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Sample records for disease ct findings

  1. CT findings in adult celiac disease.

    PubMed

    Scholz, Francis J; Afnan, Jalil; Behr, Spencer C

    2011-01-01

    Celiac disease is now recognized as a common disease, occurring in about one in every 200 Americans. However, less than 10% of cases are currently diagnosed, with a diagnostic delay of more than 10 years from onset of symptoms. In the past, barium examination of the small bowel demonstrated a pattern of abnormal findings caused by the pathophysiologic changes induced by malabsorption, thus leading to diagnosis of celiac disease and other diseases of malabsorption. Although not specific, that pattern prompted further patient evaluation. The number of barium examinations performed and the skill necessary to interpret their results are both in decline. Abdominal pain in celiac disease is a common early complaint that often leads to computed tomography (CT). Improved CT resolution now permits better depiction of the small bowel, colon, and mesenteric lymph nodes, all of which are affected by celiac disease. Detection of celiac disease with CT will allow treatment to be initiated to prevent the significant morbidity and increased mortality associated with a delay in diagnosis. The abnormal CT findings seen over the past decade during review of more than 200 cases of celiac disease demonstrate that CT depicts more features of celiac disease than did barium examination. Pattern recognition for the diagnosis of small bowel diseases that create structural changes in the bowel wall is well accepted. Because it demonstrates features of celiac disease not detected with barium examination, CT may be more sensitive than barium examination for diagnosis of this disease.

  2. CT findings of acute pelvic inflammatory disease.

    PubMed

    Lee, Mi Hee; Moon, Min Hoan; Sung, Chang Kyu; Woo, Hyunsik; Oh, Sohee

    2014-12-01

    To determine the computed tomographic (CT) findings of acute pelvic inflammatory disease (PID). This retrospective, single-institution case-control study was approved by our institutional review board, and the informed consent was waived owing to the retrospective nature of the study. CT images of 32 women with clinically proven acute PID and 32 control subjects with other conditions of similar presentation were retrospectively reviewed. Analysis of CT findings included hepatic capsular enhancement, pelvic fat haziness, complicated ascites, uterine serosal enhancement, tubal thickening, endometritis, and oophoritis. Comparison of CT findings was performed with the Chi square test or the Fisher exact test and logistic regression analysis was used to determine significant CT findings in predicting PID. The CT findings that showed a statistically significant difference were hepatic capsular enhancement on late arterial phase (p = 0.003), pelvic fat haziness (p = 0.045), and tubal thickening (p = 0.001). Subsequent multivariate logistic regression analysis revealed that the presence of hepatic capsular enhancement on late arterial phase and tubal thickening were significant predictors of PID (hepatic capsular enhancement on late arterial phase, p = 0.015, odds ratio [OR] = 4.8; tubal thickening, p = 0.005, OR = 10.5). Diagnostic morphological CT findings in women with clinically proven PID and acute abdominal pain include hepatic capsular enhancement on late arterial phase and tubal thickening.

  3. Castleman disease of the neck: CT and MR imaging findings.

    PubMed

    Jiang, Xin-Hua; Song, Hao-Ming; Liu, Qing-Yu; Cao, Yun; Li, Guo-Hong; Zhang, Wei-Dong

    2014-11-01

    To characterize the computed tomography (CT) and magnetic resonance imaging (MRI) findings of Castleman disease of the neck. The imaging findings of 21 patients with Castleman disease of the neck were reviewed retrospectively. Of the 21 patients, 16 underwent unenhanced and contrast-enhanced CT scans; 5 underwent unenhanced and contrast-enhanced MRI scans. The unenhanced CT images showed isolated or multiple well-defined homogenous mild hypodensity lesions in fifteen cases, and a heterogeneous nodule with central areas of mild hypodensity in one case. Calcification was not observed in any of the patients. In five patients, MR T1-weighted images revealed well-defined, homogeneous isointense or mild hyperintense lesions to the muscle; T2-weighted images showed these as intermediate hyperintense. Sixteen cases showed intermediate to marked homogeneous enhancement on contrast-enhanced CT or MR T1-weighted images. Of the other five cases that underwent double-phase CT scans, four showed mild or intermediate heterogeneous enhancement at the arterial phase, and homogeneous intermediate or marked enhancement at the venous phase; the remaining case showed mild and intermediate ring-enhancement with a central non-enhanced area at the arterial and venous phases, respectively. Castleman disease of the neck can be characterized as solitary or multiple well-defined, mild hypodensity or homogeneous intense lesions on plain CT/MR scans, and demonstrates intermediate and marked enhancement on contrast-enhanced CT/MR scans. On double-phase CT scans, Castleman disease often demonstrates mild enhancement at the arterial phase, and gradually uniform enhancement at venous phase. Double-phase enhanced CT or MRI may help to differentiate Castleman disease from other diseases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Pelvic hydatid disease: CT and MRI findings causing sciatica.

    PubMed

    Sanal, Hatice Tuba; Kocaoglu, Murat; Bulakbasi, Nail; Yildirim, Duzgun

    2007-01-01

    Pelvic masses, especially hydatid disease, rarely present with sciatica (1, 2). We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings.

  5. Pelvic Hydatid Disease: CT and MRI Findings Causing Sciatica

    PubMed Central

    Kocaoglu, Murat; Bulakbasi, Nail; Yildirim, Duzgun

    2007-01-01

    Pelvic masses, especially hydatid disease, rarely present with sciatica (1, 2). We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings. PMID:18071287

  6. Haemodynamic findings on cardiac CT in children with congenital heart disease.

    PubMed

    Goo, Hyun Woo

    2011-02-01

    In patients with congenital heart disease, haemodynamic findings demonstrated on cardiac CT might provide useful hints for understanding the haemodynamics of cardiac defects. In contrast to morphological features depicted on cardiac CT, such haemodynamic findings on cardiac CT have not been comprehensively reviewed in patients with congenital heart disease. This article describes normal haemodynamic phenomena of cardiovascular structures and various abnormal haemodynamic findings with their mechanisms and clinical significance on cardiac CT in patients with congenital heart disease.

  7. Urachal remnant diseases: spectrum of CT and US findings.

    PubMed

    Yu, J S; Kim, K W; Lee, H J; Lee, Y J; Yoon, C S; Kim, M J

    2001-01-01

    Computed tomography (CT) and ultrasonography (US) are ideally suited for demonstrating urachal remnant diseases. A patent urachus is demonstrated at longitudinal US and occasionally at CT as a tubular connection between the anterosuperior aspect of the bladder and the umbilicus. An umbilical-urachal sinus manifests at US as a thickened tubular structure along the midline below the umbilicus. A vesicourachal diverticulum is usually discovered incidentally at axial CT, appearing as a midline cystic lesion just above the anterosuperior aspect of the bladder. At US, it manifests as an extraluminally protruding, fluid-filled sac that does not communicate with the umbilicus. Urachal cysts manifest at both modalities as a noncommunicating, fluid-filled cavity in the midline lower abdominal wall located just beneath the umbilicus or above the bladder. Both infected urachal cysts and urachal carcinomas commonly display increased echogenicity at US and thick-walled cystic or mixed attenuation at CT, making it difficult to differentiate between them. Percutaneous needle biopsy or fluid aspiration is usually needed for diagnosis and therapeutic planning. Nevertheless, CT and US can help identify most disease entities originating from the urachal remnant in the anterior abdominal wall. Understanding the anatomy and the imaging features of urachal remnant diseases is essential for correct diagnosis and proper management.

  8. CT findings in leukemia

    SciTech Connect

    Heiberg, E.; Wolverson, M.K.; Sundaram, M.; Shields, J.B.

    1984-12-01

    Review of 84 computed tomographic (CT) scans in leukemic patients demonstrate a wide spectrum of abnormalities. Findings caused by leukemia were lymphadenopathy, visceral enlargement, focal defects, and tissue infiltration. Hemorrhage was by far the most common complication and could usually be characterized on the noncontrast CT scan. The distinction between old hematomas, foci of infection, and leukemia infiltration could not be made with certainty without CT-guided aspiration. Unusual instances of sepsis, such as microabscesses of the liver and typhlitis, were seen.

  9. Prevalence of non-cardiovascular findings on CT angiography in children with congenital heart disease.

    PubMed

    Malik, Archana; Hellinger, Jeffrey C; Servaes, Sabah; Schwartz, Mathew C; Keller, Marc S; Epelman, Monica

    2017-03-01

    CT angiography is gaining broader acceptance in the evaluation of children with known or suspected congenital heart disease. These studies include non-cardiovascular structures such as the mediastinum, lung parenchyma and upper abdominal organs. It is important to inspect all these structures for potential abnormalities that might be clinically important and, in some cases, may impact care plans. To determine the prevalence of non-cardiovascular findings in CT angiography of children with congenital heart disease. During 28 months, 300 consecutive children (170 males; mean age: 7.1 years, age range: 6 h-26 years), referred from a tertiary pediatric cardiology center, underwent clinically indicated CT angiography to evaluate known or suspected congenital heart disease. Slightly more than half (n = 169) of the patients were postoperative or post-intervention. Examinations were retrospectively reviewed, and non-cardiovascular findings were recorded and tabulated by organ system, congenital heart disease and operative procedure in conjunction with outcomes from medical charts. Non-cardiovascular findings were identified in 83% (n = 250 / 300) of the studies for a total of 857 findings. In 221 patients (n = 73.7% of 300) a total of 813 non-cardiovascular findings were clinically significant, while in 9.7% (n = 29 / 300) of patients, 5.1% (n = 44 / 857) of the findings were nonsignificant. In 38.3% (n = 115 / 300) of patients with significant non-cardiovascular pathology, the findings were unexpected and directly impacted patient care plans. Commonly involved organs with non-cardiovascular findings were the lungs with 280 non-cardiovascular findings in 176 / 300 (58.7%) of patients, the airway with 139 non-cardiovascular findings in 103 / 300 (34.3%) of patients and the liver with 108 non-cardiovascular findings in 72 / 300 (24.0%) of patients. Syndromic associations were noted in 22% (n = 66 / 300) of the

  10. Subdural empyema: CT findings

    SciTech Connect

    Zimmerman, R.D.; Leeds, N.E.; Danziger, A.

    1984-02-01

    CT scans in 49 patients with surgically proven subdural empyema were evaluated. The empyemas were crescentic or lentiform extra-axial hypodense collections (density approximating that of cerebrospinal fluid) with prominent, sharply etched medial rim enhancement. Enhancement of the adjacent cerebral cortex was identified in many cases. Mass effect was always present and in 10 cases so extensive that it overshadowed a small extra-axial collection. CT allowed for precise localization of the lesion, including contiguous or isolated involvement of the interhemispheric subdural space. Mortality was 12% (6/49 cases), a marked improvement when compared with mortality figures obtained prior to the advent of CT (40%). CT findings indicative of involvement of the adjacent parenchyma via retrograde thrombophlebitis with resultant infarction and/or abscess formation were associated with poor prognosis. Improvement in prognosis since the advent of CT is the direct result of early accurate diagnosis and timely intervention.

  11. PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

    PubMed Central

    Toma, Marieta; Zöphel, Klaus; Novotny, Vladimir; Laniado, Michael

    2017-01-01

    A 67-year-old man diagnosed with Gleason score 4 + 5 = 9 clinically localized prostate cancer with 68Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease. PMID:28396816

  12. PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings.

    PubMed

    Froehner, Michael; Toma, Marieta; Zöphel, Klaus; Novotny, Vladimir; Laniado, Michael; Wirth, Manfred P

    2017-01-01

    A 67-year-old man diagnosed with Gleason score 4 + 5 = 9 clinically localized prostate cancer with (68)Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease.

  13. [Consistency analysis between preoperative CT enterography and intraoperative findings in patients undergoing surgery for Crohn's disease].

    PubMed

    Yang, Jianbo; Gong, Jianfeng; Li, Yi; Gu, Lili; Zhu, Weiming; Li, Jieshou

    2017-05-25

    To evaluate the diagnostic value of preoperative CT enterography (CTE) on obstruction, fistula and abscess formation compared to intraoperative findings in patients undergoing surgery for Crohn's disease(CD), aiming to provide reference to clinical practice. Preoperative CTE data of 176 CD patients confirmed by clinic, endoscopy, imaging, operation and pathology at the Department of General Surgery in Nanjing Jinling Hospital from January 2013 to December 2015 were enrolled in retrospective cohort study. All the patients underwent enhanced full abdominal CT scan using SIMENS SOMATOM Definition Flash 64 row dual-source CT machine. CTE scans were performed from the dome of diaphragm to the symphysis pubis. The CT images in arterial and venous phase were reconstructed with 1.0 mm thin layer, and then processed in MMWP 4.0 workstation including multi-planar recombination, surface recombination and maximum density projection. The sensitivity, specificity, positive and negative predictive value, false negative rate and accuracy of preoperative CTE on obstruction, fistula and abscess were compared with intraoperative findings. Among 176 patients, 122 were males and 54 were females with median age of 29 (18 to 65) years, median disease duration of 48 (1 to 240) months, median time interval from CT scan to operation of 16(1 to 30) days, and median body mass index of 17.8 (10.8 to 34.7) kg/m(2). Twenty-six cases (14.8%) had nutritional risk (NRS2002≥3); 23 cases (13.1%) had lesions limited to ileum; 19 cases (10.8%) had lesions limited to colon; 126 cases (71.6%) had simultaneous lesions of ileum and colon, and 8 cases (4.5%) had lesion in upper gastrointestinal tract. A total of 199 lesions of small intestine were identified by preoperative CTE, including 131 of obstruction (65.8%), 42 of fistula (21.1%), and 26 of abscess (13.1%), while 235 lesions were confirmed by operation, including 133 of obstruction (56.6%), 74 of fistula (31.5%), 28 of abscess (11.9%). The

  14. High-resolution CT scan findings in patients with symptomatic scleroderma-related interstitial lung disease.

    PubMed

    Goldin, Jonathan G; Lynch, David A; Strollo, Diane C; Suh, Robert D; Schraufnagel, Dean E; Clements, Philip J; Elashoff, Robert M; Furst, Daniel E; Vasunilashorn, Sarinnapha; McNitt-Gray, Michael F; Brown, Mathew S; Roth, Michael D; Tashkin, Donald P

    2008-08-01

    Lung disease has become the leading cause of mortality and morbidity in scleroderma (SSc) patients. The frequency, nature, and progression of interstitial lung disease seen on high-resolution CT (HRCT) scans in patients with diffuse SSc (dcSSc) compared with those with limited SSc (lcSSc) has not been well characterized. Baseline HRCT scan images of 162 participants randomized into a National Institutes of Health-funded clinical trial were compared to clinical features, pulmonary function test measures, and BAL fluid cellularity. The extent and distribution of interstitial lung disease HRCT findings, including pure ground-glass opacity (pGGO), pulmonary fibrosis (PF), and honeycomb cysts (HCs), were recorded in the upper, middle, and lower lung zones on baseline and follow-up CT scan studies. HRCT scan findings included 92.9% PF, 49.4% pGGO, and 37.2% HCs. There was a significantly higher incidence of HCs in the three zones in lcSSc patients compared to dcSSc patients (p = 0.034, p = 0.048, and p = 0.0007, respectively). The extent of PF seen on HRCT scans was significantly negatively correlated with FVC (r = - 0.22), diffusing capacity of the lung for carbon monoxide (r = - 0.44), and total lung capacity (r = - 0.36). A positive correlation was found between pGGO and the increased number of acute inflammatory cells found in BAL fluid (r = 0.28). In the placebo group, disease progression was assessed as 30% in the upper and middle lung zones, and 45% in the lower lung zones. No difference in the progression rate was seen between lcSSc and dcSSc patients. PF and GGO were the most common HRCT scan findings in symptomatic SSc patients. HCs were seen in more than one third of cases, being more common in lcSSc vs dcSSc. There was no relationship between progression and baseline PF extent or lcSSc vs dcSSc. Clinicaltrials.gov Identifier: NCT00004563.

  15. Mesenteric findings of CT enterography are well correlated with the endoscopic severity of Crohn's disease.

    PubMed

    Sakurai, Takehiro; Katsuno, Tatsuro; Saito, Keiko; Yoshihama, Sayuri; Nakagawa, Tomoo; Koseki, Hirotaka; Taida, Takashi; Ishigami, Hideaki; Okimoto, Ken-Ichiro; Maruoka, Daisuke; Matsumura, Tomoaki; Arai, Makoto; Yokosuka, Osamu

    2017-04-01

    Maintenance of mucosal healing is a primary goal when treating Crohn's disease (CD). Endoscopy is the most precise method for the assessment of mucosal healing, but is considered overly invasive for patients with CD. In contrast, CT enterography (CTE) is less invasive, but little is known about the correlation between mucosal status and CTE parameters. We recruited CD patients who underwent CTE and double balloon endoscopy (DBE) on the same day at our hospital between 2012 and 2014. CTE parameters evaluated included bowel-wall thickening, mural hyperenhancement, mural stratification (target sign), submucosal fat deposition, mesenteric hypervascularity (comb sign), increased fat density, mesenteric fibrofatty proliferation, enlarged mesenteric lymph nodes, and stenosis/sacculation. Endoscopic findings were evaluated using the Simple Endoscopic Score for Crohn's Disease (SES-CD). CTE parameters that were predictive of higher values in the SES-CD were extracted statistically. Forty-one patients were recruited, from which 191 intestinal segments were evaluated. Spearman's rank correlation coefficients showed that the majority of CTE values exhibited mild to moderate correlations with SES-CD values. Notably, multiple ordinal logistic regression analysis demonstrated that CTE findings obtained from the mesenteric area, such as mesenteric hypervascularity (comb sign) and enlarged mesenteric lymph nodes, were more critical predictors of endoscopic mucosal ulceration than those obtained from the bowel wall. This study was the first of its kind to assess correlations between CTE values and SES-CD values. Mesenteric findings of CTE, rather than mural findings, were highly correlated with the endoscopically evaluated severity of ulceration. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. High-resolution CT findings of Mycobacterium avium-intracellulare complex pulmonary disease: correlation with pulmonary function test results.

    PubMed

    Song, Jong Woon; Koh, Won-Jung; Lee, Kyung Soo; Lee, Ji Young; Chung, Myung Jin; Kim, Tae Sung; Kwon, O Jung

    2008-10-01

    The purpose of our study was to analyze the high-resolution CT findings of the nodular bronchiectatic form of Mycobacterium avium-intracellulare complex (MAC) pulmonary disease and to correlate the extent of high-resolution CT findings with pulmonary function test (PFT) results. From January 2005 through December 2005, we identified 47 patients (mean age, 58 +/- 13 years; age range, 24-72 years; male-female ratio, 11:36) with the nodular bronchiectatic form of MAC pulmonary disease who underwent both high-resolution CT and PFTs. High-resolution CT findings were reviewed retrospectively in terms of the presence and extent of bronchiectasis, cellular or inflammatory bronchiolitis (centrilobular small nodules and tree-in-bud signs), cavity, nodule, and other findings. The extent of the abnormalities seen on high-resolution CT was scored by modifying the cystic fibrosis scoring system proposed by Helbich and coworkers. The scores were correlated with PFT results using Spearman's correlation coefficient. On high-resolution CT, the three most frequently observed patterns of parenchymal abnormalities were, in decreasing order of frequency, cellular bronchiolitis (n = 47, 100%), bronchiectasis (n = 46, 98%), and consolidation (n = 27, 57%). The total CT score showed a significant correlation with the residual volume-total lung capacity (RV/TLC) ratio (r = 0.572, p < 0.001), forced expiratory volume in 1 second (FEV(1)) value (r = -0.426, p = 0.003), forced vital capacity (FVC) value (r = -0.360, p = 0.013), peak expiratory flow value (r = -0.352, p = 0.015), and peak expiratory flow between 25% and 75% of the forced vital capacity (FEF(25-75%)) (r = -0.289, p = 0.049). CT scoring of pulmonary abnormalities correlates with measures of functional impairment in patients with MAC pulmonary disease.

  17. Thoracic textilomas: CT findings*

    PubMed Central

    Machado, Dianne Melo; Zanetti, Gláucia; Araujo, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Pereira e Silva, Jorge Luiz; Guimarães, Marcos Duarte; Escuissato, Dante Luiz; Souza, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson

    2014-01-01

    OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. PMID:25410842

  18. Multislice CT pulmonary findings in Behçet's disease (report of 16 cases).

    PubMed

    Emad, Y; Abdel-Razek, N; Gheita, T; el-Wakd, M; el-Gohary, T; Samadoni, A

    2007-06-01

    Pulmonary artery aneurysm is the best-defined type of pulmonary disease in Behçet's disease (BD) with an important morbidity and mortality. The objective of this study was to assess the contribution of high-resolution dynamic chest CT imaging for one of the most serious aspects of BD: pulmonary artery aneurysm and other pulmonary parenchymal involvement. Sixteen BD patients were recruited for this study, (14 men, 87.5%, and 2 women, 12.5%). All patients fulfilled the 1990 American College of Rheumatology criteria for classification of BD [International Study Group for Behçet's Disease, Lancet 335:1078-1080, (1990)]. All patients underwent thorough history taking, full clinical examination, and routine laboratory investigations. Plain chest X-rays and pulmonary CT angiography were performed on all patients in an attempt to assess the pulmonary vasculature and lung parenchyma. Pulmonary vascular abnormalities were as follows: pulmonary artery aneurysms of varying sizes in nine patients (56.3%), main pulmonary artery ectasia in two patients (12.5%), pulmonary artery embolism in two patients (12.5%), venacaval thrombosis in seven patients (43.8%), and pulmonary venous varices in four patients (25%). Pulmonary parenchymal abnormalities were as follows: three patients (18.8%) with mild central bronchiectasis, one patient (6.3%) with atelectasis, one patient (6.3%) with subpleural nodule, and four patients (25%) with interstitial lung disease. Eight of the male patients were smokers. Multislice CT is useful in demonstrating the entire spectrum of thoracic manifestations of BD. Multislice CT is noninvasive and provides excellent delineation of the vessel lumen and wall and perivascular tissues, as well as detailed information concerning the lung parenchyma, pleura, and mediastinal structures.

  19. How to differentiate acute pelvic inflammatory disease from acute appendicitis ? A decision tree based on CT findings.

    PubMed

    El Hentour, Kim; Millet, Ingrid; Pages-Bouic, Emmanuelle; Curros-Doyon, Fernanda; Molinari, Nicolas; Taourel, Patrice

    2017-09-11

    To construct a decision tree based on CT findings to differentiate acute pelvic inflammatory disease (PID) from acute appendicitis (AA) in women with lower abdominal pain and inflammatory syndrome. This retrospective study was approved by our institutional review board and informed consent was waived. Contrast-enhanced CT studies of 109 women with acute PID and 218 age-matched women with AA were retrospectively and independently reviewed by two radiologists to identify CT findings predictive of PID or AA. Surgical and laboratory data were used for the PID and AA reference standard. Appropriate tests were performed to compare PID and AA and a CT decision tree using the classification and regression tree (CART) algorithm was generated. The median patient age was 28 years (interquartile range, 22-39 years). According to the decision tree, an appendiceal diameter ≥ 7 mm was the most discriminating criterion for differentiating acute PID and AA, followed by a left tubal diameter ≥ 10 mm, with a global accuracy of 98.2 % (95 % CI: 96-99.4). Appendiceal diameter and left tubal thickening are the most discriminating CT criteria for differentiating acute PID from AA. • Appendiceal diameter and marked left tubal thickening allow differentiating PID from AA. • PID should be considered if appendiceal diameter is < 7 mm. • Marked left tubal diameter indicates PID rather than AA when enlarged appendix. • No pathological CT findings were identified in 5 % of PID patients.

  20. 99mTc(V)-DMSA SPECT-CT findings in a case of Gorham-Stout disease.

    PubMed

    Alves, Victor M; Vieira, Tiago S; Amorim, Nelson S; Oliveira, Ana; Rodrigues, André; Pereira, Jorge G

    2015-01-01

    The Gorham-Stout disease is a very rare condition, characterized by lymphovascular proliferation and massive bone resorption. We present a 48-year-old male patient with osteolysis involving the left femoral head and neck, as well as to the ipsilateral acetabulum. Besides the morphological imaging, he underwent bone scintigraphy, technetium-99m-V-dimercaptosuccinic acid [99mTc(V)-DMSA] single photon emission computed tomography/computed tomography (SPECT/CT) and histological examination. Together these findings gave the definitive diagnosis. This is the first case ever published with 99mTc(V)-DMSA SPECT-CT. Advances on the knowledge of disease suggests that this imaging procedure could have utility in diagnosis and evaluation of the disease activity and therapy response.

  1. Adrenal cortex dysfunction: CT findings

    SciTech Connect

    Huebener, K.H.; Treugut, H.

    1984-01-01

    The computed tomographic appearance of the adrenal gland was studied in 302 patients with possible endocrinologic disease and 107 patients undergoing CT for nonendocrinologic reasons. Measurements of adrenal size were also made in 100 adults with no known adrenal pathology. CT proved to be a sensitive diagnostic tool in combination with clinical studies. When blood hormone levels are increased, CT can differentiate among homogeneous organic hyperplasia, nodular hyperplasia, benign adenoma, and malignant cortical adenoma. When blood hormone levels are decreased, CT can demonstrate hypoplasia or metastatic tumorous destruction. Calcifications can be demonstrated earlier than on plain radiographs. When hormone elimination is increased, the morphologic substrate can be identified; tumorous changes can be localized and infiltration of surrounding organs recognized.

  2. Cytomegalovirus pneumonia in transplant patients: CT findings

    SciTech Connect

    Eun-Young Kang; Patz, E.F. Jr.; Mueller, N.L.

    1996-03-01

    Our goal was to assess the CT findings of cytomegalovirus (CMV) pneumonia in transplant patients. The study included 10 transplant patients who had chest CT scan and pathologically proven isolated pulmonary CMV infection. Five patients had bone marrow transplant and five had solid organ transplant. The CT scans were retrospectively reviewed for pattern and distribution of disease and the CT findings compared with the findings on open lung biopsy (n = 9) and autopsy (n = 1). Nine of 10 patients had parenchymal abnormalities apparent at CT and I had normal CT scans. The findings in the nine patients included small nodules (n = 6), consolidation (n = 4), ground-glass attenuation (n = 4), and irregular lines (n = 1). The nodules had a bilateral and symmetric distribution and involved all lung zones. The consolidation was most marked in the lower lung zones. The CT findings of CMV pneumonia in transplant patients are heterogeneous. The most common patterns include small nodules and areas of consolidation. 13 refs., 4 figs., 1 tab.

  3. Predictors of Urgent Findings on Abdominopelvic CT in Patients with Crohn's Disease Presenting to the Emergency Department.

    PubMed

    Jung, Yoon Suk; Park, Dong Il; Hong, Sung Noh; Kim, Eun Ran; Kim, Young Ho; Cheon, Jae Hee; Eun, Chang Soo; Han, Dong Soo; Lee, Chang Kyun; Kim, Jae Hak; Huh, Kyu Chan; Yoon, Soon Man; Song, Hyun Joo; Shin, Jeong Eun; Jeon, Seong Ran

    2015-04-01

    Patients with Crohn's disease (CD) are frequently exposed to diagnostic radiation, mainly as a result of abdominopelvic computed tomography (APCT) examinations. However, there are limited data on the impact of APCT on clinical management in this population. To investigate clinical predictors of urgent findings on APCT in patients with CD who presented to the emergency department (ED). A retrospective study was performed among patients with CD presenting to 11 EDs with a gastrointestinal complaint. The primary outcome, OPAN (obstruction, perforation, abscess, or non-CD-related urgent findings), included new or worsening CD-related urgent findings or non-CD-related urgent findings that required urgent or emergency treatment. Variables with P < 0.1 in univariate analyses were included in a multivariable logistic regression model. Of the 266 APCTs performed, 103 (38.7 %) had OPAN and 113 (42.5 %) required changes in treatment plan. Stricturing or penetrating disease (odds ratio [OR] 2.72, 95 % confidence interval [CI] 1.21-6.13), heart rate >100 beats/min (OR 2.33, 95 % CI 1.10-4.93), leukocyte count >10,000/mm(3) (OR 4.38, 95 % CI 2.10-9.13), and CRP >2.5 mg/dL (OR 3.11, 95 % CI 1.23-7.86) were identified as the independent predictors of OPAN, whereas biologic agent use (OR 0.37; 95 % CI 0.15-0.90) was identified as the negative predictor in patients with CD. Only 39 % of the APCTs performed in the ED among patients with CD showed urgent findings. Stricturing or penetrating disease, tachycardia, leukocytosis, and high CRP level were predictors of urgent CT findings, while biologic agent use was a negative predictor. To reduce unnecessary radiation exposure, the selection process for CD patients referred for APCT must be improved.

  4. Comparison of chest CT findings in nontuberculous mycobacterial diseases vs. Mycobacterium tuberculosis lung disease in HIV-negative patients with cavities

    PubMed Central

    Kim, Cherry; Park, So Hee; Oh, Sang Young; Kim, Sung-Soo; Jo, Kyung-Wook; Shim, Tae Sun

    2017-01-01

    Objectives This article focuses on the differences between CT findings of HIV-negative patients who have cavities with nontuberculous mycobacteria (NTM) disease and those with Mycobacterium tuberculosis infections (TB). Methods We retrospectively reviewed 128 NTM disease patients (79 males and 49 females) with cavities in chest CT, matched for age and gender with 128 TB patients in the same period. Sputum cultures of all patients were positive for pathogens. Two independent chest radiologists evaluated the characteristics of the largest cavity and related factors. Results Interobserver agreement was excellent (κ value, 0.853–0.938). Cavity walls in NTM disease were significantly thinner (6.9±4 mm vs 10.9±6 mm, P<0.001) and more even (the ratio of thickness, 2.6±1 vs 3.7±2, P<0.001) than those in TB. The thickening of adjacent pleura next to the cavity was also significantly thicker in NTM than TB (P<0.001). However, in the multivariate analysis, thickening of adjacent pleura was the only significant factor among the representative cavity findings (Odds ratio [OR], 6.49; P<0.001). In addition, ill-defined tree-in-bud nodules (OR, 8.82; P<0.001), number of non-cavitary nodules (≥10mm) (OR, 0.72; P = 0.003), and bronchiectasis in the RUL (OR, 5.3; P = 0.002) were significantly associated ancillary findings with NTM disease in the multivariate analysis. Conclusions The major cavities in NTM disease generally have thinner and more even walls than those in TB. When cavities are associated with adjacent pleural thickening, ill-defined satellite tree-in-bud nodules, or fewer non-cavitary nodules ≥10 mm, these CT findings are highly suggestive of NTM disease rather than TB. PMID:28346488

  5. Lumbar spine: pretest predictability of CT findings

    SciTech Connect

    Giles, D.J.; Thomas, R.J.; Osborn, A.G.; Clayton, P.D.; Miller, M.H.; Bahr, A.L.; Frederick, P.R.; O'Connor, G.D.; Ostler, D.

    1984-03-01

    Demographic and symptomatic data gathered from 460 patients referred for lumbosacral CT examinations were analyzed to determine if the prescan probability of normal or abnormal findings could be predicted accurately. The authors were unable to predict the presence of herniated disk on the basis of patient-supplied data alone. Age was the single most significant predictor of an abnormality and was sharply related to degenerative disease and spinal stenosis.

  6. Acute small bowel ischemia: CT imaging findings.

    PubMed

    Segatto, Enrica; Mortelé, Koenraad J; Ji, Hoon; Wiesner, Walter; Ros, Pablo R

    2003-10-01

    Small bowel ischemia is a disorder related to a variety of conditions resulting in interruption or reduction of the blood supply of the small intestine. It may present with various clinical and radiologic manifestations, and ranges pathologically from localized transient ischemia to catastrophic necrosis of the intestinal tract. The primary causes of insufficient blood flow to the small intestine are various and include thromboembolism (50% of cases), nonocclusive causes, bowel obstruction, neoplasms, vasculitis, abdominal inflammatory conditions, trauma, chemotherapy, radiation, and corrosive injury. Computed tomography (CT) can demonstrate changes because of ischemic bowel accurately, may be helpful in determining the primary cause of ischemia, and can demonstrate important coexistent findings or complications. However, common CT findings in acute small bowel ischemia are not specific and, therefore, it is often a combination of clinical, laboratory and radiologic signs that may lead to a correct diagnosis. Understanding the pathogenesis of various conditions leading to mesenteric ischemia and being familiar with the spectrum of diagnostic CT signs may help the radiologist recognize ischemic small bowel disease and avoid delayed diagnosis. The aim of this article is to provide a review of the pathogenesis and various causes of acute small bowel ischemia and to demonstrate the contribution of CT in the diagnosis of this complex disease.

  7. CT of Castleman disease

    SciTech Connect

    Onik, G.; Goodman, P.C.

    1983-04-01

    The value of computed tomography (CT) in distinguishing among mediastinal fatty tumors, vascular abnormalities, and fluid-filled cystic masses is well established. However, little has been written about the use of CT to identify mediastinal masses with soft-tissue characteristics nor of the ability of CT to assess the degree of enhancement of these lesions after contrast material administration. We report a case of Castleman disease which presented as a densely enhancing, soft-tissue lesion on dynamic CT scanning and suggest that enhancement characteristics may be helpful in limiting the differential diagnosis of mediastinal masses.

  8. CT and MR imaging findings in patients with acquired heart disease at risk for sudden cardiac death.

    PubMed

    Sparrow, Patrick J; Merchant, Naeem; Provost, Yves L; Doyle, Deirdre J; Nguyen, Elsie T; Paul, Narinder S

    2009-01-01

    Noninvasive imaging is an important screening and diagnostic tool in conditions associated with sudden cardiac death. The most common cause of sudden cardiac death is coronary artery disease, with myocarditis, cardiac sarcoidosis, and dilated and infiltrative cardiomyopathies being less common acquired causes. Common risk factors for sudden cardiac death, regardless of the disease process, include severe ventricular dysfunction and the presence of macroscopic scar seen at delayed contrast material-enhanced imaging. Recent advances in electrocardiographically (ECG) gated cardiac magnetic resonance (MR) imaging and multidetector computed tomography (CT) have led to increased referrals for cross-sectional imaging; thus, cardiac radiologists should be familiar with the disease entities associated with sudden cardiac death. Inflammatory processes and cardiomyopathies are best depicted with cardiac MR imaging. Steady-state free precession cine sequences coupled with inversion-recovery prepared gradient-echo T1-weighted sequences performed after the intravenous administration of gadolinium-based contrast material should form the basis of cardiac MR imaging protocols for cardiomyopathy. A clinical history that is suggestive of myocardial ischemia, specific requests to exclude coronary artery disease, or contraindications for MR imaging may imply that multidetector CT would be more appropriate. Nevertheless, both cardiac MR imaging and ECG-gated multidetector CT offer robust diagnosis and risk stratification for individual disease processes associated with sudden cardiac death.

  9. Abdominal CT findings in small bowel perforation.

    PubMed

    Zissin, R; Osadchy, A; Gayer, G

    2009-02-01

    Small bowel perforation is an emergent medical condition for which the diagnosis is usually not made clinically but by CT, a common imaging modality used for the diagnosis of acute abdomen. Direct CT features that suggest perforation include extraluminal air and oral contrast, which are often associated with secondary CT signs of bowel pathology. This pictorial review illustrates the CT findings of small bowel perforation caused by various clinical entities.

  10. Brain MRI, Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT Findings in a Patient with Wilson Disease: A Case Report.

    PubMed

    Kim, Seungyoo; Song, In Uk; Chung, Yong An; Choi, Eun Kyung; Oh, Jin Kyoung

    2014-12-01

    A 34-year-old female had experienced head and hand tremors with a dystonic component for 8 months. Brain MRI showed T2 high signal intensity in the periaqueductal region, dorsal midbrain and dorsal upper pons. No abnormal uptake was noted on Tc-99m HMPAO SPECT or F-18 FP-CIT PET/CT. Wilson disease was diagnosed according to the 2008 consensus guideline from the American Association for the Study of Liver Disease and 2012 guideline from the European Association for the Study of the Liver. This case demonstrates T2 signal change in the basal ganglia, excluding the putamen, in a Wilson disease patient with relatively severe clinical findings, but normal Tc-99m HMPAO SPECT and F-18 FP-CIT PET/CT.

  11. Intestinal Ischemia: US-CT findings correlations

    PubMed Central

    2013-01-01

    Background Intestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies. Methods Basing on experience of our institutions, over 200 cases of mesenteric ischemia/infarction investigated with both US and CT were evaluated considering, in particular, the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen). Results To make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial,venous) and nonocclusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text. Conclusion At present, the reference diagnostic modality for intestinal ischaemia is contrast-enhanced CT. However, there are some disadvantages associated with these techniques, such as radiation exposure, potential nephrotoxicity and the risk of an allergic reaction to the contrast agents. Thus, not all patients with suspected bowel ischaemia can be subjected to these examinations. Despite its limitations, US could constitutes a good imaging method as first examination in acute settings of suspected mesenteric ischemia. PMID:23902826

  12. High-resolution 18F-FDG PET/CT for assessing disease activity in rheumatoid and psoriatic arthritis: findings of a prospective pilot study

    PubMed Central

    Ferrero, Andrea; Godinez, Felipe; Yang, Kai; Shelton, David K; Hunter, John C; Naguwa, Stanley M; Boone, John M; Raychaudhuri, Siba P; Badawi, Ramsey D

    2016-01-01

    Objective: Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) commonly affect the small joints of the wrist and hand. We evaluated the performance of a new, high-resolution extremity positron emission tomography (PET)/CT scanner for characterizing and quantifying pathologies associated with the two arthritides in the wrist and hand joints. Methods: Patients with RA or PsA underwent fluorine-18 fludeoxyglucose (18F-FDG) PET/CT wrist and hand imaging, respectively, on the high-resolution scanner. Calibrated CT images and co-registered PET images were reconstructed. PET/CT was derived for the radiocarpal and pisiform–triquetral compartments, joints with erosive changes, sites of synovitis or tenosynovitis and the nail bed and were correlated with clinical and MRI findings. Results: Significantly elevated 18F-FDG uptake was measured for the radiocarpal and pisiform–triquetral compartments and at sites of bone erosion, synovitis, pannus and oedema, compared with unaffected joints (p < 0.05) in patients with RA, consistent with their clinical findings. In patients with PsA, significantly elevated 18F-FDG uptake was measured for joints with synovitis compared with unaffected joints (p < 0.05), with patterns of 18F-FDG uptake along the tendons, at the enthesis and in the nail bed, consistent with tenosynovitis, enthesitis and nail dystrophy, respectively. Conclusion: High-resolution 18F-FDG PET/CT imaging of the wrist and hand is feasible in an RA or PsA patient cohort and is capable of providing quantifiable measures of disease activity (synovitis, enthesitis, oedema and bone destruction). Advances in knowledge: High-resolution PET/CT imaging shows promise as a tool for understanding the pathogenesis of the arthritic process and for non-invasive, objective assessment of RA or PsA severity and therapy selection. PMID:27109738

  13. CT and US findings of pancreatoblastoma

    SciTech Connect

    Lee, Jae Young; Kim, In-One; Kim, Woo Sun

    1996-05-01

    Our goal was to evaluate US and CT findings of pancreatoblastoma. Three US and four CT scans before surgery and one follow-up CT after surgery were reviewed in four patients (two female, two male) with pathologically proven pancreatoblastoma. The mean age of the patients was 4 years (range 2-5 years). The masses were analyzed for origin, US and CT architecture, presence of calcification, enhancement pattern, and metastatic spread. In two patients, the tumors arose from the pancreatic head and in one patient from the pancreatic tail. The mean largest diameter of the masses was 10 cm, ranging from 5 to 14 cm. Sonography obtained from three cases showed mixed echogenic solid mass. On the CT scan, all tumors were huge, lobulated masses with heterogeneous attenuation. One tumor contained numerous foci of calcification. On the enhanced CT scan, three tumors showed multiloculated appearance by enhancing internal septations. There was no evidence of metastasis to distant organ or abdominal lymph node in any case. We suggest that the most common US finding of pancreatoblastoma is a mixed echogenic, solid mass inseparable from the pancreas, and the most common CT finding is a relatively well defined, lobulated, huge mass with multiloculated appearance by enhancing septae in or near the lesser sac. 9 refs., 4 figs.

  14. Fitz-Hugh-Curtis syndrome: CT findings of three cases.

    PubMed

    Cho, Hyeon Je; Kim, Ho Kyun; Suh, Jung Ho; Lee, Ghi Jai; Shim, Jae-Chan; Kim, Young Hwa

    2008-01-01

    Clinical manifestations and computed tomography (CT) findings of Fitz-Hugh-Curtis syndrome (FHCS) are relatively well stabilized as right upper quadrant abdominal pain and hepatic capsular enhancement because of perihepatitis associated with pelvic inflammatory disease caused by N. gonorrhoeae and C. trachomatis. We encountered three patients with serial FHCS associated with pelvic inflammatory disease, who visited the emergency room with right upper quadrant abdominal pain. Abdominal CT revealed hepatic capsular or pericapsular enhancement along the anterior surface of the liver on the arterial phase. Recently, multi-detector CT has evolved as the first-line imaging modality of acute abdomen at the emergency room; we reemphasized the importance of the CT findings of this syndrome for differential diagnosis of right upper quadrant abdominal pain in sexually active young women. Physicians at the emergency room acknowledge the syndrome and should perform dynamic abdominopelvic CT including the arterial phase.

  15. [The chest CT findings and pathologic findings of pulmonary tuberculosis].

    PubMed

    Ogata, Hideo

    2009-08-01

    The past research of the radiologic manifestations of pulmonary tuberculosis in Japan was based on morphological pathology of the untreated patient autopsy. I would like to show the chest CT scan of tuberculosis diseases with caseous granuloma at its exudative reaction, proliferative reaction, productive reaction, cirrhotic reaction until self cure. This progress reflects the normal cell mediated immunological responses. Also I would like to show the cavitation of granuloma, which results from liquefaction of caseous materials during the course and results in the formation of the source of infection. And finally I would like to show the morphological differences of acinous lesion, acino-nodular lesion and caseous lobular pneumonia. These differences reflect the amount of bacilli disseminated in the peripheral parts under the lobules. In this study, I do not show old age cases and HIV positive cases, who do not form typical granuloma due to the decreased cell mediated immnunity and whose X ray findings are atypical.

  16. Findings of cecal volvulus at CT.

    PubMed

    Rosenblat, Juliana M; Rozenblit, Alla M; Wolf, Ellen L; DuBrow, Ronelle A; Den, Elana I; Levsky, Jeffrey M

    2010-07-01

    To assess the diagnostic performance of computed tomographic (CT) and radiographic (as seen on CT topograms) signs of cecal volvulus. In this institutional review board-approved, HIPAA-compliant retrospective study, the CT and CT topogram findings in 11 patients (one man, 10 women; age range, 26-100 years) with surgically confirmed cecal volvulus and 12 control patients were reviewed. The control subjects had suspicious radiographs, had undergone CT within 24 hours of radiography, and had received a clinical diagnosis other than cecal volvulus. Three radiologists independently evaluated the CT topograms for cecal distention, the coffee bean sign, cecal apex location, and distal colon decompression. CT images were analyzed for cecal distention, cecal apex location, distal colon decompression, and presence or absence of the whirl, ileocecal twist, transition point(s), the X-marks-the-spot, and the split wall. Sensitivity, specificity, and predictive values were computed. Baseline statistical values for the cecal volvulus and control groups were analyzed by using a two-tailed Z test to compare proportions with a threshold confidence interval of 95%. CT findings of bowel ischemia (free air or fluid, pneumatosis intestinalis, portal venous gas, mesenteric stranding) were correlated with pathology report findings. On CT topograms, greater than 10-cm cecal distention, coffee bean sign, and left upper quadrant cecal apex had sensitivities of 45% (five of 11 patients), 27% (three of 11 patients), and 45% (five of 11 patients), respectively, and specificities of 100% (12 of 12 control subjects), 92% (11 of 12 control subjects), and 100% (12 of 12 control subjects), respectively. Distal colon decompression had sensitivities and specificities of 91% (10 of 11 patients) and 83% (10 of 12 control subject), respectively, on topograms and of 91% (10 of 11 patients) and 92% (11 of 12 patients), respectively, on CT images. On cross-sectional CT images, greater than 10-cm cecal

  17. Thin-section CT findings of nontuberculous mycobacterial pulmonary diseases: comparison between Mycobacterium avium-intracellulare complex and Mycobacterium abscessus infection.

    PubMed

    Chung, Myung Jin; Lee, Kyung Soo; Koh, Won-Jung; Lee, Ju Hyun; Kim, Tae Sung; Kwon, O Jung; Kim, Seonwoo

    2005-10-01

    We aimed to compare the CT findings of nontuberculous mycobacterial pulmonary diseases caused by Mycobacterium avium-intracellulare complex (MAC) and Mycobacterium abscessus. Two chest radiologists analyzed retrospectively the thin-section CT findings of 51 patients with MAC and 36 with M. abscessus infection in terms of patterns and forms of lung lesions. No significant difference was found between MAC and M. abscessus infection in the presence of small nodules, tree-in-bud pattern, and bronchiectasis. However, lobar volume decrease (p=0.001), nodule (p=0.018), airspace consolidation (p=0.047) and thin-walled cavity (p=0.009) were more frequently observed in MAC infection. The upper lobe cavitary form was more frequent in the MAC (19 of 51 patients, 37%) group than M. abscessus (5 of 36, 14%) (p=0.029), whereas the nodular bronchiectatic form was more frequent in the M. abscessus group ([29 of 36, 81%] vs. [27 of 51, 53%] in MAC) (p=0.012). In conclusion, there is considerable overlap in common CT findings of MAC and M. abscessus pulmonary infection; however, lobar volume loss, nodule, airspace consolidation, and thin-walled cavity are more frequently seen in MAC than M. abscessus infection.

  18. Stercoral colitis: diagnostic value of CT findings

    PubMed Central

    Ünal, Emre; Onur, Mehmet Ruhi; Balcı, Sinan; Görmez, Ayşegül; Akpınar, Erhan; Böge, Medine

    2017-01-01

    PURPOSE We aimed to evaluate the CT findings of stercoral colitis (SC). METHODS Forty-one patients diagnosed with SC between February 2006 and April 2015 were retrospectively reviewed. RESULTS Rectosigmoid colon was the most frequently involved segment (100%, n=41). CT findings can be summarized as follows: dilatation >6 cm and wall thickening >3 mm of the affected colon segment (100%, n=41), pericolonic fat stranding (100%, n=41), mucosal discontinuity (14.6 %, n=6), presence of free air (14.6%, n=6), free fluid (9.7%, n=4), and pericolonic abscess (2.4%, n=1). The sign most related with mortality was the length of the affected colon segment >40 cm. CONCLUSION CT has an important role in SC, since life-threatening complications can be easily revealed by this imaging modality. Increased length of involved colon segment (>40 cm) is more likely to be associated with mortality. PMID:27910814

  19. Perforation of the mesenteric small bowel: etiologies and CT findings.

    PubMed

    Hines, John; Rosenblat, Juliana; Duncan, Dameon R; Friedman, Barak; Katz, Douglas S

    2013-04-01

    The purpose of this article is to illustrate and discuss the various etiologies of perforation of the mesenteric small bowel and associated findings on abdominal CT. Perforation of the mesenteric small bowel is an uncommon cause of an acute abdomen and can be due to various etiologies. In underdeveloped countries, infection is probably the most common cause, while in industrialized nations, perforation may be due to Crohn disease, diverticulitis, foreign body, trauma, tumor, mechanical obstruction, primary ischemic event, or iatrogenic causes. CT is usually the initial imaging examination in patients with an acute abdomen and is sensitive in diagnosing small bowel perforation. CT findings in the setting of small bowel perforation are often subtle, but when present, may help the radiologist determine a specific cause of perforation. The aims of this pictorial essay are to review the various causes of mesenteric small bowel perforation and to discuss and illustrate the CT findings that can help arrive at the diagnosis.

  20. CT findings in ulcerative, granulomatous, and indeterminate colitis.

    PubMed

    Gore, R M; Marn, C S; Kirby, D F; Vogelzang, R L; Neiman, H L

    1984-08-01

    Eight patients with ulcerative colitis, three with colitis indeterminate, and 15 patients with Crohn disease were studied by computed tomography (CT) to establish CT criteria for each disorder in hopes of providing a new diagnostic perspective useful in the radiographic evaluation of inflammatory colitis. The CT findings in ulcerative colitis included thickening of the colon wall (mean, 7.8 mm), which was characterized by inhomogeneous attenuation and a "target" appearance of the rectum, and proliferation of perirectal fat. Bowel wall thickening (mean, 13 mm) with homogeneous attenuation, fistula and abscess formation, and mesenteric abnormalities were observed in patients with Crohn colitis. Patients with colitis indeterminate showed colonic changes on CT observed in both disorders. Initial experience suggests that CT can differentiate patients with well established ulcerative and Crohn colitis.

  1. FDG PET/CT findings in rare sarcomas.

    PubMed

    Ergül, N; Aydın, M

    2013-01-01

    The role of FDG PET/CT in management of soft tissue and bone sarcomas has been described in many studies up-to-date. However, contribution of PET/CT to diagnosis and treatment in some types of sarcomas that are seen with low incidence has not been identified properly yet. Clear cell sarcoma, synovial sarcoma of chest and myxoid lyposarcoma are rare types of sarcomas. We aimed to describe the FDG uptake patterns of these rare tumors and find out the role of FDG PET/CT in management of disease. Copyright © 2012 Elsevier España, S.L. and SEMNIM. All rights reserved.

  2. Intracerebral pneumatoceles following facial trauma: CT findings

    SciTech Connect

    Mendelsohn, D.B.; Hertzanu, Y.

    1985-01-01

    Three patients with delayed frontal intracerebral pneumatoceles following facial injury are presented. In one patient an unusual appearance of bilateral and symmetrical frontal lobe pneumatoceles was demonstrated. While diagnosis is not difficult on routine radiographs, CT is valuable for determining effects on the brain and clearly delineating the fracture site; CT shows the location of the pneumatocele and may show an associated air-fluid level, mass effect or surrounding edema, or rim enhancement following administration of contrast material. The radiological appearances in conjunction with the clinical findings are highly characteristic and should not be mistaken for gas-forming cerebral abscesses.

  3. Mesentery neurilemmoma: CT, MRI and angiographic findings.

    PubMed

    Lao, Wilson T; Yang, Shih-Hung; Chen, Chi-Long; Chan, Wing P

    2011-01-01

    Mesenteric neurilemmoma is extremely rare. We present a case of a 45-year-old man with mesenteric neurilemmoma, with CT, MRI and angiographic findings. The patient was healthy and had had no symptoms previously. CT and MRI images revealed a 2.2-cm well-defined, soft-tissue mass adjacent to the posterior border of the left lobe of the liver. The tumor mass displayed a heterogenous low signal on T2-weighted image and peripheral enhancement after gadolinium administration. Angiography showed a hypervascular mass beneath the tail of pancreas, which was supplied by small branches of middle splenic artery. Histopathology revealed a mesentery neurilemmoma composed of spindle tumor cells.

  4. Endoscopic Complete Remission of Crohn Disease After Anti-Tumor Necrosis Factor-α Therapy: CT Enterographic Findings and Their Clinical Implications.

    PubMed

    Kim, Cherry; Park, Seong Ho; Yang, Suk-Kyun; Ye, Byong Duk; Park, Sang Hyoung; Lee, Jong Seok; Kim, Hyun Jin; Kim, Ah Young; Ha, Hyun Kwon

    2016-06-01

    The purpose of this study was to describe the CT enterographic (CTE) findings after endoscopic complete remission (CR) of Crohn disease in patients treated with anti-tumor necrosis factor-α (anti-TNF-α) and the clinical implications of these findings. The records of 27 patients with Crohn disease (14 men, 13 women; mean age, 28.4 ± 8.6 [SD] years) who achieved endoscopic (ileocolonoscopic) CR after anti-TNF-α therapy and underwent CTE both before therapy and at endoscopic CR were identified. Two readers independently assessed the frequencies and severities of mural and perienteric CTE abnormalities, generally regarded as active inflammatory findings, in the terminal ileum and colorectum in the endoscopic CR state and compared them with the corresponding findings before anti-TNF-α therapy. The association between the presence of CTE abnormalities in the face of endoscopic CR and patient outcome during subsequent follow-up was investigated. CTE abnormalities were present in the face of endoscopic CR in 11-18 (26-42%) of 43 bowel sections (18 terminal ileum, 25 colorectum), the most frequent being mural hyperenhancement (21-40%) followed by mural thickening (12-16%). Both findings were mild and unaccompanied by other findings. The frequency and severity of mural and perienteric CTE abnormalities were statistically significantly reduced at endoscopic CR compared with the pre-treatment state. Patients with (n = 10) and without (n = 17) CTE abnormalities at endoscopic CR did not significantly differ with respect to Crohn disease aggravation during subsequent follow-up periods averaging 27.4 and 28.5 months (0/10 versus 2/17, p = 0.516). More than one-fourth of bowel sections in endoscopic CR after anti-TNF-α therapy had residual CTE abnormalities, predominantly mild mural thickening or hyperenhancement. These findings may not have any clinical significance.

  5. Uncommon pneumoconioses: CT and pathologic findings.

    PubMed

    Akira, M

    1995-11-01

    To correlate the computed tomographic (CT) features of pneumoconioses with histologic findings. Thin-section CT scans obtained in 48 patients with a history of occupational exposure to dust and radiographic changes suggestive of pneumoconiosis were retrospectively reviewed. Histologic samples were available in 22 cases. The most common CT features were as follows: in 21 arc welders, ill-defined micronodules concentrated in the centrilobular regions (n = 15); in 19 graphite workers, small nodular hyperattenuating areas (n = 17) (ill defined or well defined, corresponding to macular lesions along the walls of bronchioles and nodules, respectively), interlobular septal thickening (n = 11), and large hyperattenuating areas (n = 10); in aluminum pneumoconiosis, predominant reticular (n = 2), nodular (n = 2), and upper-lobe fibrosis (n = 2); and in hard-metal pneumoconiosis, multilobular ground-glass attenuation and consolidation with shrinkage (corresponding to marked intra-alveolar desquamation and multinucleated giant cells with mural mononuclear cell infiltrate). Predominant findings are characteristic in each type of pneumoconiosis and are depicted at thin-section CT.

  6. CT Findings in Temporal Bone Osteoradionecrosis

    PubMed Central

    Ahmed, Salmaan; Gupta, Nakul; Hamilton, Jackson D.; Garden, Adam S.; Gidley, Paul W.; Ginsberg, Lawrence E.

    2014-01-01

    Purpose The goal of this study is to describe CT findings in patients with clinically proven temporal bone osteoradionecrosis (TB-ORN). Methods and materials CT scans of twenty patients were retrospectively evaluated for bony and soft tissue abnormalities. Clinical severity was graded based on level of therapy administered: mild (observation), moderate (antibiotics/hyperbaric oxygen), or severe (surgery). Results Radiation dose to the primary tumor ranged from 30 to 75.6 Gy. Time to onset of ORN from completion of radiation therapy was 2 to 22 years (median=7yrs). Clinical findings: Exposed bone=20/20, otorrhea=17/20, hearing loss=11/20, otalgia=10/20, facial nerve paralysis=2/20, gait imbalance=2/20. CT findings: EAC erosions=18/20, mastoid effusion=18/20, mastoid bony coalescence=5/20, enhancing soft tissue=6/20, soft tissue gas=6/20, temporomandibular joint/condylar erosion=3/20. 3 patients developed an abscess. Conclusion Mastoid effusion and EAC erosions are commonly seen with TB-ORN. Clinically moderate or severe cases of TB-ORN are more likely to demonstrate enhancing soft tissue (p=0.002), soft tissue gas (p=0.002), and temporomandibular joint involvement (p=0.07). PMID:24834883

  7. PET/CT imaging in lung cancer: indications and findings*

    PubMed Central

    Hochhegger, Bruno; Alves, Giordano Rafael Tronco; Irion, Klaus Loureiro; Fritscher, Carlos Cezar; Fritscher, Leandro Genehr; Concatto, Natália Henz; Marchiori, Edson

    2015-01-01

    The use of PET/CT imaging in the work-up and management of patients with lung cancer has greatly increased in recent decades. The ability to combine functional and anatomical information has equipped PET/CT to look into various aspects of lung cancer, allowing more precise disease staging and providing useful data during the characterization of indeterminate pulmonary nodules. In addition, the accuracy of PET/CT has been shown to be greater than is that of conventional modalities in some scenarios, making PET/CT a valuable noninvasive method for the investigation of lung cancer. However, the interpretation of PET/CT findings presents numerous pitfalls and potential confounders. Therefore, it is imperative for pulmonologists and radiologists to familiarize themselves with the most relevant indications for and limitations of PET/CT, seeking to protect their patients from unnecessary radiation exposure and inappropriate treatment. This review article aimed to summarize the basic principles, indications, cancer staging considerations, and future applications related to the use of PET/CT in lung cancer. PMID:26176525

  8. Pediatric renal leukemia: spectrum of CT imaging findings.

    PubMed

    Hilmes, Melissa A; Dillman, Jonathan R; Mody, Rajen J; Strouse, Peter J

    2008-04-01

    The kidneys are a site of extramedullary leukemic disease that can be readily detected by CT. To demonstrate the spectrum of CT findings in children with renal leukemic involvement. Twelve children were identified retrospectively as having renal leukemic involvement by contrast-enhanced CT of the abdomen. Contrast-enhanced CT images through the kidneys of each patient were reviewed by two pediatric radiologists. Pertinent imaging findings and renal lengths were documented. The electronic medical record was accessed to obtain relevant clinical and pathologic information. Five patients with renal leukemic involvement presented with multiple bilateral low-attenuation masses, while three patients demonstrated large areas of wedge-shaped and geographic low attenuation. Four other patients presented with unique imaging findings, including a solitary unilateral low-attenuation mass, solitary bilateral low-attenuation masses, multiple bilateral low-attenuation masses including unilateral large conglomerate masses, and bilateral areas of ill-defined parenchymal low attenuation. Two patients showed unilateral nephromegaly, while eight other patients showed bilateral nephromegaly. Two patients had normal size kidneys. Two patients had elevated serum creatinine concentrations at the time of imaging. Renal leukemic involvement in children can present with a variety of CT imaging findings. Focal renal abnormalities as well as nephromegaly are frequently observed. Most commonly, renal leukemic involvement does not appear to impair renal function.

  9. CT evaluation of the colon: inflammatory disease.

    PubMed

    Horton, K M; Corl, F M; Fishman, E K

    2000-01-01

    Computed tomography (CT) is valuable for detection and characterization of many inflammatory conditions of the colon. At CT, a dilated, thickened appendix is suggestive of appendicitis. A 1-4-cm, oval, fatty pericolic lesion with surrounding mesenteric inflammation is diagnostic of epiploic appendagitis. The key to distinguishing diverticulitis from other inflammatory conditions of the colon is the presence of diverticula in the involved segment. In typhlitis, CT demonstrates cecal distention and circumferential thickening of the cecal wall, which may have low attenuation secondary to edema. In radiation colitis, the clinical history is the key to suggesting the diagnosis because the CT findings can be nonspecific. The location of the involved segment and the extent and appearance of wall thickening may help distinguish Crohn disease and ulcerative colitis. In ischemic colitis, CT typically demonstrates circumferential, symmetric wall thickening with fold enlargement. CT findings of graft-versus-host disease include small bowel and colonic wall thickening, which may result in luminal narrowing and separation of bowel loops. In infectious colitis, the site and thickness of colon affected may suggest a specific organism. The amount of wall thickening in pseudomembranous colitis is typically greater than in any other inflammatory disease of the colon except Crohn disease.

  10. CT findings of acute cholecystitis and its complications.

    PubMed

    Shakespear, Jonathan S; Shaaban, Akram M; Rezvani, Maryam

    2010-06-01

    The purpose of this article is to describe and illustrate the CT findings of acute cholecystitis and its complications. CT findings suggesting acute cholecystitis should be interpreted with caution and should probably serve as justification for further investigation with abdominal ultrasound. CT has a relatively high negative predictive value, and acute cholecystitis is unlikely in the setting of a negative CT. Complications of acute cholecystitis have a characteristic CT appearance and include necrosis, perforation, abscess formation, intraluminal hemorrhage, and wall emphysema.

  11. CT findings of small cell lung carcinoma

    PubMed Central

    Lee, Dongjun; Rho, Ji Young; Kang, Seunghun; Yoo, Koun Joy; Choi, Hye Jeong

    2016-01-01

    Abstract The purpose of this study was to clarify the recognizable computed tomography (CT) features of small cell lung carcinoma (SCLC). Contrast enhanced CT scans were reviewed retrospectively for mass location, mediastinal extension, and other concomitant findings in 142 patients with pathologically proven SCLC. SCLC was classified into hilar mass only (type I), hilar mass with ipsilateral mediastinal extension (type II), hilar mass with bilateral mediastinal extension (type III), and peripheral mass (type IV). When mediastinal lymphadenopathy (m-LAP) was indistinguishable from a hilar mass, we defined it as a mediastinal conglomerate mass (m-CM). Type IIa or IIIa had ipsilateral or bilateral m-LAP and type IIb, IIIb or IIIc had ipsilateral or bilateral m-CM. Type I (n = 8, 5.6%), type II (n = 58, 40.8%), type III (n = 55, 38.8%), and type IV (n = 21, 14.8%) were manifested. The combination of a hilar mass and m-CM was found in 68 patients (47.9%). Type IV masses showed lobulation in 11, microlobulation in 4, both lobulated and irregular margins in 4, and spiculation in 2. A total of 120 patients (84.5%) had a bronchial stenosis/obstruction; single (n = 52) and 2 or more (n = 68). Ninety-five patients (67.0%) had vascular invasion including main/lobar pulmonary artery and superior vena cava, and 55 (38.7%) had pleural effusion and/or pleural nodules. Concomitant parenchymal findings (n = 92, 64.8%) were noted: contiguous consolidation/nodule (n = 45), hematogeneous spread (n = 32), lymphangitic spread (n = 21), obstructive pneumonia (n = 22), and obstructive atelectasis (n = 14). In conclusion, the recognizable CT features of SCLC were a hilar mass with m-CM. Most of the hilar masses showed 2 or more bronchial stenoses/obstructions. Most cases of peripheral SCLC manifested as a lobulated mass rather than a spiculated mass. Vascular invasion and concomitant parenchymal findings were observed commonly. PMID:27893684

  12. Papillary carcinoma of the pancreas: findings of US and CT

    SciTech Connect

    Kim, S.Y.; Lim, J.H.; Lee, J.D.

    1985-02-01

    Two cases of papillary carcinoma of the pancreas were evaluated by ultrasound and CT. The sonographic and CT findings were those of a well-defined oval mass with partial cystic change. There was radiologic-pathologic correlation.

  13. Imaging findings of Pott's disease.

    PubMed

    Rivas-Garcia, Antonio; Sarria-Estrada, Silvana; Torrents-Odin, Carme; Casas-Gomila, Lourdes; Franquet, Elisa

    2013-06-01

    Tuberculosis (TB) continues to be an important public health problem in developed countries especially in deprived socioeconomic groups, older people, immunocompromised patients, drug-therapy resistant cases and the immigrant population. The spine is the most frequent location of musculoskeletal TB. The wide range of clinical presentations results in difficulties and delays in diagnosis. Advanced disease mimics other infections and malignancy. The diagnosis of spinal infections relies on three main factors: clinical symptoms, imaging and bacteriological culture. Advanced imaging such as Magnetic Resonance Imaging (MRI), Multidetector Computed Tomography (MDCT) and Fluor18-Deoxiglucose Positron Emission Tomography combined with CT (F-18 FDG PET-CT) demonstrate lesion extent, serve as guide for biopsy with aspiration for culture, assist surgery planning and contribute to follow-up. Diagnosis of TB cannot be established solely on the basis of clinical tests or imaging findings and biopsy may be required. Differential diagnosis between tuberculous and pyogenic spondylitis is of clinical importance, but may be difficult on the basis of radiological findings alone. Findings not pathognomonic but favoring tuberculous etiology include: slow progression of lesions with late preservation of disk space, involvement of several contiguous segments, large intraosseous and paraspinal abscesses containing calcifications, and body collapse with kyphotic deformity. In this essay the highlights of TB imaging are reviewed through published literature. In addition, we review retrospectively the radiological findings of 48 patients with tuberculous spondylitis treated from 1993 to 2010. There were 23 male and 25 female patients with a mean age of 53 years.

  14. Pulmonary talcosis: CT findings in three cases.

    PubMed

    Padley, S P; Adler, B D; Staples, C A; Miller, R R; Müller, N L

    1993-01-01

    The authors describe the computed tomographic (CT) appearances in three patients with pulmonary talcosis resulting from chronic intravenous drug abuse. There was widespread ground-glass attenuation in one case and an appearance similar to that of progressive massive fibrosis in two cases. In the latter cases, there were confluent perihilar masses with areas of high attenuation. While the CT appearances may be suggestive of pulmonary talcosis, tissue sampling is required for definitive diagnosis.

  15. Pulmonary embolism findings on chest radiographs and multislice spiral CT.

    PubMed

    Coche, Emmanuel; Verschuren, Franck; Hainaut, Philippe; Goncette, Louis

    2004-07-01

    Multislice spiral CT is becoming an increasingly important tool for diagnosing pulmonary embolism. However, in many instances, a chest radiograph is usually performed as a first-line examination. Many parenchymal, vascular, and other ancillary findings may be observed on both imaging modalities with a highly detailed depiction of abnormalities on multislice CT. A comprehensive review of chest radiograph findings is presented with side-by-side correlations of CT images reformatted mainly in the frontal plane.

  16. CT enterography with polyethylene glycol solution vs CT enteroclysis in small bowel disease

    PubMed Central

    Minordi, L M; Vecchioli, A; Mirk, P; Bonomo, L

    2011-01-01

    Objective The aim of the study is to compare CT enterography with polyethylene glycol solution (PEG-CT) with CT enteroclysis (CT-E) in patients with suspected small bowel disease. Methods 145 patients underwent abdominal contrast-enhanced 16-row multidetector CT after administration of 2000 ml of PEG by mouth (n = 75) or after administration of 2000 ml of methylcellulose by nasojejunal tube (n = 70). Small bowel distension, luminal and extraluminal findings were evaluated and compared with small bowel follow-through examination in 60 patients, double contrast enema in 50, surgery in 25 and endoscopy in 35. Statistical evaluation was carried out by χ2 testing. For both techniques we have also calculated the effective dose and the equivalent dose in a standard patient. Results Crohn's disease was diagnosed in 64 patients, neoplasms in 16, adhesions in 6. Distension of the jejunum was better with CT-E than PEG-CT (p<0.05: statistically significant difference). No significant difference was present for others sites (p>0.05). Evaluation of pathological ileal loops was good with both techniques. The values of sensitivity, specificity and diagnostic accuracy were respectively 94%, 100% and 96% with CT-E, and 93%, 94% and 93% with PEG-CT. The effective dose for PEG-CT was less than the dose for the CT-E (34.7 mSv vs 39.91 mSv). Conclusion PEG-CT shows findings of Crohn's disease as well as CT-E does, although CT-E gives better bowel distension, especially in the jejunum, and has higher specificity than PEG-CT. PMID:20959377

  17. Multidetector CT Findings of Bowel Transection in Blunt Abdominal Trauma

    PubMed Central

    Cho, Hyun Suk; Hong, Hye-Suk; Park, Mee Hyun; Ha, Hong Il; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji-Young

    2013-01-01

    Objective Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. Materials and Methods We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. Results The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Conclusion Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity. PMID:23901318

  18. [CT findings of the temporal bones in Waardenburg's syndrome].

