PPV 100%). Conclusion CECT remains the first-line investigation in localisation of EAS. The contrast enhancement pattern on CECT can further aid in characterisation of the lesions. 68Ga-DOTANOC PET/CT can be added to CECT, to enhance positive prediction of the suggestive lesions. PMID:27006371

  14. Enhanced X-ray absorption for micro-CT analysis of low density polymers.

    PubMed

    Crica, Livia Elena; Wengenroth, Jonas; Tiainen, Hanna; Ionita, Mariana; Haugen, Håvard Jostein

    2016-06-01

    X-ray microtomography (micro-CT), one of the most resourceful instruments for high resolution 3D analysis, can provide qualitative and quantitative accurate structural and compositional information for a broad range of materials. Yet its contribution to the field of biopolymeric materials science is often limited by low imaging contrast due to scarce X-ray attenuation features, particularly for sponges and foam-like structures. This limitation can be overcome to some extent by adjusting the working parameters of micro-CT equipment. However, such approach also facilitates noise and artefacts, and solving the signal-to-noise trade-off has been always problematic. Searching for alternatives turns one's attention towards the improvement of X-ray attenuation features. While several studies report the use of contrast agents for biological materials, studies to integrate multiple micro-CT approaches for biopolymers were not conducted so far. This method paper is thus aimed to serve as a platform for micro-CT analysis of low X-ray absorptive polymers. Here, several contrast enhancing artifices were developed and trialled on gelatin and poly(vinyl alcohol) biopolymer composites (GP). Accordingly, GP were modified with iodine, barium, silver-based chemicals and hexa(methyl disilazane) by two different methods, i.e. addition of high atomic number chemicals during materials synthesis and post-synthesis staining, respectively. Consequently, cross-sectional scanning electron microscopy emerged as complementary characterization, aimed to confirm the reproducibility of samples morphological features. The most versatile methods were barium chloride additive incorporation and iodine staining coupled with hexa(methyl disilazane) chemical drying. Both methods significantly improved the X-ray absorbance of our polymeric samples, providing better contrast of micro-CT tomograms. PMID:26863157

  15. Optimized dynamic contrast-enhanced cone-beam CT for target visualization during liver SBRT

    NASA Astrophysics Data System (ADS)

    Jones, Bernard L.; Altunbas, Cem; Kavanagh, Brian; Schefter, Tracey; Miften, Moyed

    2014-03-01

    The pharmacokinetic behavior of iodine contrast agents makes it difficult to achieve significant enhancement during contrast-enhanced cone-beam CT (CE-CBCT). This study modeled this dynamic behavior to optimize CE-CBCT and improve the localization of liver lesions for SBRT. We developed a model that allows for controlled study of changing iodine concentrations using static phantoms. A projection database consisting of multiple phantom images of differing iodine/scan conditions was built. To reconstruct images of dynamic hepatic concentrations, hepatic contrast enhancement data from conventional CT scans were used to re-assemble the projections to match the expected amount of contrast. In this way the effect of various parameters on image quality was isolated, and using our dynamic model we found parameters for iodine injection, CBCT scanning, and injection/scanning timing which optimize contrast enhancement. Increasing the iodine dose, iodine injection rate, and imaging dose led to significant increases in signal-to-noise ratio (SNR). Reducing the CBCT imaging time also increased SNR, as the image can be completed before the iodine exits the liver. Proper timing of image acquisition played a significant role, as a 30 second error in start time resulted in a 40% SNR decrease. The effect of IV contrast is severely degraded in CBCT, but there is promise that, with optimization of the injection and scan parameters to account for iodine pharmacokinetics, CE-CBCT which models venous-phase blood flow kinetics will be feasible for accurate localization of liver lesions.

  16. A method for automatic liver segmentation from multi-phase contrast-enhanced CT images

    NASA Astrophysics Data System (ADS)

    Yuan, Rong; Luo, Ming; Wang, Shaofa; Wang, Luyao; Xie, Qingguo

    2014-03-01

    Liver segmentation is a basic and indispensable function in systems of computer aided liver surgery for volume calculation, operation designing and risk evaluation. Traditional manual segmentation is very time consuming because of the complicated contours of liver and the big amount of images. For increasing the efficiency of the clinical work, in this paper, a fully-automatic method was proposed to segment the liver from multi-phase contrast-enhanced computed tomography (CT) images. As an advanced region growing method, we applied various pre- and post-processing to get better segmentation from the different phases. Fifteen sets of clinical abdomens CT images of five patients were segmented by our algorithm, and the results were acceptable and evaluated by an experienced surgeon. The running-time is about 30 seconds for a single-phase data which includes more than 200 slices.

  17. 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 ...

  18. 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 ...

  19. 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 ...

  20. 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, ...

  1. Automatic classification of lung tumour heterogeneity according to a visual-based score system in dynamic contrast enhanced CT sequences

    NASA Astrophysics Data System (ADS)

    Bevilacqua, Alessandro; Baiocco, Serena

    2016-03-01

    Computed tomography (CT) technologies have been considered for a long time as one of the most effective medical imaging tools for morphological analysis of body parts. Contrast Enhanced CT (CE-CT) also allows emphasising details of tissue structures whose heterogeneity, inspected through visual analysis, conveys crucial information regarding diagnosis and prognosis in several clinical pathologies. Recently, Dynamic CE-CT (DCE-CT) has emerged as a promising technique to perform also functional hemodynamic studies, with wide applications in the oncologic field. DCE-CT is based on repeated scans over time performed after intravenous administration of contrast agent, in order to study the temporal evolution of the tracer in 3D tumour tissue. DCE-CT pushes towards an intensive use of computers to provide automatically quantitative information to be used directly in clinical practice. This requires that visual analysis, representing the gold-standard for CT image interpretation, gains objectivity. This work presents the first automatic approach to quantify and classify the lung tumour heterogeneities based on DCE-CT image sequences, so as it is performed through visual analysis by experts. The approach developed relies on the spatio-temporal indices we devised, which also allow exploiting temporal data that enrich the knowledge of the tissue heterogeneity by providing information regarding the lesion status.

  2. Contrast enhanced multi-detector CT and MR findings of a well-differentiated pancreatic vipoma

    PubMed Central

    Camera, Luigi; Severino, Rosa; Faggiano, Antongiulio; Masone, Stefania; Mansueto, Gelsomina; Maurea, Simone; Fonti, Rosa; Salvatore, Marco

    2014-01-01

    Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography (CT) or magnetic resonance (MR) is pivotal for surgical planning. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved by somatostatin-receptor scintigraphy (SRS). We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR (Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT (Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure (3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis. PMID:25349667

  3. 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.

  4. Contrast-enhanced 3D MRA with centric ordering in k space: a preliminary clinical experience in imaging the abdominal aorta and renal and peripheral arterial vasculature.

    PubMed

    Shetty, A N; Bis, K G; Vrachliotis, T G; Kirsch, M; Shirkhoda, A; Ellwood, R

    1998-01-01

    The objective of this study was to determine the clinical utility of a contrast-enhanced, centric reordered, three-dimensional (3D) MR angiography (MRA) pulse sequence in imaging the abdominal aorta and renal and peripheral lower extremity arteries. Twenty-eight MRA studies were performed on 23 patients and four volunteers at 1.5 T using a 3D contrast-enhanced, centric reordered pulse sequence. In 20 patients, the abdominal aorta and renal arteries were imaged, and in seven patients, the lower extremity arteries were imaged. In 19 patients, a total of 51 renal vessels were evaluated (33 renal arteries using .1 mmol/kg of gadopentetate dimeglumine and 18 renal arteries using .2 mmol/kg of gadoteridol). A total of 70 peripheral arterial segments were assessed using .2 mmol/kg of gadoteridol. Correlation with conventional angiography was made for the following 14 cases: renal artery stenosis (four cases), abdominal aortic stenosis (one case), arteriovenous fistula in a transplant kidney (one case), renal arteriovenous malformation (one case), common iliac artery aneurysms (one case), and peripheral lower extremity (six cases). Of the 70 peripheral arterial segments evaluated, in 35, there was correlation with x-ray angiography. The mean percent of aortic signal enhancement was significantly higher in the .2 mmol/kg dose group (370.8 +/- 190.3) than in the .1 mmol/kg dose group (184.5 +/- 128.9) (P = .02). However, there was no apparent difference between the two doses for visualization of the renal and accessory renal arteries. There was concordance between the contrast-enhanced 3D MRA studies and conventional angiography in all cases of renal artery and peripheral arterial stenoses and occlusions, including visualization of reconstituted peripheral arterial segments. There was no evidence of spin dephasing effects at sites of stenoses on the 3D contrast-enhanced MRA studies. Contrast-enhanced, centric reordered, 3D MRA can rapidly image the abdominal aorta and renal

  5. Vascular contrast enhanced micro-CT imaging of "radiators" in the Brazilian free-tailed bat (Tadarida brasiliensis).

    PubMed

    Reichard, Jonathan D; Kunz, Thomas H; Keller, Charles; Prajapati, Suresh I

    2012-04-01

    The Brazilian free-tailed bat (Tadarida brasiliensis) exhibits a highly vascularized, hairless thermal window (or "radiator") on the proximal ventral surfaces of extended wings and body. We identified this character using thermal infrared imaging and investigated the vasculature using barium sulfate enhanced microcomputed tomography (micro-CT). Micro-CT images revealed unique arrangements of arteries and veins in the region of the radiator positioned perpendicular to the axis of the body. Coupling micro-CT imaging with analysis of surface temperature profiles, we concluded that radiators aid in thermoregulation during flight in variable environments. This study represents the first application of contrast enhanced micro-CT to visualize vasculature of bats and thus exhibits a promising technique for further investigations of cardiovascular function and anatomy in bats. PMID:22282439

  6. Quantitative Measurements of Enhancement on Preprocedure Triphasic CT Can Predict Response of Colorectal Liver Metastases to Radioembolization

    PubMed Central

    Boas, F. Edward; Brody, Lynn A.; Erinjeri, Joseph P.; Yarmohammadi, Hooman; Shady, Waleed; Kishore, Sirish; Sofocleous, Constantinos T.

    2016-01-01

    Objective Colorectal liver metastases (CLM) have a variable response to radioembolization. This may be due at least partly to differences in tumor arterial perfusion. The present study examines whether quantitative measurements of enhancement on preprocedure triphasic CT can be used to predict the response of CLM to radioembolization. Materials and Methods We retrospectively reviewed patients with CLM treated with radioembolization who underwent pretreatment PET/CT and triphasic CT examinations and posttreatment PET/CT examinations. A total of 31 consecutive patients with 60 target tumors were included in the present study. For each tumor, we calculated the hepatic artery coefficient (HAC), portal vein coefficient (PVC), and arterial enhancement fraction (AEF) based on enhancement measurements on pretreatment triphasic CT. HAC and PVC are estimates of the hepatic artery and portal vein blood supply. AEF, which is the arterial phase enhancement divided by the portal phase enhancement, provides an estimate of the hepatic artery blood supply as a fraction of the total blood supply. For each tumor, the metabolic response to radioembolization was based on findings from the initial follow-up PET/CT scan obtained at 4–8 weeks after treatment. Results A total of 55% of CLM had a complete or partial metabolic response. Arterial phase enhancement, the HAC, and the PVC did not predict which tumors responded to radioembolization. However, the AEF was statistically significantly greater in tumors with a complete or partial metabolic response than in tumors with no metabolic response (i.e., those with stable disease or disease progression) (p = 0.038). An AEF of less than 0.4 was associated with a 40% response rate, whereas an AEF greater than 0.75 was associated with a 78% response rate. Conclusion Response to radioembolization can be predicted using the AEF calculated from the preprocedure triphasic CT. PMID:27248430

  7. A novel technique for the contrast-enhanced microCT imaging of murine intervertebral discs.

    PubMed

    Lin, Kevin H; Wu, Qi; Leib, Daniel J; Tang, Simon Y

    2016-10-01

    Disc degeneration is one of the leading factors that contribute to low back pain. Thus, the further understanding of the mechanisms contributing to degeneration of the intervertebral disc degeneration is critical for the development of therapies and strategies for treating low back pain. Rodent models are attractive for conducting mechanistic studies particularly because of the availability of genetically modified animals. However, current imaging technologies such as magnetic resonance imaging, do not have the ability to resolve spatial features at the tens- to single- micrometer scale. We propose here a contrast-enhanced microCT technique to conduct high-resolution imaging of the rodent intervertebral discs at 10µm spatial resolution. Based on the iodinated-hydrophilic contrast agent Ioversol, we are able to conduct high resolution imaging on rat and mouse intervertebral discs. Leveraging the hydrophilic characteristic of the contrast agent, we are able to discriminate the annulus fibrosus from the water-rich nucleus pulposus. Moreover, this technique allows for the quantitative measurement of disc morphologies and volumes, and we demonstrate the versatility of this technique on cultured live intervertebral discs. Coupled with our semi-automated segmentation technique, we are able to quantify the intervertebral disc volumes with a high degree of reproducibility. The contrast-enhanced microCT images were qualitatively and quantitatively indistinguishable from the traditional histological assessment of the same sample. Furthermore, stereological measures compared well between histology and microCT images. Taken together, the results reveal that rat and mouse intervertebral discs can be imaged longitudinally in vitro at high resolutions, with no adverse effects on viability and features of the intervertebral disc. PMID:27341292

  8. Osmotic blood-brain barrier modification: clinical documentation by enhanced CT scanning and/or radionuclide brain scanning

    SciTech Connect

    Neuwelt, E.A.; Specht, H.D.; Howieson, J.; Haines, J.E.; Bennett, M.J.; Hill, S.A.; Frenkel, E.P.

    1983-10-01

    Results of initial clinical trials of brain tumor chemotherapy after osmotic blood-brain barrier disruption are promising. In general, the procedure is well tolerated. The major complication has been seizures. In this report, data are presented which indicate that the etiology of these seizures is related to the use of contrast agent (meglumine iothalamate) to monitor barrier modification. A series of 19 patients underwent a total of 85 barrier modification procedures. Documentation of barrier disruption was monitored by contrast-enhanced computed tomographic (CT) scanning, radionuclide brain scanning, or a combination of both techniques. In 56 procedures (19 patients) monitored by enhanced CT, seizures occurred a total of 10 times in eight patients. Twenty-three barrier modification procedures (in nine of these 19 patients) documented by nuclear brain scans alone, however, resulted in only one focal motor seizure in each of two patients. In eight of the 19 patients who had seizures after barrier disruption and enhanced CT scan, four subsequently had repeat procedures monitored by radionuclide scan alone. In only one of these patients was further seizure activity noted; a single focal motor seizure was observed. Clearly, the radionuclide brain scan does not have the sensitivity and spatial resolution of enhanced CT, but at present it appears safer to monitor barrier modification by this method and to follow tumor growth between barrier modifications by enhanced CT. Four illustrative cases showing methods, problems, and promising results are presented.

  9. 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

  10. Gadoxetate Disodium enhanced spectral dual-energy CT for evaluation of cholangiocarcinoma: Preliminary data

    PubMed Central

    Thomas, John V.; Bolus, David N.; Jackson, Bradford E.; Berland, Lincoln L.; Yester, Michael; Morgan, Desiree E.

    2016-01-01

    Purpose Evaluate Gadoxetate Disodium enhanced dual-energy CT for visualization of perihilar cholangiocarcinoma by exploiting the hepatobiliary uptake of Gadoxetate Disodium and viewing images at the k-edge of gadolinium on the spectrum of simulated monoenergetic energies available with Dual Energy CT. Material and methods In this prospective, IRB-approved study in patients with suspected cholangiocarcinoma, subjects who underwent a clinically indicated Gadoxetate Disodium liver MRI were immediately scanned without further IV contrast administration using rapid kVp-switching dual energy CT (rsDECT). Initial Gadoxetate Disodium dose was the FDA approved clinical dose, 0.025 mmol/kg; after additional IRB/FDA approval, 10 subjects were scanned with 0.05 mmol/kg. Both 50 keV and 70 keV simulated monoenergetic images as well as gadolinium(-water) material density images were viewed qualitatively and measured quantitatively for gadolinium uptake in the hepatic parenchyma and any focal lesions identified. Results Of 18 subjects (mean age 55 years, 10M, 8F, weight 84 kg), eight were scanned with 0.025 mmol/kg (Group 1) and 10 with 0.05 mmol/kg Gadoxetate Disodium (Group 2). Five patients had cholangiocarcinoma (all in Group 1). On synthetic monoenergetic images using standard and double Gadoxetate Disodium dose, the liver parenchyma did not appear enhanced qualitatively. Comparison of mean hepatic parenchymal HU at 50 and 70 keV showed a measurable increase in attenuation at the lower viewing energy, which corresponded to the k-edge of gadolinium. No statistically significant difference was observed on quantitative gadolinium measurement of hepatic parenchyma for single versus double Gadoxetate Disodium dose using rsDECT gadolinium material density images. Of the five cholangiocarcinomas, the tumor to nontumoral hepatic tissue HU differences were 51.1 (32.2) (mean and std dev) and 49.0(26.5) at 50 and 70 keV, respectively. Conclusion In this small pilot population

  11. Consistency analysis of contrast-enhanced ultrasound and contrast-enhanced CT in diagnosis of small hepatocellular carcinoma

    PubMed Central

    Liu, Jun-Jie; Li, Hong-Xue; Chen, Zhao-Bei; Yang, Wei-Ping; Zhao, Sheng-Fa; Chen, Jie; Bai, Tao; Li, Hang; Li, Le-Qun

    2015-01-01

    To compare the consistency of contrast-enhanced ultrasound (CEUS) and contrast-enhance CT (CECT) in diagnosis of 1~2 cm and 2.1~3 cm small hepatocellular carcinoma (HCC) and evaluate the value of CEUS in diagnosis of HCC. Methods: A total of 74 patients (89 lesions) with small HCC and cirrhosis background were retrospectively analyzed. All of the eighty-nine lesions were confirmed by histopathological examination of surgical samples or needle biopsy. All the cases were divided into 1~2 cm group and 2.1~3 cm group. The CEUS and CECT enhanced pattern and diagnosis results of the two groups were compared and the consistency between the two imaging methods were statistically analyzed. Results: In the diagnosis of 1.0-2.0 cm HCC, CEUS and CECT had a moderate consistency in arterial phase, CEUS showed a tolerable consistency with CECT in portal venous and delayphase. The two imaging methods have a better consistency for the diagnosis in 2.1-3.0 cm HCC. Conclusion: CEUS can be used as a supplement to provide important diagnostic information in clinical practice when positive results or definite diagnoses cannot obtain. PMID:26885093

  12. Gallbladder Tuberculosis: CT Findings with Histopathologic Correlation

    PubMed Central

    Xu, Xiu-Fang; Qiu, Ling-Ling; Shen, Jian; Dong, Fei; Chen, Ying

    2011-01-01

    Objective We wanted to describe the computed tomography (CT) findings of gallbladder tuberculosis (TB) and to correlate them with pathologic findings. Materials and Methods There were seven patients (M:F = 3:4; mean age, 46.3 years; age range, 32 to 78 years) in whom gallbladder TB was eventually diagnosed. All of them underwent cross-sectional imaging with CT, a pathologic examination and a retrospective review. CT imaging evaluation was done in each case, including the findings of a mass versus nodule, wall thickening (uniform or irregular) and the enhancement patterns (homogeneous or heterogeneous). Results All the cases of gallbladder TB revealed the following three different CT findings: micronodular lesion of the gallbladder wall (n = 1), a thickened wall (n = 4) and a gallbladder mass (n = 2). There were three cases of homogeneous enhancement of the lesions, including homogeneous enhancement with nodular lesion, homogeneous uniform thickness enhancement and homogeneous thickness enhancement in one case each, and these cases pathology showed tuberculous granuloma with a little caseating necrosis in one case and tuberculous granuloma with rich fibrous tissue, but little or no evident caseating necrosis in two cases. Four cases of heterogeneous enhancement of the lesions, including heterogeneous uniform-thickness enhancement in two cases, heterogeneous enhancement with a local mass lesion in one case and heterogeneous enhancement with a mass that replaced the gallbladder in one case; in these cases, pathology showed tuberculous granuloma with marked caseation or liquefaction necrosis in three cases and tuberculous granuloma by fibrous and calcifications accompanied by caseating necrosis in one case. Among the seven cases of gallbladder TB, six cases were accompanied by abdominal extra-gallbladder TB, including abdominal lymph node TB in five cases and hepatic TB in four cases. Conclusion Gallbladder TB has various CT manifestations, and the enhanced CT findings

  13. 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: ...

  14. 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 ...

  15. FDG-Avid Portal Vein Tumor Thrombosis from Hepatocellular Carcinoma in Contrast-Enhanced FDG PET/CT

    PubMed Central

    Nguyen, Xuan Canh; Nguyen, Dinh Song Huy; Ngo, Van Tan; Maurea, Simone

    2015-01-01

    Objective(s): In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT), complicating hepatocellular carcinoma (HCC) in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET scan. PET and CT DICOM images of patients were imported into the PET/CT imaging system for the re-analysis of contrast enhancement and FDG uptake in thrombus, the diameter of the involved portal vein, and characteristics of liver tumors and metastasis. Results: Two patients with previously untreated HCC and 7 cases with previously treated HCC had FDG-avid PVTT in contrast-enhanced FDG PET/CT scan. During the arterial phase of CT scan, portal vein thrombus showed contrast enhancement in 8 out of 9 patients (88.9%). PET scan showed an increased linear FDG uptake along the thrombosed portal vein in all patients. The mean greatest diameter of thrombosed portal veins was 1.8 ± 0.2 cm, which was significantly greater than that observed in normal portal veins (P<0.001). FDG uptake level in portal vein thrombus was significantly higher than that of blood pool in the reference normal portal vein (P=0.001). PVTT was caused by the direct extension of liver tumors. All patients had visible FDG-avid liver tumors in contrast-enhanced images. Five out of 9 patients (55.6%) had no extrahepatic metastasis, 3 cases (33.3%) had metastasis of regional lymph nodes, and 1 case (11.1%) presented with distant metastasis. The median estimated survival time of patients was 5 months. Conclusion: The intraluminal filling defect consistent with thrombous within the portal vein, expansion of the involved portal vein, contrast enhancement, and linear increased FDG uptake of the thrombus extended from liver tumor are findings of FDG

  16. 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

  17. 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

  18. 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 - ...

  19. [Small renal cell carcinoma (≤ 4 cm): enhancement patterns on triphasic spiral CT].

    PubMed

    Rebonato, Alberto; Pierotti, Luisa; Barberini, Francesco; Rosi, Giovanni; Macarini, Luca; Scialpi, Michele

    2012-11-01

    The aim of this study was to define enhancement patterns of small renal cell carcinoma (RCC) (≤4 cm) by triphasic spiral CT. In 24 patients with RCC, hypervascularity and hypovascularity were identified in 12 and 12 RO, respectively, in the cortico-medullary phase (CMP). Hypervascular RCC showed increased density in the CMP (170,7±46,3 UH) and a gradual wash-out in the nephrographic phase (NP) (152,5±41 UH) and pielographic phase (PF) (99,2±38 UH). Hypovascular RCC showed increased density in the CMP (52,9±24,7 UH) and a gradual wash-out in NP (64,5±16,9 UH) and PP phases (55,0±17,3 UH). PMID:23096734

  20. Enhancement of breast calcification visualization and detection using a modified PG method in Cone Beam Breast CT.

    PubMed

    Liu, Jiangkun; Ning, Ruola; Cai, Weixing; Benitez, Ricardo Betancourt

    2012-01-01

    Cone Beam Breast CT is a promising diagnostic modality in breast imaging. Its isotropic 3D spatial resolution enhances the characterization of micro-calcifications in breasts that might not be easily distinguishable in mammography. However, due to dose level considerations, it is beneficial to further enhance the visualization of calcifications in Cone Beam Breast CT images that might be masked by noise. In this work, the Papoulis-Gerchberg method was modified and implemented in Cone Beam Breast CT images to improve the visualization and detectability of calcifications. First, the PG method was modified and applied to the projections acquired during the scanning process; its effects on the reconstructed images were analyzed by measuring the Modulation Transfer Function and the Noise Power Spectrum. Second, Cone Beam Breast CT images acquired at different dose levels were pre-processed using this technique to enhance the visualization of calcification. Finally, a computer-aided diagnostic algorithm was utilized to evaluate the efficacy of this method to improve calcification detectability. The results demonstrated that this technique can effectively improve image quality by improving the Modulation Transfer Function with a minor increase in noise level. Consequently, the visualization and detectability of calcifications were improved in Cone Beam Breast CT images. This technique was also proved to be useful in reducing the x-ray dose without degrading visualization and detectability of calcifications. PMID:22398591

  1. Assessment of contrast enhanced respiration managed cone-beam CT for image guided radiotherapy of intrahepatic tumors

    SciTech Connect

    Jensen, Nikolaj K. G.; Stewart, Errol; Lock, Michael; Fisher, Barbara; Kozak, Roman; Chen, Jeff; Lee, Ting-Yim; Wong, Eugene

    2014-05-15

    Purpose: Contrast enhancement and respiration management are widely used during image acquisition for radiotherapy treatment planning of liver tumors along with respiration management at the treatment unit. However, neither respiration management nor intravenous contrast is commonly used during cone-beam CT (CBCT) image acquisition for alignment prior to radiotherapy. In this study, the authors investigate the potential gains of injecting an iodinated contrast agent in combination with respiration management during CBCT acquisition for liver tumor radiotherapy. Methods: Five rabbits with implanted liver tumors were subjected to CBCT with and without motion management and contrast injection. The acquired CBCT images were registered to the planning CT to determine alignment accuracy and dosimetric impact. The authors developed a simulation tool for simulating contrast-enhanced CBCT images from dynamic contrast enhanced CT imaging (DCE-CT) to determine optimal contrast injection protocols. The tool was validated against contrast-enhanced CBCT of the rabbit subjects and was used for five human patients diagnosed with hepatocellular carcinoma. Results: In the rabbit experiment, when neither motion management nor contrast was used, tumor centroid misalignment between planning image and CBCT was 9.2 mm. This was reduced to 2.8 mm when both techniques were employed. Tumors were not visualized in clinical CBCT images of human subjects. Simulated contrast-enhanced CBCT was found to improve tumor contrast in all subjects. Different patients were found to require different contrast injections to maximize tumor contrast. Conclusions: Based on the authors’ animal study, respiration managed contrast enhanced CBCT improves IGRT significantly. Contrast enhanced CBCT benefits from patient specific tracer kinetics determined from DCE-CT.

  2. Airway and pulmonary vascular measurements using contrast-enhanced micro-CT in rodents.

    PubMed

    Counter, W B; Wang, I Q; Farncombe, T H; Labiris, N R

    2013-06-15

    Preclinical imaging allows pulmonary researchers to study lung disease and pulmonary drug delivery noninvasively and longitudinally in small animals. However, anatomically localizing a pathology or drug deposition to a particular lung region is not easily done. Thus, a detailed knowledge of the anatomical structure of small animal lungs is necessary for understanding disease progression and in addition would facilitate the analysis of the imaging data, mapping drug deposition and relating function to structure. In this study, contrast-enhanced micro-computed tomography (CT) of the lung produced high-resolution images that allowed for the characterization of the rodent airway and pulmonary vasculature. Contrast-enhanced micro-CT was used to visualize the airways and pulmonary vasculature in Sprague-Dawley rats (200-225 g) and BALB/c mice (20-25 g) postmortem. Segmented volumes from these images were processed to yield automated measurements of the airways and pulmonary vasculature. The diameters, lengths, and branching angles of the airway, arterial, and venous trees were measured and analyzed as a function of generation number and vessel diameter to establish rules that could be applied at all levels of tree hierarchy. In the rat, airway, arterial, and venous tress were measured down to the 20th, 16th, and 14th generation, respectively. In the mouse, airway, arterial, and venous trees were measured down to the 16th, 8th, and 7th generation, respectively. This structural information, catalogued in a rodent database, will increase our understanding of lung structure and will aid in future studies of the relationship between structure and function in animal models of disease. PMID:23564512

  3. 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

  4. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

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

  5. Evaluation of a tuberculous abscess on the right side of the diaphragm with contrast-enhanced computed tomography: A case report

    PubMed Central

    DONG, PENG; CHEN, JING-JING; WANG, XI-ZHEN

    2016-01-01

    We herein investigate the case of a patient with a tuberculous diaphragmatic abscess confirmed by pathology. The patient underwent plain computed tomography (CT) examination of the chest and contrast-enhanced abdominal CT examination. The abscess appeared as hypodense mass with thick and irregular wall, which was enhanced on the contrast-enhanced CT images. The shape of the mass resembled an irregular double convex lens. No enlarged lymph nodes were detected on the CT images. The presence of a tuberculous diaphragmatic abscess should be suspected in patients with a diaphragmatic hypodense mass with enhanced thick walls, even when there is absence of enlarged lymph nodes on the CT images. PMID:27330800

  6. 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

  7. Value of Single-Dose Contrast-Enhanced Magnetic Resonance Angiography Versus Intraarterial Digital Subtraction Angiography in Therapy Indications in Abdominal and Iliac Arteries

    SciTech Connect

    Schaefer, Philipp J. Schaefer, Fritz K. W.; Mueller-Huelsbeck, Stefan; Both, Markus; Heller, Martin; Jahnke, Thomas

    2007-06-15

    The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy. Patients suspected of having abdominal or iliac artery stenosis were included in this study. A positive vote of the local Ethics Committee was given. After written informed consent was obtained, 37 patients were enrolled, of which 34 were available for image evaluation. Both 3D ceMRA and i.a. DSA were performed for each patient. The dosage for 3D ceMRA was 0.1 mmol/kg body weight in a 1.5-T scanner with a phased-array coil. The parameters of the 3D-FLASH sequence were as follows: TR/TE 4.6/1.8 ms, effective thickness 3.5 mm, matrix 512 x 200, flip angle 30{sup o}, field of view 420 mm, TA 23 s, coronal scan orientation. Totally, 476 vessel segments were evaluated for stenosis degree by two radiologists in a consensus fashion in a blinded read. For each patient, a therapy was proposed, if clinically indicated. Sensitivity, specificity, positive and negative predictive values, and accuracy for stenoses {>=}50% were 68%, 92%, 44%, 97%, and 90%, respectively. In 13/34 patients, a discrepancy was found concerning therapy decisions based on MRA findings versus therapy decisions based on the reference standard DSA. The results showed that the used MRA imaging technique of abdominal and iliac arteries is not competitive to i.a. DSA, with a high rate of misinterpretation of the MRAs resulting in incorrect therapies.

  8. Osmotic blood-brain barrier modification: clinical documentation by enhanced CT scanning and/or radionuclide brain scanning

    SciTech Connect

    Neuwelt, E.A; Specht, H.D.; Howieson, J.; Haines, J.E.; Bennett, M.J.; Hill, S.A.; Frenkel, E.P.

    1983-10-01

    Results of initial clinical trials of brain tumor chemotherapy after osmotic blood-brain barrier disruption are promising. In general, the procedure is well tolerated. The major complication has been seizures. In this report, data are presented which indicate that the etiology of these seizures is related to the use of contrast agent (meglumine iothalamate) to monitor barrier modification. A series of 19 patients underwent a total of 85 barrier modification procedures. Documentation of barrier disruption was monitored by contrast-enhanced computed tomographic (CT) scanning, radionuclide brain scanning, or a combination of both techniques. In 56 procedures (19 patients) monitored by enhanced CT, seizures occurred a total of 10 times in eight patients. Twenty-three barrier modification procedures (in nine of these 19 patients) documented by nuclear brain scans alone, however, resulted in only one focal motor seizure in each of two patients. Clearly, the radionuclide brain scan does not have the sensitivity and spatial resolution of enhanced CT, but at present it appears safer to monitor barrier modification by this method and to follow tumor growth between barrier modifications by enhanced CT. Four illustrative cases showing methods, problems, and promising results are presented.

  9. Contrast-Enhanced Ultrasound in Detection and Follow-Up of an Infrarenal Abdominal Aortic Aneurysm with Aorto-Caval Fistula and Endovascular Treatment

    SciTech Connect

    Clevert, D.-A. Stickel, M.; Flach, P.; Strautz, T.; Horng, A.; Jauch, K. W.; Reiser, M.

    2007-06-15

    An aorto-caval fistula is a rare complication of a symptomatic or ruptured infrarenal aortic aneurysm having a frequency of 3-6%. Patients typically present with clinical signs of diffuse abdominal pain associated with increasing venous congestion and tachycardia, rapid cardiopulmonary decompensation with acute dyspnea, and an audible machinerylike bruit. Perioperative mortality is high, ranging from 20% to 60%. We report a case of an endovascular aortic repair in a patient with a symptomatic infrarenal aortic aneurysm and an aorto-caval fistula. Contrast-enhanced ultrasound seems to be a promising new diagnostic option for the diagnosis and preoperative treatment planning for patients with abdominal aortic aneurysms with rupture into the inferior vena cava. It is in addition to computed tomography angiography. It might allow a more rapid and noninvasive diagnosis, especially for patients in intensive care because of its bedside availability. Because the examination is dynamic, additional information about blood flow between the aorta and inferior cava vein can be evaluated.

  10. Moxifloxacin-loaded nanoemulsions having tocopheryl succinate as the integral component improves pharmacokinetics and enhances survival in E. coli-induced complicated intra-abdominal infection.

    PubMed

    Shukla, Prashant; Verma, Ajeet Kumar; Dwivedi, Pankaj; Yadav, Arti; Gupta, Pramod Kumar; Rath, Srikanta Kumar; Mishra, Prabhat Ranjan

    2014-12-01

    In the present work, a novel nanoemulsion laden with moxifloxacin has been developed for effective management of complicated intra-abdominal infections. Moxifloxacin nanoemulsion fabricated using high pressure homogenization was evaluated for various pharmaceutical parameters, pharmacokinetics (PK) and pharmacodynamics (PD) in rats with E. coli-induced peritonitis and sepsis. The developed nanoemulsion MONe6 (size 168 ± 28 nm and zeta potential (ZP) 24.78 ± 0.45 mV, respectively) was effective for intracellular delivery and sustaining the release of MOX. MONe6 demonstrated improved plasma (AUC(MONe6/MOX) = 2.38-fold) and tissue pharmacokinetics of MOX (AUC(MONe6/MOX) = 2.63 and 1.47 times in lung and liver, respectively). Calculated PK/PD index correlated well with a reduction in bacterial burden in plasma as well as tissues. Enhanced survival on treatment with MONe6 (65.44%) and as compared to the control group (8.22%) was a result of reduction in lipid peroxidation, neutrophil migration, and cytokine levels (TNF-α and IL6) as compared to untreated groups in the rat model of E. coli-induced sepsis. Parenteral nanoemulsions of MOX hold a promising advantage in the therapy of E. coli-induced complicated intra-abdominal infections and is helpful in the prevention of further complications like septic shock and death. PMID:25317848

  11. [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

  12. 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

  13. Hollow organ abdominal ischemia, part II: clinical features, etiology, imaging findings and management.

    PubMed

    Ricci, Zina J; Mazzariol, Fernanda S; Kaul, Bindu; Oh, Sarah K; Chernyak, Victoria; Flusberg, Milana; Stein, Marjorie W; Rozenblit, Alla M

    2016-01-01

    Acute hollow organ ischemia commonly presents with acute pain prompting radiologic evaluation and almost always requires urgent treatment. Despite different risk factors and anatomic differences, ischemia is commonly due to low flow states but can also be due to arterial and venous occlusion. Radiologic diagnosis is critical as many present with nonspecific symptoms. Contrast-enhanced computed tomography (CT) is the modality of choice. Magnetic resonance imaging (MRI) is preferred in suspected appendicitis in pregnant patients and is superior in biliary necrosis. This article provides a pictorial review of the CT/MRI features of hollow abdominal organ ischemia while highlighting key clinical features, pathogenesis, and management. PMID:27317221

  14. Segmentation of urinary bladder in CT urography (CTU) using CLASS with enhanced contour conjoint procedure

    NASA Astrophysics Data System (ADS)

    Cha, Kenny; Hadjiiski, Lubomir; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Zhou, Chuan

    2014-03-01

    We are developing a computerized method for bladder segmentation in CT urography (CTU) for computeraided diagnosis of bladder cancer. A challenge for computerized bladder segmentation in CTU is that the bladder often contains regions filled with intravenous (IV) contrast and without contrast. Previously, we proposed a Conjoint Level set Analysis and Segmentation System (CLASS) consisting of four stages: preprocessing and initial segmentation, 3D and 2D level set segmentation, and post-processing. In case the bladder is partially filled with contrast, CLASS segments the non-contrast (NC) region and the contrast (C) filled region separately and conjoins the contours with a Contour Conjoint Procedure (CCP). The CCP is not trivial. Inaccuracies in the NC and C contours may cause CCP to exclude portions of the bladder. To alleviate this problem, we implemented model-guided refinement to propagate the C contour if the level set propagation in the region stops prematurely due to substantial non-uniformity of the contrast. An enhanced CCP with regularized energies further propagates the conjoint contours to the correct bladder boundary. Segmentation performance was evaluated using 70 cases. For all cases, 3D hand segmented contours were obtained as reference standard, and computerized segmentation accuracy was evaluated in terms of average volume intersection %, average % volume error, and average minimum distance. With enhanced CCP, those values were 84.4±10.6%, 8.3±16.1%, 3.4±1.8 mm, respectively. With CLASS, those values were 74.6±13.1%, 19.6±18.6%, 4.4±2.2 mm, respectively. The enhanced CCP improved bladder segmentation significantly (p<0.001) for all three performance measures.

  15. Effect of heart rate on CT angiography using the enhanced cardiac model of the 4D NCAT

    NASA Astrophysics Data System (ADS)

    Segars, W. P.; Taguchi, K.; Fung, G. S. K.; Fishman, E. K.; Tsui, B. M. W.

    2006-03-01

    We investigate the effect of heart rate on the quality and artifact generation in coronary artery images obtained using multi-slice computed tomography (MSCT) with the purpose of finding the optimal time resolution for data acquisition. To perform the study, we used the 4D NCAT phantom, a computer model of the normal human anatomy and cardiac and respiratory motions developed in our laboratory. Although capable of being far more realistic, the 4D NCAT cardiac model was originally designed for low-resolution imaging research, and lacked the anatomical detail to be applicable to high-resolution CT. In this work, we updated the cardiac model to include a more detailed anatomy and physiology based on high-resolution clinical gated MSCT data. To demonstrate its utility in high-resolution dynamic CT imaging research, the enhanced 4D NCAT was then used in a pilot simulation study to investigate the effect of heart rate on CT angiography. The 4D NCAT was used to simulate patients with different heart rates (60-120 beats/minute) and with various cardiac plaques of known size and location within the coronary arteries. For each simulated patient, MSCT projection data was generated with data acquisition windows ranging from 100 to 250 ms centered within the quiet phase (mid-diastole) of the heart using an analytical CT projection algorithm. CT images were reconstructed from the projection data, and the contrast of the plaques was then measured to assess the effect of heart rate and to determine the optimal time resolution required for each case. The 4D NCAT phantom with its realistic model for the cardiac motion was found to provide a valuable tool from which to optimize CT cardiac applications. Our results indicate the importance of optimizing the time resolution with regard to heart rate and plaque location for improved CT images at a reduced patient dose.

  16. Mapping the nasal airways: using histology to enhance CT-based three-dimensional reconstruction in Nycticebus.

    PubMed

    Deleon, Valerie Burke; Smith, Timothy D

    2014-11-01

    Three-dimensional reconstructions of imaging data are an increasingly common approach for studying anatomical structure. However, certain aspects of anatomy, including microscopic structure and differentiating tissue types, continue to benefit from traditional histological analyses. We present here a detailed methodology for combining data from microCT and histological imaging to create 3D virtual reconstructions for visualization and further analyses. We used this approach to study the distribution of olfactory mucosa on ethmoturbinal I of an adult pygmy slow loris, Nycticebus pygmaeus. MicroCT imaging of the specimen was followed by processing, embedding, and sectioning for histological analysis. We identified corresponding features in the CT and histological data, and used these to reconstruct the plane of section in the CT volume. The CT volume was then digitally re-sliced, such that orthogonal sections of the CT image corresponded to histological sections. Histological images were annotated for the features of interest (in this case, the contour of soft tissue on ethmoturbinal I and the extent of olfactory mucosa), and annotations were transferred to binary masks in the CT volume. These masks were combined with density-based surface reconstructions of the skull to create an enhanced 3D virtual reconstruction, in which the bony surfaces are coded for mucosal function. We identified a series of issues that may be raised in this approach, for example, deformation related to histological processing, and we make recommendations for addressing these issues. This method provides an evidence-based approach to 3D visualization and analysis of microscopic features in an anatomic context. PMID:25312369

  17. 18F-FDG PET/CT Role in Staging of Gastric Carcinomas: Comparison with Conventional Contrast Enhancement Computed Tomography

    PubMed Central

    Altini, Corinna; Niccoli Asabella, Artor; Di Palo, Alessandra; Fanelli, Margherita; Ferrari, Cristina; Moschetta, Marco; Rubini, Giuseppe

    2015-01-01

    Abstract The purpose of the report was to evaluate the role of fluorine-18 fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in staging gastric cancer comparing it with contrast enhancement computed tomography (CECT). This retrospective study included 45 patients who underwent performed whole body CECT and 18F-FDG PET/CT before any treatment. We calculated CECT and 18F-FDG PET/CT sensitivity, specificity, accuracy, positive and negative predictive values (PPV and NPV) for gastric, lymphnode, and distant localizations; furthermore, we compared the 2 techniques by McNemar test. The role of 18F-FDG PET/CT semiquantitative parameters in relation to histotype, grading, and site of gastric lesions were evaluated by ANOVA test. Sensitivity, specificity, accuracy, PPV and NPV of CECT, and 18F-FDG PET/CT for gastric lesion were, respectively, 92.11%, 57.14%, 86.66%, 92.11%, 57.14% and 81.58%, 85.71%, 82.22%, 96.88%, 46.15%. No differences were identified between the 2 techniques about sensitivity and specificity. No statistical differences were observed between PET parameters and histotype, grading, and site of gastric lesion. The results of CECT and 18F-FDG PET/CT about lymphnode involvement were 70.83%, 61.90%, 66.66%, 68%, 65% and 58.33%, 95.24%, 75.55%, 93.33%, 66.67%. The results of CECT and 18F-FDG PET/CT about distant metastases were 80%, 62.86%, 66.66%, 38.10%, 91.67% and 60%, 88.57%, 82.22%, 60%, 88.57%. 18FDG PET/CT specificity was significantly higher both for lymphnode and distant metastases. The 18F-FDG PET/CT is a useful tool for the evaluation of gastric carcinoma to detect primary lesion, lymphnode, and distant metastases using 1 single image whole-body technique. Integration of CECT with 18F-FDG PET/CT permits a more valid staging in these patients. PMID:25997066

  18. FDG PET with contrast-enhanced CT: a critical imaging tool for laryngeal carcinoma.

    PubMed

    Chu, Mae Mae A Y; Kositwattanarerk, Arpakorn; Lee, David J; Makkar, Jasnit S; Genden, Eric M; Kao, Johnny; Packer, Stuart H; Som, Peter M; Kostakoglu, Lale

    2010-09-01

    Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has evolved to be an essential imaging modality in the evaluation of laryngeal carcinoma. Although the modality has limited utility in assessing the extent of the primary tumor, FDG PET has proved to be superior to anatomic modalities in the detection of lymph node and distant metastases. The role of FDG PET in the evaluation of patients with laryngeal tumors that are clinically classified as N0 has not shown consistent usefulness because of the innate resolution limitations of the camera. In the posttherapy setting, however, FDG PET has consistently demonstrated a high negative predictive value in the identification of recurrent disease, both during the course of therapy and during long-term follow-up. In addition, contrast material-enhanced computed tomography (CT) in conjunction with FDG PET has demonstrated a complementary role by allowing for superior anatomic coregistration and therefore more definitive diagnosis. There is sufficient evidence that with further advances in PET technology, this modality will likely become more useful in the detection of small lesions and occult nodal disease, as well as in guiding the management of laryngeal carcinoma. PMID:20833855

  19. Correction of lumen contrast-enhancement influence on non-calcified coronary atherosclerotic plaque quantification on CT.

    PubMed

    Kristanto, Wisnumurti; Tuncay, Volkan; Vliegenthart, Rozemarijn; van Ooijen, Peter M A; Oudkerk, Matthijs

    2015-02-01

    Lumen contrast-enhancement influences non-calcified atherosclerotic plaque Hounsfield-unit (HU) values in computed tomography (CT). This study aimed to construct and validate an algorithm to correct for this influence. Three coronary vessel phantoms with 1, 2, and 4 mm circular hollow lumina; with normal and plaque-infested walls were scanned simultaneously in oil using a dual-source CT scanner. Scanning was repeated as the lumina were alternately filled with water and four contrast solutions (100-400 HU, at 100 HU intervals). Images were reconstructed at 0.4 mm x-y pixel size. Pixel-by-pixel comparisons of contrast-enhanced and non-contrast-enhanced images confirmed exponential declining patterns in lumen contrast-enhancement influence on wall HU-values from the lumen border (y = Ae(-λx) + c). The median difference of the inside and outside 2-pixel radius part of the contrast-enhanced coronary phantom wall to the reference (non-contrast-enhanced images) was 45 and 2 HU, respectively. Based on the lumen contrast-enhancement influence patterns, a generalized correction algorithm was formulated. Application of the generalized correction algorithm to the inside 2-pixel radius part of the wall reduced the median difference to the reference to 4 HU. In conclusion, lumen contrast-enhancement influence on the vessel wall can be defined by an exponential approximation, allowing correction of the CT density of the vessel wall closest to the lumen. With this correction, a more accurate determination of vessel wall composition can be made. PMID:25326412

  20. High Intra-abdominal Pressure Enhances the Penetration and Antitumor Effect of Intraperitoneal Cisplatin on Experimental Peritoneal Carcinomatosis

    PubMed Central

    Esquis, Philippe; Consolo, David; Magnin, Guy; Pointaire, Philippe; Moretto, Philippe; Ynsa, Maria Dolores; Beltramo, Jean-Luc; Drogoul, Carole; Simonet, Michel; Benoit, Laurent; Rat, Patrick; Chauffert, Bruno

    2006-01-01

    Objective: To investigate the role of increased intra-abdominal pressure (IAP) on the intratumoral accumulation and the antitumor effect of intraperitoneal cisplatin in rats with advanced peritoneal carcinomatosis. To evaluate the tolerance of IAP in pigs, as it is a large animal with a body size equivalent to humans. Summary Background Data: To investigate if an active convection, driven by a positive IAP, increases cisplatin penetration and antitumor effectiveness in a model of advanced peritoneal carcinomatosis in rats. Experimental Design: BDIX rats with macroscopic peritoneal tumors received cisplatin administered as intravenous injection (IV), conventional intraperitoneal injection (IP), or sustained intraperitoneal injection of cisplatin given in a large volume of solvent for maintaining IAP for 1 hour. Platinum tissue concentration was measured by atomic absorption spectroscopy (AAS), and platinum distribution into the tumor nodules was assessed by the particular-induced x-ray emission (PIXE) method. The antitumor effect was assessed in a survival experiment. The hemodynamic, local, and systemic tolerance of IAP, with or without cisplatin, was evaluated in Large White pigs. Results: The maximum tolerated IAP was 22 mm Hg for 1 hour in nonventilated rats. IAP, in comparison with IV or conventional IP injections, resulted in the increased concentration and depth of diffusion of platinum into diaphragm and peritoneal tumor nodules. Consequently, IAP treatment induced an extended survival of rats treated at an advanced stage of carcinomatosis. In 7 50- to 70-kg ventilated pigs, a 40-mm Hg IAP was well tolerated when maintained stable for 2 hours. Renal failure occurred in pigs receiving a total dose of 200 and 400 mg of cisplatin with IAP, but a dose of 100 mg was well tolerated. Conclusions: Intraperitoneal chemotherapy with increased IAP, in comparison with conventional IP or IV chemotherapy, improved the tumor accumulation and the antitumor effect of

  1. 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, ...

  2. 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.

  3. Cancers of the oral cavity and oropharynx: FDG PET with contrast-enhanced CT in the posttreatment setting.

    PubMed

    King, Kevin G; Kositwattanarerk, Arpakorn; Genden, Eric; Kao, Johnny; Som, Peter M; Kostakoglu, Lale

    2011-01-01

    The combined use of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and contrast material-enhanced computed tomography (CT) for posttreatment monitoring of cancers of the oral cavity and oropharynx has steadily increased in recent years. FDG PET/CT offers many advantages for evaluating the effects of therapy, determining whether residual or recurrent disease is present, and assessing the extent of nodal disease. Because of the high negative predictive value of this imaging test, some have advocated the deferral of neck dissection in patients with negative findings at FDG PET/CT after chemotherapy and radiation therapy; positive findings may have a similarly heavy influence on the future course of treatment. Thus, the accuracy of image interpretation is crucial. However, the interpretation of posttreatment FDG PET images is challenging, with multiple potential pitfalls and limitations that could lead to an incorrect analysis. Accuracy depends on a detailed knowledge of the patient's treatment history and a thorough understanding of the kinds of changes that might result from treatment. Awareness of the principles underlying the selection of the optimal interval between the completion of treatment and the first follow-up FDG PET/CT examination is especially important, since an interval that is too short could lead to false-positive or false-negative findings. A period of 12 weeks or more is generally recommended, but the optimal waiting period depends on the extent of therapy and other factors. If recurrence or progression is suspected during the waiting period, contrast-enhanced CT or magnetic resonance imaging should be performed without FDG PET. PMID:21415184

  4. The Utility of Gadoxetic Acid-Enhanced MR Imaging to Characterize Atypical Cirrhotic Nodules Detected on Dynamic CT Images

    PubMed Central

    Chou, Chen-Te; Wu, Wen-Pei; Chen, Chia-Bang; Su, Wei-Wen; Chen, Ran-Chou; Chen, Yao-Li

    2014-01-01

    Purpose To evaluate whether gadoxetic acid (Gd-EOB-DTPA)-enhanced MR images of tumors taken during the hepatocyte-specific phase can aid in the differentiation between hepatocellular carcinoma (HCC) and dysplastic nodules (DNs) in patients with atypical cirrhotic nodules detected on dynamic CT images. Materials and Methods Seventy-one patients with 112 nodules showing atypical dynamic enhancement on CT images underwent gadoxetic acid-enhanced MR imaging (MRI) studies. Using a reference standard, we determined that 33 of the nodules were DNs and that 79 were true HCCs. Tumor size, signal intensity on precontrast T1-weighted images (T1WI) and T2WI, and the pattern of dynamic enhancement on MR images taken in the hepatocyte-phase were determined. Results There were significant differences in tumor size, hyperintensity on T2WI, hypointensity on T1WI, typical HCC enhancement pattern on dynamic MR images, or hypointensity on hepatocyte-phase images between DNs and HCC. The sensitivity and specificity were 60.8% and 87.9% for T2WI, 38.0% and 87.9% for T1WI, 17.7% and 100% for dynamic MR imaging, 83.5% and 84.9% for hepatocyte-phase imaging, and 60.8% and 87.9% for tumor size (threshold of 1.7 cm). Conclusion Gd-EOB-DTPA-enhanced hepatocyte-phase imaging is recommended for patients at high risk of HCC who present with atypical lesions on dynamic CT images. PMID:25310817

  5. Enhanced reading time efficiency by use of automatically unfolded CT rib reformations in acute trauma.

    PubMed

    Bier, Georg; Schabel, Christoph; Othman, Ahmed; Bongers, Malte N; Schmehl, Jörg; Ditt, Hendrik; Nikolaou, Konstantin; Bamberg, Fabian; Notohamiprodjo, Mike

    2015-11-01

    Rationale of this study was to evaluate whether unfolded rib images enhance time efficiency in detection of rib fractures and time efficiency in patients with acute thoracic trauma. 51 subsequent patients with thoracic trauma underwent 64-slice computed tomography. 1mm thick axial slices were reformatted using a commercially available post-processing software application generating rotatable unfolded rib images. Diagnostic accuracy was evaluated by 3 readers and compared to multiplanar reformations of the original CT images. Reformation and evaluation times were recorded. 116 rib fractures were detected. The multiplanar reformation analysis yielded a sensitivity of 87.9%/93.9%/79.7% with a specificity of 97%/97%/82.2%, whilst the unfolded rib image analysis yielded a sensitivity of 94.8%/94.8%/92.2% and a specificity of 85.2/87.8%/82.4 (p=0.06/0.8/0.04) with high inter-observer agreement (k=0.79-0.85). The mean reading time for the multiplanar reformations was significantly longer (reader 1: 103.7 ± 27.1s/reader 2: 81.8 ± 40.6s/reader 3: 154.3 ± 39.2s) than the evaluation of the unfolded rib images (19.4 ± 4.9s/26.9 ± 15.0s/49.9 ± 18.7s; p<0.01). Concluding, the unfolded rib display reduces reading time for detection of rib fractures in acute thoracic trauma patients significantly and does not compromise the diagnostic accuracy significantly in experienced radiologists. However, unexperienced readers may profit from use of this display. PMID:26226916

  6. Influence of cone beam CT enhancement filters on diagnosis ability of longitudinal root fractures

    PubMed Central

    Nascimento, M C C; Nejaim, Y; de Almeida, S M; Bóscolo, F N; Haiter-Neto, F; Sobrinho, L C

    2014-01-01

    Objectives: To determine whether cone beam CT (CBCT) enhancement filters influence the diagnosis of longitudinal root fractures. Methods: 40 extracted human posterior teeth were endodontically prepared, and fractures with no separation of fragments were made in 20 teeth of this sample. The teeth were placed in a dry mandible and scanned using a Classic i-CAT® CBCT device (Imaging Sciences International, Inc., Hatfield, PA). Evaluations were performed with and without CBCT filters (Sharpen Mild, Sharpen Super Mild, S9, Sharpen, Sharpen 3 × 3, Angio Sharpen Medium 5 × 5, Angio Sharpen High 5 × 5 and Shadow 3 × 3) by three oral radiologists. Inter- and intraobserver agreement was calculated by the kappa test. Accuracy, sensitivity, specificity and positive and negative predictive values were determined. McNemar test was applied for agreement between all images vs the gold standard and original images vs images with filters (p < 0.05). Results: Means of intraobserver agreement ranged from good to excellent. Angio Sharpen Medium 5 × 5 filter obtained the highest positive predictive value (80.0%) and specificity value (76.5%). Angio Sharpen High 5 × 5 filter obtained the highest sensitivity (78.9%) and accuracy (77.5%) value. Negative predictive value was the highest (82.9%) for S9 filter. The McNemar test showed no statistically significant differences between images with and without CBCT filters (p > 0.05). Conclusions: Although no statistical differences was observed in the diagnosis of root fractures when using filters, these filters seem to improve diagnostic capacity for longitudinal root fractures. Further in vitro studies with endodontic-treated teeth and research in vivo should be considered. PMID:24408819

  7. Computed tomography appearance of inflammatory myofibroblastic tumor in the abdomen: CT features and pathologic correlation

    PubMed Central

    Liu, Bo; Xu, Junlong; Wang, Jiaxin; Fan, Hongguang; Ang, Xuan; Liu, Wenming

    2015-01-01

    Objective: To evaluate CT findings of abdominal inflammatory myofibroblastic tumor (IMT) and the relationship with morphological character. Materials and Methods: CT examinations and pathological findings of ten intra-abdominal IMTs were retrospectively analyzed. The histopathological characteristics of the IMTs were confirmed by two pathologists and two radiologists evaluated CT findings of the lesion, with emphasis on the imaging features compared with the corresponding histopathology. Results: The most common imaging characteristics were presence of heterogeneity, all tumors showed varying degrees of contrast enhancement. Two major different CT patterns were individualized. In type one, the tumor had a distinct boundary without a lobular appearance and displayed hypo-enhanced enhancement after administration of contrast in correlated with the mainly histopathologic findings of spindle cells myxoid and hypocellular fibrous (6/10; 60%). In type two, the lesions exhibited indistinct boundaries or complete capsule, ill-defined growth patterns or low intralesional attenuation with marked heterogeneous or circumferential enhancement, which correlated well with the presence of abundance of micromodule and inflammatory cell infiltration (4/10; 40%). Conclusions: Two major different contrast enhancement CT patterns were individualized can help to determine the relationships with histopathologic findings, while cannot be reliably differentiated from other solid lesions based solely on the CT appearance, combined with diagnostic biopsy may facilitate to achieve a correct diagnosis and treatment. PMID:26629216

  8. TH-A-18C-08: Design of a Small Animal Contrast Enhanced Dual Energy CT

    SciTech Connect

    Martin, R; Pan, T; Li, B

    2014-06-15

    Purpose: Dual energy CT has a variety of uses in a small animal setting including quantification and enhanced visualization of contrast agent. This study aims to determine the best energy combinations for contrast enhanced DECT on the XRAD 225Cx (Precision x-ray), a small animal IGRT system with a nominal energy range of 20 – 225 kVp. Focus was placed on material density accuracy and low contrast detectability. Methods: Simulations of single energy scans of an object containing concentrations of iodine varying from 0.5 to 50 mg/ml were performed using the simulation package ImaSim. Energy spectra from 50 – 220 kVp were calculated using the same software. For approximate Poisson noise modeling, mAs were chosen such that 30% of the total 10cGy dose was assigned to the low energy scan. A calibration involving projections of objects containing different thicknesses of iodine (0–0.5 mm) and water (0–50 mm) was performed for each energy and fit to a cubic equation as the calibration curve for each energy pair. Results: Contrast to noise ratios of the iodine material images and accuracies in iodine density measurements were measured. Gradual improvements in each metric were seen with increasing high energy. Larger improvements in CNR were observed for decreasing the low energy. Errors in iodine density were generally close to 5% for concentrations of iodine above 3 mg/ml but increased to around 15% for 50 kVp, likely due to its proximity to the discontinuity caused by the k-edge of iodine. Conclusion: Based on these simulations, the best energy combination for detecting low concentrations of iodine using a projection space calibration procedure is 50/200 kVp. However, if accuracy is most important 80/220 kVp is ideal, with 60/220 kVp being a good compromise to achieve both goals. Future work is necessary to verify these conclusions with physical data.

  9. Contrast Enhancement of MicroCT Scans to Aid 3D Modelling of Carbon Fibre Fabric Composites

    NASA Astrophysics Data System (ADS)

    Djukic, Luke P.; Pearce, Garth M.; Herszberg, Israel; Bannister, Michael K.; Mollenhauer, David H.

    2013-12-01

    This paper presents a methodology for volume capture and rendering of plain weave and multi-layer fabric meso-architectures within a consolidated, cured laminate. Micro X-ray Computed Tomography (MicroCT) is an excellent tool for the non-destructive visualisation of material microstructures however the contrast between tows and resin is poor for carbon fibre composites. Firstly, this paper demonstrates techniques to improve the contrast of the microCT images by introducing higher density materials such as gold, iodine and glass into the fabric. Two approaches were demonstrated to be effective for enhancing the differentiation between the tows in the reconstructed microCT visualisations. Secondly, a method of generating three-dimensional volume models of woven composites using microCT scan data is discussed. The process of generating a model is explained from initial manufacture with the aid of an example plain weave fabric. These methods are to be used in the finite element modelling of three-dimensional fabric preforms in future work.

  10. Evaluating dynamic contrast-enhanced and photoacoustic CT to assess intra-tumor heterogeneity in xenograft mouse models

    NASA Astrophysics Data System (ADS)

    Stantz, Keith M.; Liu, Bo; Cao, Minsong; Reinecke, Dan; Dzemidzic, Mario; Liang, Yun; Kruger, Robert

    2006-03-01

    Purpose: To evaluate photoacoustic CT spectroscopy (PCT-S) and dynamic contrast-enhanced CT (DCE-CT) ability to measure parameters - oxygen saturation and vascular physiology - associated with the intra-tumor oxygenation status. Material and Methods: Breast (VEGF165 enhance MCF-7) and ovarian (SKOV3x) cancer cells were implanted into the fat pads and flanks of immune deficient mice and allowed to grow to a diameter of 8-15 mm. CT was used to determine physiological parameters by acquiring a sequence of scans over a 10 minute period after an i.v. injection of a radio-opaque contrast agent (Isovue). These time-dependent contrast-enhanced curves were fit to a two-compartmental model determining tumor perfusion, fractional plasma volume, permeability-surface area produce, and fractional interstitial volume on a voxel-by-voxel basis. After which, the tumors were imaged using photoacoustic CT (Optosonics, Inc., Indianapolis, IN 46202). The near infrared spectra (700-910 nm) within the vasculature was fit to linear combination of measured oxy- and deoxy-hemoglobin blood samples to obtain oxygen saturation levels (SaO II). Results: The PCT-S scanner was first calibrated using different samples of oxygenated blood, from which a statistical error ranging from 2.5-6.5% was measured and a plot of the hemoglobin dissociation curve was consistent with empirical formula. In vivo determination of tumor vasculature SaO II levels were measurably tracked, and spatially correlated to the periphery of the tumor. Tumor depend variations in SaO II - 0.32 (ovarian) and 0.60 (breast) - and in vascular physiology - perfusion, 1.03 and 0.063 mL/min/mL, and fractional plasma volume, 0.20 and 0.07 - were observed. Conclusion: Combined, PCT-S and CED-CT has the potential to measure intra-tumor levels of tumor oxygen saturation and vascular physiology, key parameters associated with hypoxia.

  11. 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.

  12. 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.

  13. Initial evaluation of virtual un-enhanced imaging derived from fast kVp-switching dual energy contrast enhanced CT for the abdomen

    NASA Astrophysics Data System (ADS)

    Joshi, M.; Mendonca, P.; Okerlund, D.; Lamb, P.; Kulkarni, N.; Pinho, D.; Sahani, D.; Bhotika, R.

    2011-03-01

    The feasibility and utility of creating virtual un-enhanced images from contrast enhanced data acquired using a fast switching dual energy CT acquisition, is explored. Utilizing projection based material decomposition data, monochromatic images are generated and a Multi-material decomposition technique is applied. Quantitative and qualitative evaluation is performed to assess the equivalence of Virtual Un-Enhanced (VUE) and True Un-enhanced (TUE) for multiple tissue types and different organs in the abdomen. Ten patient cases were analyzed where a TUE and a subsequent Contrast Enhanced (CE) acquisition were obtained using fast kVp-switching dual energy CT utilizing Gemstone Spectral Imaging. Quantitative measurements were made by placing multiple Regions of Interest on the different tissues and organs in both the TUE and the VUE images. The absolute Hounsfield Unit (HU) differences in the mean values between TUE & VUE were calculated as well as the differences of the standard deviations. Qualitative analysis was done by two radiologists for overall image quality, presence of residual contrast, appearance of pathology, appearance and contrast of normal tissues and organs in comparison to the TUE. There is a very strong correlation between the TUE and VUE images.

  14. Delayed contrast enhancement imaging of a murine model for ischemia reperfusion with carbon nanotube micro-CT.

    PubMed

    Burk, Laurel M; Wang, Ko-Han; Wait, John Matthew; Kang, Eunice; Willis, Monte; Lu, Jianping; Zhou, Otto; Lee, Yueh Z

    2015-01-01

    We aim to demonstrate the application of free-breathing prospectively gated carbon nanotube (CNT) micro-CT by evaluating a myocardial infarction model with a delayed contrast enhancement technique. Evaluation of murine cardiac models using micro-CT imaging has historically been limited by extreme imaging requirements. Newly-developed CNT-based x-ray sources offer precise temporal resolution, allowing elimination of physiological motion through prospective gating. Using free-breathing, cardiac-gated CNT micro-CT, a myocardial infarction model can be studied non-invasively and with high resolution. Myocardial infarction was induced in eight male C57BL/6 mice aged 8-12 weeks. The ischemia reperfusion model was achieved by surgically occluding the LAD artery for 30 minutes followed by 24 hours of reperfusion. Tail vein catheters were placed for contrast administration. Iohexol 300 mgI/mL was administered followed by images obtained in diastole. Iodinated lipid blood pool contrast agent was then administered, followed with images at systole and diastole. Respiratory and cardiac signals were monitored externally and used to gate the scans of free-breathing subjects. Seven control animals were scanned using the same imaging protocol. After imaging, the heart was harvested, cut into 1mm slices and stained with TTC. Post-processing analysis was performed using ITK-Snap and MATLAB. All animals demonstrated obvious delayed contrast enhancement in the left ventricular wall following the Iohexol injection. The blood pool contrast agent revealed significant changes in cardiac function quantified by 3-D volume ejection fractions. All subjects demonstrated areas of myocardial infarct in the LAD distribution on both TTC staining and micro-CT imaging. The CNT micro-CT system aids straightforward, free-breathing, prospectively-gated 3-D murine cardiac imaging. Delayed contrast enhancement allows identification of infarcted myocardium after a myocardial ischemic event. We demonstrate

  15. Delayed Contrast Enhancement Imaging of a Murine Model for Ischemia Reperfusion with Carbon Nanotube Micro-CT

    PubMed Central

    Burk, Laurel M.; Wang, Ko-Han; Wait, John Matthew; Kang, Eunice; Willis, Monte; Lu, Jianping; Zhou, Otto; Lee, Yueh Z.

    2015-01-01

    We aim to demonstrate the application of free-breathing prospectively gated carbon nanotube (CNT) micro-CT by evaluating a myocardial infarction model with a delayed contrast enhancement technique. Evaluation of murine cardiac models using micro-CT imaging has historically been limited by extreme imaging requirements. Newly-developed CNT-based x-ray sources offer precise temporal resolution, allowing elimination of physiological motion through prospective gating. Using free-breathing, cardiac-gated CNT micro-CT, a myocardial infarction model can be studied non-invasively and with high resolution. Myocardial infarction was induced in eight male C57BL/6 mice aged 8–12 weeks. The ischemia reperfusion model was achieved by surgically occluding the LAD artery for 30 minutes followed by 24 hours of reperfusion. Tail vein catheters were placed for contrast administration. Iohexol 300mgI/mL was administered followed by images obtained in diastole. Iodinated lipid blood pool contrast agent was then administered, followed with images at systole and diastole. Respiratory and cardiac signals were monitored externally and used to gate the scans of free-breathing subjects. Seven control animals were scanned using the same imaging protocol. After imaging, the heart was harvested, cut into 1mm slices and stained with TTC. Post-processing analysis was performed using ITK-Snap and MATLAB. All animals demonstrated obvious delayed contrast enhancement in the left ventricular wall following the Iohexol injection. The blood pool contrast agent revealed significant changes in cardiac function quantified by 3-D volume ejection fractions. All subjects demonstrated areas of myocardial infarct in the LAD distribution on both TTC staining and micro-CT imaging. The CNT micro-CT system aids straightforward, free-breathing, prospectively-gated 3-D murine cardiac imaging. Delayed contrast enhancement allows identification of infarcted myocardium after a myocardial ischemic event. We demonstrate

  16. Contrast Enhanced Abdominal Ultrasound in the Assessment of Ileal Inflammation in Crohn’s Disease: A Comparison with MR Enterography

    PubMed Central

    Horjus Talabur Horje, C. S.; Roovers, L.; Groenen, M. J. M.; Wahab, P. J.

    2015-01-01

    Background and Aims To prospectively examine the feasibility and accuracy of Contrast Enhanced Ultrasound (CEUS) in the assessment of Crohn’s disease (CD) activity in the terminal ileum in comparison to Magnetic Resonance Enterography (MRE), using endoscopy as a reference standard. Methods 105 consecutive patients with alleged clinically active CD were assessed by MRE and CEUS. CEUS of the terminal ileum was performed using an intravenous microbubble contrast enhancer. Accuracy values of CEUS and MRE for the presence of active terminal ileitis were evaluated using the Receiver Operating Characteristic method, using endoscopic findings as a reference standard. Sensitivity and specificity values of MRE and CEUS were compared by the McNemar test. Results CEUS was feasible in 98% of patients, MRE in all. Optimal diagnostic accuracy in CEUS was obtained at a peak intensity value of 10%, showing 100% sensitivity, 92% specificity and an accuracy of 99% in demonstrating ileal mucosal inflammation. For MRE, overall sensitivity, specificity and accuracy were, 87%, 100%, and 88%, respectively. CEUS and MRE were highly correlated in assessing length and wall thickness of the terminal ileum. CEUS identified 11 of 16 MRE-detected strictures, but no fistulae. Conclusion The accuracy of CEUS is comparable to that of MRE in the assessment of active, uncomplicated terminal ileal CD and therefore a valuable bedside alternative to MRE in the follow-up of these patients. PMID:26322970

  17. Evaluation of stopping criteria for level set segmentation of breast masses in contrast-enhanced dedicated breast CT

    NASA Astrophysics Data System (ADS)

    Kuo, H.; Giger, M. L.; Reiser, I.; Boone, J. M.; Lindfors, K. K.; Yang, K.; Edwards, A.

    2012-03-01

    Dedicated breast CT (bCT) is an emerging technology that produces 3D images of the breast, thus allowing radiologists to detect and evaluate breast lesions in 3D. However, assessing potential cancers in the bCT volume can prove time consuming and difficult. Thus, we are developing automated 3D lesion segmentation methods to aid in the interpretation of bCT images. Based on previous studies using a 3D radial-gradient index (RGI) method [1], we are investigating whether 3D active contour segmentation can be applied in 3D to capture additional details of the lesion margin. Our data set includes 40 contract-enhanced bCT scans. Based on a radiologist-marked lesion center of each mass, an initial RGI contour is obtained that serves as the input to an active contour segmentation method. In this study, active contour level set segmentation, an iterative segmentation technique, is extended to 3D. Three stopping criteria are compared, based on 1) the change of volume (ΔV/V), 2) the mean value of the increased volume at each iteratin (dμ/dt), and 3) the changing rate of intensity inside and outside the lesion (Δvw). Lesion segmentation was evaluated by determining the overlap ratio between computer-determined segmentations and manually-drawn lesion outlines. For a given lesion, the overlap ratio was averaged across coronal, sagittal, and axial planes. The average overlap ratios for the three stopping criteria were found to be 0.66 (ΔV/V), 0.68 (dμ/dt), 0.69 (Δvw).

  18. Comparison of Contrast-Enhanced Ultrasound and Computed Tomography in Classifying Endoleaks After Endovascular Treatment of Abdominal Aorta Aneurysms: Preliminary Experience

    SciTech Connect

    Carrafiello, Gianpaolo Lagana, Domenico; Recaldini, Chiara; Mangini, Monica; Bertolotti, Elena; Caronno, Roberto; Tozzi, Matteo; Piffaretti, Gabriele; Annibale Genovese, Eugenio; Fugazzola, Carlo

    2006-12-15

    The purpose of the study was to assess the effectiveness of contrast-enhanced ultrasonography (CEUS) in endoleak classification after endovascular treatment of an abdominal aortic aneurysm compared to computed tomography angiography (CTA). From May 2001 to April 2003, 10 patients with endoleaks already detected by CTA underwent CEUS with Sonovue (registered) to confirm the CTA classification or to reclassify the endoleak. In three conflicting cases, the patients were also studied with conventional angiography. CEUS confirmed the CTA classification in seven cases (type II endoleaks). Two CTA type III endoleaks were classified as type II using CEUS and one CTA type II endoleak was classified as type I by CEUS. Regarding the cases with discordant classification, conventional angiography confirmed the ultrasound classification. Additionally, CEUS documented the origin of type II endoleaks in all cases. After CEUS reclassification of endoleaks, a significant change in patient management occurred in three cases. CEUS allows a better attribution of the origin of the endoleak, as it shows the flow in real time. CEUS is more specific than CTA in endoleak classification and gives more accurate information in therapeutic planning.

  19. 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

  20. SU-E-J-154: Image Quality Assessment of Contrast-Enhanced 4D-CT for Pancreatic Adenocarcinoma in Radiotherapy Simulation

    SciTech Connect

    Choi, W; Xue, M; Patel, K; Regine, W; Wang, J; D’Souza, W; Lu, W; Kang, M; Klahr, P

    2015-06-15

    Purpose: This study presents quantitative and qualitative assessment of the image qualities in contrast-enhanced (CE) 3D-CT, 4D-CT and CE 4D-CT to identify feasibility for replacing the clinical standard simulation with a single CE 4D-CT for pancreatic adenocarcinoma (PDA) in radiotherapy simulation. Methods: Ten PDA patients were enrolled and underwent three CT scans: a clinical standard pair of CE 3D-CT immediately followed by a 4D-CT, and a CE 4D-CT one week later. Physicians qualitatively evaluated the general image quality and regional vessel definitions and gave a score from 1 to 5. Next, physicians delineated the contours of the tumor (T) and the normal pancreatic parenchyma (P) on the three CTs (CE 3D-CT, 50% phase for 4D-CT and CE 4D-CT), then high density areas were automatically removed by thresholding at 500 HU and morphological operations. The pancreatic tumor contrast-to-noise ratio (CNR), signal-tonoise ratio (SNR) and conspicuity (C, absolute difference of mean enhancement levels in P and T) were computed to quantitatively assess image quality. The Wilcoxon rank sum test was used to compare these quantities. Results: In qualitative evaluations, CE 3D-CT and CE 4D-CT scored equivalently (4.4±0.4 and 4.3±0.4) and both were significantly better than 4D-CT (3.1±0.6). In quantitative evaluations, the C values were higher in CE 4D-CT (28±19 HU, p=0.19 and 0.17) than the clinical standard pair of CE 3D-CT and 4D-CT (17±12 and 16±17 HU, p=0.65). In CE 3D-CT and CE 4D-CT, mean CNR (1.8±1.4 and 1.8±1.7, p=0.94) and mean SNR (5.8±2.6 and 5.5±3.2, p=0.71) both were higher than 4D-CT (CNR: 1.1±1.3, p<0.3; SNR: 3.3±2.1, p<0.1). The absolute enhancement levels for T and P were higher in CE 4D-CT (87, 82 HU) than in CE 3D-CT (60, 56) and 4DCT (53, 70). Conclusions: The individually optimized CE 4D-CT is feasible and achieved comparable image qualities to the clinical standard simulation. This study was supported in part by Philips Healthcare.