    PubMed

    Irie, K; Ogata, H; Mitsudome, A

    1990-05-01

    We reported three cases of Waardenburg's syndrome and discussed CT findings of the temporal bones. Two cases of these patients were mother and daughter. Case 1, a two-year-old girl, had lateral displacement of the medial canthi, a broad nasal root, hetero-chromic iridis, left ptosis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules, short lateral semicircular canal, and absent right posterior semicircular canal. The mother had congenital deafness, heterochromia iridis, and a white forelock and showed similar abnormal CT findings of the temporal bones. Case 2, a one-year-old boy, had lateral displacement of the medial canthi, a broad nasal root, partial heterochromia iridis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules and absence of semicircular canals except the right lateral semicircular canal. These cases were diagnosed as Waardenburg's syndrome on the basis of the characteristic features.

  19. Intramammary Findings on CT of the Chest – a Review of Normal Anatomy and Possible Findings

    PubMed Central

    Gossner, Johannes

    2016-01-01

    Summary Computed tomography (CT) is a frequently performed examination in women of all ages. In all thoracic CT examinations of the chest at least parts of the breasts are included. Therefore incidental breast pathology may be observed. It has been suggested that one out of 250 women undergoing chest CT will show a malignant incidental breast lesion. Given the high number of performed chest CT examinations, this contributes to a significant number of malignancies. In this review, after a brief discussion of the value of computed tomography in breast imaging, normal and pathologic findings are discussed to create awareness of this potential “black box” on chest CT. PMID:28058068

  20. CT and MRI of aortic coarctation: pre- and postsurgical findings.

    PubMed

    Karaosmanoglu, Ali Devrim; Khawaja, Ranish Deedar Ali; Onur, Mehmet Ruhi; Kalra, Mannudeep K

    2015-03-01

    OBJECTIVE. The purpose of this article is to summarize the roles of CT and MRI in the diagnosis and follow-up of patients with aortic coarctation. CONCLUSION. Aortic coarctation is a common congenital heart disease accounting for approximately 6-8% of congenital heart defects. Despite its deceptively simple anatomic presentation, it is a complex medical problem with several associated anatomic and physiologic abnormalities. CT and MRI may provide very accurate information of the coarctation anatomy and other associated cardiac abnormalities.

  1. CT findings in silicosis due to denim sandblasting.

    PubMed

    Alper, Fatih; Akgun, Metin; Onbas, Omer; Araz, Omer

    2008-12-01

    The purpose of this study was to describe the findings of CT performed on denim sandblasters with silicosis. Fifty consecutive male patients with silicosis were evaluated. Their clinical data and pulmonary function tests (PFT) were obtained. The CT findings were recorded and the correlations between CT nodular profusion score and the other parameters were assessed. The diagnoses of the patients were classified as accelerated silicosis (n = 43) and acute silicosis (n = 7). The most common CT finding was centrilobular nodules. Twenty-three patients had complicated silicosis based on pleural involvement and presence of progressive massive fibrosis (PMF). Lymphadenopathy (LAP) was positive in 50% of the patients, with calcification in 24%. The CT grade was highly correlated with the clinical data such as exposure duration and PFT. Our findings suggest that the clinical manifestation of silicosis in denim sandblasters is severe. Although the duration of exposure is shorter the rate of complicated silicosis patients with pleural involvement was unexpectedly higher in the cases. Because the most common radiological appearance was nodules and the CT grading of the nodules was highly correlated with the clinical data, nodule grading may be used in the management of such cases.

  2. Pigmented villonodular synovitis of the temporomandibular joint: CT imaging findings.

    PubMed

    Le, Wei-Jie; Li, Ming-Hua; Yu, Qiang; Shi, Hui-Min

    2014-01-01

    The purpose of this study was to determine the characteristic computed tomography (CT) findings of pigmented villonodular synovitis (PVNS) of the temporomandibular joint (TMJ). Eight subjects with PVNS were examined with both pre and post contrast CT scans. All lesions were histopathologically confirmed through surgery. CT appearances of the lesions were reviewed. Among the eight subjects, 8 (100%) demonstrated soft tissue mass and enhancement after contrast administration, 6 (75%) appeared as all or focal areas of noncontrast hyperdensity, 6 (75%) had widening of the joint spaces. Bony erosion of the mandibular condyles and articular surfaces were found in 7 (87.5%) and 6 (75%) subjects, respectively. Based on the CT findings, PVNS of the TMJ is characterized by hyperdensity soft tissue mass and further increase in density after contrast administration, bony destruction of the mandibular condyles and skull base, and intracranial extension. © 2014.

  3. Plugoma: CT findings after prosthetic plug inguinal hernia repairs.

    PubMed

    Aganovic, Lejla; Ishioka, Kevin M; Hughes Cassidy, Fiona; Chu, Pauline K; Cosman, Bard C

    2010-10-01

    Unrecognized CT findings of a prosthetic plug used in inguinal hernia repair can lead to incorrect diagnosis or unnecessary workup of a patient. The objective of this study is to review the expected CT findings present in patients with a history of plug repair. Retrospective cohort study retrieving clinical and image data from a single-institution database. Patients who underwent prosthetic plug hernia repair during a 5-year period at our institution had their records queried for subsequent abdominal CT scans. These CT scans were reviewed by 2 radiologists for findings referable to the hernia repair. Five-hundred and sixty-four consecutive patients underwent prosthetic plug hernia repair during a 5-year period. Fifty-one patients who had had 55 surgical procedures had subsequent CT scans, none in the early postoperative period. Readers identified 100% of the plugs, 68% of which were described as round or oval in shape. All the plugs were in close proximity to the inferior epigastric artery and were of low density on CT images. Surgical scar was identifiable in 87% of patients. Thirty-two patients (63%) had a second CT scan, demonstrating no change in size and location of the plugoma. A prosthetic mesh plug is easily seen on CT images, typically appearing as a smooth round or oval hypodense mass close to the inferior epigastric artery, deep to a surgical scar, and stable over time. It can usually be distinguished from pathologic findings. It is important that the radiologist be familiar with the patient's surgical history when interpreting these images. Copyright © 2010. Published by Elsevier Inc.

  4. Askin tumor: CT and FDG-PET/CT imaging findings and follow-up.

    PubMed

    Xia, Tingting; Guan, Yubao; Chen, Yongxin; Li, Jingxu

    2014-07-01

    The aim of the study was to describe the imaging findings of Askin tumors on computed tomography (CT) and fluorine 18 fluorodeoxyglucose-positron emission tomography (FDG-PET/CT).Seventeen cases of Askin tumors confirmed by histopathology were retrospectively analyzed in terms of CT (17 cases) and FDG-PET/CT data (6 cases).Fifteen of the tumors were located in the chest wall and the other 2 were in the anterior middle mediastinum. Of the 15 chest wall cases, 13 demonstrated irregular, heterogeneous soft tissue masses with cystic degeneration and necrosis, and 2 demonstrated homogeneous soft tissue masses on unenhanced CT scans. Two mediastinal tumors demonstrated the irregular, heterogeneous soft tissue masses. Calcifications were found in 2 tumors. The tumors demonstrated heterogeneously enhancement in 16 cases and homogeneous enhancement in 1 case on contrast-enhanced scans. FDG-PET/CT images revealed increased metabolic activity in all 6 cases undergone FDG-PET/CT scan, and the lesion SUVmax ranged from 4.0 to 18.6. At initial diagnosis, CT and FDG-PET/CT scans revealed rib destruction in 9 cases, pleural effusion in 9 cases, and lung metastasis in 1 case. At follow-up, 12 cases showed recurrence and/or metastases, 4 cases showed improvement or remained stable, and 1 was lost to follow-up.In summary, CT and FDG-PET/CT images of Askin tumors showed heterogeneous soft tissue masses in the chest wall and the mediastinum, accompanied by rib destruction, pleural effusion, and increased FDG uptake. CT and FDG-PET/CT imaging play important roles in the diagnosis and follow-up of patients with Askin tumors.

  5. CT evaluation of appendicitis and its complications: imaging techniques and key diagnostic findings.

    PubMed

    Pinto Leite, Nuno; Pereira, José M; Cunha, Rui; Pinto, Pedro; Sirlin, Claude

    2005-08-01

    This article reviews various CT protocols for appendicitis, identifies key CT findings for diagnosing appendicitis, discusses unusual manifestations such as chronic and recurrent appendicitis, and profiles imaging features that differentiate appendicitis from other inflammatory and neoplastic ileocecal conditions. Patients were studied with helical CT. CT is a highly accurate, noninvasive test for appendicitis, but the optimal CT technique is controversial. Major complications of appendicitis (perforation, abscess formation, peritonitis, bowel obstruction, septic seeding of mesenteric vessels, gangrenous appendicitis) and their management are discussed. Abdominal CT is a well-established technique in the study of acute abdominal pain and has shown high sensitivity and specificity for diagnosing and differentiating appendicitis, providing an accurate diagnosis in the early stages of disease.

  6. 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

  7. CT and MR imaging findings of sinonasal angiomatous polyps.

    PubMed

    Zou, Jing; Man, Fengyuan; Deng, Kai; Zheng, Yuanyuan; Hao, Dapeng; Xu, Wenjian

    2014-03-01

    To characterize the CT and MR imaging findings of patients with sinonasal angiomatous polyps (SAPs) and evaluate their respective clinical value in the diagnosis of SAP. CT and MR imaging findings of 15 patients with pathologically proven SAP were examined. Assessed image features included location, size, margin, attenuation, and change of the bony walls of the sinonasal cavity on CT, and signal intensity and enhancement pattern on MR. On CT, the SAP was mostly isoattenuated with patches of slight hyperattenuation. Most lesions caused changes in the adjacent bone, including expansile remodeling (n=8), defect or destruction (n=7), and hyperostosis (n=6). All lesions examined by MR showed heterogeneous isointense signal intensity on T1-weighted images and mixed obvious hyperintense and hypointense signal intensity with linear hypointense septum internally (n=10), and hypointense peripheral rim on T2-weighted images (n=10). Postcontrast MR images demonstrated areas of heterogeneous and marked enhancement with an unenhanced hypointense rim and septa (n=7). CT and MR imaging have respective advantages in the diagnosis of SAP. Combined application of CT and MR examinations is necessary for patients with suspected SAP. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Cardiac calcified amorphous tumors: CT and MRI findings

    PubMed Central

    Yılmaz, Ravza; Demir, Ali Aslan; Önür, İmran; Yılbazbayhan, Dilek; Dursun, Memduh

    2016-01-01

    PURPOSE We aimed to evaluate computed tomography (CT) and magnetic resonance imaging (MRI) findings of cardiac calcified amorphous tumors (CATs). METHODS CT and MRI findings of cardiac CATs in 12 patients were included. We retrospectively examined patient demographics, location, size, shape configuration, imaging features, calcification distribution of tumors, and accompanying medical problems. RESULTS There was a female predominance (75%), with a mean age at presentation of 65 years. Patients were mostly asymptomatic on presentation (58.3%). The left ventricle of the heart was mostly involved (91%). CT findings of CATs were classified as partial calcification with a hypodense mass in four patients or a diffuse calcified form in eight. Calcification was predominant with large foci appearance as in partially calcified masses. On T1- and T2-weighted magnetic resonance images, CATs appeared hypointense and showed no contrast enhancement. CONCLUSION The shape and configuration of cardiac CATs are variable with a narrow spectrum of CT and MRI findings, but large foci in a partially calcified mass or diffuse calcification of a mass on CT is very important in the diagnosis of cardiac CATs. Masses show a low signal intensity on T1- and T2-weighted images with no contrast enhancement on MRI. PMID:27705878

  9. (18)F-FDG PET/CT and contrast-enhanced CT findings of pulmonary cryptococcosis.

    PubMed

    Wang, Si-Yun; Chen, Gang; Luo, Dong-Lan; Shao, Dan; Liu, En-Tao; Sun, Taotao; Wang, Shu-Xia

    2017-04-01

    Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules in non-AIDS patients. This study reports the (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG PET/CT) and contrast-enhanced CT (CE-CT) findings of 42 patients with pulmonary cryptococcosis. A retrospective review of the (18)F-FDG PET/CT and CE-CT findings of 42 patients with histologically proven pulmonary cryptococcosis was conducted. All patients underwent PET/CT and CE-CT in the same session. The CT diagnosis was based on the location, morphological features, and enhancement of lesions. The PET/CT findings were recorded, and clinical data and surgical and histopathological findings were collected. The results of the PET scans revealed that 37 (88%) of 42 patients showed higher FDG uptake, and 5 (12%) patients demonstrated lower FDG uptake than the mediastinal blood pool. The maximum standardized uptake value (SUV) of pulmonary cryptococcosis ranged from 1.4 to 13.0 (average: 5.7±3.3, median 4.9). A single nodular pattern was the most prevalent pattern observed and was found in 29 (69%) patients. This pattern was followed by scattered nodular (n=4, 10%), clustered nodular (n=3, 7%), mass-like (n=3, 7%), and bronchopneumonic (n=3, 7%) patterns. The most frequent pattern of immunocompetent patients was the single nodular pattern (29 of 33, 88%). Immunocompromised patients most frequently pattern exhibited mass-like (3 of 9, 33%) and bronchopneumonic (3 of 9, 33%) patterns. Pulmonary cryptococcosis most commonly appears as single nodules in immunocompetent patients. Mass-like and bronchopneumonic patterns were common in immunocompromised patients. In 88% of patients, lung lesions showed high FDG uptake, thus mimicking a possible malignant condition. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. X-linked stapes gusher: CT findings in one patient.

    PubMed

    Kumar, Gaurav; Castillo, Mauricio; Buchman, Craig A

    2003-01-01

    A 31-year-old male patient presented with progressive mixed hearing loss since birth. A stapedectomy was attempted and was unsuccessful because of perilymph gushing. CT of the temporal bones showed bulbous dilatation of the fundi of the internal auditory canals and absence of the bone plates separating them from the base of the cochleas. This unusual abnormality was found after the attempted stapedectomy and explains the clinical findings. The findings in male patients are fairly typical X-linked congenital deafness.

  11. Spleen in Hodgkin disease: diagnostic value of CT

    SciTech Connect

    Strijk, S.P.; Wagener, D.J.T.; Bogman, M.J.J.T.; de Pauw, B.E.; Wobbes, T.

    1985-03-01

    Findings of CT of the spleen were compared with those of histologic examination in 35 patients who had Hodgkin disease. CT provides a simple way to calculate splenic size. This index is also of value in the assessment of the histologic state of the spleen. An accuracy rate of 91%, specificity of 94%, and a sensitivity of 89% in diagnosing splenic localization of lymphoma was found in this study.

  12. CT of lumbar spine disk herniation: correlation with surgical findings

    SciTech Connect

    Firooznia, H.; Benjamin, V.; Kricheff, I.I.; Rafii, M.; Golimbu, C.

    1984-03-01

    Computed tomography (CT) of the lumbar spine was performed with selectively positioned 5-mm-thick axial cross sections to examine each disk level from the top of the neural foramen to the pedicle of the next caudad vertebra. One hundred consecutive patients with 116 surgical disk explorations were reviewed. There was agreement between the CT and surgical findings in 89 patients (104 explorations) in determination of presence or absence of a herniated nucleus pulposus (HNP). Discrepancy occurred in 12 instances (11 patients): two because of incorrect interpretations, five in previously operated patients, three in spondylolisthesis, and two in spinal stenosis. There were 97 true-positives, eight false-negatives, seven true-negatives, and four false-positives. If nine previously operated patients are excluded from the study, then CT was accurate in detection of presence or absence of an HNP in 93% of the disk explorations.

  13. PET/CT enterography in Crohn disease: correlation of disease activity on CT enterography with 18F-FDG uptake.

    PubMed

    Groshar, David; Bernstine, Hanna; Stern, Dorit; Sosna, Jacob; Eligalashvili, Merab; Gurbuz, Evren G; Niv, Yaron; Fraser, Gerald

    2010-07-01

    We combined (18)F-FDG PET and CT enterography in a single examination and compared the level of (18)F-FDG uptake measured by maximal standardized uptake value (SUVmax) with the CT enterography patterns of disease activity found in patients with Crohn disease (CD). Twenty-eight patients (mean age, 37.5 y; 11 male and 17 female) suspected of having active CD underwent PET/CT enterography. Abnormal bowel segments recognized on CT enterography were graded qualitatively for the presence of perienteric fat infiltration, the comb sign, and intramural attenuation and by quantitative measurements of mural enhancement (Hounsfield units) and thickness (mm). Also, for each patient, normal segments of the ileum and colon were noted, and CT enterography measurements of thickness and enhancement were obtained. For segments detected on CT enterography, a volume of interest was placed on the fused (18)F-FDG PET scan, and the SUVmax was obtained. Of the 28 patients with suspected active CD, 22 had 85 abnormal segments and 6 had no abnormal segments. SUVmax was significantly higher in the abnormal segments than in the normal segments (5.0 +/- 2.5 [95% confidence interval, 4.5-5.5] and 2.1 +/- 0.69 [95% confidence interval, 1.9-2.2], respectively; P < 0.0001). A good correlation was found between SUVmax with CT enterography measurements of mural thickness and enhancement (P < 0.00001). There was a significant difference in SUVmax between the 3 levels of disease activity found by intramural attenuation, perienteric fat infiltration, and the comb sign on CT enterography. SUVmax was significantly higher when there were intense CT enterography findings of active disease (P < 0.001). SUVmax assessment may allow an objective, reliable indication of the grade and severity of inflammation activity in abnormal segments of the bowel detected by CT enterography.

  14. CT Pulmonary Findings in Healthy Older Adult Aspirators versus Nonaspirators

    PubMed Central

    Butler, Susan G.; Clark, Hollins; Baginski, Scott G.; Todd, J. Tee; Lintzenich, Catherine; Leng, Xiaoyan

    2013-01-01

    Objectives/Hypothesis In previous studies, we consistently found that approximately 30% of asymptomatic healthy older adults silently aspirated liquids during a flexible endoscopic evaluation of swallowing (FEES), and that their aspiration status was stable for the following year. However, no studies have systematically evaluated effects of silent aspiration on lung parenchyma and airways. We used computed tomography (CT) to compare lungs of healthy older adult aspirators versus nonaspirators. We hypothesized that CT images would show pulmonary differences in healthy older adult aspirators versus nonaspirators. Study Design Prospective study. Methods Fifty healthy older adults (25 aspirators and 25 nonaspirators) who participated in a previous FEES were randomly selected. CT scans were performed; on inspiration, lung views were taken at 1.25 mm and 2.5 mm windows; on expiration, lung views were taken at 2.5 mm. CT scans were reviewed by radiologists blinded to group assignment. Outcomes included bronchiectasis, bronchiolectasis, bronchial wall thickening, parenchymal band, fibrosis, air trapping, intraluminal airway debris, and tree-in-bud pattern. Results Chi-square analyses between aspirators and nonaspirators found no statistically significant differences between aspirators and nonaspirators for any outcomes (p > 0.05). Logistic regression analyses adjusted for smoking did not change the results. Conclusion(s) There were no differences in pulmonary CT findings between healthy older adult aspirators and nonaspirators. This study adds to the evidence that some aspiration may be within the range of normal for older adults, or at least does not contribute to a change in pulmonary appearance on CT images. PMID:23832617

  15. IgG4-Related Kidney Disease in a Patient With History of Breast Cancer: Findings on 18F-FDG PET/CT.

    PubMed

    Krebs, Simone; Monti, Serena; Seshan, Surya; Fox, Josef; Mannelli, Lorenzo

    2016-08-01

    A 64-year-old African American woman with history of stage III breast carcinoma, 3 years after complete response to therapy, presents with progressive fatigue, increasing arthralgia, and unintentional weight loss of 15 lb in 3 months. An F-FDG PET demonstrated new diffuse FDG avidity of the renal parenchyma, new FDG-avid foci in pancreas and lungs, and new FDG-avid lymph nodes above and below the diaphragm. While a retroperitoneal lymph node biopsy was inconclusive, a kidney biopsy resulted in diagnosis of diffuse, severe, IgG4-related tubulointerstitial nephritis. Treatment with corticosteroid led to complete resolution of the symptoms and PET findings.

  16. Radiological findings of the cochlear aqueduct in patients with Meniere's disease using high-resolution CT and high-resolution MRI.

    PubMed

    Park, Jonas J-H; Shen, Anmin; Keil, Sebastian; Kraemer, Nils; Westhofen, Martin

    2014-12-01

    The objective of the present study was to evaluate the cochlear aqueduct (CA) in Meniere's disease (MD) and to disclose radiological differences of CA between MD and non-MD patients by means of high-resolution computed tomography (HRCT) and high-resolution magnetic resonance imaging (HRMRI). Radiological data of 86 ears of MD patients which were separated into 52 ears of diseased side group (MD-D group) and 34 ears of contralateral non-affected side group of unilateral MD (MD-ND group), 27 ears of patients with sensorineural hearing loss (SNHL group) and 56 ears of patients with somatoform dizziness and normal hearing (control group) were analyzed retrospectively. The bony type of CA, the bony length of CA, and the bony width of CA medial orifice was measured in HRCT. The visibility of CA in HRMRI was scored. Fluid length in CA and fluid width in medial orifice were measured in HRMRI. Data were compared between MD-D, MD-ND, SNHL, and control group. There were no significant differences in the bony type of CA, bony length of CA, bony width of CA medial orifice, and fluid width of CA medial orifice between MD-D, MD-ND, SNHL and control group (p > 0.05). However, CA fluid length of MD-D (5.13 ± 1.88 mm) and of MD-ND group (5.44 ± 1.81 mm) was significantly shorter than fluid length of SNHL (6.90 ± 1.55 mm) (p < 0.001, p = 0.001) and of control group (7.43 ± 1.24 mm) (p < 0.001, p < 0.001). The ratio between CA fluid length and CA bony length was the smallest in MD-D group (0.403; p = 0.009). CA bony dimensions of affected ears of MD are normal, but CA fluid length is decreased.

  17. Renal infarction: CT diagnosis and correlation between CT findings and etiologies

    SciTech Connect

    Wong, W.S.; Moss, A.A.; Federle, M.P.; Cochran, S.T.; London, S.S.

    1984-01-01

    The CT scans and the clinical records of 12 patients who had renal infarction were reviewed. The renal infarcts were classified as either focal or global. The CT findings were correlated with the etiologies of renal infarction. Embolism was the most common cause of renal infarcts that were multifocal with involvement of both kidneys. Trauma caused a unilateral global type of infract. A case of sickle cell anemia presented with multiple ''slit-like'' focal infarcts and enlarged kidneys. Forty-seven per cent of infarcts demonstrated the cortical rim sign, 11% were acapsular fluid collection, and 6% had an abnormally thickened renal fascia.

  18. Sphenoid sinus ectopic pituitary adenomas: CT and MRI findings

    PubMed Central

    Yang, B T; Chong, V F H; Wang, Z C; Xian, J F; Chen, Q H

    2010-01-01

    Ectopic pituitary adenomas (EPAs) are rare lesions. The purpose of this study was to describe the CT and MRI features of sphenoid sinus EPAs. Eight patients with histology-proven EPAs in the sphenoid sinus, all of whom underwent CT and MRI, were reviewed retrospectively. The following imaging features were analysed: (i) size, (ii) margin, (iii) CT attenuation characteristics and (iv) MRI signal intensity. In addition, the involvement of adjacent structures and the time–intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI were analysed. All EPAs had well-defined margins and showed no relationship to the intrasellar pituitary gland. The mean size was 28 mm (range, 20–46 mm). On non-enhanced CT, the lesions appeared isodense to grey matter in 7 (88%) patients and hypodense in 1 (12%) patient. Only two patients underwent post-contrast CT, and they showed moderate enhancement. On T1 weighted images, EPAs appeared isointense in 6 (75%) patients and hypointense in 2 (25%). On T2 weighted images, the lesions appeared hyperintense in 2 (25%) patients and isointense in 6 (75%). EPAs showed mild to moderate heterogeneous contrast enhancement and exhibited a cribriform-like appearance. Two patients underwent DCE MRI; the TIC showed a rapidly enhancing and slow washout pattern. The following features were also seen: an empty sella, bone changes and involvement of the cavernous sinus (5 patients; 62.5%). In conclusion, a high index of suspicion for EPA and a familiarity with the imaging findings may help to diagnose this rare entity accurately. PMID:19651706

  19. Cryptogenic organizing pneumonia: serial high-resolution CT findings in 22 patients.

    PubMed

    Lee, Ju Won; Lee, Kyung Soo; Lee, Ho Yun; Chung, Man Pyo; Yi, Chin A; Kim, Tae Sung; Chung, Myung Jin

    2010-10-01

    We conducted a review of serial high-resolution CT (HRCT) findings of cryptogenic organizing pneumonia (COP). Over the course of 14 years, we saw 32 patients with biopsy-confirmed COP. Serial HRCT scans were available for only 22 patients (seven men and 15 women; mean age, 52 years; median follow-up period, 8 months; range, 5-135 months). Serial CT scans were evaluated by two chest radiologists who reached a conclusion by consensus. Overall changes in disease extent were classified as cured, improved (i.e., ≥ 10% decrease in extent), not changed, or progressed (i.e., ≥ 10% increase in extent). When there were remaining abnormalities, the final follow-up CT images were analyzed to express observers' ideas regarding what type of interstitial lung disease the images most likely suggested. The two most common patterns of lung abnormality on initial scans were ground-glass opacification (86% of patients [19/22]) and consolidation (77% of patients [17/22]), distributed along the bronchovascular bundles or subpleural lungs in 13 patients (59%). In six patients (27%), the disease disappeared completely; in 15 patients (68%), the disease was decreased in extent; and in one patient (5%), no change in extent was detected on follow-up CT. When lesions remained, the final follow-up CT findings were reminiscent of fibrotic nonspecific interstitial pneumonia in 10 of 16 patients (63%). Although COP is a disease with a generally good prognosis, most patients (73%) with COP have some remaining disease seen on follow-up CT scans, and, in such cases, the lesions generally resemble a fibrotic nonspecific interstitial pneumonia pattern.

  20. (18)F-FDG PET/CT findings in a case with HIV (-) Kaposi sarcoma.

    PubMed

    Ozdemir, E; Poyraz, N Y; Keskin, M; Kandemir, Z; Turkolmez, S

    2014-01-01

    Although mucocutaneous sites are the most frequently encountered sites of involvement, Kaposi Sarcoma (KS) may also occasionally involve the breast and the skeletal, endocrine, urinary and nervous systems.. Various imaging modalities may be used to delineate the extent of the disease by detecting unexpected sites of involvement. Herein, we report a case of classical type KS, in whom staging with (18)F-FDG PET/CT imaging disclosed widespread disease and unexpected findings of bone and salivary gland involvement.

  1. State-of-the-art CT imaging techniques for congenital heart disease.

    PubMed

    Goo, Hyun Woo

    2010-01-01

    CT is increasingly being used for evaluating the cardiovascular structures and airways in the patients with congenital heart disease. Multi-slice CT has traditionally been used for the evaluation of the extracardiac vascular and airway abnormalities because of its inherent high spatial resolution and excellent air-tissue contrast. Recent developments in CT technology primarily by reducing the cardiac motion and the radiation dose usage in congenital heart disease evaluation have helped expand the indications for CT usage. Tracheobronchomalacia associated with congenital heart disease can be evaluated with cine CT. Intravenous contrast injection should be tailored to unequivocally demonstrate cardiovascular abnormalities. Knowledge of the state-of-the-art CT imaging techniques that are used for evaluating congenital heart disease is helpful not only for planning and performing CT examinations, but also for interpreting and presenting the CT image findings that consequently guide the proper medical and surgical management.

  2. Aortic valve calcification - a commonly observed but frequently ignored finding during CT scanning of the chest.

    PubMed

    Raju, Prashanth; Sallomi, David; George, Bindu; Patel, Hitesh; Patel, Nikhil; Lloyd, Guy

    2012-06-01

    To describe the frequency and severity of Aortic valve calcification (AVC) in an unselected cohort of patients undergoing chest CT scanning and to assess the frequency with which AVC was being reported in the radiology reports. Consecutive CT scan images of the chest and the radiological reports (December 2009 to May 2010) were reviewed at the district general hospital (DGH). AVC on CT scan was visually graded on a scale ranging from 0 to IV (0 = no calcification, IV = severe calcification). Total of 416 (232 male; 184 female) CT chest scans [Contrast enhanced 302 (72%), unenhanced 114 (28%)] were reviewed. Mean age was 70.55 ± 11.48 years. AVC in CT scans was identified in 95 of the 416 patients (22.83%). AVC classification was as follows: Grade I: 60 (63.15%), Grade II: 22 (23.15%), Grade III: 9 (9.47%), Grade IV: 4 (4.21%). Only one CT report mentioned AVC. Only 31 of 95 AVC had Transthoracic echocardiogram (TTE). The interval time between CT scan and TTE was variable.   Aortic valve calcification in CT chest scans is a common finding and studies have shown that it is strongly related to the presence and severity of aortic valve disease. As CT scans are considered as a valuable additional screening tool for detection of aortic stenosis, AVC should always be commented upon in the radiology reports. Furthermore, patients with at least Grade III and IV AVC should be sent for TTE. © 2012 Blackwell Publishing Ltd.

  3. CT Findings in People Who Were Environmentally Exposed to Asbestos in Korea.

    PubMed

    Lee, Eun Kyoung; Kim, Jeung Sook; Kim, Yookyung; Park, Jai Soung

    2015-12-01

    Asbestos related pleuropulmonary disease has been emerging health problem for recent years. It can cause variable clinical symptoms and radiological abnormalities. However, there has been no report for their characteristics in subjects who were environmentally exposed to asbestos. We reviewed the CT images of 35 people who were environmentally exposed to asbestos in Chungnam province, Korea. The study result showed high incidence of pleural plaque and pulmonary fibrosis on chest CT (94% and 77%, respectively). The common CT findings of lung parenchymal lesions were as follows: centrilobular opacities (94%), subpleural dot-like or branching opacities (80%), interlobular septal thickening (57%), intralobular interstitial thickening (46%), parenchymal bands (43%) and subpleural curvilinear line (29%). There were no significant differences in the prevalence of pulmonary fibrosis and pleural plaques according to sex, age and duration of exposure. In conclusion, pleural plaque and pulmonary fibrosis are common asbestos-related CT finding in the exposed people. Asbestos related lung parenchymal CT findings in the participants with environmental exposure show similar to those observed in the occupational exposure.

  4. Computed tomographic findings in Peyronie's disease.

    PubMed

    Rollandi, G A; Tentarelli, T; Vespier, M

    1985-01-01

    Twenty-one patients with Peyronie's disease were examined by computed tomography (CT) of the penis. Twenty nodules or plaques already diagnosed by clinical examination were identified. In 2 patients with a clinically palpable large plaque, all the albuginea could not be identified by CT, either in the fixed or mobile portion of the penis. Multiple lesions were palpable in 1 patient and could be seen by CT in 5 patients. Seven nonpalpable lesions were identified by CT. Lesions resembled calcified plaques in 10 instances and focal areas of diminished thickness and density of the tunica albuginea in 17 others. Computed tomography seems to be a very useful method in the study of Peyronie's disease. It allows precise evaluation of nodular lesions and it may be useful for monitoring their dimensional evolution. It may also give some insight into the structural composition of the nodules. This study supports theories that Peyronie's disease is a generalized disease of the penis.

  5. Efficacy of Computed Tomography (CT) Attenuation Values and CT Findings in the Differentiation of Pleural Effusion

    PubMed Central

    Yalçin-Şafak, Kadihan; Umarusman-Tanju, Neslihan; Ayyıldız, Muhammet; Yücel, Nihal; Baysal, Tamer

    2017-01-01

    Summary Background The aim of this study was to investigate the efficacy of computed tomography (CT) findings for characterizing pleural effusions with the use of attenuation values. Material/Methods One hundred and twenty eight patients with pleural effusions on thoracic CT who underwent thoracentesisis within two weeks were studied. Pleural effusions were classified as exudates or transudates according to the Light’s criteria. A region of interest was placed for the measurement of Hounsfield Unit (HU) values in the area of the greatest amount of effusion on each slice of the three slices used. CT features that were evaluated for distinguishing pleural exudates from transudates included pleural nodules, pleural thickening and loculation. Results Thirty three (26%) of the 128 pleural effusions were transudates and 95 (74%) were exudates. The mean HU values of the exudates (8.82±7.04) were significantly higher than those of the transudates (2.91±8.53), (p<0.001). No statistically significant difference was found between transudate and exudate patients in terms of pleural thickness, pleural nodules and loculation (p>0.05). Conclusions HU values can help in differentiating exudative pleural effusions from transudative pleural effusions. Because of overlapping HU values, correlation with clinical findings is essential. PMID:28289482

  6. MRI findings in Hirayama disease.

    PubMed

    Raval, Monali; Kumari, Rima; Dung, Aldrin Anthony Dung; Guglani, Bhuvnesh; Gupta, Nitij; Gupta, Rohit

    2010-11-01

    The objective of the study was to study the magnetic resonance imaging (MRI) features of Hirayama disease on a 3 Tesla MRI scanner. Nine patients with clinically suspected Hirayama disease were evaluated with neutral position, flexion, contrast-enhanced MRI and fast imaging employing steady-state acquisition (FIESTA) sequences. The spectrum of MRI features was evaluated and correlated with the clinical and electromyography findings. MRI findings of localized lower cervical cord atrophy (C5-C7), abnormal curvature, asymmetric cord flattening, loss of attachment of the dorsal dural sac and subjacent laminae in the neutral position, anterior displacement of the dorsal dura on flexion and a prominent epidural space were revealed in all patients on conventional MRI as well as with the dynamic 3D-FIESTA sequence. Intramedullary hyperintensity was seen in four patients on conventional MRI and on the 3D-FIESTA sequence. Flow voids were seen in four patients on conventional MRI sequences and in all patients with the 3D-FIESTA sequence. Contrast enhancement of the epidural component was noted in all the five patients with thoracic extensions. The time taken for conventional and contrast-enhanced MRI was about 30-40 min, while that for the 3D-FIESTA sequence was 6 min. Neutral and flexion position MRI and the 3D-FIESTA sequence compliment each other in displaying the spectrum of findings in Hirayama disease. A flexion study should form an essential part of the screening protocol in patients with suspected Hirayama disease. Newer sequences such as the 3D-FIESTA may help in reducing imaging time and obviating the need for contrast.

  7. Peritoneal tuberculosis versus peritoneal carcinomatosis: Distinction based on CT findings

    SciTech Connect

    Rodriguez, E.; Pombo, F.

    1996-03-01

    The purpose of this study was to determine the utility of CT in distinguishing peritoneal tuberculosis (PT) from peritoneal carcinomatosis (PC). CT scans were retrospectively reviewed in 19 patients known to have PT and compared with scans in 19 patients known to have PC. CT images were evaluated for thickening (smooth versus irregular), enhancement, presence of nodules, and site of involvement on the parietal peritoneum. The existence of oriental caking, nodules, and smudged patterns in the omentum, mesentery, and gastrocolic ligament was noted. The presence, distribution, and loculation of ascites were also evaluated. Ascites was present in all cases of PT and PC, loculated in 10 cases (PT = 4, PC = 6), and located in the greater peritoneal sac (PT = 15, PC = 10) or in the greater and lesser sacs (PT = 4, PC = 9). Slight smooth thickening and pronounced enhancement of the parietal peritoneum were seen in 15 of 19 PT patients and in 5 of 19 PC patients (p < 0.001), whereas irregular thickening was found in only 9 of 19 PC patients (p < 0.001). Peritoneal nodules were present exclusively in PC (7/19) (p < 0.01). The sites of the parietal peritoneum involvement were the pelvic (PT = 9, PC 3) (p < 0.05), paracolic gutters (PT = 5, PC = 6), juxtadiaphragmatic (PT 0, PC = 9) (p < 0.001), and peri- hepatic (PT = 6, PC = 8) regions. Oriental cakes were found in 4 of 19 PT and in 7 of 19 PC patients. The smudged pattern was the most common abnormality in the omentum (PT = 9/19, PC = 11/19), gastrocolic ligament (PT = 5/19, PC = 11/19) (p < 0.01), and mesentery (PT = 7/19, PC = 11/19). Isolated and discrete well defined nodules were exclusively found in the mesentery (PT 5/19, PC = 3/19). The most useful CT findings for distinguishing PT from PC were observed in the parietal peritoneum. The presence of a smooth peritoneum with minimal thickening and pronounced enhancement suggests PT, whereas nodular implants and irregular peritoneal thickening suggest PC.

  8. Early detection of recurrence or progression disease in patients with ovarian cancer after primary debulking surgery: a diagnostic challenge still unresolved. Correlation between CT findings and CA 125 levels.

    PubMed

    Giuliani, Michela; Gui, Benedetta; Valentini, Anna L; DI Giovanni, Silvia E; Miccò, Maura; Rodolfino, Elena; Falcione, Matteo; DE Waure, Chiara; Palluzzi, Eleonora; Salutari, Vanda; Scambia, Giovanni; Manfredi, Riccardo

    2017-06-09

    There are no standard approaches for follow up in advanced ovarian cancer (AOC) patients; the aim of this study is to evaluate correlation between Computed Tomography (CT) and CA 125 levels to assess early detection of recurrence or progression disease (PD). We included 76 patients with AOC, who had prior debulking surgery, starting first or second line of chemotherapy and underwent follow up CT examinations. Evaluation of tumor response to treatment by imaging was assessed using RECIST 1.1. Site of relapse was classified as: abdomen, chest and neck (observed in the upper chest scans). Change in CA 125 levels was calculated in respect previous evaluation at the end of treatment for each patient. The most suitable cut-offs could be identified in an increase in CA 125 levels >10.5% (sensitivity: 67.9%; specificity: 83.6%; LR+: 4.1; LR-: 0.4) in order to predict PD and in a change of -0.5% in order to exclude PD (sensitivity 83.0%; specificity: 69.6%; LR+: 2.7; LR-: 0.2). Site of relapse was abdomen (58.5%), abdomen and chest (33.9%), chest (3.8%), chest and neck (1.9%), and abdomen, chest and neck (1.9%). Increase in CA 125 levels >10.5% could be sufficiently predictive of PD requiring CT examination. Change of -0.5% is sufficiently predictive of absence of PD. Increase <10.5% and >0.5% needs clinical correlation to establish correct timing and extension of CT examination. Attention must be played in reducing number and extent of CT examinations to reduce exposure dose.

  9. Wassel's Type V Polydactyly with Plain Radiographic and CT Findings

    PubMed Central

    Mete, Berna Dirim; Altay, Canan; Gursoy, Merve; Oyar, Orhan

    2015-01-01

    Duplication of the thumb is the most common polydactyly of the hand. Wassel's classification is frequently used to classify the polydactyly of the hand. His classification was based on the level of duplication and the number of bones in the thumb, and has seven groups (Types I–VII) according to the level of the bifurcation, except for his Type VII. The most common type is the bifurcation at the metacarpophalangeal joint (Type IV). In this paper, we report a very rare case of Type V thumb polydactyly in a 42-year-old man, who presented with swan neck deformity of the radial thumb and discuss the plain radiography and computed tomography (CT) findings. Kumar recently reported plain radiography findings in a case of bifid first metacarpal in a 13-year-old girl, who presented with swan neck deformity of the left thumb. To our knowledge, our case is the second presented case that has a swan neck deformity with bifid metacarpal. PMID:25861550

  10. Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis.

    PubMed

    Chingkoe, Christina M; Jahed, Ali; Loreto, Michael P; Sarrazin, Josée; McGregor, Caitlin T; Blaichman, Jason I; Glanc, Phyllis

    2015-01-01

    Retroperitoneal fasciitis is a rare but potentially lethal complication of infection. Early diagnosis is crucial and is usually made when there is a high degree of clinical suspicion combined with characteristic imaging findings leading to early surgical intervention. Computed tomography (CT) can play a central role in demonstrating early findings, assessing the extent of disease to help determine the best surgical approach, identifying the primary source of infection, and evaluating the treatment response. The possible presence of retroperitoneal fasciitis should be considered in patients presenting with symptoms of sepsis, including pain that is disproportionate with the clinical abnormality. When retroperitoneal fasciitis is suspected, emergency CT can facilitate early diagnosis and evaluation of the extent of disease. Common findings at CT include fascial thickening and enhancement, muscular edema, fat stranding, fluid collections, and abscess formation. Gas tracking along fascial planes in the retroperitoneum is the hallmark of retroperitoneal fasciitis but is not seen in all cases. Another important clue to the diagnosis is asymmetric involvement of the retroperitoneal fascial planes and deep tissues. Fasciitis in the retroperitoneum may originate from infected retroperitoneal organs or from infection that spreads along indirect and/or direct pathways from a primary source elsewhere in the body. Findings of indirect tracking and transgression of fascial planes may indicate more severe infection associated with the necrotizing form of retroperitoneal fasciitis. Despite aggressive antibiotic treatment, early and repeated surgical débridement may be required to remove nonviable tissue in patients with the necrotizing form of retroperitoneal fasciitis. Awareness of the anatomy of the retroperitoneum, potential routes of spread of infection, and the spectrum of CT findings in retroperitoneal fasciitis is needed to achieve prompt diagnosis and guide treatment.

  11. Hodgkin's disease: update of findings.

    PubMed

    Pileri, S; Sabattini, E; Tazzari, P L; Gherlinzoni, F; Zucchini, L; Bigerna, B; Leoncini, L; Rosso, R; Stein, H; Falini, B

    1991-01-01

    The authors critically review the problem of Hodgkin's disease (HD) in the light of new morphological, immunohistochemical, kinetic, genotypic, and virological findings. These support the lymphoid origin of neoplastic Hodgkin's and Reed-Sternberg cells, because of regular expression of the CD30 lymphoid activation antigen and frequent detection of B- or T-cell phenotypic and/or genotypic markers. It is possible to hypothesize the release of cytokines by tumoral elements as well as the presence of specific cytokine receptors on their surface. This might explain some clinical and pathological features, such as fever, loss of weight, eosinophilia and attraction of reactive elements that make up the composite cellular milieu of typical HD. Integration of monoclonal EBV in the genoma of neoplastic elements has repeatedly been shown, and this might play an essential role in the pathogenesis of the disease. On the basis of present concepts, the borderlines between HD and some categories of non-Hodgkin's lymphomas--especially the anaplastic large cell forms--have become somewhat blurred. Additional research work in the field of HD is desirable and might pave the way for new and more effective therapeutic approaches, designed on the basis of the natural history of the neoplasm.

  12. 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

  13. Clinical and pulmonary thin-section CT findings in acute Klebsiella pneumoniae pneumonia.

    PubMed

    Okada, Fumito; Ando, Yumiko; Honda, Koichi; Nakayama, Tomoko; Kiyonaga, Maki; Ono, Asami; Tanoue, Shuichi; Maeda, Toru; Mori, Hiromu

    2009-04-01

    The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia. We retrospectively evaluated thin-section CT examinations performed between January 1991 and December 2007 from 962 patients with acute Klebsiella pneumoniae pneumonia. Seven hundred and sixty-four cases with concurrent infectious diseases were excluded. Thus, our study group comprised 198 patients (118 male, 80 female; age range 18-97 years, mean age 61.5). Underlying diseases and clinical findings were assessed. Parenchymal abnormalities were evaluated along with the presence of enlarged lymph nodes and pleural effusion. CT findings in patients with acute Klebsiella pneumoniae pneumonia consisted mainly of ground-glass attenuation (100%), consolidation (91.4%), and intralobular reticular opacity (85.9%), which were found in the periphery (96%) of both sides of the lungs (72.2%) and were often associated with pleural effusion (53%). The underlying conditions in patients with Klebsiella pneumoniae pneumonia were alcoholism or smoking habit.

  14. Automatically Pairing Measured Findings across Narrative Abdomen CT Reports

    PubMed Central

    Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William

    2013-01-01

    Radiological measurements are one of the key variables in widely adopted guidelines (WHO, RECIST) that standardize and objectivize response assessment in oncology care. Measurements are typically described in free-text, narrative radiology reports. We present a natural language processing pipeline that extracts measurements from radiology reports and pairs them with extracted measurements from prior reports of the same clinical finding, e.g., lymph node or mass. A ground truth was created by manually pairing measurements in the abdomen CT reports of 50 patients. A Random Forest classifier trained on 15 features achieved superior results in an end-to-end evaluation of the pipeline on the extraction and pairing task: precision 0.910, recall 0.878, F-measure 0.894, AUC 0.988. Representing the narrative content in terms of UMLS concepts did not improve results. Applications of the proposed technology include data mining, advanced search and workflow support for healthcare professionals managing radiological measurements. PMID:24551406

  15. FDG PET/CT findings of common bile duct tuberculosis.

    PubMed

    Dong, Aisheng; Wang, Yang; Gong, Jing; Zuo, Changjing

    2014-01-01

    Common bile duct (CBD) tuberculosis is rare. A 39-year-old woman was referred because of a 5-month history of abdominal pain. Abdominal enhanced MRI and CT showed dilatation of the distal CBD with irregularly thickened wall. Enhanced CT revealed enlarged retroperitoneal lymph nodes. FDG PET/CT showed increased FDG uptake of the CBD lesion and several retroperitoneal lymph nodes with slight FDG uptake. CBD cholangiocarcinoma with retroperitoneal lymph node metastasis was suspected. CBD tuberculosis was confirmed by endoluminal biopsy. Tuberculosis should be considered in the differential diagnosis of abnormal biliary FDG accumulation, particularly in tuberculosis endemic areas.

  16. CT findings of sinonasal respiratory epithelial adenomatoid hamartoma: a closer look at the olfactory clefts.

    PubMed

    Hawley, K A; Ahmed, M; Sindwani, R

    2013-05-01

    Respiratory epithelial adenomatoid hamartoma is a benign glandular neoplasm of the sinonasal cavities, which presents in isolation (REAHi) or in the setting of an adjacent inflammatory process such as sinonasal polyps. It is frequently found in the olfactory clefts. CT features of the 2 clinical presentations have not been well defined. We present the CT findings of REAH, focusing on the degree of associated sinusitis and changes in the OCs. We hypothesized that widening of the OCs and associated severity of the sinusitis are diagnostic features of REAH, differentiating it from SNP. In this case-control study, we compared patients with REAHi, those with REAH in the setting of SNP (REAHsnp), and those with SNP only (control patients). Patients with REAH were excluded if they had an adjacent inflammatory process other than SNP or if they did not have disease in the OC. We analyzed Harvard sinus CT scores and OC dimensions. A total of 29 patients with REAH were included: 7 with REAHi and 22 with REAHsnp. A total of 26 control patients were identified. Patients with REAHi had significantly lower Harvard CT scores than did the other groups. The OC width and the ratio of OC to the total nasal distance were significantly larger in both REAH groups compared with those of the control patients. If the OC is 10 mm or more, the sensitivity and specificity for the presence of REAH are 88% and 74%, respectively. Both clinical presentations of REAH are associated with OC widening on CT scan. In the setting of polypoid disease, an OC width of > 10 mm should increase suspicion for the presence of REAH.

  17. Computed Tomography (CT) Findings of a Diagnostic Dilemma: Atypically Located Acute Appendicitis

    PubMed Central

    Evrimler, Sehnaz; Okumuser, Irfan; Unal, Nermin

    2016-01-01

    Summary Background Acute appendicitis is an emergent surgically treated disease generally represented by right lower abdominal pain. The most common location of the appendix is descending intraperitoneal. However, it can also show atypical locations such as inguinal canal, femoral canal, subhepatic, retrocecal, intraperitoneal abdominal midline and left side in situs inversus or intestinal malrotation patients. Atypical location can lead to atypical clinical presentations. Ultrasonography is the first choice modality for imaging. However, it can be insufficient for demonstration of the appendix. Therefore, computed tomography (CT) is needed for further examination. We aim to review the CT findings of atypically located acute appendicitis with cases and remind the clinicians and radiologists the importance of the prompt diagnosis. Case Report We presented five atypically-located appendix cases, including four with acute appendicitis that presented to our emergency department with acute abdominal pain. Two of the acute appendicitis cases had normal, the other two had elevated white blood cell count, but all of them had elevated CRP. Ultrasonography imaging was performed as a first-line imaging modality. Because of the inconclusive results of both clinical-laboratory findings and ultrasonography, CT imaging was performed. Abdominal CT demonstrated all of the atypically localised appendices successfully, which were left-sided in a malrotated patient, retrocecal, subhepatic, retrocecal ascending, intraperitoneal abdominal midline localised. Conclusıons Atypically located acute appendicitis can show atypical presentation and result in misdiagnosis. If ultrasonograpgy is inconclusive, we suggest abdominal CT in such confusing, complicated cases, because misdiagnosis or delay in the right diagnosis can result in complications and increased morbidity and mortality rates. PMID:28058072

  18. CT findings in acute peritonitis: a pattern-based approach

    PubMed Central

    Filippone, Antonella; Cianci, Roberta; Pizzi, Andrea Delli; Esposito, Gianluigi; Pulsone, Pierluigi; Tavoletta, Alessandra; Timpani, Mauro; Cotroneo, Antonio Raffaele

    2015-01-01

    Many inflammatory and infectious entities may acutely affect the peritoneum causing a thickening of its layers. Unfortunately, several acute peritoneal diseases can have overlapping features, both clinically and at imaging. Therefore, the awareness of the clinical context, although useful, may be sometimes insufficient to identify the underlying cause. This article provides a specific computed tomography-based approach including morphologic characteristics of peritoneal thickening (e.g., smooth, irregular, or nodular) and ancillary findings to narrow the differential diagnosis of acute peritonitis. PMID:26359872

  19. CT in the diagnosis of interstitial lung disease

    SciTech Connect

    Bergin, C.J.; Mueller, N.L.

    1985-09-01

    The computed tomographic (CT) appearance of interstitial lung disease was assessed in 23 patients with known interstitial disease. These included seven patients with fibrosing alveolitis, six with silicosis, two with hypersensitivity pneumonitis, three with lymphangitic spread of tumor, two with sarcoidosis, one with rheumatoid lung disease, and two with neurofibromatosis. The CT appearance of the interstitial changes in the different disease entities was assessed. Nodules were a prominent CT feature in silicosis, sarcoidosis, and lymphangitic spread of malignancy. Distribution of nodules and associated interlobular septal thickening provided further distinguishing features in these diseases. Reticular densities were the predominant CT change in fibrosing alveolitis, rheumatoid lung disease, and extrinsic allergic alveolitis. CT can be useful in the investigation of selected instances of interstitial pulmonary disease.

  20. Primary Cardiac Lymphoma: Helical CT Findings and Radiopathologic Correlation

    SciTech Connect

    Marco de Lucas, Enrique Pagola, Miguel Angel; Fernandez, Fidel; Lastra, Pedro; Delgado, M. Luisa Ruiz; Sadaba, Pablo; Pinto, Jesus; Ballesteros, Ma Angeles; Ortiz, Antonio

    2004-03-15

    Primary tumors of the heart are extremely rare.Clinical manifestations are nondiagnostic and the patients are often misdiagnosed. Magnetic resonance imaging and echocardiography are standard in this diagnostic workup. We report a case of a man with acromegaly, dysphagia, chest pain and weight loss. An invasive cardiac mass was diagnosed by helical-CT. Autopsy demonstrated a B-cell aggressive lymphoma.

  1. Intracranial extramedullary hematopoiesis. CT and bone marrow scan findings

    SciTech Connect

    Urman, M.; O'Sullivan, R.A.; Nugent, R.A.; Lentle, B.C. )

    1991-06-01

    This case concerns a patient with intracranial extramedullary hematopoiesis (EH) suspected on a CT scan and subsequently confirmed with In-111 chloride and Tc-99m SC bone marrow scans. The bone marrow scans also provided additional information by demonstrating other sites of EH in the paravertebral tissues and bone marrow expansion into the distal extremities.

  2. Meckel's cave epidermoid with trigeminal neuralgia: CT findings.

    PubMed

    Kapila, A; Steinbaum, S; Chakeres, D W

    1984-12-01

    An epidermoid tumor of Meckel's cave was found in a middle-aged woman with trigeminal neuralgia. On CT the lesion had negative attenuation numbers of fat and extended from an expanded Meckel's cave through the porous trigeminus into the ambient and cerebellopontine angle cisterns. Surgical excision provided relief of the patient's trigeminal neuralgia.

  3. Spontaneous vertebral dissection: Clinical, conventional angiographic, CT, and MR findings

    SciTech Connect

    Provenzale, J.M.; Morgenlander, J.C.; Gress, D.

    1996-03-01

    The purpose of this study was to determine if typical clinical and neuroradiologic patterns exist in patients with spontaneous vertebral artery (VA) dissection. The medical records and neuroradiologic examinations of 14 patients with spontaneous VA dissection were reviewed. The medical records were examined to exclude patients with a history of trauma and to record evidence of a nontratimatic precipitating event ({open_quotes}trivial trauma{close_quotes}) and presence of possible risk factors such as hypertension. All patients under-went conventional angiography, 13 either CT or MRI (II both CT and MRI), and 3 MRA. Conventional arteriograrris were evaluated for dissection site, evidence of fibromuscular dysplasia, luminal stenosis or occlusion, and pseudoaneurysm formation, CT examinations for the presence of infarction or subarachnoid hemorrhage, MR examinations for the presence of infarction or arterial signal abnormality, and MR angiograms for abnormality of the arterial signal column. Seven patients had precipitating events within 24 h of onset of symptoms that may have been causative of dissection and five had hypertension. At catheter angiography, two patients had dissections in two arteries (both VAs in one patient, VA and internal carotid artery in one patient), giving a total of 15 VAs with dissection. Dissection sites included V1 in four patients, V2 in one patient, V3 in three patients, V4 in six patients, and both V3 and V4 in one patient. Luminal stenosis was present in 13 VAs, occlusion in 2, pseudoaneurysm in 1, and evidence of fibromuscular dysplasia in 1. Posterior circulation infarcts were found on CT or MR in five patients. Subarachnoid hemorrhage was found on CT in two patients and by lumbar puncture alone in two patients. Abnormal periarterial signal on MRI was seen in three patients. MRA demonstrated absent VA signal in one patient, pseudoaneurysm in one, and a false-negative examination in one.

  4. Concurrent Diffuse Pyelonephritis and Prostatitis: Discordant Findings on Sequential FDG PET/CT and 67Ga SPECT/CT Imaging.

    PubMed

    Lucaj, Robert; Achong, Dwight M

    2017-01-01

    A 45-year-old man underwent FDG PET/CT for initial imaging evaluation of recurrent Escherichia coli urinary tract infections, which demonstrated no significant FDG uptake in either kidney and subtle FDG uptake in the right prostate lobe. Subsequent Ga SPECT/CT demonstrated abnormal intense gallium uptake throughout the right kidney and entire prostate gland, clearly discordant with PET/CT findings and consistent with unexpected concurrent pyelonephritis and prostatitis. Although FDG has effectively replaced Ga in everyday clinical practice, the current case serves as a reminder that there is still a role for Ga in the evaluation of genitourinary infections.

  5. CT and MRI in the Evaluation of Thoracic Aortic Diseases

    PubMed Central

    2013-01-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used imaging examinations to evaluate thoracic aortic diseases because of their high spatial and temporal resolutions, large fields of view, and multiplanar imaging reconstruction capabilities. CT and MRI play an important role not only in the diagnosis of thoracic aortic disease but also in the preoperative assessment and followup after treatment. In this review, the CT and MRI appearances of various acquired thoracic aortic conditions are described and illustrated. PMID:24396601

  6. Postmortem computed tomography in victims of military air mishaps: radiological-pathological correlation of CT findings.

    PubMed

    Levy, Gad; Goldstein, Liav; Blachar, Arye; Apter, Sara; Barenboim, Erez; Bar-Dayan, Yaron; Shamis, Ari; Atar, Eli

    2007-10-01

    A thorough medical inquiry is included in every aviation mishap investigation. While the gold standard of this investigation is a forensic pathology examination, numerous reports stress the important role of computed tomography in the postmortem evaluation of trauma victims. To characterize the findings identified by postmortem CT and compare its performance to conventional autopsy in victims of military aviation mishaps, we analyzed seven postmortem CT examinations. Musculoskeletal injuries accounted for 57.8% of the traumatic findings identified by postmortem CT. The most frequent findings were fractures of the rib (47%), skull (9.6%) and facial bones (8.6%). Abnormally located air accounted for 24% of findings, for which CT was superior (3.5% detected by autopsy, 100% by postmortem CT, P < 0.001). The performance of autopsy in detecting injuries was superior (autopsy detected 85.8% of all injuries, postmortem CT detected 53.9%, P < 0.001), especially in the detection of superficial lesions (100% detected by autopsy, 10.5% by postmortem CT, P < 0.001) and solid organ injuries (100% by autopsy, 18.5% by postmortem CT, P < 0.001). Performance in the detection of musculoskeletal injuries was similar (91.3% for autopsy, 90.3% for postmortem CT, P = not significant). Postmortem CT and autopsy have distinct performance profiles, and although the first cannot replace the latter it is a useful complementary examination.

  7. CT findings of accidental fish bone ingestion and its complications

    PubMed Central

    Venkatesh, Sandeep Halagatti; Karaddi, Nanda Kumar Venkatanarasimha

    2016-01-01

    Fish bone is one of the most common accidentally ingested foreign bodies, and patients commonly present to the emergency department with nonspecific symptoms. Fortunately, most of them are asymptomatic and exit the gastrointestinal tract spontaneously. However, fish bones can get impacted in any part of the aerodigestive tract and cause symptoms. Occasionally, they are asymptomatic initially after ingestion and may present remotely at a later date with serious complications such as gastrointestinal tract perforation, obstruction, and abscess formation. Radiographs are most often negative. High degree of clinical suspicion and familiarity with CT appearance can help to detect fish bone along with any associated complications, and direct further management. We describe and illustrate various CT presentations of ingested fish bone and its complications. PMID:26714057

  8. Impact of FDG-PET/CT on Radiotherapy Volume Delineation in Non-Small-Cell Lung Cancer and Correlation of Imaging Stage With Pathologic Findings

    SciTech Connect

    Faria, Sergio L. Menard, Sonia; Devic, Slobodan; Sirois, Christian; Souhami, Luis; Lisbona, Robert; Freeman, Carolyn R.

    2008-03-15

    Purpose: Fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) is more accurate than CT in determining the extent of non-small-cell lung cancer. We performed a study to evaluate the impact of FDG-PET/CT on the radiotherapy volume delineation compared with CT without using any mathematical algorithm and to correlate the findings with the pathologic examination findings. Methods and Materials: A total of 32 patients with proven non-small-cell lung cancer, pathologic specimens from the mediastinum and lung primary, and pretreatment chest CT and FDG-PET/CT scans were studied. For each patient, two data sets of theoretical gross tumor volumes were contoured. One set was determined using the chest CT only, and the second, done separately, was based on the co-registered FDG-PET/CT data. The disease stage of each patient was determined using the TNM staging system for three data sets: the CT scan only, FDG-PET/CT scan, and pathologic findings. Results: Pathologic examination altered the CT-determined stage in 22 (69%) of 32 patients and the PET-determined stage in 16 (50%) of 32 patients. The most significant alterations were related to the N stage. PET altered the TNM stage in 15 (44%) of 32 patients compared with CT alone, but only 7 of these 15 alterations were confirmed by the pathologic findings. With respect to contouring the tumor volume for radiotherapy, PET altered the contour in 18 (56%) of 32 cases compared with CT alone. Conclusion: The contour of the tumor volume of non-small-cell lung cancer patients with co-registered FDG-PET/CT resulted in >50% alterations compared with CT targeting, findings similar to those of other publications. However, the significance of this change is unknown. Furthermore, pathologic examination showed that PET is not always accurate and histologic examination should be obtained to confirm the findings of PET whenever possible.

  9. Nonneoplastic liver disease: evaluation with CT and MR imaging.

    PubMed

    Kawamoto, S; Soyer, P A; Fishman, E K; Bluemke, D A

    1998-01-01

    A wide range of nontumorous hepatic diseases may have an impact on liver function and serve as indications for computed tomographic (CT) or magnetic resonance (MR) imaging. New imaging techniques such as spiral CT and fast MR imaging aid in detecting and characterizing these disease processes and in assessing the extent of disease. Infectious liver disease (eg, hepatic abscess, echinococcal disease, fungal infection) typically has low attenuation at CT and high signal intensity at T2-weighted MR imaging. Cholangitis is characterized by ductal dilatation at both CT and MR imaging. In acute portal vein thrombosis, the thrombus has low attenuation at CT and is hyperintense relative to liver at MR imaging. Hepatic infarcts usually appear as well-circumscribed, peripheral, wedge-shaped areas of decreased attenuation at CT. The causes or complications of cirrhosis can be most readily identified with MR imaging. In patients with chronic radiation-induced hepatitis, CT shows the irradiated parenchyma as a region of increased attenuation, whereas T1- and T2-weighted MR imaging demonstrate geographic areas of low and high signal intensity, respectively. Hemachromatosis has homogeneously increased liver attenuation at CT and decreased signal intensity at gradient-echo MR imaging in particular. Familiarity with the CT and MR imaging features of the spectrum of nonneoplastic conditions of the liver is essential in making an accurate diagnosis.

  10. Early CT findings after interstitial radiation therapy for primary malignant brain tumors

    SciTech Connect

    Tolly, T.L.; Bruckman, J.E.; Czarnecki, D.J.; Frazin, L.J.; Lewis, H.J.; Richards, M.J.; Adamkiewicz, J.J. Jr.

    1988-11-01

    The CT findings after interstitial radiation therapy for brain tumors have not been extensively described. We evaluated retrospectively the CT scans of 13 patients who were treated with brachytherapy for malignant glioma. We found no typical CT appearance that differentiates recurrent tumor from radiation effect. After undergoing brachytherapy, eight of the 13 patients scanned demonstrated enhancement of brain tissue beyond the margins of the original enhancing tumor mass. In most cases, the pattern of enhancement diminished and extended more peripherally from the central necrotic area with time. We also report a new CT finding of focal calcification developing at the site of the radioactive implant.

  11. CT findings in malignant pleural mesothelioma related to nonoccupational exposure to asbestos and fibrous zeolite (erionite)

    SciTech Connect

    Erzen, C.; Eryilmaz, M.; Kalyoncu, F.; Bilir, N.; Sahin, A.; Baris, Y.I. )

    1991-03-01

    Endemic malignant pleural mesothelioma (MPM) in Turkey is related to two mineral fibers, tremolite asbestos and fibrous zeolite (erionite). Thirteen cases of MPM from the Cappadocian area, where the soil is rich in erionite, and 29 cases of MPM, from villages whose occupants have high asbestos exposure, were examined by CT. The CT findings of the two groups of MPM were compared with respect to the configuration of the pleural lesions, stage of disease, fissural involvement, pleural effusion, presence of calcified pleural plaques, and chronic fibrosing pleuritis. In erionite-related MPM the pleural lesions were flat and smooth in 69.1%; in asbestos-related MPM the lesions were nodular in 55.1%. Stage IV disease, calcified pleural plaques, and chronic fibrosing pleuritis were more common in the erionite-related MPM. The rest of the findings were similar in both groups. The early radiological diagnosis of erionite-related MPM may be even more difficult because of the similarity of the pleural lesions to chronic fibrosing pleuritis.

  12. Large cell neuroendocrine carcinoma of the lung: CT and FDG PET findings.

    PubMed

    Lee, Kyung Won; Lee, Youkyung; Oh, So Won; Jin, Kwang Nam; Goo, Jin Mo

    2015-11-01

    To evaluate the CT and (18)fluorine FDG PET findings of large cell neuroendocrine carcinomas (LCNECs) of the lung and to evaluate whether CT and FDG PET findings can help predict the clinical outcome. Thirty-one patients (Male:Female=29:2; mean age, 69 years) who underwent surgical resection of an LCNEC of the lung were included in this retrospective study. The tumours were assessed with respect to morphologic characteristics and the maximum standardised uptake value (SUVmax) on pre-operative CT and FDG PET. For patients undergoing curative resection (n=26), disease-free survival was evaluated using the Kaplan-Meier test. The prognostic significance was assessed using a multivariate Cox proportional hazards regression analysis. The mean tumour diameter was 3.8 ± 2.1cm. Eight tumours (25.8%) were located centrally in the lung, and 23 (74.2%) were located peripherally. The margins were lobulated in 29 patients (93.5%) and well defined in 20 (64.5%). The mean SUVmax was 9.0 ± 3.8. The five-year disease-free survival rate was 46.3%. The shorter disease-free survival was related to the TNM stage greater than stage I, no lobulated margin of a tumour, a SUVmax >12.9 of a tumour, a long diameter >5.6 cm of a tumour, or female gender (P=0.115, P=0.134, P=0.056, P=0.168, P=0.113, respectively). The multivariate analysis indicated that a long diameter >5.6 cm (hazard ratio, 9.265; 90% confidence interval (CI), 1.996-42.992; P=0.017), female gender (hazard ratio, 5.579; 90% CI, 1.398-22.264; P=0.041), no lobulated margin (hazard ratio, 9.955; 90% CI, 1.433-69.136; P=0.051), and SUVmax >12.9 (hazard ratio, 4.062; 90% CI, 1.235-13.368; P=0.053) were independent predictors of shorter disease-free survival. LCNECs of the lung more commonly occurred peripherally and exhibited well-defined and lobulated margins on CT. The mean SUVmax was consistent with malignant tumours. Female gender, a larger tumour diameter, no lobulated margin, and higher SUVmax were poor prognostic

  13. Thoracic CT scanning for mediastinal Hodgkin's disease: results and therapeutic implications

    SciTech Connect

    Rostock, R.A.; Siegelman, S.S.; Lenhard, R.E.; Wharam, M.D.; Order, S.E.

    1983-10-01

    Thoracic CT scans were performed on 42 newly diagnosed patients with Hodgkin's disease. Five of 10 patients with negative chest X ray (CXR) had abnormal thoracic CT scans. Among the remaining 32 patients with mediastinal Hodgkin's disease (MHD) on CXR, pericardial (Ep) and chest wall invasion (Ec) were the two most common sites of involvement which were detectable by CT scan alone. Ep and Ec accounted for 16 of 19 of the changes in treatment portal or philosophy based on CT scan findings. Because of the high risk of cardiac or pulmonary radiation toxicity in Ep or Ec, radiation treatment alone may be inadequate. Treatment of mediastinal Hodgkin's disease is reviewed here. The use of CT scans for identification of Ep, Ec, and other abnormalities will allow for more precise treatment, further define the use of conventional radiotherapy, combined modality therapy or whole lung irradiation, and allow more accurate analysis of treatment results.

  14. CT Findings of Colonic Complications Associated with Colon Cancer

    PubMed Central

    Shin, Hyeong Cheol; Kim, Il Young; Kim, Young Tong; Kim, Chang-Jin

    2010-01-01

    A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer. PMID:20191069

  15. CT findings of colonic complications associated with colon cancer.

    PubMed

    Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young; Kim, Young Tong; Kim, Chang-Jin

    2010-01-01

    A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.