  1. High-resolution CT by diffraction-enhanced x-ray imaging: mapping of breast tissue samples and comparison with their histo-pathology.

    PubMed

    Bravin, Alberto; Keyriläinen, Jani; Fernández, Manuel; Fiedler, Stefan; Nemoz, Christian; Karjalainen-Lindsberg, Marja-Liisa; Tenhunen, Mikko; Virkkunen, Pekka; Leidenius, Marjut; von Smitten, Karl; Sipilä, Petri; Suortti, Pekka

    2007-04-21

    The aim of this study was to introduce high-resolution computed tomography (CT) of breast tumours using the diffraction-enhanced x-ray imaging (DEI) technique and to compare results with radiological and histo-pathological examinations. X-ray CT images of tumour-bearing breast tissue samples were acquired by monochromatic synchrotron radiation (SR). Due to the narrow beam and a large sample-to-detector distance scattering is rejected in the absorption contrast images (SR-CT). Large contrast enhancement is achieved by the use of the DEI-CT method, where the effects of refraction and scatter rejection are analysed by crystal optics. Clinical mammograms and CT images were recorded as reference material for a radiological examination. Three malignant and benign samples were studied in detail. Their radiographs were compared with optical images of stained histological sections. The DEI-CT images map accurately the morphology of the samples, including collagen strands and micro-calcifications of dimensions less than 0.1 mm. Histo-pathological examination and reading of the radiographs were done independently, and the conclusions were in general agreement. High-resolution DEI-CT images show strong contrast and permit visualization of details invisible in clinical radiographs. The radiation dose may be reduced by an order of magnitude without compromising image quality, which would make possible clinical in vivo DEI-CT with future compact SR sources. PMID:17404464

  2. Interaction of CtBP with adenovirus E1A suppresses immortalization of primary epithelial cells and enhances virus replication during productive infection

    SciTech Connect

    Subramanian, T.; Zhao, Ling-jun; Chinnadurai, G.

    2013-09-01

    Adenovirus E1A induces cell proliferation, oncogenic transformation and promotes viral replication through interaction with p300/CBP, TRRAP/p400 multi-protein complex and the retinoblastoma (pRb) family proteins through distinct domains in the E1A N-terminal region. The C-terminal region of E1A suppresses E1A/Ras co-transformation and interacts with FOXK1/K2, DYRK1A/1B/HAN11 and CtBP1/2 (CtBP) protein complexes. To specifically dissect the role of CtBP interaction with E1A, we engineered a mutation (DL→AS) within the CtBP-binding motif, PLDLS, and investigated the effect of the mutation on immortalization and Ras cooperative transformation of primary cells and viral replication. Our results suggest that CtBP–E1A interaction suppresses immortalization and Ras co-operative transformation of primary rodent epithelial cells without significantly influencing the tumorigenic activities of transformed cells in immunodeficient and immunocompetent animals. During productive infection, CtBP–E1A interaction enhances viral replication in human cells. Between the two CtBP family proteins, CtBP2 appears to restrict viral replication more than CtBP1 in human cells. - Highlights: • Adenovirus E1A C-terminal region suppresses E1A/Ras co-transformation. • This E1A region binds with FOXK, DYRK1/HAN11 and CtBP cellular protein complexes. • We found that E1A–CtBP interaction suppresses immortalization and transformation. • The interaction enhances viral replication in human cells.

  3. Mechanical small bowel obstruction following a blunt abdominal trauma: A case report

    PubMed Central

    Zirak-Schmidt, Samira; El-Hussuna, Alaa

    2015-01-01

    Introduction Intestinal obstruction following abdominal trauma has previously been described. However, in most reported cases pathological finding was intestinal stenosis. Presentation of the case A 51-year-old male was admitted after a motor vehicle accident. Initial focused abdominal sonogram for trauma and enhanced computerized tomography were normal, however there was a fracture of the tibia. Three days later, he complained of abdominal pain, constipation, and vomiting. An exploratory laparotomy showed bleeding from the omentum and mechanical small bowel obstruction due to a fibrous band. Discussion The patient had prior abdominal surgery, but clinical and radiological findings indicate that the impact of the motor vehicle accident initiated his condition either by causing rotation of a bowel segment around the fibrous band, or by formation of a fibrous band secondary to minimal bleeding from the omentum. Conclusion High index of suspicion of intestinal obstruction is mandatory in trauma patients presenting with complaints of abdominal pain, vomiting, and constipation despite uneventful CT scan. PMID:26566436

  4. Three-dimensional texture analysis of contrast enhanced CT images for treatment response assessment in Hodgkin lymphoma: Comparison with F-18-FDG PET

    SciTech Connect

    Knogler, Thomas; El-Rabadi, Karem; Weber, Michael; Karanikas, Georgios; Mayerhoefer, Marius E.

    2014-12-15

    Purpose: To determine the diagnostic performance of three-dimensional (3D) texture analysis (TA) of contrast-enhanced computed tomography (CE-CT) images for treatment response assessment in patients with Hodgkin lymphoma (HL), compared with F-18-fludeoxyglucose (FDG) positron emission tomography/CT. Methods: 3D TA of 48 lymph nodes in 29 patients was performed on venous-phase CE-CT images before and after chemotherapy. All lymph nodes showed pathologically elevated FDG uptake at baseline. A stepwise logistic regression with forward selection was performed to identify classic CT parameters and texture features (TF) that enable the separation of complete response (CR) and persistent disease. Results: The TF fraction of image in runs, calculated for the 45° direction, was able to correctly identify CR with an accuracy of 75%, a sensitivity of 79.3%, and a specificity of 68.4%. Classical CT features achieved an accuracy of 75%, a sensitivity of 86.2%, and a specificity of 57.9%, whereas the combination of TF and CT imaging achieved an accuracy of 83.3%, a sensitivity of 86.2%, and a specificity of 78.9%. Conclusions: 3D TA of CE-CT images is potentially useful to identify nodal residual disease in HL, with a performance comparable to that of classical CT parameters. Best results are achieved when TA and classical CT features are combined.

  5. Interobserver and Intraobserver Reproducibility with Volume Dynamic Contrast Enhanced Computed Tomography (DCE-CT) in Gastroesophageal Junction Cancer

    PubMed Central

    Lundsgaard Hansen, Martin; Fallentin, Eva; Axelsen, Thomas; Lauridsen, Carsten; Norling, Rikke; Svendsen, Lars Bo; Nielsen, Michael Bachmann

    2016-01-01

    The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT) measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal junction cancer were selected from a previous longitudinal study. Three radiologists independently reviewed all scans, and one repeated the analysis eight months later for intraobserver analysis. Review of the scans consisted of three analysis methods: (I) Four, fixed small sized regions of interest (2-dimensional (2D) fixed ROIs) placed in the tumor periphery, (II) 2-dimensional regions of interest (2D-ROI) along the tumor border in the tumor center, and (III) 3-dimensional volumes of interest (3D-VOI) containing the entire tumor volume. Arterial flow, blood volume and permeability (ktrans) were recorded for each observation. Inter- and intra-observer variability were assessed by Intraclass Correlation Coefficient (ICC) and Bland-Altman statistics. Interobserver ICC was excellent for arterial flow (0.88), for blood volume (0.89) and for permeability (0.91) with 3D-VOI analysis. The 95% limits of agreement were narrower for 3D analysis compared to 2D analysis. Three-dimensional volume DCE-CT analysis of gastroesophageal junction cancer provides higher inter- and intra-observer reproducibility with narrower limits of agreement between readers compared to 2D analysis. PMID:26838804

  6. 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

  7. A segmentation and point-matching enhanced efficient deformable image registration method for dose accumulation between HDR CT images

    NASA Astrophysics Data System (ADS)

    Zhen, Xin; Chen, Haibin; Yan, Hao; Zhou, Linghong; Mell, Loren K.; Yashar, Catheryn M.; Jiang, Steve; Jia, Xun; Gu, Xuejun; Cervino, Laura

    2015-04-01

    Deformable image registration (DIR) of fractional high-dose-rate (HDR) CT images is challenging due to the presence of applicators in the brachytherapy image. Point-to-point correspondence fails because of the undesired deformation vector fields (DVF) propagated from the applicator region (AR) to the surrounding tissues, which can potentially introduce significant DIR errors in dose mapping. This paper proposes a novel segmentation and point-matching enhanced efficient DIR (named SPEED) scheme to facilitate dose accumulation among HDR treatment fractions. In SPEED, a semi-automatic seed point generation approach is developed to obtain the incremented fore/background point sets to feed the random walks algorithm, which is used to segment and remove the AR, leaving empty AR cavities in the HDR CT images. A feature-based ‘thin-plate-spline robust point matching’ algorithm is then employed for AR cavity surface points matching. With the resulting mapping, a DVF defining on each voxel is estimated by B-spline approximation, which serves as the initial DVF for the subsequent Demons-based DIR between the AR-free HDR CT images. The calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative analysis and visual inspection of the DIR results indicate that SPEED can suppress the impact of applicator on DIR, and accurately register HDR CT images as well as deform and add interfractional HDR doses.

  8. A segmentation and point-matching enhanced efficient deformable image registration method for dose accumulation between HDR CT images.

    PubMed

    Zhen, Xin; Chen, Haibin; Yan, Hao; Zhou, Linghong; Mell, Loren K; Yashar, Catheryn M; Jiang, Steve; Jia, Xun; Gu, Xuejun; Cervino, Laura

    2015-04-01

    Deformable image registration (DIR) of fractional high-dose-rate (HDR) CT images is challenging due to the presence of applicators in the brachytherapy image. Point-to-point correspondence fails because of the undesired deformation vector fields (DVF) propagated from the applicator region (AR) to the surrounding tissues, which can potentially introduce significant DIR errors in dose mapping. This paper proposes a novel segmentation and point-matching enhanced efficient DIR (named SPEED) scheme to facilitate dose accumulation among HDR treatment fractions. In SPEED, a semi-automatic seed point generation approach is developed to obtain the incremented fore/background point sets to feed the random walks algorithm, which is used to segment and remove the AR, leaving empty AR cavities in the HDR CT images. A feature-based 'thin-plate-spline robust point matching' algorithm is then employed for AR cavity surface points matching. With the resulting mapping, a DVF defining on each voxel is estimated by B-spline approximation, which serves as the initial DVF for the subsequent Demons-based DIR between the AR-free HDR CT images. The calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative analysis and visual inspection of the DIR results indicate that SPEED can suppress the impact of applicator on DIR, and accurately register HDR CT images as well as deform and add interfractional HDR doses. PMID:25790059

  9. Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI

    PubMed Central

    Dietrich, Christoph F; Kratzer, Wolfgang; Strobel, Deike; Danse, Etienne; Fessl, Robert; Bunk, Alfred; Vossas, Udo; Hauenstein, Karlheinz; Koch, Wilhelm; Blank, Wolfgang; Oudkerk, Matthijs; Hahn, Dietbert; Greis, Christian

    2006-01-01

    AIM: To evaluate contrast-enhanced ultrasonography (CEUS) using SonoVue® in the detection of liver metastases in patients with known extrahepatic primary tumors versus the combined gold standard comprising CT, MRI and clinical/histological data. METHODS: It is an international multicenter study, and there were 12 centres and 125 patients (64 males, 61 females, aged 59 ± 11 years) involved, with 102 patients per protocol. Primary tumors were colorectal in 35 %, breast in 27 %, pancreatic in 17 % and others in 21 %. CEUS using SonoVue® was employed with a low-mechanical-index technique and contrast-specific software using Siemens Elegra, Philips HDI 5000 and Acuson Sequoia; continuous scanning for at least five minutes. RESULTS: CEUS with SonoVue® increased significantly the number of focal liver lesions detected versus unenhanced sonography. In 31.4 % of the patients, more lesions were found after contrast enhancement. The total numbers of lesions detected were comparable with CEUS (55), triple-phase spiral CT (61) and MRI with a liver-specific contrast agent (53). Accuracy of detection of metastatic disease (i.e. at least one metastatic lesion) was significantly higher for CEUS (91.2 %) than for unenhanced sonography (81.4 %) and was similar to that of triple-phase spiral CT (89.2 %). In 53 patients whose CEUS examination was negative, a follow-up examination 3-6 mo later confirmed the absence of metastatic lesions in 50 patients (94.4 %). CONCLUSION: CEUS is proved to be reliable in the detection of liver metastases in patients with known extrahepatic primary tumors and suspected liver lesions. PMID:16586537

  10. 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 ...

  11. 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 ...

  12. FDG PET/CT Findings in Multiple Splenic Amebomas (Amebic Granulomas).

    PubMed

    Dong, Aisheng; Wang, Yang; Zuo, Changjing; Zhu, Huaimin

    2016-05-01

    Splenic ameboma (amebic granuloma) is rare. A 38-year-old man with a severe pneumonia due to inhalation of swimming pool water 18 months ago complained of night sweat, tiredness, and anorexia for 1 month. Abdominal ultrasound showed multiple nodules in the spleen. These nodules showed slight enhancement on enhanced CT and intense FDG uptake on PET/CT. Splenectomy was performed. Multiple splenic amebomas were confirmed by pathology. Free-living amoebae were also detected in samples of pleural effusion and blood. Splenic ameboma, although rare, should be included in the differential diagnosis with isolated focally increased FDG activity in the spleen. PMID:26505858

  13. Multimodal visualization of 3D enhanced MRI and CT of acoustic schwannoma and related structures

    NASA Astrophysics Data System (ADS)

    Kucharski, Tomasz; Kujawinska, Malgorzata; Niemczyk, Kazimierz; Marchel, Andrzej

    2005-09-01

    According to the necessity of supporting vestibular schwannoma surgery, there is a demand to develop a convenient method of medical data visualization. The process of making choice of optimal operating access way has been uncomfortable for a surgeon so far, because there has been a necessity of analyzing two independent 3D images series (CT -bone tissues visible, MRI - soft tissues visible) in the region of ponto-cerebellar angle tumors. The authors propose a solution that will improve this process. The system used is equipped with stereoscopic helmet mounted display. It allows merged CT and MRI data representing tissues in the region of of ponto-cerebellar angle to be visualized in stereoscopic way. The process of data preparation for visualization includes: -automated segmentation algorithms, -different types of 3D images (CT, MRI) fusion. The authors focused on the development of novel algorithms for segmentation of vestibular schwannoma. It is important and difficult task due to different types of tumors and their inhomogeneous character dependent on growth models. The authors propose algorithms based on histogram spectrum and multimodal character of MRI imaging (T1 and T2 modes). However due to a variety of objects the library of algorithms with specific modifications matching to selected types of images is proposed. The applicability and functionality of the algorithms and library was proved on the series of data delivered by Warsaw Central Medical University Hospital.

  14. Myocardial Extracellular Volume Fraction with Dual-Energy Equilibrium Contrast-enhanced Cardiac CT in Nonischemic Cardiomyopathy: A Prospective Comparison with Cardiac MR Imaging.

    PubMed

    Lee, Hye-Jeong; Im, Dong Jin; Youn, Jong-Chan; Chang, Suyon; Suh, Young Joo; Hong, Yoo Jin; Kim, Young Jin; Hur, Jin; Choi, Byoung Wook

    2016-07-01

    Purpose To evaluate the feasibility of equilibrium contrast material-enhanced dual-energy cardiac computed tomography (CT) to determine extracellular volume fraction (ECV) in nonischemic cardiomyopathy (CMP) compared with magnetic resonance (MR) imaging. Materials and Methods This study was approved by the institutional review board; informed consent was obtained. Seven healthy subjects and 23 patients (six with hypertrophic CMP, nine with dilated CMP, four with amyloidosis, and four with sarcoidosis) (mean age ± standard deviation, 57.33 years ± 14.82; 19 male participants [63.3%]) were prospectively enrolled. Twelve minutes after contrast material injection (1.8 mL/kg at 3 mL/sec), dual-energy cardiac CT was performed. ECV was measured by two observers independently. Hematocrit levels were compared between healthy subjects and patients with the Mann-Whitney U test. In per-subject analysis, interobserver agreement for CT was assessed with the intraclass correlation coefficient (ICC), and intertest agreement between MR imaging and CT was assessed with Bland-Altman analysis. In per-segment analysis, Student t tests in the linear mixed model were used to compare ECV on CT images between healthy subjects and patients. Results Hematocrit level was 43.44% ± 1.80 for healthy subjects and 41.23% ± 5.61 for patients with MR imaging (P = .16) and 43.50% ± 1.92 for healthy subjects and 41.35% ± 5.92 for patients with CT (P = .15). For observer 1 in per-subject analysis, ECV was 34.18% ± 8.98 for MR imaging and 34.48% ± 8.97 for CT. For observer 2, myocardial ECV was 34.42% ± 9.03 for MR imaging and 33.98% ± 9.05 for CT. Interobserver agreement for ECV at CT was excellent (ICC = 0.987). Bland-Altman analysis between MR imaging and CT showed a small bias (-0.06%), with 95% limits of agreement of -1.19 and 1.79. Compared with healthy subjects, patients with hypertrophic CMP, dilated CMP, amyloidosis, and sarcoidosis had significantly higher myocardial ECV at dual

  15. SU-D-207-01: Markerless Respiratory Motion Tracking with Contrast Enhanced Thoracic Cone Beam CT Projections

    SciTech Connect

    Chao, M; Yuan, Y; Rosenzweig, K; Lo, Y; Brousmiche, S

    2015-06-15

    Purpose: To develop a novel technique to enhance the image contrast of clinical cone beam CT projections and extract respiratory signals based on anatomical motion using the modified Amsterdam Shroud (AS) method to benefit image guided radiation therapy. Methods: Thoracic cone beam CT projections acquired prior to treatment were preprocessed to increase their contrast for better respiratory signal extraction. Air intensity on raw images was firstly estimated and then applied to correct the projections to generate new attenuation images that were subsequently improved with deeper anatomy feature enhancement through taking logarithm operation, derivative along superior-inferior direction, respectively. All pixels on individual post-processed two dimensional images were horizontally summed to one column and all projections were combined side by side to create an AS image from which patient’s respiratory signal was extracted. The impact of gantry rotation on the breathing signal rendering was also investigated. Ten projection image sets from five lung cancer patients acquired with the Varian Onboard Imager on 21iX Clinac (Varian Medical Systems, Palo Alto, CA) were employed to assess the proposed technique. Results: Application of the air correction on raw projections showed that more than an order of magnitude of contrast enhancement was achievable. The typical contrast on the raw projections is around 0.02 while that on attenuation images could greater than 0.5. Clear and stable breathing signal can be reliably extracted from the new images while the uncorrected projection sets failed to yield clear signals most of the time. Conclusion: Anatomy feature plays a key role in yielding breathing signal from the projection images using the AS technique. The air correction process facilitated the contrast enhancement significantly and attenuation images thus obtained provides a practical solution to obtaining markerless breathing motion tracking.

  16. Automatic segmentation of abdominal vessels for improved pancreas localization

    NASA Astrophysics Data System (ADS)

    Farag, Amal; Liu, Jiamin; Summers, Ronald M.

    2014-03-01

    Accurate automatic detection and segmentation of abdominal organs from CT images is important for quantitative and qualitative organ tissue analysis as well as computer-aided diagnosis. The large variability of organ locations, the spatial interaction between organs that appear similar in medical scans and orientation and size variations are among the major challenges making the task very difficult. The pancreas poses these challenges in addition to its flexibility which allows for the shape of the tissue to vastly change. Due to the close proximity of the pancreas to numerous surrounding organs within the abdominal cavity the organ shifts according to the conditions of the organs within the abdomen, as such the pancreas is constantly changing. Combining these challenges with typically found patient-to-patient variations and scanning conditions the pancreas becomes harder to localize. In this paper we focus on three abdominal vessels that almost always abut the pancreas tissue and as such useful landmarks to identify the relative location of the pancreas. The splenic and portal veins extend from the hila of the spleen and liver, respectively, travel through the abdominal cavity and join at a position close to the head of the pancreas known as the portal confluence. A third vein, the superior mesenteric vein, anastomoses with the other two veins at the portal confluence. An automatic segmentation framework for obtaining the splenic vein, portal confluence and superior mesenteric vein is proposed using 17 contrast enhanced computed-tomography datasets. The proposed method uses outputs from the multi-organ multi-atlas label fusion and Frangi vesselness filter to obtain automatic seed points for vessel tracking and generation of statistical models of the desired vessels. The approach shows ability to identify the vessels and improve localization of the pancreas within the abdomen.

  17. 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

  18. Computer-aided detection of hepatocellular carcinoma in multiphase contrast-enhanced hepatic CT: a preliminary study

    NASA Astrophysics Data System (ADS)

    Xu, Jian-Wu; Suzuki, Kenji; Hori, Masatoshi; Oto, Aytekin; Baron, Richard

    2011-03-01

    Malignant liver tumors such as hepatocellular carcinoma (HCC) account for 1.25 million deaths each year worldwide. Early detection of HCC is sometimes difficult on CT images because the attenuation of HCC is often similar to that of normal liver parenchyma. Our purpose was to develop computer-aided detection (CADe) of HCC using both arterial phase (AP) and portal-venous phase (PVP) of contrast-enhanced CT images. Our scheme consisted of liver segmentation, tumor candidate detection, feature extraction and selection, and classification of the candidates as HCC or non-lesions. We used a 3D geodesic-active-contour model coupled with a level-set algorithm to segment the liver. Both hyper- and hypo-dense tumors were enhanced by a sigmoid filter. A gradient-magnitude filter followed by a watershed algorithm was applied to the tumor-enhanced images for segmenting closed-contour regions as HCC candidates. Seventy-five morphologic and texture features were extracted from the segmented candidate regions in both AP and PVP images. To select most discriminant features for classification, we developed a sequential forward floating feature selection method directly coupled with a support vector machine (SVM) classifier. The initial CADe before the classification achieved a 100% (23/23) sensitivity with 33.7 (775/23) false positives (FPs) per patient. The SVM with four selected features removed 96.5% (748/775) of the FPs without any removal of the HCCs in a leave-one-lesion-out cross-validation test; thus, a 100% sensitivity with 1.2 FPs per patient was achieved, whereas CADe using AP alone produced 6.4 (147/23) FPs per patient at the same sensitivity level.

  19. Fifty Years of Technological Innovation: Potential and Limitations of Current Technologies in Abdominal Magnetic Resonance Imaging and Computed Tomography.

    PubMed

    Attenberger, Ulrike I; Morelli, John; Budjan, Johannes; Henzler, Thomas; Sourbron, Steven; Bock, Michael; Riffel, Philipp; Hernando, Diego; Ong, Melissa M; Schoenberg, Stefan O

    2015-09-01

    Magnetic resonance imaging (MRI) has become an important modality for the diagnosis of intra-abdominal pathology. Hardware and pulse sequence developments have made it possible to derive not only morphologic but also functional information related to organ perfusion (dynamic contrast-enhanced MRI), oxygen saturation (blood oxygen level dependent), tissue cellularity (diffusion-weighted imaging), and tissue composition (spectroscopy). These techniques enable a more specific assessment of pathologic lesions and organ functionality. Magnetic resonance imaging has thus transitioned from a purely morphologic examination to a modality from which image-based disease biomarkers can be derived. This fits well with several emerging trends in radiology, such as the need to accurately assess response to costly treatment strategies and the need to improve lesion characterization to potentially avoid biopsy. Meanwhile, the cost-effectiveness, availability, and robustness of computed tomography (CT) ensure its place as the current workhorse for clinical imaging. Although the lower soft tissue contrast of CT relative to MRI is a long-standing limitation, other disadvantages such as ionizing radiation exposure have become a matter of public concern. Nevertheless, recent technical developments such as dual-energy CT or dynamic volume perfusion CT also provide more functional imaging beyond morphology.The aim of this article was to review and discuss the most important recent technical developments in abdominal MRI and state-of-the-art CT, with an eye toward the future, providing examples of their clinical utility for the evaluation of hepatic and renal pathologies. PMID:26039773

  20. 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

  1. 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.

  2. Enhanced detection of the vertebrae in 2D CT-images

    NASA Astrophysics Data System (ADS)

    Graf, Franz; Greil, Robert; Kriegel, Hans-Peter; Schubert, Matthias; Cavallaro, Alexander

    2012-02-01

    In recent years, a considerable amount of methods have been proposed for detecting and reconstructing the spine and the vertebrae from CT and MR scans. The results are either used for examining the vertebrae or serve as a preprocessing step for further detection and annotation tasks. In this paper, we propose a method for reliably detecting the position of the vertebrae on a single slice of a transversal body CT scan. Thus, our method is not restricted by the available portion of the 3D scan, but even suffices with a single 2D image. A further advantage of our method is that detection does not require adjusting parameters or direct user interaction. Technically, our method is based on an imaging pipeline comprising five steps: The input image is preprocessed. The relevant region of the image is extracted. Then, a set of candidate locations is selected based on bone density. In the next step, image features are extracted from the surrounding of the candidate locations and an instance-based learning approach is used for selecting the best candidate. Finally, a refinement step optimizes the best candidate region. Our proposed method is validated on a large diverse data set of more than 8 000 images and improves the accuracy in terms of area overlap and distance from the true position significantly compared to the only other method being proposed for this task so far.

  3. Comparison of Multidetector CT and Gadobutrol-Enhanced MR Imaging for Evaluation of Small, Solid Pancreatic Lesions

    PubMed Central

    Choi, Tae Won; Kim, Jung Hoon; Yu, Mi Hye; Han, Joon Koo; Choi, Byung Ihn

    2016-01-01

    Objective To compare multidetector computed tomography (MDCT) and MRI for lesion conspicuity, as well as the detection and characterization of small solid pancreatic lesions (SPLs). Materials and Methods 193 patients with small SPLs (< 3 cm) and 52 patients with normal pancreas who underwent both multiphasic MDCT and gadobutrol-enhanced MRI were included in our study. Two radiologists blinded to the pathologic diagnoses independently reviewed those images, and determined the detection of "SPL per se" and "SPL in consideration of secondary features", the lesion conspicuity, the probability of pancreatic ductal adenocarcinoma (PDAC), and the most likely specific diagnosis. Results The sensitivity of MRI for "detection of SPL per se" was significantly higher than that of CT in both reviewers: 92.7% (179/193) and 97.9% (189/193), respectively, for reviewer 1 (p = 0.031) and 90.7% (175/193) and 99.5% (192/193), respectively, for reviewer 2 (p < 0.001). In addition, MRI provided better lesion conspicuity than MDCT for both reviewers (p < 0.001). However, CT and MRI did not show significant difference in sensitivity for "detection of SPL in consideration of secondary features", specificity for SPL detection, and differentiation of PDAC vs. non-PDAC (p > 0.05). The accuracies of CT and MRI for making a specific diagnosis were as follows: 85.7% (210/245) vs. 86.9% (213/245), respectively, for reviewer 1 (p = 0.736), and 91.8% (225/245) vs. 93.5% (229/245), respectively, for reviewer 2 (p = 0.454). Conclusion MRI showed better lesion conspicuity than MDCT, but did not show significantly different diagnostic performance compared with MDCT for detecting and characterizing small SPLs. PMID:27390542

  4. Screening of mixed surfactant systems: Phase behavior studies and CT imaging of surfactant-enhanced oil recovery experiments

    SciTech Connect

    Llave, F.M.; Gall, B.L.; Lorenz, P.B.; Cook, I.M.; Scott, L.J.

    1993-11-01

    A systematic chemical screening study was conducted on selected anionic-nonionic and nonionic-nonionic systems. The objective of the study was to evaluate and determine combinations of these surfactants that would exhibit favorable phase behavior and solubilization capacity. The effects of different parameters including (a) salinity, (b) temperature, (c) alkane carbon number, (c) hydrophilic/lipophilic balance (HLB) of nonionic component, and (d) type of surfactant on the behavior of the overall chemical system were evaluated. The current work was conducted using a series of ethoxylated nonionic surfactants in combinations of several anionic systems with various hydrocarbons. Efforts to correlate the behavior of these mixed systems led to the development of several models for the chemical systems tested. The models were used to compare the different systems and provided some guidelines for formulating them to account for variations in salinity, oil hydrocarbon number, and temperature. The models were also evaluated to determine conformance with the results from experimental measurements. The models provided good agreement with experimental results. X-ray computed tomography (CT) was used to study fluid distributions during chemical enhanced oil recovery experiments. CT-monitored corefloods were conducted to examine the effect of changing surfactant slug size injection on oil bank formation and propagation. Reducing surfactant slug size resulted in lower total oil production. Oil recovery results, however, did not correlate with slug size for the low-concentration, alkaline, mixed surfactant system used in these tests. The CT measurements showed that polymer mobility control and core features also affected the overall oil recovery results.

  5. Contrast-Enhanced Proton Radiography for Patient Set-up by Using X-Ray CT Prior Knowledge

    SciTech Connect

    Spadea, Maria Francesca; Fassi, Aurora; Zaffino, Paolo; Riboldi, Marco; Baroni, Guido; Depauw, Nicolas; Seco, Joao

    2014-11-01

    Purpose: To obtain a contrasted image of the tumor region during the setup for proton therapy in lung patients, by using proton radiography and x-ray computed tomography (CT) prior knowledge. Methods and Materials: Six lung cancer patients' CT scans were preprocessed by masking out the gross tumor volume (GTV), and digitally reconstructed radiographs along the planned beam's eye view (BEV) were generated, for a total of 27 projections. Proton radiographies (PR) were also computed for the same BEV through Monte Carlo simulations. The digitally reconstructed radiograph was subtracted from the corresponding proton image, resulting in a contrast-enhanced proton radiography (CEPR). Michelson contrast analysis was performed both on PR and CEPR. The tumor region was then automatically segmented on CEPR and compared to the ground truth (GT) provided by physicians in terms of Dice coefficient, accuracy, precision, sensitivity, and specificity. Results: Contrast on CEPR was, on average, 4 times better than on PR. For 10 lateral projections (±45° off of 90° or 270°), although it was not possible to distinguish the tumor region in the PR, CEPR offers excellent GTV visibility. The median ± quartile values of Dice, precision, and accuracy indexes were 0.86 ± 0.03, 0.86 ± 0.06, and 0.88 ± 0.02, respectively, thus confirming the reliability of the method in highlighting tumor boundaries. Sensitivity and specificity analysis demonstrated that there is no systematic over- or underestimation of the tumor region. Identification of the tumor boundaries using CEPR resulted in a more accurate and precise definition of GTV compared to that obtained from pretreatment CT. Conclusions: In most proton centers, the current clinical protocol is to align the patient using kV imaging with bony anatomy as a reference. We demonstrated that CEPR can significantly improve tumor visualization, allowing better patient set-up and permitting image guided proton therapy (IGPT)

  6. Evaluation of Hepatic Tumor Response to Yttrium-90 Radioembolization Therapy using Texture Signatures Generated from Contrast-Enhanced CT Images

    PubMed Central

    Gensure, Rebekah H.; Foran, David J.; Lee, Vincent M.; Gendel, Vyacheslav M.; Jabbour, Salma K.; Carpizo, Darren R.; Nosher, John L.; Yang, Lin

    2012-01-01

    Rationale and Objectives The aim of this study was to explore the use of texture features generated from liver computed tomographic (CT) datasets as potential image-based indicators of patient response to radioembolization (RE) with yttrium-90 (90Y) resin microspheres, an emerging locoregional therapy for advanced-stage liver cancer. Materials and Methods Overall post-therapy survival and percent change in serologic tumor marker at three months post-therapy represent the primary clinical outcomes in this study. Thirty advanced-stage liver cancer cases (primary and metastatic) treated with RE over a three year period were included. Texture signatures for tumor regions, which were delineated to reveal boundaries with normal regions, were computed from pre-treatment contrast-enhanced liver CT studies and evaluated for their ability to classify patient serologic response and survival. Results A series of systematic leave-one-out cross-validation studies using soft-margin support vector machine (SVM) classifiers showed hepatic tumor texton and local binary pattern (LBP) signatures both achieve high accuracy (96%) in discriminating subjects in terms of their serologic response. The image-based indicators were also accurate in classifying subjects by survival status (80% and 93% accuracy for texton and LBP signatures, respectively). Conclusions Hepatic texture signatures generated from tumor regions on pre-treatment triphasic CT studies were highly accurate in differentiating among subjects in terms of serologic response and survival. These image-based computational markers show promise as potential predictive tools in candidate evaluation for locoregional therapy such as RE. PMID:22841288

  7. 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.

  8. Hypoxia inhibits abdominal expiratory nerve activity.

    PubMed

    Fregosi, R F; Knuth, S L; Ward, D K; Bartlett, D

    1987-07-01

    Our purpose was to examine the influence of steady-state changes in chemical stimuli, as well as discrete peripheral chemoreceptor stimulation, on abdominal expiratory motor activity. In decerebrate, paralyzed, vagotomized, and ventilated cats that had bilateral pneumothoraces, we recorded efferent activity from a phrenic nerve and from an abdominal nerve (cranial iliohypogastric nerve, L1). All cats showed phasic expiratory abdominal nerve discharge at normocapnia [end-tidal PCO2 38 +/- 2 Torr], but small doses (2-6 mg/kg) of pentobarbital sodium markedly depressed this activity. Hyperoxic hypercapnia consistently enhanced abdominal expiratory activity and shortened the burst duration. Isocapnic hypoxia caused inhibition of abdominal nerve discharge in 11 of 13 cats. Carotid sinus nerve denervation (3 cats) exacerbated the hypoxic depression of abdominal nerve activity and depressed phrenic motor output. Stimulation of peripheral chemoreceptors with NaCN increased abdominal nerve discharge in 7 of 10 cats, although 2 cats exhibited marked inhibition. Four cats with intact neuraxis, but anesthetized with ketamine, yielded qualitatively similar results. We conclude that when cats are subjected to steady-state chemical stimuli in isolation (no interference from proprioceptive inputs), hypercapnia potentiates, but hypoxia attenuates, abdominal expiratory nerve activity. Mechanisms to explain the selective inhibition of expiratory motor activity by hypoxia are proposed, and physiological implications are discussed. PMID:3624126

  9. Surgical repair of ruptured abdominal aortic aneurysm with non-bleeding aortocaval fistula.

    PubMed

    Unosawa, Satoshi; Kimura, Haruka; Niino, Tetsuya

    2013-01-01

    We present a case of an aortocaval fistula (ACF) without bleeding because a clot was covering the fistula. A 60-year-old man was diagnosed as having a ruptured abdominal aortic aneurysm (AAA) and an aortocaval fistula, by enhanced computed tomography (CT). After the aneurysm had been opened, the fistula was detected, but there was no bleeding because it was covered with clot. After graft repair, bleeding from the fistula occurred when the clot was removed by suction. Direct closure of the fistula was achieved after bleeding was controlled by digital compression. PMID:23825505

  10. 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

  11. Calcifications of the Thoracic Aorta on Extended Non-Contrast-Enhanced Cardiac CT

    PubMed Central

    Craiem, Damian; Chironi, Gilles; Casciaro, Mariano E.; Graf, Sebastian; Simon, Alain

    2014-01-01

    Background The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC) can be assessed from computed tomography (CT) scans, originally aimed at coronary artery calcium (CAC) assessment. CAC screening improves cardiovascular risk prediction, beyond standard risk assessment, whereas TAC performance remains controversial. However, the curvilinear portion of the thoracic aorta (TA), that includes the aortic arch, is systematically excluded from TAC analysis. We investigated the prevalence and spatial distribution of TAC all along the TA, to see how those segments that remain invisible in standard TA evaluation were affected. Methods and Results A total of 970 patients (77% men) underwent extended non-contrast cardiac CT scans including the aortic arch. An automated algorithm was designed to extract the vessel centerline and to estimate the vessel diameter in perpendicular planes. Then, calcifications were quantified using the Agatston score and associated with the corresponding thoracic aorta segment. The aortic arch and the proximal descending aorta, “invisible” in routine CAC screening, appeared as two vulnerable sites concentrating 60% of almost 11000 calcifications. The aortic arch was the most affected segment per cm length. Using the extended measurement method, TAC prevalence doubled from 31% to 64%, meaning that 52% of patients would escape detection with a standard scan. In a stratified analysis for CAC and/or TAC assessment, 111 subjects (46% women) were exclusively identified with the enlarged scan. Conclusions Calcium screening in the TA revealed that the aortic arch and the proximal descending aorta, hidden in standard TA evaluations, concentrated most of the calcifications. Middle-aged women were more prone to have calcifications in those hidden portions and became candidates for reclassification. PMID:25302677

  12. Combined subcutaneous, intrathoracic and abdominal splenosis.

    PubMed

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue. PMID:20804314

  13. Teng-Long-Bu-Zhong-Tang, a Chinese herbal formula, enhances anticancer effects of 5 - Fluorouracil in CT26 colon carcinoma

    PubMed Central

    2013-01-01

    Background Colorectal cancer remains one of the leading causes of cancer death worldwide. Traditional Chinese Medicine (TCM) has played a positive role in colorectal cancer treatment. There is a great need to establish effective herbal formula for colorectal cancer treatment. Based on TCM principles and clinical practices, we have established an eight herbs composed formula for colorectal cancer treatment, which is Teng-Long-Bu-Zhong-Tang (TLBZT). We have demonstrated the anticancer effects of TLBZT against colorectal carcinoma in vitro. In present study, we evaluated the anticancer potential of TLBZT, used alone or in combination with low dose of 5-Fluorouracil (5-Fu), in CT26 colon carcinoma in vivo. Methods CT26 colon carcinoma was established in BALB/c mice and treated with TLBZT, 5-Fu, or TLBZT plus 5-Fu. The tumor volumes were observed. Apoptosis was detected by TUNEL assay. Caspases activities were detected by colorimetric assay. Cell senescence was indentified by senescence β-galactosidase staining. Gene expression and angiogenesis was observed by immunohistochemistry or western blot. Results TLBZT significantly inhibited CT26 colon carcinoma growth. TLBZT elicited apoptosis in CT26 colon carcinoma, accompanied by Caspase-3, 8, and 9 activation and PARP cleavage, and downregulation of XIAP and Survivin. TLBZT also induced cell senescence in CT26 colon carcinoma, with concomitant upregulation of p16 and p21 and downregulation of RB phosphorylation. In addition, angiogenesis and VEGF expression in CT26 colon carcinoma was significantly inhibited by TLBZT treatment. Furthermore, TLBZT significantly enhanced anticancer effects of 5-Fu in CT26 colon carcinoma. Conclusions TLBZT exhibited significantly anticancer effect, and enhanced the effects of 5-Fu in CT26 colon carcinoma, which may correlate with induction of apoptosis and cell senescence, and angiogenesis inhibition. The present study provides new insight into TCM approaches for colon cancer treatment

  14. 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

  15. Dynamic contrast-enhanced x-ray CT measurement of cerebral blood volume in a rabbit tumor model

    NASA Astrophysics Data System (ADS)

    Cenic, Aleksa; Lee, Ting-Yim; Craen, Rosemary A.; Gelb, Adrian W.

    1998-07-01

    Cerebral blood volume (CBV) is a major determinant of intracranial pressure (ICP). Hyperventilation is commonly employed to reduce raised ICP (e.g. in brain tumour patients) presumably through its effect on CBV. With the advent of slip- ring CT scanners, dynamic contrast-enhanced imaging allows for the measurement of CBV with high spatial resolution. Using a two-compartment model to characterize the distribution of X- ray contrast agent in the brain, we have developed a non- equilibrium CT method to measure CBV in normal and pathological regions. We used our method to investigate the effect of hyperventilation on CBV during propofol anaesthesia in rabbits with implanted brain tumours. Eight New Zealand White rabbits with implanted VX2 carcinoma brain tumours were studied. For each rabbit, regional CBV measurements were initially made at normocapnia (PaCO2 40 mmHg) and then at hyperventilation (PaCO2 25 mmHg) during propofol anaesthesia. The head was positioned such that a coronal image through the brain incorporated a significant cross-section of the brain tumour as well as a radial artery in a forelimb. Images at the rate of 1 per second were acquired for 2 minutes as Omnipaque 300 (1.5 ml/kg rabbit weight) was injected via a peripheral vein. In these CT images, regions of interest in the brain tissue (e.g. tumour, contra-lateral normal, and peri-tumoural) and the radial artery were drawn. For each region, the mean CT number in pre-contrast images was subtracted from the mean CT number in post-contrast images to produce either the tissue contrast concentration curve, or the arterial contrast concentration curve. Using our non- equilibrium analysis method based on a two-compartment model, regional CBV values were determined from the measured contrast concentration curves. From our study, the mean CBV values [+/- SD] in the tumour, peri-tumoural, and contra-lateral normal regions during normocapnia were: 5.47 plus or minus 1.97, 3.28 plus or minus 1.01, and 1

  16. An automatic machine learning system for coronary calcium scoring in clinical non-contrast enhanced, ECG-triggered cardiac CT

    NASA Astrophysics Data System (ADS)

    Wolterink, Jelmer M.; Leiner, Tim; Takx, Richard A. P.; Viergever, Max A.; Išgum, Ivana

    2014-03-01

    Presence of coronary artery calcium (CAC) is a strong and independent predictor of cardiovascular events. We present a system using a forest of extremely randomized trees to automatically identify and quantify CAC in routinely acquired cardiac non-contrast enhanced CT. Candidate lesions the system could not label with high certainty were automatically identified and presented to an expert who could relabel them to achieve high scoring accuracy with minimal effort. The study included 200 consecutive non-contrast enhanced ECG-triggered cardiac CTs (120 kV, 55 mAs, 3 mm section thickness). Expert CAC annotations made as part of the clinical routine served as the reference standard. CAC candidates were extracted by thresholding (130 HU) and 3-D connected component analysis. They were described by shape, intensity and spatial features calculated using multi-atlas segmentation of coronary artery centerlines from ten CTA scans. CAC was identified using a randomized decision tree ensemble classifier in a ten-fold stratified cross-validation experiment and quantified in Agatston and volume scores for each patient. After classification, candidates with posterior probability indicating uncertain labeling were selected for further assessment by an expert. Images with metal implants were excluded. In the remaining 164 images, Spearman's p between automatic and reference scores was 0.94 for both Agatston and volume scores. On average 1.8 candidate lesions per scan were subsequently presented to an expert. After correction, Spearman's p was 0.98. We have described a system for automatic CAC scoring in cardiac CT images which is able to effectively select difficult examinations for further refinement by an expert.

  17. Individually optimized uniform contrast enhancement in CT angiography for the diagnosis of pulmonary thromboembolic disease—A simulation study

    SciTech Connect

    Xue, Ming; Zhang, Hao; D’Souza, Warren; Lu, Wei; Kligerman, Seth; Klahr, Paul

    2013-12-15

    Purpose: To improve the diagnostic quality of CT pulmonary angiography (CTPA) by individually optimizing a biphasic contrast injection function to achieve targeted uniform contrast enhancement. To compare the results against a previously reported discrete Fourier transform (DFT) approach. Methods: This simulation study used the CTPA datasets of 27 consecutive patients with pulmonary thromboembolic disease (PE). An optimization approach was developed consisting of (1) computation of the impulse enhancement function (IEF) based on a test bolus scan, and (2) optimization of a biphasic contrast injection function using the IEF in order to achieve targeted uniform enhancement. The injection rates and durations of a biphasic contrast injection function are optimized by minimizing the difference between the resulting contrast enhancement curve and the targeted uniform enhancement curve, while conforming to the clinical constraints of injection rate and total contrast volume. The total contrast volume was limited first to the clinical standard of 65 ml, and then to the same amount used in the DFT approach for comparison. The optimization approach and the DFT approach were compared in terms of the root mean square error (RMSE) and total contrast volume used. Results: When the total contrast volume was limited to 65 ml, the optimization approach produced significantly better contrast enhancement (closer to the targeted uniform contrast enhancement) than the DFT approach (RMSE 17 HU vs 56 HU,p < 0.00001). On average, the optimization approach used 63 ml contrast, while the DFT approach used 50 ml with four patients exceeding 65 ml. When equivalent total contrast volume was used for individual patient, the optimization approach still generated significantly better contrast enhancement (RMSE 44 HU vs 56 HU, p < 0.01). Constraints for the injection function could be easily accommodated into the optimization process when searching for the optimal biphasic injection function

  18. [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

  19. [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

  20. 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

  1. 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

  2. Investigating the use of texture features for analysis of breast lesions on contrast-enhanced cone beam CT

    NASA Astrophysics Data System (ADS)

    Wang, Xixi; Nagarajan, Mahesh B.; Conover, David; Ning, Ruola; O'Connell, Avice; Wismueller, Axel

    2014-04-01

    Cone beam computed tomography (CBCT) has found use in mammography for imaging the entire breast with sufficient spatial resolution at a radiation dose within the range of that of conventional mammography. Recently, enhancement of lesion tissue through the use of contrast agents has been proposed for cone beam CT. This study investigates whether the use of such contrast agents improves the ability of texture features to differentiate lesion texture from healthy tissue on CBCT in an automated manner. For this purpose, 9 lesions were annotated by an experienced radiologist on both regular and contrast-enhanced CBCT images using two-dimensional (2D) square ROIs. These lesions were then segmented, and each pixel within the lesion ROI was assigned a label - lesion or non-lesion, based on the segmentation mask. On both sets of CBCT images, four three-dimensional (3D) Minkowski Functionals were used to characterize the local topology at each pixel. The resulting feature vectors were then used in a machine learning task involving support vector regression with a linear kernel (SVRlin) to classify each pixel as belonging to the lesion or non-lesion region of the ROI. Classification performance was assessed using the area under the receiver-operating characteristic (ROC) curve (AUC). Minkowski Functionals derived from contrastenhanced CBCT images were found to exhibit significantly better performance at distinguishing between lesion and non-lesion areas within the ROI when compared to those extracted from CBCT images without contrast enhancement (p < 0.05). Thus, contrast enhancement in CBCT can improve the ability of texture features to distinguish lesions from surrounding healthy tissue.

  3. Dynamic contrast-enhanced MRI and CT provide comparable measurement of blood-brain barrier permeability in a rodent stroke model.

    PubMed

    Merali, Zamir; Wong, Teser; Leung, Jackie; Gao, Meah MingYang; Mikulis, David; Kassner, Andrea

    2015-10-01

    In the current management of acute ischemic stroke (AIS), clinical criteria are used to estimate the risk of hemorrhagic transformation (HT), which is a devastating early complication. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and computed tomography (DCE-CT) may serve as physiologically-based decision making tools to more reliably assess the risk of HT. Before these tools can be properly validated, the comparability of the blood-brain barrier (BBB) permeability measurements they generate should be assessed. Sixteen rats were subjected to a transient middle cerebral artery occlusion before successively undergoing DCE-CT and DCE-MRI at 24-hours. BBB permeability (K(trans)) values were generated from both modalities. A correlation of R=0.677 was found (p<0.01) and the resulting relationship was [DCE-CT=(0.610*DCE-MRI)+4.140]. A variance components analysis found the intra-rat coefficient of variation to be 0.384 and 0.258 for K(trans) values from DCE-MRI and DCE-CT respectively. Permeability measures from DCE-CT were 22% higher than those from DCE-MRI. The results of this study demonstrate for the first time comparability between DCE-CT and DCE-MRI in the assessment of AIS. These results may provide a foundation for future clinical trials making combined use of these modalities. PMID:26117703

  4. SU-D-12A-02: DeTECT, a Method to Enhance Soft Tissue Contrast From Mega Voltage CT

    SciTech Connect

    Sheng, K; Gou, S; Qi, S

    2014-06-01

    Purpose: MVCT images have been used on TomoTherapy system to align patients based on bony anatomies but its usefulness for soft tissue registration, delineation and adaptive radiation therapy is severely limited due to minimal photoelectric interaction and prominent presence of noise resulting from low detector quantum efficiency of megavoltage x-rays. We aim to utilize a non-local means denoising method and texture analysis to recover the soft tissue information for MVCT. Methods: A block matching 3D (BM3D) algorithm was adapted to reduce the noise while keeping the texture information of the MVCT images. BM3D is an imaging denoising algorithm developed from non-local means methods. BM3D additionally creates 3D groups by stacking 2D patches by the order of similarity. 3D denoising operation is then performed. The resultant 3D group is inversely transformed back to 2D images. In this study, BM3D was applied to MVCT images of a CT quality phantom, a head and neck and a prostate patient. Following denoising, imaging texture was enhanced to create the denoised and texture enhanced CT (DeTECT). Results: The original MVCT images show prevalent noise and poor soft tissue contrast. By applying BM3D denoising and texture enhancement, all MVCT images show remarkable improvements. For the phantom, the contrast to noise ratio for the low contrast plug was improved from 2.2 to 13.1 without compromising line pair conspicuity. For the head and neck patient, the lymph nodes and vein in the carotid space inconspicuous in the original MVCT image becomes highly visible in DeTECT. For the prostate patient, the boundary between the bladder and the prostate in the original MVCT is successfully recovered. Both results are visually validated by kVCT images of the corresponding patients. Conclusion: DeTECT showed the promise to drastically improve the soft tissue contrast of MVCT for image guided radiotherapy and adaptive radiotherapy.

  5. 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

  6. Investigation of optimal parameters for penalized maximum-likelihood reconstruction applied to iodinated contrast-enhanced breast CT

    NASA Astrophysics Data System (ADS)

    Makeev, Andrey; Ikejimba, Lynda; Lo, Joseph Y.; Glick, Stephen J.

    2016-03-01

    Although digital mammography has reduced breast cancer mortality by approximately 30%, sensitivity and specificity are still far from perfect. In particular, the performance of mammography is especially limited for women with dense breast tissue. Two out of every three biopsies performed in the U.S. are unnecessary, thereby resulting in increased patient anxiety, pain, and possible complications. One promising tomographic breast imaging method that has recently been approved by the FDA is dedicated breast computed tomography (BCT). However, visualizing lesions with BCT can still be challenging for women with dense breast tissue due to the minimal contrast for lesions surrounded by fibroglandular tissue. In recent years there has been renewed interest in improving lesion conspicuity in x-ray breast imaging by administration of an iodinated contrast agent. Due to the fully 3-D imaging nature of BCT, as well as sub-optimal contrast enhancement while the breast is under compression with mammography and breast tomosynthesis, dedicated BCT of the uncompressed breast is likely to offer the best solution for injected contrast-enhanced x-ray breast imaging. It is well known that use of statistically-based iterative reconstruction in CT results in improved image quality at lower radiation dose. Here we investigate possible improvements in image reconstruction for BCT, by optimizing free regularization parameter in method of maximum likelihood and comparing its performance with clinical cone-beam filtered backprojection (FBP) algorithm.

  7. Revisiting the potential signs of colorectal cancer on contrast-enhanced computed tomography without bowel preparation.

    PubMed

    Naqvi, Jawad; Hosmane, Sharath; Lapsia, Snehal

    2015-10-01

    Colorectal cancer (CRC) is the second most common cause of cancer death in the US. Earlier detection can allow treatment with curative intent and improve prognosis. Optical and virtual colonoscopy are widely used in screening for colonic polyps and in the investigation of suspected CRC. However, contrast-enhanced computed tomography (CT) is still performed to investigate various non-specific abdominal complaints. Hence, a significant number of CRC are identified on contrast-enhanced CT without bowel preparation. We describe several signs, which when present in tandem, raise suspicion of CRC, and may warrant further investigation with optical colonoscopy. These include an intraluminal mass, eccentric or circumferential wall thickening >3 mm, focal wall enhancement, pericolic fat stranding, a cluster of >3 local lymph nodes, and enlarged lymph nodes >10 mm in short axis. Multiplanar evaluation of the bowel should be performed on all CT abdominal studies, including those without bowel preparation, to identify subtle features of CRC. PMID:26194811

  8. Four-dimensional cone beam CT reconstruction and enhancement using a temporal nonlocal means method

    SciTech Connect

    Jia Xun; Tian Zhen; Lou Yifei; Sonke, Jan-Jakob; Jiang, Steve B.

    2012-09-15

    Purpose: Four-dimensional cone beam computed tomography (4D-CBCT) has been developed to provide respiratory phase-resolved volumetric imaging in image guided radiation therapy. Conventionally, it is reconstructed by first sorting the x-ray projections into multiple respiratory phase bins according to a breathing signal extracted either from the projection images or some external surrogates, and then reconstructing a 3D CBCT image in each phase bin independently using FDK algorithm. This method requires adequate number of projections for each phase, which can be achieved using a low gantry rotation or multiple gantry rotations. Inadequate number of projections in each phase bin results in low quality 4D-CBCT images with obvious streaking artifacts. 4D-CBCT images at different breathing phases share a lot of redundant information, because they represent the same anatomy captured at slightly different temporal points. Taking this redundancy along the temporal dimension into account can in principle facilitate the reconstruction in the situation of inadequate number of projection images. In this work, the authors propose two novel 4D-CBCT algorithms: an iterative reconstruction algorithm and an enhancement algorithm, utilizing a temporal nonlocal means (TNLM) method. Methods: The authors define a TNLM energy term for a given set of 4D-CBCT images. Minimization of this term favors those 4D-CBCT images such that any anatomical features at one spatial point at one phase can be found in a nearby spatial point at neighboring phases. 4D-CBCT reconstruction is achieved by minimizing a total energy containing a data fidelity term and the TNLM energy term. As for the image enhancement, 4D-CBCT images generated by the FDK algorithm are enhanced by minimizing the TNLM function while keeping the enhanced images close to the FDK results. A forward-backward splitting algorithm and a Gauss-Jacobi iteration method are employed to solve the problems. The algorithms implementation on

  9. [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

  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. Tumor Sensitive Matching Flow: A Variational Method to Detecting and Segmenting Perihepatic and Perisplenic Ovarian Cancer Metastases on Contrast-Enhanced Abdominal CT

    PubMed Central

    Liu, Jianfei; Wang, Shijun; Linguraru, Marius George; Yao, Jianhua; Summers, Ronald M.

    2015-01-01

    Accurate automated segmentation and detection of ovarian cancer metastases may improve the diagnosis and prognosis of women with ovarian cancer. In this paper, we focus on an important subset of ovarian cancer metastases that spread to the surface of the liver and spleen. Automated ovarian cancer metastasis detection and segmentation are very challenging problems to solve. These metastases have a wide variety of shapes and intensity values similar to that of the liver, spleen and adjacent soft tissues. To address these challenges, this paper presents a variational approach, called tumor sensitive matching flow (TSMF), to detect and segment perihepatic and perisplenic ovarian cancer metastases. TSMF is an image motion field that only highlights metastasis-caused deformation on the surface of liver and spleen while dampening all other image motion between the patient image and the atlas image. It provides several benefits: 1) juxtaposing the roles of image matching and metastasis classification within a variational framework; 2) only requiring a small set of features from a few patient images to train a metastasis-likelihood function for classification; and 3) dynamically creating shape priors for geodesic active contour (GAC) to prevent inaccurate metastasis segmentation. We compared the TSMF to an organ surface partition (OSP) baseline approach. At a false positive rate of 2 per patient, the sensitivities of TSMF and OSP were 87% and 17% (p < 0.001), respectively. In a comparison of the segmentations conducted using TSMF-constrained GAC and conventional GAC, the volume overlap rates were 73±9% and 46±26% (p < 0.001) and average surface distances were 2.4±1.2mm and 7.0±6.0mm (p < 0.001), respectively. These encouraging results demonstrate that TSMF could accurately detect and segment ovarian cancer metastases. PMID:24835180

  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. Hemopericardium After Superior Vena Cava Stenting for Malignant SVC Obstruction: The Importance of Contrast-Enhanced CT in the Assessment of Postprocedural Collapse

    SciTech Connect

    Brant, Jonathan; Peebles, Charles; Kalra, Paul; Odurny, Allan

    2001-09-15

    We report the complication of hemopericardium following superior vena cava (SVC) stenting with an uncovered Wallstent in a patient with malignant SVC obstruction. The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension. A CT scan demonstrated a hemopericardium which was successfully treated with a pericardial drain. The possible complications of SVC stenting, including hemopericardium, pulmonary embolism, mediastinal hematoma, and pulmonary edema from increased venous return resulting from improved hemodynamics, ensure a wide differential diagnosis in the post procedural collapsed patient and this case emphasizes the important role of contrast-enhanced CT in the peri-resuscitation assessment of these patients.

  14. Focal Hepatic Hot Spot From Superior Vena Cava Occlusion Visualized on Ventilation/Perfusion Scintigraphy With Contrast-Enhanced CT Correlate.

    PubMed

    Lawrence, Michael; Schuster, David M

    2016-05-01

    A 57-year-old woman with superior vena cava stenosis from repeated central line placements underwent ventilation/perfusion scanning after presenting with pleuritic chest pain. The ventilation/perfusion scan was not characteristic for pulmonary embolus, but perfusion images demonstrated abnormal radiotracer activity within hepatic segment 4, along with extensive collateral vessels as seen on SPECT/CT. Two months later, the patient presented with similar complaints and had a chest CT with contrast to evaluate for pulmonary embolus. This showed occlusion of the superior vena cava and arterial enhancement within segment 4 in a similar distribution to the radiotracer in the perfusion scan. PMID:26825208

  15. Water equivalence of NIPAM based polymer gel dosimeters with enhanced sensitivity for x-ray CT

    NASA Astrophysics Data System (ADS)

    Gorjiara, Tina; Hill, Robin; Bosi, Stephen; Kuncic, Zdenka; Baldock, Clive

    2013-10-01

    Two new formulations of N-isopropylacrylamide (NIPAM) based three dimensional (3D) gel dosimeters have recently been developed with improved sensitivity to x-ray CT readout, one without any co-solvent and the other one with isopropanol co-solvent. The water equivalence of the NIPAM gel dosimeters was investigated using different methods to calculate their radiological properties including: density, electron density, number of electrons per grams, effective atomic number, photon interaction probabilities, mass attenuation and energy absorption coefficients, electron collisional, radiative and total mass stopping powers and electron mass scattering power. Monte Carlo modelling was also used to compare the dose response of these gel dosimeters with water for kilovoltage and megavoltage x-ray beams and for megavoltage electron beams. We found that the density and electron density of the co-solvent free gel dosimeter are more water equivalent with less than a 2.6% difference compared to a 5.7% difference for the isopropanol gel dosimeter. Both the co-solvent free and isopropanol solvent gel dosimeters have lower effective atomic numbers than water, differing by 2.2% and 6.5%, respectively. As a result, their photoelectric absorption interaction probabilities are up to 6% and 19% different from water, respectively. Compton scattering and pair production interaction probabilities of NIPAM gel with isopropanol differ by up to 10% from water while for the co-solvent free gel, the differences are 3%. Mass attenuation and energy absorption coefficients of the co-solvent free gel dosimeter and the isopropanol gel dosimeter are up to 7% and 19% lower than water, respectively. Collisional and total mass stopping powers of both gel dosimeters differ by less than 2% from those of water. The dose response of the co-solvent free gel dosimeter is water equivalent (with <1% discrepancy) for dosimetry of x-rays with energies <100 keV while the discrepancy increases (up to 5%) for the

  16. Automated 2D-3D registration of a radiograph and a cone beam CT using line-segment enhancement

    SciTech Connect

    Munbodh, Reshma; Jaffray, David A.; Moseley, Douglas J.; Chen Zhe; Knisely, Jonathan P.S.; Cathier, Pascal; Duncan, James S.

    2006-05-15

    The objective of this study was to develop a fully automated two-dimensional (2D)-three-dimensional (3D) registration framework to quantify setup deviations in prostate radiation therapy from cone beam CT (CBCT) data and a single AP radiograph. A kilovoltage CBCT image and kilovoltage AP radiograph of an anthropomorphic phantom of the pelvis were acquired at 14 accurately known positions. The shifts in the phantom position were subsequently estimated by registering digitally reconstructed radiographs (DRRs) from the 3D CBCT scan to the AP radiographs through the correlation of enhanced linear image features mainly representing bony ridges. Linear features were enhanced by filtering the images with ''sticks,'' short line segments which are varied in orientation to achieve the maximum projection value at every pixel in the image. The mean (and standard deviations) of the absolute errors in estimating translations along the three orthogonal axes in millimeters were 0.134 (0.096) AP(out-of-plane), 0.021 (0.023) ML and 0.020 (0.020) SI. The corresponding errors for rotations in degrees were 0.011 (0.009) AP, 0.029 (0.016) ML (out-of-plane), and 0.030 (0.028) SI (out-of-plane). Preliminary results with megavoltage patient data have also been reported. The results suggest that it may be possible to enhance anatomic features that are common to DRRs from a CBCT image and a single AP radiography of the pelvis for use in a completely automated and accurate 2D-3D registration framework for setup verification in prostate radiotherapy. This technique is theoretically applicable to other rigid bony structures such as the cranial vault or skull base and piecewise rigid structures such as the spine.

  17. 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

  18. 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

  19. Hepatic schwannoma: imaging findings on CT, MRI and contrast-enhanced ultrasonography.

    PubMed

    Ota, Yu; Aso, Kazunobu; Watanabe, Kenji; Einama, Takahiro; Imai, Koji; Karasaki, Hidenori; Sudo, Ryuji; Tamaki, Yosui; Okada, Mituyoshi; Tokusashi, Yosihiko; Kono, Toru; Miyokawa, Naoyuki; Haneda, Masakazu; Taniguchi, Masahiko; Furukawa, Hiroyuki

    2012-09-21

    A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor. We compared the imaging and pathological findings, and examined the possibility of preoperatively diagnosing a benign liver schwannoma. A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver. A malignant tumor was suspected, and a right hepatectomy was performed. After this, the diagnosis of a primary benign schwannoma of the liver was made through pathological examination. Contrast-enhanced ultrasonography (CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase; most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells. In the postvascular phase, CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas; most likely due to aggregation of siderophores. Because discriminating between a benign and malignant schwannoma of the liver is difficult, surgery is generally recommended. However, the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores. PMID:23002371

  20. Hepatic schwannoma: Imaging findings on CT, MRI and contrast-enhanced ultrasonography

    PubMed Central

    Ota, Yu; Aso, Kazunobu; Watanabe, Kenji; Einama, Takahiro; Imai, Koji; Karasaki, Hidenori; Sudo, Ryuji; Tamaki, Yosui; Okada, Mituyoshi; Tokusashi, Yosihiko; Kono, Toru; Miyokawa, Naoyuki; Haneda, Masakazu; Taniguchi, Masahiko; Furukawa, Hiroyuki

    2012-01-01

    A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor. We compared the imaging and pathological findings, and examined the possibility of preoperatively diagnosing a benign liver schwannoma. A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver. A malignant tumor was suspected, and a right hepatectomy was performed. After this, the diagnosis of a primary benign schwannoma of the liver was made through pathological examination. Contrast-enhanced ultrasonography (CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase; most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells. In the postvascular phase, CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas; most likely due to aggregation of siderophores. Because discriminating between a benign and malignant schwannoma of the liver is difficult, surgery is generally recommended. However, the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores. PMID:23002371

  1. Automated noninvasive classification of renal cancer on multiphase CT

    SciTech Connect

    Linguraru, Marius George; Wang, Shijun; Shah, Furhawn; Gautam, Rabindra; Peterson, James; Linehan, W. Marston; Summers, Ronald M.

    2011-10-15

    Purpose: To explore the added value of the shape of renal lesions for classifying renal neoplasms. To investigate the potential of computer-aided analysis of contrast-enhanced computed-tomography (CT) to quantify and classify renal lesions. Methods: A computer-aided clinical tool based on adaptive level sets was employed to analyze 125 renal lesions from contrast-enhanced abdominal CT studies of 43 patients. There were 47 cysts and 78 neoplasms: 22 Von Hippel-Lindau (VHL), 16 Birt-Hogg-Dube (BHD), 19 hereditary papillary renal carcinomas (HPRC), and 21 hereditary leiomyomatosis and renal cell cancers (HLRCC). The technique quantified the three-dimensional size and enhancement of lesions. Intrapatient and interphase registration facilitated the study of lesion serial enhancement. The histograms of curvature-related features were used to classify the lesion types. The areas under the curve (AUC) were calculated for receiver operating characteristic curves. Results: Tumors were robustly segmented with 0.80 overlap (0.98 correlation) between manual and semi-automated quantifications. The method further identified morphological discrepancies between the types of lesions. The classification based on lesion appearance, enhancement and morphology between cysts and cancers showed AUC = 0.98; for BHD + VHL (solid cancers) vs. HPRC + HLRCC AUC = 0.99; for VHL vs. BHD AUC = 0.82; and for HPRC vs. HLRCC AUC = 0.84. All semi-automated classifications were statistically significant (p < 0.05) and superior to the analyses based solely on serial enhancement. Conclusions: The computer-aided clinical tool allowed the accurate quantification of cystic, solid, and mixed renal tumors. Cancer types were classified into four categories using their shape and enhancement. Comprehensive imaging biomarkers of renal neoplasms on abdominal CT may facilitate their noninvasive classification, guide clinical management, and monitor responses to drugs or interventions.

  2. High-density renal cysts in autosomal dominant polycystic kidney disease demonstrated by CT

    SciTech Connect

    Levine, E.; Grantham, J.J.

    1985-02-01

    Unenhanced abdominal CT scans of 35 patients with autosomal dominant polycystic kidney disease (ADPKD) showed multiple high-density (58-84 HU) renal cysts in 42.9% of patients, occasional high-density cysts in 25.7%, and no high-density cysts in 31.4%. These high-density cysts were usually subcapsular and were more frequent in patients with markedly enlarged kidneys and flank pain at the time of CT. Follow-up CT often showed a reduction in cyst densities, although some cysts developed mural calcification and calcification of their contents. Renal carcinomas occur rarely in ADPKD and may occasionally be hyperdense. However, high-density cysts may usually be distinguished from carcinomas on CT by their smooth contours, sharp interfaces with renal parenchyma, homogeneity, and lack of contrast enhancement.

  3. Immunoglobulin G4-related large thoraco-abdominal aortic aneurysm.

    PubMed

    Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Sasaguri, Shiro

    2016-07-01

    We report a case of immunoglobulin G4-related large thoraco-abdominal aortic aneurysm in a 38-year old man. Preoperative contrast-enhanced computed tomography revealed that the mid-descending thoracic aorta was extremely enlarged and the maximum diameter of the aneurysm was 92 mm. The patient underwent thoraco-abdominal aortic replacement through a thoraco-abdominal incision under left heart bypass. The postoperative pathological examination diagnosed immunoglobulin G4-related aortic aneurysm. PMID:27059069

  4. Automatic multiscale enhancement and segmentation of pulmonary vessels in CT pulmonary angiography images for CAD applications

    SciTech Connect

    Zhou Chuan; Chan, H.-P.; Sahiner, Berkman; Hadjiiski, Lubomir M.; Chughtai, Aamer; Patel, Smita; Wei Jun; Ge Jun; Cascade, Philip N.; Kazerooni, Ella A.

    2007-12-15

    The authors are developing a computerized pulmonary vessel segmentation method for a computer-aided pulmonary embolism (PE) detection system on computed tomographic pulmonary angiography (CTPA) images. Because PE only occurs inside pulmonary arteries, an automatic and accurate segmentation of the pulmonary vessels in 3D CTPA images is an essential step for the PE CAD system. To segment the pulmonary vessels within the lung, the lung regions are first extracted using expectation-maximization (EM) analysis and morphological operations. The authors developed a 3D multiscale filtering technique to enhance the pulmonary vascular structures based on the analysis of eigenvalues of the Hessian matrix at multiple scales. A new response function of the filter was designed to enhance all vascular structures including the vessel bifurcations and suppress nonvessel structures such as the lymphoid tissues surrounding the vessels. An EM estimation is then used to segment the vascular structures by extracting the high response voxels at each scale. The vessel tree is finally reconstructed by integrating the segmented vessels at all scales based on a 'connected component' analysis. Two CTPA cases containing PEs were used to evaluate the performance of the system. One of these two cases also contained pleural effusion disease. Two experienced thoracic radiologists provided the gold standard of pulmonary vessels including both arteries and veins by manually tracking the arterial tree and marking the center of the vessels using a computer graphical user interface. The accuracy of vessel tree segmentation was evaluated by the percentage of the 'gold standard' vessel center points overlapping with the segmented vessels. The results show that 96.2% (2398/2494) and 96.3% (1910/1984) of the manually marked center points in the arteries overlapped with segmented vessels for the case without and with other lung diseases. For the manually marked center points in all vessels including arteries

  5. Diffusible iodine-based contrast-enhanced computed tomography (diceCT): an emerging tool for rapid, high-resolution, 3-D imaging of metazoan soft tissues.

    PubMed

    Gignac, Paul M; Kley, Nathan J; Clarke, Julia A; Colbert, Matthew W; Morhardt, Ashley C; Cerio, Donald; Cost, Ian N; Cox, Philip G; Daza, Juan D; Early, Catherine M; Echols, M Scott; Henkelman, R Mark; Herdina, A Nele; Holliday, Casey M; Li, Zhiheng; Mahlow, Kristin; Merchant, Samer; Müller, Johannes; Orsbon, Courtney P; Paluh, Daniel J; Thies, Monte L; Tsai, Henry P; Witmer, Lawrence M

    2016-06-01

    Morphologists have historically had to rely on destructive procedures to visualize the three-dimensional (3-D) anatomy of animals. More recently, however, non-destructive techniques have come to the forefront. These include X-ray computed tomography (CT), which has been used most commonly to examine the mineralized, hard-tissue anatomy of living and fossil metazoans. One relatively new and potentially transformative aspect of current CT-based research is the use of chemical agents to render visible, and differentiate between, soft-tissue structures in X-ray images. Specifically, iodine has emerged as one of the most widely used of these contrast agents among animal morphologists due to its ease of handling, cost effectiveness, and differential affinities for major types of soft tissues. The rapid adoption of iodine-based contrast agents has resulted in a proliferation of distinct specimen preparations and scanning parameter choices, as well as an increasing variety of imaging hardware and software preferences. Here we provide a critical review of the recent contributions to iodine-based, contrast-enhanced CT research to enable researchers just beginning to employ contrast enhancement to make sense of this complex new landscape of methodologies. We provide a detailed summary of recent case studies, assess factors that govern success at each step of the specimen storage, preparation, and imaging processes, and make recommendations for standardizing both techniques and reporting practices. Finally, we discuss potential cutting-edge applications of diffusible iodine-based contrast-enhanced computed tomography (diceCT) and the issues that must still be overcome to facilitate the broader adoption of diceCT going forward. PMID:26970556

  6. Does the Gadoxetic Acid-Enhanced Liver MRI Impact on the Treatment of Patients with Colorectal Cancer? Comparison Study with 18F-FDG PET/CT

    PubMed Central

    Oh, Ji-Won; Oh, Soon Nam; Choi, Joon Il; Choi, Moon Hyung; Yoo, Ie Ryung; Lee, Myung Ah; Yoo, Young-Kyung; Oh, Seong Taek

    2016-01-01

    Objectives. We evaluated the value of Gadoxetic acid-enhanced liver MRI in the preoperative staging of colorectal cancer and estimated the clinical impact of liver MRI in the management plan of liver metastasis. Methods. We identified 108 patients who underwent PET/CT and liver MRI as preoperative evaluation of colorectal cancer, between January 2011 and December 2013. We evaluated the per nodule sensitivity of PET/CT and liver MRI for liver metastasis. Management plan changes were estimated for patients with metastatic nodules newly detected on liver MRI, to assess the clinical impact. Results. We enrolled 131 metastatic nodules (mean size 1.6 cm) in 41 patients (mean age 65 years). The per nodule sensitivities of PET/CT and liver MRI were both 100% for nodules measuring 2 cm or larger but were significantly different for nodules measuring less than 2 cm (59.8% and 95.1%, resp., P = 0.0001). At least one more metastatic nodule was detected on MRI in 16 patients. Among these, 7 patients indicated changes of management plan after performing MRI. Conclusions. Gadoxetic acid-enhanced liver MRI detected more metastatic nodules compared with PET/CT, especially for small (<2 cm) nodules. The newly detected nodules induced management plan change in 43.8% (7/16) of patients. PMID:27022613

  7. The impact of dual energy CT on pseudo enhancement of kidney lesions

    NASA Astrophysics Data System (ADS)

    Müller, Jan; Vrtiska, Terri; Schmidt, Bernhard; Howe, Ben; McCollough, Cynthia; Buzug, Thorsten M.; Petersilka, Martin; Eusemann, Christian

    2010-04-01

    Renal lesion detection and characterization using Computed Tomography is an important application in genitourinary radiology. Although in general the detection of renal lesions has been shown to be exceedingly accuratce, the detection of benign renal cysts is still problematic. Under certain circumstances, the attenuation values inside a cyst increase incorrectly with an increase in the iodine concentration in the surrounding soft tissue. This so called pseudoenhancement complicates the classification of cysts and creates severe difficulties to distinguish a benign nonenhancing lesion from an enhancing mass. In the present study, the standard procedure based on a single energy 120 kV mode is compared to three dual energy modes available on the Siemens Somatom Definition Flash scanner. In order to simulate the kidney and the lesions, several plastic rods were placed inside a small container filled with different iodine concentrations. This phantom is then positioned inside water tanks of different sizes. The rods simulating the lesions are made out of a special plastic with constant HU value throughout the relevant X-ray energy range. During the project, three important aspects have been discovered: 1) for normal situations, a 100/140 Sn kV mode on the Siemens Flash scanner is similar to the traditional single energy 120 kV mode. 2) For small patient sizes, all dual energy modes show a reduction of pseudoenhancement. 3) For larger patients, only the 100/140 Sn kV mode results in a reduction of pseudoenhancement. Both the 80/140 kV and the 80/140 Sn kV mode show a worse performance than the 120 kV single energy mode in a very large phantom size.

  8. 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

  9. 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

  10. 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. ...

  11. 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 ...

  12. 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) ...

  13. 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, ...

  14. 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, ...

  15. 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.