  16. CT and clinical findings of peripheral primitive neuroectodermal tumour in children

    PubMed Central

    Xiao, Huijuan; Bao, Fengchang; Tan, Hongna; Wang, Bo; Liu, Wei

    2016-01-01

    Objective: To describe the clinical, CT and pathological findings of paediatric peripheral primitive neuroectodermal tumours (pPNETs) to enhance the recognition of these rare tumours. Methods: The clinical, CT and pathological findings of 18 paediatric patients with pPNETs confirmed by biopsy or surgical pathology were retrospectively reviewed. Results: The age of these 18 paediatric patients with pPNETs ranged from 4 months to 15 years, with a mean age of 7.7 years. The lesions of these 18 paediatric patients with pPNETs were located in the head and neck (n = 4), chest (n = 2), abdomen and pelvic cavity (n = 6), spine (n = 3), ilium (n = 2) and femur (n = 1). Immunohistochemical examination revealed Homer–Wright rosettes in seven lesions, and 94.4% of lesions showed consistent positive staining for CD99. On plain CT images, the majority of pPNETs showed lesions that were ill-defined (72.2%), irregularly shaped (83.3%), heterogeneous (66.7%) or hypodense masses (94.4%), and together with osteolytic bone destruction when the lesion originated in the bone. Calcifications were found in three lesions. After contrast administration, all soft-tissue masses were persistently enhanced heterogeneously with various cystic or necrotic regions, and 71.4% of them had linear enhancement. 94.4% of soft-tissue masses showed a moderate degree of enhancement. Seven cases had lymph node metastasis at diagnosis. Conclusion: Paediatric pPNET can involve any part of the body, and a large, ill-defined, aggressive soft-tissue mass and moderate heterogeneous enhancement with varying cystic regions and linear enhancement, with or without osteolytic bone destruction, on CT images could suggest the diagnosis. Advances in knowledge: Primitive neuroectodermal tumours constitute a rare type of malignant neuroectodermal tumours that have chromosomal translocations identical to Ewing's sarcoma, and reports about radiological characteristics of this disease in children are

  17. Multidetector CT angiography for acute gastrointestinal bleeding: technique and findings.

    PubMed

    Artigas, José M; Martí, Milagros; Soto, Jorge A; Esteban, Helena; Pinilla, Inmaculada; Guillén, Eugenia

    2013-01-01

    Acute gastrointestinal bleeding is a common reason for emergency department admissions and an important cause of morbidity and mortality. Factors that complicate its clinical management include patient debility due to comorbidities; intermittence of hemorrhage; and multiple sites of simultaneous bleeding. Its management, therefore, must be multidisciplinary and include emergency physicians, gastroenterologists, and surgeons, as well as radiologists for diagnostic imaging and interventional therapy. Upper gastrointestinal tract bleeding is usually managed endoscopically, with radiologic intervention reserved as an alternative to be used if endoscopic therapy fails. Endoscopy is often less successful in the management of acute lower gastrointestinal tract bleeding, where colonoscopy may be more effective. The merits of performing bowel cleansing before colonoscopy in such cases might be offset by the resultant increase in response time and should be weighed carefully against the deficits in visualization and diagnostic accuracy that would result from performing colonoscopy without bowel preparation. In recent years, multidetector computed tomographic (CT) angiography has gained acceptance as a first-line option for the diagnosis and management of lower gastrointestinal tract bleeding. In selected cases of upper gastrointestinal tract bleeding, CT angiography also provides accurate information about the presence or absence of active bleeding, its source, and its cause. This information helps shorten the total diagnostic time and minimizes or eliminates the need for more expensive and more invasive procedures. © RSNA, 2013.

  18. Crouzon syndrome associated with acanthosis nigricans: prenatal 2D and 3D ultrasound findings and postnatal 3D CT findings

    PubMed Central

    Nørgaard, Pernille; Hagen, Casper Petri; Hove, Hanne; Dunø, Morten; Nissen, Kamilla Rothe; Kreiborg, Sven; Jørgensen, Finn Stener

    2012-01-01

    Crouzon syndrome with acanthosis nigricans (CAN) is a very rare condition with an approximate prevalence of 1 per 1 million newborns. We add the first report on prenatal 2D and 3D ultrasound findings in CAN. In addition we present the postnatal 3D CT findings. The diagnosis was confirmed by molecular testing. PMID:23986840

  19. Crouzon syndrome associated with acanthosis nigricans: prenatal 2D and 3D ultrasound findings and postnatal 3D CT findings.

    PubMed

    Nørgaard, Pernille; Hagen, Casper Petri; Hove, Hanne; Dunø, Morten; Nissen, Kamilla Rothe; Kreiborg, Sven; Jørgensen, Finn Stener

    2012-01-01

    Crouzon syndrome with acanthosis nigricans (CAN) is a very rare condition with an approximate prevalence of 1 per 1 million newborns. We add the first report on prenatal 2D and 3D ultrasound findings in CAN. In addition we present the postnatal 3D CT findings. The diagnosis was confirmed by molecular testing.

  20. Inflammatory aneurysms of the abdominal aorta: CT findings.

    PubMed

    Arrivé, L; Corréas, J M; Lesèche, G; Ghebontni, L; Tubiana, J M

    1995-12-01

    Inflammatory aneurysm of the abdominal aorta (IAAA) is a variant of atherosclerotic aneurysm that is characterized by inflammatory and/or fibrotic changes in the periaortic regions of the retroperitoneum [1, 2]. These inflammatory and/or fibrotic changes are probably the result of a local autoallergic reaction to certain components of atherosclerotic plaques [2]. This distinct entity has important implications, as the periaortic fibrotic tissue adherent to ureters, the duodenum, and the inferior vena cava may complicate surgical repair [1, 2]. The purpose of this essay is to illustrate the CT appearance of IAAA, with emphasis on the identification of IAAA and differentiation from conventional aortic aneurysms, evaluation of the involvement of adjacent structures by the periaortic fibrosis, and evaluation of the retroperitoneum after aneurysmal repair to analyze the resolution or the persistence of the periaortic fibrosis.

  1. CT Findings of Patients Treated with Irreversible Electroporation for Locally Advanced Pancreatic Cancer

    PubMed Central

    Akinwande, Olaguoke; Ahmad, Shakeeb S.; Van Meter, Tracy; Schulz, Brittany; Martin, Robert C. G.

    2015-01-01

    Introduction. In patients with locally advanced pancreatic cancer (LAPC), IRE has been shown to be safe for local disease control and palliation. As IRE continues to gain acceptance it is important to characterize the expected imaging findings. Materials and Methods. A review of our prospective soft tissue ablation registry from July 2010 to June 2013 was performed on patients who had undergone IRE for LAPC. Five masses treated with intraoperative IRE ablation for pancreatic tumors that underwent CT imaging before and after ablation were reviewed. Results and Discussion. Following IRE, the postablation bed is larger than the original ablated tumor. This ablation zone may get smaller in size (due to decreased edema and hyperemia) in the following months and more importantly remains stable provided there is no recurrence. In cases of recurrent disease there is increased size of the ablation bed, mass effect, and new or worsening vascular encasement or occlusion. Conclusion. CT imaging remains the best current imaging modality to assess post-IRE ablation changes. Serial imaging over at least 2–6 months must be employed to detect recurrence by comparing with prior studies in conjunction with clinical and serum studies. Larger imaging studies are underway to evaluate a more ideal imaging modality for this unique patient population. PMID:26649039

  2. Central airway pathology: clinic features, CT findings with pathologic and virtual endoscopy correlation.

    PubMed

    Barnes, Daniel; Gutiérrez Chacoff, José; Benegas, Mariana; Perea, Rosario J; de Caralt, Teresa M; Ramirez, José; Vollmer, Ivan; Sanchez, Marcelo

    2017-04-01

    To describe the imaging features of the central airway pathology, correlating the findings with those in pathology and virtual endoscopy. To propose a schematic and practical approach to reach diagnoses, placing strong emphasis on multidetector computed tomography (MDCT) findings. We reviewed our thoracic pathology database and the central airway pathology-related literature. Best cases were selected to illustrate the main features of each disease. MDCT was performed in all cases. Multiplanar and volume-rendering reconstructions were obtained when necessary. Virtual endoscopy was obtained from the CT with dedicated software. Pathological conditions affecting the central airways are a heterogeneous group of diseases. Focal alterations include benign neoplasms, malignant neoplasms, and non-neoplastic conditions. Diffuse abnormalities are divided into those that produce dilation and those that produce stenosis and tracheobronchomalacia. Direct bronchoscopy (DB) visualises the mucosal layer and is an important diagnostic and therapeutic weapon. However, assessing the deep layers or the adjacent tissue is not possible. MDCT and post-processing techniques such as virtual bronchoscopy (VB) provide an excellent evaluation of the airway wall. This review presents the complete spectrum of the central airway pathology with its clinical, pathological and radiological features. • Dividing diseases into diffuse and focal lesions helps narrow the differential diagnosis. • Focal lesions with nodularity are more likely to correspond to tumours. • Focal lesions with stenosis are more likely to correspond to inflammatory disease. • Posterior wall involvement is the main feature in diffuse lesions with stenosis.

  3. CT enteroclysis in the diagnostics of small bowel diseases

    PubMed Central

    Kołodziej, Marian; Annabhani, Abdulhabib; Sąsiadek, Marek

    2010-01-01

    Summary Background: The role of CT enteroclysis is gaining on importance in the diagnostics of small bowel diseases. The aim of the study was to present own experiences in CT enteroclysis application, with the use of a 64-detector CT unit. Material/Methods: CT enteroclyses were performed in 60 patients: 53 with the suspicion of the Crohn’s disease, 2 suspected for carcinoid, 1 with suspicion of the fistula between the small bowel and the bladder, 2 suspected for the tumor of the ileo-caecal region, and in 1 case, the aim of examination was to carry out an evaluation of the postsurgical state of the bowel-bowel anastomosis. We used own endoscopic technique of catheter insertion into the bowel, which shortens the examination time and improves patient’s comfort. Results: The catheter was correctly introduced into the small bowel in 58 patients (endoscopy had to be repeated in 4 cases). Only 2 examinations failed, because patients refused repeated endoscopy. Radiological signs of the Crohn’s disease were found in 50 out of 53 patients. In the 3 remaining patients, the appearance of the small bowel was normal. In 5 non-Crohn’s disease patients, CT enteroclysis enabled a good visualization of the pathology (tumors, fistula). Conclusions: CT enteroclysis with the use of the 64-detector CT unit is a valuable method in the diagnostics of small bowel diseases. It could supplement or precede capsule endoscopy. PMID:22802779

  4. CT pulmonary densitovolumetry in patients with acromegaly: a comparison between active disease and controlled disease.

    PubMed

    Camilo, Gustavo B; Carvalho, Alysson R S; Machado, Dequitier C; Mogami, Roberto; Melo, Pedro L; Lopes, Agnaldo J

    2015-10-01

    Our purpose was to compare the findings of CT pulmonary densitovolumetry and pulmonary function in patients with active acromegaly and controlled acromegaly and, secondarily, to correlate these findings. 11 patients with active acromegaly, 18 patients with controlled acromegaly and 17 control subjects, all non-smokers, underwent quantification of lung volume using multidetector CT (Q-MDCT) and pulmonary function tests. Patients with active acromegaly had larger total lung mass (TLM) values than the controls and larger amounts of non-aerated compartments than the other two groups. Patients with active acromegaly also had larger amounts of poorly aerated compartments than the other two groups, a difference that was observed in both total lung volume (TLV) and TLM. TLV as measured by inspiratory Q-MDCT correlated significantly with total lung capacity, whereas TLV measured using expiratory Q-MDCT correlated significantly with functional residual capacity. Patients with active acromegaly have more lung mass and larger amounts of non-aerated and poorly aerated compartments. There is a relationship between the findings of CT pulmonary densitovolumetry and pulmonary function test parameters. Although the nature of our results demands further investigation, our data suggest that both CT pulmonary densitovolumetry and pulmonary function tests can be used as useful tools for patients with acromegaly by assisting in the prediction of disease activity.

  5. CT pulmonary densitovolumetry in patients with acromegaly: a comparison between active disease and controlled disease

    PubMed Central

    Camilo, Gustavo B; Carvalho, Alysson R S; Machado, Dequitier C; Mogami, Roberto; Melo, Pedro L

    2015-01-01

    Objective: Our purpose was to compare the findings of CT pulmonary densitovolumetry and pulmonary function in patients with active acromegaly and controlled acromegaly and, secondarily, to correlate these findings. Methods: 11 patients with active acromegaly, 18 patients with controlled acromegaly and 17 control subjects, all non-smokers, underwent quantification of lung volume using multidetector CT (Q-MDCT) and pulmonary function tests. Results: Patients with active acromegaly had larger total lung mass (TLM) values than the controls and larger amounts of non-aerated compartments than the other two groups. Patients with active acromegaly also had larger amounts of poorly aerated compartments than the other two groups, a difference that was observed in both total lung volume (TLV) and TLM. TLV as measured by inspiratory Q-MDCT correlated significantly with total lung capacity, whereas TLV measured using expiratory Q-MDCT correlated significantly with functional residual capacity. Conclusion: Patients with active acromegaly have more lung mass and larger amounts of non-aerated and poorly aerated compartments. There is a relationship between the findings of CT pulmonary densitovolumetry and pulmonary function test parameters. Advances in knowledge: Although the nature of our results demands further investigation, our data suggest that both CT pulmonary densitovolumetry and pulmonary function tests can be used as useful tools for patients with acromegaly by assisting in the prediction of disease activity. PMID:26246281

  6. CT and MRI findings of cyclosporine-related encephalopathy and hypertensive encephalopathy.

    PubMed

    Yamamoto, Akira; Hayakawa, Katsumi; Houjyou, Makoto

    2002-05-01

    We present the MRI and CT findings of one child with cyclosporine-related encephalopathy, and one child with hypertensive encephalopathy following cyclosporine-related encephalopathy. The imaging findings were shown well on T2-weighted and fluid-attenuated inversion recovery (FLAIR) MR images. Cyclosporine-related encephalopathy was distributed predominantly in the posterior white matter. Hypertensive encephalopathy showed similar changes of CT attenuation, but with wider distribution. These two disorders seem to have the same pathogenesis.

  7. PET and PET-CT imaging findings of peritoneal and omental involvement in patients with lymphoma.

    PubMed

    Karaosmanoglu, Ali D; Butros, Selim R; Scott, James; Blake, Michael A

    2013-01-01

    A retrospective institutional-review-board-approved study was performed evaluating positron emission tomography (PET)-computed tomography (CT) imaging findings of peritoneal and omental involvement of lymphoma. Twelve patients were identified with a wide spectrum of imaging findings on PET-CT including but not limited to peritoneal thickening, ascites, and serosal involvement. Lymphoma is among the rare causes of malignant peritoneal or omental involvement. The most common manifestations of peritoneal lymphomatosis are peritoneal 2-[fluorine 18] fluoro-2-deoxy-D-glucose uptake with corresponding peritoneal thickening and nonobstructive serosal masses on CT. © 2013 Elsevier Inc. All rights reserved.

  8. CT findings of pulmonary tuberculosis and tuberculous pleurisy in diabetes mellitus patients

    PubMed Central

    Kim, Jihyun; Lee, In Jae; Kim, Joo-Hee

    2017-01-01

    PURPOSE We aimed to assess computed tomography (CT) findings of pulmonary tuberculosis (TB) and TB pleurisy in diabetes mellitus (DM) patients and to evaluate the effect of duration of DM on radiologic findings of pulmonary TB and TB pleurisy. METHODS Ninety-three consecutive patients diagnosed as active pulmonary TB with underlying DM were enrolled in our study. As a control group, 100 pulmonary TB patients without DM were randomly selected. TB patients with DM were subdivided into two subgroups depending on diabetes duration of ≥10 years or <10 years. Medical records and CT scans of the patients were retrospectively reviewed and compared. RESULTS Bilateral pulmonary involvement (odds ratio [OR]=2.39, P = 0.003), involvement of all lobes (OR=2.79, P = 0.013), and lymph node enlargement (OR=1.98, P = 0.022) were significantly more frequent CT findings among TB patients with DM compared with the controls. There were no statistically significant differences in CT findings of pulmonary TB depending on the duration of DM. CONCLUSION Bilateral pulmonary involvement, involvement of all lobes, and lymph node enlargement are significantly more common CT findings in TB patients with underlying DM than in patients without DM. Familiarity with the CT findings may be helpful to suggest prompt diagnosis of pulmonary TB in DM patients. PMID:28185999

  9. CT and MRI findings in X-linked progressive deafness.

    PubMed

    Altay, Hakan; Savaş, Recep; Oğüt, Fatih; Kirazli, Tayfun; Alper, Hüdaver

    2008-09-01

    Congenital X-linked mixed deafness is a rare anomaly that has typical features and can be diagnosed on the basis of progressive mixed hearing loss and the typical imaging findings. Recognition of these findings may alter the course of treatment and perilymph gushing can be avoided. A 10-year-old male patient presented with a history of progressive hearing loss. Computed tomography of the temporal bones showed bulbous dilatation of the fundi of the internal auditory canals (IAC) and the absence of the bony plates separating the basal turn of the cochleas and IAC. Magnetic resonance imaging demonstrated obliteration of the labyrinthine spaces at the right side.

  10. Extensive dentigerous cyst associated with a mesiodens: CT findings.

    PubMed

    Kim, Kyung Soo; Mun, Seog-Kyun

    2013-08-01

    The most common of the supernumerary teeth in humans are mesiodentes, which arise in the midline of the maxilla between the central incisors. The most common pathologic findings associated with a mesiodens are retention of the adjacent incisors, malposition, and diastema. The development of a dentigerous cyst in association with an impacted mesiodens is relatively uncommon. We report the case of a 35-year-old man with an extensive dentigerous cyst associated with a mesiodens who presented with a painful swelling in the left nasolabial area. We discuss the imaging findings in this case, particularly the contribution of computed tomography, and we review the literature on this interesting condition.

  11. Parenchymal opacification in chronic infiltrative lung diseases: CT-pathologic correlation.

    PubMed

    Leung, A N; Miller, R R; Müller, N L

    1993-07-01

    To correlate areas of parenchymal opacification on thin-section computed tomographic (CT) scans with histologic findings in patients with chronic infiltrative lung disease, the CT and histologic findings were evaluated in 29 patients with 11 such diseases. Open-lung biopsy was performed after CT. The area of predominant involvement was classified as air space, interstitium, or a mixture of both. A pathologic score of disease activity was assigned, and the extent of fibrosis was assessed whenever fibrosis was present. Parenchymal opacification on CT scans corresponded to abnormalities that affected mainly the air spaces in three patients (10%), the interstitium in 13 patients (45%), or both to a similar degree in 13 patients (45%). In 25 of 29 patients (86%), parenchymal opacification was associated with potentially treatable or reversible disease. Abnormalities considered irreversible were seen in three patients with end-stage fibrosis and one patient with talcosis. Parenchymal opacification on thin-section CT scans is a nonspecific finding in diseases that affect the air spaces, interstitium, or both but usually indicates potentially treatable or reversible disease.

  12. Correlation of pre-operative CT findings with surgical & histological tumor dissemination patterns at cytoreduction for primary advanced and relapsed epithelial ovarian cancer: A retrospective evaluation.

    PubMed

    Nasser, S; Lazaridis, A; Evangelou, M; Jones, B; Nixon, K; Kyrgiou, M; Gabra, H; Rockall, A; Fotopoulou, C

    2016-11-01

    Computed tomography (CT) is an essential part of preoperative planning prior to cytoreductive surgery for primary and relapsed epithelial ovarian cancer (EOC). Our aim is to correlate pre-operative CT results with intraoperative surgical and histopathological findings at debulking surgery. We performed a systematic comparison of intraoperative tumor dissemination patterns and surgical resections with preoperative CT assessments of infiltrative disease at key resection sites, in women who underwent multivisceral debulking surgery due to EOC between January 2013 and December 2014 at a tertiary referral center. The key sites were defined as follows: diaphragmatic involvement(DI), splenic disease (SI), large (LBI) and small (SBI) bowel involvement, rectal involvement (RI), porta hepatis involvement (PHI), mesenteric disease (MI) and lymph node involvement (LNI). A total of 155 patients, mostly with FIGO stage IIIC disease (65%) were evaluated (primary=105, relapsed=50). Total macroscopic cytoreduction rates were: 89%. Pre-operative CT findings displayed high specificity across all tumor sites apart from the retroperitoneal lymph node status, with a specificity of 65%. The ability however of the CT to accurately identify sites affected by invasive disease was relatively low with the following sensitivities as relating to final histology: 32% (DI), 26% (SI), 46% (LBI), 44% (SBI), 39% (RI), 57% (PHI), 31% (MI), 63% (LNI). Pre-operative CT imaging shows high specificity but low sensitivity in detecting tumor involvement at key sites in ovarian cancer surgery. CT findings alone should not be used for surgical decision making. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  13. Prevalence of abnormal CT findings in patients with proven ovarian torsion and a proposed triage schema.

    PubMed

    Moore, Christopher; Meyers, Arthur B; Capotasto, Juliana; Bokhari, Jamal

    2009-03-01

    Many women with ovarian torsion present with nonspecific abdominal/pelvic pain and initially receive computed tomography (CT). We hypothesize that the CT scans preformed on these women will all show abnormalities of the involved ovary. Our purpose is to review cases of surgically proven ovarian torsion at our institution over the last 20 years, assessing CT findings in women with ovarian torsion. A retrospective review of all patients at our institution with surgically proven ovarian torsion from 1985-2005 was conducted. Two physicians reviewed available CT reports, and a radiologist reviewed all available images. CT was obtained in 33% of the 167 patients. Dictated reports were available for 28 studies; all described an enlarged ovary, ovarian cyst, or adnexal mass of the involved ovary. Radiologist review of the available CT images confirmed these findings. This series supports the claim that a CT scan with well-visualized normal appearing ovaries rules out ovarian torsion, while abnormal pelvic findings or failure to visualize the ovaries in women with pelvic pain necessitates further evaluation of torsion.

  14. Relationship between CT findings and sensorineural hearing loss in chronic otitis media.

    PubMed

    Yoshida, Haruo; Miyamoto, Ikue; Takahashi, Haruo

    2014-06-01

    To investigate the relationships between the temporal bone CT findings and sensorineural hearing loss in ears with non-cholesteatomatous chronic otitis media (COM). Preoperative bone conduction (BC) hearing thresholds of 266 patients (304 ears) with COM were compared with those of 342 normal individuals (440 ears) by audiometry. The incidence of abnormal BC threshold at lower frequencies (250-1000 Hz) and at higher frequencies (2000-4000 Hz) were examined and the differences between control and COM groups were compared by using χ2 test. In the COM group, the cross-sectional area of the mastoid air cells based on the axial CT image (n=255) were correlated with the results of BC threshold. The percentage in the COM group exceeds 15% in their 50s at lower frequencies while in their 40s at higher frequencies. The BC thresholds were significantly better in the group with normal mastoid area than in those with smaller mastoid area at each decadal age group. The BC impairment from COM becomes worse as the course of the disease progresses and deteriorated from 40s rapidly, especially at higher frequencies and in the group with smaller mastoid area. These results recommend that early treatment, including surgery, should be considered as early as possible before BC impairment occurs, especially for COM cases with smaller mastoid area, which may indicate the existence of more severe otitis media since earlier childhood. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Mucocele involving the anterior clinoid process: MR and CT findings.

    PubMed

    Lim, C C; Dillon, W P; McDermott, M W

    1999-02-01

    We report two patients with surgically proved mucoceles involving the anterior clinoid process. One patient had a mucocele of an Onodi cell and the other had a mucocele isolated to the anterior clinoid process. The MR signal was increased on both T1- and T2-weighted images in the first patient but was isointense on both sequences in the second patient, a finding that resulted in misdiagnosis. The developmental and anatomic features, as well as the diagnostic pitfalls, are discussed.

  16. Traumatic aortic injury: CT findings, mimics, and therapeutic options

    PubMed Central

    Lantz, Eric J.; Johnson, C. Michael; Young, Philip M.

    2014-01-01

    Objective Traumatic aortic injury (TAI) is rare, but frequently lethal. However, with prompt diagnosis, patients can undergo life-saving open or endovascular repair. Unfortunately, because these injuries are relatively rare, subtle forms of these injuries may be missed, and normal variants may mimic TAI leading to misdiagnosis. Conclusions We will discuss computed tomography findings of typical injury patterns of traumatic aortic injuries as well as treatment options, diagnostic pitfalls and injury mimics. These are highlighted with clinical case examples. PMID:25009793

  17. High-resolution CT findings of patients with pulmonary nocardiosis

    PubMed Central

    Tsujimoto, Naoki; Saraya, Takeshi; Kikuchi, Ken; Takata, Saori; Kurihara, Yasuyuki; Hiraoka, Sayuki; Makino, Hiroshi; Yonetani, Shota; Araki, Koji; Ishii, Haruyuki; Takizawa, Hajime

    2012-01-01

    Background Opportunistic pulmonary infection with Nocardia species is rare in humans, and only a few studies have radiologically analyzed patients with pulmonary nocardiosis using high-resolution computed tomography (HRCT). Methods We retrospectively reviewed the medical records of patients with pulmonary nocardiosis at our hospital between April 2006 and December 2011 to assess HRCT and clinical findings. We also searched the medical literature for pulmonary nocardiosis reported in Japan between 2002 and 2011 for comparison. Results We identified seven patients at our institution and 33 reported infections in Japan. Four of our patients were immunocompetent, whereas the other three had impaired cellular immunity due to type 2 diabetes mellitus or having been inappropriately treated with steroid. Thoracic HRCT revealed no zonal predominance, but tropism for distribution from the middle to the peripheral area, and radiological findings of nodules, cavitation, mass, consolidations, bronchial wall thickening, septal line thickening and ground glass opacity (GGO) were evident. The main HRCT finding in our study comprised nodules (n=5, 71.4%) <30 mm and four patients had multiple nodules as described in other reports. Furthermore, we discovered a crazy paving appearance (CPA) around nodules, cavities, masses or consolidations in five patients (71.4%). Conclusions Multiple nodules distributed from the middle to the peripheral area on HRCT might reflect pulmonary nocardiosis, and CPA seemed to be a worth paying attention to the diagnosis. PMID:23205281

  18. Neuroradiological findings in maple syrup urine disease.

    PubMed

    Indiran, Venkatraman; Gunaseelan, R Emmanuel

    2013-01-01

    Maple syrup urine disease is a rare inborn error of amino acid metabolism involving catabolic pathway of the branched-chain amino acids. This disease, if left untreated, may cause damage to the brain and may even cause death. These patients typically present with distinctive maple syrup odour of sweat and urine. Patients typically present with skin and urine smelling like maple syrup. Here we describe a case with relevant magnetic resonance imaging findings and confirmatory biochemical findings.

  19. Trapping volumetric measurement by multidetector CT in chronic obstructive pulmonary disease: Effect of CT threshold

    SciTech Connect

    Wang, Xiaohua; Yuan, Huishu; Duan, Jianghui; Du, Yipeng; Shen, Ning; He, Bei

    2013-08-15

    Purpose: The purpose of this study was to evaluate the effect of various computed tomography (CT) thresholds on trapping volumetric measurements by multidetector CT in chronic obstructive pulmonary disease (COPD).Methods: Twenty-three COPD patients were scanned with a 64-slice CT scanner in both the inspiratory and expiratory phase. CT thresholds of −950 Hu in inspiration and −950 to −890 Hu in expiration were used, after which trapping volumetric measurements were made using computer software. Trapping volume percentage (Vtrap%) under the different CT thresholds in the expiratory phase and below −950 Hu in the inspiratory phase was compared and correlated with lung function.Results: Mean Vtrap% was similar under −930 Hu in the expiratory phase and below −950 Hu in the inspiratory phase, being 13.18 ± 9.66 and 13.95 ± 6.72 (both lungs), respectively; this difference was not significant (P= 0.240). Vtrap% under −950 Hu in the inspiratory phase and below the −950 to −890 Hu threshold in the expiratory phase was moderately negatively correlated with the ratio of forced expiratory volume in one second to forced vital capacity and the measured value of forced expiratory volume in one second as a percentage of the predicted value.Conclusions: Trapping volumetric measurement with multidetector CT is a promising method for the quantification of COPD. It is important to know the effect of various CT thresholds on trapping volumetric measurements.

  20. Metrizamide CT myelography in cervical myelopathy and radiculopathy: correlation with conventional myelography and surgical findings

    SciTech Connect

    Badami, J.P.; Norman, D.; Barbaro, N.M.; Cann, C.E.; Weinstein, P.R.; Sobel, D.F.

    1985-04-01

    Conventional myelography, metrizamide computed tomographic (CT) myelography, and surgical findings were correlated in 30 patients with cervical radiculopathy and/or myelopathy. In 60% of patients, metrizamide CT myelography provided significant additional information including better characterization of the abnormality, lateralization if the conventional myelogram was indeterminate, more definitive demonstration of cord atrophy, foraminal narrowing not appreciated on myelography, and demonstration of abnormalities distal to a myelographic block. In no case was a myelographic abnormality not detected on metrizamide CT meyelography. In patients with cervical myelopathy, a cross-sectional diameter of the cord equaling less than 50% of the subarachnoid space is predictive of poor patient response to surgical intervention.

  1. CT Imaging Findings after Stereotactic Radiotherapy for Liver Tumors

    PubMed Central

    Brook, Olga R.; Thornton, Eavan; Mendiratta-Lala, Mishal; Mahadevan, Anand; Raptopoulos, Vassilious; Brook, Alexander; Najarian, Robert; Sheiman, Robert; Siewert, Bettina

    2015-01-01

    Purpose. To study radiological response to stereotactic radiotherapy for focal liver tumors. Materials and Methods. In this IRB-approved, HIPAA-compliant study CTs of 68 consecutive patients who underwent stereotactic radiotherapy for liver tumors between 01/2006 and 01/2010 were retrospectively reviewed. Two independent reviewers evaluated lesion volume and enhancement pattern of the lesion and of juxtaposed liver parenchyma. Results. 36 subjects with hepatocellular carcinoma (HCC), 25 with liver metastases, and seven with cholangiocarcinoma (CCC) were included in study. Mean follow-up time was 5.6 ± 7.1 months for HCC, 6.4 ± 5.1 months for metastases, and 10.1 ± 4.8 months for the CCC. Complete response was seen in 4/36 (11.1%) HCCs and 1/25 (4%) metastases. Partial response (>30% decrease in long diameter) was seen in 25/36 (69%) HCCs, 14/25 (58%) metastases, and 7/7 (100%) of CCCs. Partial response followed by local recurrence (>20% increase in long diameter from nadir) occurred in 2/36 (6%) HCCs and 4/25 (17%) metastases. Liver parenchyma adjacent to the lesion demonstrated a prominent halo of delayed enhancement in 27/36 (78%) of HCCs, 19/21 (91%) of metastases, and 7/7 (100%) of CCCs. Conclusion. Sustainable radiological partial response to stereotactic radiotherapy is most frequent outcome seen in liver lesions. Prominent halo of delayed enhancement of the adjacent liver is frequent finding. PMID:26221135

  2. Pulmonary diseases with imaging findings mimicking aspergilloma.

    PubMed

    Gazzoni, Fernando Ferreira; Severo, Luiz Carlos; Marchiori, Edson; Guimarães, Marcos Duarte; Garcia, Tiago Severo; Irion, Klaus L; Camargo, José Jesus; Felicetti, José Carlos; de Mattos Oliveira, Flavio; Hochhegger, Bruno

    2014-06-01

    Patients with preexisting lung cavities are at risk of developing intracavitary fungal colonization. Because Aspergillus spp. are the most commonly implicated fungi, these fungal masses are called aspergillomas. Their characteristic "ball-in-hole" appearance, however, may be found in a variety of other conditions that can produce radiologic findings mimicking aspergilloma. In this paper, we review the main diseases that may mimic the radiographic findings of aspergilloma, with brief descriptions of clinical, radiologic, and histopathologic findings.

  3. Tracking the Remodeling of SNOMED CT's Bacterial Infectious Diseases.

    PubMed

    Ochs, Christopher; Case, James T; Perl, Yehoshua

    2016-01-01

    SNOMED CT's content undergoes many changes from one release to the next. Over the last year SNOMED CT's Bacterial infectious disease subhierarchy has undergone significant editing to bring consistent modeling to its concepts. In this paper we analyze the stated and inferred structural modifications that affected the Bacterial infectious disease subhierarchy between the Jan 2015 and Jan 2016 SNOMED CT releases using a two-phased approach. First, we introduce a methodology for creating a human readable list of changes. Next, we utilize partial-area taxonomies, which are compact summaries of SNOMED CT's content and structure, to identify the "big picture" changes that occurred in the subhierarchy. We illustrate how partial-area taxonomies can be used to help identify groups of concepts that were affected by these editing operations and the nature of these changes. Modeling issues identified using our two-phase methodology are discussed.

  4. Parasitic diseases in the abdomen: imaging findings.

    PubMed

    Lim, Jae Hoon

    2008-01-01

    Parasitic diseases of the liver and biliary tract include echinococcosis, schistosomiasis, toxocariasis, clonorchiasis, and opisthorchiasis, affecting millions people in some endemic areas. Amebiasis and ascariasis are believed to be the most common bowel lumen indwelling parasitic diseases, affecting billions people worldwide, but sometimes these parasites migrate inadvertently to the liver and biliary tract, resulting in liver abscess or obstructive jaundice. Imaging findings of these parasitic diseases are fairly characteristic and easy to recognize if radiologists are aware of the findings, especially in endemic areas. Because of increased immigration and frequent travelling, some patients with "exotic" parasitic diseases may be encountered in non-endemic areas, and the diagnosis may be delayed or difficult, and it is often made only after operation. This feature section was designed to provide the detailed imaging features of common parasitic diseases affecting the abdominal organs and peritoneal cavity, based on pathology-image correlation.

  5. Comparison of CT scanning and radionuclide imaging in liver disease

    SciTech Connect

    Friedman, M.L.; Esposito, F.S.

    1980-01-01

    Early experience with body CT suggested its usefulness in many diagnostic problems; jaundice, renal and pancreatic masses, and in the evaluation of relatively inaccessible parts of the body, such as the retroperitineum, mediastinum, and pelvis. Investigation of hepatic disease by CT was not unexpectedly compared to radionuclide liver scanning, the major preexisting modality for imaging the liver. In the evaluation of the jaundiced patient, CT rapidly assumed a major role, providing more specific information about the liver than the RN liver scan, as well as demonstrating adjacent organs. CT differentiate obstructive from non-obstructive jaundice. With respect to mass lesions of the liver, the RN liver scan is more sensitive than CT but less specific. The abnormalities on an isotope image of the liver consist of normal variants in configuration, extrinsic compression by adjacent structures, cysts, hemangiomata, abscesses, and neoplasms. These suspected lesions may then be better delineated by the CT image, and a more precise diagnosis made. The physiologic information provided by the RN liver scan is an added facet which is helpful in the patient with diffuse hepatic disease. The CT image will be normal in many of these patients, however, hemochromatosis and fatty infiltration lend themselves especially to density evaluation by CT. The evaluation of lymphoma is more thorough with CT. Structures other than the liver, such as lymph nodes, are visualized. Gallium, however, provides additional isotopic information in patients with lymphoma, and in addition, is known to be useful in the investigation of a febrile patient with an abscess. Newer isotopic agents expand hepatic imaging in other directions, visualizing the biliary tree and evaluating the jaundiced patient.

  6. Findings of non-pathologic perfusion defects by CT arterial portography and non-pathologic enhancement of CT hepatic arteriography

    PubMed Central

    Li, Li; Wu, Pei-Hong; Lin, Hao-Gao; Li, Jin-Qing; Mo, Yun-Xian; Zheng, Lie; Lu, Li-Xia; Ruan, Chao-Mei; Chen, Lin

    1998-01-01

    AIM: To recognize the characteristic findings of non-pathologic perfusion defects with CT arterial portography (CTAP) and nonpathologic enhancement found in CT hepatic arteriography (CTHA). METHONDS: The manifestations of nonpathologic perfusion defects with CTAP and non-pathologic enhancement found in CTHA were analyzed in 50 patients with primary hepatocellular carcinoma. RESULTS: The false-positive rate of perfusion defects detected in CTAP was 15.1%. The shapes of perfusion defects were peripheral wedge, small, round, and patchy. The occurrence rate of non-pathologic enhancement found in CTHA was 22.0%. The shapes of non-pathologic enhancement were small, round, irregular, and wedge. CONCLUSION: There was high frequency of non-pathologic perfusion defects detected with CTAP and non-pathologic enhancement found in CTHA. The simultaneous use of both procedures may help decrease the false-positive rate, and increase the veracity of diagnosis for hepatocellular carcinoma. PMID:11819358

  7. Current Update on Interstitial Lung Disease of Infancy: New Classification System, Diagnostic Evaluation, Imaging Algorithms, Imaging Findings, and Prognosis.

    PubMed

    Thacker, Paul G; Vargas, Sara O; Fishman, Martha P; Casey, Alicia M; Lee, Edward Y

    2016-11-01

    Childhood interstitial lung disease represents a rare and heterogeneous group of diseases that can result in significant morbidity and mortality, some leading to death during infancy. CT is the imaging test of choice. Although many CT findings are nonspecific and a definitive diagnosis usually cannot be reached by CT alone, the interpreting radiologist is instrumental in defining disease extent and refining the diagnosis. Chest CTs are of key importance in guiding site selection for lung biopsy and for following disease progression and response to treatment. Thus, from the radiologist's perspective, ensuring maximal quality of CT imaging and interpretation is paramount.

  8. Experimental Actinobacillus pleuropneumoniae challenge in swine: comparison of computed tomographic and radiographic findings during disease.

    PubMed

    Brauer, Carsten; Hennig-Pauka, Isabel; Hoeltig, Doris; Buettner, Falk F R; Beyerbach, Martin; Gasse, Hagen; Gerlach, Gerald-F; Waldmann, Karl-H

    2012-04-30

    In pigs, diseases of the respiratory tract like pleuropneumonia due to Actinobacillus pleuropneumoniae (App) infection have led to high economic losses for decades. Further research on disease pathogenesis, pathogen-host-interactions and new prophylactic and therapeutic approaches are needed. In most studies, a large number of experimental animals are required to assess lung alterations at different stages of the disease. In order to reduce the required number of animals but nevertheless gather information on the nature and extent of lung alterations in living pigs, a computed tomographic scoring system for quantifying gross pathological findings was developed. In this study, five healthy pigs served as control animals while 24 pigs were infected with App, the causative agent of pleuropneumonia in pigs, in an established model for respiratory tract disease. Computed tomographic (CT) findings during the course of App challenge were verified by radiological imaging, clinical, serological, gross pathology and histological examinations. Findings from clinical examinations and both CT and radiological imaging, were recorded on day 7 and day 21 after challenge. Clinical signs after experimental App challenge were indicative of acute to chronic disease. Lung CT findings of infected pigs comprised ground-glass opacities and consolidation. On day 7 and 21 the clinical scores significantly correlated with the scores of both imaging techniques. At day 21, significant correlations were found between clinical scores, CT scores and lung lesion scores. In 19 out of 22 challenged pigs the determined disease grades (not affected, slightly affected, moderately affected, severely affected) from CT and gross pathological examination were in accordance. Disease classification by radiography and gross pathology agreed in 11 out of 24 pigs. High-resolution, high-contrast CT examination with no overlapping of organs is superior to radiography in the assessment of pneumonic lung lesions

  9. Extensive invasive extramammary Paget disease evaluated by F-18 FDG PET/CT: a case report.

    PubMed

    Li, Zu-Gui; Qin, Xiao-Jing

    2015-01-01

    Extramammary Paget disease (EMPD) is a rare cutaneous, intraepithelial adenocarcinoma. Because of its rarity, little is known about the value of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in evaluating this disease. Our case report aims to increase current knowledge of FDG PET/CT in EMPD as a noninvasive imaging tool for assessing the extension of the disease and detecting distant metastases.We reported a 64-year-old Chinese man who presented with a slowly progressive, ill-margined erythematous lesion with a crusted, eroded, and scaly surface involving multiple sites of penis, scrotum, left pelvic wall, hip, groin, and thigh for >4 years, which became extensive in the past 1 year. He was referred for an FDG PET/CT examination to further evaluate the lesions. A following skin biopsy was performed to obtain a definitive histological diagnosis.FDG PET/CT imaging revealed mild FDG uptake at the extensive cutaneous lesion with subcutaneous invasion, involvement of lymph nodes, and multiple intense FDG-avid of skeletal metastases. According to the appearance of FDG PET/CT, a provisional diagnosis of advanced cutaneous malignancy was made. Histopathology findings indicated characteristic of EMPD. The patient was treated with radiation therapy and died from complications 2 months after the last dose of radiotherapy.Our case highlighted that a whole-body FDG PET/CT should be incorporated into the diagnostic algorithm of EMPD to give a comprehensive assessment of this disease.

  10. CT brain findings in a patient with elevated brain cesium levels.

    PubMed

    Khangure, Simon R; Williams, Eric S; Welman, Christopher J

    2013-12-01

    We describe the CT findings in the brain of a woman with pathologically proven elevated levels of blood and tissue cesium. The 42-year-old woman had been receiving cesium chloride as a non-mainstream treatment for metastatic breast carcinoma. She presented to hospital following a seizure, and died 48 hours after admission. A brain CT performed on hospital admission showed a diffuse increase in attenuation of brain parenchyma. Autopsy revealed elevated levels of cesium in blood and solid organs including the brain. We hypothesize that the imaging findings are attributable to the abnormally elevated level of brain cesium at the time of the CT scan. To our knowledge, this is the first reported case of this imaging finding.

  11. A Comparison between 18F-FDG PET/CT Imaging and Biological and Radiological Findings in Restaging of Hepatoblastoma Patients

    PubMed Central

    Treglia, Giorgio; Pagano, Manuela; Fania, Piercarlo; Basso, Maria Eleonora; Fagioli, Franca; Ficola, Umberto

    2013-01-01

    Background. In this study we retrospectively evaluated if 18F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging. Procedure. Nine patients (mean age: 5.9 years; range: 3.1–12 years) surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI) and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB) were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard. Results. α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but 18F-FDG-PET/CT provided a better definition of disease extent); in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. 18F-FDG-PET/CT showed an agreement of 100% (8/8) with FNAB results. Conclusions. 18F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients. PMID:24063012

  12. Periodontal findings in patients with Hansen's disease.

    PubMed

    Ranganathan, Aravindhan Thiruputkuzhi; Khalid, Waleed; Saraswathy, Ponnandai Krishnamurthy; Chandran, Chitraa Rama; Mahalingam, Lakshmiganthan

    2014-09-01

    To find out whether there are any relationship between leprosy and periodontitis as evidenced by clinical parameters. Fifteen diagnosed patients with Hansen's disease were selected and compared against 50 healthy individuals. Clinical parameters like probing pocket depth and clinical attachment level were evaluated for both the groups and the results were subjected to statistical analysis. Mean probing depth and attachment loss is seen more in patients with Hansen's disease than the healthy controls which are statistically significant. Patients with Hansen's disease tend to have more periodontal destruction than the healthy controls. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  13. [Hypoglycemic encephalopathy demonstrating generalized multiple cortical infarctions--sequential CT findings].

    PubMed

    Isono, O; Araki, S; Shiota, J; Toyota, S; Sugita, K

    1993-11-01

    A fifty-nine-year-old alcoholic man with severe hypoglycemic encephalopathy was examined using sequential CT scans of the brain (CT). Twenty-seven hours after the attack, which resulted in a comatose state, CT disclosed multiple low density areas throughout the cerebral cortex which resembled multiple cortical infarctions. CT obtained four days after the ictus demonstrated more prominent low density areas in the cerebral cortex, diffuse cerebral edema and partial cortical enhancement after administration of contrast medium. Sixteen days after the ictus, the multiple low density areas in the cerebral cortex disappeared. Enhanced CT on day 23 demonstrated marked gyral enhancement throughout the cerebral cortex. Thereafter diffuse brain atrophy progressed rapidly as demonstrated by MRI on day 82 which showed extensive cortical and subcortical atrophy particularly in the frontoparietal and parieto-occipital regions bilaterally with dilated lateral ventricles. Hypoglycemia and anoxia have long been thought to give rise to similar types of brain damage based on neuropathological observations. But it has recently been shown that they are quite different based on neurochemical and neurophysiological findings. Numerous previously reported autopsy cases of hypoglycemia confirm these findings which are neuropathologically similar to the multiple infarction seen in the present case. We conclude that the acute cortical changes of the present case are specific for hypoglycemic encephalopathy. The findings indicate that the basic mechanisms operating in hypoglycemia and anoxia are different.

  14. Visual Assessment of CT Findings in Smokers With Nonobstructed Spirometric Abnormalities in The COPDGene® Study

    PubMed Central

    Kim, Song Soo; Yagihashi, Kunihiro; Stinson, Douglas S.; Zach, Jordan A.; McKenzie, Alexander S.; Curran-Everett, Douglas; Wan, Emily S.; Silverman, Edwin K.; Crapo, James D.; Lynch, David A.

    2014-01-01

    Within the COPD Genetic Epidemiology (COPDGene®) study population of cigarette smokers, 9% were found to be unclassifiable by the Global Initiative for chronic Obstructive Lung Disease (GOLD) criteria. This study was to identify the differences in computed tomography (CT) findings between this nonobstructed (GOLDU) group and a control group of smokers with normal lung function. This research was approved by the institutional review board of each institution. CT images of 400 participants in the COPDGene® study (200 GOLDU, 200 smokers with normal lung function) were retrospectively evaluated in a blinded fashion. Visual CT assessment included lobar analysis of emphysema (type, extent), presence of paraseptal emphysema, airway wall thickening, expiratory air trapping, centrilobular nodules, atelectasis, non-fibrotic and fibrotic interstitial lung disease (ILD), pleural thickening, diaphragmatic eventration, vertebral body changes and internal thoracic diameters (in mm). Univariate comparisons of groups for each CT parameter and multiple logistic regression were performed to determine the imaging features associated with GOLDU. When compared with the control group, GOLDU participants had a significantly higher prevalence of unilateral diaphragm eventration (30% vs. 16%), airway wall thickening, centrilobular nodules, reticular abnormality, paraseptal emphysema (33% vs. 17%), linear atelectasis (60% vs. 35.6%), kyphosis (12% vs. 4%), and a smaller internal transverse thoracic diameter (255 ± 22.5 [standard deviation] vs. 264.8 ± 22.4, mm) (all p<0.05). With multiple logistic regression, all of these CT parameters, except non-fibrotic ILD and kyphosis, remained significantly associated with GOLDU status (p<0.05). In cigarette smokers, chest wall abnormalities and parenchymal lung disease, which contribute to restrictive physiologic impairment, are associated with GOLD-nonobstructed status. PMID:25197723

  15. Imaging of inflammatory bowel disease: CT and MR.

    PubMed

    Zalis, Michael; Singh, Ajay K

    2004-01-01

    Cross-sectional imaging has come to play a central role in the imaging of the abdomen. Concurrent to this, the role of CT and MRI in the imaging of inflammatory bowel disease has also increased in importance. These modalities offer numerous advantages over more traditional methods of radiologic diagnosis, and provide essential information not only for initial diagnosis, but for management, follow-up and detection of potential complications. On the horizon are several derivative techniques involving CT and MRI, potentially in combination with PET imaging; these may further improve the specificity and sensitivity of imaging modalities for diagnosis of inflammatory bowel disease.

  16. Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

    PubMed Central

    Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

    2015-01-01

    Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P < .001) and positive smoking history (P = .001) were associated with increased likelihood of a recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in

  17. [Retrospective study on CT findings on the sternal bone after bone marrow aspiration procedure in hematological patients].

    PubMed

    Fujita, Hiroshi; Nishimura, Shigeko; Oyama, Kazuyuki

    2009-12-01

    We retrospectively studied the CT findings of sternal bone in 129 patients with hematological diseases who underwent bone marrow aspiration in Tokyo Metropolitan Bokutoh Hospital between August 2005 and July 2007. Sternal findings demonstrated sternal foramen (3 cases), incomplete fracture (1 case) and irregularity and decreased bone density of the visceral cortical bone (first intercostal space: 66 cases, third intercostal space: 3 cases). Irregularity and decreased bone density of the visceral cortical bone were significantly related to findings of decreased bone density in the third lumbar spine, indicating osteoporosis. These findings suggest that sternal bones demonstrated various bone diseases such as sternal foramen, fracture and osteoporosis, and that bone marrow aspiration from sternal bones might not be as safe as previously thought.

  18. Food residue granuloma mimicking metastatic disease on FDG-PET/CT.

    PubMed

    Crucitti, Antonio; Grossi, Ugo; Leccisotti, Lucia; Maggi, Fabio; Ricci, Riccardo; Mazzari, Andrea; Tomaiuolo, Pasquina M C; Giordano, Alessandro

    2013-05-01

    A 31-year-old woman presenting with acute abdomen underwent an emergency Hartmann's procedure for fecal peritonitis due to perforated adenocarcinoma of the left colon. Shortly after a 7-month course of adjuvant chemotherapy, follow-up contrast-enhanced CT showed multiple peritoneal and hepatic nodules, showing focal intense and homogeneous FDG uptake on FDG-PET/CT, highly suspected for recurrence of disease. Excisional biopsy of the nodules revealed foreign body granulomas made up of alimentary materials surrounded by a fibrous wall. We report a unique case of a false-positive finding secondary to food residues mimicking metastatic disease on FDG-PET in a patient with colon cancer.

  19. Acute headache and subarachnoid haemorrhage: a retrospective review of CT and lumbar puncture findings.

    PubMed

    O'Neill, J; McLaggan, S; Gibson, R

    2005-11-01

    Assess and correlate the clinical presentation, cranial CT and lumbar puncture (LP) findings in patients presenting with acute headache, clinically suspicious of subarachnoid haemorrhage, from the Accident and Emergency (A/E) department of a main teaching hospital. We retrospectively reviewed over a 1-year period all patients referred for cranial CT from the A/E department, with clinically suspected non-traumatic SAH. Patients with a negative CT, with a diagnosis of SAH on LP, had their initial CT examination reassessed in a double blind review. 116 consecutive patients were included in the study. Patients were divided into 3 groups post CT results: diagnostic of SAH (19), abnormal without evidence of SAH (16) and normal (81). The clinical management of the latter group was analysed with particular emphasis on the performance and results of lumbar puncture (LP). 81 patients, clinically suspicious of SAH in our study had a normal cranial CT and were eligible for LP 49% had an LP, which was positive in 15% and contributed 24% to the total number diagnosed with SAH. LP was not performed in 51% of eligible patients. This study reviews the varying clinical presentations of SAH and the difficulty in clinically diagnosing SAH where headache is the only symptom. We review the wide differential diagnosis on cranial CT and on discharge of patients presenting with symptoms clinically suspicious of SAH. In addition this study identfies a high proportion of patients without detailed clinical notes and discharged without a diagnosis. The study reaffirms that a significant proportion of patients are diagnosed on LP and stress the importance of performing a LP in all cases with clinically suspected SAH with a negative CT This latter point requires highlighting in the medical literature as over half of eligible patients did not have a LP performed despite this being accepted diagnostic protocol.

  20. Imaging features of Paget's disease on (11)C choline PET/CT.

    PubMed

    Leitch, Cameron E; Goenka, Ajit H; Howe, Benjamin M; Broski, Stephen M

    2017-01-01

    The purpose of this study was to investigate the appearance of Paget's disease (PD) on (11)C choline PET/CT and correlate these findings to serum alkaline phosphatase (ALP) level and skeletal scintigraphy. With IRB approval, our institutional (11)C choline PET/CT database (9/2005-6/2015) was searched for patients with PD. Site of osseous involvement, CT appearance, and multiple semi-quantitative measures were measured and correlated with ALP and degree of uptake on bone scan. Our search identified 10 males (mean age 79.6 ± 7.8 years). Four had polyostotic disease and seven had more than one (11)C choline PET/CT. In total, 58 affected bones were evaluated on 25 PET/CTs. Mean lesion SUVmax was 2.6 ± 0.89 (range 1.0-4.4), SUVmax/Liver SUVmean 0.33 ± 0.13 (0.12-0.61), SUVmax/Liver SUVmax 0.29 ± 0.11 (0.10-0.52), SUVmax/BP SUVmean 2.47 ± 0.86 (0.91-4.22), and SUVmax/BP SUVmax 1.92 ± 0.71 (0.68-3.45). There was no correlation between ALP and any semiquantitative measure. Bone scan uptake was marked in 41 bones, moderate in nine, and mild in six. There was no correlation between lesion SUVmax and bone scan uptake (P = 0.26). Paget's disease on (11)C choline PET/CT demonstrates mild to moderate activity, which does not correlate with bone scan uptake or ALP level. It is important to recognize Paget's disease as a potential pitfall on (11)C choline PET/CT. However, the characteristic appearance on the CT portion of PET/CT examinations should allow confident diagnosis and differentiation from prostate cancer osseous metastases.

  1. Semantic analysis of SNOMED CT for a post-coordinated database of histopathology findings

    PubMed Central

    Campbell, Walter S; Campbell, James R; West, William W; McClay, James C; Hinrichs, Steven H

    2014-01-01

    Objective This research investigated the use of SNOMED CT to represent diagnostic tissue morphologies and notable tissue architectures typically found within a pathologist's microscopic examination report to identify gaps in expressivity of SNOMED CT for use in anatomic pathology. Methods 24 breast biopsy cases were reviewed by two board certified surgical pathologists who independently described the diagnostically important tissue architectures and diagnostic morphologies observed by microscopic examination. In addition, diagnostic comments and details were extracted from the original diagnostic pathology report. 95 unique clinical statements were extracted from 13 malignant and 11 benign breast needle biopsy cases. Results 75% of the inventoried diagnostic terms and statements could be represented by valid SNOMED CT expressions. The expressions included one pre-coordinated expression and 73 post-coordinated expressions. No valid SNOMED CT expressions could be identified or developed to unambiguously assert the meaning of 21 statements (ie, 25% of inventoried clinical statements). Evaluation of the findings indicated that SNOMED CT lacked sufficient definitional expressions or the SNOMED CT concept model prohibited use of certain defined concepts needed to describe the numerous, diagnostically important tissue architectures and morphologic changes found within a surgical pathology microscopic examination. Conclusions Because information gathered during microscopic histopathology examination provides the basis of pathology diagnoses, additional concept definitions for tissue morphometries and modifications to the SNOMED CT concept model are needed and suggested to represent detailed histopathologic findings in computable fashion for purposes of patient information exchange and research. Trial registration number UNMC Institutional Review Board ID# 342-11-EP. PMID:24833774

  2. Disease quantification on PET/CT images without object delineation

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Odhner, Dewey; Wu, Caiyun; Fitzpatrick, Danielle; Winchell, Nicole; Schuster, Stephen J.; Torigian, Drew A.

    2017-03-01

    The derivation of quantitative information from images to make quantitative radiology (QR) clinically practical continues to face a major image analysis hurdle because of image segmentation challenges. This paper presents a novel approach to disease quantification (DQ) via positron emission tomography/computed tomography (PET/CT) images that explores how to decouple DQ methods from explicit dependence on object segmentation through the use of only object recognition results to quantify disease burden. The concept of an object-dependent disease map is introduced to express disease severity without performing explicit delineation and partial volume correction of either objects or lesions. The parameters of the disease map are estimated from a set of training image data sets. The idea is illustrated on 20 lung lesions and 20 liver lesions derived from 18F-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT scans of patients with various types of cancers and also on 20 NEMA PET/CT phantom data sets. Our preliminary results show that, on phantom data sets, "disease burden" can be estimated to within 2% of known absolute true activity. Notwithstanding the difficulty in establishing true quantification on patient PET images, our results achieve 8% deviation from "true" estimates, with slightly larger deviations for small and diffuse lesions where establishing ground truth becomes really questionable, and smaller deviations for larger lesions where ground truth set up becomes more reliable. We are currently exploring extensions of the approach to include fully automated body-wide DQ, extensions to just CT or magnetic resonance imaging (MRI) alone, to PET/CT performed with radiotracers other than FDG, and other functional forms of disease maps.

  3. Acute Klebsiella pneumoniae pneumonia alone and with concurrent infection: comparison of clinical and thin-section CT findings.

    PubMed

    Okada, F; Ando, Y; Honda, K; Nakayama, T; Ono, A; Tanoue, S; Maeda, T; Mori, H

    2010-10-01

    The purpose of this study was to identify the clinical and thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia (KPP) alone and with concurrent infection. We retrospectively identified 160 patients with acute KPP who underwent chest thin-section CT examinations between August 1998 and August 2008 at our institution. The study group comprised 80 patients (54 male, 26 female; age range 18-97 years, mean age 61.5) with acute KPP alone, 55 (43 male, 12 female; age range 46-92 years, mean age 76.0) with KPP combined with methicillin-resistant Staphylococcus aureus (MRSA) and 25 (23 male, 2 female; age range 56-91 years, mean age 72.7) with KPP combined with Pseudomonas aeruginosa (PA). Underlying diseases in patients with each type of pneumonia were assessed. Parenchymal abnormalities were evaluated along with enlarged lymph nodes and pleural effusion. In patients with concurrent pneumonia, underlying conditions such as cardiac diseases, diabetes mellitus and malignancy were significantly more frequent than in patients with KPP alone. The mortality rate in patients with KPP combined with MRSA or PA was significantly higher than in those with KPP alone. In concurrent KPP, CT findings of centrilobular nodules, bronchial wall thickening, cavity, bronchiectasis, nodules and pleural effusion were significantly more frequent with concurrent pneumonia than in those with KPP alone.

  4. Intraosseous pneumatocyst of the ilium: CT findings in two cases and literature review.

    PubMed

    Catalano, O; De Rosa, F; Muto, M

    1997-01-01

    Intraosseous pneumatocyst of the ilium is a rare lesion of uncertain origin. It predilects male subjects and may be associated or not with sacroiliac joint degenerative disease, intra-articular gas, sacral pneumatocyst, and communication with the articular space. To our knowledge, only 16 observations have been reported in the literature. We have evaluated with plain radiographs and CT two additional cases. Plain films frequently identify these lesions, but CT is the method of choice in demonstrating their air density and assessing the possible abnormalities of the surrounding bone and sacroiliac joints.

  5. Sonographic and CT Findings of Sialadenosis in a Child with Leukemia

    PubMed Central

    Wen, Yang

    2012-01-01

    Sialadenosis is characterized by asymptomatic bilateral enlargement of the parotid glands. It is uncommon, especially in children. Diagnosis and analysis of sialadenosis based on imaging modalities have been rarely reported. Here, we report a case of sialadenosis in a child with leukemia, in which the diagnosis was made based on sonography and CT findings. PMID:22977332

  6. Sonographic and CT findings of sialadenosis in a child with leukemia.

    PubMed

    Wen, Yang; Goo, Hyun Woo

    2012-01-01

    Sialadenosis is characterized by asymptomatic bilateral enlargement of the parotid glands. It is uncommon, especially in children. Diagnosis and analysis of sialadenosis based on imaging modalities have been rarely reported. Here, we report a case of sialadenosis in a child with leukemia, in which the diagnosis was made based on sonography and CT findings.

  7. CT findings of a unicameral calcaneal bone cyst containing a fluid-fluid level.

    PubMed

    Gallagher, Thomas A; Lim-Dunham, Jennifer E; Vade, Aruna

    2007-03-01

    Calcaneal unicameral bone cysts often contain fluid, but rarely contain fluid-fluid levels. We present a case focusing on the CT findings of a large calcaneal bone cyst with a fluid-fluid level and a review of the literature.

  8. Abdominal CT findings of disseminated Mycobacterium avium-intracellulare in AIDS

    SciTech Connect

    Nyberg, D.A.; Federle, M.P.; Jeffrey, R.B.; Bottles, K.; Wofsy, C.B.

    1985-08-01

    Disseminated infection from Mycobacterium avium-intracellulare (MAI) has recently been recognized as a common and serious complication of the acquired immuno-deficiency syndrome (AIDS). The authors report the computed tomographic (CT) findings of 17 patients with AIDS and disseminated MAI referred for abdominal CT examination. Multiple large retroperitoneal and mesenteric lymph nodes were demonstrated in 14 patients (82%). The authors concluded that large, bulky, intraabdominal adenopathy in AIDS patients should suggest the diagnosis of MAI infection as well as other known causes of adenopathy, including lymphoma and metastatic Kaposi sarcoma. The authors recommend percutaneous aspiration of enlarged intraabdominal lymph nodes to establish the correct diagnosis.

  9. CT imaging findings and endovascular management of isolated spontaneous dissecting aneurysm of celiac artery.

    PubMed

    Rama Krishnan, Rs; Murali, K; Madan, R; Francis, G

    2013-07-01

    Isolated spontaneous dissecting aneurysm of celiac artery without concomitant involvement of aorta is a rare entity and only a few cases are reported in the literature. More cases are being detected recently with greater advancements in CT technology. Clinicians and emergency physicians should be aware of this condition and should include it in the differential diagnosis of patients who present with refractory postprandial epigastric pain, particularly in middle-aged men. We present a case of a 45-year-old male with isolated spontaneous dissecting celiac artery aneurysm, with special emphasis on CT findings and the role of endovascular management.

  10. CT demonstration of a 5th ventricle--a finding to KO boxers?

    PubMed

    Macpherson, P; Teasdale, E

    1988-01-01

    The reported prevalence of 5th ventricles based on air studies varies from 1-12% and ranges up to 60% as an autopsy finding. The prevalence of what is usually an incidental anomaly has not been determined by computed tomography (CT). 5th ventricles are however known to be more common in brain damaged boxers and with the introduction of compulsory CT scanning for certain boxers it is necessary to know what significance to attach to the finding of a cavum in these individuals. To ascertain the prevalence and morphology of 5th ventricles as detected by CT in the population, a thousand consecutive scans were analysed for the presence or absence of a 5th ventricle and other associated midline developmental abnormalities and correlations made with any pathology found. A 5th ventricle was present in 5.5% of the group and in most cases was less than 3 mm wide. An apparent association with other pathology was found only in patients under the age of 15. A 6th ventricle was found in 0.5% while a cavum velum interpositum was present in 9.5%. The isolated finding of a small 5th ventricle on the CT scan of a young active boxer almost certainly represents a persistent congenital anomaly of no significance.

  11. Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

    PubMed Central

    Tonolini, Massimo

    2016-01-01

    Inguinal hernia repair (IHR) with prosthetic mesh implantation is the most common procedure in general surgery, and may be performed using either an open or laparoscopic approach. This paper provides an overview of contemporary tension-free IHR techniques and materials, and illustrates the expected postoperative imaging findings and iatrogenic injuries. Emphasis is placed on multidetector CT, which represents the ideal modality to comprehensively visualize the operated groin region and deeper intra-abdominal structures. CT consistently depicts seroma, mesh infections, hemorrhages, bowel complications and urinary bladder injuries, and thus generally provides a consistent basis for therapeutic choice. Since radiologists are increasingly requested to investigate suspected iatrogenic complications, this paper aims to provide an increased familiarity with early CT studies after IHR, including complications and normal postoperative appearances such as focal pseudolesions, in order to avoid misinterpretation and inappropriate management. PMID:27460285

  12. Particle Disease on Fluoride-18 (NaF) PET/CT imaging

    PubMed Central

    Kuo, Jonathan; Foster, Cameron; Shelton, David

    2011-01-01

    Particle disease is a loss of bone that commonly occurs about five years after arthroplasty. The cause is secondary to microabrasive wear and shedding of any portion of the prosthesis, and the microscopic foreign bodies activate inflammation which can lead to pain. This report describes the imaging findings of an 80-year-old female with particle disease detected with 18F-fluoride PET/CT. PMID:22470793

  13. Samonella-and Shigella-induced ileitis: CT findings in four patients

    SciTech Connect

    Balthazar, E.J.; Charles, H.W.; Megibow, A.J.

    1996-05-01

    The purpose of this study is to describe and illustrate the CT appearance of four cases of acute terminal ileitis induced by nontyphoidal Salmonella and Shigella infection and to review the radiographic and endoscopic findings of these entities. The medical records, CT examinations, and small bowel examinations of three patients with Salmonella ileitis and one patient with Shigella ileitis were retrospectively reviewed. CT examinations were done in four patients, colonoscopy in three patients, and small bowel examinations in two patients. Stool cultures established the diagnosis of nontyphoidal Salmonella enteritis in three patients and Shigella enteritis in one patient. The patients symptoms and clinical findings resolved promptly following supportive therapy and appropriate antibiotic therapy. CT showed slight circumferential and homogeneous thickening of the terminal ileum over a segment of 10-15 cm in patients with Salmonella ileitis. Associated mild thickening of the wall of the colon was present in addition. Small bowel examination performed in one patient revealed a spastic terminal ileum with thickened mucosal folds. Colonoscopy revealed acute colitis involving the colon diffusely in one case, but sparing the distal 50 cm of the colon in one case. CT showed more pronounced thickening of the terminal ileum and a target configuration in the patient with Shigella ileitis. Small bowel examination revealed narrowing, irregular contour, several large nodular defects, and a severely ulcerated mucosa affecting the terminal ileum. Colonoscopy revealed a normal colon and large ulcerations with fibro-purulent exudate in the terminal ileum. In patients with severe Salmonella or Shigella infections or persistent and/or confusing clinical presentations, CT can play a complementary but important role in the initial diagnostic evaluation. 20 refs., 2 figs.

  14. Triage of Limited Versus Extensive Disease on (18)F-FDG PET/CT Scan in Small Cell lung Cancer.

    PubMed

    Saima, Riaz; Humayun, Bashir; Khalid, Niazi Imran

    2017-01-01

    Small cell lung cancer (SCLC) is an aggressive neuroendocrine carcinoma, which accounts for 10-15% of pulmonary cancers and exhibits early metastatic spread. This study aimed to determine the added value of (18)F-FDG PET/CT imaging in tumor, node, and metastasis (TNM) staging of SCLC, compared to the conventional computed tomography (CT) scan and its potential role as a prognosticator. This retrospective review was conducted on 23 patients, who were histopathologically diagnosed to have SCLC and referred for undergoing (18)F-FDG PET/CT scanning during October 2009-December 2015. The rate of agreement between the CT and (18)F-FDG PET/CT findings for TNM staging was calculated using the Cohen's kappa (κ). The median follow-up time was eight months, ranging 27-3 months). The overall and disease-free survival rates were calculated based on the extent of disease. 19 cases were male and four female with the mean age of 58±9 years. The (18)F-FDG PET/CT identified limited and extensive diseases in 2 (8.7%) and 21 (91.3%) patients, respectively. In addition, the results of the Cohen's kappa demonstrated a strong (κ=0.82), fair (κ=0.24), and poor (κ=0.12) agreement between the PET/CT and CT findings for determining tumor, node, and metastasis stages, respectively. The (18)F-FDG PET/CT scans upstaged disease in 47% of the cases with visceral and osseous metastasis. The disease-free survival rates for the limited and extensive diseases were 100% and 23% within the 12-month follow-up. In addition, 8 (35%) patients expired during the follow-up period. Improved nodal and metastatic disease identification highlights the role of (18)F-FDG PET/CT scanning in initial staging of SCLC with prognostic implications.

  15. A case of severe sepsis presenting marked decrease of neutrophils and interesting findings on dynamic CT.

    PubMed

    Makino, Isamu; Tajima, Hidehiro; Kitagawa, Hirohisa; Nakagawara, Hisatoshi; Miyashita, Tomoharu; Nakanuma, Shinichi; Hayashi, Hironori; Takamura, Hiroyuki; Fushida, Sachio; Ohta, Tetsuo

    2015-05-28

    In a patient with severe sepsis, we sometimes observe immediate decrease of the counts of white blood cells (WBCs) and neutrophils, which is known as an indicator for poor prognosis. We observed marked decrease of white blood cells and neutrophils on blood examination and interesting findings on dynamic CT. Here, we present the case of a patient with severe postoperative sepsis occurring after major abdominal surgery and we discuss the mechanism of such clinical presentations. A 60-year-old man received pancreatoduodenectomy with colectomy for pancreatic cancer. He developed a high fever on postoperative day 3. We observed marked decrease of WBCs and neutrophils on blood examination. We also observed slight swelling of the liver, inhomogeneous enhancement of liver parenchyma in arterial phase, and periportal low density in the Glisson capsule in portal phase, without any findings indicating infectious complications on dynamic CT. WBCs and neutrophils increased above normal range in just 6 hours. Blood culture examination performed while the patient had a high fever was positive for Aeromonas hydrophila. After receiving intensive care, he promptly recovered from severe sepsis. The CT findings disappeared on second dynamic CT examination performed 3 days after the first examination. We treated a patient with severe sepsis after major abdominal surgery who presented very rapid change of the counts of WBCs and neutrophils and interesting CT findings in the liver. We rescued him from a critical situation by prompt and intensive treatment. Research is needed to accumulate and analyze data from more patients who present a similar clinical course to better understand their pathophysiological conditions.