  16. 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

  17. Coronary Stent Artifact Reduction with an Edge-Enhancing Reconstruction Kernel – A Prospective Cross-Sectional Study with 256-Slice CT

    PubMed Central

    Tan, Stéphanie; Soulez, Gilles; Diez Martinez, Patricia; Larrivée, Sandra; Stevens, Louis-Mathieu; Goussard, Yves; Mansour, Samer; Chartrand-Lefebvre, Carl

    2016-01-01

    Purpose Metallic artifacts can result in an artificial thickening of the coronary stent wall which can significantly impair computed tomography (CT) imaging in patients with coronary stents. The objective of this study is to assess in vivo visualization of coronary stent wall and lumen with an edge-enhancing CT reconstruction kernel, as compared to a standard kernel. Methods This is a prospective cross-sectional study involving the assessment of 71 coronary stents (24 patients), with blinded observers. After 256-slice CT angiography, image reconstruction was done with medium-smooth and edge-enhancing kernels. Stent wall thickness was measured with both orthogonal and circumference methods, averaging thickness from diameter and circumference measurements, respectively. Image quality was assessed quantitatively using objective parameters (noise, signal to noise (SNR) and contrast to noise (CNR) ratios), as well as visually using a 5-point Likert scale. Results Stent wall thickness was decreased with the edge-enhancing kernel in comparison to the standard kernel, either with the orthogonal (0.97 ± 0.02 versus 1.09 ± 0.03 mm, respectively; p<0.001) or the circumference method (1.13 ± 0.02 versus 1.21 ± 0.02 mm, respectively; p = 0.001). The edge-enhancing kernel generated less overestimation from nominal thickness compared to the standard kernel, both with the orthogonal (0.89 ± 0.19 versus 1.00 ± 0.26 mm, respectively; p<0.001) and the circumference (1.06 ± 0.26 versus 1.13 ± 0.31 mm, respectively; p = 0.005) methods. The edge-enhancing kernel was associated with lower SNR and CNR, as well as higher background noise (all p < 0.001), in comparison to the medium-smooth kernel. Stent visual scores were higher with the edge-enhancing kernel (p<0.001). Conclusion In vivo 256-slice CT assessment of coronary stents shows that the edge-enhancing CT reconstruction kernel generates thinner stent walls, less overestimation from nominal thickness, and better image quality

  18. Randomized multicentre trial of gadoxetic acid-enhanced MRI versus conventional MRI or CT in the staging of colorectal cancer liver metastases

    PubMed Central

    Zech, C J; Korpraphong, P; Huppertz, A; Denecke, T; Kim, M-J; Tanomkiat, W; Jonas, E; Ba-Ssalamah, A

    2014-01-01

    Background This multicentre international randomized trial compared the impact of gadoxetic acid-enhanced magnetic resonance imaging (MRI), MRI with extracellular contrast medium (ECCM-MRI) and contrast-enhanced computed tomography (CE-CT) as a first-line imaging method in patients with suspected colorectal cancer liver metastases (CRCLM). Methods Between October 2008 and September 2010, patients with suspected CRCLM were randomized to one of the three imaging modalities. The primary endpoint was the proportion of patients for whom further imaging after initial imaging was required for a confident diagnosis. Secondary variables included confidence in the therapeutic decision, intraoperative deviations from the initial imaging-based surgical plan as a result of additional operative findings, and diagnostic efficacy of the imaging modalities versus intraoperative and pathological extent of the disease. Results A total of 360 patients were enrolled. Efficacy was analysed in 342 patients (118, 112 and 112 with gadoxetic acid-enhanced MRI, ECCM-MRI and CE-CT respectively as the initial imaging procedure). Further imaging was required in 0 of 118, 19 (17·0 per cent) of 112 and 44 (39·3 per cent) of 112 patients respectively (P < 0·001). Diagnostic confidence was high or very high in 98·3 per cent of patients for gadoxetic acid-enhanced MRI, 85·7 per cent for ECCM-MRI and 65·2 per cent for CE-CT. Surgical plans were changed during surgery in 28, 32 and 47 per cent of patients in the respective groups. Conclusion The diagnostic performance of gadoxetic acid-enhanced MRI was better than that of CE-CT and ECCM-MRI as the initial imaging modality. No further imaging was needed in the gadoxetic acid-enhanced MRI group and comparison of diagnostic efficacy parameters demonstrated the diagnostic superiority of gadoxetic acid-enhanced MRI. Registration number: NCT00764621( http://clinicaltrials.gov ); EudraCT number: 2008-000583-16 ( https://eudract.ema.europa.eu/ ). PMID

  19. 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

  20. Iodine-enhanced micro-CT imaging: methodological refinements for the study of the soft-tissue anatomy of post-embryonic vertebrates.

    PubMed

    Gignac, Paul M; Kley, Nathan J

    2014-05-01

    The now widespread use of non-destructive X-ray computed tomography (CT) and micro-CTCT) has greatly augmented our ability to comprehensively detail and quantify the internal hard-tissue anatomy of vertebrates. However, the utility of X-ray imaging for gaining similar insights into vertebrate soft-tissue anatomy has yet to be fully realized due to the naturally low X-ray absorption of non-mineralized tissues. In this study, we show how a wide diversity of soft-tissue structures within the vertebrate head-including muscles, glands, fat deposits, perichondria, dural venous sinuses, white and gray matter of the brain, as well as cranial nerves and associated ganglia-can be rapidly visualized in their natural relationships with extraordinary levels of detail using iodine-enhanced (i-e) µCT imaging. To date, Lugol's iodine solution (I2 KI) has been used as a contrast agent for µCT imaging of small invertebrates, vertebrate embryos, and certain isolated parts of larger, post-embryonic vertebrates. These previous studies have all yielded promising results, but visualization of soft tissues in smaller invertebrate and embryonic vertebrate specimens has generally been more complete than that for larger, post-embryonic vertebrates. Our research builds on these previous studies by using high-energy µCT together with more highly concentrated I2 KI solutions and longer staining times to optimize the imaging and differentiation of soft tissues within the heads of post-embryonic archosaurs (Alligator mississippiensis and Dromaius novaehollandiae). We systematically quantify the intensities of tissue staining, demonstrate the range of anatomical structures that can be visualized, and generate a partial three-dimensional reconstruction of alligator cephalic soft-tissue anatomy. PMID:24482316

  1. 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

  2. Excision of the urachal remnant using the abdominal wall-lift laparoscopy: A case report

    PubMed Central

    Kobayashi, Kosuke; Sasaki, Kazuhito; Iijima, Tatsuo; Yoshimi, Fuyo; Nagai, Hideo

    2016-01-01

    Introduction Here, we report the surgical excision of the urachal remnant using the abdominal wall-lift laparoscopy with a camera port in the umbilicus, combined with a small Pfannenstiel incision to optimally treat the bladder apex. Presentation of case A 21-year-old woman presented with periumbilical discharge and pain on urination. Contrast enhanced CT and MRI showed an abscess in the umbilical region that was connected to the bladder via a long tube-like structure. It was diagnosed as an infected urachal sinus. Partial excision of the umbilical fossa followed by dissection of the urachal remnant was easily performed using the abdominal wall-lift laparoscopy from the umbilicus down to the bladder without pneumoperitoneum or additional trocar placement. A Pfannenstiel incision was made above the pubis to get access to the junction between the urachal remnant and the bladder. Under direct vision, we succeeded in accurately dividing the remnant tract, and we adequately closed the bladder opening with absorbable sutures. This method has the advantage of easily closing peritoneal defects after excision of the urachal remnant with direct sutures under a laparoscopic view from the umbilicus. Cosmetic satisfaction was obtained postoperatively. Discussion and conclusion Urachal sinus excision using the abdominal wall-lift laparoscopy seems to surpass the previously reported methods in term of safety, cosmetics, and adequacy of surgical procedures. PMID:27064744

  3. Is hepatotropic contrast enhanced MR a more effective method in differential diagnosis of hemangioma than multi-phase CT and unenhanced MR?

    PubMed Central

    2011-01-01

    Background Cavernous hemangiomas are the most frequent neoplasms of the liver and in routine clinical practice they often need to be differentiated from malignant tumors and other benign focal lesions. The purpose of this study is to evaluate whether diagnostic accuracy of magnetic resonance imaging (MRI) of hepatic hemangiomas, showing atypical pattern on US, improves with the use of Gd-BOPTA in comparison with contrast-enhanced multi-phase computed tomography (CT). Methods 178 consecutive patients with ambiguous hepatic masses showing atypical hyperechoic pattern on grey-scale US, underwent unenhanced and contrast-enhanced multi-phase multi-detector CT and MR (1.5T) with the use of liver-specific contrast medium gadobenate dimeglumine (Gd-BOPTA). After intravenous contrast administration arterial (HAP), venous-portal (PVP), equilibrium phases (EP) both in CT and MR and additionally hepatobiliary phase (HBP) in MR were obtained. 398 lesions have been detected including 99 hemangiomas and 299 other lesions. Results In non-enhanced MDCT examination detection of hemangiomas was characterized by sensitivity of 76%, specificity of 90%, PPV of 71%, NPV of 92% and accuracy of 86%. Non-enhanced MR examination showed sensitivity of 98%, specificity of 99%, PPV of 99%, NPV of 99% and accuracy of 99%. After intravenous administration of contrast medium in MR the mentioned above parameters did not increase significantly. Conclusion Gd-BOPTA-enhanced MR in comparison with unenhanced MRI does not improve diagnostic accuracy in discriminating hemangiomas that show non-specific appearance in ultrasound examination. Unenhanced MR as a method of choice should directly follow US in course of diagnostic algorithm in differentiation of hemangiomas from other liver tumors. PMID:21504593

  4. CT and MR Imaging Findings of Pancreatic Paragangliomas

    PubMed Central

    Liang, Wenjie; Xu, Shunliang

    2016-01-01

    Abstract Previous studies on pancreatic paraganglioma, a rare neoplasm, have primarily reported its ultrasound and routine and contrast-enhanced computed tomography (CT) findings. To our knowledge, we are the first to report the contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) sequence findings of pancreatic paraganglioma. A male patient, ages 41 years, was admitted to our hospital due to a pancreatic space-occupying lesion that had been present for more than 10 days. The patient had no obvious discomfort. He had a history of hypertension and hyperthyroidism. Physical examination revealed upper abdominal tenderness without a palpable mass. Routine and contrast-enhanced abdominal CT showed a soft tissue mass at the pancreatic head/uncinate process, with patchy calcification within the lesion. On a contrast-enhanced CT scan, severe enhancement of the mass in the arterial phase was noted, as was slightly reduced but still marked enhancement in the venous phase. The celiac trunk and superior mesenteric artery segment were wrapped by the tumor. Thickened, tortuous vessels were observed at the lesion edges, around which there were multiple enlarged lymph nodes. The main pancreatic duct was markedly dilated. Routine and contrast-enhanced pancreatic MRI demonstrated an abnormal nodular signal in the pancreatic head/uncinate process that was approximately 4.3 × 6.4 cm2 in size. T1-weighted imaging (T1WI) revealed hypointensity, whereas T2-weighted imaging (T2WI) revealed nonhomogeneous, slight hyperintensity. Patchy hypointensity on both T1WI and T2WI was observed within the lesion. DWI showed slight hyperintensity. Grossly heterogeneous enhancement of the mass was observed on a contrast-enhanced MRI scan, with the tumor wrapped around the adjacent vasculature, and multiple enlarged lymph nodes were observed peripherally. After preoperative preparation, the patient underwent pancreatoduodenectomy. Histopathology and

  5. 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

  6. Fused SPECT/CT imaging of Peri-iliopsoas infection using Indium-111-labeled leukocytes.

    PubMed

    Nathan, Jennifer; Crawford, Joseph A; Sodee, D Bruce; Bakale, George

    2006-12-01

    Nuclear imaging with In-111-labeled leukocytes has become an instrumental tool in localizing sites of infection and is superior to Ga-67 in localizing abdominal and pelvic abscesses resulting from absence of a normal bowel excretory pathway. Labeled white blood cells (WBCs) localize at sites of infection through diapedesis, chemotaxis, and enhanced vascular permeability and can thus be used to identify infection. The accuracy of this functional imaging modality can be enhanced by fusing SPECT images of labeled WBC with CT images that provide anatomic detail to facilitate reading as illustrated in the case described. PMID:17117077

  7. 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

  8. 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.

  9. 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

  10. 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

  11. Evaluation of Tumor-associated Stroma and Its Relationship with Tumor Hypoxia Using Dynamic Contrast-enhanced CT and (18)F Misonidazole PET in Murine Tumor Models.

    PubMed

    Koyasu, Sho; Tsuji, Yoshihisa; Harada, Hiroshi; Nakamoto, Yuji; Nobashi, Tomomi; Kimura, Hiroyuki; Sano, Kohei; Koizumi, Koji; Hamaji, Masatsugu; Togashi, Kaori

    2016-03-01

    Purpose To determine the relationship between the fractional interstitial volume (Fis), as calculated at dynamic contrast material-enhanced (DCE) computed tomography (CT), and tumor-associated stroma and to analyze its spatial relationship with tumor hypoxia in several xenograft tumor models. Materials and Methods All animal experiments were approved by the animal research committee. Mice with three different xenograft tumors (U251, CFPAC-1, and BxPC-3; n = 6, n = 8, and n = 6, respectively) underwent DCE CT then hypoxia imaging with fluorine 18 ((18)F) fluoromisonidazole (FMISO) positron emission tomography (PET) within 24 hours. Immunohistochemical analysis was performed in harvested tumors to detect hypoxia markers and to quantify microvascular and stromal density. Two DCE CT parameters (amount of interstitial space associated with the amount of stroma [Fis] and flow velocity [Fv]) were identified and quantitatively validated by using immunohistochemistry. FMISO uptake within the tumor was also assessed in relation to DCE CT parameters. Imaging and immunohistochemical parameters were assessed by using the Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni correction, and Pearson correlation coefficient. Results Almost no α-smooth muscle actin-positive cells were found in the U251 xenograft, while abundant stroma was found in the entire BxPC-3 xenograft and in the periphery of the CFPAC-1 xenograft. Quantitative analysis showed a significant correlation (R = 0.83, P < .0001) between Fis and stromal density. FMISO uptake had a negative correlation with Fis (R = -0.58, P < .0001) and Fv (R = -0.53, P < .0001). Conclusion DCE CT can be used to quantify parameters associated with tumor-associated stroma. Tumor hypoxia was Complementarily localized in tumor-associated stroma in these models. (©) RSNA, 2015 Online supplemental material is available for this article. PMID:26393963

  12. Positron Emission Tomography and Magnetic Resonance Imaging of Cellular Inflammation in Patients with Abdominal Aortic Aneurysms

    PubMed Central

    McBride, O.M.B.; Joshi, N.V.; Robson, J.M.J.; MacGillivray, T.J.; Gray, C.D.; Fletcher, A.M.; Dweck, M.R.; van Beek, E.J.R.; Rudd, J.H.F.; Newby, D.E.; Semple, S.I.

    2016-01-01

    Objectives Inflammation is critical in the pathogenesis of abdominal aortic aneurysm (AAA) disease. Combined 18F-fludeoxyglucose (18F-FDG) positron emission tomography with computed tomography (PET-CT) and ultrasmall superparamagnetic particles of iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) are non-invasive methods of assessing tissue inflammation. The aim of this study was to compare these techniques in patients with AAA. Materials and methods Fifteen patients with asymptomatic AAA with diameter 46 ± 7 mm underwent PET-CT with 18F-FDG, and T2*-weighted MRI before and 24 hours after administration of USPIO. The PET-CT and MRI data were then co-registered. Standardised uptake values (SUVs) were calculated to measure 18F-FDG activity, and USPIO uptake was determined using the change in R2*. Comparisons between the techniques were made using a quadrant analysis and a voxel-by-voxel evaluation. Results When all areas of the aneurysm were evaluated, there was a modest correlation between the SUV on PET-CT and the change in R2* on USPIO-enhanced MRI (n = 70,345 voxels; r = .30; p < .0001). Although regions of increased 18F-FDG and USPIO uptake co-localised on occasion, this was infrequent (kappa statistic 0.074; 95% CI 0.026–0.122). 18F-FDG activity was commonly focused in the shoulder region whereas USPIO uptake was more apparent in the main body of the aneurysm. Maximum SUV was lower in patients with mural USPIO uptake. Conclusions Both 18F-FDG PET-CT and USPIO-MRI uptake identify vascular inflammation associated with AAA. Although they demonstrate a modest correlation, there are distinct differences in the pattern and distribution of uptake, suggesting a differential detection of macrophage glycolytic and phagocytic activity respectively. PMID:26919936

  13. Bioprosthetic Mesh in Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Mesh materials have undergone a considerable evolution over the last several decades. There has been enhancement of biomechanical properties, improvement in manufacturing processes, and development of antiadhesive laminate synthetic meshes. The evolution of bioprosthetic mesh materials has markedly changed our indications and methods for complex abdominal wall reconstruction. The authors review the optimal properties of bioprosthetic mesh materials, their evolution over time, and their indications for use. The techniques to optimize outcomes are described using bioprosthetic mesh for complex abdominal wall reconstruction. Bioprosthetic mesh materials clearly have certain advantages over other implantable mesh materials in select indications. Appropriate patient selection and surgical technique are critical to the successful use of bioprosthetic materials for abdominal wall repair. PMID:23372454

  14. Quantitative Myocardial Perfusion with Dynamic Contrast-Enhanced Imaging in MRI and CT: Theoretical Models and Current Implementation

    PubMed Central

    Handayani, A.; Dijkstra, H.; Prakken, N. H. J.; Slart, R. H. J. A.; Oudkerk, M.; Van Ooijen, P. M. A.; Vliegenthart, R.; Sijens, P. E.

    2016-01-01

    Technological advances in magnetic resonance imaging (MRI) and computed tomography (CT), including higher spatial and temporal resolution, have made the prospect of performing absolute myocardial perfusion quantification possible, previously only achievable with positron emission tomography (PET). This could facilitate integration of myocardial perfusion biomarkers into the current workup for coronary artery disease (CAD), as MRI and CT systems are more widely available than PET scanners. Cardiac PET scanning remains expensive and is restricted by the requirement of a nearby cyclotron. Clinical evidence is needed to demonstrate that MRI and CT have similar accuracy for myocardial perfusion quantification as PET. However, lack of standardization of acquisition protocols and tracer kinetic model selection complicates comparison between different studies and modalities. The aim of this overview is to provide insight into the different tracer kinetic models for quantitative myocardial perfusion analysis and to address typical implementation issues in MRI and CT. We compare different models based on their theoretical derivations and present the respective consequences for MRI and CT acquisition parameters, highlighting the interplay between tracer kinetic modeling and acquisition settings. PMID:27088083

  15. Quantitative Myocardial Perfusion with Dynamic Contrast-Enhanced Imaging in MRI and CT: Theoretical Models and Current Implementation.

    PubMed

    Pelgrim, G J; Handayani, A; Dijkstra, H; Prakken, N H J; Slart, R H J A; Oudkerk, M; Van Ooijen, P M A; Vliegenthart, R; Sijens, P E

    2016-01-01

    Technological advances in magnetic resonance imaging (MRI) and computed tomography (CT), including higher spatial and temporal resolution, have made the prospect of performing absolute myocardial perfusion quantification possible, previously only achievable with positron emission tomography (PET). This could facilitate integration of myocardial perfusion biomarkers into the current workup for coronary artery disease (CAD), as MRI and CT systems are more widely available than PET scanners. Cardiac PET scanning remains expensive and is restricted by the requirement of a nearby cyclotron. Clinical evidence is needed to demonstrate that MRI and CT have similar accuracy for myocardial perfusion quantification as PET. However, lack of standardization of acquisition protocols and tracer kinetic model selection complicates comparison between different studies and modalities. The aim of this overview is to provide insight into the different tracer kinetic models for quantitative myocardial perfusion analysis and to address typical implementation issues in MRI and CT. We compare different models based on their theoretical derivations and present the respective consequences for MRI and CT acquisition parameters, highlighting the interplay between tracer kinetic modeling and acquisition settings. PMID:27088083

  16. Liver segmentation in contrast enhanced CT data using graph cuts and interactive 3D segmentation refinement methods

    SciTech Connect

    Beichel, Reinhard; Bornik, Alexander; Bauer, Christian; Sorantin, Erich

    2012-03-15

    Purpose: Liver segmentation is an important prerequisite for the assessment of liver cancer treatment options like tumor resection, image-guided radiation therapy (IGRT), radiofrequency ablation, etc. The purpose of this work was to evaluate a new approach for liver segmentation. Methods: A graph cuts segmentation method was combined with a three-dimensional virtual reality based segmentation refinement approach. The developed interactive segmentation system allowed the user to manipulate volume chunks and/or surfaces instead of 2D contours in cross-sectional images (i.e, slice-by-slice). The method was evaluated on twenty routinely acquired portal-phase contrast enhanced multislice computed tomography (CT) data sets. An independent reference was generated by utilizing a currently clinically utilized slice-by-slice segmentation method. After 1 h of introduction to the developed segmentation system, three experts were asked to segment all twenty data sets with the proposed method. Results: Compared to the independent standard, the relative volumetric segmentation overlap error averaged over all three experts and all twenty data sets was 3.74%. Liver segmentation required on average 16 min of user interaction per case. The calculated relative volumetric overlap errors were not found to be significantly different [analysis of variance (ANOVA) test, p = 0.82] between experts who utilized the proposed 3D system. In contrast, the time required by each expert for segmentation was found to be significantly different (ANOVA test, p = 0.0009). Major differences between generated segmentations and independent references were observed in areas were vessels enter or leave the liver and no accepted criteria for defining liver boundaries exist. In comparison, slice-by-slice based generation of the independent standard utilizing a live wire tool took 70.1 min on average. A standard 2D segmentation refinement approach applied to all twenty data sets required on average 38.2 min of

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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 ...

  2. 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 ...

  3. CT findings and clinical features of pancreatic hemolymphangioma: a case report and review of the literature.

    PubMed

    Pan, Liang; Jian-bo, Gao; Javier, Pullas Tapia Gonzalo

    2015-01-01

    Pancreatic hemolymphangioma is a very rare benign tumor. There were only 10 reports of this disease until June 2014.The aim of the present study was to describe a hemolymphangioma in the neck and body of the pancreas in a 57-year-old woman.The method used in the present study consists of description of the clinical history, image lab features, and pathological result.The patient complained of a 10-day history of epigastric discomfort. Abdominal computed tomography (CT) showed a cystic-solid tumor with an irregular shape, in the neck and body of the pancreas. The tumoral cystic wall and its internal division could be seen intensified on contrast-enhanced CT images compared with those on precontrast images. The pathological examination confirmed the diagnosis.The clinical feature of pancreatic hemolymphangioma includes a lack of specificity. The CT appearance combined with age and sex may be useful in making an early diagnosis. PMID:25621699

  4. 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

  5. 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.

  6. 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

  7. 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

  8. Pott's puffy tumour in a 5-year old boy: the role of ultrasound and contrast-enhanced CT imaging; surgical case report.

    PubMed

    Vanderveken, O M; De Smet, K; Dogan-Duyar, S; Desimpelaere, J; Duval, E L I M; De Praeter, M; Van Rompaey, D

    2012-01-01

    We report a case of Pott's puffy tumour, a subperiosteal abscess of the frontal bone associated with an underlying frontal osteomyelitis, in a 5-year-old boy. Ultrasonography played a crucial role in the diagnosis of our patient, suggesting the presence of a Pott's puffy tumour with epidural abscess by showing a subperiosteal abscess associated with erosion of the frontal bone. Subsequently, the diagnosis of Pott's puffy tumour with epidural abscess was confirmed by contrast-enhanced CT scanning. Prompt neurosurgical intervention with drainage of abscesses and debridement of bone sequestrate, together with prolonged antibiotic therapy, significantly contributes to a favorable outcome. PMID:22896932

  9. A CT-ultrasound-coregistered augmented reality enhanced image-guided surgery system and its preliminary study on brain-shift estimation

    NASA Astrophysics Data System (ADS)

    Huang, C. H.; Hsieh, C. H.; Lee, J. D.; Huang, W. C.; Lee, S. T.; Wu, C. T.; Sun, Y. N.; Wu, Y. T.

    2012-08-01

    With the combined view on the physical space and the medical imaging data, augmented reality (AR) visualization can provide perceptive advantages during image-guided surgery (IGS). However, the imaging data are usually captured before surgery and might be different from the up-to-date one due to natural shift of soft tissues. This study presents an AR-enhanced IGS system which is capable to correct the movement of soft tissues from the pre-operative CT images by using intra-operative ultrasound images. First, with reconstructing 2-D free-hand ultrasound images to 3-D volume data, the system applies a Mutual-Information based registration algorithm to estimate the deformation between pre-operative and intra-operative ultrasound images. The estimated deformation transform describes the movement of soft tissues and is then applied to the pre-operative CT images which provide high-resolution anatomical information. As a result, the system thus displays the fusion of the corrected CT images or the real-time 2-D ultrasound images with the patient in the physical space through a head mounted display device, providing an immersive augmented-reality environment. For the performance validation of the proposed system, a brain phantom was utilized to simulate brain-shift scenario. Experimental results reveal that when the shift of an artificial tumor is from 5mm ~ 12mm, the correction rates can be improved from 32% ~ 45% to 87% ~ 95% by using the proposed system.

  10. Feasibility of Single-Input Tracer Kinetic Modeling with Continuous-Time Formalism in Liver 4-Phase Dynamic Contrast-Enhanced CT

    PubMed Central

    Lee, Sang Ho; Ryu, Yasuji; Hayano, Koichi; Yoshida, Hiroyuki

    2015-01-01

    The modeling of tracer kinetics with use of low-temporal-resolution data is of central importance for patient dose reduction in dynamic contrast-enhanced CT (DCE-CT) study. Tracer kinetic models of the liver vary according to the physiologic assumptions imposed on the model, and they can substantially differ in the ways how the input for blood supply and tissue compartments are modeled. In this study, single-input flow-limited (FL), Tofts-Kety (TK), extended TK (ETK), Hayton-Brady (HB), two compartment exchange (2CX), and adiabatic approximation to the tissue homogeneity (AATH) models were applied to the analysis of liver 4-phase DCE-CT data with fully continuous-time parameter formulation, including the bolus arrival time. The bolus arrival time for the 2CX and AATH models was described by modifying the vascular transport operator theory. Initial results indicate that single-input tracer kinetic modeling is feasible for distinguishing between hepatocellular carcinoma and normal liver parenchyma. PMID:26236779

  11. Radiochemotherapy-induced changes of tumour vascularity and blood supply estimated by dynamic contrast-enhanced CT and fractal analysis in malignant head and neck tumours

    PubMed Central

    Hietschold, V; Appold, S; von Kummer, R; Abolmaali, N

    2015-01-01

    Objective: To investigate radiochemotherapy (RChT)-induced changes of transfer coefficient (Ktrans) and relative tumour blood volume (rTBV) estimated by dynamic contrast-enhanced CT (DCE-CT) and fractal analysis in head and neck tumours (HNTs). Methods: DCE-CT was performed in 15 patients with inoperable HNTs before RChT, and after 2 and 5 weeks. The dynamics of Ktrans and rTBV as well as lacunarity, slope of log(lacunarity) vs log(box size), and fractal dimension were compared with tumour behaviour during RChT and in the 24-month follow-up. Results: In 11 patients, an increase of Ktrans and/or rTBV after 20 Gy followed by a decrease of both parameters after 50 Gy was noted. Except for one local recurrence, no tumour residue was found during the follow-up. In three patients with partial tumour reduction during RChT, a decrease of Ktrans accompanied by an increase in rTBV between 20 and 50 Gy was detected. In one patient with continuous elevation of both parameters, tumour progressed after RChT. Pre-treatment difference in intratumoral heterogeneity with its decline under RChT for the responders vs non-responders was observed. Conclusion: Initial growth of Ktrans and/or rTBV followed by further reduction of both parameters along with the decline of the slope of log(lacunarity) vs log(box size) was associated with positive radiochemotherapeutic response. Increase of Ktrans and/or rTBV under RChT indicated a poor outcome. Advances in knowledge: The modification of Ktrans and rTBV as measured by DCE-CT may be applied for the assessment of tumour sensitivity to chose RChT regimen and, consequently, to reveal clinical impact allowing individualization of RChT strategy in patients with HNT. PMID:25412001

  12. 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

  13. 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 ...

  14. Functional Contrast-Enhanced CT For Evaluation of Acute Ischemic Stroke Does Not Increase the Risk of Contrast-Induced Nephropathy

    PubMed Central

    Lima, F.O.; Lev, M.H.; Levy, R.A.; Silva, G.S.; Ebril, M.; de Camargo, É.C.; Pomerantz, S.; Singhal, A.B.; Greer, D.M.; Ay, H.; González, R. Gilberto; Koroshetz, W.J.; Smith, W.S.; Furie, K.L.

    2010-01-01

    BACKGROUND AND PURPOSE Concerns have recently grown regarding the safety of iodinated contrast agents used for CTA and CTP imaging. We tested whether the incidence of AN, defined by a ≥25% increase in the post–contrast scan creatinine level, was higher among patients with ischemic stroke who underwent a functional contrast-enhanced CT protocol compared with those who had no iodinated contrast administration. MATERIALS AND METHODS The contrast-exposed group consisted of 575 patients with acute ischemic stroke who underwent CTA (n = 313), CTA/CTP (n = 224), or CTA/CTP followed by conventional angiography (n = 38) within 24 hours of stroke onset and were consecutively enrolled in a prospective cohort study. The nonexposed group consisted of 343 patients with ischemic stroke, consecutively admitted to the same institution, who did not receive iodinated contrast material. Patients were stratified by baseline eGFR. In the primary analysis, the Fisher exact test was used to compare the incidence of AN between the contrast-exposed and the nonexposed patients at 24, 48, and 72 hours and on a cumulative basis. A secondary analysis compared the incidence of AN in patients who underwent conventional angiography following CTA/CTP versus patients who underwent CTA/CTP only. RESULTS The incidence of AN was 5% in the exposed and 10% in the nonexposed group (P = .003). Patients who underwent conventional angiography after contrast CT were at no greater risk of AN than patients who underwent CTA/CTP alone (26 patients, 5%; and 2 patients, 5%, respectively; P = .7). CONCLUSIONS Administration of a contrast-enhanced CT protocol involving CTA/CTP and conventional angiography in selected patients does not appear to increase the incidence of CIN. PMID:20044502

  15. 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

  16. 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

  17. 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.

  18. Automated Voxel-Based Analysis of Volumetric Dynamic Contrast-Enhanced CT Data Improves Measurement of Serial Changes in Tumor Vascular Biomarkers

    SciTech Connect

    Coolens, Catherine; Driscoll, Brandon; Chung, Caroline; Shek, Tina; Gorjizadeh, Alborz; Ménard, Cynthia; Jaffray, David

    2015-01-01

    Objectives: Development of perfusion imaging as a biomarker requires more robust methodologies for quantification of tumor physiology that allow assessment of volumetric tumor heterogeneity over time. This study proposes a parametric method for automatically analyzing perfused tissue from volumetric dynamic contrast-enhanced (DCE) computed tomography (CT) scans and assesses whether this 4-dimensional (4D) DCE approach is more robust and accurate than conventional, region-of-interest (ROI)-based CT methods in quantifying tumor perfusion with preliminary evaluation in metastatic brain cancer. Methods and Materials: Functional parameter reproducibility and analysis of sensitivity to imaging resolution and arterial input function were evaluated in image sets acquired from a 320-slice CT with a controlled flow phantom and patients with brain metastases, whose treatments were planned for stereotactic radiation surgery and who consented to a research ethics board-approved prospective imaging biomarker study. A voxel-based temporal dynamic analysis (TDA) methodology was used at baseline, at day 7, and at day 20 after treatment. The ability to detect changes in kinetic parameter maps in clinical data sets was investigated for both 4D TDA and conventional 2D ROI-based analysis methods. Results: A total of 7 brain metastases in 3 patients were evaluated over the 3 time points. The 4D TDA method showed improved spatial efficacy and accuracy of perfusion parameters compared to ROI-based DCE analysis (P<.005), with a reproducibility error of less than 2% when tested with DCE phantom data. Clinically, changes in transfer constant from the blood plasma into the extracellular extravascular space (K{sub trans}) were seen when using TDA, with substantially smaller errors than the 2D method on both day 7 post radiation surgery (±13%; P<.05) and by day 20 (±12%; P<.04). Standard methods showed a decrease in K{sub trans} but with large uncertainty (111.6 ± 150.5) %. Conclusions

  19. Abdominal closure using nonabsorbable mesh after massive resuscitation prevents abdominal compartment syndrome and gastrointestinal fistula.

    PubMed

    Ciresi, D L; Cali, R F; Senagore, A J

    1999-08-01

    Patients who receive high-volume resuscitation after massive abdominopelvic trauma, or emergent repair of a ruptured abdominal aortic aneurysm (RAAA), are at a significant risk for postoperative abdominal compartment syndrome (ACS). Absorbable prosthetic closure of the abdominal wall has been recommended as a means of managing ACS. However, use of absorbable prosthetic has been associated with very high rates of intestinal fistula formation and ventral hernia formation. The purpose of this study was to retrospectively review our experience with the use of nonabsorbable prosthetic abdominal closures in patients with documented ACS or at high risk for ACS. All patients managed by this technique from July 1995 through July 1997 after repair of ruptured abdominal aortic aneurysm or massive abdominopelvic trauma were evaluated. A total of 18 patients were identified: 15 primary prosthetic placements (Gore-Tex patch, 12; Marlex mesh, 2; and silastic mesh, 1) and 3 delayed prosthetic placements for ACS (Gore-Tex, 1 and Marlex, 2). The mortality rate was 22 percent (4 of 18) and resulted from multisystem organ failure (2 patients), cardiac arrest 1 hour postoperatively (1 patient), and severe closed head injury (1 patient). Secondary closure and prosthetic removal was possible in 16 of 18 patients, including the 2 patients who died of multisystem organ failure within the same hospitalization. Delayed abdominal closure at a subsequent admission was performed in two cases. This same patient developed an enterocutaneous fistula 2 months after discharge. Importantly, only 1 of 18 closed in this manner developed ACS requiring reoperation. The results indicate that use of a nonabsorbable prosthetic, particularly with Gore-Tex, is efficacious in the prevention of postoperative ACS in high-risk patients, while it enhances the possibility for delayed abdominal closure and minimizes the risk of gastrointestinal fistulization associated with other techniques. PMID:10432080

  20. Sphere-Enhanced Microwave Ablation (sMWA) Versus Bland Microwave Ablation (bMWA): Technical Parameters, Specific CT 3D Rendering and Histopathology

    SciTech Connect

    Gockner, T. L.; Zelzer, S.; Mokry, T. Gnutzmann, D. Bellemann, N.; Mogler, C.; Beierfuß, A. Köllensperger, E. Germann, G.; Radeleff, B. A. Stampfl, U. Kauczor, H. U.; Pereira, P. L.; Sommer, C. M.

    2015-04-15

    PurposeThis study was designed to compare technical parameters during ablation as well as CT 3D rendering and histopathology of the ablation zone between sphere-enhanced microwave ablation (sMWA) and bland microwave ablation (bMWA).MethodsIn six sheep-livers, 18 microwave ablations were performed with identical system presets (power output: 80 W, ablation time: 120 s). In three sheep, transarterial embolisation (TAE) was performed immediately before microwave ablation using spheres (diameter: 40 ± 10 μm) (sMWA). In the other three sheep, microwave ablation was performed without spheres embolisation (bMWA). Contrast-enhanced CT, sacrifice, and liver harvest followed immediately after microwave ablation. Study goals included technical parameters during ablation (resulting power output, ablation time), geometry of the ablation zone applying specific CT 3D rendering with a software prototype (short axis of the ablation zone, volume of the largest aligned ablation sphere within the ablation zone), and histopathology (hematoxylin-eosin, Masson Goldner and TUNEL).ResultsResulting power output/ablation times were 78.7 ± 1.0 W/120 ± 0.0 s for bMWA and 78.4 ± 1.0 W/120 ± 0.0 s for sMWA (n.s., respectively). Short axis/volume were 23.7 ± 3.7 mm/7.0 ± 2.4 cm{sup 3} for bMWA and 29.1 ± 3.4 mm/11.5 ± 3.9 cm{sup 3} for sMWA (P < 0.01, respectively). Histopathology confirmed the signs of coagulation necrosis as well as early and irreversible cell death for bMWA and sMWA. For sMWA, spheres were detected within, at the rim, and outside of the ablation zone without conspicuous features.ConclusionsSpecific CT 3D rendering identifies a larger ablation zone for sMWA compared with bMWA. The histopathological signs and the detectable amount of cell death are comparable for both groups. When comparing sMWA with bMWA, TAE has no effect on the technical parameters during ablation.

  1. Reconstruction of muscle fascicle architecture from iodine-enhanced microCT images: A combined texture mapping and streamline approach.

    PubMed

    Kupczik, Kornelius; Stark, Heiko; Mundry, Roger; Neininger, Fabian T; Heidlauf, Thomas; Röhrle, Oliver

    2015-10-01

    Skeletal muscle models are used to investigate motion and force generation in both biological and bioengineering research. Yet, they often lack a realistic representation of the muscle's internal architecture which is primarily composed of muscle fibre bundles, known as fascicles. Recently, it has been shown that fascicles can be resolved with micro-computed tomography (µCT) following staining of the muscle tissue with iodine potassium iodide (I2KI). Here, we present the reconstruction of the fascicular spatial arrangement and geometry of the superficial masseter muscle of a dog based on a combination of pattern recognition and streamline computation. A cadaveric head of a dog was incubated in I2KI and µCT-scanned. Following segmentation of the masseter muscle a statistical pattern recognition algorithm was applied to create a vector field of fascicle directions. Streamlines were then used to transform the vector field into a realistic muscle fascicle representation. The lengths of the reconstructed fascicles and the pennation angles in two planes (frontal and sagittal) were extracted and compared against a tracked fascicle field obtained through cadaver dissection. Both fascicle lengths and angles were found to vary substantially within the muscle confirming the complex and heterogeneous nature of skeletal muscle described by previous studies. While there were significant differences in the pennation angle between the experimentally derived and µCT-reconstructed data, there was congruence in the fascicle lengths. We conclude that the presented approach allows for embedding realistic fascicle information into finite element models of skeletal muscles to better understand the functioning of the musculoskeletal system. PMID:26141643

  2. Diffuse Infiltrative Splenic Lymphoma: Diagnostic Efficacy of Arterial-Phase CT

    PubMed Central

    Lee, Jeong Eun; Shin, Kyung Sook; Kim, Song Soo; You, Sun Kyoung; Park, Jae Woo; Shin, Hye Soo; Yoon, Yeo Chang

    2016-01-01

    Objective To evaluate the diagnostic performance of obliteration of normal heterogeneous enhancement of the spleen (ONHES) on arterial phase (AP) computed tomography (CT) images in diffuse infiltrative splenic lymphoma (DISL). Materials and Methods One hundred and thirty-six patients with lymphoma who had undergone two-phase (arterial and portal venous) abdominal CT were included in this study. We retrospectively evaluated the diagnostic performance of ONHES on AP CT in diagnosing DISL. Two observers evaluated ONHES on AP CT using the 5-point confidence level and assessed the presence or absence of subjective splenomegaly on axial CT images. Another two observers measured the splenic index as proposed by objective CT criteria. Statistical analysis included interobserver agreement and diagnostic performance of CT findings. Results Eleven of the 136 patients with lymphoma had DISL. The area under the receiver operating characteristic curve of ONHES (0.948 for observer 1 and 0.922 for observer 2) was superior to that of the splenic index (0.872 for observer 3 and 0.877 for observer 4), but the difference was not statistically significant (p > 0.05). The diagnostic performance of ONHES in conjunction with subjective splenomegaly showed higher diagnostic performance, as compared with subjective splenomegaly alone (accuracy: 100% and 85.3% for observer 1, 98.5% and 87.5% for observer 2; positive predictive value: 100% and 35.5% for observer 1, 90.9% and 39.3% for observer 2, respectively). Conclusion Obliteration of normal heterogeneous enhancement of the spleen in conjunction with subjective splenomegaly can improve the diagnostic performance for DISL. Our results suggest that ONHES on AP CT images could be useful as an adjunctive diagnostic indicator of DISL in patients with lymphoma. PMID:27587962

  3. Hysterectomy for Benign Conditions of the Uterus: Total Abdominal Hysterectomy.

    PubMed

    Moen, Michael

    2016-09-01

    Hysterectomy is the most common major gynecologic procedure. Although alternatives to hysterectomy result in fewer procedures performed annually, and the use of endoscopic techniques and vaginal hysterectomy have resulted in a lower percentage performed by the open abdominal route, certain pelvic disorders require abdominal hysterectomy. Preoperative evaluation with informed consent and surgical planning are essential to select appropriate candidates. Prophylactic antibiotics, thromboprophylaxis, attention to surgical technique, and enhanced recovery protocols should be used to provide optimal outcomes. PMID:27521877

  4. [Differential diagnosis of abdominal pain].

    PubMed

    Frei, Pascal

    2015-09-01

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain. PMID:26331201

  5. Lower Abdominal Pain.

    PubMed

    Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S

    2016-05-01

    Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation. PMID:27133242

  6. Pediatric Abdominal Organ Transplantation: Current Indications, Techniques, and Imaging Findings.

    PubMed

    Stanescu, A Luana; Hryhorczuk, Anastasia L; Chang, Patricia T; Lee, Edward Y; Phillips, Grace S

    2016-03-01

    The anatomy, normal postoperative radiological appearance, and imaging features of common postoperative complications of pediatric abdominal transplants are reviewed, including renal, liver, and intestinal transplants. Doppler ultrasound is the mainstay of imaging after transplantation. Computed tomography (CT) and CT angiography, MR imaging and magnetic resonance (MR) angiography, MR cholangiopancreatography, conventional angiography, and nuclear medicine imaging may be used for problem-solving in pediatric transplant patients. Accurate and timely radiological diagnosis of transplant complications facilitates appropriate treatment and minimizes morbidity and mortality. PMID:26896225

  7. FDG PET/CT in Sarcomatoid Carcinoma of the Gallbladder With Chondroid Differentiation.

    PubMed

    Dong, Aisheng; Dong, Hui; Jing, Wei; Zuo, Changjing

    2016-08-01

    Sarcomatoid carcinoma of the gallbladder, composed of epithelial and sarcomatous components, is a rare malignant tumor with a poor prognosis. A 61-year-old man was admitted because of abdominal distention for 2 weeks. Enhanced CT showed a large gallbladder tumor with central necrosis. The tumor measuring 18 cm in maximum diameter showed intense peripheral FDG uptake with SUVmax of 15.4. The specimen of the resected tumor revealed tubular adenocarcinoma and sarcomatoid tissue with chondroid differentiation. Immunohistochemical staining showed the sarcomatoid tissue was positive for EMA, CD10, and VIM, with proliferation index of 80%. These pathologic findings were consistent with sarcomatoid carcinoma. PMID:26859217

  8. Improved target volume definition for precision radiotherapy planning of meningiomas by correlation of CT and dynamic, Gd-DTPA-enhanced FLASH MR imaging.

    PubMed

    Schad, L R; Blüml, S; Debus, J; Scharf, J; Lorenz, W J

    1994-10-01

    In this methodological paper the authors report a fast, T1-weighted gradient-echo sequence (FLASH) for dynamic, Gd-DTPA-enhanced magnetic resonance (MR) imaging of meningiomas and its application in precision radiotherapy planning. Indications for radiotherapy included unresected tumors, tumor remaining after surgery, and recurrences. The patient's head was fixed in a stereotactic localization system which is usable at the CT, MR and the linear accelerator installations. By phantom measurements different materials (steel, aluminum, titanium, plastic, wood, ceramics) used for the stereotactic system were tested for mechanical stability and geometric MR image distortion. All metallic stereotactic rings (closed rings made of massive metal) led to a more or less dramatic geometric distortion and signal cancellation in the MR images. The best properties--nearly no distortion and high mechanic stability--are provided by a ceramic ring. If necessary, the remaining geometric MR image distortion can be 'corrected' (reducing displacements to the size of a pixel) by calculations based on modeling the distortion as a fourth order two-dimensional polynomial. The target volume was defined in dynamic, T1-weighted FLASH MR images, which were measured before, during, and after the controlled intravenous infusion of 0.1 mmol/kg body weight Gd-DTPA. The stereotactic localization technique allows the precise transfer of the target volume information from MR onto CT data to provide a map of the radiation attenuation coefficient for dose calculation. In genera, the superior soft tissue contrast of MR showed an excellent tumor delineation, especially in regions, such as the base of the skull, where the target often was obscured in CT images.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7878213

  9. Imaging of Chest and Abdominal Trauma in Children.

    PubMed

    Goodwin, Susie J; Flanagan, Sean G; McDonald, Kirsteen

    2015-01-01

    Trauma is the commonest cause of death in children over a year old. The injuries sustained and management of these children differs to adults, due to differences in anatomy and physiology. Careful thought must also be given to exposing children to radiation, and CT scans should be performed only in select patients. This article reviews these important points and explains the imaging findings in chest and abdominal trauma. PMID:26219741

  10. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  11. Geometric feature-based multimodal image registration of contrast-enhanced cardiac CT with gated myocardial perfusion SPECT

    PubMed Central

    Woo, Jonghye; Slomka, Piotr J.; Dey, Damini; Cheng, Victor Y.; Hong, Byung-Woo; Ramesh, Amit; Berman, Daniel S.; Karlsberg, Ronald P.; Kuo, C.-C. Jay; Germano, Guido

    2009-01-01

    Purpose: Cardiac computed tomography (CT) and single photon emission computed tomography (SPECT) provide clinically complementary information in the diagnosis of coronary artery disease (CAD). Fused anatomical and physiological data acquired sequentially on separate scanners can be coregistered to accurately diagnose CAD in specific coronary vessels. Methods: A fully automated registration method is presented utilizing geometric features from a reliable segmentation of gated myocardial perfusion SPECT (MPS) volumes, where regions of myocardium and blood pools are extracted and used as an anatomical mask to de-emphasize the inhomogeneities of intensity distribution caused by perfusion defects and physiological variations. A multiresolution approach is employed to represent coarse-to-fine details of both volumes. The extracted voxels from each level are aligned using a similarity measure with a piecewise constant image model and minimized using a gradient descent method. The authors then perform limited nonlinear registration of gated MPS to adjust for phase differences by automatic cardiac phase matching between CT and MPS. For phase matching, they incorporate nonlinear registration using thin-plate-spline-based warping. Rigid registration has been compared with manual alignment (n=45) on 20 stress/rest MPS and coronary CTA data sets acquired from two different sites and five stress CT perfusion data sets. Phase matching was also compared to expert visual assessment. Results: As compared with manual alignment obtained from two expert observers, the mean and standard deviation of absolute registration errors of the proposed method for MPS were4.3±3.5, 3.6±2.6, and 3.6±2.1mm for translation and 2.1±3.2°, 0.3±0.8°, and 0.7±1.2° for rotation at site A and 3.8±2.7, 4.0±2.9, and 2.2±1.8mm for translation and 1.1±2.0°, 1.6±3.1°, and 1.9±3.8° for rotation at site B. The results for CT perfusion were 3.0±2.9, 3.5±2.4, and 2.8±1.0mm for translation and 3

  12. Conservative management of an abdominal gunshot injury with a peritoneal breach: wisdom or absurdity?

    PubMed Central

    Khan, Salma; Pardhan, Amyn; Bawa, Tufail; Haroon, Naveed

    2013-01-01

    Surgical exploration has been the standard of care for abdominal gunshot injuries. The authors report a case of a 28-year-old man who sustained a transabdominal gunshot injury, which entered the anterior abdominal wall and exited adjacent to the T12 vertebra posteriorly with a tangential trajectory. On presentation, the patient was haemodynamically stable with no peritoneal signs. Based on trajectory of the bullet, intra-abdominal injury was suspected. Therefore a CT scan abdomen with intravenous and rectal contrast was performed. The CT scan revealed no extravasation of the rectal contrast but showed free air specks behind the descending colon. Delayed renal images of the left ureter were also normal. Based on the clinical findings, the patient was managed non-operatively with nothing per oral, intravenous antibiotics and frequent abdominal assessments. He made an uneventful recovery without necessitating laparotomy. PMID:24272989

  13. CT Scans

    MedlinePlus

    ... cross-sectional pictures of your body. Doctors use CT scans to look for Broken bones Cancers Blood clots Signs of heart disease Internal bleeding During a CT scan, you lie still on a table. The table ...

  14. Contrast medium usage reduction in abdominal computed tomography by using high-iodinated concentration contrast medium

    NASA Astrophysics Data System (ADS)

    Suwannasri, A.; Kaewlai, R.; Asavaphatiboon, S.

    2016-03-01

    This study was to determine if administration of a low volume high-concentration iodinated contrast medium can preserve image quality in comparison with regular-concentration intravenous contrast medium in patient undergoing contrast-enhancement abdominal computed tomography (CT). Eighty-four patients were randomly divided into 3 groups of similar iodine delivery rate; A: 1.2 cc/kg of iomeprol-400, B: 1.0 cc/kg of iomeprol-400 and C: 1.5 cc/kg of ioversol-350. Contrast enhancement of the liver parenchyma, pancreas and aorta was quantitatively measured in Hounsfield units and qualitative assessed by a radiologist. T-test was used to evaluate contrast enhancement, and Chi-square test was used to evaluate qualitative image assessment, at significance level of 0.05 with 95% confidence intervals. There were no statistically significant differences in contrast enhancement of liver parenchyma and pancreas between group A and group C in both quantitative and qualitative analyses. Group C showed superior vascular enhancement to group A and B on quantitative analysis.

  15. Visualization of microvascular proliferation as a tumor infiltration structure in rat glioma specimens using the diffraction-enhanced imaging in-plane CT technique

    NASA Astrophysics Data System (ADS)

    Seo, Seung-Jun; Sunaguchi, Naoki; Yuasa, Tetsuya; Huo, Qingkai; Ando, Masami; Choi, Gi-Hwan; Kim, Hong-Tae; Kim, Ki-Hong; Jeong, Eun-Ju; Chang, Won-Seok; Kim, Jong-Ki

    2012-03-01

    In order to study potent microenvironments of malignant gliomas with a high- resolution x-ray imaging technique, an injection orthotopic glioma model was made using the Sprague-Dawley rat. Total brain tissue, taken out as an ex vivo model, was examined with diffraction-enhanced imaging (DEI) computed tomography (CT) acquired with a 35 keV monochromatic x-ray. In the convolution-reconstructed 2D/3D images with a spatial resolution of 12.5 × 12.5 × 25 µm, distinction among necrosis, typical ring-shaped viable tumors, edemas and healthy tissues was clearly observed near the frontal lobe in front of the rat's caudate nucleus. Multiple microvascular proliferations (MVPs) were observed surrounding peritumoral edemas as a tumor infiltration structure. Typical dimensions of tubular MVPs were 130 (diameter) ×250 (length) µm with a partial sprout structure revealed in the 3D reconstructed image. Hyperplasia of cells around vessel walls was revealed with tumor cell infiltration along the perivascular space in microscopic observations of mild MVP during histological analysis. In conclusion, DEI-CT is capable of imaging potent tumor-infiltrating MVP structures surrounding high-grade gliomas.

  16. Mapping transitions between healthy and pathological lesions in human breast tissues by diffraction enhanced imaging computed tomography (DEI-CT) and small angle x-ray scattering (SAXS)

    NASA Astrophysics Data System (ADS)

    Conceição, A. L. C.; Antoniassi, M.; Geraldelli, W.; Poletti, M. E.

    2014-02-01

    In this work we have combined the DEI-CT and SAXS technique to study the transition between healthy and pathological breast tissues, which include benign and malignant lesions. The ability of DEI-CT to enhance the contrast between soft tissues was used to localize the tumor region in the sample. Then, the tumor region and its surroundings were scanned by SAXS in order to map the changes promoted by the neoplasias at nano-level.It was clearly observed that pathological tissues present distinguishable SAXS scattering profiles from those of normal tissue. These differences are mainly related to changes in arrangement and diameter of collagen fibrils, evaluated by the higher order of reflection peaks of these fibrils. Differences related to the peak intensities and the total scattered intensity were found by comparing the healthy and pathological regions. The 2nd order of collagen reflection arises only in the healthy region neighboring the benign lesion. A broader peak at q=0.16 nm-1 seems to characterize the malignant lesions. Finally, based on this information, the transition between healthy and pathological human breast tissues was mapped which allowed to get insights into the changes promoted by tumors during growth and progression.

  17. Discriminative dictionary learning for abdominal multi-organ segmentation.

    PubMed

    Tong, Tong; Wolz, Robin; Wang, Zehan; Gao, Qinquan; Misawa, Kazunari; Fujiwara, Michitaka; Mori, Kensaku; Hajnal, Joseph V; Rueckert, Daniel

    2015-07-01

    An automated segmentation method is presented for multi-organ segmentation in abdominal CT images. Dictionary learning and sparse coding techniques are used in the proposed method to generate target specific priors for segmentation. The method simultaneously learns dictionaries which have reconstructive power and classifiers which have discriminative ability from a set of selected atlases. Based on the learnt dictionaries and classifiers, probabilistic atlases are then generated to provide priors for the segmentation of unseen target images. The final segmentation is obtained by applying a post-processing step based on a graph-cuts method. In addition, this paper proposes a voxel-wise local atlas selection strategy to deal with high inter-subject variation in abdominal CT images. The segmentation performance of the proposed method with different atlas selection strategies are also compared. Our proposed method has been evaluated on a database of 150 abdominal CT images and achieves a promising segmentation performance with Dice overlap values of 94.9%, 93.6%, 71.1%, and 92.5% for liver, kidneys, pancreas, and spleen, respectively. PMID:25988490

  18. A mycotic abdominal aortic aneurysm caused by Listeria monocytogenes in a patient with HIV infection

    PubMed Central

    Gunst, Jesper Damsgaard; Jensen-Fangel, Søren

    2014-01-01

    A 65-year-old man with HIV infection presented with acute severe abdominal pain radiating to the back. A CT scan revealed an infrarenal abdominal aortic aneurysm, and an aortobifemoral bypass was undertaken. Subsequently, tissue specimens from the aortic wall grew Listeria monocytogenes. The patient received 8 weeks of intravenous antibiotic treatment followed by oral sulfotrim as secondary prophylaxis and made an uneventful recovery. PMID:24443338

  19. CT angiography in the diagnosis of cardiovascular disease: a transformation in cardiovascular CT practice

    PubMed Central

    Al Moudi, Mansour; Cao, Yan

    2014-01-01

    Computed tomography (CT) angiography represents the most important technical development in CT imaging and it has challenged invasive angiography in the diagnostic evaluation of cardiovascular abnormalities. Over the last decades, technological evolution in CT imaging has enabled CT angiography to become a first-line imaging modality in the diagnosis of cardiovascular disease. This review provides an overview of the diagnostic applications of CT angiography (CTA) in cardiovascular disease, with a focus on selected clinical challenges in some common cardiovascular abnormalities, which include abdominal aortic aneurysm (AAA), aortic dissection, pulmonary embolism (PE) and coronary artery disease. An evidence-based review is conducted to demonstrate how CT angiography has changed our approach in the diagnosis and management of cardiovascular disease. Radiation dose reduction strategies are also discussed to show how CT angiography can be performed in a low-dose protocol in the current clinical practice. PMID:25392823

  20. CT angiography in the diagnosis of cardiovascular disease: a transformation in cardiovascular CT practice.

    PubMed

    Sun, Zhonghua; Al Moudi, Mansour; Cao, Yan

    2014-10-01

    Computed tomography (CT) angiography represents the most important technical development in CT imaging and it has challenged invasive angiography in the diagnostic evaluation of cardiovascular abnormalities. Over the last decades, technological evolution in CT imaging has enabled CT angiography to become a first-line imaging modality in the diagnosis of cardiovascular disease. This review provides an overview of the diagnostic applications of CT angiography (CTA) in cardiovascular disease, with a focus on selected clinical challenges in some common cardiovascular abnormalities, which include abdominal aortic aneurysm (AAA), aortic dissection, pulmonary embolism (PE) and coronary artery disease. An evidence-based review is conducted to demonstrate how CT angiography has changed our approach in the diagnosis and management of cardiovascular disease. Radiation dose reduction strategies are also discussed to show how CT angiography can be performed in a low-dose protocol in the current clinical practice. PMID:25392823

  1. A numerical investigation of the healthy abdominal wall structures.

    PubMed

    Pachera, P; Pavan, P G; Todros, S; Cavinato, C; Fontanella, C G; Natali, A N

    2016-06-14

    The present work aims to assess, via numerical modeling, the global passive mechanical behavior of the healthy abdominal wall under the action of pressures that characterize different daily tasks and physiological functions. The evaluation of a normal range of intra-abdominal pressure (IAP) during activities of daily living is fundamental because pressure alterations can cause several adverse effects. At this purpose, a finite element model is developed from literature histomorphometric data and from diagnostic images of Computed Tomography (CT), detailing the different anatomical regions. Numerical simulations cover an IAP up to the physiological limit of 171 (0.0223MPa) mmHg reached while jumping. Numerical results are in agreement with evidences on physiological abdomens when evaluating the local deformations along the craniocaudal direction, the transversal load forces in different regions and the increase of the abdominal area at a IAP of 12mmHg. The developed model can be upgraded for the investigation of the abdominal hernia repair and the assessment of prostheses mechanical compatibility, correlating stiffness and tensile strength of the abdominal tissues with those of surgical meshes. PMID:27133659

  2. Intravenous contrast-enhanced CT of the postoperative lumbar spine: improved identification of recurrent disk herniation, scar, arachnoiditis, and diskitis

    SciTech Connect

    Teplick, J.G.; Haskin, M.E.

    1984-10-01

    Unsuccessful relief of symptoms after back surgery is usually attributable to hypertrophic extradural scar or recurrent herniated disk. Their clinical and myelographic differentiation is difficult, yet important because reoperation is not always beneficial for scar removal. This article examines the usefulness of intravenous contrast-enhanced computed tomography for this problem. Forty-five postsurgical patients were studied; eight had subsequent surgery. In the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with recurrent disk herniation, nonenhancement of the extruded disk allowed its recognition in three. In the other 37 patients who were not reoperated, 33 were believed to have scar on the basis of contrast enhancement. The method seems promising for more accurate evaluation of failed back surgery, including the recognition of diskitis.

  3. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  4. Functional Abdominal Pain in Children

    MedlinePlus

    ... dominalPa in inCh ildre n What is functional abdominal pain, and why does it happen? Most otherwise-healthy ... stomachaches for two months or more have functional abdominal pain. The term “functional” refers to the fact that ...

  5. Estimation of Cardiac Respiratory-Motion by Semi-Automatic Segmentation and Registration of Non-Contrast-Enhanced 4D-CT Cardiac Datasets

    PubMed Central

    Dey, Joyoni; Pan, Tinsu; Choi, David J.; Robotis, Dennis; Smyczynski, Mark S.; Pretorius, P. Hendrik; King, Michael A.

    2010-01-01

    The goal of this work is to investigate, for a large set of patients, the motion of the heart with respiration during free-breathing supine medical imaging. For this purpose we analyzed the motion of the heart in 32 non-contrast enhanced respiratory-gated 4D-CT datasets acquired during quiet unconstrained breathing. The respiratory-gated CT images covered the cardiac region and were acquired at each of 10 stages of the respiratory cycle, with the first stage being end-inspiration. We devised a 3-D semi-automated segmentation algorithm that segments the heart in the 4D-CT datasets acquired without contrast enhancement for use in estimating respiratory motion of the heart. Our semi-automated segmentation results were compared against interactive hand segmentations of the coronal slices by a cardiologist and a radiologist. The pairwise difference in segmentation among the algorithm and the physicians was on the average 11% and 10% of the total average segmented volume across the patient, with a couple of patients as outliers above the 95% agreement limit. The mean difference among the two physicians was 8% with an outlier above the 95% agreement limit. The 3-D segmentation was an order of magnitude faster than the Physicians’ manual segmentation and represents significant reduction of Physicians’ time. The segmented first stages of respiration were used in 12 degree-of-freedom (DOF) affine registration to estimate the motion at each subsequent stage of respiration. The registration results from the 32 patients indicate that the translation in the superior-inferior direction was the largest component motion, with a maximum of 10.7 mm, mean of 6.4 mm, and standard deviation of 2.2 mm. Translation in the anterior-posterior direction was the next largest component of motion, with a maximum of 4.0 mm, mean of 1.7 mm, and standard deviation of 1.0 mm. Rotation about the right-left axis was on average the largest component of rotation observed, with a maximum of 4

  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. Abdominal Mondor disease mimicking acute appendicitis

    PubMed Central

    Schuppisser, Myriam; Khallouf, Joe; Abbassi, Ziad; Erne, Michel; Vettorel, Denise; Paroz, Alexandre; Naiken, Surennaidoo P.

    2016-01-01

    Introduction Mondor disease (MD), a superficial thrombophlebitis of the thoraco-epigastric veins and their confluents is rarely reported in the literature. The superior epigastric vein is the most affected vessel but involvement of the inferior epigastric vessels or their branches have also been described. There is no universal consensus on treatment in the literature but most authors suggest symptomatic treatment with non-steroid anti-inflammatory drugs (NSAIDs). Case report We report the case of a marathon runner who presented with right iliac fossa pain mimicking the clinical symptomatology of an acute appendicitis. The history and the calculated Alvarado score were not in favor of an acute appendicitis. This situation motivated multiple investigations and we finally arrived at the diagnosis of MD. Discussion Acute appendicitis (AA) is the most common cause of surgical emergencies and one of the most frequent indications for an urgent abdominal surgical procedure around the world. In some cases, right lower quadrant pain remains unclear in spite of US, CT scan, and exclusion of urological and gynecological causes, thus we need to think of some rare pathologies like MD. Conclusion MD is often mentioned in the differential diagnosis of breast pathologies but rarely in abdominal pain assessment. It should be mentioned in the differential diagnosis of the right lower quadrant pain when the clinical presentation is unclear and when acute appendicitis has been excluded. Awareness of MD can avoid misdiagnosis and decrease extra costs by sparing unnecessary imaging. PMID:26803533

  8. Endovascular Repair of an Anastomotic Leak Following Open Repair of Abdominal Aortic Aneurysm

    SciTech Connect

    Mofidi, R. Flett, M.; Milne, A.; Chakraverty, S.

    2007-09-15

    This report describes the case of an early postoperative anastomotic leak following elective open repair of an infrarenal abdominal aortic aneurysm which was successfully treated by endovascular stent-grafting. A 71-year-old man underwent open tube graft repair of abdominal aortic aneurysm. Twelve days later he presented with a contained leak from the distal anastomosis, which was confirmed on CT scan. This was successfully treated with a bifurcated aortic stent-graft. This case illustrates the usefulness of the endovascular approach for resolving this rare surgical complication of open repair of abdominal aortic aneurysm and the challenges associated with the deployment of such a device within an aortic tube graft.

  9. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    PubMed

    Cervellin, Gianfranco; Lippi, Giuseppe

    2015-06-01

    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established. PMID:25616589

  10. Atlas and feature based 3D pathway visualization enhancement for skull base pre-operative fast planning from head CT

    NASA Astrophysics Data System (ADS)

    Aghdasi, Nava; Li, Yangming; Berens, Angelique; Moe, Kris S.; Bly, Randall A.; Hannaford, Blake

    2015-03-01

    Minimally invasive neuroendoscopic surgery provides an alternative to open craniotomy for many skull base lesions. These techniques provides a great benefit to the patient through shorter ICU stays, decreased post-operative pain and quicker return to baseline function. However, density of critical neurovascular structures at the skull base makes planning for these procedures highly complex. Furthermore, additional surgical portals are often used to improve visualization and instrument access, which adds to the complexity of pre-operative planning. Surgical approach planning is currently limited and typically involves review of 2D axial, coronal, and sagittal CT and MRI images. In addition, skull base surgeons manually change the visualization effect to review all possible approaches to the target lesion and achieve an optimal surgical plan. This cumbersome process relies heavily on surgeon experience and it does not allow for 3D visualization. In this paper, we describe a rapid pre-operative planning system for skull base surgery using the following two novel concepts: importance-based highlight and mobile portal. With this innovation, critical areas in the 3D CT model are highlighted based on segmentation results. Mobile portals allow surgeons to review multiple potential entry portals in real-time with improved visualization of critical structures located inside the pathway. To achieve this we used the following methods: (1) novel bone-only atlases were manually generated, (2) orbits and the center of the skull serve as features to quickly pre-align the patient's scan with the atlas, (3) deformable registration technique was used for fine alignment, (4) surgical importance was assigned to each voxel according to a surgical dictionary, and (5) pre-defined transfer function was applied to the processed data to highlight important structures. The proposed idea was fully implemented as independent planning software and additional

  11. Head CT scan

    MedlinePlus

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial ... or other growth (mass) Cerebral atrophy (loss of brain tissue) ... with the hearing nerve Stroke or transient ischemic attack (TIA)

  12. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  13. Technical prerequisites and imaging protocols for CT perfusion imaging in oncology.

    PubMed

    Klotz, Ernst; Haberland, Ulrike; Glatting, Gerhard; Schoenberg, Stefan O; Fink, Christian; Attenberger, Ulrike; Henzler, Thomas

    2015-12-01

    The aim of this review article is to define the technical prerequisites of modern state-of-the-art CT perfusion imaging in oncology at reasonable dose levels. The focus is mainly on abdominal and thoracic tumor imaging, as they pose the largest challenges with respect to attenuation and patient motion. We will show that low kV dynamic scanning in conjunction with detection technology optimized for low photon fluxes has the highest impact on reducing dose independently of other choices made in the protocol selection. We discuss, derived from relatively simple first principles, on what appropriate temporal sampling and total scan duration depend on and why optimized contrast medium injection protocols are also essential in limiting dose. Finally we will examine the possibility of simultaneously extracting standard morphological and functional information from one single 4D examination as a potential enabler for a more widespread use of dynamic contrast enhanced CT in oncology. PMID:26137905

  14. Economics of abdominal wall reconstruction.

    PubMed

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. PMID:24035086

  15. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  16. Kinematic modeling and its implication in longitudinal chemotherapy study of tumor physiology: ovarian xenograft mouse model and contrast-enhanced dynamic CT (Honorable Mention Poster Award)

    NASA Astrophysics Data System (ADS)

    Stantz, Keith M.; Liang, Yun; Hutchins, Gary D.

    2004-04-01

    The purpose of this study is to demonstrate that dynamic CT provides the necessary sensitivity to quantify tumor physiology and differences in chemotherapeutic response. A compartmental mouse model utilizing measured contrast-enhanced dynamic CT scans is used to simulate systematic and statistical errors associated with tumor physiology: perfusion, permeability (PS), fractional plasma volume (fp), and fractional interstitial volume. The solute utilized is a small molecular weight radio-opaque contrast agent (isovue). For such an intravascular-interstitial medium, the kinematics simplifies to a two compartmental diffusive dominated set of coupled differential equations. Each combination of physiological parameters is repeatedly simulated fifteen times from which statistical errors calculated. The fractional change relative to the true value (systematic error) and standard deviation (statistical error) are plotted as a function of PS, fp, scanner temporal resolution and noise, and contrast media injection rates. By extrapolating from experimental data found in literature, a relative change in PS and fp of approximately 40% is required. Thus, the longitudinal response of two chemotherapeutic drugs under investigation - proteasome and IMPDH inhibitors - are hypothesized to induce different physiological responses. The first set of simulations varies PS from 0.05 to 0.40 mL/min/mL and fp from 0.01 to 0.07 mL/mL while holding all other physiological parameters constant. Errors in PS remain below 3% while statistical errors for fp increase significantly as the volume decreases toward 1-2%: errors remain less than 6% for fp>0.03 while increasing to above 15% for fp<0.02. The second set of simulations are performed quantifying the relationship between scanner temporal resolution and contrast media injection rate for various tumor permeabilities. For the majority of cases, the errors remain below 5%. As PS approaches perfusion, a total error less than 6% can be maintained

  17. 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

  18. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-01-01

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. PMID:25398912

  19. Emergency abdominal MRI: current uses and trends.

    PubMed

    Yu, Hei S; Gupta, Avneesh; Soto, Jorge A; LeBedis, Christina

    2016-05-01

    When evaluating the abdomen in the emergency setting, CT and ultrasound are the imaging modalities of choice, mainly because of accessibility, speed and lower relative cost. CT has the added benefit of assessing the whole abdomen for a wide spectrum of gastrointestinal disease, whereas ultrasound has the benefit of avoiding ionizing radiation. MRI is another tool that has demonstrated increasing utility in the emergency setting and also avoids the use of ionizing radiation. MRI also has the additional advantage of excellent soft-tissue contrast. However, widespread use of MRI in the emergency setting is limited by availability and relative cost. Despite such limitations, advances in MRI technology, including improved pulse sequences and coil technology and increasing clinician awareness of MRI, have led to an increased demand in abdominal MRI in the emergency setting. This is particularly true in the evaluation of acute pancreatitis; choledocholithiasis with or without cholecystitis; acute appendicitis, particularly in pregnant patients; and, in some cases, Crohn's disease. In cases of pancreatitis and Crohn's disease, MRI also plays a role in subsequent follow-up examinations. PMID:26514590

  20. Modern CT applications in veterinary medicine.

    PubMed

    Garland, Melissa R; Lawler, Leo P; Whitaker, Brent R; Walker, Ian D F; Corl, Frank M; Fishman, Elliot K

    2002-01-01

    Although computed tomography (CT) is used primarily for diagnosis in humans, it can also be used to diagnose disease in veterinary patients. CT and associated three-dimensional reconstruction have a role in diagnosis of a range of illnesses in a variety of animals. In a sea turtle with failure to thrive, CT showed a nodal mass in the chest, granulomas in the lungs, and a ball in the stomach. CT of a sea dragon with balance and movement problems showed absence of the swim bladder. In a sloth with failure to thrive, CT allowed diagnosis of a coin in the intestine. CT of a puffin with failure to thrive showed a mass in the chest, which was found to be a hematoma. In a smooth-sided toad whose head was tilted to one side and who was circling in that direction, CT showed partial destruction of the temporal bone. CT of a domestic cat with listlessness showed a mass with focal calcification, which proved to be a leiomyosarcoma. CT of a sea otter showed pectus excavatum, which is caused by the animal smashing oysters against its chest. In a Japanese koi with abdominal swelling, CT allowed diagnosis of a hepatoma. PMID:11796898

  1. 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

  2. JAMA Patient Page: Abdominal Hernia

    MedlinePlus

    ... an operation. Umbilical hernia Abdominal wall Intestinal loop Peritoneum Skin Peritoneum Umbilical annulus SYMPTOMS The first symptom of a ... vomiting, or constipation. Inguinal hernia Indirect inguinal hernia Peritoneum Deep inguinal ring Inguinal canal Superficial inguinal ring ...

  3. Functional Abdominal Pain in Children

    MedlinePlus

    ... At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain ...

  4. Comparison of cone beam CT scans with enhanced photostimulated phosphor plate images in the detection of root fracture of endodontically treated teeth

    PubMed Central

    Bechara, B; McMahan, C A; Noujeim, M; Faddoul, T; Moore, W S; Teixeira, F B; Geha, H

    2013-01-01

    Objectives: Two-dimensional intraoral radiography is the most common tool for diagnosing root fractures (RFs). Cone beam CT (CBCT) is widely used to depict RFs in endodontically treated teeth. Beam hardening and other artefacts caused by gutta percha may result in an incorrect diagnosis when using CBCT only. A comparison of two CBCT machines with photostimulated phosphor (PSP) plate images enhanced with the equalization tool was carried out to detect RFs in endodontically treated teeth. Methods: 66 roots were collected, decoronated and treated endodontically using the same technique with gutta percha. 33 of these roots were randomly selected and fractured; the 2 root fragments were glued together with 1 layer of methyl methacrylate and placed randomly in 8 prepared beef rib fragments. Large fields of view (FOVs) were acquired with one CBCT unit and small FOVs with the second CBCT unit. Periapical radiographs (using intraoral PSP plates) were also acquired. A contrast enhancement tool was used when evaluating the PSP plate images. Results: Small FOV images had significantly higher accuracy (area under the receiver operating characteristic curve) and sensitivity in detecting RFs than PSP plates and large FOV images. The specificity of the enhanced PSP images was higher than, although not significantly higher than, the small FOV images and was significantly higher than the large FOV images. Conclusions: CBCT small FOVs should be acquired for depicting RFs of endodontically treated teeth. Images obtained using PSP plates had the lowest rate of false-positive results and their use can save the patient a radiation dose. PMID:23625067

  5. DIEP breast reconstruction following multiple abdominal liposuction procedures

    PubMed Central

    Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine

    2014-01-01

    Objective: Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Methods: Review of case notes and radiological investigations of two patients, and a PubMed search using the terms “DIEP”, “deep inferior epigastric”, “TRAM”, “transverse rectus abdominis”, “perforator” and “laparotomy”, “abdominal wall”, “liposuction”, “liposculpture”, “fat graft”, “pfannenstiel”, with subsequent appraisal of relevant papers by the first and second authors. Results: Patient 1 had 3 episodes of liposuction from the abdomen for fat grafting to a reconstructed breast. Subsequent revision reconstruction of the same breast with DIEP flap was preceded by CT angiography, which demonstrated normal perforator anatomy. The reconstruction healed well with no ischaemic complications. Patient 2 had 5 liposuction procedures from the abdomen to graft fat to a wide local excision defect. Recurrence of cancer led to mastectomy and immediate reconstruction with free DIEP flap. Preoperative MR angiography demonstrated a large perforator right of the umbilicus, with which the intraoperative findings were consistent. The patient had an uneventful recovery and good healing with no fat necrosis or wound dehiscence. Conclusions: We demonstrate that DIEP flaps can safely be raised without perfusion-related complications following multiple liposuction procedures to the abdomen. The safe interval between procedures is difficult to quantify, but we demonstrate successful free flap after 16 months. PMID:25671046

  6. Endovascular Treatment of Ruptured Abdominal Aortic Aneurysm with Aortocaval Fistula

    SciTech Connect

    Guzzardi, Giuseppe Fossaceca, Rita; Divenuto, Ignazio; Musiani, Antonello; Brustia, Piero; Carriero, Alessandro

    2010-08-15

    Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA). We report the endovascular repair of an AAA rupture into the inferior vena cava. A 78-year-old woman was admitted to our hospital for acute hypotension. She presented with a pulsatile abdominal mass and became rapidly anuric. Abdominal computed tomography (CT) showed an AAA rupture into the inferior vena cava. The features of the AAA made it suitable for endovascular repair. To prevent pulmonary embolism caused by the presence of sac thrombosis near the vena cava lumen, a temporary vena cava filter was deployed before the procedure. A bifurcated stent-graft was placed with the patient under local anaesthesia, and the AAA was successfully treated. A transient type II endoleak was detected on CT 3 days after endograft placement. At routine follow-up 6 and 12 months after the procedure, the patient was in good clinical condition, and the type II endoleak had sealed completely. Endovascular treatment offers an attractive therapeutic alternative to open repair in case of ACF; however, only small numbers of patients have been treated, and long-term follow-up interval is lacking.