  16. Postoperative CT findings in acoustic neurinomas operated upon by a translabyrinthine approach.

    PubMed

    Larsson, E M; Cronqvist, S; Sundbärg, G; Mercke, U; Harris, S

    1986-01-01

    The findings at CT examinations, performed on 46 patients with acoustic neurinomas about 6 months after translabyrinthine surgery, were analyzed and compared with preoperative findings. Direct as well as indirect signs of expansion had disappeared postoperatively. Bulging of cerebellar tissue towards the operative defect in the petrous bone, a finding not connected with local adhesions, was notable. Hypodensity in the vicinity of the removed tumor occurred either due to local widening of the subarachnoid space or due to changes within the cerebellar parenchyma. Local and general widening of the fourth ventricle as a sign of atrophy was a frequent finding.

  17. Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

    PubMed Central

    Ogbole, Godwin I.; Adeleye, Amos O.; Owolabi, Mayowa O.; Olatunji, Richard B.; Yusuf, Bolutife P.

    2015-01-01

    Background: Incidental findings on computed tomography (CT) scans are occasionally noted in patients presenting with head injury. Since it can be assumed that head injured patients are of normal health status before the accident, these findings may be a representation of their frequency in the general population. Our aim was to determine the prevalence of such incidental findings among head injured patients in Nigeria's foremost center of clinical neurosciences. Materials and Methods: We conducted a retrospective review of CT scan images of 591 consecutive eligible patients over a 5-year period (2006-2010) to identify incidental findings. The images were evaluated by consensus agreement of two radiologists. Associations with gender and age were explored using appropriate statistical tests with an alpha level of 0.05. Results: The mean patient age was 34.6 ± 21.2 years, and male to female ratio was 3.2: 1. Incidental findings were noted in 503/591 (85.1 %) of the scans. Intracranial calcification was the commonest finding occurring in 61.8% of patients. Over 90% of the findings were benign. Compared with older ones, patients under the age of 60 were less likely, (P < 0.001), to have incidental findings. Conclusion: Although the majority of incidental findings in this African cohort of head injury patients are benign some clinically significant lesions were detectable. It is therefore recommended that such findings be adequately described in the radiological reports for proper counseling and follow-up. PMID:25949036

  18. Mucinous versus nonmucinous solitary pulmonary nodular bronchioloalveolar carcinoma: CT and FDG PET findings and pathologic comparisons.

    PubMed

    Lee, Ho Yun; Lee, Kyung Soo; Han, Joungho; Kim, Byung-Tae; Cho, Young-Seok; Shim, Young Mog; Kim, Jhingook

    2009-08-01

    We aimed to evaluate the CT, PET, and pathologic findings of solitary pulmonary nodular mucinous and nonmucinous bronchioloalveolar carcinomas (BACs). From August 2003 to March 2008, we saw 24 patients with solitary pulmonary nodular mucinous (n=6) or nonmucinous (n=18) BACs that were resected. CT and PET findings of the lesions were assessed in terms of size, solidity, morphologic characteristics, attenuation and maximum standardized uptake value (mSUV). All nonmucinous BACs appeared as a pure ground-glass opacity (GGO) nodule, whereas mucinous BACs appeared as solid (n=4) or part-solid (n=2) nodules. CT attenuation values were significantly higher for mucinous BACs (-21.0 HU+/-4.9) than for nonmucinous BACs (-491.8 HU+/-172.5) (P<.001). Mean mSUVs were 2.3+/-1.9 for mucinous BACs and 0.5+/-0.8 for nonmucinous BACs (P=.007), but mSUVs were not statistically different after size adjustment (r=0.371, P=.081). Mucinous BACs appear as solid or part-solid nodules at CT, whereas nonmucinous BACs present as pure GGO nodules. Both subtypes of tumors show scant FDG uptake at PET.

  19. Treatment of Alzheimer Disease With CT Scans

    PubMed Central

    Moore, Eugene R.; Hosfeld, Victor D.; Nadolski, David L.

    2016-01-01

    Alzheimer disease (AD) primarily affects older adults. This neurodegenerative disorder is the most common cause of dementia and is a leading source of their morbidity and mortality. Patient care costs in the United States are about 200 billion dollars and will more than double by 2040. This case report describes the remarkable improvement in a patient with advanced AD in hospice who received 5 computed tomography scans of the brain, about 40 mGy each, over a period of 3 months. The mechanism appears to be radiation-induced upregulation of the patient’s adaptive protection systems against AD, which partially restored cognition, memory, speech, movement, and appetite. PMID:27103883

  20. Orbital positron emission tomography/computed tomography (PET/CT) imaging findings in graves ophthalmopathy

    PubMed Central

    2013-01-01

    Background We aimed to describe orbital positron emission tomography/computed tomography (PET/CT) imaging findings, both structural and metabolic, in different clinical stages of Graves ophthalmopathy (GO). This prospective, observational, cross-sectional study examined 32 eyes of 16 patients with GO. Methods Patients were assessed with a complete ophthalmological evaluation and assigned a VISA classification for GO. All patients underwent serum thyroid hormone measurement, antibody profile, and 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT) of the orbits. The 18-FDG uptake on PET images was expressed in terms of maximum standard uptake value (SUVmax). CT images were analyzed, and orbital structures were measured in millimeters. Vision, inflammation, strabismus, and overall appearance were assessed according to the VISA classification system, thyroid hormone levels, antibody values, 18-FDG uptake, and thickness of orbital structures. Results Altogether, 32 eyes of 16 patients (10 women, 6 men; mean age 44.31 ± 13 years, range 20–71 years) were included. Three patients were hypothyroid, seven were euthyroid, and six were hyperthyroid. CT measurements of extraocular muscle diameter were elevated (P < 0.05), and muscle 18-FDG uptake values were increased. Eyes with a clinical VISA inflammation score of ≤ 4 had an average extraocular muscle SUVmax of 3.09, and those with a score of ≥ 5 had an average SUVmax of 3.92 (P = 0.09), showing no clear correlation between clinically observed inflammation and 18-FDG uptake. 18-FDG uptake values also did not show a correlation with extraocular muscle diameter as measured by CT (R2 = 0.0755, P > 0.05). Conclusions We demonstrated a lack of correlation between 18-FDG extraocular muscle uptake and either clinical inflammation score or muscle diameter. Although 18-FDG uptake has been used as an inflammation marker in other pathologies, inflammation in GO may

  1. Comparison of pulmonary CT findings and serum KL-6 levels in patients with cryptogenic organizing pneumonia.

    PubMed

    Okada, F; Ando, Y; Honda, K; Tanoue, S; Matsumoto, S; Mori, H

    2009-03-01

    The aim of this study was to retrospectively compare high-resolution CT findings among cryptogenic organizing pneumonia (COP) patients with normal and elevated serum KL-6 levels. Chest CT scans performed between April 1999 and April 2007 in 20 COP patients with a normal KL-6 level and 17 COP patients with an elevated KL-6 level were evaluated retrospectively by two chest radiologists. The CT findings in the COP patients with either a normal or an elevated KL-6 level mainly consisted of consolidation (n = 17 and n = 13, respectively) followed by ground-glass opacity (n = 11 and n = 13, respectively). Traction bronchiectasis and architectural distortion were significantly more frequent in patients with an elevated KL-6 level than in those with normal levels (n = 7 and n = 1, and n = 13 and n = 3, respectively) (p = 0.0077 and p = 0.00017, respectively). In follow-up CT scans, a relapse within 1 year after initial treatment with steroids, performed in 16 patients with a normal KL-6 level and 16 with an elevated KL-6 level, occurred in 2 (12.5%) patients with a normal KL-6 level and in 6 (37.5%) with an elevated KL-6 level. The frequency of relapse in patients with an elevated KL-6 level was higher than in those with a normal KL-6 level; however, no significant difference between the two groups was observed (p = 0.103). In conclusion, CT findings of traction bronchiectasis and architectural distortion in COP patients are associated with increased serum KL-6 levels, which might be related to a relapse after treatment.

  2. The diagnostic role of abdominal CT imaging findings in adults intussusception: focused on the vascular compromise.

    PubMed

    Park, Sung Bin; Ha, Hyun Kwon; Kim, Ah Young; Lee, Seung Soo; Kim, Hye Jin; Park, Beom Jin; Jin, Yong Hyun; Park, Seong Ho; Kim, Kyoung Won

    2007-06-01

    Intussusception is defined as telescoping of one segment of the gastrointestinal tract into an adjacent one. Unlike that in children, adult intussusception is a relatively rare condition. More than 90% of patients with adult intussusception have been reported to have an organic cause, with benign or malignant tumors for accounting for approximately 65% of the cases. In general, the diagnosis is easily made by means of computed tomography (CT) or magnetic resonance (MR) imaging. The imaging appearance of a bowel-within-bowel configuration with or without contained fat and mesenteric vessels, is pathognomonic. As the intussusceptum enters into the intussuscipiens, the mesentery is carried forward and trapped between the overlapping layers of bowel. The twisting or severe constriction of the mesenteric vessels may result in vascular compromise with subsequent edematous thickening of the involved bowel. In these circumstances, ischemic necrosis may develop if timely intervention is not undertaken. Therefore, determination of the presence or absence of intestinal necrosis in intussusception is important in patient management. On CT, the presence of well-known diagnostic CT criteria for strangulated obstruction (especially severe engorgement or twisting of the mesenteric vessels) as well as evidence of loss of the layered pattern, accumulation of extraluminal fluid collection, and bowel perforation, may suggest the diagnosis of intestinal necrosis. CT and MR imaging are limited in determining the primary disease causing intussusception. However, CT and MR provide excellent pre-operative evaluation, including the possible extension and/or dissemination of a malignant tumor. CT and MR imaging may also be useful in suggesting the presence of vascular compromise.

  3. Scrotal inflammatory disease: color Doppler US findings.

    PubMed

    Horstman, W G; Middleton, W D; Melson, G L

    1991-04-01

    A study of 45 patients with 51 cases of hemiscrotal inflammatory disease was done to determine the color Doppler ultrasonographic appearance of scrotal inflammatory disorders. The diagnosis was ultimately established by means of appropriate response to antibiotic treatment (47 cases) or surgery (four cases). In all cases, there was evidence of hyperemia: an increased number and concentration of detectable vessels in the affected portion of the scrotum. In 17 cases, the gray scale images were normal, and the only evidence of inflammation was the presence of hypervascularity. Abnormally decreased epididymal vascular resistance was detected in 14 cases of epididymitis; abnormally decreased testicular vascular resistance was detected in six cases of orchitis. Spontaneous venous flow was present in 18 patients. The authors conclude that color Doppler can demonstrate the hyperemic response to scrotal inflammatory disease and that, in the proper clinical setting, it can supplement the gray scale findings and increase diagnostic confidence.

  4. Intraabdominal complications secondary to ventriculoperitoneal shunts: CT findings and review of the literature.

    PubMed

    Chung, Jae-Joon; Yu, Jeong-Sik; Kim, Joo Hee; Nam, Se Jin; Kim, Myeong-Jin

    2009-11-01

    The purpose of our study was to evaluate the abdominopelvic CT findings of various intraabdominal complications secondary to ventriculoperitoneal shunts for hydrocephalus and to review the literature. The CT images of 70 patients (33 men and 37 women; mean age, 48.5 years) who underwent ventriculoperitoneal shunt placement and abdominopelvic CT because of shunt-related abdominal symptoms were reviewed retrospectively. CT images were analyzed with regard to the location of the shunting catheter tip; site, size, wall, and septa of localized fluid collection; peritoneal thickening; omentomesentery infiltration; abscess; bowel perforation; abdominal wall infiltration; and thickening of the catheter track wall. The mean period between the last ventriculoperitoneal shunting operation and CT was 11 months (range, 1 week to 115 months), and the mean number of ventriculoperitoneal shunting operations undergone was 1.4 (range, 1-6). A total of 76 ventriculoperitoneal shunting catheters were introduced in 70 patients: 64 patients had a unilateral catheter inserted and six patients had bilateral catheters inserted. Sixteen patients (22.9%) were pathologically diagnosed with ventriculoperitoneal shunt-related complications: 11 cases (15.7%) of shunt infection, six cases (8.6%) of CSF pseudocyst, four cases (5.7%) of abdominal abscess, three cases (4.3%) of infected fluid collection, and one case (1.4%) of bowel perforation. Microorganisms were cultured from the tip of the shunting catheter or peritoneal fluid in 11 patients (15.7%). On abdominopelvic CT, various intraabdominal complications secondary to ventriculoperitoneal shunt were shown, of which, shunt infection was the most common, followed by CSF pseudocyst, abscess, and infected fluid collection.

  5. Pulmonary cryptococcosis: comparison of CT findings in immunocompetent and immunocompromised patients.

    PubMed

    Xie, Li-xuan; Chen, You-san; Liu, Shi-yuan; Shi, Yu-xin

    2015-04-01

    Computed tomography (CT) findings in patients with pulmonary cryptococcosis have been reported, however, many reports were limited by the small number of patients, and not taken into account the distinction between immunocompetent and immunocompromised patients. To retrospectively evaluate thoracic CT findings in patients with pulmonary cryptococcosis whose immune status ranged from normal to severely compromised, and determine characteristic imaging features of pulmonary cryptococcosis between patients with different immune status. CT scan findings of 29 immunocompetent and 43 immunocompromised patients with clinically proven pulmonary cryptococcosis were reviewed retrospectively. Different patterns of CT scan abnormalities between immunocompromised and immunocompetent patients, AIDS and non-AIDS immunocompromised patients were compared by Fisher's exact test. Pulmonary nodules/masses, either solitary or multiple, were the most common CT finding, present in 65 (90.3%) of the 72 patients; associated findings included CT halo sign (n = 24), cavitation (n = 23), and air bronchogram (n = 17). Areas of consolidation (n = 14), areas of GGO (n = 13), linear opacities (n = 11), lymphadenopathy (n = 5), and pleural effusion (n = 8) were uncommon. The parenchymal abnormalities were peripherally located in 47 (65.2%) of the cases. Cavitations within nodules/masses were more frequently present in immunocompromised patients than in immunocompetent patients (P = 0.009), and in AIDS patients than in non-AIDS immunocompromised patients (P = 0.002). Air bronchograms within nodules/masses were more frequent present in immunocompetent patients than in immunocompromised patients (P = 0.005). Nodules/masses with halo sign were less frequent in AIDS patients than those in non-AIDS immunocompromised patients (P = 0.027). Pulmonary cryptococcosis should be considered in the differential diagnosis of solitary or multiple pulmonary nodules

  6. The accordion sign at CT: report of a case of Crohn's disease with diffuse colonic involvement.

    PubMed

    Mountanos, G I; Manolakakis, I S

    2001-01-01

    The accordion sign is a finding that could be seen on CT scans of the abdomen in patients who have received oral contrast material. Initially, it was described as a sign specific of Clostridium difficile colitis, but it is also reported to represent a sign of diffuse colonic edema of several other etiologies. We report a case of a patient with Crohn's pancolitis whose abdominal CT scan presented the accordion sign throughout the entire large bowel together with signs of Crohn's disease of the small bowel.

  7. Small bowel adenocarcinoma in Crohn disease: CT-enterography features with pathological correlation.

    PubMed

    Soyer, Philippe; Hristova, Lora; Boudghène, Frank; Hoeffel, Christine; Dray, Xavier; Laurent, Valérie; Fishman, Elliot K; Boudiaf, Mourad

    2012-06-01

    The aim of this study was to analyze the clinical, pathological, and CT-enterography findings of small bowel adenocarcinomas in Crohn disease patients. Clinical, histopathological, and imaging findings were retrospectively evaluated in seven Crohn disease patients with small bowel adenocarcinoma. CT-enterography examinations were reviewed for morphologic features and location of tumor, presence of stratification, luminal stenosis, proximal dilatation, adjacent lymph nodes, and correlated with findings at histological examination. The tumor was located in the terminal (n = 6) or distal (n = 1) ileum. On CT-enterography, the tumor was visible in five patients, whereas two patients had no visible tumor. Four different patterns were individualized including small bowel mass (n = 2), long stenosis with heterogeneous submucosal layer (n = 2), short and severe stenosis with proximal small bowel dilatation (n = 2), and sacculated small bowel loop with irregular and asymmetric circumferential thickening (n = 1). Stratification, fat stranding, and comb sign were present in two, two, and one patients, respectively. Identification of a mass being clearly visible suggests strongly the presence of small bowel adenocarcinoma in Crohn disease patients but adenocarcinoma may be completely indistinguishable from benign fibrotic or acute inflammatory stricture. Knowledge of these findings is critical to help suggest the diagnosis of this rare but severe complication of Crohn disease.

  8. Inhalational pulmonary talcosis: high-resolution CT findings in 3 patients.

    PubMed

    Marchiori, Edson; Souza Júnior, Arthur Soares; Müller, Nestor L

    2004-01-01

    We describe the high-resolution CT findings in 3 patients with pulmonary talcosis acquired by the inhalation of talc. The predominant abnormalities consisted of small centrilobular and subpleural nodules and conglomerated masses containing focal areas of high attenuation consistent with talc deposition. All patients also had focal ground glass opacities. The abnormalities were diffuse but were most severe in the upper and middle lung zones with relative sparing of the lung bases.

  9. Small bowel obstruction due to phytobezoar formation within meckel diverticulum: CT findings

    SciTech Connect

    Frazzini, V.I. Jr.; English, W.J.; Bashist, B.; Moore, E.

    1996-05-01

    Intestinal obstruction due to a phytobezoar within a Meckel diverticulum is exceedingly rare, with only seven reported cases in the surgical literature. The most important precipitating factor is the ingestion of agents high in fiber and cellulose. Small bowel obstruction in all but one case was due to retrograde propagation of the bezoar into the small bowel lumen. We report the clinical and CT findings in such a patient following a vegetarian diet. 14 refs., 2 figs.

  10. Melorheostosis involving the cervical and upper thoracic spine: radiographic, CT, and MR imaging findings.

    PubMed

    Motimaya, A M; Meyers, S P

    2006-01-01

    Melorheostosis, an uncommon mesenchymal dysplasia, rarely affects the axial skeleton. We describe the imaging findings of melorheostosis involving the cervical and upper thoracic spine. Radiographs and CT showed unilateral well-marginated undulating zones of cortical hyperostosis involving multiple vertebrae that were contiguous with a coalescent ossified right paravertebral mass. MR imaging showed zones of signal intensity void on all pulse sequences without contrast enhancement. Conservative management was elected because of lack of interval clinical and imaging changes for 8 years.

  11. CT and MR findings of Krukenberg tumors: Comparison with primary ovarian tumors

    SciTech Connect

    Kim, Seung Hyup; Kim, Won Hong; Park, Kyung Joo

    1996-05-01

    The purposes of this study were to evaluate the CT and MR findings of Krukenberg tumors and to compare them with those of primary ovarian tumors. This study included 20 patients with Krukenberg tumors and 65 patients with various primary ovarian tumors. CT/MR/both imaging studies were available in 15/1/4 patients with Krukenberg tumor and 31/10/24 patients with primary ovarian tumors, respectively. Imaging findings of the tumors were categorized into three subgroups: a solid mass with intratumoral cysts, a solid mass without intratumoral cysts, and a predominantly cystic mass. Among 32 Krukenberg tumors (bilateral in 12 patients), 22 were solid masses with intratumoral cysts, in 14 of which the wall of the intratumoral cysts showed apparently strong contrast enhancement on CT and/or MRI. Six Krukenberg tumors were solid masses without intratumoral cysts, and four were predominantly cystic masses. Imaging findings of 88 primary ovarian tumors (bilateral in 23 patients) were 5 solid masses with intratumoral cysts, 27 solid masses without intratumoral cysts, and 56 predominantly cystic masses. None of the five primary ovarian tumors with solid mass with intratumoral cysts demonstrated apparently strong contrast enhancement of the cyst wall. Krukenberg tumor should be suspected when one sees solid ovarian tumors containing well demarcated intratumoral cystic lesions, especially if the walls of those cysts demonstrate apparently strong contrast enhancement. 11 refs., 4 figs., 1 tab.

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

    PubMed

    Chen, Jingjing; Wu, Zengjie; Sun, Binbin; Li, Dacheng; Wang, Zhenguang; Liu, Fangjun; Hua, Hui

    2016-05-01

    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.

  13. CT of chronic infiltrative lung disease: Prevalence of mediastinal lymphadenopathy

    SciTech Connect

    Niimi, Hiroshi; Kang, Eun-Young; Kwong, S.

    1996-03-01

    Our goal was to determine the prevalence of mediastinal lymph node enlargement at CT in patients with diffuse infiltrative lung disease. The study was retrospective and included 175 consecutive patients with diffuse infiltrative lung diseases. Diagnoses included idiopathic pulmonary fibrosis (IPF) (n = 61), usual interstitial pneumonia associated with collagen vascular disease (CVD) (n = 20), idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) (n = 22), extrinsic allergic alveolitis (EAA) (n = 17), and sarcoidosis (n = 55). Fifty-eight age-matched patients with CT of the chest performed for unrelated conditions served as controls. The presence, number, and sites of enlarged nodes (short axis {ge}10 mm in diameter) were recorded. Enlarged mediastinal nodes were present in 118 of 175 patients (67%) with infiltrative lung disease and 3 of 58 controls (5%) (p < 0.001). The prevalence of enlarged nodes was 84% (46 of 55) in sarcoidosis, 67% (41 of 61) in IPF, 70% (14 of 20) in CVD, 53% (9 of 17) in EAA, and 36% (8 of 22) in BOOP. The mean number of enlarged nodes was higher in sarcoidosis (mean 3.2) than in the other infiltrative diseases (mean 1.2) (p < 0.001). Enlarged nodes were most commonly present in station 10R, followed by 7, 4R, and 5. Patients with infiltrative lung disease frequently have enlarged mediastinal lymph nodes. However, in diseases other than sarcoid, usually only one or two nodes are enlarged and their maximal short axis diameter is <15 mm. 11 refs., 2 figs., 1 tab.

  14. Calcified plaque: measurement of area at thin-section flat-panel CT and 64-section multidetector CT and comparison with histopathologic findings.

    PubMed

    Sarwar, Ammar; Rieber, Johannes; Mooyaart, Eline A Q; Seneviratne, Sujith K; Houser, Stuart L; Bamberg, Fabian; Raffel, O Christopher; Gupta, Rajiv; Kalra, Mannudeep K; Pien, Homer; Lee, Hang; Brady, Thomas J; Hoffmann, Udo

    2008-10-01

    The purpose of this study was to assess the blooming artifacts in ex vivo coronary arteries at multidetector computed tomography (CT) and flat-panel-volume CT by comparing measured areas of calcified plaque with respect to the reference standard of histopathologic findings. Three ex vivo hearts were scanned with multidetector CT and flat-panel-volume CT after institutional review board approval. The area of calcified plaque was measured at histopathologic examination, multidetector CT, and flat-panel-volume CT. The plaque area was overestimated at multidetector CT by 400% (4.61/1.15) on average, and the predicted difference between the measurements was significant (3.46 mm(2), P = .018). The average overestimation of plaque area at flat-panel-volume CT was twofold (214% [2.18/1.02]), and the predicted difference was smaller (1.16 mm(2), P = .08). The extent of the blooming artifact in visualizing calcified coronary plaque is reduced by using flat-panel-volume CT. (c) RSNA, 2008.

  15. CT Metrics of Airway Disease and Emphysema in Severe COPD

    PubMed Central

    Kim, Woo Jin; Silverman, Edwin K.; Hoffman, Eric; Criner, Gerard J.; Mosenifar, Zab; Sciurba, Frank C.; Make, Barry J.; Carey, Vincent; Estépar, Raúl San José; Diaz, Alejandro; Reilly, John J.; Martinez, Fernando J.; Washko, George R.

    2009-01-01

    Background: CT scan measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT scan-assessed airway disease to objective measures of lung function and respiratory symptoms such as dyspnea in severe emphysema is less clear. Methods: Using data from 338 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study, densitometric measures of emphysema using a threshold of −950 Hounsfield units (%LAA-950) and airway wall phenotypes of the wall thickness (WT) and the square root of wall area (SRWA) of a 10-mm luminal perimeter airway were calculated for each subject. Linear regression analysis was performed for outcome variables FEV1 and percent predicted value of FEV1 with CT scan measures of emphysema and airway disease. Results: In univariate analysis, there were significant negative correlations between %LAA-950 and both the WT (r = −0.28, p = 0.0001) and SRWA (r = −0.19, p = 0.0008). Airway wall thickness was weakly but significantly correlated with postbronchodilator FEV1% predicted (R = −0.12, p = 0.02). Multivariate analysis showed significant associations between either WT or SRWA (β = −5.2, p = 0.009; β = −2.6, p = 0.008, respectively) and %LAA-950 (β = −10.6, p = 0.03) with the postbronchodilator FEV1% predicted. Male subjects exhibited significantly thicker airway wall phenotypes (p = 0.007 for WT and p = 0.0006 for SRWA). Conclusions: Airway disease and emphysema detected by CT scanning are inversely related in patients with severe COPD. Airway wall phenotypes were influenced by gender and associated with lung function in subjects with severe emphysema. PMID:19411295

  16. CT features and pathologic characteristics of IgG4-related systemic disease of submandibular gland.

    PubMed

    Wang, Zhiwei; Feng, Ruie; Chen, Yu; Duan, Miao; Wang, Man; Jin, Zhengyu; Rumboldt, Zoran; Zhang, Zhuhua

    2015-01-01

    The submandibular gland is one of the most frequently affected salivary gland in IgG4-related systemic disease, usually demonstrate homogeneous attenuation on CT imaging as reported, but without much pathological comparison of many cases. This article is to investigate and analyze the typical CT findings and pathologic characteristics of IgG4-related systemic disease (IgG4-RSD) of submandibular gland. A retrospective analysis of the preoperative CT findings in patients with IgG4-RSD of submandibular glands who underwent surgical resection between January 2010 and February 2014 was performed. Twenty patients (16 women) were identified, with a mean age of 58.1±10.2 years. All patients presented with painless submandibular gland swelling. Diffuse gland enlargement, with clear margins and homogeneous density, was found on non-enhanced CT scans in all cases. There were no calcifications or stones within the involved glands. Based on contrast-enhanced CT appearance the patients could be divided into two groups: 11 cases showed homogeneous gland enhancement; and multiple hyperenhancing foci, with a crazy-paving pattern, were detected in 9 cases, which were in consistent with the pathologic findings. The maximum submandibular gland diameter on transverse images was significantly larger (P=0.008) in patients with crazy-paving appearance (32±4 mm) compared to patients with homogeneous enhancement (28±3 mm). It is concluded that the submandibular glands with IgG4-RSD can be characterized by either homogenous appearance or crazy-paving pattern on contrast-enhanced CT imaging.

  17. Fluorine-18 fluorodeoxyglucose PET/CT patterns of extranodal involvement in patients with Non-Hodgkin lymphoma and Hodgkin's disease.

    PubMed

    Even-Sapir, Einat; Lievshitz, Genady; Perry, Chava; Herishanu, Yair; Lerman, Hedva; Metser, Ur

    2007-07-01

    Lymphoma may originate in extranodal sites. Extranodal lymphoma may also be secondary to and accompany nodal disease. Fluorine-18 fluorodeoxyglucose (18F-FDG) imaging has an essential role in the staging of lymphoma, in monitoring the response to therapy, and in detection of recurrence. The introduction of 18F-FDG PET/CT hybrid imaging allows for accurate localization of disease and may be specifically beneficial for the detection of unexpected extranodal sites of disease or exclusion of disease in the presence of nonspecific extranodal CT findings. Accurate staging and localization often dictate the appropriate treatment strategy in patients with lymphoma. Therefore, at any stage in the course of the disease, the potential presence of extranodal disease should be considered when interpreting 18F-FDG PET/CT studies in patients with non-Hodgkin lymphoma and Hodgkin's disease.

  18. Distribution of abdominal and pelvic Hodgkin disease: implications for CT scanning

    SciTech Connect

    Aisen, A.M.; Gross, B.H.; Glazer, G.M.; Amendola, M.A.

    1985-05-01

    Computed tomography of the abdomen and pelvis is frequently performed for the staging of abdominal and pelvic lymphoma. Certain limited CT protocols have been nearly as accurate as more complete examinations at defining the extent of lymphadenopathy and the response to therapy, with the advantages of decreased scanning time and patient radiation dose. The authors reviewed abdominal and pelvic CT scans and reports of 58 patients with Hodgkin disease to determine whether the entire abdomen and pelvis must always be scanned in such patients. Pelvic adenopathy without concurrent abdominal adenopathy was present in only one of 58 patients, and that patient presented clinically with inguinal adenopathy. These findings are supported by larger pathologic studies showing that Hodgkin disease always spreads contiguously. Patients with Hodgkin disease presenting above the diaphragm should undergo abdominal CT for staging; if the abdomen is normal, the pelvis need not be scanned. For Hodgkin patients with clinical or CT evidence of disease below the diaphragm, both abdomen and pelvis should be scanned.

  19. Prevalence of CT features of axial spondyloarthritis in patients with Crohn's disease.

    PubMed

    De Kock, Isabelle; Hindryckx, Pieter; De Vos, Martine; Delrue, Louke; Verstraete, Koenraad; Jans, Lennart

    2017-05-01

    Background The sacroiliac joint and spine are seen on abdominal computed tomography (CT) and may show structural lesions as part of spondyloarthritis. Purpose To determine the prevalence of CT features of spondyloarthritis in patients with Crohn's disease (CD). Material and Methods A retrospective study of structural lesions of spondyloarthritis on abdominal CT was performed. The sacroiliac joints and spine of 120 patients were studied: study group I consisted of 40 patients with known CD and inflammatory back pain, group II involved 40 patients with CD without inflammatory back pain, and group III consisted of 40 patients without known joint or inflammatory bowel disease. Recorded CT features included sclerosis, erosions or ankylosis of the sacroiliac joint, enthesopathy, spinal syndesmophytes, and costovertebral joint lesions. Results CT showed structural lesions of the sacroiliac joints in 19/40 (48%) patients with CD and inflammatory back pain (sclerosis [n = 14; 35%], erosions [n = 14; 35%], ankylosis [n = 3; 8%]), in 8/40 (8%) patients with CD without inflammatory back pain (sclerosis [n = 3; 8%], erosions [n = 4; 10%], ankylosis [n = 3; 8%]), and in 3/40 (8%) patients without known joint or bowel disease (sclerosis [n = 2; 5%], ankylosis [n = 1; 3%]). Syndesmophytes were exclusively seen in group I (n = 6; 15%). Conclusion CT of the abdomen in patients with CD and inflammatory back pain shows structural lesions of the sacroiliac joint, entheses, or spine in almost half of the patients. Awareness and knowledge of these findings may guide the referring clinician to further clinical evaluation, imaging, and biomarker evaluation of the disease.

  20. A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma.

    PubMed

    Yamazaki, Motohiko; Ishikawa, Hiroyuki; Kunii, Ryosuke; Tasaki, Akiko; Sato, Suguru; Ikeda, Yohei; Yoshimura, Norihiko; Hashimoto, Takehisa; Tsuchida, Masanori; Aoyama, Hidefumi

    2015-01-01

    To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma. This retrospective study included 250 consecutive patients who underwent complete resection for ≤ 3-cm pathological stage I (T1-2aN0M0) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC). Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (P<0.05). A combination of these three findings had a greater accuracy in predicting 5-year disease-free survival than did %solid alone (AUC=0.853 versus 0.792; P=0.023), with a sensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were ≥ 48% and ≥ 3.7 ng/mL, respectively. Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Internal Hernias in the Era of Multidetector CT: Correlation of Imaging and Surgical Findings.

    PubMed

    Doishita, Satoshi; Takeshita, Tohru; Uchima, Yasutake; Kawasaki, Masayasu; Shimono, Taro; Yamashita, Akiyoshi; Sugimoto, Michiko; Ninoi, Teruhisa; Shima, Hideki; Miki, Yukio

    2016-01-01

    Clinical diagnosis of internal hernias is challenging because of their nonspecific signs and symptoms. Many types of internal hernias have been defined: paraduodenal, small bowel mesentery-related, greater omentum-related, lesser sac, transverse mesocolon-related, pericecal, sigmoid mesocolon-related, falciform ligament, pelvic internal, and Roux-en-Y anastomosis-related. An internal hernia is a surgical emergency that can develop into intestinal strangulation and ischemia. Accurate preoperative diagnosis is crucial for appropriate management. Multidetector computed tomography (CT), with its thin-section axial images, high-quality multiplanar reformations, and three-dimensional images, currently plays an essential role in preoperative diagnosis of internal hernias. The diagnostic approach to internal hernias at multidetector CT includes detecting an intestinal closed loop, identifying the hernia orifice, and analyzing abnormal displacement of surrounding structures and key vessels around the hernia orifice and hernia sac. At each step, multidetector CT can depict pathognomonic findings. A saclike appearance suggests an intestinal closed loop in several types of internal hernias. Convergence, engorgement, and twisting of mesenteric vessels in the hernia orifice can be seen clearly at multidetector CT, especially with use of multiplanar reformations. For definitive diagnosis of an internal hernia, analysis of displacement of anatomic landmarks around the hernia orifice is particularly important, and thin-section images provide the required information. Detailed knowledge of the anatomy, etiology, and imaging landmarks of the various hernia types is also necessary. Familiarity with the appearances of internal hernias at multidetector CT allows accurate and specific preoperative diagnosis. (©)RSNA, 2015.

  2. Hepatic Parasitic Abscess Caused by Clonorchiasis: Unusual CT Findings of Clonorchiasis

    PubMed Central

    Jang, Yun-Jin; Yoon, Seong Eon; Yu, EunSil

    2007-01-01

    Clonorchiasis is caused by a chronic infestation of liver flukes, Clonorchis sinensis, and these reside mainly in the medium- and small-sized intrahepatic bile ducts. Therefore, diffuse, uniform, minimal or mild dilatation of these bile ducts, particularly in the periphery, without dilatation of the extrahepatic bile duct is the typical finding on several imaging modalities. We report here on the CT findings of an unusual case of hepatic parasitic abscess that was caused by clonorchiasis; this malady mimicked cholangiocarcinoma, and there was no dilatation of the intrahepatic bile ducts. PMID:17277566

  3. Parkinson's disease pharmacogenomics: new findings and perspectives.

    PubMed

    Schumacher-Schuh, Artur F; Rieder, Carlos R M; Hutz, Mara H

    2014-06-01

    Parkinson's disease (PD) is unique among neurodegenerative disorders because a highly effective pharmacological symptomatic treatment is available. The marked variability in drug response and in adverse profiles associated with this treatment led to the search of genetic markers associated with these features. We present a review of the literature on PD pharmacogenetics to provide a critical discussion of the current findings, new approaches, limitations and recommendations for future research. Pharmacogenetics studies in this field have assessed several outcomes and genes, with special focus on dopaminergic genes, mainly DRD2, which is the most important receptor in nigrostriatal pathway. The heterogeneity in methodological strategies employed by different studies is impressive. The question of whether PD pharmacogenetics studies will improve clinical management by causing a shift from a trial-and-error approach to a pharmacological regimen that takes into account the individual variability remains an open question. Collaborative longitudinal studies with larger sample sizes, better outcome definitions and replication studies are required.

  4. Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings

    PubMed Central

    Gui, Benedetta; Danza, Francesco Maria; Valentini, Anna Lia; Laino, Maria Elena; Caruso, Alessandro; Carducci, Brigida; Rodolfino, Elena; Devicienti, Ersilia; Bonomo, Lorenzo

    2016-01-01

    Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture. Pelvic infections include endometritis, abscess, wound infection, and retained product of conception. Radiologists play an important role in the diagnosis and management of postoperative complications as a result of increasing use of multidetector CT in emergency room. The knowledge of normal and abnormal postsurgical anatomy and findings should facilitate the correct diagnosis so that the best management can be chosen for the patient, avoiding unnecessary surgical interventions and additional treatments. In this article we review the surgical cesarean technique and imaging CT technique followed by description of normal and abnormal post-CS CT findings. PMID:27756714

  5. Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings.

    PubMed

    Gui, Benedetta; Danza, Francesco Maria; Valentini, Anna Lia; Laino, Maria Elena; Caruso, Alessandro; Carducci, Brigida; Rodolfino, Elena; Devicienti, Ersilia; Bonomo, Lorenzo

    2016-01-01

    Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture. Pelvic infections include endometritis, abscess, wound infection, and retained product of conception. Radiologists play an important role in the diagnosis and management of postoperative complications as a result of increasing use of multidetector CT in emergency room. The knowledge of normal and abnormal postsurgical anatomy and findings should facilitate the correct diagnosis so that the best management can be chosen for the patient, avoiding unnecessary surgical interventions and additional treatments. In this article we review the surgical cesarean technique and imaging CT technique followed by description of normal and abnormal post-CS CT findings.

  6. Radiological imaging findings of scheuermann disease

    PubMed Central

    Gokce, Erkan; Beyhan, Murat

    2016-01-01

    AIM To find accompanying anomalies of typical and atypical Scheuermann’s disease (SD) is reported in the present study. METHODS Study included 20 patients (16 men and 4 women) who had radiological imaging radiography, magnetic resonance imaging (MRI) and computed tomography, if available, due to back pain, curved back and low back pain in November 2011-February 2016 period. Patients were categorized into typical and atypical patterns based on the region involved. Thoracic kyphosis values were measured using real Cobb angle. Accompanying disc degeneration, herniations and spinal cord pathologies were studied using MRI. RESULTS Age of the patients ranged from 11.0 to 23.0 (mean 17.2 ± 3.0). Typical pattern of SD were detected in 15 patients while atypical pattern were detected in 5 patients. Cobb angle range was 40.2-67.2 (mean 55.5 ± 8.7) in typical Scheuermann’s patients and 24.7-49.9 (mean 36.7 ± 10.8) in atypical ones. Intervertebral level was affected and had the measures of 3-8 (mean 5.3 ± 1.6) and 7-9 (mean 8.2 ± 0.8) in typical and atypical Scheuermann’s patients, respectively. Level of degenerative disc disease in MRI was 1-7 discs (mean 4.1 ± 1.7) in typical patients and 5-10 discs (mean 7.6 ± 1.9) in atypical patients. CONCLUSION SD can be seen in typical and atypical patterns, typical being more frequent. Because degenerative disc diseases, herniations and cord pathologies such as syringomyelia can accompany SD (albeit more common in atypical pattern), it is necessary to evaluate these patients with plain radiography and MRI together. PMID:27928471

  7. [CT-findings in penetrating captive bolt injuries to the head and brain: analysis of the trauma-related CT-findings and review of the literature].

    PubMed

    Bula-Sternberg, J; Laniado, M; Kittner, T; Bonnaire, F; Lein, T; Bula, P

    2011-11-01

    Penetrating gunshot injuries to the head and brain are rare in Germany and the rest of Western Europe. Due to the small number of cases over here no consistent diagnostic and therapeutic standards exist in this respect. Thus these kinds of injuries present a great challenge to the attending physicians. Most of these violations are a result of a suicidal attempt or an accident. Beside violations by firearms also penetrating injuries to the head and brain due to captive bolt devices, as used in slaughtery business for the "humane" killing of animals, occur from time to time. The impact on the head differs from that caused by firearms because no projectile is leaving the barrel and the used bolt, as a fix part of the device, does not remain in the affected tissue. That implies characteristic results within the radiological imaging that might be pathbreaking for the further treatment, because the origin of such a head injury is often unknown during primary care. Consequently the knowledge of these specific findings is central to the radiologist to make the appropriate diagnosis. Based on some clinical examples the trauma-related CT-findings are introduced and a short overview of the relevant literature is also given.

  8. Acute left colonic diverticulitis: can CT findings be used to predict recurrence?

    PubMed

    Poletti, Pierre-Alexandre; Platon, Alexandra; Rutschmann, Olivier; Kinkel, Karen; Nyikus, Vince; Ghiorghiu, Serban; Morel, Philippe; Terrier, François; Becker, Christoph D

    2004-05-01

    We explored CT and demographic predictors for unfavorable outcome of nonoperative treatment in patients with a first event of left colonic diverticulitis. We retrospectively analyzed the medical files and CT scans of 312 consecutive patients who were diagnosed as having diverticulitis on an admission CT report or who had a final diagnosis of left colonic diverticulitis. Patients who did not undergo nonoperative treatment or were lost to follow-up (n = 144) were excluded from the study. Admission CT scans of 168 consecutive patients with a diagnosis of left colonic diverticulitis who underwent nonoperative treatment and had an 18-month follow-up were reassessed by three radiologists unaware of the clinical findings. Nonoperative treatment was defined as an attempt to treat the patient with only antibiotics without scheduling them for elective (delayed) surgery. Unfavorable outcome was defined as a failure of nonoperative treatment 18 months after admission that required either surgery or rehospitalization for antibiotic treatment. The risk of unfavorable outcome was modeled using logistic regression as a function of sex, age, and CT criteria including the maximum number of diverticula per 10 cm of colon; the presence of intraabdominal abscess or extraintestinal gas bubbles (< 5 mm diameter) or gas pockets (>or=5 mm); the length and location of the abnormal colonic segment; the maximum thickness of the colonic wall; the presence of associated free intraperitoneal fluid; and the extent of fatty infiltration. Among these 168 patients, 115 (68%) had an uneventful outcome, but nonoperative treatment failed in 53 (32%). The presence of an abscess (n = 19) or extraintestinal gas pocket (n = 14) were the only CT findings significantly associated with failure of nonoperative treatment. Adjusted odds ratios (95% confidence interval) for failure were 6.18 (1.76-21.68) when an abscess was diagnosed and 4.26 (1.04-17.57) when pockets of free air were observed. Sex and age were

  9. Peripheral arterial occlusive disease: diagnostic performance and effect on therapeutic management of 64-section CT angiography.

    PubMed

    Napoli, Alessandro; Anzidei, Michele; Zaccagna, Fulvio; Cavallo Marincola, Beatrice; Zini, Chiara; Brachetti, Giulia; Cartocci, Gaia; Fanelli, Fabrizio; Catalano, Carlo; Passariello, Roberto

    2011-12-01

    To evaluate the diagnostic performance and effect on therapeutic management of 64-section computed tomographic (CT) angiography in the assessment of steno-occlusive disease in patients with peripheral arterial disease (PAD), with conventional digital subtraction angiography (DSA) as the reference standard. The study protocol was approved by the institutional review board, and written informed consent was obtained from all patients. A total of 212 patients with symptomatic PAD underwent CT angiography and subsequent DSA. For stenosis analysis (≥ 70% stenosis), the arterial bed was divided into 35 segments and evaluated by three readers. Interobserver agreement was determined with generalized κ statistics. Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated. In addition, according to the TransAtlantic Inter-Society Consensus (TASC) Document on Management of Peripheral Arterial Disease guidelines, treatment recommendations based on CT angiographic and DSA findings were compared. McNemar test was used to prove significant differences between CT angiographic and DSA findings. A total of 7420 arterial segments were evaluated, with excellent agreement between readers (κ ≥ 0.928). On a segmental basis, both sensitivity and specificity for stenosis of 70% or more were at least 96% (3072 of 3113 segments and 4141 of 4279 segments, respectively), with an accuracy of 98% (7213 of 7392 segments), a PPV of 96% (3072 of 3187 segments), an NPV of 99% (3141 of 3187 segments), a PLR of 36.7, and an NLR of 0.013. There was no significant difference between CT angiographic and DSA findings (P = .62-.87). In accordance with TASC II guidelines, 49 patients were referred for conservative treatment, 87 underwent endovascular procedures, 38 underwent surgery, and 17 received hybrid treatment. Therapy recommendations based on CT angiographic findings

  10. Correlation between clinical findings and CT scan parameters for shoulder deformities in birth brachial plexus palsy.

    PubMed

    Bhardwaj, Praveen; Burgess, Tanya; Sabapathy, S Raja; Venkataramani, Hari; Ilayaraja, Venkatachalam

    2013-08-01

    The shoulder is the most common site of secondary deformities after birth brachial plexus palsy. The severity and the pattern of deformity vary in patients and have implications for clinical decision making. This study aimed to find the correlation between clinical findings and computed tomography (CT) scan parameters for these deformities. This prospective study included 75 patients aged 3 to 23 years. The clinical parameters included age, extent of involvement (nerve roots affected), degree of shoulder abduction, active and passive external rotation, and Mallet score. These were correlated with 3 CT scan parameters: elevation of the scapula above the clavicle, relative glenoid version, and percentage of the humeral head anterior to the scapular line. There was a significant correlation between lack of active and passive external rotation and relative glenoid version and humeral head subluxation. There was a significant correlation between active abduction and elevation of the scapula above the clavicle. There was no significant correlation between age or Mallet score with any of the CT scan parameters. These results suggest that presence of active and passive external rotation beyond 10° is associated with significantly lesser shoulder deformity irrespective of the degree of shoulder abduction. Hence, a patient with more than 10° external rotation does not need a screening CT scan evaluation regardless of the degree of shoulder abduction present. Conversely, a lack of external rotation beyond 10° strongly suggests relative glenoid retroversion and posterior subluxation of the humeral head and should be considered a clinical indicator of shoulder deformation. Diagnostic II. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Is it Crohn's disease or intestinal tuberculosis? CT analysis.

    PubMed

    Makanjuola, D

    1998-08-01

    A computed tomographic (CT) analysis of 36 patients with differential diagnosis of intestinal tuberculosis (IT) or Crohn's disease (CD) in barium gastrointestinal studies was undertaken to identify distinguishing bowel wall or mesenteric features which could provide a radiological definitive diagnosis. Final diagnoses obtained in 32 cases were tuberculosis (N = 18), CD (N = 9), carcinoid (N = 2), chronic appendicitis (N = 2) and bowel infarction (N = 1). In IT, the bowel wall changes were varied: absence of wall thickening (N = 6), minimal asymmetric wall thickening with and without mucosal tethering (N = 8), minimal symmetric wall thickening often with mild peritonitis (N = 3), exophytic mass encircling bowel lumen (N = 4). Mural stratification (target sign) was not found. CD showed concentric or symmetrical wall thickening ranging from 0.6 to 1.5 mm and mural stratification occurred in about a half of the cases. Lymphadenopathy was the commonest associated feature in both but in IT, the nodes were larger and a third had necrotic centers. Displacement of bowel loops was more often due to enlarged lymphadenopathy in IT while in CD it was frequently due to fibrofatty change. CT was able to provide the correct diagnosis in 26 out of these 32 (81%) cases of indeterminate barium studies. CT is recommended when barium gastrointestinal studies are unable to differentiate between intestinal tuberculosis and Crohn's disease.

  12. Chest CT Features of Cystic Fibrosis in Korea: Comparison with Non-Cystic Fibrosis Diseases

    PubMed Central

    Yang, So Yeon; Cha, Min Jae; Kim, Tae Jung; Kim, Tae Sung; Yoon, Hyun Jung

    2017-01-01

    Objective Cystic fibrosis (CF) is a rare congenital disease in Korea, and its clinical and imaging findings are unclear. The objective of our study was to describe the clinical and CT features of CF in Korea and compare its features with those of other diseases mimicking CF. Materials and Methods From November 1994 to December 2014, a presumptive diagnosis of CF was made in 23 patients based on clinical or radiological examination. After the exclusion of 10 patients without diagnostic confirmation, 13 patients were included in the study. A diagnosis of CF was made with the CF gene study. CT findings were evaluated for the presence and distribution of parenchymal abnormalities including bronchiectasis, tree-in-bud (TIB) pattern, mucus plugging, consolidation, and mosaic attenuation. Results Of the 13 patients, 7 (median age, 15 years) were confirmed as CF, 4 (median age, 19 years) had primary ciliary dyskinesia, 1 had bronchiectasis of unknown cause, and 1 had chronic asthma. CT of patients with CF showed bilateral bronchiectasis, TIB pattern, mosaic attenuation, and mucus plugging in all patients, with upper lung predominance (57%). In CT of the non-CF patients, bilateral bronchiectasis, TIB pattern, mosaic attenuation, and mucus plugging were also predominant features, with lower lung predominance (50%). Conclusion Korean patients with CF showed bilateral bronchiectasis, cellular bronchiolitis, mucus plugging, and mosaic attenuation, which overlapped with those of non-CF patients. CF gene study is recommended for the definitive diagnosis of CF in patients with these clinical and imaging features. PMID:28096734

  13. The role of FDG-PET/CT in the evaluation of residual disease in paediatric non-Hodgkin lymphoma.

    PubMed

    Bhojwani, Deepa; McCarville, Mary B; Choi, John K; Sawyer, Jennifer; Metzger, Monika L; Inaba, Hiroto; Davidoff, Andrew M; Gold, Robert; Shulkin, Barry L; Sandlund, John T

    2015-03-01

    (18) F-labelled-fluorodeoxyglucose positron emission tomography (FDG-PET) findings are challenging to interpret for residual disease versus complete response in paediatric patients with non-Hodgkin lymphoma (NHL). A biopsy is often warranted to confirm the presence or absence of viable tumour if there is clinical or radiographic evidence of residual disease. In this study, we compared conventional imaging and FDG-PET/computerized tomography (CT) findings with biopsy results in 18 children with NHL. Our goal was to provide additional data to establish more reliable criteria for response evaluation. Residual disease was suspected after conventional imaging alone in eight patients, after FDG-PET/CT alone in three and after both modalities in seven patients. Biopsy confirmed the presence of viable tumour in two patients. Two additional patients experienced progressive disease or relapse. The sensitivity and negative predictive value of FDG-PET/CT using the London criteria to indicate residual tumour detectable by biopsy were 100%, but specificity was low (60%), as was the positive predictive value (25%). Thus, in this study, a negative FDG-PET/CT finding was a good indicator of complete remission. However, because false-positive FDG-PET/CT findings are common, biopsy and close monitoring are required for accurate determination of residual disease in individual patients.

  14. Dedicated multi-detector CT of the esophagus: spectrum of diseases.

    PubMed

    Ba-Ssalamah, Ahmed; Zacherl, Johannes; Noebauer-Huhmann, Iris Melanie; Uffmann, Martin; Matzek, Wolfgang Karl; Pinker, Katja; Herold, Christian; Schima, Wolfgang

    2009-01-01

    Multi-detector computed tomography (CT) offers new opportunities in the imaging of the gastrointestinal tract. Its ability to cover a large volume in a very short scan time, and in a single breath hold with thin collimation and isotropic voxels, allows the imaging of the entire esophagus with high-quality multiplanar reformation and 3D reconstruction. Proper distention of the esophagus and stomach (by oral administration of effervescent granules and water) and optimally timed administration of intravenous contrast material are required to detect and characterize disease. In contrast to endoscopy and double-contrast studies of the upper GI tract, CT provides information about both the esophageal wall and the extramural extent of disease. Preoperative staging of esophageal carcinoma appears to be the main indication for MDCT. In addition, MDCT allows detection of other esophageal malignancies, such as lymphoma and benign esophageal tumors, such as leiomyma. A diagnosis of rupture or fistula of the esophagus can be firmly established using MDCT. Furthermore, miscellaneous esophageal conditions, such as achalasia, esophagitis, diverticula, and varices, are incidental findings and can also be visualized with hydro-multi-detector CT. Multi-detector CT is a valuable tool for the evaluation of esophageal wall disease and serves as an adjunct to endoscopy.

  15. Comparison between clinical, ultrasound, CT, MRI, and pathology findings in dogs presented for suspected thyroid carcinoma.

    PubMed

    Taeymans, Olivier; Penninck, Dominique G; Peters, Rachel M

    2013-01-01

    This study compares clinical, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and pathology findings in 16 prospectively, and seven retrospectively recruited dogs presented for suspected thyroid carcinoma. Of these, 17 were confirmed thyroid carcinoma, while six were initially misdiagnosed. These included four carotid body tumors, one para-esophageal abscess, and one undifferentiated squamous cell carcinoma. Thyroid carcinomas occurred in older dogs without evidence of sex predilection, and were more often unilateral. All were large, heterogeneous, moderately to strongly vascularized, and most commonly contained areas of dystrophic mineralization and/or fluid accumulations. On MRI, thyroid carcinomas appeared hyperintense compared to surrounding musculature in all imaging sequences used, while on CT they had a lower attenuation value than normal thyroid gland tissue. Histologically confirmed tumor capsule disruption with invasion of the surrounding structures was most commonly detected with MRI. Palpation was not an accurate predictor of locally invasive vs. well-encapsulated masses. Computed tomography had the highest specificity (100%) and MRI had the highest sensitivity (93%) in diagnosing thyroid carcinoma, while ultrasound had considerably lower results. We conclude that ultrasound is adequate for use as a screening tool for dogs with suspected thyroid carcinoma, but recommend either CT or MRI for preoperative diagnosis and staging.

  16. [Case of spontaneous ventriculocisternostomy: with special reference to a CT finding].

    PubMed

    Yamane, K; Yoshimoto, H; Harada, K; Uozumi, T; Kuwabara, S

    1983-05-01

    Spontaneous ventriculocisternostomy rarely occurs in obstructive hydrocephalus. The authors experienced a case of spontaneous ventriculocisternostomy diagnosed by CT scan with metrizamide and Conray. Patient was 23-year-old male who had been in good health until one month before admission, when he began to have headache and tinnitus. He noticed bilateral visual acuity was decreased about one week before admission and vomiting appeared two days before admission. He was admitted to our hospital because of bilateral papilledema and remarkable hydrocephalus diagnosed by CT scan. On admission, no abnormal neurological signs except for bilateral papilledema were noted. Immediately, right ventricular drainage was performed. Pressure of the ventricle was over 300 mmH2O and CSF was clear. PVG and PEG disclosed an another cavity behind the third ventricle, which was communicated with the third ventricle, and occlusion of aqueduct of Sylvius. Metrizamide CT scan and Conray CT scan showed a communication between this cavity and quadrigeminal and supracerebellar cisterns. On these neuroradiological findings, the diagnosis of obstructive hydrocephalus due to benign aqueduct stenosis accompanied with spontaneous ventriculocisternostomy was obtained. Spontaneous ventriculocisternostomy was noticed to produce arrest of hydrocephalus, but with our case, spontaneous regression of such symptoms did not appeared. In the literature, arrest of hydrocephalus was noted in 50 per cent of 14 cases of obstructive hydrocephalus with spontaneous ventriculocisternostomy. By surgical ventriculocisternostomy (method by Torkildsen, Dandy, or Scarff), arrest of hydrocephalus was seen in about 50 to 70 per cent, which was the same results as those of spontaneous ventriculocisternostomy. It is concluded that VP shunt or VA shunt is thought to be better treatment of obstructive hydrocephalus than the various kinds of surgical ventriculocisternostomy.

  17. CT radiographic findings: atrio-esophageal fistula after transcatheter percutaneous ablation of atrial fibrillation.

    PubMed

    Malamis, Angelo P; Kirshenbaum, Kevin J; Nadimpalli, Surya

    2007-05-01

    Radio-frequency catheter ablation (RFCA) is an ever increasing modality for treating refractory atrial fibrillation. Radiologists should not only be able to interpret and convey anatomic variations of pulmonary veins and left atrium to referring electrophysiologists, but also should be aware of all the post-RFCA complications and their radiographic findings including this rare, but often fatal complication. This report describes a fatal atrio-esophageal fistula (AEF) involving a normal variant single left common pulmonary vein after transcatheter ablation. A 59-year-old man who presented to the Emergency Department (ED) with altered mental status previously complaining of fatigue and malaise. The patient underwent a total of 2 uneventful circumferential percutaneous pulmonary vein ablations for atrial fibrillation. The most recent was performed 5 weeks before admission to ED. Within hours of initial evaluation, the patient quickly deteriorated owing to overwhelming sepsis requiring both inotropic and ventilatory support. Transthoracic echocardiography within ED showed no evidence of valvular vegetation or gas bubbles in the left atrium. Computed tomography (CT) of the chest with intravenous contrast revealed findings compatible with AEF. Head CT was negative for ischemic changes or emboli. Patient underwent emergent cardiac and esophageal surgery at which point the patient later died on the operating table. Patients who present with signs and symptoms of endocarditis, and particularly with new neurologic symptom after RFCA should be promptly evaluated for AEF. In our case, radiographic findings in correlation with clinical history and high suspicion strongly suggested this rare, often fatal complication. During review of the chest CT, particular vigilance should be made to the left pulmonary vein/posterior left atrium junction at which site fistulous tracts tend to occur. Prompt diagnosis necessitates emergent cardiac and esophageal surgery to prevent rapid

  18. 3D documentation and visualization of external injury findings by integration of simple photography in CT/MRI data sets (IprojeCT).

    PubMed

    Campana, Lorenzo; Breitbeck, Robert; Bauer-Kreuz, Regula; Buck, Ursula

    2016-05-01

    This study evaluated the feasibility of documenting patterned injury using three dimensions and true colour photography without complex 3D surface documentation methods. This method is based on a generated 3D surface model using radiologic slice images (CT) while the colour information is derived from photographs taken with commercially available cameras. The external patterned injuries were documented in 16 cases using digital photography as well as highly precise photogrammetry-supported 3D structured light scanning. The internal findings of these deceased were recorded using CT and MRI. For registration of the internal with the external data, two different types of radiographic markers were used and compared. The 3D surface model generated from CT slice images was linked with the photographs, and thereby digital true-colour 3D models of the patterned injuries could be created (Image projection onto CT/IprojeCT). In addition, these external models were merged with the models of the somatic interior. We demonstrated that 3D documentation and visualization of external injury findings by integration of digital photography in CT/MRI data sets is suitable for the 3D documentation of individual patterned injuries to a body. Nevertheless, this documentation method is not a substitution for photogrammetry and surface scanning, especially when the entire bodily surface is to be recorded in three dimensions including all external findings, and when precise data is required for comparing highly detailed injury features with the injury-inflicting tool.

  19. It's not a cervical lymph node, it's a vein: CT and MR imaging findings in the veins of the head and neck.

    PubMed

    Escott, Edward J; Branstetter, Barton F

    2006-01-01

    The anatomy and imaging appearances of the veins of the head and neck can vary considerably, and normal veins may mimic disease processes at computed tomography (CT) and magnetic resonance (MR) imaging. On unenhanced CT scans, aberrant veins may be difficult to differentiate from lymph nodes or other pathologic conditions. Even at contrast material-enhanced CT, differences in venous enhancement or the mixing of opacified with nonopacified blood can lead to confusion, particularly if the vein is focally dilated. Similarly, the size and signal intensity of head and neck veins may vary at MR imaging due to slow or turbulent flow or variable enhancement, resulting in misdiagnosis. A thorough understanding of the normal venous anatomy and common variants is necessary to properly differentiate an unopacified or focally dilated vein from lymphadenopathy or some other disease entity and can help the radiologist avoid the erroneous interpretation of findings.

  20. CT and MRI Findings in a Rare Case of Renal Primitive Neuroectodermal Tumor

    PubMed Central

    Akkaya, Zehra; Peker, Elif; Gulpinar, Basak; Karadag, Hale; Erden, Ayse

    2016-01-01

    Summary Background Primary renal primitive neuroectodermal tumor/extraskeletal Ewing’s sarcoma (PNET/EES) is a very rare renal tumor. Case Report We report a case of primary renal PNET/EES of the kidney in an adult patient and describe its computed tomography and magnetic resonance imaging findings, including diffusion weighted images along with a review of the current medical literature. Conclusions Although very rare, a relatively large renal mass which shows very infiltrative growth pattern on CT and MR imaging and striking diffusion restriction should raise the suspicion of a renal primitive neuroectodermal tumor, in a young adult. PMID:27635170

  1. Secreted frizzled-related protein 1 overexpression in gastric cancer: Relationship with radiological findings of dual-energy spectral CT and PET-CT

    PubMed Central

    Lin, Huimin; Yang, Guoyuan; Ding, Bei; Zhang, Miao; Zhang, Mingjun; Yan, Fuhua; Qu, Ying; Zhang, Huan

    2017-01-01

    We explored the role of secreted frizzled-related protein 1 (sFRP1) overexpression in gastric cancer and its relationship with radiological findings from dual-energy spectral CT(DEsCT) and positron emission tomography/computed tomography (PET/CT). We established mouse metastatic models using the SGC-7901/sFRP1 gastric cancer cell line. A control group was established using the SGC-7901/vector cell line. The models were then scanned with dual-energy spectral CT and PET-CT. Subsequent analysis, including immunohistochemistry and Transferase-mediated deoxyuridine triphosphate-biotin nick end labelling (TUNEL), was performed to confirm the role of sFRP1. Transwell chamber and angiogenesis assays were conducted to verify the effect of sFRP1 in vitro. We found that the control group showed negative radiological performance with successful implantation. Concurrently, the treated group showed visible lesions, a higher FDG uptake and increasing enhancement. The immunological and histological analysis confirmed the positive radiological performance with larger size, increasing proliferation, more microvessels and less apoptosis. The angiogenic up-regulation of sFRP1 overexpression were further verified with in vitro cell models. This preliminary study demonstrates that sFRP1 overexpression in gastric cancer cells leads to increased cell proliferation and angiogenesis, which may, in turn, contribute to positive PET/CT and CT performances. PMID:28169332

  2. Prediction of intracranial findings on CT-scans by alternative modelling techniques

    PubMed Central

    2011-01-01

    Background Prediction rules for intracranial traumatic findings in patients with minor head injury are designed to reduce the use of computed tomography (CT) without missing patients at risk for complications. This study investigates whether alternative modelling techniques might improve the applicability and simplicity of such prediction rules. Methods We included 3181 patients with minor head injury who had received CT scans between February 2002 and August 2004. Of these patients 243 (7.6%) had intracranial traumatic findings and 17 (0.5%) underwent neurosurgical intervention. We analyzed sensitivity, specificity and area under the ROC curve (AUC-value) to compare the performance of various modelling techniques by 10 × 10 cross-validation. The techniques included logistic regression, Bayes network, Chi-squared Automatic Interaction Detection (CHAID), neural net, support vector machines, Classification And Regression Trees (CART) and "decision list" models. Results The cross-validated performance was best for the logistic regression model (AUC 0.78), followed by the Bayes network model and the neural net model (both AUC 0.74). The other models performed poorly (AUC < 0.70). The advantage of the Bayes network model was that it provided a graphical representation of the relationships between the predictors and the outcome. Conclusions No alternative modelling technique outperformed the logistic regression model. However, the Bayes network model had a presentation format which provided more detailed insights into the structure of the prediction problem. The search for methods with good predictive performance and an attractive presentation format should continue. PMID:22026551

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

    PubMed

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

    2014-10-28

    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.

  4. ECG gated NMR-CT for cardiovascular diseases

    SciTech Connect

    Nishikawa, J.; Ohtake, T.; Machida, K.; Iio, M.; Yoshimoto, N.; Sugimoto, T.

    1985-05-01

    The authors have been applying ECG gated NMR-CT to mainly patients with myocardial infarction (MI), and hypertrophic cardiomyopathy (HCM). Thirteen patients with MI, 8 with HCM and 5 without any heart diseases were studied by ECG gated NMR imaging (spin-echo technique, TR: depends on patient heart rate, TE: 35 and 70 msec.) with 0.35 T superconducting magnet. On NMR images (MRI), the authors examined the wall thickness, wall motion and T/sub 2/ relaxation time in the area of diseased myocardium. The lesions of old MI were depicted as the area of thin wall and T/sub 2/ relaxation time of those lesions were similar to the area of non-infarcted myocardium. The lesions of recent MI (up to 3.5 months from the recent attack) were shown as the same wall thickness as the non-infarcted myocardium and the area of prolonged T/sub 2/ relaxation time compared with that of non-infarcted myocardium. MRI demonstrated diffusely thick myocardium in all patients with HCM. T/sub 2/ relaxation time of the areas of HCM was almost the same as that of normal myocardium, and it's difference among each ventricular wall in patients with HCM was not statistically significant. The authors conclude that ECG gated NMR-CT offers 3-D morphological information of the heart without any contrast material nor radioisotopes. ECG gated MRI provides the useful informations to diagnose MI, especially in the differential diagnosis between old and recent MI.

  5. Assessment of non-invasive chronic fungal rhinosinusitis by cone beam CT: comparison with multidetector CT findings.

    PubMed

    Yamauchi, Tomohiko; Tani, Akiko; Yokoyama, Shuji; Ogawa, Hiroshi

    2017-08-09

    To investigate the accuracy of cone beam CT (CBCT) to diagnose non-invasive chronic fungal rhinosinusitis. Preoperative CT evaluation of non-invasive chronic fungal rhinosinusitis was performed by CBCT (3D Accuitomo 170(®)) and traditional multidetector CT (MDCT) (Aquilion 32(®)) in 13 and 38 patients with non-invasive chronic fungal maxillary sinusitis, respectively, in different facilities. Detection of intrasinus calcification was compared between these two groups. Detection of intrasinus calcification in patients with non-invasive chronic fungal maxillary sinusitis was higher in the MDCT group (84.2%) than the CBCT group (46.2%). CBCT is inferior to MDCT in detection of intrasinus calcification in patients with non-invasive chronic fungal maxillary sinusitis. CBCT is frequently used in the screening of the paranasal lesion, but it is not enough to evaluate non-invasive chronic fungal maxillary sinusitis alone. Retrospective study.

  6. Stage IE/IIE extranodal NK/T-cell lymphoma arising in the nasal cavity: analysis of CT findings and their prognostic value.

    PubMed

    Kim, J Y; Lee, S-W; Lee, J H; Suh, C; Yoon, D H; Lee, B-J; Huh, J; Choi, E K; Kim, J H; Song, S Y; Yoon, S M; Kim, Y S; Kim, S S; Park, J-H; Shin, H S; Chang, S-K; Ahn, S D

    2013-07-01

    To investigate the computed tomography (CT) findings in patients with stage IE/IIE extranodal natural killer/T-cell lymphoma (ENKTL) arising in the nasal cavity and to evaluate whether imaging findings revealed by CT have prognostic value. The CT findings of 62 patients diagnosed with IE/IIE ENKTL arising in the nasal cavity were retrospectively reviewed. Imaging findings were investigated, and evaluated imaging findings were analysed for the prognostic value of overall survival (OS) and disease-free survival (DFS). Of the 62 patients, 21 (34%) presented with a superficial infiltrative, 38 (61%) with a mass forming, and three (5%) with a combined pattern. Of all imaging findings, local invasiveness (n = 26, 42%), including bony destruction, erosion, or soft-tissue involvement, was the only independent prognostic factor for OS [p = 0.008; hazard ratio (HR): 3.85; 95% confidence intervals (CI): 1.42-10.44] and DFS (p = 0.001; HR: 4.25; 95% CI: 1.72-10.47). In a subgroup analysis of 36 cases with no local invasiveness, a superficial infiltrative pattern in one nasal cavity was a positive prognostic factor for OS (p = 0.028) and DFS (p = 0.008). Imaging findings at CT provided clinically useful predictions for treatment outcomes. Local invasiveness revealed by CT findings was a strong prognostic factor for poor OS and DFS. In addition, in patients with no local invasiveness, a superficial infiltrative pattern in one nasal cavity predicted favourable OS and DFS. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  7. Repetitive (18)F-FDG-PET/CT in patients with large-vessel giant-cell arteritis and controlled disease.

    PubMed

    de Boysson, Hubert; Aide, Nicolas; Liozon, Eric; Lambert, Marc; Parienti, Jean-Jacques; Monteil, Jacques; Huglo, Damien; Bienvenu, Boris; Manrique, Alain; Aouba, Achille

    2017-08-30

    (18)F-FDG PET/CT can detect large-vessel involvement in giant-cell arteritis (GCA) with a good sensitivity. In patients with clinically and biologically controlled disease, we aimed to assess how vascular uptakes evolve on repetitive FDG-PET/CT. All included patients had to satisfy the 4 following criteria: 1) diagnosis of GCA was retained according to the criteria of the American College of Rheumatology or based on the satisfaction of 2 criteria associated with the demonstration of large-vessel involvement on FDG-PET/CT; 2) all patients had a positive PET/CT that was performed at diagnosis before treatment or within the first 10days of treatment; 3) another FDG-PET/CT was performed after at least 3months of controlled disease without any relapse; 4) patients were followed-up at least for 12months. Twenty-five patients (17 [68%] women, median age: 69 [65-78]) with large-vessel inflammation on a baseline FDG-PET/CT and with repetitive imaging during the period with controlled disease were included and followed-up for 62 [25-95] months. Four repeated procedures revealed total extinction of vascular uptakes at 11.5 [8-12] months after the first FDG-PET/CT. Eight PET/CT revealed decreased numbers of vascular uptakes, and 10 procedures revealed no changes. The 3 remaining procedures indicated worsening of the numbers of vascular uptakes in the absence of relapse. Our study revealed long-term persistent vascular uptake on repeated FDG-PET/CT in >80% of our GCA patients with large-vessel inflammation and clinical-biological controlled disease. Prospective studies are required to confirm these findings. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Computed tomography findings of hepatic veno-occlusive disease caused by Sedum aizoon with histopathological correlation

    PubMed Central

    Shao, H.; Chen, H. Z.; Zhu, J. S.; Ruan, B.; Zhang, Z. Q.; Lin, X.; Gan, M. F.

    2015-01-01

    This study investigated the value of computed tomography (CT) in the diagnosis and treatment of hepatic veno-occlusive disease (HVOD) caused by Sedum aizoon (SA). The clinical manifestations, treatment results, imaging findings, and histological findings of the liver were analyzed in 39 patients with HVOD caused by SA. Hepatomegaly, liver dysfunction, abdominal effusion, and geographic density changes on liver CT scans were found in all 39 patients. The pathological findings of histological liver examination included swelling and point-like necrosis of liver cells, significant expansion and congestion of the sinuses, endothelial swelling, and wall thickening with incomplete lumen occlusion of small liver vessels. CT geographic density changes were confirmed by histological examination of the liver in 18 patients. Sixteen patients with small amounts of ascites that started within 4 weeks of treatment recovered completely or significantly improved after symptomatic and supportive treatment. However, only 43.75% of the patients with larger amounts of ascites improved following symptomatic and supportive treatment. In conclusion, liver CT examination is a valuable, safe, and noninvasive tool for the diagnosis of HVOD caused by SA. In selected cases, liver CT examination may replace liver biopsy and histological analysis. PMID:26517336

  9. Early Head CT Findings Are Associated With Outcomes After Pediatric Out-of-Hospital Cardiac Arrest

    PubMed Central

    Starling, Rebecca M.; Shekdar, Karuna; Licht, Dan; Nadkarni, Vinay M.; Berg, Robert A.; Topjian, Alexis A.

    2015-01-01

    Objectives Head CT after out-of-hospital cardiac arrest is often obtained to evaluate intracranial pathology. Among children admitted to the PICU following pediatric out-of-hospital cardiac arrest, we hypothesized that loss of gray-white matter differentiation and basilar cistern and sulcal effacement are associated with mortality and unfavorable neurologic outcome. Design Retrospective, cohort study. Setting Single, tertiary-care center PICU. Patients Seventy-eight patients less than 18 years old who survived out-of-hospital cardiac arrest to PICU admission and had a head CT within 24 hours of return of spontaneous circulation were evaluated from July 2005 through May 2012. Interventions None. Measurements and Main Results Median time to head CT from return of spontaneous circulation was 3.3 hours (1.0, 6.0). Median patient age was 2.3 years (0.4, 9.5). Thirty-nine patients (50%) survived, of whom 29 (74%) had favorable neurologic outcome. Nonsurvivors were more likely than survivors to have 1) loss of gray-white matter differentiation (Hounsfield unit ratios, 0.96 [0.88, 1.07] vs 1.1 [1.07, 1.2]; p < 0.001), 2) basilar cistern effacement (93% vs 7%; p = 0.001; positive predictive value, 94%; negative predictive value, 59%), and 3) sulcal effacement (100% vs 0%; p ≤ 0.001; positive predictive value, 100%; negative predictive value, 68%). All patients with poor gray-white matter differentiation or sulcal effacement had unfavorable neurologic outcomes. Only one patient with basilar cistern effacement had favorable outcome. Conclusions Loss of gray-white matter differentiation and basilar cistern effacement and sulcal effacement are associated with poor outcome after pediatric out-of-hospital cardiac arrest. Select patients may have favorable outcomes despite these findings. PMID:25844694

  10. Early Head CT Findings Are Associated With Outcomes After Pediatric Out-of-Hospital Cardiac Arrest.

    PubMed

    Starling, Rebecca M; Shekdar, Karuna; Licht, Dan; Nadkarni, Vinay M; Berg, Robert A; Topjian, Alexis A

    2015-07-01

    Head CT after out-of-hospital cardiac arrest is often obtained to evaluate intracranial pathology. Among children admitted to the PICU following pediatric out-of-hospital cardiac arrest, we hypothesized that loss of gray-white matter differentiation and basilar cistern and sulcal effacement are associated with mortality and unfavorable neurologic outcome. Retrospective, cohort study. Single, tertiary-care center PICU. Seventy-eight patients less than 18 years old who survived out-of-hospital cardiac arrest to PICU admission and had a head CT within 24 hours of return of spontaneous circulation were evaluated from July 2005 through May 2012. None. Median time to head CT from return of spontaneous circulation was 3.3 hours (1.0, 6.0). Median patient age was 2.3 years (0.4, 9.5). Thirty-nine patients (50%) survived, of whom 29 (74%) had favorable neurologic outcome. Nonsurvivors were more likely than survivors to have 1) loss of gray-white matter differentiation (Hounsfield unit ratios, 0.96 [0.88, 1.07] vs 1.1 [1.07, 1.2]; p < 0.001), 2) basilar cistern effacement (93% vs 7%; p = 0.001; positive predictive value, 94%; negative predictive value, 59%), and 3) sulcal effacement (100% vs 0%; p ≤ 0.001; positive predictive value, 100%; negative predictive value, 68%). All patients with poor gray-white matter differentiation or sulcal effacement had unfavorable neurologic outcomes. Only one patient with basilar cistern effacement had favorable outcome. Loss of gray-white matter differentiation and basilar cistern effacement and sulcal effacement are associated with poor outcome after pediatric out-of-hospital cardiac arrest. Select patients may have favorable outcomes despite these findings.

  11. Processing of CT images for analysis of diffuse lung disease in the lung tissue research consortium

    NASA Astrophysics Data System (ADS)

    Karwoski, Ronald A.; Bartholmai, Brian; Zavaletta, Vanessa A.; Holmes, David; Robb, Richard A.

    2008-03-01

    2200 patients with 1800 CT scans in the repository for the 5-year effort. Ongoing analysis of the results in the LTRC database by the LTRC participating institutions and outside investigators are underway to look at the clinical and physiological significance of the imaging features of these diseases and correlate these findings with quality of life and other important prognostic indicators of severity. In the future, the quantitative measures of disease may have greater utility by showing correlation with prognosis, disease severity and other physiological parameters. These imaging features may provide non-invasive alternative endpoints or surrogate markers to alleviate the need for tissue biopsy or provide an accurate means to monitor rate of disease progression or response to therapy.

  12. Finding chemical drugs for genetic diseases.

    PubMed

    Sun, Hui-Yong; Hou, Ting-Jun; Zhang, Hong-Yu

    2014-12-01

    Chemical drugs provide alternative treatments for genetic diseases in addition to gene therapy. Inherited diseases arising from gain-of-function (GOF) or loss-of-function (LOF) mutations of certain genes can be ameliorated by the antagonists and/or agonists of the target genes. However, a premise for this chemical therapeutic strategy is that the GOF/LOF mutations in drug targets have a negligible influence on drug-target binding. Here, we analyze the disease-causing mutations [derived from Online Mendelian Inheritance in Man (OMIM)] in successful drug targets. We found that >70% of the mutations are located far from the drug-binding sites (>12 Å), and most of the other mutations are unlikely to have adverse effects on drug binding, supporting the chemical strategy for combating genetic diseases.

  13. CORAL DISEASE & HEALTH CONSORTIUM: FINDING SOLUTIONS

    EPA Science Inventory

    The National Oceanic Atmospheric Administration (NOAA), the Environmental Protection Agency (EPA), and the Department of Interior (DOI) developed the framework for a Coral Disease and Health Consortium (CDHC) for the United States Coral Reef Task Force (USCRTF) through an interag...

  14. CORAL DISEASE & HEALTH CONSORTIUM: FINDING SOLUTIONS

    EPA Science Inventory

    The National Oceanic Atmospheric Administration (NOAA), the Environmental Protection Agency (EPA), and the Department of Interior (DOI) developed the framework for a Coral Disease and Health Consortium (CDHC) for the United States Coral Reef Task Force (USCRTF) through an interag...

  15. Diagnostic Capabilities of 64 Slice CT Coronography Compared to Classic in Coronary Disease Detection

    PubMed Central

    Sehovic, Sanja

    2013-01-01

    Introduction: Cardiovascular disease, among which the most common is coronary disease of the hearth are the main cause of death at middle aged persons in the majority of European countries. Percent of cardiovascular disease in overall mortality among our population is even more than 50%. Up to 55 years of live myocardial infarction is by 5-6 times more common among men, and up to age of 75 years that difference decreases to 2.5 times. Goal: The goal of this study is to determine the diagnostic value of 64 slices computerized tomography in detection of coronary disease compared to classic, invasive coronography. Material and methods: Study included 50 patients, of both genders, at average age of 60 years. Patients underwent CT coronography as well as classic coronography. Results: Our research prove that the sensitivity of MSCT coronography 92% with positive predictive value of 86%. Mayor difference was in the analysis of CX artery in the evaluation of significant and non-significant stenosis in application of these two methods. During the analysis of LAD and RCA artery there was no statistically significant difference in findings of these two methods. Conclusion: CT coronography is non-invasive, comfortable and reliable method in coronary disease diagnostics. Thanks to its high sensitivity and PPV it enables reliable exclusion of coronary disease and takes significant place in a cardiovascular diseases diagnostic algorithm. PMID:24167394

  16. Suture Granuloma With False-Positive Findings on FDG-PET/CT Resected via Laparoscopic Surgery.

    PubMed

    Takeshita, Nobuyoshi; Tohma, Takayuki; Miyauchi, Hideaki; Suzuki, Kazufumi; Nishimori, Takanori; Ohira, Gaku; Narushima, Kazuo; Imanishi, Shunsuke; Toyozumi, Takeshi; Matsubara, Hisahiro

    2015-04-01

    A 61-year-old woman who had undergone total hysterectomy 16 years previously exhibited a pelvic tumor on computed tomography (CT). F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/CT imaging revealed a solitary small focus of increased FDG activity in the pelvis. A gastrointestinal stromal tumor originating in the small intestine or another type of tumor originating in the mesentery (desmoid, schwannoma, or foreign body granuloma) was suspected; therefore, laparoscopic resection was conducted. A white, hard tumor was found to originate from the mesentery of the sigmoid colon and adhered slightly to the small intestine. The tumor was resected with a negative margin, and the pathologic diagnosis was suture granuloma. The possibility of suture granuloma should be kept in mind in cases of tumors with positive PET findings and a history of surgery close to the lesion. However, it is difficult to preoperatively diagnose pelvic tumors using a biopsy. Therefore, considering the possibility of malignancy, it is necessary to achieve complete resection without exposing the tumor.

  17. Relationships among subgross anatomy, computed tomography, and histologic findings in dogs with disease localized to the pulmonary acini.

    PubMed

    Scrivani, Peter V; Thompson, Margret S; Dykes, Nathan L; Holmes, Nedra L; Southard, Teresa L; Gerdin, Jodie A; Bezuidenhout, Abraham J

    2012-01-01

    During computed tomography (CT), the appearance of disease involving the pulmonary acinus may be described using terms such as atelectasis, ground-glass opacity, or consolidation. These CT signs, however, have not been correlated with histologic findings in canine pulmonary disease. To facilitate interpretation of lung diseases by CT signs, our goals were to review the morphologic organization of the lung and evaluate the medical records of four dogs with different types of pulmonary acinar disease. Anatomic review focused on understanding the pulmonary acinus and the secondary pulmonary lobule; the secondary pulmonary lobule is a fundamental unit for interpretation in people. All dogs had similar CT findings of fully expanded lungs with increased attenuation and partial-to-complete obscuring of the pulmonary blood vessels. Histologic findings varied between dogs and included partial-to-complete filling of airspaces with cells or fluid, interstitial thickening, increased capillary blood volume, or a combination of these findings. Final diagnoses were hemorrhagic pneumonia, bronchiolar carcinoma, metastatic mammary adenocarcinoma, and pulmonary edema. In summary, the morphologic organization of the lungs is complex and has implications for diagnostic interpretation needing further evaluation in dogs. In this study, increased lung attenuation during CT due to disease localized to the pulmonary acini was due to the displacement of air from the lungs and not to the microscopic distribution of lesions within the pulmonary acinus. Imaging descriptors that classify diseases according to structures larger than the pulmonary acini, for example, regions of the secondary pulmonary lobule or larger, may be appropriate for dogs.

  18. Multislice CT angiography in coronary artery disease: Technical developments, radiation dose and diagnostic value

    PubMed Central

    Sun, Zhonghua

    2010-01-01

    Multislice computed tomography (CT) angiography has been increasingly used in the detection and diagnosis of coronary artery disease because of its rapid technical evolution from the early generation of 4-slice CT scanners to the latest models such as 64-slice, 256-slice and 320-slice CT scanners. Technical developments of multislice CT imaging enable improved diagnostic value in the detection of coronary artery disease, and this indicates that multislice CT can be used as a reliable less-invasive alternative to invasive coronary angiography in selected patients. In addition, multislice CT angiography has played a significant role in the prediction of disease progression and cardiac events. Despite promising results reported in the literature, multislice CT has the disadvantage of having a high radiation dose which could contribute to the radiation-induced malignancy. A variety of strategies have been currently undertaken to reduce the radiation dose associated with multislice CT coronary angiography while in the meantime acquiring diagnostic images. In this article, the author will review the technical developments, radiation dose associated with multislice CT coronary angiography, and strategies to reduce radiation dose. The diagnostic and prognostic value of multislice CT angiography in coronary artery disease is briefly discussed, and future directions of multislice CT angiography in the diagnosis of coronary artery disease will also be highlighted. PMID:21160611

  19. Cervix carcinoma and incidental finding of medullary thyroid carcinoma by 18F-FDG PET/CT--clinical case.

    PubMed

    Chaushev, Borislav; Bochev, Pavel; Klisarova, Anelia; Yordanov, Kaloyan; Encheva, Elitsa; Dancheva, Jivka; Yordanova, Cvetelina; Hristozov, Kiril; Krasnaliev, Ivan; Radev, Radoslav; Nenkov, Rumen

    2014-01-01

    Thyroid nodules are encountered in clinical practice during the diagnostic procedures or patients' follow-up due to other diseases quite far from the thyroid gland with prevalence 4-50% in general population, depending on age, diagnostic method and race. The prevalence of thyroid nodules increases with age and their clarification should be done for their adequate treatment. An 18F-FDG PET/CT was done with a PET/CT scanner (Philips Gemini TF), consisting of dedicated lutetium orthosilicate full ring PET scanner and 16 slice CT. The PET/CT scan of the whole-body revealed on the CT portion a hypodense nodular lesion in the left lobe of the thyroid gland with increased uptake of 18F-FDG on the PET with SUVmax 10.3 and demonstrated a complete response to the induction therapy of the main oncological disease of the patient--squamous cell carcinoma. This clinical case demonstrates that whole-body 18F-FDG-PET/CT has an increasingly important role in the early evaluation of thyroid cancer as a second independent malignant localization. Focal thyroid lesion with high risk of thyroid malignancy was incidentally found on 18F-FDG PET/CT.

  20. [Osseous abnormalities and CT findings in Stueve-Wiedemann-Syndrome (SWS)].

    PubMed

    Langer, R; Al-Gazali, Li; Haas, D; Raupp, P; Varady, E

    2004-02-01

    Analysis of typical conventional radiological and CT findings in our group of patients with the rare skeletal dysplasia Stueve-Wiedemann-Syndrome (SWS) and comparison with published data. In 16 newborns with clinically dysmorphic features, dwarfism, and bowed limbs, radiographs of the chest and skeleton were obtained for classification of the underlying skeletal dysplasia. For the first time, computed tomography was performed for further investigation of midface hypoplasia. The early diagnosis of SWS could be made by correlation of the radiological and clinical findings. For evaluation of progression, follow-up radiological examinations of the skeleton were performed in four children surviving infancy. Clinically, the newborns with SWS showed dwarfism, midface hypoplasia, bowed extremities with contractures and had severe problems with respiration, feeding, and swallowing as well as episodes of hyperthermia. Skeletal radiographs revealed bowing of the long tubular bones, most pronounced at the lower extremities. Additional findings were internal triangular cortical diaphyseal thickening at the concave side of the bowing, wide metaphyses with abnormal trabecular pattern and radiolucencies. Four patients survived infancy. Clinically, they suffered from recurrent aspiration pneumonia and recurrent episodes of hyperthermia as well as form cutaneous and mucosal infections. The follow-up radiographs showed progressive bowing of the long tubular bones as well as progressive metaphyseal decalcification. Skeletal abnormalities in SWS are so characteristic that an early post partum diagnosis can be made. However, a close cooperation between radiologists, clinicians, and geneticists is required for correlation of clinical and radiological findings. The few cases that survive infancy have progressing orthopaedic problems.

  1. Three-Dimensional CT Findings of Os Calcaneus Secundarius Mimicking a Fracture

    PubMed Central

    Bulut, Mehmet Deniz; Bora, Aydın; Gökalp, Mehmet Ata; Özkaçmaz, Sercan; Batur, Abdussamet

    2014-01-01

    Os calcaneus secundarius is one of several accessory ossicles of the foot that have been identified as normal variants of skeletal development. It may cause ankle pain and may mimic an avulsion fracture of the anterior calcaneal process. A twenty-year-old male was admitted to our institution with right ankle pain following an inversion injury. An axial CT image of the patient's right ankle revealed a shape with smooth and sharp margins, identified as a well-corticated bone fragment in the subtalar region. A diagnosis of an accessory ossicle, os calcaneus secundarius, was made based on radiographic findings. As a result of this case, it is recommended that potential locations of the accessory bones should be well understood in order to prevent misdiagnosis and inappropriate surgical procedures. Os calcaneus secundarius must be considered when an apparent bone fragment or a suspicious fracture line at the anterior region of os calcaneus is demonstrated. PMID:25610694

  2. 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.

  3. Serial changes of (18)F-FDG PET/CT findings in ischiopubic synchondrosis: comparison with contrast-enhanced MRI.

    PubMed

    Tsuji, Kazunobu; Tsuchida, Tatsuro; Kosaka, Nobuyuki; Tanizawa, Akihiko; Kimura, Hirohiko

    2015-01-01

    A 3 years old female patient underwent resection and chemotherapy for a yolk sac tumor of the retroperitoneum. Two years later, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) showed high uptake in the right ischiopubic synchondrosis (IPS), which had a radiolucent structure on CT. The structure showed contrast enhancement on magnetic resonance imaging (MRI), which was a non-specific finding. Six weeks later, a follow-up (18)F-FDG PET/CT scan was performed which showed no abnormal uptake in the IPS. The disappearance of (18)F-FDG uptake preceded that of contrast enhancement on MRI, which was seen 7 months after the initial (18)F-FDG PET/CT scan. This is the first report showing serial changes of (18)F-FDG uptake in IPS, in comparison to MRI findings.

  4. Mammography Findings of Male Breast Diseases

    PubMed Central

    Şafak, Kadihan Yalçın

    2015-01-01

    Over the past 2 decades, the percentage of men presenting with breast complaints has increased from 0.8% to 2.4%, and men now account for 1% of all breast cancer cases. The most common male breast mass is gynecomastia, followed by lipoma and epidermal inclusion cysts. Because there is a paucity of parenchyma as compared with the female breast, the malignancy rapidly progresses to the next stage, with the appearance of secondary signs like nipple retraction, fixation to deeper tissues, skin ulceration or adenopathy. Diagnostic evaluation is needed only when the palpable mass is unilateral, hard, fixed, peripheral to the nipple, or associated with nipple discharge, skin changes, or lymphadenopathy. Male breast cancer usually occurs in a subareolar location or is positioned eccentric to the nipple; occasionally, it occurs in a peripheral position. Secondary signs like skin thickening, nipple retraction, and axillary lymphadenopathy may be seen. Microcalcifications can occur. Mammography can accurately distinguish between malignant and benign male breast disease. Radiologists are generally less familiar with breast disease in males compared with females. In this article, we discuss the clinical, and mammographic features of a variety of benign and malignant diseases that can occur in the male breast.

  5. Specific gastroduodenoscopic findings in Crohn's disease: Comparison with findings in patients with ulcerative colitis and gastroesophageal reflux disease.

    PubMed

    Kuriyama, M; Kato, J; Morimoto, N; Fujimoto, T; Okada, H; Yamamoto, K

    2008-06-01

    Crohn's disease patients often carry gastroduodenal lesions. However, few reports have addressed specific gastroduodenoscopic findings in Crohn's disease patients. The gastroduodenoscopic findings of 63 Crohn's disease patients were examined. Those of 62 ulcerative colitis and 63 age- and gender-matched gastroesophageal reflux disease patients were also reviewed as controls. Findings of bamboo-joint-like appearance, gastric antral erosions, and duodenal lesions were the specific findings that were highlighted. Of 63 Crohn's disease patients, 47 (75%) had at least one of the specific gastroduodenoscopic findings, and the prevalence of these findings was significantly higher in Crohn's disease patients than in ulcerative colitis and gastroesophageal reflux disease patients (ulcerative colitis, 24/62, 39%; gastroesophageal reflux disease, 15/63, 24%, P < 0.0001). In particular, bamboo-joint-like appearance was almost unique to Crohn's disease patients (Crohn's disease, 28/63, 44%; ulcerative colitis, 3/62, 5%; gastroesophageal reflux disease, 0/63, 0%, P < 0.0001). Analysis of the relationship between the Crohn's disease patient's background and gastrodunodenoscopic findings revealed that both patients with disease affecting the ileum and those with previous gut operations were more likely to exhibit the specific gastroduodenoscopic findings (P = 0.030 and P = 0.043, respectively). Specific gastroduodenoscopic findings were observed in Crohn's disease patients. In particular, bamboo-joint-like appearance could be a unique marker of Crohn's disease.

  6. Non-familial degenerative disease and atrophy of brainstem and cerebellum. Clinical and CT data in 47 patients.

    PubMed

    Staal, A; Meerwaldt, J D; van Dongen, K J; Mulder, P G; Busch, H F

    1990-03-01

    We studied the clinical features of 47 patients with a non-hereditary degenerative disease and with atrophy of brainstem or cerebellum or both in CT scanning. There was no relation between the CT findings and duration or severity of the disease, nor with the kind of the neurological signs which comprised ataxia, a hypokinetic rigid syndrome, oculomotor abnormalities, upper and lower motor neuron signs, orthostatic hypotension and dementia. The 2 main diagnoses were olivopontocerebellar atrophy (OPCA), or a combination of OPCA and striatonigral degeneration (SND). The differential diagnosis with Parkinson's disease and progressive supranuclear palsy was discussed. We concluded, that a CT scan is warranted in all cases of suspected Parkinson's disease, especially in those without tremor, and in cases of motoneuron disease with broad-based gait. In our patients with mainly hypokinesia and rigidity, levodopa treatment had no or brief beneficial effects. If ataxia predominated, OPCA appeared the most sensible diagnosis; if a hypokinetic-rigid syndrome predominated, the diagnoses SND plus OPCA appeared the most suitable. We assessed the degree of atrophy on CT subjectively, because an interobserver study of 60 normal CT scans, did not produce reliable measurements.

  7. Evaluation of diagnostic value of CT scan, physical examination and ultrasound based on pathological findings in patients with pelvic masses.

    PubMed

    Firoozabadi, Razieh Dehghani; Karimi Zarchi, Mojgan; Mansurian, Hamid Reza; Moghadam, Bita Rafiei; Teimoori, Soraya; Naseri, Ali

    2011-01-01

    Because benign and malignant cervical and ovarian masses occur with different percentages in different age groups, the importance of primary diagnosis and selection of a suitable surgical procedure is underlined. Diagnosis of pelvic masses is carried out using ultrasound, physical examination, CT scan and MRI. The objective of this study is to evaluate the diagnostic value of CT scan in pelvic masses in comparison with physical examination-ultrasound based on pathology of the lesion in patients undergoing laparotomic surgery. This analytic-descriptive study focused on age, sonographic findings, physical examinations, CT scan and pathological findings in 139 patients with pelvic mass, gathered with questionnaires and statistically analayzed using the SPSS software programme. Of 139 patients with pelvic mass (patients aged from 17 to 75 years old), 62 (44%) cases were diagnosed as benign and 77 (55.4%) as malignant; among them malignant tratoma serocyst adenocarsinoma with 33 (23.7%) cases and benign myoma with 21 (15.2%) cases comprised the most frequent cases. The sensitivity and specificity of sonography-physical examination were 51.9% and 87.9% respectively and the sensitivity and specificity of CT scan images were 79.2% and 91.6% respectively. It was shown that CT scan images were more consistant with pathological findings in predicting appropriate surgical procedures than do sonography-physical examinations. The sensitivity of CT scan is far higher than that of sonography-physical examination in the diagnosis of pelvic mass malignancy.

  8. Nasal endoscopy and paranasal sinus computerised tomography (CT) findings in an Irish cystic fibrosis adult patient group.

    PubMed

    Casserly, P; Harrison, M; O'Connell, O; O'Donovan, N; Plant, B J; O'Sullivan, P

    2015-11-01

    Cystic fibrosis (CF) is a common inherited disorder in Caucasians in Ireland having the highest reported incidence. CF has well-recognised clinical sequelae in several physiological systems. Its' impact on the sinonasal system is less well established. We evaluated symptoms, endoscopic and computerised tomographic (CT) findings in an Irish adult CF group with the aim of characterising the relationship between these clinical features in an Irish CF group. Adult CF patients attending a specialist clinic underwent prospective evaluation of sinonasal symptoms using a specifically designed questionnaire. They subsequently underwent nasoendoscopy and CT scanning of their paranasal sinuses. Abnormalities identified were quantified using established radiological (Lund-Mackay) and endoscopic (Lund-Kennedy) scoring systems. The relationship between symptoms of chronic rhinosinusitis (CRS), endoscopic findings and CT abnormalities were then compared. Sixty-three CF patients (n = 63) were studied. 29 patients had a CT scan. Thirty-three CF patients (52%) had no symptoms of CRS. Fifty CF patients (80% of CF group) had evidence of CRS on nasoendoscopy including thirteen patients (20%) with nasal polyposis. 98% of patients scanned have positive findings on CT scan. There was no significant difference between symptomatic and asymptomatic CF groups with respect to their Lund-Kennedy endoscopic score or their Lund-Mackay CT score. 86% demonstrated one or more hypoplastic sinus. There was no increased incidence of hypoplastic sinuses amongst Δf508 homozygotes than other mutation groups.

  9. Usefulness of F-18 FDG PET/CT in subcutaneous panniculitis-like T cell lymphoma: disease extent and treatment response evaluation.

    PubMed

    Kim, Jin-Suk; Jeong, Young Jin; Sohn, Myung-Hee; Jeong, Hwan-Jeong; Lim, Seok Tae; Kim, Dong Wook; Kwak, Jae-Yong; Yim, Chang-Yeol

    2012-12-01

    BACKGROUND.: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of cutaneous lymphomas, accounting for less than 1% of cases of non-Hodgkin's lymphoma. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron-emission tomography/computed tomography (PET/CT) findings of SPTCL before and after treatment were rarely reported. CASE REPORT.: We report a case of SPTCL in which F-18 FDG PET/CT showed increased FDG accumulations in numerous subcutaneous nodules without extracutaneous disease. Contrast-enhanced CT during F-18 FDG PET/CT showed multiple minimally enhancing nodules with an infiltrative pattern in the subcutaneous layer throughout the body. Follow-up F-18 FDG PET/CT after three cycles of CHOP chemotherapy showed a complete metabolic remission of the lesions. CONCLUSIONS.: F-18 FDG PET/CT is suggested to be useful in assessing the disease activity, extent and treatment response in SPTCL.

  10. Incidental Radiologic Findings at Breast Cancer Diagnosis and Likelihood of Disease Recurrence

    PubMed Central

    Brothers, Joel M; Kidwell, Kelley M; Brown, Richard KJ; Henry, N Lynn

    2016-01-01

    Purpose Despite guidelines recommending against its routine use, perioperative imaging for distant metastases is frequently performed in newly diagnosed breast cancer patients, uncovering incidental findings of uncertain significance. We assessed the clinical significance of incidental findings by determining if their presence is associated with disease recurrence. Methods A retrospective review of staging imaging was performed in patients with stage II or III invasive breast cancer diagnosed 2008–2009 at a large academic medical center. Data related to perioperative imaging and disease recurrence were abstracted from the medical record. Kaplan Meier curves and Cox proportional hazards models were used to assess the association between incidental findings and time to disease recurrence. Results A total of 169 of 340 patients (49.7%) underwent staging evaluation for distant metastases (CT chest, abdomen, pelvis, bone scan, and/or PET-CT). Of these, 146 (86.4%) had at least one suspicious or indeterminate finding. Follow-up studies were performed in 73 (43.2%) patients. Nineteen patients were diagnosed with metastatic disease at diagnosis, 18 of whom had stage III disease. In patients without metastatic disease at diagnosis, 32 later developed recurrence. Non-calcified pulmonary nodules were associated with shorter time to disease recurrence (hazard ratio 2.51, 95% CI 1.13–5.57, p=0.02). Conclusions Imaging for distant metastases frequently reveals indeterminate findings, most of which are not associated with disease recurrence. The association between pulmonary nodules and recurrence warrants validation in an independent cohort. Overall, these findings support current guidelines recommending against routine extent of disease evaluation in patients with newly diagnosed stage II breast cancer. PMID:26797222

  11. Value of CT angiography in anterior circulation large vessel occlusive stroke: Imaging findings, pearls, and pitfalls.

    PubMed

    Power, Sarah; McEvoy, Sinead H; Cunningham, Jane; Ti, Joanna P; Looby, Seamus; O'Hare, Alan; Williams, David; Brennan, Paul; Thornton, John

    2015-07-01

    Hyperacute stroke imaging is playing an increasingly important role in determining management decisions in acute stroke patients, particularly patients with large vessel occlusive stroke who may benefit from endovascular intervention. CT angiography (CTA) is an important tool in the work-up of the acute stroke patient. It reliably detects large occlusive thrombi in proximal cerebral arteries and is a quick and highly accurate method in identifying candidates for endovascular stroke treatment. In this article we review the imaging findings on CTA in acute large vessel occlusive stroke using a pictorial case based approach. We retrospectively reviewed CTA studies in 48 patients presenting with acute anterior circulation large vessel occlusive stroke who were brought for intra-arterial acute stroke intervention. We discuss and illustrate patterns of proximal intracranial arterial occlusion, collateralization to the occluded territory, as well as reviewing some important pearls, pitfalls and teaching points in CTA assessment of the acute stroke patient. Performed from the level of the aortic arch CTA also gives valuable information regarding the state of other vessels in the acute stroke patient, identifying additional significant vascular stenoses or occlusions, and as we illustrate, can demonstrate other clinically significant findings which may impact on patient management and outcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. CT enteroclysis/enterography findings in drug-induced small-bowel damage

    PubMed Central

    Shimizu, K; Hashimoto, S; Onoda, H; Washida, Y; Sakaida, I; Matsunaga, N

    2014-01-01

    Objective: To evaluate the CT enteroclysis (CTE)/enterography findings of patients with small-bowel mucosal damage induced by aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) and to compare these findings with the duration of drug use and endoscopic findings. Methods: CTE findings of 11 patients (22 lesions) with drug-induced small-bowel damage were reviewed, including 8 NSAID users and 3 aspirin users. Three patients were short-term users (6 months or shorter) and eight were long-term users (3 years or longer). Nine patients also underwent videocapsule endoscopy (VCE) or double-balloon enteroscopy (DBE). Results: Small-bowel abnormalities were visible in 8 of 11 patients (73%) on CTE. Multiple lesions were seen in five patients, including all short-term users. Lesions were classified into three types. Type 1 (mucosal patchy enhancement) was found in four of eight patients (50%, 12 lesions) all were short-term users. Small erosions with mild oedema/redness were shown by DBE. Type 2 (homogeneous hyperenhancement) was found in two of eight patients (25%, four lesions) who were long-term users. Large ulcers with marked oedema/redness were shown by DBE. Type 3 (stratification enhancement) was found in four of eight patients (50%, six lesions), both short-term and long-term users. Annular or large ulcers with strictures were shown by VCE or DBE. Conclusion: On CTE, Type 1 lesions in patients with mostly short-term aspirin or NSAID use, Type 2 lesions in patients with long-term use and Type 3 lesions in both types of patients were detected. CTE may have usefulness for the detection of mild damage. Advances in knowledge: Small-bowel abnormalities owing to aspirin or NSAID present with three different patterns on CTE. PMID:25348282

  13. Thoracic computerized tomographic (CT) findings in 2009 influenza A (H1N1) virus infection in Isfahan, Iran

    PubMed Central

    Rostami, Mojtaba; Javadi, Abbas-Ali; Khorvash, Farzin; Mostafavizadeh, Kamyar; Adibi, Atoosa; Babak, Anahita; Ataei, Behrooz; Meidani, Mohsen; Naeini, Alireza Emami; Salehi, Hasan; Avijgan, Majid; Yazdani, Mohammad Reza; Rezaei, Farshid

    2011-01-01

    BACKGROUND: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT) scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1) in an appropriate clinical setting. METHODS: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23rd 2009 to February 20th 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1) virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. RESULTS: Patchy infiltration (34.6%), lobar consolidation (30.8%), and interstitial infiltration (26.9%) with airbronchogram (38.5%) were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8%) showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS). CONCLUSIONS: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1) in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific. PMID:22091280

  14. A challenging diagnosis of late-onset tumefactive multiple sclerosis associated to cervicodorsal syringomyelia: doubtful CT, MRI, and bioptic findings

    PubMed Central

    Conforti, Renata; Capasso, Raffaella; Galasso, Rosario; Cirillo, Mario; Taglialatela, Gemma; Galasso, Luigi

    2016-01-01

    Abstract Background: Tumefactive multiple sclerosis (MS) is an unusual variant of demyelinating disease characterized by lesions with pseudotumoral appearance on radiological imaging mimicking other space-occupying lesions, such as neoplasms, infections, and infarction. Especially when the patient's medical history is incompatible with MS, the differential diagnosis between these lesions constitutes a diagnostic challenge often requiring histological investigation. An older age at onset makes distinguishing tumefactive demyelinating lesion (TDL) from tumors even more challenging. Methods: We report a case of brain TDL as the initial manifestation of late-onset MS associated with cervico-dorsal syringomyelia. A 66-year-old Caucasian woman with a 15-day history headache was referred to our hospital because of the acute onset of paraphasia. She suffered from noncommunicating syringomyelia associated to basilar impression and she reported a 10-year history of burning dysesthesia of the left side of the chest extended to the internipple line level. Results: Computed tomography (CT) and magnetic resonance imaging (MRI) examinations revealed a left frontal lesion with features suspicious for a tumor. Given the degree of overlap with other pathologic processes, CT and MRI findings failed to provide an unambiguous diagnosis; furthermore, because of the negative cerebrospinal fluid analysis for oligoclonal bands, the absence of other lesions, and the heightened suspicion of neoplasia, the clinicians opted to perform a stereotactic biopsy. Brain specimen analysis did not exclude the possibility of perilesional reactive gliosis and the patient, receiving anitiedemigen therapy, was monthly followed up. In the meanwhile, the second histological opinion of the brain specimen described the absence of pleomorphic glial cells indicating a tumor. These findings were interpreted as destructive inflammatory demyelinating disease and according to the evolution of MRI lesion burden, MS

  15. (18)FDG uptake associated with CT density on PET/CT in lungs with and without chronic interstitial lung diseases.

    PubMed

    Inoue, Kentaro; Okada, Ken; Taki, Yasuyuki; Goto, Ryoi; Kinomura, Shigeo; Fukuda, Hiroshi

    2009-05-01

    The dependent-density of computed tomography (CT) images of positron emission tomography (PET)/CT is sometimes difficult to distinguish from chronic interstitial lung disease (ILD) when it accompanies increased (18)F-fluorodeoxy-D: -glucose ((18)FDG) uptake. Though the possible utility of (18)FDG-PET for the diagnosis of active ILD has been reported, the clinical relevance of mild lung (18)FDG uptake in ILD cases without signs and symptoms suggesting acute progression has not been described. This study aimed to test relationships between (18)FDG uptake and lung density on CT using PET/CT in patients with normal lung as well as clinically stable chronic ILD. Thirty-six patients with normal lungs (controls) and 28 patients with chronic ILD (ILD cases) without acute exacerbation were retrospectively selected from (18)FDG-PET/CT scans performed in examination of malignant neoplasms. Elliptical regions of interest (ROIs) were placed on the lung. The relationships between CT density and (18)FDG uptake between the control and ILD cases were tested. The CT density and (18)FDG uptake had a linear correlation in both the controls and the ILD cases without a difference in their regression slopes, and they were overlapped between the controls and the ILD cases with higher mean values in the ILD cases. Lung (18)FDG uptake was considered to reflect a gravity-dependent tissue density in the normal lung. Though the lung (18)FDG uptake as well as the CT density tended to be higher in chronic ILD patients, it may be difficult to distinguish them in normal dependent regions from those related to chronic ILD in some cases.

  16. Hepatic trauma: CT findings and considerations based on our experience in emergency diagnostic imaging.

    PubMed

    Romano, Luigia; Giovine, Sabrina; Guidi, Guido; Tortora, Giovanni; Cinque, Teresa; Romano, Stefania

    2004-04-01

    Abdominal blunt trauma represents the main cause of death in people of age less than 40 years; the liver injury occurs frequently, with an incidence varying from 3 to 10%. Isolated hepatic lesions are rare and in 77-90% of cases, lesions of other organs and viscera are involved. Right hepatic lobe is a frequent site of injury, because it is the more voluminous portion of liver parenchyma; posterior superior hepatic segments are proximal to fixed anatomical structures such as ribs and spine that may have an important role in determining of the lesion. The coronal ligaments' insertion in this parenchymal region augments the effect of acceleration-deceleration mechanism. Associated lesions usually are homolateral costal fractures, laceration or contusion of the inferior right pulmonary lobe, haemothorax, pneumothorax, renal and/or adrenal lesions. Traumatic lesions of left hepatic lobe are rare and usually associated with direct impact on the superior abdomen, such as in car-crash when the wheel causes a compressive effect on thorax and abdomen. Associated lesions to left hepatic lobe injuries correlated to this mechanism are: sternal fractures, pancreatic, myocardial, gastrointestinal tract injuries. Lesions of the caudal lobe are extremely rare, usually not isolated and noted with other large parenchymal lesions. The Institution of Specialized Trauma Centers and the technical progress in imaging methodology developed in the last years a great reduction of mortality. New diagnostic methodologies allow a reduction of negatives laparotomies and allow the possibility of conservative treatment of numerous traumatic lesions; however, therapy depends from imaging findings and clinical conditions of the patient. Computed tomography (CT) certainly presents a large impact on diagnosis and management of patients with lesions from blunt abdominal traumas. It is important to establish a prognostic criteria allowing decisions for conservative or surgical treatment; CT findings

  17. Dentomaxillofacial manifestations of Gaucher's disease: preliminary clinical and radiographic findings

    PubMed Central

    Nobre, RM; Ribeiro, ALR; Alves-Junior, SM; Tuji, FM; Rodrigues Pinheiro, M das G; Pinheiro, LR; Pinheiro, JJV

    2012-01-01

    Objectives A wide variety of manifestations is presented in patients with Gaucher's disease (GD), including bone, haematology and visceral disturbances. This study was conducted to ascertain the main maxillofacial abnormalities by means of clinical survey, panoramic and cone beam CT (CBCT); to compare the patient's group with an age–sex matched control group; and to correlate clinical and radiological data. Methods Ten patients previously diagnosed with GD were submitted to clinical and radiological surveys (CBCT and panoramic radiographs). The examination consisted of anamnesis, extra- and intraoral examinations and analyses of each patient's records. Imaging data were collected from the point of view of 3 observers, and the results compared with a healthy group (20 individuals) by means of statistical analysis (Fisher's exact test). Results Gaucher patients had significantly more manifestations than otherwise healthy carriers. The most prevalent findings were enlarged marrow spaces, generalized osteopenia and effacement of jaw structures (mandibular canal, lamina dura and mental foramen). Here we describe a case in which thickening of the maxillary sinus mucosa was observed on CBCT rather than opacification of the sinus as seen on panoramic radiographs. Pathological fractures, root resorption and delay on tooth eruption were not observed. Conclusions A poor relationship could be observed between clinical and radiological data. Patients showed important bone manifestations, which require careful diagnostic and surgical planning whenever necessary. Although panoramic radiographs have shown significant differences, CBCT is more effective in pointing out differences between patients and a control group, thus showing it as an important tool for evaluation of Gaucher patients. PMID:22988312

  18. Study on Neurological Manifestations of Eclampsia & Findings of CT scan of Brain.

    PubMed

    Begum, F; Nahar, K; Ahmed, M U; Ferdousi, R A; Akter, F A; Rahman, M M

    2015-10-01

    This cross sectional study was carried out in the Department of Obstetrics & Gynaecology in Mymensingh Medical College Hospital during the period of January 2011 to December 2012 to evaluate neurological manifestations in eclampsia by CT scan of brain. A total 35 patients with eclampsia were studied, who underwent CT scan of brain in Radiology & Imaging Department of Mymensingh Medical College Hospital. The study patients were divided into two groups, those who had changes in brain on CT scan (Group A) & those who had no changes in brain on CT scan (Group B). Finally the study variables were compared between these two groups. Each selected patient fulfilling the criteria was sent to the department of Radiology & Imaging for CT scanning of brain. In antepartum cases of eclampsia CT scan of brain were done after delivery/ termination of pregnancy. In all cases, CT scan of brain was done within 72 hours of admission. Out of 35 patients total 85.72% had changes in brain on CT scan & 14.28% had no changes in brain on CT scan. Among them 45.72% patients had cerebral oedema, 37.14% had cerebral infarct & 2.86% patients had intracerebral haemorrhage. Comparison of neurological parameters were done & showed that there were statistically significant difference between the two groups regarding headache, visual disturbance, hypereflexia & depression of consciousness. There was no statistically significant difference regarding aphasia & hemiplegia between the two groups. So the CT scan of brain has been useful in demonstrating the lesion of brain in patients with eclampsia & also helpful to evaluate the neurological manifestations in eclampsia.

  19. Multi-detector CT assessment in pulmonary hypertension: techniques, systematic approach to interpretation and key findings.

    PubMed

    Lewis, Gareth; Hoey, Edward T D; Reynolds, John H; Ganeshan, Arul; Ment, Jerome

    2015-06-01

    Pulmonary arterial hypertension (PAH) may be suspected based on the clinical history, physical examination and electrocardiogram findings but imaging is usually central to confirming the diagnosis, establishing a cause and guiding therapy. The diagnostic pathway of PAH involves a variety of complimentary investigations of which computed tomography pulmonary angiography (CTPA) has established a central role both in helping identify an underlying cause for PAH and assessing resulting functional compromise. In particular CTPA is considered as the gold standard technique for the diagnosis of thromboembolic disease. This article reviews the CTPA evaluation in PAH, describing CTPA techniques, a systematic approach to interpretation and spectrum of key imaging findings.

  20. Natural history of atherosclerotic disease progression as assessed by (18)F-FDG PET/CT.

    PubMed

    Hetterich, Holger; Rominger, Axel; Walter, Lisa; Habs, Maximilian; Volpers, Sarah; Hacker, Marcus; Reiser, Maximilian F; Bartenstein, Peter; Saam, Tobias

    2016-01-01

    The aim of this study was to assess the impact of cardiovascular risk factors and plaque inflammation on the progression of atherosclerosis as assessed by positron emission tomography/computed tomography (PET/CT) imaging with (18)F-radiolabled fluorodeoxyglucose ((18)F-FDG). This study was designed as a retrospective cohort study. Patients who received a (18)F-FDG PET/CT scan and follow-up scan 9-24 months later without systemic inflammation or steroid medication were eligible for the study. (18)F-FDG PET/CT included a full diagnostic contrast enhanced CT scan. Cardiovascular risk factors and medication were documented. Calcified plaque volume, lumen area and (18)F-FDG uptake, quantified by the target-to-background ratio (TBR), were measured in the carotid arteries, aorta and iliac arteries. Influence of cardiovascular risk factors and vessel wall inflammation on atherosclerotic disease progression was analyzed. Ninety-four patients underwent baseline and follow-up whole body (18)F-FDG PET/CT (mean follow-up time 14.5 ± 3.5 months). Annualized calcified plaque volume increased by 15.4 % (p < 0.0001), carotid and aortic lumen area decreased by 10.5 % (p < 0.0001) and 1.7 % (p = 0.045). There was no significant difference in (18)F-FDG uptake at baseline and follow-up (mean TBR 1.44 ± 0.18 vs. 1.42 ± 0.19, p = 0.18). Multiple linear regression analysis identified hypertension as an independent predictor for total, aortic and iliac calcified plaque volume progression (all p < 0.04). Carotid lumen reduction was predicted by hypercholesterolemia (p = 0.008) while aortic lumen reduction was associated with BMI and mean (18)F-FDG uptake (p ≤ 0.005). Furthermore we observed a dose response relationship between the number of cardiovascular risk factors and calcified plaque volume progression in the aorta (p = 0.03). Findings from this study provide data on the natural history of atherosclerotic disease burden in multiple vascular beds and emphasize the value of

  1. The role of HRCT and three-dimensional VR CT findings in patients of congenital atresia combined with microtia.

    PubMed

    Gao, Ruzhen; Wang, Yun; Fan, Yue; Ai, Xing; Zhang, Xiaona; Xue, Huadan; Chen, Xiaowei; Jin, Zhengyu

    2012-12-01

    To determine the anatomic differences in patients of atresia by using high-resolution computed tomography (HRCT) and 3D volume rendered (VR) CT. High-resolution computed tomography (HRCT) was performed in 43 atresia patients including 34 unilateral atresia patients (n=34, 26 males, 8 females, mean age 13.82 years, range 8-19 years) and 9 bilateral atresia patients (6 males, 3 females, mean age 13.2 years, range 9-19 years). HRCT and 3D VR findings were compared with those in 43 normal ears of the unilateral atresia patients with normal PTA results (n=34, 26 males, 8 females, mean age 13.82 years, range 8-19 years) and 11 patients with sensorineural hearing loss but with no associated aplasia of the middle and inner ear (n=22, 7 males and 4 females, range 8-20.8 years, median age of 13.4 years) by using the independent one sample T test. On the HRCT images, the angle between the basic line and the tympanic segment of the facial nerve is more acute. And the area of the malleus-incus-joint or the malleus-incus-complex in the diseased ears is smaller than that in the control subjects (P<0.05). The tympanic segment is shorter and the area of the tympanic cavity is smaller in the atresia group, while the diameter of the oval window is also smaller in atresia group than that in the control group (P<0.05). The morphologic differences of the small ossicles and the entire length of the tympanic and mastoid segments can be depicted on a single 3D VR CT image. The facial nerve demonstrates abnormal lateral and anterior displacement in the CAA patients and the area of the Malleus-incus-joint and the tympanic cavity are significantly smaller, and the oval window is much narrower in the control group. HRCT and 3D VR CT provide valuable information about preoperative planning of patients with CAA. Measurements of all the angles and length serve as useful adjunct measurements in determining surgical candidacy. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Primary clear cell carcinoma in the liver: CT and MRI findings

    PubMed Central

    Liu, Qing-Yu; Li, Hai-Gang; Gao, Ming; Lin, Xiao-Feng; Li, Yong; Chen, Jian-Yu

    2011-01-01

    AIM: To retrospectively analyze the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of primary clear cell carcinoma of the liver (PCCCL) and compare the imaging appearances of PCCCL and common type hepatocellular carcinoma (CHCC) to determine whether any differences exist between the two groups. METHODS: Twenty cases with pathologically proven PCCCL and 127 cases with CHCC in the Second Affiliated Hospital of Sun Yat-sen University were included in this study. CT or MRI images from these patients were retrospectively analyzed. The following imaging findings were reviewed: the presence of liver cirrhosis, tumor size, the enhancement pattern on dynamic contrast scanning, the presence of pseudo capsules, tumor rupture, portal vein thrombosis and lymph node metastasis. RESULTS: Both PCCCL and CHCC were prone to occur in patients with liver cirrhosis, the association rate of liver cirrhosis was 80.0% and 78.7%, respectively (P > 0.05). The mean sizes of PCCCL and CHCC tumors were (7.28 ± 4.25) cm and (6.96 ± 3.98) cm, respectively. Small HCCs were found in 25.0% (5/20) of PCCCL and 19.7% (25/127) of CHCC cases. No significant differences in mean size and ratio of small HCCs were found between the two groups (P = 0.658 and 0.803, respectively). Compared with CHCC patients, PCCCL patients were more prone to form pseudo capsules (49.6% vs 75.0%, P = 0.034). Tumor rupture, typical HCC enhancement patterns and portal vein tumor thrombosis were detected in 15.0% (3/20), 72.2% (13/18) and 20.0% (4/20) of patients with PCCCL and 3.1% (4/127), 83.6% (97/116) and 17.3% (22/127) of patients with CHCC, respectively. There were no significant differences between the two groups (all P > 0.05). No patients with PCCCL and 2.4% (3/127) of patients with CHCC showed signs of lymph node metastasis (P > 0.05). CONCLUSION: The imaging characteristics of PCCCL are similar to those of CHCC and could be useful for differentiating these from other liver tumors (such

  3. Posteromedial olecranon impingement of the pitching elbow: Additional findings provided by CT.

    PubMed

    Ko, Ching Chung; Tai, Ming Hong; Lin, Chien Hung; Tzeng, Wen Sheng; Chen, Jeon Hor; Shu, Ginger; Da Wu, Chung; Chen, Clement Kuen Huang

    2016-01-01

    Posteromedial olecranon impingement (PMOI) is the most common diagnosis in baseball players with throwing-induced elbow injuries. CT imaging manifestations of PMOI have seldom been previously reported. Our purpose is to investigate the additional value of CT imaging in the evaluation of PMOI. From July 2010 to December 2013, 47 baseball players with throwing-induced elbow pain received imaging studies (CT and/or MRI) of the elbow at our institution. After retrospectively reviewing the clinical records and imaging studies, 31 of the 47 players were diagnosed with PMOI by the criteria of posteromedial elbow pain with clinical consistency for PMOI and characteristic osteoarthrosis at the posteromedial ulnotrochlear articulation (posteromedial olecranon space, PMOS) detected by CT and/or MRI. The imaging modalities of these 31 players including radiography, CT, and MRI were reviewed by 2 experienced musculoskeletal radiologists. The most common imaging manifestations of PMOI by CT or MRI include joint space narrowing, subchondral sclerosis, and osteophytes at the PMOS. CT was superior to MRI with a statistically significant (P<0.05) difference in detecting joint space narrowing, medial olecranon subluxation, as well as the number of loose bodies. In contrast, bone marrow edema and associated soft tissue injuries in PMOI are more readily observed on MRI. CT is superior in identifying some imaging features of PMOI. Whenever PMOI is diagnosed in the pitching elbow of a baseball player, CT should be considered prior to surgical intervention as it will often provide additional information to the surgeon that may alter surgical management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Findings

    MedlinePlus

    ... Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry ... Glycobiology, Synthesis, Natural Products, Chemical Reactions Computers in Biology Bioinformatics, Modeling, Systems Biology, Data Visualization Diseases Cancer, ...

  5. Finding directionality and gene-disease predictions in disease associations.

    PubMed

    Garcia-Albornoz, Manuel; Nielsen, Jens

    2015-07-15

    Understanding the underlying molecular mechanisms in human diseases is important for diagnosis and treatment of complex conditions and has traditionally been done by establishing associations between disorder-genes and their associated diseases. This kind of network analysis usually includes only the interaction of molecular components and shared genes. The present study offers a network and association analysis under a bioinformatics frame involving the integration of HUGO Gene Nomenclature Committee approved gene symbols, KEGG metabolic pathways and ICD-10-CM codes for the analysis of human diseases based on the level of inclusion and hypergeometric enrichment between genes and metabolic pathways shared by the different human disorders. The present study offers the integration of HGNC approved gene symbols, KEGG metabolic pathways andICD-10-CM codes for the analysis of associations based on the level of inclusion and hypergeometricenrichment between genes and metabolic pathways shared by different diseases. 880 unique ICD-10-CM codes were mapped to the 4315 OMIM phenotypes and 3083 genes with phenotype-causing mutation. From this, a total of 705 ICD-10-CM codes were linked to 1587 genes with phenotype-causing mutations and 801 KEGG pathways creating a tripartite network composed by 15,455 code-gene-pathway interactions. These associations were further used for an inclusion analysis between diseases along with gene-disease predictions based on a hypergeometric enrichment methodology. The results demonstrate that even though a large number of genes and metabolic pathways are shared between diseases of the same categories, inclusion levels between these genes and pathways are directional and independent of the disease classification. However, the gene-disease-pathway associations can be used for prediction of new gene-disease interactions that will be useful in drug discovery and therapeutic applications.

  6. Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings.

    PubMed

    Asil, Kiyasettin; Gunduz, Yasemin; Yaldiz, Can; Aksoy, Yakup Ersel

    2015-01-01

    A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan showed herniation through this defect of the arachnoid membrane and protruded cerebral tissue into the right orbita. Intraorbital encephalocele is an important entity that can cause pulsatile exophthalmos and blindness.

  7. The comparison of CT fistulography and MR imaging of perianal fistulae with surgical findings: a case-control study.

    PubMed

    Soker, Gokhan; Gulek, Bozkurt; Yilmaz, Cengiz; Kaya, Omer; Arslan, Muhammet; Dilek, Okan; Gorur, Mustafa; Kuscu, Ferit; İrkorucu, Oktay

    2016-08-01

    The purpose of this study was to evaluate the diagnostic efficacies of CT fistulography and MRI, in the diagnostic work-up of perianal fistula patients. All 41 patients who were included in the study (36 males and 5 females, with an average age of 41 years) underwent CT fistulography and MRI examinations prior to surgery. The fistula characteristics obtained from these examinations were compared with the surgical findings. The comparative results were evaluated by means of the Kappa analysis method. CT fistulography predicted the correct perianal fistula classification in 30 (73.1%) of the 41 patients, whereas MRI correctly defined fistula classification in 38 (92.7%) of these patients (the K values were 0.621 and 0.896, respectively; with p < 0.001). CT fistulography depicted 29 secondary extensions in 16 patients, whereas MR imaging revealed 28 secondary extensions in 15 patients. A substantial agreement was found between surgical findings and two modalities (K value was 0.789 and 0.793 for CT fistulography and MRI, respectively, with a p value < 0.001). In terms of locations of internal openings, CT fistulography was able to detect the locations in 28 patients (68.2%), whereas MRI was more successful in this aspect, with a number of 35 patients (85.3%). Granulation tissues, inflammation and edema around the fistula, abscesses, and fistular wall fibrosis were also evaluated. CT fistulography and MRI have different advantages in the diagnosis of perianal fistulas. A good command of knowledge concerning the issue may be a key factor in modality decision.

  8. [Exclusion of coronary artery disease using cardiac CT. What impact do CT results have on patient management?].

    PubMed

    Kadalie, Clemens Themba; Sternitzky, Reinhardt

    2011-05-01

    Rapid advancement of multidetector head computed tomography (MDCT) during the past 10 years has facilitated noninvasive evaluation of CAD (coronary artery disease). Since the introduction of 320-row technology, examination of the whole heart in a single heart beat with diagnostic quality has become feasible. Direct imaging of vessel morphology, a high sensitivity for CAD above 96%, and low requirements of patient compliance represent advantages over other imaging modalities, such as MRI (magnetic resonance imaging), scintigraphy, and echocardiography. In some cases radiation exposure can be reduced to an effective dose below 1 mSV.Current data suggest that cardiac CT represents a more effective diagnostic tool than treadmill testing in order to decide whether cardiac catheterization is indicated. Treadmill testing has been an integral procedure of cardiac examinations for decades, although sensitivity for detecting CAD is as low as 70%.Cardiac CT represents a rather new modality and is almost exclusively performed in diagnostic imaging centers. Innovative concepts in the evaluation of CAD including CT are expected. Some authors propose cardiac CT as a major diagnostic tool for the exclusion of CAD. MRI, scintigraphy, or echocardiography in combination with a stress test remain important procedures in order to evaluate the hemodynamic relevance of coronary artery stenosis. Treadmill testing prior to cardiac CT has become questionable.The future role of cardiac CT in CAD in "change of management" concepts is promising. In order to optimize decisions of patient management on the basis of a cardiac CT examinations, awareness of current data is mandatory for the referring clinician and the performing radiological department.

  9. Chest CT findings in patients with dysphagia and aspiration: a systematic review.

    PubMed

    Scheeren, Betina; Gomes, Erissandra; Alves, Giordano; Marchiori, Edson; Hochhegger, Bruno

    2017-07-31

    The objective of this systematic review was to characterize chest CT findings in patients with dysphagia and pulmonary aspiration, identifying the characteristics and the methods used. The studies were selected from among those indexed in the Brazilian Virtual Library of Health, LILACS, Indice Bibliográfico Español de Ciencias de la Salud, Medline, Cochrane Library, SciELO, and PubMed databases. The search was carried out between June and July of 2016. Five articles were included and reviewed, all of them carried out in the last five years, published in English, and coming from different countries. The sample size in the selected studies ranged from 43 to 56 patients, with a predominance of adult and elderly subjects. The tomographic findings in patients with dysphagia-related aspiration were varied, including bronchiectasis, bronchial wall thickening, pulmonary nodules, consolidations, pleural effusion, ground-glass attenuation, atelectasis, septal thickening, fibrosis, and air trapping. Evidence suggests that chest CT findings in patients with aspiration are diverse. In this review, it was not possible to establish a consensus that could characterize a pattern of pulmonary aspiration in patients with dysphagia, further studies of the topic being needed. RESUMO O objetivo deste estudo foi realizar uma revisão sistemática dos achados de TC de tórax que caracterizem aspiração pulmonar em pacientes com disfagia, identificando as características e os métodos utilizados. Para a seleção dos estudos, foram utilizadas as bases de dados da Biblioteca Virtual em Saúde, LILACS, Indice Bibliográfico Español de Ciencias de la Salud, Medline, Biblioteca Cochrane, SciELO e PubMed. A busca foi realizada no período entre junho e julho de 2016. Foram incluídos e revisados cinco artigos, todos realizados nos últimos cinco anos, publicados em língua inglesa e oriundos de diferentes países. O tamanho da amostra nos estudos selecionados variou de 43 a 56 pacientes

  10. A combined pulmonary-radiology workshop for visual evaluation of COPD: study design, chest CT findings and concordance with quantitative evaluation.

    PubMed

    Barr, R Graham; Berkowitz, Eugene A; Bigazzi, Francesca; Bode, Frederick; Bon, Jessica; Bowler, Russell P; Chiles, Caroline; Crapo, James D; Criner, Gerard J; Curtis, Jeffrey L; Dass, Chandra; Dirksen, Asger; Dransfield, Mark T; Edula, Goutham; Erikkson, Leif; Friedlander, Adam; Galperin-Aizenberg, Maya; Gefter, Warren B; Gierada, David S; Grenier, Philippe A; Goldin, Jonathan; Han, MeiLan K; Hanania, Nicola A; Hansel, Nadia N; Jacobson, Francine L; Kauczor, Hans-Ulrich; Kinnula, Vuokko L; Lipson, David A; Lynch, David A; MacNee, William; Make, Barry J; Mamary, A James; Mann, Howard; Marchetti, Nathaniel; Mascalchi, Mario; McLennan, Geoffrey; Murphy, James R; Naidich, David; Nath, Hrudaya; Newell, John D; Pistolesi, Massimo; Regan, Elizabeth A; Reilly, John J; Sandhaus, Robert; Schroeder, Joyce D; Sciurba, Frank; Shaker, Saher; Sharafkhaneh, Amir; Silverman, Edwin K; Steiner, Robert M; Strange, Charlton; Sverzellati, Nicola; Tashjian, Joseph H; van Beek, Edwin J R; Washington, Lacey; Washko, George R; Westney, Gloria; Wood, Susan A; Woodruff, Prescott G

    2012-04-01

    The purposes of this study were: to describe chest CT findings in normal non-smoking controls and cigarette smokers with and without COPD; to compare the prevalence of CT abnormalities with severity of COPD; and to evaluate concordance between visual and quantitative chest CT (QCT) scoring. Volumetric inspiratory and expiratory CT scans of 294 subjects, including normal non-smokers, smokers without COPD, and smokers with GOLD Stage I-IV COPD, were scored at a multi-reader workshop using a standardized worksheet. There were 58 observers (33 pulmonologists, 25 radiologists); each scan was scored by 9-11 observers. Interobserver agreement was calculated using kappa statistic. Median score of visual observations was compared with QCT measurements. Interobserver agreement was moderate for the presence or absence of emphysema and for the presence of panlobular emphysema; fair for the presence of centrilobular, paraseptal, and bullous emphysema subtypes and for the presence of bronchial wall thickening; and poor for gas trapping, centrilobular nodularity, mosaic attenuation, and bronchial dilation. Agreement was similar for radiologists and pulmonologists. The prevalence on CT readings of most abnormalities (e.g. emphysema, bronchial wall thickening, mosaic attenuation, expiratory gas trapping) increased significantly with greater COPD severity, while the prevalence of centrilobular nodularity decreased. Concordances between visual scoring and quantitative scoring of emphysema, gas trapping and airway wall thickening were 75%, 87% and 65%, respectively. Despite substantial inter-observer variation, visual assessment of chest CT scans in cigarette smokers provides information regarding lung disease severity; visual scoring may be complementary to quantitative evaluation.

  11. Gallbladder torsion resulting in gangrenous cholecystitis within a parastomal hernia: Findings on unenhanced CT

    PubMed Central

    Rosenblum, Jessica K.; Dym, R. Joshua; Sas, Norman; Rozenblit, Alla M.

    2013-01-01

    Gallbladder torsion is a rare cause of acute gangrenous cholecystitis; its occurrence within an abdominal hernia has not been previously reported. We present such a case occurring within a parastomal hernia and imaged with unenhanced CT. PMID:24421934

  12. Malignant myoepithelioma arising in salivary tissue on the masseter muscle: US, CT, and MR findings

    SciTech Connect

    Martinoli, C.; Cittadini, G.; Derchi, L.E.; Rollandi, G.A.

    1996-01-01

    We report the US, CT, and MR appearances of a malignant myoepithelioma arising on the masseter muscle from aberrant salivary tissue, associated with postobstructive atrophy of the main parotid gland. 13 refs., 4 figs.

  13. Increased bone tracer uptake in symptomatic patients with ACL graft insufficiency: a correlation of MRI and SPECT/CT findings.

    PubMed

    Mathis, Dominic T; Hirschmann, Anna; Falkowski, Anna L; Kiekara, Tommi; Amsler, Felix; Rasch, Helmut; Hirschmann, Michael T

    2017-05-27

    Magnetic resonance imaging (MRI) and single-photon emission computerised tomography/computerised tomography (SPECT/CT) are used as diagnostic tools in symptomatic patients after reconstruction of the anterior cruciate ligament (ACL). The benefit of SPECT/CT in comparison with MRI is under debate. The purpose of this study was to investigate whether and how bone tracer uptake (BTU) intensity and distribution in SPECT/CT correlate with MRI findings in symptomatic patients after ACL reconstruction. Twenty-nine patients (male:female = 22:7, mean age ± SD 26 ± 10 years) with symptoms of pain and instability after ACL reconstruction were retrospectively investigated using prospectively acquired SPECT/CT and MRI. On MRI graft tear, graft signal intensity, bone marrow oedema, tunnel cyst formation, roof impingement, roof osteophytes, local arthrofibrosis, joint effusion and synovial thickness were analysed by two readers blinded to the BTU results. BTU was anatomically localised and volumetrically quantified. Spearman's rho test was used for correlation of BTU in SPECT/CT and MRI findings (p < 0.05). SPECT/CT showed increased femoral and tibial BTU in patients with MRI-confirmed graft tear, signal hyperintensity of the intraarticular graft section, joint effusion, synovial thickening, roof osteophytes and bone marrow oedema. Cyst formation in the femoral tunnel results in significantly reduced BTU in femur and tibia. No correlation of increased BTU was found for graft impingement and graft arthrofibrosis. Bone tracer uptake in SPECT/CT and defined MRI findings in symptomatic patients after ACL reconstruction were correlated. Both imaging modalities have a definite role in post-operative diagnostic and have established their value in those patients. This study provides a better understanding of the clinical value of SPECT/CT versus MRI in the clinical decision-making process. SPECT/CT provides a window into the in vivo loading of the joint as well as bone

  14. Assessment of CF lung disease using motion corrected PROPELLER MRI: a comparison with CT.

    PubMed

    Ciet, Pierluigi; Serra, Goffredo; Bertolo, Silvia; Spronk, Sandra; Ros, Mirco; Fraioli, Francesco; Quattrucci, Serena; Assael, M Baroukh; Catalano, Carlo; Pomerri, Fabio; Tiddens, Harm A W M; Morana, Giovanni

    2016-03-01

    To date, PROPELLER MRI, a breathing-motion-insensitive technique, has not been assessed for cystic fibrosis (CF) lung disease. We compared this technique to CT for assessing CF lung disease in children and adults. Thirty-eight stable CF patients (median 21 years, range 6-51 years, 22 female) underwent MRI and CT on the same day. Study protocol included respiratory-triggered PROPELLER MRI and volumetric CT end-inspiratory and -expiratory acquisitions. Two observers scored the images using the CF-MRI and CF-CT systems. Scores were compared with intra-class correlation coefficient (ICC) and Bland-Altman plots. The sensitivity and specificity of MRI versus CT were calculated. MRI sensitivity for detecting severe CF bronchiectasis was 0.33 (CI 0.09-0.57), while specificity was 100% (CI 0.88-1). ICCs for bronchiectasis and trapped air were as follows: MRI-bronchiectasis (0.79); CT-bronchiectasis (0.85); MRI-trapped air (0.51); CT-trapped air (0.87). Bland-Altman plots showed an MRI tendency to overestimate the severity of bronchiectasis in mild CF disease and underestimate bronchiectasis in severe disease. Motion correction in PROPELLER MRI does not improve assessment of CF lung disease compared to CT. However, the good inter- and intra-observer agreement and the high specificity suggest that MRI might play a role in the short-term follow-up of CF lung disease (i.e. pulmonary exacerbations). PROPELLER MRI does not match CT sensitivity to assess CF lung disease. PROPELLER MRI has lower sensitivity than CT to detect severe bronchiectasis. PROPELLER MRI has good to very good intra- and inter-observer variability. PROPELLER MRI can be used for short-term follow-up studies in CF.

  15. Coronary competitive reverse flow: Imaging findings at CT angiography and correlation with invasive coronary angiography.