  7. Preoperative Gross Classification of Gastric Adenocarcinoma: Comparison of Double Contrast-Enhanced Ultrasound and Multi-Detector Row CT.

    PubMed

    Yan, Caoxin; Bao, Xiaofeng; Shentu, Weihui; Chen, Jian; Liu, Chunmei; Ye, Qin; Wang, Liuhong; Tan, Yangbin; Huang, Pintong

    2016-07-01

    The aim of this study was to compare the accuracy of multi-detector computed tomography (MDCT) with double contrast-enhanced ultrasound (DCEUS), in which intravenous microbubbles are used alongside oral contrast-enhanced ultrasound, in determining the gross classification of patients with gastric carcinoma (GC). Altogether, 239 patients with GC proved by histology after endoscopic biopsy were included in this study. DCEUS and MDCT were performed pre-operatively. The diagnostic accuracies of DCEUS and MDCT in determining the gross classification were calculated and compared. The overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT (84.9% vs. 79.9%, p < 0.001). There was no significant difference in accuracy between DCEUS and MDCT for Borrmann I and IV classifications of advanced gastric cancer (χ(2), p = 0.323 for Borrmann type I, p = 0.141 for Borrmann type IV). The accuracy of DCEUS for early GC and Borrmann II and III classifications of GC was higher than that of MDCT (χ(2), p = 0.000 for all). DCEUS may be regarded as a valuable complementary tool to MDCT in determining the gross appearance of gastric adenocarcinoma pre-operatively. PMID:27072076

  8. 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.

  9. Abdominal organs (image)

    MedlinePlus

    ... small intestine further digests food and begins the absorption of nutrients. Secretions from the pancreas in the ... gallbladder and liver emulsify fat and enhance the absorption of fatty acids. The large intestine temporarily stores ...

  10. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  11. Abdominal intrauterine vacuum aspiration.

    PubMed

    Tjalma, W A A

    2014-01-01

    Evaluating and "cleaning" of the uterine cavity is probably the most performed operation in women. It is done for several reasons: abortion, evaluation of irregular bleeding in premenopausal period, and postmenopausal bleeding. Abortion is undoubtedly the number one procedure with more than 44 million pregnancies terminated every year. This procedure should not be underestimated and a careful preoperative evaluation is needed. Ideally a sensitive pregnancy test should be done together with an ultrasound in order to confirm a uterine pregnancy, excluding extra-uterine pregnancy, and to detect genital and/or uterine malformations. Three out of four abortions are performed by surgical methods. Surgical methods include a sharp, blunt, and suction curettage. Suction curettage or vacuum aspiration is the preferred method. Despite the fact that it is a relative safe procedure with major complications in less than one percent of cases, it is still responsible for 13% of all maternal deaths. All the figures have not declined in the last decade. Trauma, perforation, and bleeding are a danger triage. When there is a perforation, a laparoscopy should be performed immediately, in order to detect intra-abdominal lacerations and bleeding. The bleeding should be stopped as soon as possible in order to not destabilize the patient. When there is a perforation in the uterus, this "entrance" can be used to perform the curettage. This is particularly useful if there is trauma of the isthmus and uterine wall, and it is difficult to identify the uterine canal. A curettage is a frequent performed procedure, which should not be underestimated. If there is a perforation in the uterus, then this opening can safely be used for vacuum aspiration. PMID:25134300

  12. The Value of Contrast-Enhanced Ultrasonography and Contrast-Enhanced CT in the Diagnosis of Malignant Renal Cystic Lesions: A Meta-Analysis

    PubMed Central

    Lan, Dong; Qu, Hong-Chen; Li, Ning; Zhu, Xing-Wang; Liu, Yi-Li; Liu, Chun-Lai

    2016-01-01

    We compared the efficacy of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) for the diagnosis of renal cystic lesions via a meta-analysis to determine the value of CEUS in the prediction of the malignant potential of complex renal cysts. Eleven studies were evaluated: 4 control studies related to CEUS and CECT, 3 studies related to CEUS and 4 studies related to CECT. According to the random effects model, the pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for CEUS/CECT were 0.95/0.90, 0.79/0.85, 4.39/5.00, and 0.10/0.15, respectively. The areas under the summary receiver operating characteristic (AUCs-SROC) curves for the two methods were 94.24% and 93.39%, and the estimated Q values were 0.8805 and 0.8698, respectively. Comparing the Q index values of CEUS and CECT revealed no significant difference between the two methods (P>0.05). When compared with conventional CECT, CEUS is also useful for diagnosing renal cystic lesions in the clinic. PMID:27203086

  13. The Value of Contrast-Enhanced Ultrasonography and Contrast-Enhanced CT in the Diagnosis of Malignant Renal Cystic Lesions: A Meta-Analysis.

    PubMed

    Lan, Dong; Qu, Hong-Chen; Li, Ning; Zhu, Xing-Wang; Liu, Yi-Li; Liu, Chun-Lai

    2016-01-01

    We compared the efficacy of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) for the diagnosis of renal cystic lesions via a meta-analysis to determine the value of CEUS in the prediction of the malignant potential of complex renal cysts. Eleven studies were evaluated: 4 control studies related to CEUS and CECT, 3 studies related to CEUS and 4 studies related to CECT. According to the random effects model, the pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for CEUS/CECT were 0.95/0.90, 0.79/0.85, 4.39/5.00, and 0.10/0.15, respectively. The areas under the summary receiver operating characteristic (AUCs-SROC) curves for the two methods were 94.24% and 93.39%, and the estimated Q values were 0.8805 and 0.8698, respectively. Comparing the Q index values of CEUS and CECT revealed no significant difference between the two methods (P>0.05). When compared with conventional CECT, CEUS is also useful for diagnosing renal cystic lesions in the clinic. PMID:27203086

  14. The 18F-FDG PET/CT finding of a condyloma acuminata mimicking primary anorectal carcinoma in an HIV-infected patient.

    PubMed

    Kim, Bom Sahn

    2013-10-01

    This case report describes a condyloma acuminata with intense FDG uptake mimicking primary anorectal carcinoma in an HIV-infected patient.A 44-year-old HIV-positive homosexual man with a history of lymphoma underwent an 18F-FDG PET/CT for restaging. A focal intense hypermetabolic lesion around the anorectal area was found by the PET/CT and it was suggested as a tumorous lesion. However, the lesion was not detected on the contrast-enhanced abdominal CT. Via a sigmoidoscopy, cauliflower-like masses were visualized in the intra-anal area. The tumor was surgically excised and proven to be condyloma acuminata by permanent pathology. PMID:22996249

  15. 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

  16. Added value of lung window in detecting drug mules on non-contrast abdominal computed tomography.

    PubMed

    Bahrami-Motlagh, Hooman; Vakilian, Fatemeh; Hassanian-Moghaddam, Hossein; Pourghorban, Ramin

    2016-06-01

    We evaluated the added value of lung window in non-contrast computed tomography (CT) of suspected body packers or stuffers. Forty suspected drug mules who were referred to our tertiary toxicology center were included. The final diagnosis of drug mule was based on the detection of packs in stool examination or surgery. Non-contrast CT scans were retrospectively interpreted by two blinded radiologists in consensus before and after reviewing the lung window images. The diagnostic performance of abdominal window scans alone and scans in both abdominal and lung windows were subsequently compared. Seven body packers and 21 body stuffers were identified. The sensitivity, negative predictive value (NPV), and diagnostic accuracy of scans in detection of drug mules (either drug packers or stuffers) raised from 60.7, 52.1, and 72.5 to 64.2, 54.5, and 75.0 %, respectively, with a more number of packs being detected (114 vs. 105 packs). In the body packers group, the diagnostic performance of both abdominal windows scans and combined abdominal and lung windows scans were 100 %. In the body stuffers group, the sensitivity, NPV, and diagnostic accuracy of scans increased from 47.6, 52.1, and 55.0 to 52.3, 54.5, and 57.5 %, respectively, after the addition of lung windows. Reviewing the lung window on non-contrast abdominal CT can be helpful in detection of drug mules. PMID:26830789

  17. Cardiac CT Imaging of Plaque Vulnerability: Hype or Hope?

    PubMed

    Willemink, Martin J; Leiner, Tim; Maurovich-Horvat, Pál

    2016-03-01

    Advances in cardiovascular computed tomography (CT) have resulted in an excellent ability to exclude coronary heart disease (CHD). Anatomical information, functional information, and spectral information can already be obtained with current CT technologies. Moreover, novel developments such as targeted nanoparticle contrast agents, photon-counting CT, and phase contrast CT will further enhance the diagnostic value of cardiovascular CT. This review provides an overview of current state of the art and future cardiovascular CT imaging. PMID:26922591

  18. 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.

  19. Entrapped ovarian cyst. An unusual case of persistent abdominal pain.

    PubMed

    Hederström, E; Forsberg, L

    1990-05-01

    Recurrent abdominal pain in the left fossa often mimicking attacks of subileus is described in a woman aged 48 with extensive adhesions caused by multiple surgical procedures. Repeated examinations with conventional abdominal radiography and barium meals were negative with regard to mechanical intestinal obstruction. A cystic lesion varying in size from 2 to 8 cm in diameter was seen adjacent to the left ovary on repeat US examinations and also on CT. Pain episodes were sometimes correlated to increasing size of the lesion which was finally thought to be either a peritoneal inclusion cyst (fluid trapped between pelvic adhesions) or, as was finally confirmed at surgery, a true ovarian cyst (corpus luteum cyst) similarly trapped. PMID:2201330

  20. Bubble gum simulating abdominal calcifications.

    PubMed

    Geller, E; Smergel, E M

    1992-01-01

    CT examination of the abdomens of two children demonstrated sites of high attenuation in the stomach, which were revealed to be bubble gum. Investigation of the CT appearance of samples of chewing gum showed that it consistently has high attenuation (178-345 HU). The attenuation of gum base, which contains calcium carbonate, was 476 HU. In addition, examination of a volunteer who had swallowed bubble gum confirmed the CT appearance. PMID:1523059

  1. Prospective evaluation of hand-held focused abdominal sonography for trauma (FAST) in blunt abdominal trauma

    PubMed Central

    Kirkpatrick, Andrew W.; Sirois, Marco; Laupland, Kevin B.; Goldstein, Leanelle; Brown, David Ross; Simons, Richard K.; Dulchavsky, Scott; Boulanger, Bernard R.

    2005-01-01

    Background Ultrasonography (US) has become indispensable in assessing the status of the injured patient. Although hand-held US equipment is now commercially available and may expand the availability and speed of US in assessing the trauma patient, it has not been subjected to controlled evaluation in early trauma care. Methods A 2.4-kg hand-held (HH) US device was used to perform focused abdominal sonography for trauma (FAST) on blunt trauma victims at 2 centres. Results were compared with the “truth” as determined through formal FAST examinations (FFAST), CT, operative findings and serial examination. The ability of HHFAST to detect free fluid, intra-abdominal injuries and injuries requiring therapeutic interventions was assessed. Results HHFAST was positive in 80% of 313 patients who needed surgery or angiography. HHFAST test performances (sensitivity, specificity, positive and negative predictive values, likelihood ratios of positive and negative test results) were 77%, 99%, 96%, 94%, 95%, 95 and 0.2, respectively, for free fluid, and 64%, 99%, 96%, 89%, 90%, 74 and 0.4, respectively, for documented injuries. HHFAST missed or gave an indeterminate result in 8 (3%) of 270 patients with injuries who required therapeutic intervention and 25 (9%) of 270 patients who did not require intervention. FFAST performance was comparable. Conclusions HHFAST performed by clinicians detects intraperitoneal fluid with a high degree of accuracy. All FAST examinations are valuable tests when positive. They will miss some injuries, but the majority of the injuries missed do not require therapy. HHFAST provides an early extension of the physical examination but should be complemented by the selective use of CT, rather than formal repeat US. PMID:16417051

  2. 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

  3. Bipolar radiofrequency ablation for liver tumors: comparison of contrast-enhanced ultrasound with contrast-enhanced MRI/CT in the posttreatment imaging evaluation

    PubMed Central

    Bo, Xiao-Wan; Xu, Hui-Xiong; Sun, Li-Ping; Zheng, Shu-Guang; Guo, Le-Hang; Lu, Feng; Wu, Jian; Xu, Xiao-Hong

    2014-01-01

    Objective: The aim of the study was to assess the role of contrast-enhanced ultrasound (CEUS) in treatment response evaluation after percutaneous bipolar radiofrequency ablation (BRFA) for liver tumors. Methods: From May 2012 to May 2014, 39 patients with 73 tumors were treated by BRFA. One month after the treatment, CEUS and CEMRI/CECT were conducted to evaluate the treatment response. The results of CEUS were compared with CEMRI/CECT. Results: Of the 73 tumors ablated, eight (11.0%) were found to have residual viable tumor tissue and 65 (89.0%) were successfully ablated based on CEMRI/CECT within 1-month after ablation. CEUS detected seven of the eight residual tumors and 63 of 65 completely ablated tumors. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were 87.5% (7/8), 96.9% (63/65), 77.8% (7/9), 98.4% (63/64) and 95.9% (70/73), respectively. The complete ablation (CR) rates for the tumors ≤3.0 cm, 3.1-5.0 cm, and >5.0 cm were 96.6% (58/60), 63.6% (7/11), and 0% (0/2), respectively (P<0.001). CR rates were 94.7% (36/38) for primary liver tumors and 82.9% (29/35) for metastatic liver tumors (P=0.212), and were 97.4% (38/39) for the tumors with curative treatment intention and 79.4% (27/34) for those with palliative treatment intention (P=0.037). Major complication was not encountered in this series. Conclusions: BRFA is an effective technique of percutaneous ablation for liver tumors and CEUS can be used to assess its therapeutic effect accurately. PMID:25337258

  4. Sterile abdominal abscess resulting from remnant laparoscopic clips after sigmoidectomy: a case report and literature review.

    PubMed

    Komori, Koji; Kimura, Kenya; Kinoshita, Takashi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Misawa, Kazunari; Ito, Yuichi; Uemura, Norihisa; Kawai, Ryosuke; Osawa, Takaaki; Kawakami, Jiro; Asano, Tomonari; Iwata, Yoshinori; Kurahashi, Shintaro; Shimizu, Yasuhiro

    2014-08-01

    The occurrence of intra-abdominal sterile abscesses due to remnant clips after laparoscopic sigmoidectomy is rare. Here, we report one such case in a 74-year-old woman. Two years after laparoscopic sigmoidectomy, abdominal CT indicated an area of fluid accumulation approximately 5 cm in diameter and located in the middle of the abdominal cavity that contained a cluster of clips. Fine-needle aspiration of the fluid was performed through the wall of the sigmoid colon. The luminal fluid was found not to contain cancer cells on histological examination. After 1 year, abdominal surgery was performed. The abscess was located in the mesorectum at the anastomosis site; it was incised and a significant quantity of ivory-white viscous solution containing a cluster of clips was extracted. This case emphasizes the importance of reducing the number of clips used in laparoscopic surgery. PMID:25131325

  5. CT scan

    MedlinePlus

    ... that slides into the center of the CT scanner. Once you are inside the scanner, the machine's x-ray beam rotates around you. Modern spiral scanners can perform the exam without stopping. A computer ...

  6. 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.

  7. 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

  8. 18F-FDG PET/CT Imaging of Primary Hepatic Neuroendocrine Tumor

    PubMed Central

    Mitamura, Katsuya; Yamamoto, Yuka; Tanaka, Kenichi; Sanomura, Takayuki; Murota, Makiko; Nishiyama, Yoshihiro

    2015-01-01

    Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare neoplasms. Herein, we report a case of a 70- year-old man with a hepatic mass. The non-contrast computed tomography (CT) image showed a low-density mass, and dynamic CT images indicated the enhancement of the mass in the arterial phase and early washout in the late phase. F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and fused PET/CT images showed increased uptake in the hepatic mass. Whole-body 18F-FDG PET images showed no abnormal activity except for the liver lesion. Presence of an extrahepatic tumor was also ruled out by performing upper gastrointestinal endoscopy, total colonoscopy, and chest and abdominal CT. A posterior segmentectomy was performed, and histologic examination confirmed a neuroendocrine tumor (grade 1). The patient was followed up for about 2 years after the resection, and no extrahepatic lesions were radiologically found. Therefore, the patient was diagnosed with PHNET. To the best of our knowledge, no previous case of PHNET have been detected by 18F-FDG PET imaging.

  9. (18)F-FDG PET/CT Imaging of Primary Hepatic Neuroendocrine Tumor.

    PubMed

    Mitamura, Katsuya; Yamamoto, Yuka; Tanaka, Kenichi; Sanomura, Takayuki; Murota, Makiko; Nishiyama, Yoshihiro

    2015-01-01

    Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare neoplasms. Herein, we report a case of a 70- year-old man with a hepatic mass. The non-contrast computed tomography (CT) image showed a low-density mass, and dynamic CT images indicated the enhancement of the mass in the arterial phase and early washout in the late phase. F-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and fused PET/CT images showed increased uptake in the hepatic mass. Whole-body (18)F-FDG PET images showed no abnormal activity except for the liver lesion. Presence of an extrahepatic tumor was also ruled out by performing upper gastrointestinal endoscopy, total colonoscopy, and chest and abdominal CT. A posterior segmentectomy was performed, and histologic examination confirmed a neuroendocrine tumor (grade 1). The patient was followed up for about 2 years after the resection, and no extrahepatic lesions were radiologically found. Therefore, the patient was diagnosed with PHNET. To the best of our knowledge, no previous case of PHNET have been detected by (18)F-FDG PET imaging. PMID:27408882

  10. A Curious Case of Right Upper Quadrant Abdominal Pain

    PubMed Central

    Grock, Andrew; Chan, Wendy; deSouza, Ian S.

    2016-01-01

    An otherwise healthy 36-year-old man presented with sudden-onset right upper quadrant abdominal pain and vomiting. A bedside ultrasound, performed to evaluate hepatobiliary pathology, revealed a normal gallbladder but free intraperitoneal fluid. After an expedited CT and emergent explorative laparotomy, the patient was diagnosed with a small bowel obstruction with ischemia secondary to midgut volvulus. Though midgut volvulus is rare in adults, delays in definitive diagnosis and management can result in bowel necrosis. Importantly, an emergency physician must be able to recognize bedside ultrasound findings associated with acutely dangerous intrabdominal pathology. PMID:27625732

  11. Abdominal bloating: pathophysiology and treatment.

    PubMed

    Seo, A Young; Kim, Nayoung; Oh, Dong Hyun

    2013-10-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  12. Abdominal pain with a twist

    PubMed Central

    2011-01-01

    Malrotation in children is due to either an incomplete or non-rotation of the foetal mid-gut during perinatal development. Presentation is usually in the first few weeks of life, often with life-threatening volvulus and ischaemia. However, it can be a rare cause of abdominal pain in older children and young adults. We present such a case, as a reminder to emergency physicians that malrotation should be considered in the differential diagnosis of recurrent or chronic abdominal pain not only in children but also in adolescents. PMID:21635723

  13. Ultrasonographic diagnosis in abdominal tuberculosis.

    PubMed

    Sheikh, M; Moosa, I; Hussein, F M; Qurttom, M A; Behbehani, A I

    1999-05-01

    Sonographic findings were retrospectively analysed in 39 patients with proven abdominal tuberculosis (TB). The patients were treated over 15 years at a major teaching hospital, Mubarak Al-Kabber Hospital, in Kuwait. The findings included clear or complex ascites with fine strands, loculations and debris. The other findings were lymphadenopathy, bowel wall thickening, omental mass, focal lesions in the liver and spleen and psoas abscess. The sonographic findings in abdominal TB are not specific but may give valuable information to prevent unnecessary laparotomy. PMID:10901897

  14. 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

  15. Secondary abdominal appendicular ectopic pregnancy.

    PubMed

    Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac

    2007-01-01

    Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy. PMID:17630175

  16. 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

  17. Blunt Abdominal Wall Disruption by Seatbelt Injury; A Case Report and Review of the Literature

    PubMed Central

    Cornelissen, Maarten Philip; van Buijtenen, Jesse; van den Heuvel, Baukje; Bloemers, Frank; Geeraedts Jr., Leo

    2016-01-01

    With the introduction of the use of seatbelts in cars, mortality following motor vehicle crashes has decreased significantly. However, two patterns of injuries, the ‘seatbelt sign’ and ‘seatbelt syndrome’ have emerged. Injuries may consist of traumatic abdominal wall disruption. We present two cases of severe abdominal wall disruption caused by a seatbelt injury and treated with primary repair. A review of the literature is provided. Two patients were brought in after a high velocity Motor Vehicle Collision. Both presented with an acute abdomen and a seatbelt sign upon which the decision was made to perform emergency laparotomies. Both patients had an abdominal wall disruption along the seatbelt sign. These disruptions were primarily closed and during six months of follow-up no complications occurred. A disruption of the abdominal wall is a rare complication. However, it is a diagnosis that may not be missed as patients have a higher risk of morbidity and mortality. CT-scanning is an accurate method to detect disruptions. Closure of blunt traumatic abdominal wall disruption can be done primarily with sutures or addition of a mesh. In both cases of the severe abdominal wall disruption, primary repair without mesh in the acute phase was successful. When a laparotomy is not indicated, the abdominal wall must be assessed for disruption. If there is a disruption primary repair is a good option. PMID:27331068

  18. Personalized identification of abdominal wall hernia meshes on computed tomography.

    PubMed

    Pham, Tuan D; Le, Dinh T P; Xu, Jinwei; Nguyen, Duc T; Martindale, Robert G; Deveney, Clifford W

    2014-01-01

    An abdominal wall hernia is a protrusion of the intestine through an opening or area of weakness in the abdominal wall. Correct pre-operative identification of abdominal wall hernia meshes could help surgeons adjust the surgical plan to meet the expected difficulty and morbidity of operating through or removing the previous mesh. First, we present herein for the first time the application of image analysis for automated identification of hernia meshes. Second, we discuss the novel development of a new entropy-based image texture feature using geostatistics and indicator kriging. Third, we seek to enhance the hernia mesh identification by combining the new texture feature with the gray-level co-occurrence matrix feature of the image. The two features can characterize complementary information of anatomic details of the abdominal hernia wall and its mesh on computed tomography. Experimental results have demonstrated the effectiveness of the proposed study. The new computational tool has potential for personalized mesh identification which can assist surgeons in the diagnosis and repair of complex abdominal wall hernias. PMID:24184112

  19. INFLAMMATORY ABDOMINAL AORTIC ANEURYSM--A FORM OF CHRONIC PERIAORTITIS.

    PubMed

    Pop, Corina; Nemeş, Roxana Maria; Jantea, Petruţa; Tomescu, Alina; Postolache, Paraschiva

    2015-01-01

    Chronic periaortitis represents a unique pathogenic concept for three entities: Inflammatory Abdominal Aortic Aneurysm, Idiopathic Retroperitoneal Fibrosis and Perianeurysmal Retroperitoneal Fibrosis. The fundamental meaning of an inflammatory reaction to advanced atherosclerosis has been developed on the bottom of clinical and histological features. The triad of abdominal pain, weight loss and elevated inflammatory markers: erythrocyte sedimentation rate/C-reactive protein in patients with abdominal aortic aneurysms revealed on contrast-enhanced computer tomography is highly suggestive for inflammatory aneurysm. We report a case of a heavy-smoker adult male presented with suddenly abdominal symptoms suggestive for mesenteric ischemia which have proved to be due to inflammatory abdominal aortic aneurysm. The most favorable management of patients with inflammatory aneurysm is ambiguous. Surgical approach seems reasonable even supposing inflammatory aneurysm emerges less likely to rupture than the atherosclerotic variant. Corticosteroids are used in inoperable inflammatory aneurysm, even if is well known that this treatment does not change the long-term outcome of the disease. Surgical-open or Endovascular Repair of the aneurysm is the elective treatment. PMID:26793850

  20. Reviewing the morphology of the jaw-closing musculature in squirrels, rats, and guinea pigs with contrast-enhanced microCT.

    PubMed

    Cox, Philip G; Jeffery, Nathan

    2011-06-01

    Rodents are defined by their unique masticatory apparatus and are frequently separated into three nonmonophyletic groups--sciuromorphs, hystricomorphs, and myomorphs--based on the morphology of their masticatory muscles. Despite several comprehensive dissections in previous work, inconsistencies persist as to the exact morphology of the rodent jaw-closing musculature, particularly, the masseter. Here, we review the literature and document for the first time the muscle architecture noninvasively and in 3D by using iodine-enhanced microCT. Observations and measurements were recorded with reference to images of three individuals, each belonging to one of the three muscle morphotypes (squirrel, guinea pig, and rat). Results revealed an enlarged superficial masseter muscle in the guinea pig compared with the rat and squirrel, but a reduced deep masseter (possibly indicating reduced efficiency at the incisors). The deep masseter had expanded forward to take an origin on the rostrum and was also separated into anterior and posterior parts in the rat and squirrel. The zygomaticomandibularis muscle was split into anterior and posterior parts in all the three specimens by the masseteric nerve, and in the rat and guinea pig had an additional rostral expansion through the infraorbital foramen. The temporalis muscle was found to be considerably larger in the rat, and its separation into anterior and posterior parts was only evident in the rat and squirrel. The pterygoid muscles were broadly similar in all three specimens, although the internal pterygoid was somewhat enlarged in the guinea pig implying greater lateral movement of the mandible during chewing in this species. PMID:21538924

  1. Contrast-enhanced CT using a cationic contrast agent enables non-destructive assessment of the biochemical and biomechanical properties of mouse tibial plateau cartilage.

    PubMed

    Lakin, Benjamin A; Patel, Harsh; Holland, Conor; Freedman, Jonathan D; Shelofsky, Joshua S; Snyder, Brian D; Stok, Kathryn S; Grinstaff, Mark W

    2016-07-01

    Mouse models of osteoarthritis (OA) are commonly used to study the disease's pathogenesis and efficacy of potential treatments. However, measuring the biochemical and mechanical properties of articular cartilage in these models currently requires destructive and time-consuming histology and mechanical testing. Therefore, we examined the feasibility of using contrast-enhanced CT (CECT) to rapidly and non-destructively image and assess the glycosaminoglycan (GAG) content. Using three ex vivo C57BL/6 mouse tibial plateaus, we determined the time required for the cationic contrast agent CA4+ to equilibrate in the cartilage. The whole-joint coefficient of friction (μ) of 10 mouse knees (some digested with Chondroitenase ABC to introduce variation in GAG) was evaluated using a modified Stanton pendulum. For both the medial and lateral tibial plateau cartilage of these knees, linear regression was used to compare the equilibrium CECT attenuations to μ, as well as each side's indentation equilibrium modulus (E) and Safranin-O determined GAG content. CA4+ equilibrated in the cartilage in 30.9 ± 0.95 min (mean ± SD, tau value of 6.17 ± 0.19 min). The mean medial and lateral CECT attenuation was correlated with μ (R(2)  = 0.69, p < 0.05), and the individual medial and lateral CECT attenuations correlated with their respective GAG contents (R(2)  ≥ 0.63, p < 0.05) and E (R(2)  ≥ 0.63, p < 0.05). In conclusion, CECT using CA4+ is a simple, non-destructive technique for three-dimensional imaging of ex vivo mouse cartilage, and significant correlations between CECT attenuation and GAG, E, and μ are observed. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1130-1138, 2016. PMID:26697956

  2. Quantifying tumour heterogeneity with CT

    PubMed Central

    Miles, Kenneth A.

    2013-01-01

    Abstract Heterogeneity is a key feature of malignancy associated with adverse tumour biology. Quantifying heterogeneity could provide a useful non-invasive imaging biomarker. Heterogeneity on computed tomography (CT) can be quantified using texture analysis which extracts spatial information from CT images (unenhanced, contrast-enhanced and derived images such as CT perfusion) that may not be perceptible to the naked eye. The main components of texture analysis can be categorized into image transformation and quantification. Image transformation filters the conventional image into its basic components (spatial, frequency, etc.) to produce derived subimages. Texture quantification techniques include structural-, model- (fractal dimensions), statistical- and frequency-based methods. The underlying tumour biology that CT texture analysis may reflect includes (but is not limited to) tumour hypoxia and angiogenesis. Emerging studies show that CT texture analysis has the potential to be a useful adjunct in clinical oncologic imaging, providing important information about tumour characterization, prognosis and treatment prediction and response. PMID:23545171

  3. Investigation of optimal feature value set in false positive reduction process for automated abdominal lymph node detection method

    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

    2015-03-01

    This paper presents an investigation of optimal feature value set in false positive reduction process for the automated method of enlarged abdominal lymph node detection. We have developed the automated abdominal lymph node detection method to aid for surgical planning. Because it is important to understand the location and the structure of an enlarged lymph node in order to make a suitable surgical plan. However, our previous method was not able to obtain the suitable feature value set. This method was able to detect 71.6% of the lymph nodes with 12.5 FPs per case. In this paper, we investigate the optimal feature value set in the false positive reduction process to improve the method for automated abdominal lymph node detection. By applying our improved method by using the optimal feature value set to 28 cases of abdominal 3D CT images, we detected about 74.7% of the abdominal lymph nodes with 11.8 FPs/case.

  4. 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

  5. Abdominal lymphadenopathy detection using random forest

    NASA Astrophysics Data System (ADS)

    Cherry, Kevin M.; Wang, Shijun; Turkbey, Evrim B.; Summers, Ronald M.

    2014-03-01

    We propose a new method for detecting abdominal lymphadenopathy by utilizing a random forest statistical classifier to create voxel-level lymph node predictions, i.e. initial detection of enlarged lymph nodes. The framework permits the combination of multiple statistical lymph node descriptors and appropriate feature selection in order to improve lesion detection beyond traditional enhancement filters. We show that Hessian blobness measurements alone are inadequate for detecting lymph nodes in the abdominal cavity. Of the features tested here, intensity proved to be the most important predictor for lymph node classification. For initial detection, candidate lesions were extracted from the 3D prediction map generated by random forest. Statistical features describing intensity distribution, shape, and texture were calculated from each enlarged lymph node candidate. In the last step, a support vector machine (SVM) was trained and tested based on the calculated features from candidates and labels determined by two experienced radiologists. The computer-aided detection (CAD) system was tested on a dataset containing 30 patients with 119 enlarged lymph nodes. Our method achieved an AUC of 0.762+/-0.022 and a sensitivity of 79.8% with 15 false positives suggesting it can aid radiologists in finding enlarged lymph nodes.

  6. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe it to you. Here are different kinds of pain: ...

  7. Clinical observation of the adverse drug reactions caused by non-ionic iodinated contrast media: results from 109,255 cases who underwent enhanced CT examination in Chongqing, China

    PubMed Central

    Li, X; Chen, J; Zhang, L; Liu, H; Wang, S; Chen, X; Fang, J; Wang, S

    2015-01-01

    Objective: To analyse the pattern and factors that influence the incidence of adverse drug reactions (ADRs) induced by non-ionic iodinated contrast media and to evaluate their safety profiles. Methods: Data from 109,255 cases who underwent enhanced CT examination from 1 January 2008 to 31 August 2013 were analysed. ADRs were classified according to the criteria issued by the American College of Radiology and the Chinese Society of Radiology. Results: A total of 375 (0.34%) patients had ADRs, including 281 mild (0.26%); 80 moderate (0.07%); and 14 severe (0.01%) ADRs; no death was found. 302 (80.53%) of the ADRs occurred within 15 min after examination. Patients aged 40–49 years (204 cases, 0.43%; p < 0.01) or who underwent coronary CT angiography (93 cases, 0.61%; p < 0.01) were at a higher risk of ADRs. Female patients (180 cases, 0.40%; p < 0.01) or outpatients had significantly higher incidence rates of ADRs. The symptoms and signs of most of the ADRs were resolved spontaneously within 24 h after appropriate treatment without sequelae. Conclusion: The occurrence of ADRs is caused by the combined effects of multiple factors. The ADRs induced by non-ionic iodinated contrast media are mainly mild ones, while moderate or severe ADRs are relatively rare, suggesting that enhanced CT examination with non-ionic iodinated contrast media is highly safe, and severe adverse events will seldom occur under appropriate care. Advances in knowledge: The study included 109,255 patients enrolled in various types of enhanced CT examinations, which could reflect ADR conditions and regulations in Chinese population accurately and reliably. PMID:25582519

  8. An unusual duplication of the inferior vena cava in a patient with endovascular repair for abdominal aortic aneurysm.

    PubMed

    Polguj, Michał; Szubert, Wojciech; Topol, Mirosław; Stefańczyk, Ludomir

    2015-01-01

    A 66-year-old Caucasian male, with sensation of abdominal pulsation was admitted to our hospital. In multidetector 64-row computed tomography (CT) angiography, an abdominal aortic aneurysm was observed. Endovascular aortic repair was performed. Control CT confirmed prosperity with stent graft fixation and absence of any vascular complications. Investigation also showed asymmetrical duplication of the inferior vena cava (IVC). Right (RIVC) and left (LIVC) inferior vena cava arose from the confluence of the right and left iliac veins. The LIVC continued as left renal vein. PMID:26429190

  9. Jujitsu kick to the abdomen: a case of blunt abdominal trauma resulting in hematochezia and transient ischemic colitis.

    PubMed

    Rosenberg, Hans; Beck, Jeremy

    2011-08-01

    Blunt abdominal trauma is a common presentation to the emergency department. Ischemic colitis is a rare complication of this and its possible sequelae are important for an emergency physician to recognize. A 21-year-old man presented to the emergency department with abdominal pain and hourly episodes of bright red blood per rectum shortly after being kicked in the stomach at his jujitsu class. He had no significant medical history, and results of his systems review were otherwise unremarkable. On examination, he appeared well, with normal vital signs. He had mild lower abdominal tenderness, but there were no peritoneal signs present. There was blood on the digital rectal examination. His hemoglobin, platelet, and international normalized ratio levels were normal and his abdominal radiograph was unremarkable. The gastroenterology service was contacted because of the hematochezia and a flexible sigmoidoscopy was performed. The sigmoidoscopy showed erythema, ulceration, and edema of a segment in the left colon, consistent with ischemic colitis. This was later confirmed on biopsy. A computed tomography (CT) scan of the abdomen was conducted, which revealed left colonic inflammation consistent with colonic ischemia. There was no mesenteric vascular thrombosis or mesenteric hematoma found on CT. His hematochezia and abdominal pain subsided spontaneously, and he was discharged home. This case illustrates transient ischemic colitis as a potential presentation of blunt abdominal trauma, and emergency physicians should consider this uncommon diagnosis in the differential diagnosis of patients presenting after abdominal trauma. PMID:21392850

  10. Digital bowel cleansing free detection method of colonic polyp from fecal tagging CT images

    NASA Astrophysics Data System (ADS)

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

    2008-03-01

    This paper presents a digital bowel cleansing (DBC) free detection method of colonic polyp from fecal tagging CT images. Virtual colonoscopy (VC) or CT colonography is a new colon diagnostic method to examine the inside of the colon. However, since the colon has many haustra and its shape is long and convoluted, there is a risk of overlooking of lesions existing in blinded areas caused by haustra. Automated polyp detection from colonic CT images will reduce the risk of overlooking. Although many methods for polyp detection have been proposed, these methods needed DBC to detect polyps surrounded by tagged fecal material (TFM). However, DBC may changes shapes of polyps or haustra while removing TFM and it adversely affect polyp detection. We propose a colonic polyp detection method that enables us to detect polyps surrounded by either the air or the TFM simultaneously without any DBC processes. CT values inside polyps surrounded by the air and polyps surrounded by the TFM regions tend to gradually increase (blob structure) and decrease (inverse-blob structure) from outward to inward, respectively. We thus employ blob and inverse-blob structure enhancement filters based on the eigenvalues of the Hessian matrix to detect polyps using intensity characteristic of polyps. False positive elimination is performed using three feature values: the volume, maximum value of the filter outputs, and the standard deviation of CT values inside polyp candidate regions. We applied the proposed method to 104 cases of abdominal CT images. Sensitivity for polyps >= 6 mm was 91.2% with 7.8 FPs/case.

  11. 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

  12. 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

  13. [Omental infarction: CT findings (case report)].

    PubMed

    Yildiz, Seçil; Atasoy, Cetin; Yağci, Cemil; Akyar, Serdar

    2004-06-01

    Omental infarction, the end result of impaired perfusion of the greater omentum, is an uncommon cause of acute abdominal pain. Because its clinical symptoms are nonspecific, it is usually confused with more common conditions such as appendicitis or cholecystitis. Consequently, the diagnosis is generally made intraoperatively. However, computed tomography shows characteristic findings and allows a reliable preoperative diagnosis, preventing unnecessary laparotomy. We report two cases of omental infarction, and describe typical CT findings of this rare entitiy. PMID:15236134

  14. Paget sarcoma of the pelvic bone with widespread metastatic disease on radiography, CT, MRI, and 18F-FDG PET/CT with pathologic correlation.