    PubMed

    Li, Minghua; Liu, Shuyong; Zhang, Jiayin; Lu, Zhigang; Wei, Meng; Chun, Eun-Ju; Lu, Bin

    2015-01-01

    To study the imaging features of coronary competitive reverse flow and incidence of a "reverse attenuation gradient" in coronary CT angiography (CTA) with correlation to invasive coronary angiography (ICA). Patients who had undergone coronary CTA and ICA within 2 weeks were retrospectively identified in our database and reviewed. All cases with ICA-confirmed competitive reverse flow or chronic total occlusions (CTOs) were included for further analysis. The "reverse attenuation gradient sign" was defined as a reverse intraluminal opacification gradient of vessels which showed higher opacification in more distal compared with proximal segments. ICA findings were recorded and served as the reference to identify the clinical implications of this sign. In total, 134 patients (mean age, 68.1 ± 11.3 years; range, 38-90 years; 104 men) were included in our study. ICA revealed 11 cases of coronary competitive reverse flow and 123 cases of CTO. A reverse attenuation gradient sign was present in 9 of 11 patients (82%) with coronary competitive reverse flow and 72 of 123 (59%) chronically occluded coronary arteries. Myocardial bridges, distal collateral filling, as well as direct visualization of collateral connection were all more frequent in cases with coronary competitive reverse flow group compared with cases with a CTO. The reverse attenuation gradient sign distal to an upstream coronary severe stenosis indicates the presence of competitive collateral flow. Coronary CTA is able to correctly detect coronary competitive collateral flow and differentiate it from CTOs. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  16. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases.

    PubMed

    D'Elia, F; Zingarelli, A; Palli, D; Grani, M

    2000-01-01

    The aim of this study was to evaluate the accuracy of dynamic CT in the preoperative staging of gastric cancer. One hundred seven patients affected by gastric cancer diagnosed by endoscopic biopsy were prospectively staged by dynamic CT prior to tumor resection. After an oral intake of 400-600 ml of tap water and an intravenous infusion of a hypotonic agent, 200 ml of non-ionic contrast agent were administered by power injector using a biphasic technique. The CT findings were prospectively analyzed and correlated with the pathological findings at surgery. The accuracy of dynamic CT for tumor detection was 80 and 99% in early and advanced gastric cancer, respectively, with overall detection rate of 96% (103 of 107). Three early (pT1) and one advanced (pT2) cancers were undetected. Tumor stage as determined by dynamic CT agreed with pathological findings in 83 of 107 patients with an overall accuracy of 78%. The accuracy of CT in detecting increasing degrees of depth of tumor invasion when compared with pathological TNM staging was 20% (3 of 15) and 87% (80 of 92) in early and advanced cancer, respectively. The sensitivity, specificity, and accuracy of CT in the preoperative staging (pT3-pT4 vs pT1-pT2) was 93, 90, and 91.6%, respectively. The sensitivity, specificity, and accuracy of CT in assessing metastasis to regional lymph nodes was 97.2, 65.7, and 87%, respectively. Computed tomography correctly staged liver metastases in 105 of 107 patients with an overall sensitivity of 87.5% and specificity of 99 %. The sensitivity of peritoneal involvement was 30% when ascites or peritoneal nodules were absent. Our findings show that dynamic CTcan play a role in the preoperative definition of gastric cancer stage. The results can be used to optimize the therapeutic strategy for each individual patient prior to surgery, thus avoiding unnecessary intervention and allowing careful planning of extended surgery in eligible patients.

  17. Early Detection of Amyloid Plaque in Alzheimer’s Disease Via X-ray Phase CT

    DTIC Science & Technology

    2015-06-01

    SUBTITLE 5a. CONTRACT NUMBER W81XWH-12-1-0138 Early Detection of Amyloid Plaque in Alzheimer’s Disease Via X - ray Phase CT 5b. GRANT NUMBER 5c...major tasks of Year 1 and Year 2 are the construction and optimization of a prototype x - ray phase contrast CT system to carry out the tasks specified

  18. Day of Injury CT and Late MRI Findings: Cognitive Outcome in a Pediatric Sample with Complicated Mild Traumatic Brain Injury

    PubMed Central

    Jantz, Paul B; Farrer, Thomas J.; Abildskov, Tracy J.; Dennis, Maureen; Gerhardt, Cynthia A.; Rubin, Kenneth H.; Stancin, Terry; Taylor, H. Gerry; Vannatta, Kathryn; Yeates, Keith Owen

    2016-01-01

    Objectives Complicated mild traumatic brain injury (mTBI) or cmTBI is based on the presence of visibly identifiable brain pathology on the day-of-injury computed tomography (CT) scan. In a pediatric sample the relation of DOI CT to late MRI findings and neuropsychological outcome was examined. Methods MRI (> 12 months) was obtained in pediatric cmTBI patients and a sample of orthopedically injured (OI) children. Those children with positive imaging findings (MRI+) were quantitatively compared to those without (MRI-) or with the OI sample. Groups were also compared in neurocognitive outcome from WASI subtests and the WISC-IV Processing Speed Index (PSI), along with the Test of Everyday Attention for Children (TEA-Ch) and a parent-rated behavioral functioning measure (ABAS-II). Results Despite the MRI+ group having significantly more DOI CT findings than the MRI-group, no quantitative differences were found. WASI Vocabulary and Matrix Reasoning scores were significantly lower, but not PSI, TEA-Ch or ABAS-II scores. MRI+ and MRI-groups did not differ on these measures. Conclusions Heterogeneity in the occurrence of MRI-identified focal pathology was not associated with uniform changes in quantitative analyses of brain structure in cmTBI. Increased number of DOI CT abnormalities was associated with lowered neuropsychological performance. PMID:26186038

  19. Benign incidental findings of osteopoikilosis on Tc-99m MDP bone SPECT/CT: A case report and literature review.

    PubMed

    Tsai, Szu-Ying; Wang, Shan-Ying; Shiau, Yu-Chien; Wu, Yen-Wen

    2016-06-01

    Osteopoikilosis is a benign but rare condition characterized by bone islands throughout the osseous tissue, which could be easily confused with bone metastasis. We present a case of a 37-year-old man presented to orthopedic outpatient clinic with right hip pain for 2 weeks. There were multiple, small punctate lesions scattered throughout the skeleton on radiograph. Subsequent Tc-99m methylene diphosphonate (MDP) bone scan with pelvic single-photon emission computed tomography (SPECT)/computed tomography (CT) showed multiple enostoses without abnormal focal MDP uptake. Therefore, clinical diagnosis was compatible with osteopoikilosis while bone metastasis was unlikely. The symptoms then improved by conservative treatments. Osteopoikilosis is usually an incidental finding on radiograph or CT, and a normal MDP confirmed the diagnosis by excluding bone metastasis. It is important for clinicians to recognize the specific image features to prevent further unnecessary interventions. In addition, bone SPECT/CT could also make the diagnosis in one step.

  20. Pulmonary congenital cystic disease in adults. Spiral computed tomography findings with pathologic correlation and management.

    PubMed

    Scialpi, M; Cappabianca, S; Rotondo, A; Scalera, G B; Barberini, F; Cagini, L; Donato, S; Brunese, L; Piscioli, I; Lupattelli, L

    2010-06-01

    The aim of this study was to assess the computed tomography (CT) features of intrapulmonary congenital cystic diseases in adults and to correlate the imaging features with the pathological findings, with emphasis on the oncogenic potential of the lesions. We retrospectively reviewed the CT scans in three institutions from August 1996 to December 2008, of nine patients (six men, three women; mean age 48.6 years; range 26-75 years) who had histological diagnosis of pulmonary cystic disease after surgery. Six patients had a diagnosis of intrapulmonary bronchogenic cyst (IBC), and three had a type-I cystic adenomatoid malformation (CAM). In one case, intralobar sequestration (ILS) was associated with type-I CAM. Three patients were symptomatic and six were asymptomatic. On CT scans, IBCs showed homogeneous fluid attenuation (n=2), air-fluid level (n=2), air attenuation (n=1) or soft-tissue attenuation (n=1). The surrounding lung tissue showed areas of band-like linear attenuation in three IBCs, atelectasia in two and mucocele-like areas in one. On CT, type-I CAM appeared as a unilocular cystic lesion with air-fluid level (n=1) or air content (n=1). Both cases had thin walls surrounded by normal lung parenchyma. ILS appeared as a fluid-filled cyst with afferent and efferent vessels. Of the six IBCs, one occurred in the upper right lobe, two in the middle lobe and three in the lower right lobe. Of the three type-I CAMs, one was in the upper left lobe and one in the middle lobe. The type-I CAM associated with ILS was located in the left lower lobe. The similar CT patterns preclude differentiation between IBC and type-I CAM. Surgical resection of all intrapulmonary cystic lesions detected in adults is mandatory because type-I CAM is a precursor of mucinous bronchioloalveolar carcinoma.

  1. CT angiography after 20 years: a transformation in cardiovascular disease characterization continues to advance.

    PubMed

    Rubin, Geoffrey D; Leipsic, Jonathon; Joseph Schoepf, U; Fleischmann, Dominik; Napel, Sandy

    2014-06-01

    Through a marriage of spiral computed tomography (CT) and graphical volumetric image processing, CT angiography was born 20 years ago. Fueled by a series of technical innovations in CT and image processing, over the next 5-15 years, CT angiography toppled conventional angiography, the undisputed diagnostic reference standard for vascular disease for the prior 70 years, as the preferred modality for the diagnosis and characterization of most cardiovascular abnormalities. This review recounts the evolution of CT angiography from its development and early challenges to a maturing modality that has provided unique insights into cardiovascular disease characterization and management. Selected clinical challenges, which include acute aortic syndromes, peripheral vascular disease, aortic stent-graft and transcatheter aortic valve assessment, and coronary artery disease, are presented as contrasting examples of how CT angiography is changing our approach to cardiovascular disease diagnosis and management. Finally, the recently introduced capabilities for multispectral imaging, tissue perfusion imaging, and radiation dose reduction through iterative reconstruction are explored with consideration toward the continued refinement and advancement of CT angiography.

  2. Ossifying renal tumor of infancy: findings at ultrasound, CT and MRI.

    PubMed

    Lee, Sang Hwan; Choi, Young Hun; Kim, Woo Sun; Cheon, Jung-Eun; Moon, Kyung Chul

    2014-05-01

    A 4-month-old boy presented with persistent gross hematuria. At ultrasonography, a 3.5-cm echogenic mass with posterior shadowing and tumor vascularity was detected within the right renal pelvis. Precontrast CT showed a slightly hyperattenuating mass in the renal pelvis. At MRI the mass was heterogeneously hypointense on T2-weighted images and isointense on T1-weighted images. Contrast-enhanced CT and MRI both revealed peripheral enhancement of the mass. A histological diagnosis of ossifying renal tumor of infancy was made after open pyelostomy and tumor enucleation. We suggest that ossifying renal tumor of infancy should be considered when a mass with posterior acoustic shadowing and tumor vascularity on US, hyperattenuation on precontrast CT and hypointensity on T2-weighted MRI is seen within the renal pelvis of an infant with hematuria.

  3. Cone beam CT findings of retromolar canals: Report of cases and literature review

    PubMed Central

    Han, Sang-Sun

    2013-01-01

    A retromolar canal is an anatomical variation in the mandible. As it includes the neurovascular bundle, local anesthetic insufficiency can occur, and an injury of the retromolar canal during dental surgery in the mandible may result in excessive bleeding, paresthesia, and traumatic neuroma. Using imaging analysis software, we evaluated the cone-beam computed tomography (CT) images of two Korean patients who presented with retromolar canals. Retromolar canals were detectable on the sagittal and cross-sectional images of cone-beam CT, but not on the panoramic radiographs of the patients. Therefore, the clinician should pay particular attention to the identification of retromolar canals by preoperative radiographic examination, and additional cone beam CT scanning would be recommended. PMID:24380072

  4. Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings

    PubMed Central

    Gunduz, Yasemin; Yaldiz, Can; Aksoy, Yakup Ersel

    2015-01-01

    A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan showed herniation through this defect of the arachnoid membrane and protruded cerebral tissue into the right orbita. Intraorbital encephalocele is an important entity that can cause pulsatile exophthalmos and blindness. PMID:25674346

  5. Value of 18F-FDG PET/CT in diagnosing chronic Q fever in patients with central vascular disease.

    PubMed

    Hagenaars, J C J P; Wever, P C; Vlake, A W; Renders, N H M; van Petersen, A S; Hilbink, M; de Jager-Leclercq, M G L; Moll, F L; Koning, O H J; Hoekstra, C J

    2016-08-01

    The aim of this study is to describe the value of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in diagnosing chronic Q fever in patients with central vascular disease and the added value of 18F-FDG PET/CT in the diagnostic combination strategy as described in the Dutch consensus guideline for diagnosing chronic Q fever. 18F-FDG PET/CT was performed in patients with an abdominal aortic aneurysm or aorto-iliac reconstruction and chronic Q fever, diagnosed by serology and positive PCR for Coxiella burnetii DNA in blood and/or tissue (PCR-positive study group). Patients with an abdominal aortic aneurysm or aorto-iliac reconstruction without clinical and serological findings indicating Q fever infection served as a control group. Patients with a serological profile of chronic Q fever and a negative PCR in blood were included in additional analyses (PCR-negative study group). Thirteen patients were evaluated in the PCR-positive study group and 22 patients in the control group. 18F-FDG PET/CT indicated vascular infection in 6/13 patients in the PCR-positive study group and 2/22 patients in the control group. 18F-FDG PET/CT demonstrated a sensitivity of 46% (95% CI: 23-71%), specificity of 91% (95% CI: 71-99%), positive predictive value of 75% (95% CI:41-93%) and negative predictive value of 74% (95% CI: 55-87%). In the PCR-negative study group, 18F-FDG PET/CT was positive in 10/20 patients (50%). The combination of 18F-FDG PET/CT, as an imaging tool for identifying a focus of infection, and Q fever serology is a valid diagnostic strategy for diagnosing chronic Q fever in patients with central vascular disease.

  6. Wegener's granulomatosis: parotid involvement and associated pancreatitis with C.T. findings.

    PubMed

    Stuckey, S L; Smart, P J

    1992-11-01

    Parotid enlargement is an uncommon physical sign and even less commonly the reason for referral for computerised tomography (CT) as the aetiology is usually self-evident. In cases referred for CT examination Wegener's granulomatosis should be considered, particularly if the pathology appears bilateral. This diagnosis may be confirmed by biopsy and/or supported by Anti-Neutrophil Cytoplasmic Antibody (ANCA) assay. A case of Wegener's granulomatosis with parotid gland involvement and temporally related pancreatitis with pseudocyst formation is reported. This is the second reported case of possible pancreatic involvement in Wegeners granulomatosis and approximately the tenth reported case of salivary gland involvement.

  7. Pulmonary Artery Sarcoma Detected on 18F-FDG PET/CT With Unusual Findings.

    PubMed

    Guo, Yuehong; Wang, Tie; Yang, Minfu

    2015-11-01

    A 32-year-old woman, who presented with "sharp pain" in the right chest for more than 1 month and worsening dyspnea and fever for 10 days, was initially thought to have a pulmonary embolism. Cardiac ultrasound showed an ill-defined echogenic mass within the pulmonary trunk. F-FDG PET/CT was performed for further evaluation. PET/CT showed an intense hypermetabolism in the main, bilateral proximal, and the right main pulmonary arteries, suggesting the presence of a malignant lesion. Biopsy confirmed the lesion as a primary pulmonary artery sarcoma.

  8. Normal variations and benign findings in pediatric 18F-FDG-PET/CT.

    PubMed

    Grant, Frederick D

    2014-04-01

    (18)F-FDG PET and PET/CT have a wide variety of indications in children and young adults. Oncologic indications are the most common, but others include neurology, sports medicine, cardiology, and infection imaging. Accurate interpretation of pediatric (18)F-FDG PET and PET/CT requires a technically adequate study and knowledgeable interpretation of the images. A successful pediatric (18)F-FDG PET requires age-appropriate patient preparation and consideration of patient age and developmental stage. Accurate interpretation of the study requires familiarity with normal patterns of physiologic (18)F-FDG uptake in children at all stages of development.

  9. CT evaluation of the acute abdomen: bowel pathology spectrum of disease.

    PubMed

    Johnson, G L; Johnson, P T; Fishman, E K

    1996-08-01

    CT has become the primary imaging modality for the evaluation of the patient with clinical symptoms of an acute abdomen and a confusing clinical picture. Because these patients may have a range of various pathologies, CT has been used successfully to define the presence of disease and localize it to a specific organ or organ system. In this article, we review the various processes that resulted in acute abdomen focusing on the small bowel and colon. Specific entities discussed include appendicitis, diverticulitis, Crohn disease, and ulcerative colitis. Other less common processes, including pseudomembranous colitis, intussusception, and bowel ischemia are also discussed. The specific role of CT scanning and specific CT signs are discussed and addressed. The value of CT in relationship to other modalities and clinical evaluation is discussed and key statistics provided.

  10. Research Finds Link Between Statin Use and Progressive Muscle Disease

    MedlinePlus

    ... Research Finds Link Between Statin Use and Progressive Muscle Disease Each year, millions of Americans take statins, ... people these benefits come at a cost: widespread muscle pain that persists as long as the drugs ...

  11. Parkinson's Disease and Melanoma May Occur Together, Study Finds

    MedlinePlus

    ... gov/news/fullstory_167078.html Parkinson's Disease and Melanoma May Occur Together, Study Finds Doctors should counsel ... are about four times more likely to develop melanoma skin cancer, and conversely, people with melanoma have ...

  12. The Evaluation of FDG PET/CT Scan Findings in Patients with Organizing Pneumonia Mimicking Lung Cancer

    PubMed Central

    Erdoğan, Yurdanur; Akıncı Özyürek, Berna; Özmen, Özlem; Yılmaz Demirci, Nilgün; Duyar, Sezgi Şahin; Dadalı, Yeliz; Demirağ, Funda; Karakaya, Jale

    2015-01-01

    Objective: Organizing pneumonia (OP) is a rare lung condition that is characterized by the presence of polypoid tissues due to fibroblastic plugs within respiratory bronchioles, alveolar ducts and sacs. The three main radiologic patterns of OP include typical, solitary-focal and infiltrative forms. The maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography (PET/CT) may be high in benign conditions such as OP as well as malignant diseases. The aim of our study was to investigate PET-CT characteristics of OP in patients mimicking lung cancer. Methods: The clinical and radiologic characteristics of 50 patients who were referred to our hospital for PET/CT evaluation due to suspicion of lung malignancy, and who were pathologically diagnosed as OP between 2009 and 2013 were retrospectively reviewed. Results: The mean age of the patients was 58.2 years. Ninety-six percent of patients (48) were male. Radiologic evaluation revealed 27 (54%) focal involvement, 10 (20%) consolidation with air-bronchogram (typical), 1 (2%) infiltrative and 12 (24%) other types of involvement (multiple nodules and cavitary lesions). The mean SUVmax value of the lesions on PET/CT was calculated as 6.5. Mediastinal lymph node involvement (at least one station) was detected in 76% of our study group with a mean SUVmax value of 3.27. Conclusion: OP may cause false positive results on PET/CT. However, PET/CT results may be used as a guide for invasive procedures that should be performed when there is suspicion of malignancy. PMID:26316470

  13. Study Finds Small Increase in Cancer Risk after Childhood CT Scans

    Cancer.gov

    A study published in the June 6, 2012, issue of The Lancet shows that radiation exposure from computed tomography (CT) scans in childhood results in very small but increased risks of leukemia and brain tumors in the first decade after exposure.

  14. 18F-DOPA PET/CT and MRI Findings in a Patient With Multiple Meningiomas.

    PubMed

    Calabria, Ferdinando F; Chiaravalloti, Agostino; Calabria, Eros N; Grillea, Giovanni; Schillaci, Orazio

    2016-08-01

    A 56-year-old man was referred to our Department for a 2-year story of upper limb tremor, severe headache, and episodes of confusion. Brain F-DOPA PET/CT showed multiple areas of tracer uptake in the two hemispheres of the brain. Subsequent MRI displayed demyelinating foci with high contrast enhancement. Histological specimen confirmed the diagnosis of multiple meningiomas.

  15. Bone erosion caused by sinonasal cavernous hemangioma: CT findings in two patients.

    PubMed

    Kim, H J; Kim, J H; Kim, J H; Hwang, E G

    1995-05-01

    We report two cases of cavernous hemangioma originating in the sinonasal cavity. Although CT showed some enhancing areas within both tumors, the substantial bone destruction caused by these tumors made it difficult to differentiate them from the more common malignant epithelial tumors. Angiography was performed in one patient and showed characteristic pooling of contrast material.

  16. Gastrointestinal cancers in inflammatory bowel disease: An update with emphasis on imaging findings.

    PubMed

    Barral, Matthias; Dohan, Anthony; Allez, Matthieu; Boudiaf, Mourad; Camus, Marine; Laurent, Valérie; Hoeffel, Christine; Soyer, Philippe

    2016-01-01

    Inflammatory bowel diseases (IBD) are associated with an increased risk of gastrointestinal cancers depending on the specific type of IBD, the extent of the disease and its location. Patients with IBD and extensive colonic involvement are at increased risk of colorectal cancer whereas patients with Crohn disease have an increased risk for small-bowel and anal carcinoma. These cancers preferentially develop on sites of longstanding inflammation. In regards to colon cancer, several key pathogenic events are involved, including chromosomal instability, microsatellite instability and hypermethylation. The risk for colon cancer in IBD patients correlates with longer disease duration, presence of sclerosing cholangitis, pancolitis, family history of colorectal cancer, early onset of the disease and severity of bowel inflammation. Identification of increased colorectal cancer risk in individual IBD patients has led to formal surveillance guidelines. Conversely, although an increased risk for other types of cancer has been well identified, no specific formal screening recommendations exist. Consequently, the role of the radiologist is crucial to alert the referring gastroenterologist when a patient with IBD presents with unusual imaging findings at either computed tomography (CT) or magnetic resonance (MR) imaging. This review provides an update on demographics, molecular, clinical and histopathological features of gastrointestinal cancers in IBD patients including colorectal carcinoma, small bowel adenocarcinoma, neuroendocrine tumors and anal carcinoma, along with a special emphasis on the current role of CT and MR imaging.

  17. Broncho-Pleural Fistula with Hydropneumothorax at CT: Diagnostic Implications in Mycobacterium avium Complex Lung Disease with Pleural Involvement

    PubMed Central

    Yoon, Hyun Jung; Chung, Myung Jin; Lee, Kyung Soo; Kim, Jung Soo; Park, Hye Yun

    2016-01-01

    Objective To determine the patho-mechanism of pleural effusion or hydropneumothorax in Mycobacterium avium complex (MAC) lung disease through the computed tomographic (CT) findings. Materials and Methods We retrospectively collected data from 5 patients who had pleural fluid samples that were culture-positive for MAC between January 2001 and December 2013. The clinical findings were investigated and the radiological findings on chest CT were reviewed by 2 radiologists. Results The 5 patients were all male with a median age of 77 and all had underlying comorbid conditions. Pleural fluid analysis revealed a wide range of white blood cell counts (410–100690/µL). The causative microorganisms were determined as Mycobacterium avium and Mycobacterium intracellulare in 1 and 4 patients, respectively. Radiologically, the peripheral portion of the involved lung demonstrated fibro-bullous changes or cavitary lesions causing lung destruction, reflecting the chronic, insidious nature of MAC lung disease. All patients had broncho-pleural fistulas (BPFs) and pneumothorax was accompanied with pleural effusion. Conclusion In patients with underlying MAC lung disease who present with pleural effusion, the presence of BPFs and pleural air on CT imaging are indicative that spread of MAC infection is the cause of the effusion. PMID:26957917

  18. Clinical utility of (18)F-fluoride PET/CT in benign and malignant bone diseases.

    PubMed

    Li, Yuxin; Schiepers, Christiaan; Lake, Ralph; Dadparvar, Simin; Berenji, Gholam R

    2012-01-01

    (18)F labeled sodium fluoride is a positron-emitting, bone seeking agent with more favorable skeletal kinetics than conventional phosphate and diphosphonate compounds. With the expanding clinical usage of PET/CT, there is renewed interest in using (18)F-fluoride PET/CT for imaging bone diseases. Growing evidence indicates that (18)F fluoride PET/CT offers increased sensitivity, specificity, and diagnostic accuracy in evaluating metastatic bone disease compared to (99m)Tc based bone scintigraphy. National Oncologic PET Registry (NOPR) has expanded coverage for (18)F sodium fluoride PET scans since February 2011 for the evaluation of osseous metastatic disease. In this article, we reviewed the pharmacological characteristics of sodium fluoride, as well as the clinical utility of PET/CT using (18)F-fluoride in both benign and malignant bone disorders.

  19. Clear-Cell Meningioma: CT and MR Imaging Findings in Two Cases Involving the Spinal Canal and Cerebellopontine Angle

    PubMed Central

    Yu, Ki Bong; Kim, Hyung Jin; Suh, Chang Hae; Park, Hyung Chun; Kim, Eun Young; Han, Hye Seung

    2002-01-01

    Clear-cell meningioma is a rare subtype of meningioma which occurs at a younger age and has a higher recurrence rate than other subtypes. We report two cases of clear-cell meningioma, one in the thoracolumbar spinal canal and the other in the cerebellopontine angle. Though the CT and MR imaging findings were not different from those of ordinary meningioma, after surgical removal the condition recurred repeatedly in the patient with spinal canal involvement. PMID:12087202

  20. A comparative study of thin-section CT findings between seasonal influenza virus pneumonia and Streptococcus pneumoniae pneumonia

    PubMed Central

    Okada, F; Takata, S; Hiramatsu, K; Ando, Y; Nakayama, T; Maeda, T; Mori, H

    2014-01-01

    Objective: To compare the pulmonary thin-section CT findings in patients with seasonal influenza virus pneumonia with Streptococcus pneumoniae pneumonia. Methods: The study group included 30 patients (20 males and 10 females; age range, 20–91 years; mean age, 55.9 years) with seasonal influenza virus pneumonia and 71 patients (47 males and 24 females; age range, 27–92 years; mean age, 67.5 years) with S. pneumoniae pneumonia. Results: The proportion of community-acquired infection was significantly higher in patients with influenza virus pneumonia than with S. pneumoniae pneumonia (p = 0.001). CT findings of ground-glass attenuation (GGA) (p = 0.012) and crazy-paving appearance (p = 0.03) were significantly more frequent in patients with influenza virus pneumonia than with S. pneumoniae pneumonia. Conversely, consolidation (p < 0.001), mucoid impaction (p < 0.001), centrilobular nodules (p = 0.04) and pleural effusion (p = 0.003) were significantly more frequent in patients with S. pneumoniae pneumonia than in those with influenza virus pneumonia. Conclusion: Pulmonary thin-section CT findings, such as consolidation and mucoid impaction may be useful in distinguishing between seasonal influenza virus pneumonia and S. pneumoniae pneumonia. Advances in knowledge: (1) Distinguishing seasonal influenza virus pneumonia with S. pneumoniae pneumonia is important. (2) The CT findings of GGA and crazy-paving appearance were more frequently found in patients with influenza virus pneumonia than in patients with S. pneumoniae pneumonia, whereas consolidation, mucoid impaction, centrilobular nodules and pleural effusion were more frequently found in patients with S. pneumoniae pneumonia. PMID:24834476

  1. A comparative study of thin-section CT findings between seasonal influenza virus pneumonia and Streptococcus pneumoniae pneumonia.

    PubMed

    Ono, A; Okada, F; Takata, S; Hiramatsu, K; Ando, Y; Nakayama, T; Maeda, T; Mori, H

    2014-07-01

    To compare the pulmonary thin-section CT findings in patients with seasonal influenza virus pneumonia with Streptococcus pneumoniae pneumonia. The study group included 30 patients (20 males and 10 females; age range, 20-91 years; mean age, 55.9 years) with seasonal influenza virus pneumonia and 71 patients (47 males and 24 females; age range, 27-92 years; mean age, 67.5 years) with S. pneumoniae pneumonia. The proportion of community-acquired infection was significantly higher in patients with influenza virus pneumonia than with S. pneumoniae pneumonia (p = 0.001). CT findings of ground-glass attenuation (GGA) (p = 0.012) and crazy-paving appearance (p = 0.03) were significantly more frequent in patients with influenza virus pneumonia than with S. pneumoniae pneumonia. Conversely, consolidation (p < 0.001), mucoid impaction (p < 0.001), centrilobular nodules (p = 0.04) and pleural effusion (p = 0.003) were significantly more frequent in patients with S. pneumoniae pneumonia than in those with influenza virus pneumonia. Pulmonary thin-section CT findings, such as consolidation and mucoid impaction may be useful in distinguishing between seasonal influenza virus pneumonia and S. pneumoniae pneumonia. (1) Distinguishing seasonal influenza virus pneumonia with S. pneumoniae pneumonia is important. (2) The CT findings of GGA and crazy-paving appearance were more frequently found in patients with influenza virus pneumonia than in patients with S. pneumoniae pneumonia, whereas consolidation, mucoid impaction, centrilobular nodules and pleural effusion were more frequently found in patients with S. pneumoniae pneumonia.

  2. Comparison of CT and MRI findings for cervical spine clearance in obtunded patients without high impact trauma.

    PubMed

    Tan, Lee A; Kasliwal, Manish K; Traynelis, Vincent C

    2014-05-01

    Cervical spinal injuries occur in 2.0-6.6% of patients after blunt trauma and can have devastating neurological sequelae if left unrecognized. Although there is high quality evidence addressing cervical clearance in asymptomatic and symptomatic awake patients, cervical spine clearance in patients with altered level of alertness (i.e., obtunded patients with Glasgow coma scale (GCS) of 14 or less) following blunt trauma has been a matter of great controversy. Furthermore, there are no data on cervical spine clearance in obtunded patients without high impact trauma and these patients are often treated based on evidence from similar patients with high impact trauma. This retrospective study was conducted on this specific subgroup of patients who were admitted to a neurointensive care unit (NICU) with primary diagnoses of intracranial hemorrhage with history of minor trauma; the objective being to evaluate and compare cervical spinal computed tomography (CT) and magnetic resonance imaging (MRI) findings in this particular group of patients. Patients with GCS of 14 or less admitted to neruointensive care unit (NICU) at RUSH University Medical Center from 2008 to 2010 with diagnoses of intracranial hemorrhage (surgical or non-surgical) who had reported or presumed fall (i.e., "found down") were queried from the computer data registry. A group of these patients had cervical spine CT and subsequently MRI for clearing the cervical spine and removal of the cervical collar. Medical records of these patients were reviewed for demographics, GCS score and injury specific data and presence or absence of cervical spine injury. Eighty-three patients were identified from the computer database. Twenty-eight of these patients had positive findings on both CT and MRI (33.73% - Group I); four patients had a negative CT but had positive findings on follow-up MRI (4.82% - Group II); fifty-one patients had both negative CT and MRI (61.44% - Group III). All patients in Group I required

  3. Giant Serous Cystadenoma of the Pancreas (⩾10 cm): The Clinical Features and CT Findings

    PubMed Central

    Zhou, Jun; Zeng, Yu-Rong; Lin, Xiao-Feng; Min, Jun

    2016-01-01

    Purpose. To report the clinical features and CT manifestations of giant pancreatic serous cystadenoma (≥10 cm). Methods. We retrospectively reviewed the clinical features and CT findings of 6 cases of this entity. Results. All 6 patients were symptomatic. The tumors were 10.2 cm–16.5 cm (median value, 13.0 cm). CT imaging revealed that all 6 cases showed microcystic appearances (n = 5) or mixed microcystic and macrocystic appearances (n = 1). Five patients with tumors at the distal end of the pancreas received distal pancreatectomy. Among these 5 patients, 2 patients underwent partial transverse colon resection or omentum resection due to close adhesion. One patient whose tumor was located in the pancreatic head underwent pancreaticoduodenectomy; however, due to encasement of the portal and superior mesenteric veins, the tumor was incompletely resected. One patient had abundant draining veins on the tumor surface and suffered large blood loss (700 mL). After 6–49 months of follow-up the 6 patients showed no tumor recurrence or signs of malignant transformation. Conclusions. Giant pancreatic serous cystadenoma necessitates surgical resection due to large size, symptoms, uncertain diagnosis, and adjacent organ compression. The relationship between the tumors and the neighboring organs needs to be carefully assessed before operation on CT image. PMID:27610132

  4. Diffuse Infantile Hepatic Hemangioendothelioma With Early Central Enhancement in an Adult: A Case Report of CT and MRI Findings.

    PubMed

    Dong, Aisheng; Dong, Hui; Zuo, Changjing; He, Tianlin

    2015-12-01

    Infantile hepatic hemangioendothelioma (IHH) is the most common vascular tumor of the liver in infancy. Adult with IHH is extremely rare. We presented a diffuse IHH in an adult patient with computed tomography (CT) and magnetic resonance image (MRI) findings.A 39-year-old man was admitted to our hospital because of a 2-year history of abnormal liver function tests and a 7-day history of jaundice. Physical examination revealed enlarged liver. Unenhanced abdominal CT showed enlargement of the liver with diffuse hypodensity. Enhanced CT on the arterial phase revealed multiple centrally enhanced lesions diffusely involved the enlarged liver. The enhanced areas of the lesions became larger on the portal phase and all the lesions became homogeneous enhanced on the delayed phase. These lesions showed heterogeneously hyperintense on T2-weighted image, hypointense on T1-weighted image, and early centrally enhanced on dynamic gadolinium-enhanced MRI, with complete tumor enhancement after 180 s. The patient underwent orthotopic liver transplantation. IHH type 2 was confirmed by pathology. The patient died of tumor recurrence in the liver 4 months after transplantation.Unlike the previously described imaging appearances of IHH, this case showed diffuse nodules with early central enhancement on CT and MRI. Considering the importance of the ability to differentiate IHH from other hepatic tumors, radiologists should be aware of these imaging appearances to establish knowledge of the entire spectrum of IHH.

  5. Primary lymphoma of the gallbladder accompanied by cirrhosis: CT and MRI findings

    PubMed Central

    Batur, Abdussamed; Odev, Kemal

    2014-01-01

    A 60-year-old patient with cirrhosis due to chronic hepatitis B was admitted to the hospital for routine controls. An ultrasonographic examination demonstrated a soft tissue mass originating from the gallbladder. A CT scan and after 3 months a dynamic liver MRI were performed for the possible diagnosis. Based on these imaging studies, laparoscopic cholecystectomy was performed. The histopathological examination diagnosed non-Hodgkin's lymphoma. PMID:24827653

  6. Capillary Hemangioma of Thoracic Spinal Cord: PET/CT and MR Findings.

    PubMed

    Shen, Guohua; Su, Minggang; Zhao, Junyi; Liu, Bin; Kuang, Anren

    2017-02-13

    Capillary hemangiomas are frequently encountered superficially in the cutaneous, subcutaneous, or mucosal tissues during the childhood and early adulthood, but the occurrence of spinal intradural capillary hemangioma is relatively rare. Herein, we report a case with capillary hemangioma of the thoracic spine. MR and PET/CT features of this lesion are presented, and awareness of this entity may help differentiate it from other spinal intradural tumors.

  7. Calcification as a sign of sarcomatous degeneration of malignant pleural mesotheliomas: A new CT finding

    SciTech Connect

    Raizon, A.; Schwartz, A.; Hix, W.; Rockoff, S.D.

    1996-01-01

    We present two cases demonstrating, on CT examination, heavily calcified mass lesions associated with malignant pleural mesothelioma in workers occupationally exposed to asbestos. These masses proved to be osteogenic sarcomatous degeneration within mesotheliomas. The observation of dense calcification within a pleural mass should raise a suspicion of osteosarcomatous degeneration if it is seen in conjunction with other classic signs of malignant pleural mesothelioma. 8 refs., 5 figs.

  8. PET/CT: First-Line Examination to Assess Disease Extent of Disseminated Coccidioidomycosis.

    PubMed

    Foerter, Jason; Sundell, John; Vroman, Penny

    2016-09-01

    Coccidioidomycosis is an infection caused by inhalation of the Coccidioides fungus. Most infections remain subclinical or are confined to the pulmonary system. Disseminated disease is rare. Traditionally, a combination of imaging modalities has been used to determine disease extent. We suggest (18)F-FDG PET/CT as a single first-line imaging examination to assess disease extent. We present a case of disseminated coccidioidomycosis to the lung, mediastinum, soft tissues, and skeletal system. To our knowledge, no prior case reports demonstrate such widespread disease using PET/CT. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  9. Post traumatic deafness: a pictorial review of CT and MRI findings.

    PubMed

    Maillot, Olivier; Attyé, Arnaud; Boyer, Eric; Heck, Olivier; Kastler, Adrian; Grand, Sylvie; Schmerber, Sébastien; Krainik, Alexandre

    2016-06-01

    Hearing loss is a common functional disorder after trauma, and radiologists should be aware of the ossicular, labyrinthine or brain lesions that may be responsible. After a trauma, use of a systematic approach to explore the main functional components of auditory pathways is essential. Conductive hearing loss is caused by the disruption of the conductive chain, which may be due to ossicular luxation or fracture. This pictorial review firstly describes the normal 2-D and 3-D anatomy of the ossicular chain, including the incudo-malleolar and incudo-stapedial joints. The role of 3-D CT in the post-traumatic evaluation of injury to the temporal bone is then evaluated. In the case of sensorineural hearing loss, CT can detect pneumolabyrinth and signs of perilymphatic fistulae but fails to detect subtle lesions within the inner ear, such as labyrinthine haemorrhage or localized brain axonal damage along central auditory pathways. The role that MRI with 3-D-FLAIR acquisition plays in the detection of inner ear haemorrhage and post-traumatic lesions of the brain parenchyma that may lead to auditory agnosia is also discussed. • The most common middle ear injuries are incudo-malleolar and incudo-stapedial joint luxation. • In patients with SNHL, CT can detect pneumolabyrinth or perilymphatic fistula • 3-D-FLAIR MRI appears the best sequence to highlight labyrinthine haemorrhage • Axonal damage and brain hematoma may lead to deafness.

  10. PET CT Thresholds for Radiotherapy Target Definition in Non-Small-Cell Lung Cancer: How Close are we to the Pathologic Findings?

    SciTech Connect

    Wu Kailiang; Ung, Yee C.; Hornby, Jennifer

    2010-07-01

    Purpose: Optimal target delineation threshold values for positron emission tomography (PET) and computed tomography (CT) radiotherapy planning is controversial. In this present study, different PET CT threshold values were used for target delineation and then compared pathologically. Methods and Materials: A total of 31 non-small-cell lung cancer patients underwent PET CT before surgery. The maximal diameter (MD) of the pathologic primary tumor was obtained. The CT-based gross tumor volumes (GTV{sub CT}) were delineated for CT window-level thresholds at 1,600 and -300 Hounsfield units (HU) (GTV{sub CT1}); 1,600 and -400 (GTV{sub CT2}); 1,600 and -450 HU (GTV{sub CT3}); 1,600 and -600 HU (GTV{sub CT4}); 1,200 and -700 HU (GTV{sub CT5}); 900 and -450 HU (GTV{sub CT6}); and 700 and -450 HU (GTV{sub CT7}). The PET-based GTVs (GTV{sub PET}) were autocontoured at 20% (GTV{sub 20}), 30% (GTV{sub 30}), 40% (GTV{sub 40}), 45% (GTV{sub 45}), 50% (GTV{sub 50}), and 55% (GTV{sub 55}) of the maximal intensity level. The MD of each image-based GTV in three-dimensional orientation was determined. The MD of the GTV{sub PET} and GTV{sub CT} were compared with the pathologically determined MD. Results: The median MD of the GTV{sub CT} changed from 2.89 (GTV{sub CT2}) to 4.46 (GTV{sub CT7}) as the CT thresholds were varied. The correlation coefficient of the GTV{sub CT} compared with the pathologically determined MD ranged from 0.76 to 0.87. The correlation coefficient of the GTV{sub CT1} was the best (r = 0.87). The median MD of GTV{sub PET} changed from 5.72cm to 2.67cm as the PET thresholds increased. The correlation coefficient of the GTV{sub PET} compared with the pathologic finding ranged from 0.51 to 0.77. The correlation coefficient of GTV{sub 50} was the best (r = 0.77). Conclusion: Compared with the MD of GTV{sub PET}, the MD of GTV{sub CT} had better correlation with the pathologic MD. The GTV{sub CT1} and GTV{sub 50} had the best correlation with the pathologic results.

  11. Aneurysms of the portal venous system. Gray-scale and color Doppler ultrasonographic findings with CT and MRI correlation.

    PubMed

    Atasoy, K C; Fitoz, S; Akyar, G; Aytaç, S; Erden, I

    1998-01-01

    Two cases of incidentally detected aneurysms involving the portal venous system are described with emphasis on gray-scale and color Doppler ultrasonographic (US) findings. Appearing on US as anechoic masses showing direct luminal continuity with the right portal vein and superior mesenteric vein, the lesions displayed spectral findings characteristic of portal venous system on color Doppler US. Dynamic helical computed tomography (CT) demonstrated simultaneous enhancement with the portal system, while the aneurysms were hypointense owing to flow void on T1-weighted spin-echo magnetic resonance (MR) images.

  12. Automatic detection of patients with invasive fungal disease from free-text computed tomography (CT) scans.

    PubMed

    Martinez, David; Ananda-Rajah, Michelle R; Suominen, Hanna; Slavin, Monica A; Thursky, Karin A; Cavedon, Lawrence

    2015-02-01

    Invasive fungal diseases (IFDs) are associated with considerable health and economic costs. Surveillance of the more diagnostically challenging invasive fungal diseases, specifically of the sino-pulmonary system, is not feasible for many hospitals because case finding is a costly and labour intensive exercise. We developed text classifiers for detecting such IFDs from free-text radiology (CT) reports, using machine-learning techniques. We obtained free-text reports of CT scans performed over a specific hospitalisation period (2003-2011), for 264 IFD and 289 control patients from three tertiary hospitals. We analysed IFD evidence at patient, report, and sentence levels. Three infectious disease experts annotated the reports of 73 IFD-positive patients for language suggestive of IFD at sentence level, and graded the sentences as to whether they suggested or excluded the presence of IFD. Reliable agreement between annotators was obtained and this was used as training data for our classifiers. We tested a variety of Machine Learning (ML), rule based, and hybrid systems, with feature types including bags of words, bags of phrases, and bags of concepts, as well as report-level structured features. Evaluation was carried out over a robust framework with separate Development and Held-Out datasets. The best systems (using Support Vector Machines) achieved very high recall at report- and patient-levels over unseen data: 95% and 100% respectively. Precision at report-level over held-out data was 71%; however, most of the associated false-positive reports (53%) belonged to patients who had a previous positive report appropriately flagged by the classifier, reducing negative impact in practice. Our machine learning application holds the potential for developing systematic IFD surveillance systems for hospital populations. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. CT findings for intracerebral hemorrhage have little incremental impact on post-stroke mortality prediction model performance

    PubMed Central

    Zahuranec, Darin B.; Sánchez, Brisa N.; Brown, Devin L.; Wing, Jeffrey J.; Smith, Melinda A.; Garcia, Nelda M.; Meurer, William J.; Morgenstern, Lewis B.; Lisabeth, Lynda D.

    2012-01-01

    Background Stroke outcome studies often combine cases of intracerebral hemorrhage (ICH) and ischemic stroke (IS). These studies of mixed stroke typically ignore computed tomography (CT) findings for ICH cases, though the impact of omitting these traditional predictors of ICH mortality is unknown. We investigated the incremental impact of ICH CT findings on mortality prediction model performance. Methods Cases of ICH and IS (2000–2003) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) project. Base models predicting 30-day mortality included demographics, stroke type, and clinical findings (National Institutes of Health Stroke Scale (NIHSS) +/− Glasgow coma scale (GCS)). The impact of adding CT data (volume, intraventricular hemorrhage, infratentorial location) was assessed with the area under the curve (AUC), unweighted sum of squared residuals (Ŝ), and integrated discrimination improvement (IDI). The model assessment was performed first for the mixed case of IS and ICH, and then repeated for ICH cases alone to determine whether any lack of improvement in model performance with CT data for mixed stroke type was due to IS cases naturally forming a larger proportion of the total sample than ICH. Results A total of 1,256 cases were included (86% IS, 14% ICH). Thirty-day mortality was 16% overall (11% for IS; 43% for ICH). When both clinical scales (NIHSS and GCS) were included, none of the model performance measures showed improvement with the addition of CT findings whether considering IS and ICH together (ΔAUC: 0.002, 95% CI −0.01, 0.02; ΔŜ: −3.0, 95% CI −9.1, 2.6; IDI: 0.017, 95% CI −0.004, 0.05) or considering ICH cases alone (ΔAUC: 0.02, 95% CI −0.02, 0.08; Δ Ŝ: −2.0, 95% CI −9.7, 3.4); IDI 0.065, 95% CI −0.03, 0.21). If NIHSS was the only clinical scale included, there was still no improvement in AUC or Ŝ when CT findings were added for the sample with IS/ICH combined (ΔAUC: 0.005, 95%CI −0.01, 0.02;

  14. Use of Dual-Energy CT and Iodine Maps in Evaluation of Bowel Disease.

    PubMed

    Fulwadhva, Urvi P; Wortman, Jeremy R; Sodickson, Aaron D

    2016-01-01

    Dual-energy computed tomography (CT) relies on material-dependent x-ray absorption behavior from concurrently acquired high- and low-kilovolt peak data and has a range of imaging applications. This article focuses on use of dual-energy CT in assessment of bowel disease. After a summary of relevant dual-energy CT image acquisition and postprocessing principles, the authors describe dual-energy techniques of greatest utility in evaluation of benign and malignant pathologic conditions in the bowel, including neoplastic, vascular, infectious, and inflammatory disorders, as well as in assessment of abdominopelvic trauma. The dual-energy postprocessing techniques of iodine-selective imaging and virtual monochromatic imaging have the broadest applicability in bowel imaging. They may be used for improved visualization of subtle differences in bowel wall enhancement or for quantitative assessment of altered enhancement for evaluation of a neoplasm or bowel ischemia. Iodine images and virtual monochromatic low-kiloelectron volt images are particularly helpful for assessment of a neoplasm, ischemia, infection, or inflammation, while iodine maps paired with virtual nonenhanced images are most helpful to differentiate iodine from other dense materials, as in gastrointestinal bleeding or trauma. In most applications, radiation doses at dual-energy CT are comparable to those at traditional CT. However, dual-energy CT may allow reduction in radiation dose by using virtual nonenhanced images that obviate an additional nonenhanced CT acquisition. Limitations of dual-energy CT are discussed, including potential challenges in acquisition, postprocessing, and interpretation. (©)RSNA, 2016.

  15. Thin-section CT findings of patients with acute Streptococcus pneumoniae pneumonia with and without concurrent infection

    PubMed Central

    Okada, F; Ando, Y; Matsushita, S; Ishii, R; Nakayama, T; Morikawa, K; Ono, A; Maeda, T; Mori, H

    2012-01-01

    Objectives The aim of this study was to compare the pulmonary thin-section CT findings of patients with acute Streptococcus pneumoniae pneumonia with and without concurrent infection. Methods The study group comprised 86 patients with acute S. pneumoniae pneumonia, 36 patients with S. pneumoniae pneumonia combined with Haemophilus influenzae infection, 26 patients with S. pneumoniae pneumonia combined with Pseudomonas aeruginosa infection and 22 patients with S. pneumoniae pneumonia combined with methicillin-susceptible Staphylococcus aureus (MSSA) infection. We compared the thin-section CT findings among the groups. Results Centrilobular nodules and bronchial wall thickening were significantly more frequent in patients with pneumonia caused by concurrent infection (H. influenzae: p<0.001 and p<0.001, P. aeruginosa: p<0.001 and p<0.001, MSSA: p<0.001 and p<0.001, respectively) than in those infected with S. pneumoniae alone. Cavity and bilateral pleural effusions were significantly more frequent in cases of S. pneumoniae pneumonia with concurrent P. aeruginosa infection than in cases of S. pneumoniae pneumonia alone (p<0.001 and p<0.001, respectively) or with concurrent H. influenzae (p<0.05 and p<0.001, respectively) or MSSA infection (p<0.05 and p<0.05, respectively). Conclusions When a patient with S. pneumoniae pneumonia has centrilobular nodules, bronchial wall thickening, cavity or bilateral pleural effusions on CT images, concurrent infection should be considered. PMID:22215884

  16. Thin-section CT findings of patients with acute Streptococcus pneumoniae pneumonia with and without concurrent infection.

    PubMed

    Okada, F; Ando, Y; Matsushita, S; Ishii, R; Nakayama, T; Morikawa, K; Ono, A; Maeda, T; Mori, H

    2012-08-01

    The aim of this study was to compare the pulmonary thin-section CT findings of patients with acute Streptococcus pneumoniae pneumonia with and without concurrent infection. The study group comprised 86 patients with acute S. pneumoniae pneumonia, 36 patients with S. pneumoniae pneumonia combined with Haemophilus influenzae infection, 26 patients with S. pneumoniae pneumonia combined with Pseudomonas aeruginosa infection and 22 patients with S. pneumoniae pneumonia combined with methicillin-susceptible Staphylococcus aureus (MSSA) infection. We compared the thin-section CT findings among the groups. Centrilobular nodules and bronchial wall thickening were significantly more frequent in patients with pneumonia caused by concurrent infection (H. influenzae: p<0.001 and p<0.001, P. aeruginosa: p<0.001 and p<0.001, MSSA: p<0.001 and p<0.001, respectively) than in those infected with S. pneumoniae alone. Cavity and bilateral pleural effusions were significantly more frequent in cases of S. pneumoniae pneumonia with concurrent P. aeruginosa infection than in cases of S. pneumoniae pneumonia alone (p<0.001 and p<0.001, respectively) or with concurrent H. influenzae (p<0.05 and p<0.001, respectively) or MSSA infection (p<0.05 and p<0.05, respectively). When a patient with S. pneumoniae pneumonia has centrilobular nodules, bronchial wall thickening, cavity or bilateral pleural effusions on CT images, concurrent infection should be considered.

  17. [Application of adaptive iterative dose reduction technique in CT enterography in diagnosing Crohn disease].

    PubMed

    Lian, Yanbang; Cao, Wuteng; Zhu, Shanshan; Lin, Yanghao; Liu, Dechao; Wang, Xinhua; Qiu, Jianping; Zhou, Zhiyang

    2014-07-01

    To evaluate the application of low-dose CT enterography with adaptive iterative dose reduction(AIDR) technique in diagnosing Crohn's disease. Retrospective analysis was performed on 26 patients diagnosed as Crohn's disease by the multidisciplinary team in our hospital. Low-dose CT enterography with 640-slice MDCT was performed on these 26 patients using adaptive iterative dose reduction(AIDR) technique. Characteristics of Crohn's disease in CT enterography images were independently analyzed by two radiologists who were experienced in Crohn's disease with calculating the total radiation dosage. The radiation dosage of 26 patients ranged from 5.58 to 12.90 [mean (9.00±2.00)] mSv, which was lower than conventional scan (around 15 mSv) known from the literatures. According to the images of CT enterography of 26 cases, bowel wall thickening with abnormal enhancement and lymphadenectasis were found in 25 cases with total 109 segmental bowel wall thickening. Among 25 thickening cases, enterostenosis was found in 16 cases, stratification enhancement in 12 cases and comb sign in 14 cases. Besides, it was found that 8 cases with hyperdense fat on the mesenteric side, 7 cases with intestinal fistula, 6 cases with abdominal cavity abscess, and 3 cases with anal fistula. CT enterography of Crohn's disease with adaptive iterative dose reduction technique is an effective method to evaluate Crohn's disease without compromising image quality with reduced radiation dosage.

  18. Scintigraphic and CT findings of Tietze's syndrome: Report of a case and review of the literature

    SciTech Connect

    Honda, N.; Machida, K.; Mamiya, T.; Takahashi, T.; Takishima, T.; Hasegawa, N.; Kamano, T.; Hashimoto, M.; Ohno, K.; Itoyama, S.; )

    1989-08-01

    A case of Tietze's syndrome is reported. A 43-year-old woman, who had experienced right anterior chest pain and tender swelling of the right first costosternal junction for seven months, showed increased accumulation of the right first, the right fourth, and the left first costochondral junction on bone imaging. Ga-67 imaging showed increased accumulation at the right first costosternal junction. CT showed sclerosis of the sternal manubrium, partial calcification of costal cartilage, and soft tissue swelling. Biopsy of the right first costal cartilage showed chronic inflammation with fibrosis and ossification. Increased uptake of bone gallium imaging is consistent with Tietze's syndrome.15 references.

  19. Characteristic CT Findings After Percutaneous Cryoablation Treatment of Malignant Lung Nodules.

    PubMed

    Chaudhry, Ammar; Grechushkin, Vadim; Hoshmand, Mahsa; Kim, Choo Won; Pena, Andres; Huston, Brett; Chaya, Yair; Bilfinger, Thomas; Moore, William

    2015-10-01

    Assess computed tomography (CT) imaging characteristics after percutaneous cryotherapy for lung cancer.A retrospective IRB-approved analysis of 40 patients who underwent nonsurgical treatment for primary stage 1 lung cancer performed from January 2007 to March 2011 was included in this study. All procedures were performed using general anesthesia and CT guidance. Follow-up imaging with CT of the chest was obtained at 1 month, 3 months, 6 months, and 12 months postprocedure to evaluate the ablated lung nodule. Nodule surface area, density (in Hounsfield units), and presence or absence of cavitations were recorded. In addition, the degree of nodule enhancement was also recorded. Patients who were unable to obtain the aforementioned follow-up were excluded from the study.Thirty-six patients underwent percutaneous cryoablation with men to women ratio of 75% with mean age for men 74.6 and mean age for women 74.3 years of age. The average nodule surface area preablation and postcryoablation at 1-, 3-, 6-, and 12-month follow-ups were 2.99, 7.86, 3.89, 3.18 and 3.07[REPLACEMENT CHARACTER]cm, respectively. The average precontrast nodule density before cryoablation was 8.9 and average precontrast nodule density postprocedure at 1, 3, 6, and 12 months follow-ups were 8.5, -5.9, -9.4, and -3.8 HU, respectively. There is increased attenuation of lung nodules over time with an average postcontrast enhancement of 11.4, 18.5, 16.1, and 25.7 HU at the aforementioned time intervals. Cavitations occurred in the cryoablation zone in 53% (19/36) of patients. 80.6% (29/36) of the cavitations in the cryoablation zone resolved within 12 months. Four patients (11%) had recurrence of tumor at the site of cryoablation and none of the patients had satellite or distant metastasis.Our study shows that patients who underwent cryotherapy for lung nodules treatment had characteristic changes on follow-up CT including. The surface area of the nodule increases at the 1-month follow-up with

  20. A case of intussusception of the appendix secondary to endometriosis: US and CT findings.

    PubMed

    Lee, Dong Jun; Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won; Ryu, Jung Kyu; Won, Kyu Yeoun; Lee, Suk Hwan

    2015-09-01

    Intussusception of the appendix is an uncommon condition that is difficult to diagnose with radiology. Endometriosis causing appendiceal intussusception is a rare condition that has only been reported a few times in the literature. Here, we report a case of appendiceal intussusception caused by endometriosis in a 33-year-old woman who presented with intermittent right lower abdominal pain. Sonography revealed a hypoechoic mass invaginating into the cecum, which was covered by echogenic cecal wall with central dimpling indicating the appendiceal orifice. On CT, the mass was identified as an enhancing mass invaginating into the cecum at the level the appendiceal orifice. © 2014 Wiley Periodicals, Inc.

  1. Characteristic CT Findings After Percutaneous Cryoablation Treatment of Malignant Lung Nodules

    PubMed Central

    Chaudhry, Ammar; Grechushkin, Vadim; Hoshmand, Mahsa; Kim, Choo Won; Pena, Andres; Huston, Brett; Chaya, Yair; Bilfinger, Thomas; Moore, William

    2015-01-01

    Abstract Assess computed tomography (CT) imaging characteristics after percutaneous cryotherapy for lung cancer. A retrospective IRB-approved analysis of 40 patients who underwent nonsurgical treatment for primary stage 1 lung cancer performed from January 2007 to March 2011 was included in this study. All procedures were performed using general anesthesia and CT guidance. Follow-up imaging with CT of the chest was obtained at 1 month, 3 months, 6 months, and 12 months postprocedure to evaluate the ablated lung nodule. Nodule surface area, density (in Hounsfield units), and presence or absence of cavitations were recorded. In addition, the degree of nodule enhancement was also recorded. Patients who were unable to obtain the aforementioned follow-up were excluded from the study. Thirty-six patients underwent percutaneous cryoablation with men to women ratio of 75% with mean age for men 74.6 and mean age for women 74.3 years of age. The average nodule surface area preablation and postcryoablation at 1-, 3-, 6-, and 12-month follow-ups were 2.99, 7.86, 3.89, 3.18 and 3.07�cm2, respectively. The average precontrast nodule density before cryoablation was 8.9 and average precontrast nodule density postprocedure at 1, 3, 6, and 12 months follow-ups were 8.5, −5.9, −9.4, and −3.8 HU, respectively. There is increased attenuation of lung nodules over time with an average postcontrast enhancement of 11.4, 18.5, 16.1, and 25.7 HU at the aforementioned time intervals. Cavitations occurred in the cryoablation zone in 53% (19/36) of patients. 80.6% (29/36) of the cavitations in the cryoablation zone resolved within 12 months. Four patients (11%) had recurrence of tumor at the site of cryoablation and none of the patients had satellite or distant metastasis. Our study shows that patients who underwent cryotherapy for lung nodules treatment had characteristic changes on follow-up CT including. The surface area of the nodule increases at the 1-month follow-up with

  2. Uterus-like mass involving the appendix: US and CT findings.

    PubMed

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won; Kim, Gou Young; Choi, Sung Il; Park, Seong Jin

    2012-10-01

    Uterus-like mass is a rare extrauterine mass composed of a central cavity lined by endometrium and surrounding smooth muscle. Uterus-like mass has frequently been reported in the ovary, but has rarely been found in extraovarian regions. We report a case of uterus-like mass involving the appendix in a woman who presented with right lower abdominal pain indistinguishable from acute appendicitis. Sonography revealed a heterogeneous mass of mixed echogenicity with inner cystic change, abutting the appendix. CT depicted an enhanced mass with inner cystic change abutting the appendix. Histopathologic examination confirmed the diagnosis.

  3. Cat-Scratch Disease: A Pitfall for Lymphoma Evaluation by FDG-PET/CT.

    PubMed

    Dubreuil, Julien; Dony, Arthur; Salles, Gilles; Traverse-Glehen, Alexandra; Giammarile, Francesco; Skanjeti, Andrea

    2017-02-01

    FDG-PET/CT is a standard of care in staging and response assessment of Hodgkin lymphoma. Hence, it is important to recognize pitfalls owing to the potential therapeutic impact. We report a case of a 29-year-old woman affected by stage III bulky Hodgkin lymphoma. The interim FDG-PET/CT showed a complete metabolic response. After three new cycles of chemotherapy, the patient showed fever and lymphadenopathy at clinic examination, PET/CT revealed several FDG uptakes at lymph nodes in inguinal and iliac region. Pathologic analyses, after biopsy and serologic examinations, led to the diagnosis of cat-scratch disease.

  4. Weight preserving image registration for monitoring disease progression in lung CT.

    PubMed

    Gorbunova, Vladlena; Lol, Pechin; Ashraf, Haseem; Dirksen, Asger; Nielsen, Mads; de Bruijne, Marleen

    2008-01-01

    We present a new image registration based method for monitoring regional disease progression in longitudinal image studies of lung disease. A free-form image registration technique is used to match a baseline 3D CT lung scan onto a following scan. Areas with lower intensity in the following scan compared with intensities in the deformed baseline image indicate local loss of lung tissue that is associated with progression of emphysema. To account for differences in lung intensity owing to differences in the inspiration level in the two scans rather than disease progression, we propose to adjust the density of lung tissue with respect to local expansion or compression such that the total weight of the lungs is preserved during deformation. Our method provides a good estimation of regional destruction of lung tissue for subjects with a significant difference in inspiration level between CT scans and may result in a more sensitive measure of disease progression than standard quantitative CT measures.

  5. Common and unexpected findings in mummies from ancient Egypt and South America as revealed by CT.

    PubMed

    Jackowski, Christian; Bolliger, Stephan; Thali, Michael J

    2008-01-01

    Computed tomography (CT) has proved to be a valuable investigative tool for mummy research and is the method of choice for examining mummies. It allows for noninvasive insight, especially with virtual endoscopy, which reveals detailed information about the mummy's sex, age, constitution, injuries, health, and mummification techniques used. CT also supplies three-dimensional information about the scanned object. Mummification processes can be summarized as "artificial," when the procedure was performed on a body with the aim of preservation, or as "natural," when the body's natural environment resulted in preservation. The purpose of artificial mummification was to preserve that person's morphologic features by delaying or arresting the decay of the body. The ancient Egyptians are most famous for this. Their use of evisceration followed by desiccation with natron (a compound of sodium salts) to halt putrefaction and prevent rehydration was so effective that their embalmed bodies have survived for nearly 4500 years. First, the body was cleaned with a natron solution; then internal organs were removed through the cribriform plate and abdomen. The most important, and probably the most lengthy, phase was desiccation. After the body was dehydrated, the body cavities were rinsed and packed to restore the body's former shape. Finally, the body was wrapped. Animals were also mummified to provide food for the deceased, to accompany the deceased as pets, because they were seen as corporal manifestations of deities, and as votive offerings. Artificial mummification was performed on every continent, especially in South and Central America.

  6. Soft-tissue changes after head and neck radiation: CT findings.

    PubMed

    Bronstein, A D; Nyberg, D A; Schwartz, A N; Shuman, W P; Griffin, B R

    1989-01-01

    To identify possible soft-tissue changes of the head and neck after radiation therapy, 102 CT scans from 78 patients with head and neck tumors were reviewed to assess (1) skin thickening, (2) epiglottic thickening, (3) stranding of subcutaneous fat, and (4) stranding of deep cervical fat. Scans were obtained after radiation therapy alone (10 cases), after radiation and surgery (27 cases), after surgery alone (24 cases), or before either surgery or radiation (41 cases). Skin thickening, epiglottic thickening, and stranding of subcutaneous fat were seen more frequently after radiation therapy than before such treatment. However, skin thickening and stranding of subcutaneous fat were sometimes also associated with tumor involvement and/or previous surgery, while epiglottic thickening was only occasionally associated with tumor involvement. Stranding of deep cervical fat was noted with increased frequency after radiation or surgery, but postradiation effects could not be reliably distinguished from postsurgical or tumor effects. We conclude that soft-tissue changes of the head and neck on CT may commonly be associated with previous radiation therapy, but these postradiation effects are not always distinguishable from postsurgical effects or tumor.

  7. CT and MRI findings of a solitary extramedullary plasmacytoma of the oropharynx: case report.

    PubMed

    Narumi, Tomohiko; Kozawa, Eito; Heshiki, Atsuko; Tomoda, Megumi; Shimizu, Yoshihiko

    2005-12-01

    We report a case of solitary extramedullary plasmacytoma (SEP) of the oropharynx. A 53-year-old man presented who had had bloody phlegm and a sore throat for a few days. A mass was endoscopically detected in his right posterior oropharyngeal wall, and biopsy revealed a neoplasm consisting of a uniform population of plasma cells. Computed tomography (CT) showed a broad-based papillary soft tissue density mass projecting into the oropharynx from the right posterior wall of the pharynx, and post-contrast CT showed marked enhancement of the tumor. The tumor showed slightly higher signal intensity compared with surrounding muscle on MR Tl-weighted images (T1WI) and high signal intensity on MR T2-weighted images (T2WI). The mass showed homogeneous enhancement on post-contrast T1WI. Further clinical examination showed an absence of multiple myeloma (MM). The patient was diagnosed as having SEP. Following radiation therapy, a reduction in tumor size was observed. Although SEP is a rare tumor, it should be included in the differential diagnosis of tumors of the oropharynx because of its imaging similarities to other, more common malignant tumors, such as squamous cell carcinoma and lymphoma.

  8. CT detection of intraabdominal disease in patients with lower extremity signs and symptoms.

    PubMed

    Meshkov, S L; Seltzer, S E; Finberg, H J

    1982-06-01

    The initial clinical presentation of intraabdominal disease can be in an extraabdominal location. This phenomenon most commonly occurs in the setting of bowel perforation secondary to diverticulitis, appendicitis, or carcinoma, with resultant spread of infection caudal to the abdomen. Hematomas and pancreatic fluid collections may also dissect out of the abdomen. The spread of these disease processes is likely to occur in a predictable fashion along anatomic tissue planes. Computed tomography (CT) is well suited to demonstrate the extraabdominal site of disease, the pathway of spread from the abdomen, and the occult intraabdominal process. We describe four such cases in which CT was useful and discuss the anatomic pathways involved.

  9. Pulmonary CT and MRI phenotypes that help explain chronic pulmonary obstruction disease pathophysiology and outcomes.

    PubMed

    Hoffman, Eric A; Lynch, David A; Barr, R Graham; van Beek, Edwin J R; Parraga, Grace

    2016-03-01

    Pulmonary x-ray computed tomographic (CT) and magnetic resonance imaging (MRI) research and development has been motivated, in part, by the quest to subphenotype common chronic lung diseases such as chronic obstructive pulmonary disease (COPD). For thoracic CT and MRI, the main COPD research tools, disease biomarkers are being validated that go beyond anatomy and structure to include pulmonary functional measurements such as regional ventilation, perfusion, and inflammation. In addition, there has also been a drive to improve spatial and contrast resolution while at the same time reducing or eliminating radiation exposure. Therefore, this review focuses on our evolving understanding of patient-relevant and clinically important COPD endpoints and how current and emerging MRI and CT tools and measurements may be exploited for their identification, quantification, and utilization. Since reviews of the imaging physics of pulmonary CT and MRI and reviews of other COPD imaging methods were previously published and well-summarized, we focus on the current clinical challenges in COPD and the potential of newly emerging MR and CT imaging measurements to address them. Here we summarize MRI and CT imaging methods and their clinical translation for generating reproducible and sensitive measurements of COPD related to pulmonary ventilation and perfusion as well as parenchyma morphology. The key clinical problems in COPD provide an important framework in which pulmonary imaging needs to rapidly move in order to address the staggering burden, costs, as well as the mortality and morbidity associated with COPD.

  10. FindZebra: a search engine for rare diseases.

    PubMed

    Dragusin, Radu; Petcu, Paula; Lioma, Christina; Larsen, Birger; Jørgensen, Henrik L; Cox, Ingemar J; Hansen, Lars Kai; Ingwersen, Peter; Winther, Ole

    2013-06-01

    The web has become a primary information resource about illnesses and treatments for both medical and non-medical users. Standard web search is by far the most common interface to this information. It is therefore of interest to find out how well web search engines work for diagnostic queries and what factors contribute to successes and failures. Among diseases, rare (or orphan) diseases represent an especially challenging and thus interesting class to diagnose as each is rare, diverse in symptoms and usually has scattered resources associated with it. We design an evaluation approach for web search engines for rare disease diagnosis which includes 56 real life diagnostic cases, performance measures, information resources and guidelines for customising Google Search to this task. In addition, we introduce FindZebra, a specialized (vertical) rare disease search engine. FindZebra is powered by open source search technology and uses curated freely available online medical information. FindZebra outperforms Google Search in both default set-up and customised to the resources used by FindZebra. We extend FindZebra with specialized functionalities exploiting medical ontological information and UMLS medical concepts to demonstrate different ways of displaying the retrieved results to medical experts. Our results indicate that a specialized search engine can improve the diagnostic quality without compromising the ease of use of the currently widely popular standard web search. The proposed evaluation approach can be valuable for future development and benchmarking. The FindZebra search engine is available at http://www.findzebra.com/. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. High-resolution CT findings of primary lung cancer with cavitation: a comparison between adenocarcinoma and squamous cell carcinoma.

    PubMed

    Kunihiro, Y; Kobayashi, T; Tanaka, N; Matsumoto, T; Okada, M; Kamiya, M; Ueda, K; Kawano, H; Matsunaga, N

    2016-11-01

    To evaluate the high-resolution computed tomography (CT) findings of primary lung cancer with cavitation and compare the findings in adenocarcinoma and squamous cell carcinoma. The high-resolution CT findings of tumours with cavitation were retrospectively evaluated in 60 patients. Forty-seven of the lesions were diagnosed as adenocarcinomas; 13 were diagnosed as squamous cell carcinomas. The diameters of the tumour and cavity, the maximum thickness of the cavity wall, shape of the cavity wall, the number of cavities, and the presence of ground-glass opacity, bronchial obstruction, intratumoural bronchiectasis, emphysema, and honeycombing were evaluated. The mechanisms of cavity formation were examined according to the pathological features. The maximum thickness of the cavity wall was significantly greater in squamous cell carcinomas than in adenocarcinomas (p=0.002). Ground-glass opacity and intratumoural bronchiectasis were significantly more common in adenocarcinomas than in squamous cell carcinomas (p<0.001 and p=0.040, respectively). Regarding the pathological findings, intratumoural bronchiectasis with or without alveolar wall destruction contributed to a significant difference between adenocarcinoma and squamous cell carcinoma (p<0.001; odds ratio [OR], 20.35; 95% confidence interval [CI], 3.87-107.10). The cavity wall tends to be thicker in squamous cell carcinomas than in adenocarcinomas. The presence of ground-glass opacity and intratumoural bronchiectasis is strongly suggestive of adenocarcinoma. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  12. Neuronopathic Lysosomal Storage Diseases: Clinical and Pathologic Findings

    ERIC Educational Resources Information Center

    Prada, Carlos E.; Grabowski, Gregory A.

    2013-01-01

    Background: The lysosomal--autophagocytic system diseases (LASDs) affect multiple body systems including the central nervous system (CNS). The progressive CNS pathology has its onset at different ages, leading to neurodegeneration and early death. Methods: Literature review provided insight into the current clinical neurological findings,…

  13. Neuronopathic Lysosomal Storage Diseases: Clinical and Pathologic Findings

    ERIC Educational Resources Information Center

    Prada, Carlos E.; Grabowski, Gregory A.

    2013-01-01

    Background: The lysosomal--autophagocytic system diseases (LASDs) affect multiple body systems including the central nervous system (CNS). The progressive CNS pathology has its onset at different ages, leading to neurodegeneration and early death. Methods: Literature review provided insight into the current clinical neurological findings,…

  14. Assessment of medial coronoid disease in 180 canine lame elbow joints: a sensitivity and specificity comparison of radiographic, computed tomographic and arthroscopic findings.

    PubMed

    Villamonte-Chevalier, A; van Bree, H; Broeckx, Bjg; Dingemanse, W; Soler, M; Van Ryssen, B; Gielen, I

    2015-09-25

    Diagnostic imaging is essential to assess the lame patient; lesions of the elbow joint have traditionally been evaluated radiographically, however computed tomography (CT) has been suggested as a useful technique to diagnose various elbow pathologies. The primary objective of this study was to determine the sensitivity and specificity of CT to assess medial coronoid disease (MCD), using arthroscopy as gold standard. The secondary objective was to ascertain the radiographic sensitivity and specificity for MCD compared with CT. For this study 180 elbow joints were assessed, of which 141 had been examined with radiography, CT and arthroscopy; and 39 joints, had radiographic and CT assessment. Sensitivity and specificity were calculated for CT and radiographic findings using available statistical software. Sensitivity and specificity of CT using arthroscopy as gold standard resulted in high values for sensitivity (100 %) and specificity (93 %) for the assessment of MCD. For the radiographic evaluation, a sensitivity of 98 % and specificity of 64 - 69 % using CT as the technique of reference, were found. These results suggest that in case of doubt during radiographic assessment, CT could be used as a non-invasive technique to assess the presence of MCD. Based on the high sensitivity and specificity obtained in this study it has been considered that CT, rather than arthroscopy, is the preferred noninvasive technique to assess MCD lesions of the canine elbow joint.

  15. Chronic obstructive pulmonary disease: thin-section CT measurement of airway wall thickness and lung attenuation.

    PubMed

    Orlandi, Ilaria; Moroni, Chiara; Camiciottoli, Gianna; Bartolucci, Maurizio; Pistolesi, Massimo; Villari, Natale; Mascalchi, Mario

    2005-02-01

    To prospectively evaluate airway wall thickness and lung attenuation at spirometrically gated thin-section computed tomography (CT) in patients with chronic obstructive pulmonary disease (COPD) and to correlate gated CT findings with pulmonary function test (PFT) results. The ethical committee approved the study, and all patients gave informed consent. Forty-two consecutive patients with COPD (20 with and 22 without chronic bronchitis [CB]) underwent gated thin-section CT and PFTs on the same day. The percentage wall area (PWA) and the thickness-to-diameter ratio (TDR) for all depicted bronchi that were round and larger than 2 mm in diameter, the mean lung attenuation (MLA), and the pixel index (PI) at -950 HU were determined. The reproducibility of the airway measurements was preliminarily tested by performing a five-trial examination in a patient with COPD and in a control patient. Differences in airway and lung attenuation measurements between the patients with and those without CB were evaluated at Mann-Whitney U testing. Simple and multiple regression analyses were used to assess the correlation between thin-section CT and PFT measurements. The mean intraoperator coefficient of variation for airway measurements was 7.8% (range, 3.8%-13.4%). An average of nine bronchi per patient were assessed. Patients with CB had significantly higher PWAs, TDRs, and MLAs and significantly lower PIs than patients without CB (P < .05 for all values). The combination of PWA, TDR, and PWA normalized to body weight correlated significantly (P < .05) with the forced expiratory volume in 1 second-to-slow vital capacity ratio and the diffusing capacity of the lung for carbon monoxide in patients with but not in patients without CB. PFT results correlated better with MLA and PI in patients without CB. Bronchial wall measurements differ between patients who have COPD with CB and those who have COPD without CB. The correlation between airway dimensions and indexes of airway obstruction

  16. Computer-aided diagnosis as a second reader: spectrum of findings in CT studies of the chest interpreted as normal.

    PubMed

    Peldschus, Kersten; Herzog, Peter; Wood, Susan A; Cheema, Jugesh I; Costello, Philip; Schoepf, U Joseph

    2005-09-01

    To assess the performance of an automated computer-aided detection (CAD) system as a second reader on chest CT studies interpreted as normal at routine clinical interpretation. Chest CT studies were processed using a prototype CAD system for automated detection of lung lesions. Three experienced radiologists analyzed each CAD finding and confirmed or dismissed the marked image features as lung lesions. Noncalcified, focal lung lesions were classified according to size as being of high (> or = 10 mm), intermediate (5 to 9 mm), or low (< or = 4 mm) significance. Two sub-specialized academic tertiary referral centers in the United States and Germany. Chest CT studies were performed in 100 patients, with results initially reported as normal at clinical double reading. Indications for chest CT were suspected pulmonary embolism (PE) [n = 33], lung cancer screening in a high-risk population (n = 28), or follow-up for a cancer history (n = 39). Reevaluation of all chest CT studies for focal lung lesions with the CAD system as a second reader. Prevalence and spectrum of lung lesions missed at routine clinical interpretation but found by the CAD system. In 33% (33 of 100 patients), CAD detected significant lung lesions that were not previously reported. Fifty-three significant lesions were detected (mean, 1.6 lesions per case), of which 5 lesions (9.4%) were of high significance, 21 lesions (39.6%) were of intermediate significance, and 27 lesions (50.9%) were of low significance. In the PE group, the lung cancer screening group, and the group with a cancer history, four patients (12.1%), six patients (21.4%), and nine patients (23.1%), respectively, had focal lung lesions of high and/or intermediate significance. The false-positive rate of the CAD system was an average of 1.25 per case (range, 0 to 11). Significant lung lesions are frequently missed at routine clinical interpretation of chest CT studies but may be detected if CAD is used as an additional reader.

  17. MR findings of Minamata disease--organic mercury poisoning.

    PubMed

    Korogi, Y; Takahashi, M; Okajima, T; Eto, K

    1998-01-01

    We describe MR findings in patients with Minamata disease who have been followed for a long time. All patients examined were affected after daily eating of a large quantity of methylmercury-contaminated seafood, from 1955 to 1958, and showed typical neurological findings. On MR images, the visual cortex, the cerebellar vermis and hemispheres, and the postcentral cortex are significantly atrophic in Minamata disease. The visual cortex is slightly hypointense on T1-weighted images and hyperintense on T2-weighted images, probably representing the pathologic changes of status spongiosus. MRI can demonstrate the lesions located in the calcarine area, cerebellum, and postcentral gyri, which are probably related to three of the characteristic manifestations of this disease: the constriction of the visual fields, ataxia, and sensory disturbance, respectively.

  18. Cervical neuroblastoma in eleven infants--a tumor with favorable prognosis. Clinical and radiologic (US, CT, MRI) findings.

    PubMed

    Abramson, S J; Berdon, W E; Ruzal-Shapiro, C; Stolar, C; Garvin, J

    1993-01-01

    Cervical neuroblastoma, a disease primarily of infants, has a favorable prognosis. Eleven patients are reported. Clinical presentations (other than mass) included stridor and swallowing problems. Masses when felt were commonly mistaken for infectious adenitis. Imaging studies (US, CT, MRI) showed solid masses with vascular displacement and narrowing; intraspinal extension was absent though extension into the adjacent sites of mediastinum and skull occurred. Horner syndrome was seen in five patients with accompanying heterochromia iridis in one. Five tumors had calcification. A high index of suspicion will lead to biopsy and less delay in diagnosis once a mass is felt or imaged.

  19. [Findings of the (18)F-FDG PET-CT in a cardiac angiosarcoma complicated by a cardiac rupture].

    PubMed

    Santiago-Chinchilla, Alicia; Ruiz-Carazo, Eduardo; Moral-Ruiz, Antonio; Testart Dardel, Nathalie; Martínez-Martínez, Alberto; López-Fernández, Silvia

    2014-01-01

    Primary malignant tumors of the heart are a rare condition. The most common type is the cardiac angiosarcoma. The symptoms of this disease are very nonspecific and can be very difficult to diagnose by conventional imaging techniques. We report the case of a male patient with cardiac angiosarcoma who also had a rare complication, this being cardiac rupture, which required the use of (18)F-FDG PET-CT to demonstrate the mass malignancy and to reach a definitive diagnosis. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  20. 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.

  1. Primary malignant fibrous histiocytoma of the abdominal cavity: CT findings and pathological correlation

    PubMed Central

    Karki, Bivek; Xu, Yi-Kai; Wu, Yuan-Kui; Zhang, Wei-Wei

    2012-01-01

    AIM: To study computed tomography (CT) features of abdominal malignant fibrous histiocytoma (MFH) in various rare locations. METHODS: We retroprospectively identified cases of MFH involving the abdominal cavity. Particular attention was paid to details regarding imaging features and histological types. RESULTS: The study population consisted of seven men and one woman, with a mean age of 52.5 years. Seven patients had some physical symptoms, while one was incidentally detected. The sites of origin were liver (n = 3), greater omentum (n = 1), superior mesentery (n = 1), ileum (n = 1), right psoas muscle (n = 1) and right kidney (n = 1). With the exception of the ileum lesion, all were of huge size. The contour of the lesions was more or less clear. Foci of necrosis were present in six lesions (n = 6). On plain CT scan, all lesions were hypo to iso dense. The lesion in the greater omentum was cystic. One lesion (n = 1) showed significant enhancement and the cystic lesion showed mild peripheral enhancement. An abundance of blood vessels surrounding the mass was seen in two lesions (n = 2) and both were of the inflammatory variety. Pathological examination revealed storiform-pleomorphic variety (n = 4), inflammatory variety (n = 3) and myxoid variety (n = 1). Two of the patients with inflammatory MFH had a clinical presentation of fever and one was afebrile, however, blood investigations in all three showed leukocytosis. CONCLUSION: Primary MFHs of the abdominal viscera and gastrointestinal tract are generally huge soft tissue masses containing areas of low attenuation and mild to moderate contrast enhancement. PMID:22590669

  2. Coeliac disease in primary care: case finding study

    PubMed Central

    Hin, Harold; Bird, Graham; Fisher, Peter; Mahy, Nick; Jewell, Derek

    1999-01-01

    Objectives To provide evidence of underdiagnosis of coeliac disease and to describe the main presenting symptoms of coeliac disease in primary care. Design Case finding in a primary care setting by testing for coeliac disease by using the endomysial antibody test. Setting Nine surgeries in and around a market town in central England, serving a population of 70 000. Participants First 1000 patients screened from October 1996 to October 1997. Outcome measures Determination of endomysial antibody titre of patients fulfilling the study criteria, followed by small intestine biopsy of those with positive results. Results The 30 patients (out of 1000 samples) with positive results on the endomysial antibody test all had histological confirmation on small intestine biopsy. The commonest mode of presentation (15/30) was anaemia of varying severity. Most patients (25/30) presented with non-gastrointestinal symptoms. Specificity of the endomysial antibody test was 30/30. Conclusions Underdiagnosis and misdiagnosis of coeliac disease are common in general practice and often result in protracted and unnecessary morbidity. Serological screening in primary care will uncover a large proportion of patients with this condition and should be made widely available and publicised. Coeliac disease should be considered in patients who have anaemia or are tired all the time, especially when there is a family history of the disease. Key messagesGeneral practitioners currently see many people with undiagnosed coeliac diseaseThe most likely presentation is a combination of microcytic anaemia, past or present, a family history of the disease, and feeling tired all the timeEstimations of endomysial antibody and IgA are reliable diagnostic toolsThe prevalence of coeliac disease in Britain is higher than the accepted figure of 1:1000 populationIncreased awareness of the extra intestinal manifestations of coeliac disease, coupled with a low threshold for serological testing, will uncover a

  3. CT-Guided Transthoracic Core Biopsy for Pulmonary Tuberculosis: Diagnostic Value of the Histopathological Findings in the Specimen

    SciTech Connect

    Fukuda, Hozumi Ibukuro, Kenji; Tsukiyama, Toshitaka; Ishii, Rei

    2004-09-15

    We evaluated the value of CT-guided transthoracic core biopsy for the diagnosis of mycobacterial pulmonary nodules. The 30 subjects in this study had pulmonary nodules that had been either diagnosed histopathologically as tuberculosis or were suspected as tuberculosis based on a specimen obtained by CT-guided transthoracic core biopsy. The histopathological findings, the existence of acid-fast bacilli in the biopsy specimens, and the clinical course of the patients after the biopsy were reviewed retrospectively. Two of the three histological findings for tuberculosis that included epithelioid cells, multinucleated giant cells and caseous necrosis were observed in 21 of the nodules which were therefore diagnosed as histological tuberculosis. Six of these 21 nodules were positive for acid-fast bacilli, confirming the diagnosis of tuberculosis. Thirteen of the 21 nodules did not contain acid-fast bacilli but decreased in size in response to antituberculous treatment and were therefore diagnosed as clinical tuberculosis. Seven nodules with only caseous necrosis were diagnosed as suspected tuberculosis, with a final diagnosis of tuberculosis being made in 4 of the nodules and a diagnosis of old tuberculosis in 2 nodules. Two nodules with only multinucleated giant cells were diagnosed as suspected tuberculosis with 1 of these nodules being diagnosed finally as tuberculosis and the other nodule as a nonspecific granuloma. When any two of the three following histopathological findings - epithelioid cells, multinucleated giant cells or caseous necrosis - are observed in a specimen obtained by CT-guided transthoracic core biopsy, the diagnosis of tuberculosis can be established without the detection of acid-fast bacilli or Mycobacterium tuberculosis.

  4. Glycogen Storage Disease Type IV: A Case With Histopathologic Findings in First-Trimester Placental Tissue.

    PubMed

    Bendroth-Asmussen, Lisa; Aksglaede, Lise; Gernow, Anne B; Lund, Allan M

    2016-01-01

    A 30-yr-old woman presented with 2 consecutive miscarriages within 7 mo. Histopathologic examination of the placental tissue showed intracytoplasmic inclusion vacuoles with a strong reaction in Periodic acid-Schiff staining and a slightly pallor reaction in alcian blue staining. Additional molecular genetic analyses confirmed glycogen storage disease Type IV with the finding of compound heterozygosity for 2 mutations (c.691+2T>C and c.1570C>T, p.R524X) in the GBE1 gene. We conclude that glycogen storage disease Type IV can cause early miscarriage and that diagnosis can initially be made on histopathologic examination. Genetic analysis is required to confirm the diagnosis and to offer prenatal genetic testing in future pregnancies.

  5. 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.

  6. Association of Esophageal Inflammation, Obesity and Gastroesophageal Reflux Disease: From FDG PET/CT Perspective

    PubMed Central

    Lee, Yi-Chia; Wang, Shan-Ying; Chiu, Han-Mo; Tu, Chia-Hung; Wang, Hsiu-Po; Lin, Jaw-Town; Wu, Ming-Shiang; Yang, Wei-Shiung

    2014-01-01

    Objective Gastroesophageal reflux disease (GERD) is associated with bothersome symptoms and neoplastic progression into Barrett's esophagus and esophageal adenocarcinoma. We aim to determine the correlation between GERD, esophageal inflammation and obesity with 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Methods We studied 458 subjects who underwent a comprehensive health check-up, which included an upper gastrointestinal endoscopy, FDG PET/CT and complete anthropometric measures. GERD symptoms were evaluated with Reflux Disease Questionnaire. Endoscopically erosive esophagitis was scored using the Los Angeles classification system. Inflammatory activity, represented by standardized uptake values (SUVmax) of FDG at pre-determined locations of esophagus, stomach and duodenum, were compared. Association between erosive esophagitis, FDG activity and anthropometric evaluation, including body mass index (BMI), waist circumference, visceral and subcutaneous adipose tissue volumes were analyzed. Results Subjects with erosive esophagitis (n = 178, 38.9%) had significantly higher SUVmax at middle esophagus (2.69±0.74 vs. 2.41±0.57, P<.001) and esophagogastric junction (3.10±0.89 vs. 2.38±0.57, P<.001), marginally higher at upper esophageal sphincter (2.29±0.42 vs. 2.21±0.48, P = .062), but not in stomach or duodenum. The severity of erosive esophagitis correlated with SUVmax and subjects with Barrett's esophagus had the highest SUVmax at middle esophagus and esophagogastric junction. Heartburn positively correlated with higher SUVmax at middle oesophagus (r = .262, P = .003). Using multivariate regression analyses, age (P = .027), total cholesterol level (P = .003), alcohol drinking (P = .03), subcutaneous adipose tissue (P<.001), BMI (P<.001) and waist circumference (P<.001) were independently associated with higher SUVmax at respective esophageal locations. Conclusions Esophageal inflammation

  7. Early interim FDG PET/CT prediction of treatment response and prognosis in pediatric Hodgkin disease-added value of low-dose CT.

    PubMed

    Ilivitzki, Anat; Radan, Lea; Ben-Arush, Miriam; Israel, Ora; Ben-Barak, Ayelet

    2013-01-01

    Interim 18F-FDG PET helps predict outcome and tailor treatment in adults with Hodgkin disease (HD). The purpose of this study was to assess predictive values of interim 18F-FDG PET/CT in children with HD and to define the potential added value to interim PET of low-dose CT. Children were prospectively enrolled August 2002-April 2007. PET/low-dose CT was performed at staging, after 2 cycles, at the end of treatment and during follow-up (mean 45 months). Treatment was unchanged regardless of interim results. PET and low-dose CT were read independently. Of 34 enrolled children (ages 3-17 years), 27 achieved complete response, 4 had progressive disease and 3 had relapse. Interim PET alone had positive and negative predictive values of 67% and 89%, respectively. Interim low-dose CT alone had positive and negative predictive values of 35% and 100%, respectively. Interim PET/CT had positive and negative predictive values of 75% and 96%, respectively. Early interim PET/CT was a good predictor of outcome. Integrated PET and low-dose CT improved the predictive value in children with HD.

  8. Is it possible to limit the use of CT scanning in acute diverticular disease without compromising outcomes? A preliminary experience.

    PubMed

    Caputo, Pierpaolo; Rovagnati, Marco; Carzaniga, Pier Luigi

    2015-01-01

    The aim of our study was to determine whether the use of CT scanning in the assessment of acute diverticulitis can be reduced without a negative effect on outcome. Our series consisted of 93 out of 100 patients with acute diverticulitis admitted to the Emergency Room of our institution in the period from February 2012 to March 2013.The Hinchey classification system was used to stage disease based on findings on ultrasound (US) examination and/or computed tomography (CT) scanning. We compared the patients' Hinchey stage (HS) on admission and 72 hours later. Types of treatment were defined as emergency or delayed intervention (operative approaches (OA); ultrasound-guided percutaneous drainage (UPD), and surgery. The borderline between conservative and surgical management was identified. In patients with a HS CT scans. The skill of the individual operator in US examination was found to be of key importance. As regards CT scanning, we found, in agreement with the literature, that it has greater specificity and sensitivity than US, and is therefore indicated if the patient's condition has deteriorated.

  9. Characteristics of false positive findings in CT colonography CAD: a comparison of two fecal tagging regimens

    NASA Astrophysics Data System (ADS)

    Morra, Lia; Delsanto, Silvia; Agliozzo, Silvano; Baggio, Riccardo; Belluccio, Erika; Correale, Loredana; Genova, Dario; Bert, Alberto; Regge, Daniele

    2009-02-01

    The successful application of Computer Aided Detection schemes to CT Colonography depends not only on their performances in terms of sensitivity and specificity, but also on the interaction with the radiologist, and thus ultimately on factors such as the nature of CAD prompts and the reading paradigm. Fecal tagging is emerging as a widely accepted technique for patient preparation, and patient-friendlier schemes are being proposed in an effort to increase compliance to screening programs; the interaction between CAD and FT regimens should likewise be taken into account. In this scenario, an analysis of the characteristics of CAD prompts is of paramount importance in order to guide further research, both from clinical and technical viewpoints. The CAD scheme analyzed in this paper is essentially composed of five steps: electronic cleansing, colon surface extraction, polyp candidate segmentation, pre-filtering of residual tagged stool and classification of the generated candidates in true polyps vs. false alarms. False positives were divided into six categories: untagged and tagged solid stool, haustral folds, extra-colonic candidates, ileocecal valve and cleansing artifacts. A full cathartic preparation was compared with a semi-cathartic regimen with sameday fecal tagging, which is characterized by higher patient acceptance but also higher inhomogeneity. The distribution of false positives at segmentation reflects the quality of preparation, as more inhomogeneous tagging results in a higher number of untagged solid stool and cleansing artifacts.

  10. 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 ...

  11. Chest radiographic and CT findings in hyperleukocytic acute myeloid leukemia: A retrospective cohort study of 73 patients.

    PubMed

    Stefanski, Michael; Jamis-Dow, Carlos; Bayerl, Michael; Desai, Ruchi J; Claxton, David F; Van de Louw, Andry

    2016-11-01

    Hyperleukocytic acute myeloid leukemia (AML) is associated with pulmonary complications and high early mortality rate, but given its rarity, data on chest radiographic presentation are scarce.We retrospectively reviewed the charts of 73 AML patients admitted with white blood cell count >100 × 10/L between 2003 and 2014 in order to describe the chest radiographic and computed tomography (CT) findings and to correlate them with AML subtype and respiratory symptoms.Forty-two of the 73 patients (58%) overall and 36 of the 54 patients (67%) with clinical signs of pulmonary leukostasis had abnormal radiographs on admission. The presence of radiographic abnormalities was significantly associated with dyspnea and oxygen/ventilatory support requirements (P < 0.01) and with day 28 mortality (45% vs 13%, P = 0.005) but not with monocytic subtype of AML. Sixteen patients had isolated focal basilar airspace opacities, unilateral (n = 13) or bilateral (n = 3), while 16 patients had bilateral diffuse opacities, interstitial (n = 12) or airspace and interstitial (n = 4). Two patients had isolated pleural effusion, 2 patients had unilateral midlung airspace opacities, and 6 patients had a combination of focal airspace and diffuse interstitial opacities. Overall, 2 patterns accounted for 75% of abnormal findings: bilateral diffuse opacities tended to be associated with monocytic AML, whereas basilar focal airspace opacities were more frequent in nonmonocytic AML (P < 0.05). Eighteen patients had CT scans, revealing interlobular septal thickening (n = 12), airspace (n = 11) and ground-glass (n = 9) opacities, pleural effusions (n = 12), and acute pulmonary embolism (n = 2).Hyperleukocytic AML is frequently associated with abnormal chest radiographs, involving mostly focal basilar airspace opacities (more frequent in nonmonocytic AML) or diffuse bilateral opacities. CT scan should be considered broadly due to the suboptimal

  12. FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease.

    PubMed

    Paes, Fabio M; Kalkanis, Dimitrios G; Sideras, Panagiotis A; Serafini, Aldo N

    2010-01-01

    The term extranodal disease refers to lymphomatous infiltration of anatomic sites other than the lymph nodes. Almost any organ can be affected by lymphoma, with the most common extranodal sites of involvement being the stomach, spleen, Waldeyer ring, central nervous system, lung, bone, and skin. The prevalence of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease has increased in the past decade. The imaging characteristics of extranodal involvement can be subtle or absent at conventional computed tomography (CT). Imaging of tumor metabolism with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) has facilitated the identification of affected extranodal sites, even when CT has demonstrated no lesions. More recently, hybrid PET/CT has become the standard imaging modality for initial staging, follow-up, and treatment response assessment in patients with lymphoma and has proved superior to CT in these settings. Certain PET/CT patterns are suggestive of extranodal disease and can help differentiate tumor from normal physiologic FDG activity, particularly in the mucosal tissues, bone marrow, and organs of the gastrointestinal tract. Familiarity with the different extranodal manifestations in various locations is critical for correct image interpretation. In addition, a knowledge of the differences in FDG avidity among the histologic subtypes of lymphoma, appropriate timing of scanning after therapeutic interventions, and use of techniques to prevent brown fat uptake are essential for providing the oncologist with accurate information.

  13. Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD

    PubMed Central

    2013-01-01

    Background Gas trapping quantified on chest CT scans has been proposed as a surrogate for small airway disease in COPD. We sought to determine if measurements using paired inspiratory and expiratory CT scans may be better able to separate gas trapping due to emphysema from gas trapping due to small airway disease. Methods Smokers with and without COPD from the COPDGene Study underwent inspiratory and expiratory chest CT scans. Emphysema was quantified by the percent of lung with attenuation < −950HU on inspiratory CT. Four gas trapping measures were defined: (1) Exp−856, the percent of lung < −856HU on expiratory imaging; (2) E/I MLA, the ratio of expiratory to inspiratory mean lung attenuation; (3) RVC856-950, the difference between expiratory and inspiratory lung volumes with attenuation between −856 and −950 HU; and (4) Residuals from the regression of Exp−856 on percent emphysema. Results In 8517 subjects with complete data, Exp−856 was highly correlated with emphysema. The measures based on paired inspiratory and expiratory CT scans were less strongly correlated with emphysema. Exp−856, E/I MLA and RVC856-950 were predictive of spirometry, exercise capacity and quality of life in all subjects and in subjects without emphysema. In subjects with severe emphysema, E/I MLA and RVC856-950 showed the highest correlations with clinical variables. Conclusions Quantitative measures based on paired inspiratory and expiratory chest CT scans can be used as markers of small airway disease in smokers with and without COPD, but this will require that future studies acquire both inspiratory and expiratory CT scans. PMID:23566024

  14. Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD.

    PubMed

    Hersh, Craig P; Washko, George R; Estépar, Raúl San José; Lutz, Sharon; Friedman, Paul J; Han, MeiLan K; Hokanson, John E; Judy, Philip F; Lynch, David A; Make, Barry J; Marchetti, Nathaniel; Newell, John D; Sciurba, Frank C; Crapo, James D; Silverman, Edwin K

    2013-04-08

    Gas trapping quantified on chest CT scans has been proposed as a surrogate for small airway disease in COPD. We sought to determine if measurements using paired inspiratory and expiratory CT scans may be better able to separate gas trapping due to emphysema from gas trapping due to small airway disease. Smokers with and without COPD from the COPDGene Study underwent inspiratory and expiratory chest CT scans. Emphysema was quantified by the percent of lung with attenuation < -950HU on inspiratory CT. Four gas trapping measures were defined: (1) Exp(-856), the percent of lung < -856HU on expiratory imaging; (2) E/I MLA, the ratio of expiratory to inspiratory mean lung attenuation; (3) RVC(856-950), the difference between expiratory and inspiratory lung volumes with attenuation between -856 and -950 HU; and (4) Residuals from the regression of Exp(-856) on percent emphysema. In 8517 subjects with complete data, Exp(-856) was highly correlated with emphysema. The measures based on paired inspiratory and expiratory CT scans were less strongly correlated with emphysema. Exp(-856), E/I MLA and RVC(856-950) were predictive of spirometry, exercise capacity and quality of life in all subjects and in subjects without emphysema. In subjects with severe emphysema, E/I MLA and RVC(856-950) showed the highest correlations with clinical variables. Quantitative measures based on paired inspiratory and expiratory chest CT scans can be used as markers of small airway disease in smokers with and without COPD, but this will require that future studies acquire both inspiratory and expiratory CT scans.

  15. Ruling out coronary artery disease with noninvasive coronary multidetector CT angiography before noncoronary cardiovascular surgery.

    PubMed

    Catalán, Paz; Leta, Rubén; Hidalgo, Alberto; Montiel, José; Alomar, Xavier; Viladés, David; Barros, Antonio; Pujadas, Sandra; Carreras, Francesc; Padró, Josep M; Cinca, Juan; Pons-Lladó, Guillem

    2011-02-01

    To assess the usefulness of preoperative coronary computed tomographic (CT) angiography in the detection of coronary artery disease (CAD) in nonselected patients scheduled to undergo noncoronary cardiovascular surgery to avoid unnecessary invasive coronary angiography (ICA). The institutional review board approved the study protocol; informed consent was given. This prospective study involved 161 consecutive patients who underwent coronary calcium scoring and coronary CT angiography before undergoing noncoronary cardiovascular surgery. Seven patients were excluded because of contraindications to CT angiography. The major indication of noncoronary cardiovascular surgery was valvular heart disease (121 patients). Follow-up was performed at a median of 20 months to define ischemic events described as acute coronary syndrome or death secondary to acute coronary syndrome, arrhythmias, or cardiac failure. Multivariate analysis was performed to determine predictors of nondiagnostic coronary CT angiography. Kaplan-Meier analysis was performed to evaluate outcome at follow-up. Twenty-one patients did not undergo surgery, which left 133 patients as the study group. Atrial fibrillation was present in 45 of 133 patients. The interquartile range of the Agatston coronary calcium score was 0-471. Coronary CT angiography was diagnostic in 108 of 133 patients. Of these, 93 of 108 had no significant CAD (≤ 50% stenosis), and noncoronary cardiovascular surgery was performed in them without preoperative ICA. No patients in this group had postoperative ischemic events at follow-up. Coronary CT angiography was nondiagnostic in 25 of 133 patients who were referred for preoperative ICA. Multivariate analysis showed Agatston score to be the only independent predictor of nondiagnostic coronary CT angiography (odds ratio = 1.002; 95% confidence interval: 1.001, 1.003; P = .001). The best Agatston score cutoff for diagnostic coronary CT angiography was 579. In nonselected patients scheduled

  16. MRI findings in pediatric neuro-Behçet's disease.

    PubMed

    Saltik, S; Saip, S; Kocer, N; Siva, A; Yalçinkaya, C

    2004-06-01

    Behçet's disease (BD), a systemic vasculitis of unknown cause, affects many organs and systems. Neurological involvement is seen in 5-15% of the patients, and the two major forms of neurological disease seen in BD are central nervous system (CNS) parenchymal involvement and cerebral venous sinus thrombosis. We report a 14-year-old boy with BD who had neuro-parenchymal involvement. The diagnosis of the systemic disease was not made until the onset of the neurological manifestations, which led to an MRI study that revealed findings suggestive of CNS involvement of BD. We therefore emphasize the importance of the localization and appearance of other characteristics of the lesions on MRI in the differential diagnosis of parenchymal neuro-Behçet syndrome.

  17. Neuropsychological findings in patients with Unverricht-Lundborg disease.

    PubMed

    Ferlazzo, Edoardo; Gagliano, Antonella; Calarese, Tiziana; Magaudda, Adriana; Striano, Pasquale; Cortese, Lara; Cedro, Clemente; Laguitton, Virgilie; Bramanti, Placido; Carbonaro, Marilena; Albachiara, Addolorata; Fragassi, Nina; Italiano, Domenico; Sessa, Edoardo; Coppola, Antonietta; Genton, Pierre

    2009-03-01

    The aims of this study were to clarify if patients with Unverricht-Lundborg disease (ULD) have adequate cognitive functioning and to delineate their neuropsychological profile. We evaluated 20 patients with ULD and 20 healthy, matched controls. Mean age of the patients was 35 years, and mean duration of disease, 22 years. Patients underwent a neuropsychological battery exploring intelligence, executive functions, visuospatial and verbal memory, depression, and anxiety. Eleven of 20 subjects with ULD had mild to moderate cognitive impairment. Compared with controls, patients with ULD had lower scores on all short-term memory and executive function tasks. Linear regression analysis disclosed significant associations between impaired performance on some memory tests and duration of disease and between severity of myoclonus and performance on most executive function tests. In conclusion, most patients with ULD seem to be impaired with respect to cognitive abilities. Longitudinal prospective studies are needed to confirm and further expand our findings.

  18. Extracolonic Findings on CT Colonography Increases Yield of Colorectal Cancer Screening

    DTIC Science & Technology

    2010-09-01

    Potentially important finding: communicate to referring physician as per accepted practice guidelines Ovarian mass; kidney mass; abdominal aortic aneurysm ...study. Examples of E4 findings are potential malignancies or large abdominal aortic aneurysms [12] (Fig. 1). According to this classification, only...abdominal aortic aneurysm (≥ 5 cm) confirmed in the operating room. Assignment of CTC Reporting and Data System Because the CTC reporting and data

  19. The role of 18F–NaF PET/CT in metastatic bone disease

    PubMed Central

    Araz, Mine; Aras, Gülseren; Küçük, Özlem N.

    2015-01-01

    Aim To investigate the role of 18F–NaF PET/CT and compare it with 99m Tc-MDP whole body bone scintigraphy and 18F-FDG PET/CT in detecting the extent of metastatic bone disease and to present our first experience with 18F–NaF PET/CT in our country. Materials and methods A total of 37 histopathologically proven cancer patients (22 male, 15 female) with bone metastasis detected on Tc-99m MDP whole body bone scan were prospectively enrolled Cebeci, following ethics committee approval. 18F–NaF PET/CT was performed to the participants in Ankara University Medical Faculty Nuclear Medicine Department for evaluation of symptomatic skeletal sites which were negative on Tc-99m MDP whole body bone scan. A lesion based comparison was made between 18F–NaF PET/CT and Tc-99m MDP whole body bone scan for each patient and between 18F–NaF PET/CT and 18F-FDG PET/CT in 12/37 patients. Results The number of lesions demonstrated by 99m Tc-MDP bone scan and 18F–NaF PET/CT was equal in 4/37 (%11) of the cases. 18F–NaF PET/CT showed a greater number of pathological foci in 89% of participants. 18F–NaF PET/CT was able to show both lytic and blastic lesions and small lesions were better visualized due to the advantage of sectional imaging with much better resolution and higher target/background ratio. 18F–NaF PET/CT demonstrated a greater number of metastases in 10/12 (83%) of the patients when compared to 18F-FDG PET/CT. In the other two patients, bone metastasis could be demonstrated only by 18F–NaF PET/CT. The uptake of 18F-FDG was variable in blastic lesions and cranial bone involvement was missed by 18F-FDG PET/CT in some cases due to physiological brain metabolism. Conclusion Although further prospective clinical studies in specific cancer populations are indicated to set the place of 18F–NaF PET/CT in diagnostic scheme, the results of this pilot study from our country support the superiority of 18F–NaF PET/CT in investigation of bone metastasis over 99m

  20. Thoracic manifestations of Behçet disease at CT.

    PubMed

    Hiller, Nurith; Lieberman, Sivan; Chajek-Shaul, Tova; Bar-Ziv, Jacob; Shaham, Dorith

    2004-01-01

    Behçet disease is a multisystemic and chronic inflammatory disorder of unknown cause that is characterized by recurrent oral and genital ulcerations, ocular manifestations, and additional clinical manifestations in multiple organ systems. Behçet disease involving the chest can manifest as a wide spectrum of abnormalities. Although conventional chest radiography is commonly used for initial assessment, spiral computed tomography can demonstrate the entire spectrum of thoracic manifestations of Behçet disease, including abnormalities of the vessel lumen and wall, perivascular tissues, lung parenchyma, pleura, and mediastinal structures. Aneurysms of the pulmonary arteries, with or without thrombosis, are a typical manifestation of Behçet disease. Other manifestations include thrombosis, vasculitis, hemorrhage, infarction, and inflammation. Familiarity with these manifestations can be useful in the diagnosis of Behçet disease, helping to determine the cause of symptoms in patients who present with hemoptysis and guide the choice of appropriate therapy.

  1. Adolescent Kawasaki disease: usefulness of 64-slice CT coronary angiography for follow-up investigation.

    PubMed

    Carbone, Iacopo; Cannata, David; Algeri, Emanuela; Galea, Nicola; Napoli, Alessandro; De Zorzi, Andrea; Bosco, Giovanna; D'Agostino, Rita; Menezes, Leon; Catalano, Carlo; Passariello, Roberto; Francone, Marco

    2011-09-01

    Kawasaki disease (KD) is a systemic vasculitis that mainly affects coronary arteries in children, and requires regular follow-up from the time of diagnosis. To evaluate the feasibility of 64-slice CT angiography (CTA) for follow-up of patients with KD using previously performed invasive catheter coronary angiography (CCA) as reference standard. The study group comprised 12 patients (age 17.6 ± 2.9 years, mean ± SD) with a diagnosis of KD and a previously performed CCA (interval, 32.6 ± 13.5 months) who underwent 64-slice cardiac CTA. The quality of the images for establishing the presence of coronary abnormalities was determined by two observers. The CTA findings were compared with those from the prior CCA. Adequate image quality was obtained in all patients. Mean effective dose for CTA was 6.56 ± 0.95 mSv. CTA allowed accurate identification, characterization and measurement of all coronary aneurysms (n = 32), stenoses (n = 3) and occlusions (n = 9) previously demonstrated by CCA. One patient with disease progression went on to have percutaneous coronary intervention. Coronary lesions were reliably evaluated by 64-slice CTA in the follow-up of compliant patients with KD, reducing the need for repeated diagnostic invasive CCA. Hence, in an adequately selected patient population, the role of CCA could be limited almost only to therapeutic procedures.

  2. CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

    PubMed Central

    Austin, John H. M.; Hogg, James C.; Grenier, Philippe A.; Kauczor, Hans-Ulrich; Bankier, Alexander A.; Barr, R. Graham; Colby, Thomas V.; Galvin, Jeffrey R.; Gevenois, Pierre Alain; Coxson, Harvey O.; Hoffman, Eric A.; Newell, John D.; Pistolesi, Massimo; Silverman, Edwin K.; Crapo, James D.

    2015-01-01

    The purpose of this statement is to describe and define the phenotypic abnormalities that can be identified on visual and quantitative evaluation of computed tomographic (CT) images in subjects with chronic obstructive pulmonary disease (COPD), with the goal of contributing to a personalized approach to the treatment of patients with COPD. Quantitative CT is useful for identifying and sequentially evaluating the extent of emphysematous lung destruction, changes in airway walls, and expiratory air trapping. However, visual assessment of CT scans remains important to describe patterns of altered lung structure in COPD. The classification system proposed and illustrated in this article provides a structured approach to visual and quantitative assessment of COPD. Emphysema is classified as centrilobular (subclassified as trace, mild, moderate, confluent, and advanced destructive emphysema), panlobular, and paraseptal (subclassified as mild or substantial). Additional important visual features include airway wall thickening, inflammatory small airways disease, tracheal abnormalities, interstitial lung abnormalities, pulmonary arterial enlargement, and bronchiectasis. © RSNA, 2015 PMID:25961632

  3. Comparison of CT and MR in 400 patients with suspected disease of the brain and cervical spinal cord

    SciTech Connect

    Bradley, W.G. Jr.; Waluch, V.; Yadley, R.A.; Wycoff, R.R.

    1984-09-01

    Magnetic resonance imaging (MR) (0.35T) and computed tomography (CT) were compared in 400 consecutive patients with suspected disease of the brain and cervical spinal cord. Of 325 positive diagnoses, MR detected abnormality while CT was normal in 93; MR was more specific in 68; MR and CT gave equivalent information in 129; CT was more specific in 32; and CT was positive while MR was normal in 3. MR was superior to CT in detection of multiple sclerosis, subcortical arteriosclerotic encephalopathy, posterior fossa infarcts and tumors, small extra-axial fluid collections, and cervical syringomyelia. CT was preferable in evaluation of meningiomas and separation of tumor from edema. CT takes less time and may be preferable in patients with acute trauma as well as very young or elderly individuals. Thus the two studies should be considered complementary.

  4. Traumatic optic neuropathy prediction after blunt facial trauma: derivation of a risk score based on facial CT findings at admission.

    PubMed

    Bodanapally, Uttam K; Van der Byl, Giulia; Shanmuganathan, Kathirkamanathan; Katzman, Lee; Geraymovych, Elena; Saksobhavivat, Nitima; Mirvis, Stuart E; Sudini, Kuladeep R; Krejza, Jaroslaw; Shin, Robert Kang

    2014-09-01

    To determine the specific facial computed tomographic (CT) findings that can be used to predict traumatic optic neuropathy (TON) in patients with blunt craniofacial trauma and propose a scoring system to identify patients at highest risk of TON. This study was compliant with HIPAA, and permission was obtained from the institutional review board. Facial CT examination findings in 637 consecutive patients with a history of blunt facial trauma were evaluated retrospectively. The following CT variables were evaluated: midfacial fractures, extraconal hematoma, intraconal hematoma, hematoma along the optic nerve, hematoma along the posterior globe, optic canal fracture, nerve impingement by optic canal fracture fragment, extraconal emphysema, and intraconal emphysema. A prediction model was derived by using regression analysis, followed by receiver operating characteristic analysis to assess the diagnostic performance. To examine the degree of overfitting of the prediction model, a k-fold cross-validation procedure (k = 5) was performed. The ability of the cross-validated model to allow prediction of TON was examined by comparing the mean area under the receiver operating characteristic curve (AUC) from cross-validations with that obtained from the observations used to create the model. The five CT variables with significance as predictors were intraconal hematoma (odds ratio, 12.73; 95% confidence interval [CI]: 5.16, 31.42; P < .001), intraconal emphysema (odds ratio, 5.21; 95% CI: 2.03, 13.36; P = .001), optic canal fracture (odds ratio, 4.45; 95% CI: 1.91, 10.35; P = .001), hematoma along the posterior globe (odds ratio, 0.326; 95% CI: 0.111, 0.958; P = .041), and extraconal hematoma (odds ratio, 2.36; 95% CI: 1.03, 5.41; P = .042). The AUC was 0.818 (95% CI: 0.734, 0.902) for the proposed model based on the observations used to create the model and 0.812 (95% CI: 0.723, 0.9) after cross-validation, excluding substantial overfitting of the model. The risk model

  5. [Application of multislice CT for the diagnosis of cerebro-vascular disease].

    PubMed

    Katada, Kazuhiro

    2004-11-01

    Introduction of multislice CT (MSCT) has revolutionizing the diagnosis of cerebro-vascular disease. Newly developed 32-slice MSCT enabled us to acquire isotropic volumetric data of whole brain with the resolution of 0.5-mm. CT perfusion is one of the promising application for the diagnosis of early-staged cerebral ischemia. However, it can be hazardous in terms of ionic radiation because of multiplied exposure to the same level. A new quantum denoising filter was developed in order to solve this problem. It is possible to reduce more than 80% of dose using the filter in combination with lower kv/lower mA technique. This filter can also aids to improve the detection of early CT signs, which is important for the diagnosis of cerebral ischemia. Detection of the penumbra can be made by revealing the absence of early CT sign and low perfusion area in CT perfusion. Isotropic volumetric data provided by MSCA can also be an ideal source data for the high-quality 3D-CT angiography. Improved temporal resolution of MSCT in obtaining volumetric data made it possible separated visualization of arteries and veins on single 3D-CTA image. The technique to visualize brain surface using isotropic data and volume rendering algorithm was also reported.

  6. [Potentialities of computed tomography and ultrasound in diagnosis of hormonally active adrenal diseases: results of comparison CT and US with operative adn histological data].

    PubMed

    Denisova, L B; Vorontsova, S V; Emel'ianova, L N

    2000-01-01

    The data given in the paper suggest that X-ray computed tomography (CT) is highly effective in detecting all types of hormonally active adrenal abnormalities. CT used in hormonally active adrenal diseases yielded data on major quantitative and qualitative (primarily densitometric) criteria that could be used in assessing the images of the adrenal area in these patients. Ultrasound study (USS) made at the first stage of topical diagnostic searches was of informative value in detecting adrenal tumor lesions, the technique being highly sensitive in the diagnosis of adrenal pheochromocytomas and adenocarcinomas, but less informative in the detection of hormonally active adrenocortical adenomas (aldesterone-producing ones in particular) than CT. The diagnosis of various adrenocortical hyperplasies and the differentiation of hyperplastic and tumor forms of hypercorticoidism are a prerogative of CT that substantially supplements USS findings in such cases.

  7. Bone Disease in the Common Marmoset: Radiographic and Histological Findings.

    PubMed

    Olson, E J; Shaw, G C; Hutchinson, E K; Schultz-Darken, N; Bolton, I D; Parker, J B; Morrison, J M; Baxter, V K; Pate, K A Metcalf; Mankowski, J L; Carlson, C S

    2015-09-01

    The common marmoset (Callithrix jacchus) is a New World primate that is used in biomedical research due to its small size and relative ease of handling compared with larger primates. Although bone disease in common marmosets is well recognized, there are very few detailed descriptions in the literature that cover the range of lesions seen in these animals. For all animals used to model human disease, it is important to be aware of background lesions that may affect the interpretation of study findings. This retrospective study details bone diseases encountered in marmoset breeding colonies at 2 different institutions. Affected marmosets at Johns Hopkins University had lesions compatible with diagnoses of rickets, fibrous osteodystrophy and osteopenia. Affected marmosets at the Wisconsin National Primate Research Center exhibited severe lesions of osteoclastic bone resorption and remodeling that had an unusual distribution and were not easily categorized into a known disease entity. The purpose of this report is to document these naturally occurring skeletal lesions of common marmosets and suggest an approach to evaluating skeletal disease in prospective studies of these animals that will allow the most accurate diagnoses.

  8. Recent Findings in Alzheimer Disease and Nutrition Focusing on Epigenetics.

    PubMed

    Athanasopoulos, Dimitrios; Karagiannis, George; Tsolaki, Magda

    2016-09-01

    Alzheimer disease (AD) is a chronic neurodegenerative disease with no effective cure so far. The current review focuses on the epigenetic mechanisms of AD and how nutrition can influence the course of this disease through regulation of gene expression, according to the latest scientific findings. The search strategy was the use of scientific databases such as PubMed and Scopus in order to find relative research or review articles published in the years 2012-2015. By showing the latest data of various nutritional compounds, this study aims to stimulate the scientific community to recognize the value of nutrition in this subject. Epigenetics is becoming a very attractive subject for researchers because it can shed light on unknown aspects of complex diseases like AD. DNA methylation, histone modifications, and microRNAs are the principal epigenetic mechanisms involved in AD pathophysiology. Nutrition is an environmental factor that is related to AD through epigenetic pathways. Vitamin B-12, for instance, can alter the one-carbon metabolism and thus interfere in the DNA methylation process. The research results might seem ambiguous about the clinical role of nutrition, but there is strengthening evidence that proper nutrition can not only change epigenetic biomarker levels but also prevent the development of late-onset AD and attenuate cognition deficit. Nutrition might grow to become a preventive and even therapeutic alternative against AD, especially if combined with other antidementia interventions, brain exercise, physical training, etc. Epigenetic biomarkers can be a very helpful tool to help researchers find the exact nutrients needed to create specific remedies, and perhaps the same biomarkers can be used even in patient screening in the future.

  9. Molecular findings from 537 individuals with inherited retinal disease

    PubMed Central

    Ellingford, Jamie M; Barton, Stephanie; Bhaskar, Sanjeev; O'Sullivan, James; Williams, Simon G; Lamb, Janine A; Panda, Binay; Sergouniotis, Panagiotis I; Gillespie, Rachel L; Daiger, Stephen P; Hall, Georgina; Gale, Theodora; Lloyd, I Christopher; Bishop, Paul N; Ramsden, Simon C; Black, Graeme C M

    2016-01-01

    Background Inherited retinal diseases (IRDs) are a clinically and genetically heterogeneous set of disorders, for which diagnostic second-generation sequencing (next-generation sequencing, NGS) services have been developed worldwide. Methods We present the molecular findings of 537 individuals referred to a 105-gene diagnostic NGS test for IRDs. We assess the diagnostic yield, the spectrum of clinical referrals, the variant analysis burden and the genetic heterogeneity of IRD. We retrospectively analyse disease-causing variants, including an assessment of variant frequency in Exome Aggregation Consortium (ExAC). Results Individuals were referred from 10 clinically distinct classifications of IRD. Of the 4542 variants clinically analysed, we have reported 402 mutations as a cause or a potential cause of disease in 62 of the 105 genes surveyed. These variants account or likely account for the clinical diagnosis of IRD in 51% of the 537 referred individuals. 144 potentially disease-causing mutations were identified as novel at the time of clinical analysis, and we further demonstrate the segregation of known disease-causing variants among individuals with IRD. We show that clinically analysed variants indicated as rare in dbSNP and the Exome Variant Server remain rare in ExAC, and that genes discovered as a cause of IRD in the post-NGS era are rare causes of IRD in a population of clinically surveyed individuals. Conclusions Our findings illustrate the continued powerful utility of custom-gene panel diagnostic NGS tests for IRD in the clinic, but suggest clear future avenues for increasing diagnostic yields. PMID:27208204

  10. [Retrospective computation of the ISS in multiple trauma patients: Potential pitfalls and limitations of findings in full body CT scans].

    PubMed

    Bogner, V; Brumann, M; Kusmenkov, T; Kanz, K G; Wierer, M; Berger, F; Mutschler, W

    2016-03-01

    The Injury Severity Score (ISS) is a well-established anatomical scoring system for polytraumatized patients. However, any inaccuracy in the Abbreviated Injury Score (AIS) directly increases the ISS impreciseness. Using the full body computed tomography (CT) scan report, ISS computation can be associated with certain pitfalls. This study evaluates interpretation variations depending on radiological reports and indicates requirements to reliably determine the ISS. The ISS of 81 polytraumatized patients was calculated based on the full body CT scan report. If an injury could not be attributed to a precise AIS cipher, the minimal and maximal ISS was computed. Real ISS included all conducted investigations, intraoperative findings, and final medical reports. The differences in ISS min, ISS max, and ISS real were evaluated using the Kruskal-Wallis test (p<0.05) and plotted in a linear regression analysis. Mean ISS min was 24.0 (± 0.7 SEM) points, mean ISS real 38.6 (±1.3 SEM) and mean ISS max was 48.3 (±1.4 SEM) points. All means were significantly different compared to one another (p<0.001). The difference between possible and real ISS showed a distinctive variation. Mean deviation was 9.7 (±0.9 SEM) points downward and 14.5 (±1.1 SEM) points upward. The difference between deviation to ISS min and ISS max was highly significant (p<0.001). Objectification of injury severity in polytraumatized patients using the ISS is an internationally well-established method in clinical and scientific settings. The full body CT scan report must meet distinct criteria and has to be written in acquaintance to the AIS scale if intended to be used for correct ISS computation.

  11. Ultrasonography and contrast-enhanced CT findings of tularemia in the neck

    PubMed Central

    Doğan, Serap; Ekinci, Afra; Demiraslan, Hayati; Kılıç, Ayşegül Ulu; Mavili, Ertuğrul; Öztürk, Mustafa; İmamoğlu, Hakan; Doğanay, Mehmet

    2016-01-01

    PURPOSE We aimed to evaluate the ultrasonography (US) and contrast-enhanced computed tomography (CECT) findings of tularemia in the neck. METHODS US and CECT findings of 58 patients with serologically proven tularemia were retrospectively evaluated. Forty-eight patients underwent US and 42 patients underwent CECT. Lymph node characteristics and parotid preauricular region involvement were analyzed using US and CECT. In addition, involvement of larynx, oropharynx, and retropharynx; presence of periorbital edema; and neck abscess formation were evaluated using CECT. Fine needle aspiration cytology (FNAC) results of enlarged lymph nodes were analyzed in 29 patients. RESULTS Hypoechoic pattern, round shape, absence of hilum, and cystic necrosis were seen in most of the lymph nodes especially at level 2 and 3 on US and CECT. Matting was more commonly observed than irregular nodal border on US and CECT. Parotid preauricular region involvement was seen in 20.8% of patients on US. Oropharyngeal, retropharyngeal, laryngeal and parotid preauricular region involvement and periorbital edema were seen in 52.4%, 19.1%, 4.8%, 31%, and 9.5% of tularemia patients, respectively. Neck abscess was found in 59.5% of patients on CECT. Suppurative inflammation was the most common finding of FNAC. CONCLUSION Tularemia should be considered in the presence of level 2 and 3 lymph nodes with cystic necrosis, matting, absence of calcification, oropharyngeal and retropharyngeal region involvement, and neck abscess, particularly in endemic areas. PMID:27498683

  12. Ultrasonography and contrast-enhanced CT findings of tularemia in the neck.

    PubMed

    Doğan, Serap; Ekinci, Afra; Demiraslan, Hayati; Ulu Kılıç, Ayşegül; Mavili, Ertuğrul; Öztürk, Mustafa; İmamoğlu, Hakan; Doğanay, Mehmet

    2016-01-01

    We aimed to evaluate the ultrasonography (US) and contrast-enhanced computed tomography (CECT) findings of tularemia in the neck. US and CECT findings of 58 patients with serologically proven tularemia were retrospectively evaluated. Forty-eight patients underwent US and 42 patients underwent CECT. Lymph node characteristics and parotid preauricular region involvement were analyzed using US and CECT. In addition, involvement of larynx, oropharynx, and retropharynx; presence of periorbital edema; and neck abscess formation were evaluated using CECT. Fine needle aspiration cytology (FNAC) results of enlarged lymph nodes were analyzed in 29 patients. Hypoechoic pattern, round shape, absence of hilum, and cystic necrosis were seen in most of the lymph nodes especially at level 2 and 3 on US and CECT. Matting was more commonly observed than irregular nodal border on US and CECT. Parotid preauricular region involvement was seen in 20.8% of patients on US. Oropharyngeal, retropharyngeal, laryngeal and parotid preauricular region involvement and periorbital edema were seen in 52.4%, 19.1%, 4.8%, 31%, and 9.5% of tularemia patients, respectively. Neck abscess was found in 59.5% of patients on CECT. Suppurative inflammation was the most common finding of FNAC. Tularemia should be considered in the presence of level 2 and 3 lymph nodes with cystic necrosis, matting, absence of calcification, oropharyngeal and retropharyngeal region involvement, and neck abscess, particularly in endemic areas.

  13. High-resolution CT findings of pulmonary tuberculosis in liver transplant patients.

    PubMed

    Schuhmacher Neto, R; Giacomelli, I L; Schuller Nin, C; da Silva Moreira, J; Comaru Pasqualotto, A; Marchiori, E; Loureiro Irion, K; Hochhegger, B

    2017-10-01

    To assess the high-resolution computed tomography (HRCT) findings in liver transplant patients diagnosed with pulmonary Mycobacterium tuberculosis infection. The HRCT findings from 19 patients diagnosed with pulmonary tuberculosis infection after liver transplantation were reviewed. The patients included were 12 men and seven women, age range 23-65 years; mean age 57 years. The diagnosis was established with Mycobacterium tuberculosis detection in bronchoalveolar lavage, sputum, or biopsy. HRCT images were reviewed independently by two observers who reached a consensus decision. The HRCT findings were classified as (1) miliary nodules; (2) cavitation and centrilobular tree-in-bud nodules; (3) ground-glass attenuation and consolidation; and (4) mediastinal lymph node enlargement. The time between the transplantation and the diagnosis of pulmonary tuberculosis ranged from 7 to 153 days with an average of 79 days. The main HRCT pattern was cavitation and centrilobular tree-in-bud nodules (79%) followed by mediastinal lymph node enlargement (10.4%), ground-glass attenuation or consolidation (5.2%) and miliary nodules (5.2%). None of the patients presented pleural effusion. The cavitation and centrilobular tree-in-bud nodules pattern had upper lobe predominance, and ground-glass attenuation and consolidation pattern had middle lobe/lingular segment predominance. The main HRCT pattern of pulmonary tuberculosis in liver transplant patients was cavitation and centrilobular tree-in-bud nodules. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  14. CT Scan Does Not Differentiate Patients with Hepatopulmonary Syndrome from Other Patients with Liver Disease

    PubMed Central

    Prabhudesai, Vikramaditya; Castel, Helene; Gupta, Samir

    2016-01-01

    Background Hepatopulmonary syndrome (HPS) is defined by liver dysfunction, intrapulmonary vascular dilatations, and impaired oxygenation. The gold standard for detection of intrapulmonary vascular dilatations in HPS is contrast echocardiography. However, two small studies have suggested that patients with HPS have larger segmental pulmonary arterial diameters than both normal subjects and normoxemic subjects with cirrhosis, when measured by CT. We sought to compare CT imaging-based pulmonary vasodilatation in patients with HPS, patients with liver dysfunction without HPS, and matching controls on CT imaging. Methods We performed a retrospective cohort study at two quaternary care Canadian HPS centers. We analyzed CT thorax scans in 23 patients with HPS, 29 patients with liver dysfunction without HPS, and 52 gender- and age-matched controls. We measured the artery-bronchus ratios (ABRs) in upper and lower lung zones, calculated the “delta ABR” by subtracting the upper from the lower ABR, compared these measurements between groups, and correlated them with clinically relevant parameters (partial pressure of arterial oxygen, alveolar-arterial oxygen gradient, macroaggregated albumin shunt fraction, and diffusion capacity). We repeated measurements in patients with post-transplant CTs. Results Patients had significantly larger lower zone ABRs and delta ABRs than controls (1.20 +/- 0.19 versus 0.98 +/- 0.10, p<0.01; and 0.12 +/- 0.17 versus -0.06 +/- 0.10, p<0.01, respectively). However, there were no significant differences between liver disease patients with and without HPS, nor any significant correlations between CT measurements and clinically relevant parameters. There were no significant changes in ABRs after liver transplantation (14 patients). Conclusions Basilar segmental artery-bronchus ratios are larger in patients with liver disease than in normal controls, but this vasodilatation is no more severe in patients with HPS. CT does not distinguish patients

  15. MAGNETIC RESONANCE IMAGING FINDINGS IN SMALL RUMINANTS WITH BRAIN DISEASE.

    PubMed

    Ertelt, Katrin; Oevermann, Anna; Precht, Christina; Lauper, Josiane; Henke, Diana; Gorgas, Daniela

    2016-01-01

    Brain disease is an important cause of neurologic deficits in small ruminants, however few MRI features have been described. The aim of this retrospective, case series study was to describe MRI characteristics in a group of small ruminants with confirmed brain disease. A total of nine small ruminants (six sheep and three goats) met inclusion criteria. All had neurologic disorders localized to the brain and histopathologic confirmation. In animals with toxic-metabolic diseases, there were bilaterally symmetric MRI lesions affecting either the gray matter (one animal with polioencephalomalacia) or the white matter (two animals with enterotoxemia). In animals with suppurative inflammation, asymmetric focal brainstem lesions were present (two animals with listeric encephalitis), or lesions typical of an intra-axial (one animal) or dural abscess (one animal), respectively. No MRI lesions were detected in one animal with suspected viral cerebellitis and one animal with parasitic migration tracts. No neoplastic or vascular lesions were identified in this case series. Findings from the current study supported the use of MRI for diagnosing brain diseases in small ruminants.

  16. Unusual thoracic radiographic findings in children treated for Hodgkin's disease

    SciTech Connect

    Jochelson, M.S.; Tarbell, N.J.; Weinstein, H.J.

    1986-06-01

    Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

  17. "Bottle Brush Sign"-Spinal Meningeal Disease on 18F-FDG PET-CT Scan.

    PubMed

    Riaz, Saima; Naz, Fozia; Bashir, Humayun; Niazi, Imran Khalid

    2016-09-01

    A 30-year-old man with a history of stage IV AE diffuse large cell lymphoma of left proximal humerus presented with new onset lower limb weakness at completion of chemotherapy. The F-FDG PET-CT scan showed increased intraspinal uptake from T12 to S1 vertebrae with unique "bottle brush" appearance in keeping with spinal meningeal disease. The leptomeningeal disease was further confirmed on correlative MRI scan.

  18. Seizure semiology and EEG findings in mitochondrial diseases.

    PubMed

    Chevallier, Justyna A; Von Allmen, Gretchen K; Koenig, Mary Kay

    2014-05-01

    Seizures constitute a frequent yet under-described manifestation of mitochondrial disorders (MDs). The aim of this study was to describe electroencephalography (EEG) findings and clinical seizure types in a population of children and adults with mitochondrial disease. Retrospective chart review of 165 records of children and adults with mitochondrial disease seen in the University of Texas Houston Mitochondrial Center between 2007 and 2012 was performed; all subjects were diagnosed with confirmed mitochondrial disease. EEG findings and clinical data, including seizure semiology and response to antiepileptic drugs (AEDs), were analyzed and categorized. Sixty-six percent (109/165) of subjects had a routine EEG performed. Sixty-one percent (67/109) of EEG studies were abnormal and 85% (56/67) had epileptiform discharges. The most common EEG finding was generalized slowing (40/67, 60%). The most frequent category of epileptiform activity seen was multifocal discharges (41%), followed by focal (39%) and generalized (39%) discharges. Clinical seizures were seen in 55% of subjects and the most common types of seizures observed were complex partial (37%) and generalized tonic-clonic (GTC; 37%). The most common seizure type in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) was GTC (33%), with generalized or focal discharges seen on EEG. In Leigh syndrome GTC (11%) and complex partial (11%) seizures were the most frequent types. Of 60 subjects with clinical seizures, 28% were intractable to medical treatment. Mitochondrial disorder should be included in the list of differential diagnosis in any child that presents with encephalopathy, seizures, and a fluctuating clinical course. Given the relatively high prevalence of EEG abnormalities in patients with MD, EEG should be performed during initial evaluation in all patients with MD, not only upon clinical suspicion of epilepsy. Wiley Periodicals, Inc. © 2014 International

  19. [Recommendations for reporting benign asbestos-related findings in chest X-ray and CT to the accident insurances].

    PubMed

    Kraus, T; Borsch-Galetke, E; Elliehausen, H J; Frank, K; Hering, K G; Hieckel, H G; Hofmann-Preiss, K; Jacques, W; Jeremie, U; Kotschy-Lang, N; Mannes, E; Otten, H; Raab, W; Raithel, H J; Schneider, W D; Tuengerthal, S

    2009-12-01

    Asbestos-related diseases still play an important role in occupational medicine. The detection of benign asbestos-related diseases is one condition for the compensation of asbestos-related lung cancer in Germany. Due to the increasing use of computed tomography, asbestos-related diseases are more frequently detected in the early stages. The present article proposes recommendations for the findings which have to be reported as suspicious for being asbestos-related based on a) chest X-rays and b) computed tomography using the International Classification System for Occupational and Environmental Respiratory Diseases (ICOERD).

  20. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics.

    PubMed

    Jaffe, Tracy; Thompson, William M

    2015-06-01

    Large-bowel obstruction is an abdominal emergency with high morbidity and mortality rates if left untreated. Although abdominal radiography is usually the initial imaging study performed in patients suspected of having large-bowel obstruction, it may not be sufficient to distinguish obstruction from other causes of colonic dilatation. Computed tomography is the imaging method of choice as it can establish the diagnosis and cause of large-bowel obstruction. A contrast agent enema may be used to confirm or exclude large-bowel obstruction. In this review, the imaging findings in multiple causes of large-bowel obstruction are illustrated and compared with acute colonic pseudo-obstruction.

  1. CT Findings of Ruptured Intramural Hematoma of the Aorta Extending Along the Pulmonary Artery

    SciTech Connect

    Sueyoshi, Eijun Sakamoto, Ichiro; Uetani, Masataka; Matsuoka, Yojiro; Suenaga, Etsuro

    2007-04-15

    Mediastinal hematoma extending along the pulmonary artery is a rare complication of Stanford type A classic (double-barreled) aortic dissection. Rupture from the posterior aspect of the aortic root penetrates the shared adventitia of the aorta and pulmonary artery. From this location, hematoma can spread along the adventitial planes of the pulmonary arteries out into the lungs. We report a case of ruptured intramural hematoma of the aorta (IMH) extending along the pulmonary artery. To our knowledge, this finding in patients with IMH has not been reported in the literature.

  2. Correlation of 18F-FDG PET/CT findings with histopathological results in differentiated thyroid cancer patients who have increased thyroglobulin or antithyroglobulin antibody levels and negative 131I whole-body scan results.

    PubMed

    Ozkan, Elgin; Aras, Gulseren; Kucuk, N Ozlem

    2013-05-01

    This study aimed to investigate the correlation of 18F-FDG PET/CT findings with histopathological results in defining the recurrence of the disease in patients with differentiated thyroid cancer (DTC) who have increased thyroglobuline (Tg) or anti-Tg antibody (TgAb) levels and negative 131I whole-body scan (WBS) result. A total of 59 patients with DTC (44 women, 15 men; mean [SD] age, 48.2 [22.6] years) were included in the study. All of the patients had previous papillary thyroid cancer, and all of them had undergone radioiodine ablation after a total or near-total thyroidectomy. After radioiodine ablation, patients were followed up for approximately 2.5 years. In the follow-up, the patients with negative 131I-WBS results and increased Tg or TgAb levels under thyroid-stimulating hormone-stimulated conditions underwent an 18F-FDG PET/CT scan to determine any recurrence of disease. There were negative or uncertain findings in the neck ultrasonography and/or thorax CT in most of the patients. The 18F-FDG PET/CT findings were compared with the histopathological results in all patients. Although 49 patients had increased Tg levels, the remaining 10 patients had increased TgAb levels. In patients with high Tg levels, 18F-FDG PET/CT scan results were negative in 10 and positive in 39 patients. In this patient group, 18F-FDG PET/CT findings were true positive, true negative, false positive, and false negative in 32, 3, 7, and 7 patients, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG PET/CT in this group were calculated as 82%, 30%, 80%, 30%, and 71%, separately. In the receiver operating characteristic analysis, a 4.5 cutoff SUV(max) was calculated with 75% sensitivity and 70% specificity for predicting disease recurrence. Cutoff Tg level was calculated as 20.7 ng/mL with 75% sensitivity and 55% specificity. In 10 patients with high TgAb levels, 18F-FDG PET/CT was true positive, true negative and

  3. Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings.