    PubMed

    Davis, Michael A; Scalcione, Luke R; Gimber, Lana H; Thompson, Rebecca B; Avery, Ryan J; Taljanovic, Mihra S

    2014-04-01

    We report a case of Paget sarcoma of the left superior pubic ramus and disseminated metastatic disease in a 70-year-old man. Paget disease of the left hemipelvis with malignant degeneration in the region of the left superior pubic ramus was initially diagnosed on radiographs. Subsequent CT, MRI, PET/CT imaging, and CT-guided biopsy confirmed the diagnosis and showed extensive left-sided pelvic and abdominal lymphadenopathy with widespread metastatic disease to liver, spleen, and lungs. PMID:24566398

  15. 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

  16. 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

  17. Computer Tomography Imaging Findings of Abdominal Follicular Dendritic Cell Sarcoma: A Report of 5 Cases.

    PubMed

    Li, Jing; Geng, Zhi-Jun; Xie, Chuan-Miao; Zhang, Xin-Ke; Chen, Rui-Ying; Cai, Pei-Qiang; Lv, Xiao-Fei

    2016-01-01

    Follicular dendritic cell sarcoma (FDCS) is a neoplasm that arises from follicular dendritic cells. FDCSs originating in the abdomen are extremely rare. Clinically, they often mimic a wide variety of other abdominal tumors, and correct preoperative diagnosis is often a challenging task. To date, only scattered cases of abdominal FDCS have been reported and few data are available on their radiological features. Here we present the computer tomography imaging findings of 5 patients with surgically and pathologically demonstrated abdominal FDCS. An abdominal FDCS should be included in the differential diagnosis when single or multiple masses with relatively large size, well- or ill-defined borders, complex internal architecture with marked internal necrosis and/or focal calcification, and heterogeneous enhancement with "rapid wash-in and slow wash-out" or "progressive enhancement" enhancement patterns in the solid component are seen. PMID:26735543

  18. Diagnostic imaging of blunt abdominal trauma in pediatric patients.

    PubMed

    Miele, Vittorio; Piccolo, Claudia Lucia; Trinci, Margherita; Galluzzo, Michele; Ianniello, Stefania; Brunese, Luca

    2016-05-01

    Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements. The liver is the most common organ injured in blunt abdominal trauma followed by the spleen. Renal, pancreatic, and bowel injuries are quite rare. In this review we present various imaging findings of blunt abdominal trauma in children. PMID:27075018

  19. Multiple giant intra abdominal lipomas: A rare presentation

    PubMed Central

    Kshirsagar, Ashok Y.; Nangare, Nitin R.; Gupta, Vaibhav; Vekariya, Mayank A.; Patankar, Ritvij; Mahna, Abhishek; Wader, J.V.

    2014-01-01

    INTRODUCTION Solitary or multiple lipomas, composed of mature fat, represents by far the most common benign mesenchymal neoplasm occurring throughout the whole body, but they rarely originate in the intestinal mesentery. PRESENTATION OF CASE A 60-year-old male presented with left sided abdominal distension and pain since 4 months, ultrasonography and computerized tomography abdomen was suggestive of multiple well-defined fat density lesions in the lower abdomen and pelvis. USG guided fine needle aspiration cytology was conclusive of a spindle cell lesion. Exploratory laparotomy was performed and multiple major fat tissue swellings were excised. Histopathology confirmed it to be spindle cell type of lipoma. DISCUSSION Because of the silent nature the exact prevalence of lipomas is unknown. It can arise in any location in which fat is normally present, reported intra abdominal lipomas have been very rare. Clinical manifestations depend on the size and location of the growth. In most patients, symptoms are few or absent. USG and CT scan abdomen are used for the diagnosis. Complete surgical excision being the only treatment. CONCLUSION Intra abdominal lipoma is a very rare entity, and many cases might be ignored due to their silent nature. They might or might not present with any symptoms. Complete surgical excision being the only treatment, with a very good prognosis. PMID:24862028

  20. Pathologic aerophagia: a rare cause of chronic abdominal distension

    PubMed Central

    de Jesus, Lisieux Eyer; Cestari, Ana Beatriz C.S.S.; da Silva, Orli Carvalho; Fernandes, Marcia Antunes; Firme, Livia Honorato

    2015-01-01

    Objective: To describe an adolescent with pathologic aerophagia, a rare condition caused by excessive and inappropriate swallowing of air and to review its treatment and differential diagnoses. Case description: An 11-year-old mentally impaired blind girl presenting serious behavior problems and severe developmental delay with abdominal distension from the last 8 months. Her past history included a Nissen fundoplication. Abdominal CT and abdominal radiographs showed diffuse gas distension of the small bowel and colon. Hirschsprung's disease was excluded. The distention was minimal at the moment the child awoke and maximal at evening, and persisted after control of constipation. Audible repetitive and frequent movements of air swallowing were observed. The diagnosis of pathologic aerophagia associated to obsessive-compulsive disorder and developmental delay was made, but pharmacological treatment was unsuccessful. The patient was submitted to an endoscopic gastrostomy, permanently opened and elevated relative to the stomach. The distention was resolved, while maintaining oral nutrition. Comments: Pathologic aerophagia is a rare self-limiting condition in normal children exposed to high levels of stress and may be a persisting problem in children with psychiatric or neurologic disease. In this last group, the disease may cause serious complications. Pharmacological and behavioral treatments are ill-defined. Severe cases may demand surgical strategies, mainly decompressive gastrostomy. PMID:26100594

  1. Comparative assessment of three image reconstruction techniques for image quality and radiation dose in patients undergoing abdominopelvic multidetector CT examinations

    PubMed Central

    Desai, G S; Thabet, A; Elias, A Y A; Sahani, D V

    2013-01-01

    Objective To compare image quality and radiation dose of abdominal CT examinations reconstructed with three image reconstruction techniques. Methods In this Institutional Review Board-approved study, contrast-enhanced (CE) abdominopelvic CT scans from 23 patients were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASiR) and iterative reconstruction in image space (IRIS) and were reviewed by two blinded readers. Subjective (acceptability, sharpness, noise and artefacts) and objective (noise) measures of image quality were recorded for each image data set. Radiation doses in CT dose index (CTDI) dose–length product were also calculated for each examination type and compared. Imaging parameters were compared using the Wilcoxon signed rank test and a paired t-test. Results All 69 CECT examinations were of diagnostic quality and similar for overall acceptability (mean grade for ASiR, 3.9±0.3; p=0.2 for Readers 1 and 2; IRIS, 3.9±0.4, p=0.2; FBP, 3.8±0.9). Objective noise was considerably lower with both iterative techniques (p<0.0001 and 0.0016 for ASiR and IRIS). Recorded mean radiation dose, i.e. CTDIvol, was 24% and 10% less with ASiR (11.4±3.4 mGy; p<0.001) and IRIS (13.5±3.7 mGy; p=0.06), respectively, than with FBP: 15.0±3.5 mGy. Conclusion At the system parameters used in this study, abdominal CT scans reconstructed with ASiR and IRIS provide diagnostic images with reduced image noise and 10–24% lower radiation dose than FBP. Advances in knowledge CT images reconstructed with FBP are frequently noisy on lowering the radiation dose. Newer iterative reconstruction techniques have different approaches to produce images with less noise; ASiR and IRIS provide diagnostic abdominal CT images with reduced image noise and radiation dose compared with FBP. This has been documented in this study. PMID:23255538

  2. Understanding the pathogenesis of abdominal aortic aneurysms

    PubMed Central

    Kuivaniemi, Helena; Ryer, Evan J.; Elmore, James R.; Tromp, Gerard

    2016-01-01

    Summary An aortic aneurysm is a dilatation in which the aortic diameter is ≥ 3.0 cm. If left untreated, the aortic wall continues to weaken and becomes unable to withstand the forces of the luminal blood pressure resulting in progressive dilatation and rupture, a catastrophic event associated with a mortality of 50 – 80%. Smoking and positive family history are important risk factors for the development of abdominal aortic aneurysms (AAA). Several genetic risk factors have also been identified. On the histological level, visible hallmarks of AAA pathogenesis include inflammation, smooth muscle cell apoptosis, extracellular matrix degradation, and oxidative stress. We expect that large genetic, genomic, epigenetic, proteomic and metabolomic studies will be undertaken by international consortia to identify additional risk factors and biomarkers, and to enhance our understanding of the pathobiology of AAA. Collaboration between different research groups will be important in overcoming the challenges to develop pharmacological treatments for AAA. PMID:26308600

  3. Principles of CT and CT technology.

    PubMed

    Goldman, Lee W

    2007-09-01

    This article provides a review of the basic principles of CT within the context of the evolution of CT. Modern CT technology can be understood as a natural progression of improvements and innovations in response to both engineering problems and clinical requirements. Detailed discussions of multislice CT, CT image quality evaluation, and radiation doses in CT will be presented in upcoming articles in this series. PMID:17823453

  4. Multimodality Molecular Imaging (FDG-PET/CT, US Elastography, and DWI-MRI) as Complimentary Adjunct for Enhancing Diagnostic Confidence in Reported Intermediate Risk Category Thyroid Nodules on Bethesda Thyroid Cytopathology Reporting System

    PubMed Central

    Basu, Sandip; Mahajan, Abhishek; Arya, Supreeta

    2016-01-01

    The potential complimentary role of various molecular imaging modalities [fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), ultrasound (US)-elastography, and diffusion weighted imaging-magnetic resonance imaging (DWI-MRI)] in characterizing thyroid nodules, which have been designated as “intermediate risk category” on the Bethesda thyroid cytopathology reporting system (BTCRS), is illustrated in this communication. The clinical cases described (category III thyroid nodules on BTCRS) show the imaging features and the final diagnostic impressions rendered by the interpreting physicians with the modalities that have been independently compared in a tabular format at the end; of particular note is the high negative predictive value of these (specifically FDG-PET/CT), which could aid in enhancing the diagnostic confidence in the reported “intermediate risk category” thyroid nodules, a “gray zone” from the patient management viewpoint. PMID:27134564

  5. Lumbosacral spine CT

    MedlinePlus

    Spinal CT; CT - lumbosacral spine ... In other cases, a CT of the lumbosacral spine may be done after injecting contrast dye into ... of the body. A CT of the lumbosacral spine can evaluate fractures and changes of the spine, ...

  6. Thoracic CT

    MedlinePlus

    ... table that slides into the center of the scanner. Once you are inside the scanner, the machine's x-ray beam rotates around you. ... than 300 pounds, have your doctor contact the scanner operator before the exam. CT scanners have a ...

  7. Significance of bacterial flora in abdominal irradiation-induced inhibition of lung metastases

    SciTech Connect

    Matsumoto, T.; Ando, K.; Koike, S.

    1988-06-01

    We have previously reported that abdominal irradiation prior to i.v. injection of syngeneic tumor cells reduced metastases in lung. Our report described an investigation of the significance of intestinal organisms in the radiation effect. We found that eliminating intestinal organisms with antibiotics totally abolished the radiation effect. Monoassociation of germ-free mice revealed that the radiation effect was observable only for Enterobacter cloacae, never for Streptococcus faecium, Bifidobacterium adlesentis, or Escherichia coli. After abdominal irradiation of regular mice, E. cloacae multiplied in cecal contents, adhered to mucous membranes, invaded the cecal wall, and translocated to mesenteric lymph nodes. Intravenous administration of E. cloacae in place of abdominal irradiation inhibited metastases. E. cloacae-monoassociated mice developed fewer metastases than germ-free mice, and the reduction was further enhanced by abdominal irradiation. We concluded that abdominal irradiation caused the invasion of E. cloacae from the mucous membrane of the intestine and inhibited formation of lung metastases.

  8. Abdominal Distension and Vascular Collapse.

    PubMed

    Cosentino, Gina; Uwaifo, Gabriel I

    2016-04-01

    We present the case of a 43-year-old gentleman who presented to the emergency room with acute abdominal distension, confusion and vascular collapse. The emergent radiologic imaging obtained showed massive bilateral adrenal enlargement, but despite the initial clinical suspicion of possible overwhelming sepsis and/or massive abdominal/intralesional hemorrhage, lab tests based obtained rapidly confirmed the diagnosis of acute Addisonian crisis which responded dramatically to adrenocorticoid hormone replacement therapy and aggressive fluid resuscitation. The patient's established history of metastatic lung cancer confirmed this as a case of metastatic massive bilateral adrenal metastases with an initial presentation of acute adrenal insufficiency which is uncommon in the setting of metastatic carcinomatosis but more typically associated with lymphomas. Recognition of this clinical possibility is vital to enable rapid diagnosis and consequent life saving therapy. PMID:27328473

  9. [Abdominal bruit associated with hypertension].

    PubMed

    Fontseré, N; Bonet, J; Bonal, J; Romero, R

    2004-01-01

    First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated. PMID:15219082

  10. A Mimic of Intra-abdominal Malignancy: Physiological Urinary Excretion of FDG in the Rare Adult Vesicourachal Diverticulum.

    PubMed

    Hsieh, Te-Chun; Sun, Shung-Shung; Lin, Chen-Yuan; Wu, Yu-Chin; Kao, Chia-Hung

    2016-06-01

    Urachal remnant anomalies are rare, and vesicourachal diverticulum is the most uncommon subtype of these anomalies. We present such a rare case of vesicourachal diverticulum that is incidentally discovered during the staging surveillance of a known esophageal cancer with F-FDG PET/CT. The physiological urinary excretion of radiopharmaceutical in the vesicourachal diverticulum mimics intra-abdominal malignancy, which resolves spontaneously in the follow-up FDG PET/CT. PMID:26825197

  11. Management of voluminous abdominal incisional hernia.

    PubMed

    Bouillot, J-L; Poghosyan, T; Pogoshian, T; Corigliano, N; Canard, G; Veyrie, N

    2012-10-01

    Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference. PMID:23137643

  12. [A case of abdominal wall actinomycosis].

    PubMed

    Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

    2015-04-01

    Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodeficiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

  13. Acute Abdominal Pain in Children.

    PubMed

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  14. Internal abdominal hernia: Intestinal obstruction due to trans-mesenteric hernia containing transverse colon

    PubMed Central

    Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Orendo-Velásquez, Edwin; Andrade, Felipe P.

    2014-01-01

    INTRODUCTION Internal abdominal hernias are infrequent but an increasing cause of bowel obstruction still often underdiagnosed. Among adults its usual causes are congenital anomalies of intestinal rotation, postsurgical iatrogenic, trauma or infection diseases. PRESENTATION OF CASE We report the case of a 63-year-old woman with history of chronic constipation. The patient was hospitalized for two days with acute abdominal pain, abdominal distension and inability to eliminate flatus. The X-ray and abdominal computerized tomography scan (CT scan) showed signs of intestinal obstruction. Exploratory laparotomy performed revealed a trans-mesenteric hernia containing part of the transverse colon. The intestine was viable and resection was not necessary. Only the hernia was repaired. DISCUSSION Internal trans-mesenteric hernia constitutes a rare type of internal abdominal hernia, corresponding from 0.2 to 0.9% of bowel obstructions. This type carries a high risk of strangulation and even small hernias can be fatal. This complication is specially related to trans-mesenteric hernias as it tends to volvulize. Unfortunately, the clinical diagnosis is rather difficult. CONCLUSION Trans-mesenteric internal abdominal hernia may be asymptomatic for many years because of its nonspecific symptoms. The role of imaging test is relevant but still does not avoid the necessity of exploratory surgery when clinical features are uncertain. PMID:24880799

  15. Traumatic rupture of a Meckel’s diverticulum due to blunt abdominal trauma in a soccer game: A case report

    PubMed Central

    Tummers, W.S.; van der Vorst, J.R.; Swank, D.J.

    2015-01-01

    Introduction a Meckel’s diverticulum is one of the most common congenital anomalies of the digestive tract. The reported lifetime complication rate is 4%, mostly due to hemorrhage, obstruction, perforation or inflammation. A symptomatic Meckel’s diverticulum due to rupture after blunt abdominal trauma is very rare. We believe this case report is the first reporting a rupture of a Meckel’s diverticulum after a low velocity blunt abdominal trauma and outlining the importance of a thorough and complete examination of the patient after blunt abdominal trauma. Presentation of case a 17-year-old male presented with abdominal pain after blunt abdominal trauma during a soccer game. Physical examination showed signs of peritonitis in all quadrants of the abdomen. During admission the patient deteriorated with decreasing blood pressure and raising pulse rate. A CT-scan showed free abdominal fluid. Our patient was scheduled for an emergent laparotomy where a perforated Meckel’s diverticulum with fecal spill was found. A segmental ileal resection was performed. Post-operative, patient developed a pneumonia and also intra-abdominal abscesses treated with percutaneous drainage. After an admission period of 17-days the patient was discharged. Conclusion perforation of a Meckel’s diverticulum is rarely suspected as a cause of acute deterioration following blunt abdominal trauma. This case shows the importance of awareness of this kind of injury especially in male patients. PMID:26701844

  16. 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.

  17. [CT fluoroscopy].

    PubMed

    Rogalla, P; Juran, R

    2004-07-01

    Percutaneous biopsy of pulmonary nodules requires precise needle placement, with the goal of attaining a secure position of the needle for therapeutic or diagnostic purposes as quickly as possible and with minimal tissue damage along the access route. The requirements from the image guidance system during the intervention are, in addition to universal applicability, a quick reaction time and a user-friendly interface. CT fluoroscopy fulfils these requirements, although radiation protection for the patient and radiologist becomes an important issue. PMID:15232690

  18. Pulmonary langerhans cell histiocytosis: PET/CT for initial workup and treatment response evaluation.

    PubMed

    Hansen, Neil J; Hankins, Jordan H

    2015-02-01

    A 40-year-old man underwent pan-endoscopy owing to abdominal pain. Biopsies of the gastrointestinal tract demonstrated diffuse Langerhans cell histiocytosis. PET/CT was done, with CT demonstrating classic pulmonary manifestations of Langerhans cell histiocytosis that had association with intense FDG uptake on PET. Bowel appeared normal. Treatment was initiated with smoking cessation and 6 cycles of cytarabine. Follow-up PET/CT after initial treatment demonstrated improvement of parenchymal abnormalities seen on CT, with resolution of hypermetabolic activity. Maintenance chemotherapy was initiated. PET/CT is increasingly being used for initial staging and treatment response assessment in this rare disorder. PMID:24999688

  19. Malignant Schwannoma of Anterior Abdominal Wall: Report of a Case

    PubMed Central

    Khorgami, Zhamak; Nasiri, Shirzad; Rezakhanlu, Freshteh; Sodagari, Nassim

    2009-01-01

    Malignant schwannoma of the anterior abdominal wall nerves is extremely rare. Malignant peripheral nerve sheath tumors (MPNST) represent approximately 10% of all soft tissue sarcomas and it is found in 4% of patients with neurofibromatosis 1. We present a case of malignant schwannoma in a 28-year-old female patient with neurofibromatosis 1. She presented with a painful mass in the right upper quadrant of her abdomen. The tumor location was in the abdominal wall in explorative laparatomy and malignant schwannoma was diagnosed in pathologic assessment. The tumor recurred in 3 months and computed tomography showed two masses in the right side of abdominopelvic cavity. Thereafter, second complete surgical resection was performed and pathologic finding was the same. In spite of administering chemotherapy after second surgery,the tumor recurred and magnetic resonance imaging finding showed a huge heterogeneously enhancing mass with adhesion to the inner side of the abdominal wall. The patient died because of acute respiratory failure due to multiple bilateral pulmonary metastases. Tumor location and rapid recurrence was unique in our patient. Keywords Malignant peripheral nerve sheath tumor; Malignant schwannoma; Abdominal wall PMID:22461875

  20. Invisible fat on CT: making it visible by MRI

    PubMed Central

    Ünal, Emre; Karaosmanoğlu, Ali Devrim; Akata, Deniz; Özmen, Mustafa Nasuh; Karçaaltıncaba, Muşturay

    2016-01-01

    Presence of fat in a lesion significantly narrows the differential diagnosis. Small quantities of macroscopic fat and intracellular fat are invisible on computed tomography (CT) and ultrasonography. Magnetic resonance imaging (MRI) can reveal any fatty change in a lesion and can also differentiate macroscopic fat from intracellular and intravoxel fat. Hypodensity on CT may be a sign of invisible fat and MRI can help to diagnose even minute amounts of fat in liver, pancreas, adrenal, musculoskeletal, and omental pseudolesions and lesions. This article will review the superiority of MRI over CT in demonstrating fat in abdominal lesions. PMID:26782156

  1. MR Evaluation of the Nontraumatic Acute Abdomen with CT Correlation.

    PubMed

    Bannas, Peter; Pickhardt, Perry J

    2015-11-01

    Cross-sectional imaging plays a crucial role in the triage of patients with acute abdominal pain. Ionizing radiation exposure is a recognized drawback of computed tomography (CT), the primary imaging technique. MR imaging is a promising alternative to CT; it provides excellent image quality with high-contrast resolution without the disadvantages of ionizing radiation and iodinated contrast. This article provides a basic overview of the typical MR findings of the most frequent disease entities encountered in the setting of the nontraumatic acute abdomen, including direct comparison with CT findings to familiarize the readers with these same findings on MR. PMID:26526441

  2. A simple method for labeling CT images with respiratory states

    SciTech Connect

    Berlinger, Kajetan; Sauer, Otto; Vences, Lucia; Roth, Michael

    2006-09-15

    A method is described for labeling CT images with their respiratory state by a needle, connected to the patient's chest/abdomen. By means of a leverage the needle follows the abdominal respiratory motion. The needle is visible as a blurred spot in every CT slice. The method was tested with nine patients. A series of volume scans during free breathing was performed. The detected positions of the moving needle in every single slice were compared to each other thus enabling respiratory state assignment. The tool is an inexpensive alternative to complex respiratory measuring tools for four dimensional (4D) CT and was greatly accepted in the clinic due to its simplicity.

  3. ABDOMINAL SUBCUTANEOUS ADIPOSE TISSUE (SAT) AND VICERAL ADIPOSE TISSUE (VAT) MEASUREMENTS IN HIV+ ADULTS: INFLUENCES OF MEASUREMENT SITE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Loss of SAT and an increase in VAT are common with HIV lipodystrophy. Excess abdominal VAT is a known risk factor for cardiovascular disease. Computerized axial tomography (CT) can be used to measure SAT and VAT areas in cross-sectional images of the abdomen. The ideal site(s) and number of abdomina...

  4. 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

  5. Swarm Intelligence Integrated Graph-Cut for Liver Segmentation from 3D-CT Volumes

    PubMed Central

    Eapen, Maya; Korah, Reeba; Geetha, G.

    2015-01-01

    The segmentation of organs in CT volumes is a prerequisite for diagnosis and treatment planning. In this paper, we focus on liver segmentation from contrast-enhanced abdominal CT volumes, a challenging task due to intensity overlapping, blurred edges, large variability in liver shape, and complex background with cluttered features. The algorithm integrates multidiscriminative cues (i.e., prior domain information, intensity model, and regional characteristics of liver in a graph-cut image segmentation framework). The paper proposes a swarm intelligence inspired edge-adaptive weight function for regulating the energy minimization of the traditional graph-cut model. The model is validated both qualitatively (by clinicians and radiologists) and quantitatively on publically available computed tomography (CT) datasets (MICCAI 2007 liver segmentation challenge, 3D-IRCAD). Quantitative evaluation of segmentation results is performed using liver volume calculations and a mean score of 80.8% and 82.5% on MICCAI and IRCAD dataset, respectively, is obtained. The experimental result illustrates the efficiency and effectiveness of the proposed method. PMID:26689833

  6. CRYPTOSPORIDIUM LOG-INACTIVATION WITH OZONE USING EFFLUENT CT 10, GEOMETRIC MEAN CT 10 EXTENDED INTEGRATED CT 10 AND EXTENDED-CSTR CALCULATIONS

    EPA Science Inventory

    The draft Long Term 2 Enhanced Surface Water Treatment Rule ("LT2ESWTR") contains Cryptosporidium log-inactivation CT tables. Depending on the water temperature, the Cryptosporidium CT values that are listed are 15 to 25 times greater than CT values fo...

  7. 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

  8. Abdominal Wall Metastasis of Uterine Papillary Serous Carcinoma in a Post-Menopausal Woman: A Case Report

    PubMed Central

    Park, Jung-Woo

    2014-01-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy. PMID:25371890

  9. Abdominal wall metastasis of uterine papillary serous carcinoma in a post-menopausal woman: a case report.

    PubMed

    Park, Jung-Woo; Hwang, Sung-Ook

    2014-04-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy. PMID:25371890

  10. [Abdominal CSF pseudocyst recurrence in a 14-year-old patient with ventricular-peritoneal shunt].

    PubMed

    Laurent, P; Hennecker, J-L; Schillaci, A; Scordidis, V

    2014-08-01

    Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare complication of ventricular-peritoneal shunt (VPS) but needs to be considered in every patient with abdominal complaints or signs of intracranial hypertension (IH). The pathogenesis of pseudocysts remains unclear. Diverse predisposing factors have been proposed such as previous abdominal surgeries, multiple VPS revisions, infections, history of necrotizing enterocolitis, and nonspecific inflammatory processes. We report the case of a 14-year-old patient, known to have a VPS as intraventricular hemorrhage treatment, presenting cephalalgia, vomiting, apathy, and an indurate abdominal mass without fever. The first abdominal CSF pseudocyst diagnosis had been established 3 months earlier. Abdominal ultrasounds confirmed a large homogeneous cyst with the shunt tip within the pseudocyst. Cerebral CT revealed an increased ventricular size. An exploratory laparotomy with cyst aspiration, lysis of adhesions, excision of cystic walls, and repositioning of the peritoneal catheter was performed. No antibiotics were initiated given that the cultures were negative. Ultrasonography proved to be the method of choice in the diagnosis of VPS abdominal complications, especially CSF pseudocyst. CT can also reliably confirm the pseudocyst. In case of IH signs, a cerebral CT scan can be performed to evaluate the ventricular distension and to check the shunt position. Various methods to process the cyst have been described in the medical literature, but the recurrence rate remains elevated (25-100%). Then the probability of an infection without any clinical sign has to be considered. In case of suspected infection, the VPS is removed and replaced by an external ventricular drain. Antibiotics are started and adjusted to the results of the CSF culture. If there is no direct sign of infection, only the distal catheter is externalized and antibiotics are introduced until infection is treated. Depending on the peritoneal absorption state

  11. 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.

  12. 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.

  13. Blunt abdominal trauma in children.

    PubMed

    Tepas, J J

    1993-06-01

    The growing popularity of nonoperative treatment of children with splenic injuries has seduced some physicians into a false sense of security regarding care of the injured child. Although it has been established that hemodynamically stable children with splenic, hepatic, and even renal injuries can safely be treated "expectantly," this concept cannot be applied indiscriminately. Accurate diagnosis and effective care of the child with blunt abdominal trauma is an exercise of clinical precision that demands attention to detail and thorough evaluation. This review addresses this process in light of recent advances in diagnostic imaging and in consideration of recent reports analyzing different protocols for therapeutic decision making. PMID:8374651

  14. 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

  15. [Abdominal pain, constipation and anemia].

    PubMed

    Barresi, Fabio; Kunz Caflish, Isabel; Bayly-Schinzel, Leena; Dressel, Holger

    2016-03-30

    We present the case of a 42-year old man who went to the emergency department because of spasmodic abdominal pain. The abdomen was soft. A gastroscopy and a colonoscopy were without pathological findings. The laboratory analyses indicated anemia. The differential blood count showed basophilic granules in the red blood cells. The blood lead level was elevated. A lead poisoning was diagnosed. The cause was the oral intake of an ayurvedic medication which the patient had received in Bangladesh to treat his vitiligo. PMID:27005735

  16. Dairy foods in a moderate energy restricted diet do not enhance central fat, weight & intra-abdominal adipose tissue loss or reduce adipocyte size & inflammatory markers in overweight & obese adults; Controlled feeding study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Research on the role of dairy foods to enhance weight and fat loss when incorporated into a modest weight loss diet has had mixed results. Objective: A 15 week controlled feeding study to answer the question: do dairy foods enhance central fat and weight loss when incorporated in a mode...

  17. Aorta-Left Renal Vein Fistula Complicating an Aortic Aneurysm: Preoperative and Postoperative Multislice CT Findings

    SciTech Connect

    Barrier, Pierre Otal, Philippe; Garcia, Olivier; Vahdat, Olivier; Domenech, Brice; Lannareix, Valerie; Joffre, Francis; Rousseau, Herve

    2007-06-15

    Fistulas complicating an abdominal aortic aneurysm (AAA) are rare, and fistulas involving the left renal vein are particularly uncommon. We highlight here a fistula between an infrarenal aortic aneurysm and a retroaortic left renal vein, revealed by left flank pain associated with hematuria and acute renal failure. The multislice CT angiography performed in this 68-year-old patient revealed communication and equal enhancement between the aorta and the left gonadic vein, suggesting the presence of a fistula. The three-dimensional VRT reconstructions presented in this case were of great value in the preoperative planning, enabling immediate visualization of this unusual feature. Alternative diagnoses to consider when encountering this clinical presentation are reviewed.

  18. Endovascular repair of a pseudoaneurysm of the abdominal aorta secondary to translumbar aortography.

    PubMed

    Mir, Naheed; De Nunzio, Mario; Pollock, John G

    2006-01-01

    This report describes an incidental finding of a pseudoaneurysm of the abdominal aorta on a computed tomography (CT) renal angiogram during investigation of chronic renal failure in a 73-year-old man. The patient had undergone a translumbar aortogram 20 years previously. An increase in the size of the aneurysm by 7 mm over 6 months prompted treatment and the aneurysm underwent successful endovascular repair with a custom-made stent-graft. PMID:16184323

  19. Abdominal wall reconstruction with implantable meshes.

    PubMed

    Masden, Derek; Felder, John M; Iorio, Matthew L; Bhanot, Parag; Attinger, Christopher E

    2011-01-01

    Abdominal wall defects present a difficult problem for the reconstructive surgeon. Over the years, numerous implantable materials have becomes available to aid the surgeon in recreating the abdominal wall. This spectrum of implants includes permanent synthetic meshes, absorbable meshes, composite meshes and biomaterials. This review includes the pros and cons for the commercially available abdominal wall implants as well as a review of the literature regarding outcomes for each material. This review will provide the surgeon with current evidence-based information on implantable abdominal materials to be able to make a more informed decision about which implant to use. PMID:21663579

  20. Acute Abdominal Pain after Intercourse: Adrenal Hemorrhage as the First Sign of Metastatic Lung Cancer

    PubMed Central

    Packer, Clifford D.

    2014-01-01

    Although the adrenal glands are a common site of cancer metastases, they are often asymptomatic and discovered incidentally on CT scan or autopsy. Spontaneous adrenal hemorrhage associated with metastatic lung cancer is an exceedingly rare phenomenon, and diagnosis can be difficult due to its nonspecific symptoms and ability to mimic other intra-abdominal pathologies. We report a case of a 65-year-old man with a history of right upper lobectomy seven months earlier for stage IB non-small cell lung cancer who presented with acute abdominal pain after intercourse. CT scan revealed a new right adrenal mass with surrounding hemorrhage, and subsequent FDG-PET scan confirmed new metabolic adrenal metastases. The patient's presentation of abdominal pain and adrenal hemorrhage immediately after sexual intercourse suggests that exertion, straining, or increased intra-abdominal pressure might be risk factors for precipitation of hemorrhage in patients with adrenal metastases. Management includes pain control and supportive treatment in mild cases, with arterial embolization or adrenalectomy being reserved for cases of severe hemorrhage. PMID:25126096

  1. [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

  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. MO-C-17A-11: A Segmentation and Point Matching Enhanced Deformable Image Registration Method for Dose Accumulation Between HDR CT Images

    SciTech Connect

    Zhen, X; Chen, H; Zhou, L; Yan, H; Jiang, S; Jia, X; Gu, X; Mell, L; Yashar, C; Cervino, L

    2014-06-15

    Purpose: To propose and validate a novel and accurate deformable image registration (DIR) scheme to facilitate dose accumulation among treatment fractions of high-dose-rate (HDR) gynecological brachytherapy. Method: We have developed a method to adapt DIR algorithms to gynecologic anatomies with HDR applicators by incorporating a segmentation step and a point-matching step into an existing DIR framework. In the segmentation step, random walks algorithm is used to accurately segment and remove the applicator region (AR) in the HDR CT image. A semi-automatic seed point generation approach is developed to obtain the incremented foreground and background point sets to feed the random walks algorithm. In the subsequent point-matching step, a feature-based thin-plate spline-robust point matching (TPS-RPM) algorithm is employed for AR surface point matching. With the resulting mapping, a DVF characteristic of the deformation between the two AR surfaces is generated by B-spline approximation, which serves as the initial DVF for the following Demons DIR between the two AR-free HDR CT images. Finally, the calculated DVF via Demons combined with the initial one serve as the final DVF to map doses between HDR fractions. Results: The segmentation and registration accuracy are quantitatively assessed by nine clinical HDR cases from three gynecological cancer patients. The quantitative results as well as the visual inspection of the DIR indicate that our proposed method can suppress the interference of the applicator with the DIR algorithm, and accurately register HDR CT images as well as deform and add interfractional HDR doses. Conclusions: We have developed a novel and robust DIR scheme that can perform registration between HDR gynecological CT images and yield accurate registration results. This new DIR scheme has potential for accurate interfractional HDR dose accumulation. This work is supported in part by the National Natural ScienceFoundation of China (no 30970866 and no

  4. 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

    of tumor motion. However, in most of the authors’ patients, the use of abdominal compression seemed to increase the interfraction variation in tumor position, despite reducing lung tumor motion. The daily tumor position deviated more systematically from the tumor position in the planning CT scan in the lateral and longitudinal directions in patients treated with abdominal compression compared to those treated without compression. Therefore, target matching is required to correct or minimize the interfraction variation.

  5. 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

  6. Enhanced diagnostic value for coronary CT angiography of calcified coronary arteries using dual energy and a novel high-Z contrast material: a phantom study

    NASA Astrophysics Data System (ADS)

    Lambert, Jack W.; Ordovas, Karen G.; Sun, Yuxin; Yeh, Benjamin M.

    2016-03-01

    Dual-energy CT is emerging as a dose-saving tool for coronary CT angiography that allows calcium-scoring without the need for a separate unenhanced scan acquisition. Unfortunately the similar attenuation coefficient profiles of iodine and calcium limits the accuracy of their decomposition in the material basis images. We evaluate a tungsten-based contrast material with a more distinct attenuation profile from calcium, and compare its performance to a conventional iodinated agent. We constructed a custom thorax phantom containing simulated sets of vessels 3, 6 and 9 mm in diameter. The vessel sets were walled with concentric and eccentric calcifications ("plaque") with concentrations of 0, 20, 30 and 40% weight calcium hydroxyapatite (HAP). The phantom was filled sequentially with iodine and tungsten contrast material, and scanned helically using a fast-kV-switching DECT scanner. At material decomposition, both iodine and tungsten vessel lumens were separable from the HAP vessel walls, but separation was superior with tungsten which showed minimal false positive signal in the HAP image. Assessing their relative performance using line profiles, the HAP signal was greater in the tungsten separation in 6/9 of the vessel sets, and within 15% of the iodine separation for the remaining 3/9 sets. The robust phantom design enabled systematic evaluation of dual-energy material separation for calcium and a candidate non-iodinated vascular contrast element. This approach can be used to screen further agents and also refine dual energy CT material decomposition approaches.

  7. A technique for multi-dimensional optimization of radiation dose, contrast dose, and image quality in CT imaging

    NASA Astrophysics Data System (ADS)

    Sahbaee, Pooyan; Abadi, Ehsan; Sanders, Jeremiah; Becchetti, Marc; Zhang, Yakun; Agasthya, Greeshma; Segars, Paul; Samei, Ehsan

    2016-03-01

    The purpose of this study was to substantiate the interdependency of image quality, radiation dose, and contrast material dose in CT towards the patient-specific optimization of the imaging protocols. The study deployed two phantom platforms. First, a variable sized phantom containing an iodinated insert was imaged on a representative CT scanner at multiple CTDI values. The contrast and noise were measured from the reconstructed images for each phantom diameter. Linearly related to iodine-concentration, contrast to noise ratio (CNR), was calculated for different iodine-concentration levels. Second, the analysis was extended to a recently developed suit of 58 virtual human models (5D-XCAT) with added contrast dynamics. Emulating a contrast-enhanced abdominal image procedure and targeting a peak-enhancement in aorta, each XCAT phantom was "imaged" using a CT simulation platform. 3D surfaces for each patient/size established the relationship between iodine-concentration, dose, and CNR. The Sensitivity of Ratio (SR), defined as ratio of change in iodine-concentration versus dose to yield a constant change in CNR was calculated and compared at high and low radiation dose for both phantom platforms. The results show that sensitivity of CNR to iodine concentration is larger at high radiation dose (up to 73%). The SR results were highly affected by radiation dose metric; CTDI or organ dose. Furthermore, results showed that the presence of contrast material could have a profound impact on optimization results (up to 45%).