    PubMed

    Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicova, Eva; Schuster, Frederick; Lombardo, Paolo

    2016-01-01

    In their daily forensic casework, the authors experienced discrepancies of tracheobronchial content findings between postmortem computed tomography (PMCT) and autopsy to an extent previously unnoticed in the literature. The goal of this study was to evaluate such discrepancies in routine forensic cases. A total of 327 cases that underwent PMCT prior to routine forensic autopsy were retrospectively evaluated for tracheal and bronchial contents according to PMCT and autopsy findings. Hounsfield unit (HU) values of tracheobronchial contents, causes of death, and presence of pulmonary edema were assessed in mismatching and matching cases. Comparing contents in PMCT and autopsy in each of the separately evaluated compartments of the respiratory tract low positive predictive values were assessed (trachea, 38.2%; main bronchi, 40%; peripheral bronchi, 69.1%) indicating high discrepancy rates. The majority of tracheobronchial contents were viscous stomach contents in matching cases and low radiodensity materials (i.e., HU < 30) in mismatching cases. The majority of causes of death were cardiac related in the matching cases and skull/brain trauma in the mismatching cases. In mismatching cases, frequency of pulmonary edema was significantly higher than in matching cases. It can be concluded that discrepancies in tracheobronchial contents observed between PMCT and routine forensic autopsy occur in a considerable number of cases. Discrepancies may be explained by the runoff of contents via nose and mouth during external examination and the flow back of tracheal and main bronchial contents into the lungs caused by upright movement of the respiratory tract at autopsy.

  4. Learning with distribution of optimized features for recognizing common CT imaging signs of lung diseases

    NASA Astrophysics Data System (ADS)

    Ma, Ling; Liu, Xiabi; Fei, Baowei

    2017-01-01

    Common CT imaging signs of lung diseases (CISLs) are defined as the imaging signs that frequently appear in lung CT images from patients. CISLs play important roles in the diagnosis of lung diseases. This paper proposes a novel learning method, namely learning with distribution of optimized feature (DOF), to effectively recognize the characteristics of CISLs. We improve the classification performance by learning the optimized features under different distributions. Specifically, we adopt the minimum spanning tree algorithm to capture the relationship between features and discriminant ability of features for selecting the most important features. To overcome the problem of various distributions in one CISL, we propose a hierarchical learning method. First, we use an unsupervised learning method to cluster samples into groups based on their distribution. Second, in each group, we use a supervised learning method to train a model based on their categories of CISLs. Finally, we obtain multiple classification decisions from multiple trained models and use majority voting to achieve the final decision. The proposed approach has been implemented on a set of 511 samples captured from human lung CT images and achieves a classification accuracy of 91.96%. The proposed DOF method is effective and can provide a useful tool for computer-aided diagnosis of lung diseases on CT images.

  5. Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings.

    PubMed

    Kim, Young Sung; Lee, Ho Min; Kim, Jong Pil

    2013-11-01

    Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the rectus femoris origin. Mostly reported cases were occurred in the reflected head of the rectus femoris, and only few cases were in the direct head of the rectus femoris. Intraosseous marrow involvement of calcific tendinitis is a more rare condition; it often goes misdiagnosed as an infection or a neoplasm. We report a rare, unusual case of acute calcific tendinitis of the direct head of the rectus femoris associated with intraosseous marrow involvement of calcification in anterior inferior iliac spine with serial CT and MRI findings. Aggressive osseous change may occur in acute calcific tendinitis of the rectus femoris as in this case which should be made an appropriate diagnosis to avoid unnecessary investigation and overtreatment like a surgery.

  6. CT findings of a thoracic vertebral hemangioma presenting with acute neurological symptoms.

    PubMed

    Tan, Sinan; Kurt, Aydın; Okutan, Ozerk; Keskin, Suat

    2011-01-01

    Vertebral body hemangiomas are benign lesions and account for 4% of all spinal tumors. The most common histological type is cavernous hemangioma. These tumors generally locate in the vertebral body as a solitary lesion. Multiple lesions are seen in approximately 25-30% of vertebral hemangiomas. Mostly they are asymptomatic and incidentally found with radiological studies. Symptomatic vertebral hemangiomas are rare and represent < 1% of all hemangiomas; however, if untreated, they may cause local or radicular pain and neurological deficits ranging from myeloradiculopathy to paralysis. In this case we aim to present preoperative and postoperative Computed Tomography findings of a cavernous hemangioma that caused sudden motor deficit and was localised to the thoracic vertebra corpus and posterior elements.

  7. Post-mortem CT imaging of the lungs: pathological versus non-pathological findings.

    PubMed

    Filograna, Laura; Thali, Michael J

    2017-08-23

    Nowadays, the modern computed tomography techniques are more and more applied in forensic investigations. The detection of abnormalities in post-mortem computed tomography (PMCT) imaging of the lungs is very common. As in clinical imaging, also in post-mortem imaging the right interpretation of alterations has an extreme importance for the assessment of correct conclusions. This is even crucial when the radiologist who approaches the PMCT images is not routinely involved in forensic cases. The aim of this article is to provide radiologists who approach PMCT imaging cases with some indications for a proper and correct interpretation of pulmonary findings, to avoid misleading forensic conclusions. Particularly, the following issues will be addressed: PMCT imaging of post-mortem changes of the lungs; PMCT imaging of pathological lungs [(a) in thoracic trauma cases, (b) in cases without thoracic trauma]. Finally, the possible pitfalls in interpretation of PMCT imaging of the lungs will be also discussed.

  8. CT Scan Findings of Probable Usual Interstitial Pneumonitis Have a High Predictive Value for Histologic Usual Interstitial Pneumonitis

    PubMed Central

    Chawla, Ashish; Peljto, Anna L.; Cool, Carlyne D.; Groshong, Steve D.; Talbert, Janet L.; McKean, David F.; Brown, Kevin K.; Fingerlin, Tasha E.; Schwarz, Marvin I.; Schwartz, David A.; Lynch, David A.

    2015-01-01

    BACKGROUND: The current usual interstitial pneumonitis (UIP)/idiopathic pulmonary fibrosis CT scan classification system excludes probable UIP as a diagnostic category. We sought to determine the predictive effect of probable UIP on CT scan on histology and the effect of the promoter polymorphism in MUC5B (rs35705950) on histologic and CT scan UIP diagnosis. METHODS: The cohort included 201 subjects with pulmonary fibrosis who had lung tissue samples obtained within 1 year of chest CT scan. UIP diagnosis on CT scan was categorized as inconsistent with, indeterminate, probable, or definite UIP by two to three pulmonary radiologists. Tissue slides were scored by two expert pulmonary pathologists. All subjects with available DNA (N = 200) were genotyped for rs35705950. RESULTS: The proportion of CT scan diagnoses were as follows: inconsistent with (69 of 201, 34.3%), indeterminate (72 of 201, 35.8%), probable (34 of 201, 16.9%), and definite (26 of 201, 12.9%) UIP. Subjects with probable UIP on CT scan were more likely to have histologic probable/definite UIP than subjects with indeterminate UIP on CT scan (82.4% [28 of 34] vs 54.2% [39 of 72]; P = .01). CT scan and microscopic honeycombing were not associated with each other (P = .76). The minor (T) allele of the MUC5B polymorphism was associated with concordant CT scan and histologic UIP diagnosis (P = .03). CONCLUSIONS: Probable UIP on CT scan is associated with a higher rate of histologic UIP than indeterminate UIP on CT scan suggesting that they are distinct groups and should not be combined into a single CT scan category as currently recommended by guidelines. CT scan and microscopic honeycombing may be dissimilar entities. The T allele at rs35705950 predicts a UIP diagnosis by both chest CT scan and histology. PMID:25317858

  9. Anterior mediastinal fat in Behçet's disease: qualitative and quantitative CT analysis.

    PubMed

    Lee, Sang Yub; Lee, Jongmin; Lee, Hui Joong; Choi, Sun Ju; Hahm, Myong Hun; Yoon, Sung Won

    2013-12-01

    The fat-rich anterior mediastinum could be a sensitive window for monitoring minute changes in vascularity induced by systemic vasculitis. To evaluate this hypothesis, an analysis of anterior mediastinal fat in patients with Behçet's disease and a control group was conducted. This study included 43 patients diagnosed with Behçet's disease within the last 11 years who underwent CT scan; 55 patients were selected as a control population. Mediastinal fat was classified according to CT morphology. Comparison of serum inflammatory markers was performed for evaluation of disease activity according to morphologic types, and average Hounsfield unit of the anterior mediastinum was measured. Significantly higher mean CT attenuation was observed in the Behçet's disease group, compared with the control group (-48.5 ± 33.5 vs. -67.7 ± 18.7, respectively, P < 0.05). Mediastinal fat types were classified as follows: pure fatty tissue (2 vs. 31 % [Behçet's disease vs. control group]), diffuse soft tissue infiltration (16 vs. 29 %), tubular structures (21 vs. 4 %), mixed infiltration with tubular structures (42 vs. 15 %), and evident thymic tissue (19 vs. 22 %). The value for mean mediastinal attenuation was significantly higher in the group with a high level of C-reactive protein than in the normal level group. The mean CT attenuation of anterior mediastinal fat is significantly higher in the Behçet's disease group, compared with the normal group. Although pathologic confirmation is needed, the cause is postulated to be either inflammatory neovascularization or minimal thymic hyperplasia induced by Behçet's disease.

  10. Usefulness of multislice-CT using multiplanar reconstruction in the preoperative assessment of the ossicular lesions in the middle ear diseases.

    PubMed

    Fujiwara, Seiko; Toyama, Yoshihiro; Miyashita, Takenori; Osaki, Yasuhiro; Inamoto, Ryuhei; Hoshikawa, Hiroshi; Mori, Nozomu

    2016-06-01

    The aim of the study is to evaluate the usefulness of multislice computed tomography (MSCT) using multiplanar reconstruction (MPR) in obtaining preoperative information on the ossicular lesions of middle ear diseases by comparing the ossicular findings of MPR images with the operative findings. Sixty-two ears and 10 ears with preoperative middle ear diseases underwent 4- and 64-detector row CT of the temporal bone in Kagawa University Hospital, respectively. MPR images of three ossicles were created at the planes parallel to the long axis of ossicles. The findings of the three ossicles in MPR images were compatible with their operative findings in approximately 91% of 72 ears with various middle ear diseases. There was no significant difference in the coincidence rate of both findings between 4- and 64-detector row CT scanners. The ears with no soft tissue shadows around the ossicles had the coincidence rate of 96-100% in each ossicular part, whereas the coincidence rate was lower in the ears with soft tissue shadows around the ossicles. MPR imagings of the ossicles provide accurate preoperative information on the ossicular lesions in middle ear diseases. The 4-detector CT is still a useful device for imaging of the ossicles. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Low-Grade and High-Grade Mucoepidermoid Carcinoma of the Lung: CT Findings and Clinical Features of 17 Cases.

    PubMed

    Wang, Yiqi Q; Mo, Yunxian X; Li, Sheng; Luo, Rongzhen Z; Mao, Siyue Y; Shen, Jingxian X

    2015-12-01

    The objective of our study was to characterize the CT features and clinical findings of low-grade and high-grade mucoepidermoid carcinoma (MEC) of the lung. The CT findings and clinical information of 17 consecutive patients with primary low-grade (n = 11) or high-grade (n = 6) MEC were analyzed retrospectively. We assessed tumor location, size, contour, margin, density, calcification, obstructive changes, presence of metastasis, and enhancement. In patients with low-grade MEC, tumor location was central in 10 and peripheral in one. In contrast, one and five tumors in patients with high-grade MEC were central and peripheral, respectively. There was a significant difference between central and peripheral locations among tumor grades (p = 0.005). In low-grade MECs, tumor contour was smoothly oval (n = 3) or spheric (n = 4); four were lobular. In five patients with low-grade MEC, tumors had well-defined margins; margins in the other six were poorly defined. Tumor density was homogeneous and heterogeneous in eight and three low-grade tumors, respectively. All six high-grade tumors had heterogeneous density, lobular contours, and poorly defined margins. Enhancement in both low-grade and high-grade tumors was greater than that of chest wall muscles, and low-grade tumors showed greater enhancement (46.90 ± 20.44 HU) than did high-grade tumors (22.50 ± 8.38 HU) (p = 0.015). A markedly enhanced homogeneous central bronchial nodule or mass may suggest low-grade MEC. High-grade MEC tends to be peripheral, to have poorly defined margins, and to be lobular, heterogeneous nodules or masses with less enhancement.

  12. Ophthalmologic Psychophysical Tests Support OCT Findings in Mild Alzheimer's Disease

    PubMed Central

    Salobrar-Garcia, Elena; de Hoz, Rosa; Rojas, Blanca; Ramirez, Ana I.; Yubero, Raquel; Gil, Pedro; Triviño, Alberto; Ramirez, José M.

    2015-01-01

    Purpose. To analyze in mild Alzheimer's disease (MAD) patients, GDS-4 (Reisberg Scale), whether or not some psychophysical tests (PTs) support OCT macular findings in the same group of MAD patients reported previously. Methods. Twenty-three MAD patients and 28 age-matched control subjects with mean Mini Mental State Examination of 23.3 and 28.2, respectively, with no ocular disease or systemic disorders affecting vision were included. Best-corrected visual acuity (VA), contrast sensitivity (CS) (3, 6, 12, and 18 cpds), color perception (CP), and perception digital test (PDT) were tested in one eye of each patient. Results. In comparison with the controls, MAD patients presented (i) a significant decrease in VA, PDT, and CS for all spatial frequencies analyzed, especially the higher ones, and (ii) a significant increase in unspecific errors on the blue axis (P < 0.05 in all instances). In MAD patients, a wide aROC curve was plotted in all PTs. Conclusions. In MAD, CS, VA, and the tritan axis in CP were impaired. The PTs with the greatest predictive value are the higher spatial frequencies in CS and tritan unspecific errors in CP. PT abnormalities are consistent with the structural findings reported in the same MAD patients using OCT. PMID:26106485

  13. CT pulmonary angiography findings that predict 30-day mortality in patients with acute pulmonary embolism.

    PubMed

    Bach, Andreas Gunter; Nansalmaa, Baasai; Kranz, Johanna; Taute, Bettina-Maria; Wienke, Andreas; Schramm, Dominik; Surov, Alexey

    2015-02-01

    Standard computed tomography pulmonary angiography (CTPA) can be used to diagnose acute pulmonary embolism. In addition, multiple findings at CTPA have been proposed as potential tools for risk stratification. Therefore, the aim of the present study is to examine the prognostic value of (I) thrombus distribution, (II) morphometric parameters of right ventricular dysfunction, and (III) contrast reflux in inferior vena cava on 30-day mortality. In a retrospective, single-center study from 06/2005 to 01/2010 365 consecutive patients were included. Inclusion criteria were: presence of acute pulmonary embolism, and availability of 30-day follow-up. A review of patient charts and images was performed. There were no significant differences between the group of 326 survivors and 39 non-survivors in (I) thrombus distribution, and (II) morphometric measurements of right ventricular dysfunction. However, (III) contrast reflux in inferior vena cava was significantly stronger in non-survivors (odds ratio 3.29; p<0.001). Results were independent from comorbidities like heart insufficiency and pulmonary hypertension. Measurement of contrast reflux is a new and robust method for predicting 30-day mortality in patients with acute pulmonary embolism. Obstruction scores and morphometric measurements of right ventricular dysfunction perform poor as risk stratification tools. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. CT findings of the temporal bone in CHARGE syndrome: aspects of importance in cochlear implant surgery.

    PubMed

    Vesseur, A C; Verbist, B M; Westerlaan, H E; Kloostra, F J J; Admiraal, R J C; van Ravenswaaij-Arts, C M A; Free, R H; Mylanus, E A M

    2016-12-01

    To provide an overview of anomalies of the temporal bone in CHARGE syndrome relevant to cochlear implantation (CI), anatomical structures of the temporal bone and the respective genotypes were analysed. In this retrospective study, 42 CTs of the temporal bone of 42 patients with CHARGE syndrome were reviewed in consensus by two head-and-neck radiologists and two otological surgeons. Anatomical structures of the temporal bone were evaluated and correlated with genetic data. Abnormalities that might affect CI surgery were seen, such as a vascular structure, a petrosquamosal sinus (13 %), an underdeveloped mastoid (8 %) and an aberrant course of the facial nerve crossing the round window (9 %) and/or the promontory (18 %). The appearance of the inner ear varied widely: in 77 % of patients all semicircular canals were absent and the cochlea varied from normal to hypoplastic. A stenotic cochlear aperture was observed in 37 %. The middle ear was often affected with a stenotic round (14 %) or oval window (71 %). More anomalies were observed in patients with truncating mutations than with non-truncating mutations. Temporal bone findings in CHARGE syndrome vary widely. Vascular variants, aberrant route of the facial nerve, an underdeveloped mastoid, aplasia of the semicircular canals, and stenotic round window may complicate cochlear implantation.

  15. CT findings of thoracic manifestations of primary Sjögren syndrome: radiologic-pathologic correlation.

    PubMed

    Egashira, Ryoko; Kondo, Tetsuya; Hirai, Tetsuyoshi; Kamochi, Noriyuki; Yakushiji, Mai; Yamasaki, Fumio; Irie, Hiroyuki

    2013-01-01

    Primary Sjögren syndrome is an immune-mediated exocrinopathy characterized by lymphoplasmacytic infiltration of the salivary and lacrimal glands. Various systemic extraglandular disorders are associated with primary Sjögren syndrome, and the thorax is commonly affected. The pulmonary manifestations of primary Sjögren syndrome may be categorized as airway abnormalities, interstitial pneumonias, and lymphoproliferative disorders; in each category, bronchiectasis or centrilobular nodules, nonspecific interstitial pneumonia, and lymphoid interstitial pneumonia are common. These manifestations do not usually occur in isolation; they are concomitantly seen with other types of lesions. Mucosa-associated lymphoid tissue (MALT) lymphoma and amyloidosis are key components of lymphoproliferative disorders, and MALT lymphoma should always be considered because its morphologic characteristics are similar to those of benign lymphoproliferative disorders. Amyloidosis is rare but important because it carries a risk for underlying MALT lymphoma or plasmacytoma, and it may lead to hemoptysis during biopsy. In addition, thin-walled air cysts are characteristic of primary Sjögren syndrome, irrespective of the main pulmonary manifestations. Lymphadenopathy and multilocular thymic cysts may be seen in the mediastinum. During the follow-up period, there is a risk for acute exacerbation of interstitial pneumonia and development of malignant lymphoma. Often, primary Sjögren syndrome is subclinical, but there are various underlying risks. Thus, imaging findings are important. In addition to the various types of interstitial pneumonia and airway abnormalities, air cysts and mediastinal manifestations may help diagnose primary Sjögren syndrome. © RSNA, 2013.

  16. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used

    PubMed Central

    Jögi, Jonas; Markstad, Hanna; Tufvesson, Ellen; Bjermer, Leif; Bajc, Marika

    2015-01-01

    Ventilation/perfusion (V/P) single-photon emission computed tomography (SPECT) is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF), pneumonia, and chronic obstructive pulmonary disease (COPD). The development of hybrid SPECT/computed tomography (CT) systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT), may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I–IV) and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects) were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD patients. In 16 patients (23%), perfusion defects were observed. HF and perfusion defects were not recognized with LDCT. In COPD patients and long-time smokers, hybrid imaging had added value compared to V/P SPECT alone, by identifying patients with lung malignancy and more clearly identifying

  17. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used.

    PubMed

    Jögi, Jonas; Markstad, Hanna; Tufvesson, Ellen; Bjermer, Leif; Bajc, Marika

    2015-01-01

    Ventilation/perfusion (V/P) single-photon emission computed tomography (SPECT) is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF), pneumonia, and chronic obstructive pulmonary disease (COPD). The development of hybrid SPECT/computed tomography (CT) systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT), may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I-IV) and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects) were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD patients. In 16 patients (23%), perfusion defects were observed. HF and perfusion defects were not recognized with LDCT. In COPD patients and long-time smokers, hybrid imaging had added value compared to V/P SPECT alone, by identifying patients with lung malignancy and more clearly identifying

  18. FDG PET/CT in Type I Glycogen Storage Disease.

    PubMed

    Manca, Chloé; Claudin, Marine; Belle, Arthur; Marie, Pierre Yves; Verger, Antoine

    2016-04-01

    Type I glycogen storage disease (GSD) is a rare autosomal recessive disorder caused by glucose-6-phosphatase deficiency. We report herein the particular pattern provided by FDG PET imaging in a 33-year-old patient with type Ib GSD. PET images yielded evidence of a pulmonary infectious focus as well as of: (1) a dramatically enlarged liver leading to a high global FDG uptake, (2) increased bone marrow activity, (3) splenomegalia leading to a high global spleen uptake, (4) a diffuse enhancement in muscle FDG uptake.

  19. Dual-Energy CT Angiography in Peripheral Arterial Occlusive Disease

    SciTech Connect

    Brockmann, Carolin Jochum, Susanne; Sadick, Maliha; Huck, Kurt; Ziegler, Peter; Fink, Christian; Schoenberg, Stefan O.; Diehl, Steffen J.

    2009-07-15

    We sought to study the accuracy of dual-energy computed tomographic angiography (DE-CTA) for the assessment of symptomatic peripheral arterial occlusive disease of the lower extremity by using the dual-energy bone removal technique compared with a commercially available conventional bone removal tool. Twenty patients underwent selective digital subtraction angiography and DE-CTA of the pelvis and lower extremities. CTA data were postprocessed with two different applications: conventional bone removal and dual-energy bone removal. All data were reconstructed and evaluated as 3D maximum-intensity projections. Time requirements for reconstruction were documented. Sensitivity, specificity, accuracy, and concordance of DE-CTA regarding degree of stenosis and vessel wall calcification were calculated. A total of 359 vascular segments were analyzed. Compared with digital subtraction angiography, sensitivity, specificity, and accuracy, respectively, of CTA was 97.2%, 94.1%, and 94.7% by the dual-energy bone removal technique. The conventional bone removal tool delivered a sensitivity of 77.1%, a specificity of 70.7%, and an accuracy of 72.0%. Best results for both postprocessing methods were achieved in the vascular segments of the upper leg. In severely calcified segments, sensitivity, specificity, and accuracy stayed above 90% by the dual-energy bone removal technique, whereas the conventional bone removal technique showed a substantial decrease of sensitivity, specificity, and accuracy. DE-CTA is a feasible and accurate diagnostic method in the assessment of symptomatic peripheral arterial occlusive disease. Results obtained by DE-CTA are superior to the conventional bone removal technique and less dependent on vessel wall calcifications.

  20. [CT and MRI features of Castleman's disease of the abdomen and pelvis].

    PubMed

    Xiao, Lu; Zhang, Zhong-lin; Liu, Yu-bao; Liu, Zai-yi; Li, Jing-lei; Yu, Yuan-xin; Xie, Shu-fei

    2011-01-01

    To analyze the CT/MRI features of Castleman's disease of the abdomen and pelvis. CT/MRI images of 6 cases of pathologically confirmed Castleman's disease of the abdomen and pelvis were retrospectively reviewed. All the patients received plain CT scan and dynamic enhanced scan, and one had an additional MR scan. One case was identified as the disseminated type with multicentric enlarged lymph nodes and hepatosplenomegaly, and 5 cases were found to have localized type, of which 3 had retroperitoneal, 1 had mesentery and 1 had pelvic lesions. On CT scan, all the 5 cases with localized lesions showed single, round or ellipse soft tissue masses, with intra-tumoral calcification in 2 cases, fascial thickening around the mass in 3 cases, and satellite nodules in 4 cases. Enhanced scanning revealed obvious enhancement in the arterial phase and continuous enhancement in the portal vein and delayed phase in all the lesions, with an attenuation pattern similar to that of large vessels; enlarged blood vessels within or around the mass were displayed in each case. In 4 cases, the intra-tumoral radial or fissured non-enhanced areas in early stage of enhancement were gradually filled up as the scan time was delayed. The patient receiving MRI showed hypo-intensity on T(1)WI and hyper-intensity on T(2)WI, presenting with an enhancement feature similar to that of CT. Castleman's disease in the abdomen and pelvis is rare and liable to misdiagnosis, but its characteristic imaging features can help in the diagnosis and differential diagnosis.

  1. High-Resolution CT Scan Findings in Familial Interstitial Pneumonia Do Not Conform to Those of Idiopathic Interstitial Pneumonia

    PubMed Central

    Lee, Ho Yun; Seo, Joon Beom; Steele, Mark P.; Schwarz, Marvin I.; Brown, Kevin K.; Loyd, James E.; Talbert, Janet L.

    2012-01-01

    Background: The aim of this study was to describe the high-resolution CT (HRCT) scan features that characterize familial interstitial pneumonia (FIP). Methods: FIP was defined by the presence of two or more cases of probable or definite idiopathic interstitial pneumonia (IIP) in individuals related within three degrees. The cases were collected consecutively from three centers. We identified 371 individuals with potential FIP from 289 families, including 340 individuals who had HRCT scans. Two chest radiologists independently reviewed the HRCT scans, scoring the extent and distribution of HRCT scan findings, and assessed the overall radiologic diagnosis. Results: HRCT scan abnormalities suggestive of IIP were present in 85% (289 of 340 subjects). The most frequent findings were reticular pattern (n = 238, 82%) and ground-glass opacity (GGO) associated with reticular abnormality (n = 231, 80%). Other changes included GGO in 116 (40%), honeycombing in 92 (32%), and micronodules in 65 (22%). In the 289 cases with evidence of IIP, the findings were diffusely distributed in the craniocaudal plane in 186 (64%), and the lower lung zones were predominantly involved in 89 (31%). In the axial plane, 194 (67%) had a subpleural distribution; 88 (30%) were diffuse. The imaging pattern was classified as definite or probable usual interstitial pneumonia (UIP) in only 62 subjects (22%) and definite or probable nonspecific interstitial pneumonia (NSIP) in 35 subjects (12%). In 160 subjects (55%), the imaging findings did not conform to previously described UIP or NSIP patterns. Conclusions: Reticulation and a mixed GGO/reticular pattern are the most common HRCT scan findings in FIP. The parenchymal abnormalities are most often diffuse in the craniocaudal dimension and have a predominantly peripheral distribution in the axial dimension. Although a radiologic UIP pattern is not uncommon, most cases do not conform to typical UIP or NSIP patterns. PMID:23364926

  2. The role of high-resolution chest CT in the diagnosis of neuroendocrine cell hyperplasia of infancy - A rare form of pediatric interstitial lung disease.

    PubMed

    Lee, Julia; Sanchez, Thomas Ray; Zhang, Yanhong; Jhawar, Sanjay

    2015-01-01

    Interstitial lung disease (ILD) is rare in infancy or early childhood. Differentiating between the different types of ILD is important for reasons of treatment, monitoring of clinical course and prognosis. We present a case of a 5-month old female with tachypnea and hypoxemia. The clinical suspicion of neuroendocrine cell hyperplasia of infancy (NEHI) was confirmed by high-resolution chest CT and subsequent lung biopsy. We conclude that high-resolution chest CT has characteristics findings that can be used as a non-invasive test to support the clinical diagnosis of neuroendocrine cell hyperplasia of infancy.

  3. 18F-FDG PET/CT in multicentric Castleman disease: a case report

    PubMed Central

    Zhang, Jiexin; Yang, Lu

    2016-01-01

    Castleman disease (CD) is a chronic lymphoproliferative disorder characterized by unexplained enlarged lymph nodes. According to lymph nodes distribution it contains two types of single-centric and multicentric (more than one site) disease. Multicentric Castleman disease (MCD) is rare, and shows unspecific manifestation with high misdiagnosis rate. Here we reported a case of MCD in a 43-year-old male. 18F-FDG PET/CT imaging demonstrated higher FDG uptake in multiple lymph nodes and slightly FDG uptake in spleen and bone marrow. Right inguinal Lymph node biopsy was taken and the results confirmed CD. PMID:26904580

  4. Visual evoked potential findings in Behcet's disease without neurological manifestations.

    PubMed

    Anlar, Omer; Akdeniz, Necmettin; Tombul, Temel; Calka, Omer; Bilgili, Serap G

    2006-03-01

    Behçet's disease (BD) is a chronic, recurrent multisystem inflammatory disorder firstly described by Turkish dermatologist Dr. Hulusi Behçet in 1937. The classic triad consists of recurrent oral and genital ulcerations and uveitis. The article presents the value of visual evoked potential findings of a series of 44 patients with BD without neurological manifestations seen at the Medical Hospital in Neurology and Dermatology clinics over the past 8 years. The mean latency value of positive peak P100 in BD patients was significantly delayed compared to that of control subjects (patients's mean: 105.6 ms in right eye and 107.7 ms in left eye; control subject's mean: 101.4 ms in right eye and 101.7 ms in left eye).

  5. [CT findings of peripheral atelectasis associated with pleural effusion: in association with the mechanism of rounded atelectasis formation].

    PubMed

    Mori, M

    1994-04-25

    The role of pleural effusion in the formation of rounded atelectasis (RA) was evaluated using CT in 159 patients with 210 pleural effusions. The forms of peripheral atelectasis associated with pleural effusion (PA-PE) were classified into five types: type 1: no atelectasis, type 2: flat or crescent type, type 3: convex type, type 4: mass-like type, type 5: consolidation type. Atelectasis (type 2-5) accounted for 78% (164/210) of all lesions. Type 2 was the commonest type of PA-PE, followed by type 5. Types 2 and 5 accounted for 79% (130/164) of all lesions with PA-PE. In most lesions of types 2 and 5, the collapsed pulmonary parenchyma re-expanded following decrease or disappearance of pleural effusion. Types 3 and 4 accounted for only 15% (25/164) and 5% (9/164), respectively. Most lesions of type 4 satisfied the criteria of CT findings of RA. Type 3 was similar to type 4 except for the obtuse angle between the collapsed pulmonary parenchyma and the pleura. As a consequence, it is reasonable to regard type 4 as RA, type 3 as the similar lesion of RA. Most lesions of types 3 and 4 were found in patients with small or moderate inflammatory exudate and pleural thickening, and most of them remained the same type in the follow-up studies. Three lesions of type 3 changed to type 4. This study showed that RA was mainly formed in the patients with inflammatory exudate and thickened pleura, rarely in the patients with transudate. It is concluded that inflammatory pleural effusion plays an important role in the formation of RA formation.

  6. Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations

    PubMed Central

    Budoff, Matthew J.

    2012-01-01

    Cardiovascular disease remains the leading cause of mortality in the US and worldwide, and no widespread screening for this number one killer has been implemented. Traditional risk factor assessment does not fully account for the coronary risk and underestimates the prediction of risk even in patients with established risk factors for atherosclerosis. Coronary artery calcium (CAC) represents calcified atherosclerosis in the coronary arteries. It has been shown to be the strongest predictor of adverse future cardiovascular events and provides incremental information to the traditional risk factors. CAC consistently outperforms traditional risk factors, including models such as Framingham risk to predict future CV events. It has been incorporated into both the European and American guidelines for risk assessment. CAC is the most robust test today to reclassify individuals based on traditional risk factor assessment and provides the opportunity to better strategize the treatments for these subjects (converting patients from intermediate to high or low risk). CAC progression has also been identified as a risk for future cardiovascular events, with markedly increased events occurring in those patients exhibiting increases in calcifications over time. The exact intervals for rescanning is still being evaluated. PMID:24278742

  7. Allergies and Disease Severity in Childhood Narcolepsy: Preliminary Findings

    PubMed Central

    Aydinoz, Secil; Huang, Yu-Shu; Gozal, David; Inocente, Clara O.; Franco, Patricia; Kheirandish-Gozal, Leila

    2015-01-01

    Introduction: Narcolepsy frequently begins in childhood, and is characterized by excessive daytime sleepiness, with the presence of cataplexy reflecting a more severe phenotype. Narcolepsy may result from genetic predisposition involving deregulation of immune pathways, particularly involving T helper 2 cells (Th2). Increased activation of Th2 cells is usually manifested as allergic conditions such as rhinitis, atopic dermatitis, and asthma. We hypothesized that the presence of allergic conditions indicative of increased Th2 balance may dampen the severity of the phenotype in children with narcolepsy. Methods: A retrospective chart review of childhood narcolepsy patients was conducted at three major pediatric sleep centers. Patients were divided into those with narcolepsy without cataplexy (NC−) and narcolepsy with cataplexy (NC+). Demographics, polysomnographic and multiple sleep latency test data, and extraction of information on the presence of allergic diseases such allergic rhinitis, atopic dermatitis, and asthma was performed. Results: There were 468 children identified, with 193 children in NC− group and 275 patients in the NC+ group. Overall, NC+ children were significantly younger, had higher body mass index, and had shorter mean sleep latencies and increased sleep onset rapid eye movement events. The frequency of allergic conditions, particularly asthma and allergic rhinitis, was markedly lower in NC+ (58/275) compared to NC− patients (94/193; P < 0.0001). Conclusion: Involvement of the immune system plays an important role in the pathophysiology of narcolepsy. Current findings further suggest that an increased shift toward T helper 2 cells, as indicated by the presence of allergic conditions, may modulate the severity of the phenotype in childhood narcolepsy, and reduce the prevalence of cataplexy in these patients. Citation: Aydinoz S, Huang YS, Gozal D, Inocente CO, Franco P, Kheirandish-Gozal L. Allergies and disease severity in childhood

  8. False Positive Findings on I-131 WBS and SPECT/CT in Patients with History of Thyroid Cancer: Case Series

    PubMed Central

    Hannoush, Zeina C.; Palacios, Juan D.; Kuker, Russ A.

    2017-01-01

    Introduction. Although whole body scan (WBS) with I-131 is a highly sensitive tool for detecting normal thyroid tissue and metastasis of differentiated thyroid cancer (DTC), it is not specific. Additional information, provided by single photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) and by the serum thyroglobulin level, is extremely useful for the interpretation of findings. Case Presentation. We report four cases of false positive WBS in patients with DTC: ovarian uptake corresponding to an endometrioma, scrotal uptake due to a spermatocele, rib-cage uptake due to an old fracture, and hepatic and renal uptake secondary to a granuloma and simple cyst, respectively. Conclusions. Trapping, organification, and storage of iodine are more prominent in thyroid tissue but not specific. Physiologic sodium-iodine symporter expression in other tissues explains some, but not all, of the WBS false positive cases. Other proposed etiologies are accumulation of radioiodine in inflamed organs, metabolism of radiodinated thyroid hormone, presence of radioiodine in body fluids, and contamination. In our cases nonthyroidal pathologies were suspected since the imaging findings were not corroborated by an elevated thyroglobulin level, which is considered a reliable tumor marker for most well-differentiated thyroid cancers. Clinicians should be aware of the potential pitfalls of WBS in DTC to avoid incorrect management. PMID:28246564

  9. WE-B-207-01: CT Lung Cancer Screening and the Medical Physicist: Background, Findings and Participant Dosimetry Summary of the National Lung Screening Trial (NLST)

    SciTech Connect

    Kruger, R.

    2015-06-15

    The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Under the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan

  10. A scientific update on biosimilar infliximab (CT-P13) in rheumatic diseases.

    PubMed

    Taylor, Peter

    2015-01-01

    The development of biologic drugs has undoubtedly enhanced the spectrum of treatments available for immune-mediated inflammatory rheumatic diseases such as rheumatoid arthritis. However, despite their clear clinical benifits, use of biologics is often hindered by their high costs. The manufacture and subsequent approval of more cost-effective 'biosimilar' versions of these drugs may address this issue and improve patient access. CT-P13 (Remsima(®), Inflectra(®)), a biosimilar of infliximab (Remicade(®)), has shown comparable efficacy, safety and pharmacokinetics to its originator drug in clinical studies. The articles in this supplement present a scientific update on the development and use of biosimilars in rheumatic disorders, with specific focus on CT-P13. The information discussed highlights the predicted positive clinical and economic impact of biosimilars on the management of rheumatic diseases.

  11. PET/CT adapted therapy in Hodgkin disease: current state of the art and future directions.

    PubMed

    Dann, Eldad J

    2012-10-01

    Current therapy of Hodgkin disease (HD) is based on risk assessment, taking into consideration both staging and risk factors. Interim positron emission tomography/computerized tomography (PET/CT) has proven to distinguish between patients with advanced disease who have early response and good prognosis and those with interim positive response who have inferior progression free survival (PFS) with current therapy. Several issues need to be elucidated: (1) Which interim study should be defined as positive? (2) Should the same cutoff value be used for decision-making about escalation vs de-escalation of therapy? (3) Should it apply to different chemotherapy protocols? Currently, there are several ongoing studies where treatment is modified based on interim PET/CT. These studies may enable the medical community to establish whether bleomycin or radiation therapy could be omitted in early responders, whether chemotherapy could be shortened in these patients, and whether therapy escalation for patients with interim positive PET/CT could decrease disease progression rate.

  12. Three‐dimensional CT scanning: a new diagnostic modality in congenital heart disease

    PubMed Central

    Ou, Phalla; Celermajer, David S; Calcagni, Giulio; Brunelle, Francis; Bonnet, Damien; Sidi, Daniel

    2007-01-01

    New generation multislice CT technology has changed the approach to non‐invasive assessment of congenital heart disease, in both paediatric and adult patients. This is mainly because of rapid advances in spatial and temporal resolution and in post‐processing capability. At Hôpital Necker‐Enfants Malades, CT with multiplanar and three‐dimensional reconstruction has become a routine examination in the evaluation of congenital heart disease planning surgery, complex interventional catheterisations and for follow‐up. It has proved to be an invaluable diagnostic and decision‐aiding methodology in these situations, as a complement to echocardiography and, increasingly, as a substitute for diagnostic angiography (which is usually associated with higher‐dose radiation and longer sedation times, as well as occasional morbidity). This review illustrates the current status of 64‐slice CT in congenital heart diseases, including assessment of the aorta, the coronary arteries, the pulmonary arteries, the systemic and pulmonary veins, and other intra‐ and extracardiac malformations. PMID:16952967

  13. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim-Chester disease.

    PubMed

    García-Gómez, F J; Acevedo-Báñez, I; Martínez-Castillo, R; Tirado-Hospital, J L; Cuenca-Cuenca, J I; Pachón-Garrudo, V M; Álvarez-Pérez, R M; García-Jiménez, R; Rivas-Infante, E; García-Morillo, J S; Borrego-Dorado, I

    2015-08-01

    Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different presentations of the disease were observed in our casuistic: most indolent form was a cutaneous confined disease, presented in only one patient. Multifocal involvement with central nervous system (CNS) preservation was observed in two patients. Most aggressive form consisted in a systemic involvement with CNS infiltration, presented in three patients. In our experience neurological involvement, among one case with isolate pituitary infiltration, was associated with mortality in all cases. 18FDG-PET/CT and BS were particularly useful in despite systemic involvement; locate the site for biopsy and the treatment response evaluation. By our knowledge, 18FDOPA-PET/CT not seems useful in the initial staging of ECD. A baseline 18FDG-PET/CT and BS may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically 18FDG-PET/CT must be performed in the follow up to evaluate treatment response.

  14. 75 FR 38148 - Finding of No Significant Impact Related to Approval of the Mallinckrodt C-T Phase 2...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... the Manhattan Engineering District and the Atomic Energy Commission (MED-AEC) to process uranium ore..., NRC must be assured that the areas of the Mallinckrodt facility associated with the C-T project meet NRC(s release criteria stated in 10 CFR 20.1402. Mallinckrodt elected to decommission the C-T...

  15. 18F-FDG PET-CT Findings Before and After Laparoscopic Cryoablation of Small Renal Mass: An Initial Report

    PubMed Central

    Sivro, Ferida; van der Zee, Johan A.; Baars, Phillippe C.

    2015-01-01

    The aim of this study was to describe the characteristics of positron emission tomography (PET) molecular imaging combined with low-dose computed tomography (CT) in small renal mass (SRM) treated with cryoablation (CA). Currently, treatment success is defined by the absence of contrast enhancement at CT. However, the use of contrast is relatively contraindicated in patients with renal function impairment, mandating alternative follow-up strategies. Several reasons were identified as criteria for performing PET-CT before and/or after SRM-CA in 9 patients, and the results were retrospectively studied. The histology revealed renal cell carcinoma in 7 patients and oncocytoma in 2 patients. In 6 patients, a PET-CT was performed before and after CA. In one patient, the PET-CT was performed only before CA and in 2 patients only after CA. Before CA, clearly there was metabolic uptake of fluorine-18 fluorodeoxyglucose (18F-FDG) in the SRM in all patients. Following CA, the absence of 18F-FDG uptakes in the SRM could clearly be noticed. However, the tracer cannot always be distinguished from focal recurrence or reactive inflammatory tissue. In one patient, asymptomatic metastatic bone lesions were noticed when performing PET-CT at follow-up. This pilot study with 18F-FDG PET-CT for the follow-up of SRM cryosurgery showed that 18F-FDG PET-CT imaging could be used to characterize cryoablative tissue injury at different times after CA. PMID:28326272

  16. Correlating Photoreceptor Mosaic Structure to Clinical Findings in Stargardt Disease

    PubMed Central

    Razeen, Moataz M.; Cooper, Robert F.; Langlo, Christopher S.; Goldberg, Mara R.; Wilk, Melissa A.; Han, Dennis P.; Connor, Thomas B.; Fishman, Gerald A.; Collison, Frederick T.; Sulai, Yusufu N.; Dubra, Alfredo; Carroll, Joseph; Stepien, Kimberly E.

    2016-01-01

    Purpose To demonstrate a method for correlating photoreceptor mosaic structure with optical coherence tomography (OCT) and microperimetry findings in patients with Stargardt disease. Methods A total of 14 patients with clinically diagnosed Stargardt disease were imaged using confocal and split-detection adaptive optics scanning light ophthalmoscopy. Cone photoreceptors were identified manually in a band along the temporal meridian. Resulting values were compared to a normative database (n = 9) to generate cone density deviation (CDD) maps. Manual measurement of outer nuclear layer plus Henle fiber layer (ONL+HFL) thickness was performed, in addition to determination of the presence of ellipsoid zone (EZ) and interdigitation zone (IZ) bands on OCT. These results, along with microperimetry data, were overlaid with the CDD maps. Results Wide variation in foveal structure and CDD maps was seen within this small group. Disruption of ONL+HFL and/or IZ band was seen in all patients, with EZ band preservation in regions with low cone density in 38% of locations analyzed. Normality of retinal lamellar structure on OCT corresponded with cone density and visual function at 50/78 locations analyzed. Outer retinal tubulations containing photoreceptor-like structures were observed in 3 patients. Conclusions The use of CDD color-coded maps enables direct comparison of cone mosaic local density with other measures of retinal structure and function. Larger normative datasets and improved tools for automation of image alignment are needed. Translational Relevance The approach described facilitates comparison of complex multimodal data sets from patients with inherited retinal degeneration, and can be expanded to incorporate other structural imaging or functional testing. PMID:26981328

  17. Relationship between -889 C/T polymorphism in interleukin-1A gene and risk of chronic periodontitis: Evidence from a meta-analysis with new published findings

    PubMed Central

    da Silva, Felipe-Rodolfo-Pereira; Guimarães-Vasconcelos, Any-Carolina-Cardoso; de-Carvalho-França, Luiz-Felipe; di-Lenardo, David; Rodrigues, Luana-Silva; Barreto-do-Nascimento, Maria-Luísa-Lima

    2017-01-01

    Background Periodontitis results from an inflammatory response caused by accumulative microorganisms in periodontal sites. Several factors are involved in pathogenesis of periodontitis, for example the -889 C/T polymorphism in interleukin-1A gene. This study aimed to evaluate the relationship between this polymorphism and risk of development of chronic periodontitis by a meta-analysis based in new published findings. Material and Methods Thereunto a review in literature was performed in the electronic biomedical and education databases (Cochrane Library, Google Scholar, MEDLINE and PubMed) to studies published before August 2, 2015, the abstracts were evaluated and the data extraction performed by two calibrated examiners. The calculations of the meta-analysis were obtained through statistical software Review Manager version 5.2 with calculation of Odds Ratio (OR), heterogeneity (I²) and Funnel plots with P <0.05. Results In overall, twenty-one case/control studies were selected with 2,174 patients with chronic periodontitis and 1, 756 controls. The meta-analysis showed T allele was associated with chronic periodontitis (OR = 1.22, 95% CI: 1.09, 1.36, P = 0.0004) with decreased value to heterogeneity (I² = 15%, P = 0.28). TT genotype was associated to patients with chronic periodontitis (OR = 1.40, 95% CI: 1.07, 1.83, P = 0.01). No publication bias was found in this meta-analysis by asymmetry in Funnel plots. Conclusions This meta-analysis with 2,174 patients with chronic periodontitis and 1, 756 controls evidenced the -889 C/T polymorphism is associated to risk of development of chronic periodontitis with no significant value to heterogeneity to allelic evaluation. Key words:Alleles, odds ratio, periodontal disease, cytokines. PMID:27918732

  18. Evaluation of Spleen Glucose Metabolism Using (18)F-FDG PET/CT in Patients with Febrile Autoimmune Disease.

    PubMed

    Ahn, Sung Soo; Hwang, Sang Hyun; Jung, Seung Min; Lee, Sang-Won; Park, Yong-Beom; Yun, Mijin; Song, Jason Jungsik

    2017-03-01

    The purpose of this study was to evaluate the clinical significance of (18)F-FDG uptake by the spleen in patients with autoimmune disease. Methods: We retrospectively reviewed Severance Hospital's electronic medical records of patients hospitalized for the evaluation of fever who underwent (18)F-FDG PET/CT. We found 91 patients with autoimmune diseases and 101 patients with localized infection. (18)F-FDG uptake was assessed by measuring SUV in the spleen and liver. The spleen-to-liver ratio of the SUVmean (SLRmean) was calculated. Clinical and laboratory parameters were collected and evaluated for association with SLRmean In-hospital mortality was defined as all-cause mortality during hospital admission for fever. Results: SLRmean was significantly higher in autoimmune disease than in localized infectious disease (1.28 ± 0.43 vs. 0.91 ± 0.21, P < 0.001). In autoimmune disease, SLRmean was correlated with monocytes, aspartate aminotransferase, alanine aminotransferase, albumin, and ferritin. Analysis of receiver-operating-characteristic curves revealed that in comparison with laboratory parameters, SLRmean had the highest performance in differentiating autoimmune from localized infectious disease. Multivariate logistic regression analysis demonstrated that high SLRmean and low platelets were significantly associated with in-hospital mortality in febrile autoimmune disease. Conclusion: These findings suggest that spleen glucose metabolism is increased in febrile autoimmune disease. Spleen (18)F-FDG uptake may provide information useful in differentiating febrile autoimmune disease from localized infectious disease and predicting clinical outcomes in febrile autoimmune disease. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  19. A prospective feasibility study of sub-millisievert abdominopelvic CT using iterative reconstruction in Crohn's disease.

    PubMed

    O'Neill, Siobhan B; Mc Laughlin, Patrick D; Crush, Lee; O'Connor, Owen J; Mc Williams, Sebastian R; Craig, Orla; Mc Garrigle, Anne Marie; O'Neill, Fiona; Bye, Jackie; Ryan, Max F; Shanahan, Fergus; Maher, Michael M

    2013-09-01

    Iterative reconstruction (IR) allows diagnostic CT imaging with less radiation exposure than filtered back projection (FBP). We studied an IR low-dose CT abdomen/pelvis (LDCTAP) protocol, designed to image at an effective dose (ED) approximating 1 mSv in patients with Crohn's disease (CD). Forty patients, mean age 37 ± 13.4 years (range 17-69), with CD underwent two synchronous CT protocols (conventional-dose (CDCTAP) and LDCTAP). CDCTAP and LDCTAP images were compared for diagnostic acceptability, yield, image quality and ED (in millisieverts). The optimal level of IR for LDCTAP was also studied. LDCTAP yielded a mean ED of 1.3 ± 0.8 mSv compared with 4.7 ± 2.9 mSv for CDCTAP, reducing ED by 73.7 ± 3.3 % (mean dose reduction, 3.5 ± 2.1 mSv; P < 0.001) and dose length product by 73.6 ± 2.6 % (P < 0.001). Sub-millisievert (0.84 mSv) imaging was performed for patients with a body mass index (BMI) less than 25 (i.e. 63 % of our cohort). LDCTAP resulted in increased image noise and reduced diagnostic acceptability compared with CDCTAP despite use of IR, but detection of extra-luminal complications was comparable. Patients with suspected active CD can be adequately imaged using LDCTAP, yielding comparable information regarding extent, activity and complications of CD compared with CDCTAP, but with 74 % less dose. LDCTAP at doses equivalent to that of two abdominal radiographs represents a feasible alternative to CDCTAP. • Radiation dose is a concern when imaging patients with Crohn's disease. • New techniques allow low-dose abdominopelvic CT with acceptable image quality. • Using hybrid iterative reconstruction, its diagnostic yield compares well with that of conventional CT. • Sub-millisievert CT of patients with Crohn's disease appears technically and clinically feasible.

  20. High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial.

    PubMed

    Treskes, K; Bos, S A; Beenen, L F M; Sierink, J C; Edwards, M J R; Beuker, B J A; Muradin, G S R; Hohmann, J; Luitse, J S K; Hollmann, M W; Dijkgraaf, M G W; Goslings, J C

    2017-06-01

    To determine whether there is a difference in frequency and clinical relevance of incidental findings detected by total-body computed tomography scanning (TBCT) compared to those by the standard work-up (STWU) with selective computed tomography (CT) scanning. Trauma patients from five trauma centres were randomized between April 2011 and January 2014 to TBCT imaging or STWU consisting of conventional imaging with selective CT scanning. Incidental findings were divided into three categories: 1) major finding, may cause mortality; 2) moderate finding, may cause morbidity; and 3) minor finding, hardly relevant. Generalized estimating equations were applied to assess differences in incidental findings. In total, 1083 patients were enrolled, of which 541 patients (49.9 %) were randomized for TBCT and 542 patients (50.1 %) for STWU. Major findings were detected in 23 patients (4.3 %) in the TBCT group compared to 9 patients (1.7 %) in the STWU group (adjusted rate ratio 2.851; 95%CI 1.337-6.077; p < 0.007). Findings of moderate relevance were detected in 120 patients (22.2 %) in the TBCT group compared to 86 patients (15.9 %) in the STWU group (adjusted rate ratio 1.421; 95%CI 1.088-1.854; p < 0.010). Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning. • Total-body CT scanning in trauma results in 1.5 times more incidental findings. • Evaluation by TBCT in trauma results in more patients with incidental findings. • In every category of clinical relevance, TBCT detects more incidental findings.

  1. Baseline motor findings and Parkinson disease prognostic subtypes.

    PubMed

    Rajput, Ali H; Rajput, Michele L; Ferguson, Leslie W; Rajput, Alex

    2017-07-11

    To identify the significance of baseline motor features to the lifelong prognostic motor subtypes in a Parkinson disease (PD) cohort. In a previous study of 166 PD cases, we observed different prognosis in tremor-dominant, akinetic-rigid, and mixed subtypes. This study includes the same cases, but we excluded 10 cases with symptoms of ≥15 years duration at baseline. Relative severity of tremor, bradykinesia/akinesia, and rigidity at baseline were evaluated as predictors of the motor subtypes, which are known to have different prognosis. The most common motor subtype was mixed, followed by akinetic-rigid and then the tremor-dominant. Seventy cases were not receiving antiparkinsonian drugs at baseline. The prognostic subtypes could be predicted at baseline in 85% of all and in 91% of the treatment-naive cases. Sensitivity, specificity, and positive predictive values were strong for the mixed and the akinetic-rigid but weak for the tremor-dominant subtype. Our data show that motor profile at baseline can predict prognosis in most PD cases. These findings can be incorporated into clinical practice. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  2. Postmenopausal estrogen therapy and Alzheimer disease: overall negative findings.

    PubMed

    Roberts, Rosebud O; Cha, Ruth H; Knopman, David S; Petersen, Ronald C; Rocca, Walter A

    2006-01-01

    An inverse association between estrogen therapy (ET) and Alzheimer disease (AD) has been reported in some, but not in all studies. We investigated the association between ET and AD in postmenopausal women using a population-based case-control design. Women who developed AD from 1985 through 1989 in Rochester, MN (cases, n=264) were individually matched by age (+/-1 y) to control women free of dementia from the same population (controls, n=264). ET exposure (>/=6 mo after menopause) was ascertained by abstracting the complete medical records archived in the records-linkage system of the Rochester Epidemiology Project. The frequency of ET use was similar in cases (11.4%) and controls [10.6%; odds ratio=1.10; 95% confidence interval (CI)=0.63-1.93]. However, cases who used ET had a suggestive trend for an earlier age at start of ET compared with controls (median, 49.0 vs. 50.5 y; P=0.06). Although smoking (ever vs. never) was not associated with AD overall, we observed an interaction between smoking and ET. The odds ratio of AD in ET users was 4.55 (95% CI=1.33-15.53) among smokers, but was 0.68 (95% CI=0.35-1.32) among never-smokers (P for interaction=0.01). Our findings do not confirm a significant association between ET and AD overall; however, the possible interaction with smoking deserves further study.

  3. Clinical significance of thyroid incidentalomas identified by 18F-FDG PET/CT: correlation of ultrasonograpy findings with cytology results.

    PubMed

    Demir, Özgür; Köse, Naziyet; Özkan, Elgin; Ünlütürk, Uğur; Aras, Gülseren; Erdoğan, Murat Faik

    2016-07-01

    The aim of this study was to investigate the clinical importance of incidental focal or diffuse fluorine-18 fluorodeoxyglucose (F-FDG) uptake in the thyroid gland on positron emission tomography (PET)/computed tomography (CT) and to evaluate the additive value of thyroid ultrasonography (US) in defining the malignancy potential of thyroid incidentalomas. A total of 1450 patients, who had undergone a PET/CT scan for staging or restaging of various malignancies, were screened retrospectively and 52 (3.6%) patients with focal or diffuse F-FDG uptake in the thyroid gland on PET/CT were enrolled in the study. None of the patients had any history of thyroid diseases. Thyroid US with elastography for a thyroid nodule was performed for all the patients cross-sectionally. Thyroid fine-needle aspiration biopsy (FNAB) was also applied at the same time as the thyroid US to 34 patients with a nodule(s) 10 mm or more in diameter or less than 10 mm, but with malignancy potential ultrasonographically. The cytology results were compared with the thyroid US and F-FDG PET/CT findings. Although 39 patients had focal (group 1) F-FDG uptake in the thyroid gland, the remaining 13 patients had diffuse (group 2) uptake. In group 1, FNAB was performed in 32 patients. In 10 of 32 (31%) patients, FNAB results were concordant with malignant cytology (seven primary thyroid malignancy and three metastasis to thyroid). In group 2, in one of two patients who had undergone FNAB, malignant cytology (metastasis to thyroid) was detected. Although the difference between the maximum standardized uptake value (SUVmax) of malignant and benign nodules was statistically significant (10.2±8.9 vs. 5.6±3.0, P=0.013), the difference between the nodule sizes was not statistically significant (20.0±7.3 vs. 16.7±7.4, P=0.923). The presence of suspicious US findings and a high elastography score (≥4) were also statistically significant (P<0.001 and P=0.035, respectively). In the receiver

  4. [18F-FDG PET/CT diagnosis of liver cyst infection in a patient with autosomal dominant polycystic kidney disease and fever of unknown origin].

    PubMed

    Banzo, J; Ubieto, M A; Gil, D; Prats, E; Razola, P; Tardín, L; Andrés, A; Rambalde, E F; Ayala, S M; Cáncer, L; Velilla, J

    2013-01-01

    The diagnosis, localization and treatment of infected cysts in the kidney or liver of patients with autosomal dominant polycystic kidney disease (ADPKD) remain a clinical challenge. We report the findings of (18)F-FDG PET-CT in an ADPKD diagnosed patient who required renal transplantation five years before and in his follow up presented repeated episodes of bacteriemia without known focus on radiological tests performed. The (18)F-FDG PET-CT scan showed numerous hypermetabolic images with focal or ring-shaped morphology related to the content and the wall of some hepatic cysts. The increased metabolic activity was localized on segments VI and VII. We proceeded to drainage of one cyst in segment VI, removing 110 cc of purulent fluid which grew E. Coli BLEE. The (18)F-FDG PET/CT scan should be included in the diagnostic algorithm for detecting infected liver cysts in patients with ADPKD and fever of unknown origin.

  5. 18F-FDG PET versus CT for the detection of enteropathy-associated T-cell lymphoma in refractory celiac disease.

    PubMed

    Hadithi, Muhammed; Mallant, Maarten; Oudejans, Joost; van Waesberghe, Jan-Hein T M; Mulder, Chris J; Comans, Emile F I

    2006-10-01

    Refractory celiac disease (RCD) can evolve into enteropathy-associated T-cell lymphoma (EATL). 18F-FDG PET has been reported to discriminate between RCD and EATL. Because prospective data are lacking, we designed a prospective study to evaluate the potential of 18F-FDG PET for detection of EATL in patients with RCD and compared the results with those obtained using abdominal CT in a referral center. Between April 2003 and April 2005, 8 consecutive patients (median age, 66 y; range, 52-89 y) with EATL and 30 patients (median age, 61 y; range, 44-71 y) with RCD were included. CT and 18F-FDG PET were performed on all patients. Histologic evidence of EATL was identified in tissue samples obtained during upper gastrointestinal endoscopy or surgical resection. Villous atrophy was found in all patients with RCD and all (except 1) patients with EATL in nontumoral mucosa. Histologic examination of 1 patient with EATL localized in the duodenum showed intraepithelial lymphocytosis only. 18F-FDG PET could reveal sites histologically proven to be EATL in all 8 patients, whereas CT showed normal findings in 1 patient with EATL. 18F-FDG PET detected unsuspected extraintestinal sites affected by EATL in 2 patients. CT showed abnormalities such as a thickened small-bowel wall or lymphadenopathy in 14 patients with RCD lacking evidence of EATL at follow-up. 18F-FDG PET findings were positive in 3 and equivocal in another 3 patients with RCD. 18F-FDG PET was more sensitive and specific than CT (100% vs. 87% and 90% vs. 53%, respectively). Our data show that 18F-FDG PET is more sensitive in detecting EATL in patients with RCD than is CT. 18F-FDG PET, in addition to conventional CT, is recommended for evaluating patients with RCD.

  6. CT, MRI, and (18)F-FDG PET/CT findings of malignant peripheral nerve sheath tumor of the head and neck.

    PubMed

    Kim, Ha Youn; Hwang, Ji Young; Kim, Hyung-Jin; Kim, Yi Kyung; Cha, Jihoon; Park, Gyeong Min; Kim, Sung Tae

    2017-10-01

    Background Malignant peripheral nerve sheath tumor (MPNST) is a highly malignant tumor and rarely occurs in the head and neck. Purpose To describe the imaging features of MPNST of the head and neck. Material and Methods We retrospectively analyzed computed tomography (CT; n = 14), magnetic resonance imaging (MRI; n = 16), and (18)F-FDG PET/CT (n = 5) imaging features of 18 MPNSTs of the head and neck in 17 patients. Special attention was paid to determine the nerve of origin from which the tumor might have arisen. Results All lesions were well-defined (n = 3) or ill-defined (n = 15) masses (mean, 6.1 cm). Lesions were at various locations but most commonly the neck (n = 8), followed by the intracranial cavity (n = 3), paranasal sinus (n = 2), and orbit (n = 2). The nerve of origin was inferred for 11 lesions: seven in the neck, two in the orbit, one in the cerebellopontine angle, and one on the parietal scalp. Attenuation, signal intensity, and enhancement pattern of the lesions on CT and MRI were non-specific. Necrosis/hemorrhage/cystic change within the lesion was considered to be present on images in 13 and bone change in nine. On (18)F-FDG PET/CT images, all five lesions demonstrated various hypermetabolic foci with maximum standard uptake value (SUVmax) from 3.2 to 14.6 (mean, 7.16 ± 4.57). Conclusion MPNSTs can arise from various locations in the head and neck. Though non-specific, a mass with an ill-defined margin along the presumed course of the cranial nerves may aid the diagnosis of MPSNT in the head and neck.

  7. Analyzing structural changes in SNOMED CT's Bacterial infectious diseases using a visual semantic delta.

    PubMed

    Ochs, Christopher; Case, James T; Perl, Yehoshua

    2017-03-01

    Thousands of changes are applied to SNOMED CT's concepts during each release cycle. These changes are the result of efforts to improve or expand the coverage of health domains in the terminology. Understanding which concepts changed, how they changed, and the overall impact of a set of changes is important for editors and end users. Each SNOMED CT release comes with delta files, which identify all of the individual additions and removals of concepts and relationships. These files typically contain tens of thousands of individual entries, overwhelming users. They also do not identify the editorial processes that were applied to individual concepts and they do not capture the overall impact of a set of changes on a subhierarchy of concepts. In this paper we introduce a methodology and accompanying software tool called a SNOMED CT Visual Semantic Delta ("semantic delta" for short) to enable a comprehensive review of changes in SNOMED CT. The semantic delta displays a graphical list of editing operations that provides semantics and context to the additions and removals in the delta files. However, there may still be thousands of editing operations applied to a set of concepts. To address this issue, a semantic delta includes a visual summary of changes that affected sets of structurally and semantically similar concepts. The software tool for creating semantic deltas offers views of various granularities, allowing a user to control how much change information they view. In this tool a user can select a set of structurally and semantically similar concepts and review the editing operations that affected their modeling. The semantic delta methodology is demonstrated on SNOMED CT's Bacterial infectious disease subhierarchy, which has undergone a significant remodeling effort over the last two years.

  8. Sudden death as a late sequel of Kawasaki disease: postmortem CT demonstration of coronary artery aneurysm.

    PubMed

    Okura, Naoki; Okuda, Takahisa; Shiotani, Seiji; Kohno, Mototsugu; Hayakawa, Hideyuki; Suzuki, Atsuko; Kawasaki, Tomisaku

    2013-02-10

    Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that primarily affects the coronary artery (CA) and presents during childhood. The characteristic coronary arterial lesion of KD is an aneurysm. Ischemic heart disease derived from a CA aneurysm is experienced approximately two decades after the onset of acute KD. In recent years, the primary issue of concern has been asymptomatic adults with a CA aneurysm caused by undiagnosed KD. We present a case of sudden death as a late KD sequel in a young adult. A postmortem CT scan revealed a coarse calcification of a left anterior descending CA aneurysm, which was confirmed at the time of autopsy. A postmortem CT scan is useful in cases of sudden death where the detection of a calcified CA aneurysm would suggest to the forensic pathologist that the deceased suffered from a late sequel of KD. The use of screening postmortem CT scans for young people may detect cases of unsuspected CA aneurysms, raising the possibility of untreated KD.

  9. CT imaging of chronic obstructive pulmonary disease: insights, disappointments, and promise.

    PubMed

    Washko, George R; Coxson, Harvey O; O'Donnell, Denis E; Aaron, Shawn D

    2017-09-28

    CT imaging is a readily quantifiable tool that can provide in-vivo assessments of lung structure in conditions such as chronic obstructive pulmonary disease (COPD). The information extracted from these data has been used in many clinical, epidemiological, and genetic investigations for patient stratification and prognostication, and to determine intermediate endpoints for clinical trials. Although these efforts have informed our understanding of the heterogeneity of pulmonary disease in smokers, they have not yet translated into new treatments for COPD or the personalisation of patient care. There are a multitude of potential reasons for this, including the lack of insight that static imaging provides for lung function and dysfunction, the limited resolution of clinical CT scanning for microscopic changes to the lung architecture, and the challenges that the biomedical community faces when trying to translate discovery to therapy. Such limitations might be addressed through novel image analysis techniques, up-and-coming CT-based and MRI-based technologies, closer ties between academia and industry, and an expanded endeavour to share data across the biomedical community. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Finding aroma clues in the human breath to diagnose diseases

    Treesearch

    A. Dan Wilson

    2016-01-01

    History of human odor analysis in disease diagnosis The use of the sense of smell as an indicator of human disease probably originated with Hippocrates (circa 400 BC). Early medical practitioners recognized that the presence of human diseases changed the odors released from the body and breath. Physicians once relied heavily on their sense of smell to provide useful...

  11. The Infectious Disease Manpower Crisis: Finding the Cure.

    PubMed

    Berk, Steven L

    2017-02-01

    The challenges of infectious diseases, including new pathogens, dangerous outbreaks, antibiotic-resistant bacteria, and the perils of international travel have never been more publically appreciated. These challenges require a well-trained workforce of infectious disease specialists. Just when the need appears to be greatest, however, the interest in infectious diseases among today's young physicians is at its lowest point.

  12. The impact of image fusion in resolving discrepant findings between FDG-PET and MRI/CT in patients with gynaecological cancers.

    PubMed

    Tsai, Cheng-Chien; Tsai, Chien-Sheng; Ng, Koon-Kwan; Lai, Chyong-Huey; Hsueh, Swei; Kao, Pan-Fu; Chang, Ting-Chang; Hong, Ji-Hong; Yen, Tzu-Chen

    2003-12-01

    This study was performed to prospectively investigate the impact of image fusion in resolving discrepant findings between fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) or X-ray computed tomography (CT) in patients with gynaecological cancers. Discrepant findings were defined as lesions where the difference between the FDG-PET and MRI/CT images was assigned a value of at least 2 on a 5-point probability scale. The FDG-PET and MRI/CT images were taken within 1 month of each other. Image fusion between FDG-PET and CT was performed by automatic registration between the two images. During an 18-month period, 34 malignant lesions and seven benign lesions from 32 patients who had undergone either surgical excision or a CT-guided histopathological investigation were included for analysis. Among these cases, image fusion was most frequently required to determine the nature and/or the extent of abdominal and pelvic lesions (28/41, 68%), especially as regards peritoneal seeding (8/41, 20%). Image fusion was most useful in providing better localisation for biopsy (16/41, 39%) and in discriminating between lesions with pathological versus physiological FDG uptake (12/41, 29%). Image fusion changed the original diagnosis based on MRI/CT alone in 9/41 lesions (22%), and the original diagnosis based on FDG-PET alone in 5/41 lesions (12%). It led to alteration of treatment planning (surgery or radiotherapy) in seven of the 32 patients (22%). In patients with gynaecological cancers, the technique of image fusion is helpful in discriminating the nature of FDG-avid lesions, in effectively localising lesions for CT-guided biopsy and in providing better surgical or radiotherapy planning.

  13. Evaluations of multiplanar reconstruction in CT recognition of lumbar disk disease

    SciTech Connect

    Rosenthal, D.I.; Stauffer, A.E.; Davis, K.R.; Ganott, M.; Taveras, J.M.

    1984-07-01

    Axial computed tomographic (CT) images were compared with sagittal and coronal reformations and myelograms in 60 patients to evaluate the diagnostic usefulness of multiplanar reconstructions for the recognition of lumbar disk disease. The axial CT scans were most sensitive and specific. The sagittal scans were helpful in evaluating the neural foramina, the size of the disk bulge into the spinal canal, especially at L5-S1, and patients with spondylolisthesis. The coronal images were the least informative, although they contributed to the evaluation of lumbar nerve roots. The myelograms and the sagittal images were equally useful in the detection of herniated disk, but axial scans were superior to either. It was concluded that reformatted sagittal and coronal images are not required if all axial images are normal.

  14. Peripleural lung disease detection based on multi-slice CT images

    NASA Astrophysics Data System (ADS)

    Matsuhiro, M.; Suzuki, H.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.

    2015-03-01

    With the development of multi-slice CT technology, obtaining accurate 3D images of lung field in a short time become possible. To support that, a lot of image processing methods need to be developed. Detection peripleural lung disease is difficult due to its existence out of lung region, because lung extraction is often performed based on threshold processing. The proposed method uses thoracic inner region extracted by inner cavity of bone as well as air region, covers peripleural lung diseased cases such as lung nodule, calcification, pleural effusion and pleural plaque. We applied this method to 50 cases including 39 peripleural lung diseased cases. This method was able to detect 39 peripleural lung disease with 2.9 false positive per case.

  15. ECG findings after myocardial infarction in children after Kawasaki disease

    SciTech Connect

    Nakanishi, T.; Takao, A.; Kondoh, C.; Nakazawa, M.; Hiroe, M.; Matsumoto, Y.

    1988-10-01

    Standard 12-lead ECGs were evaluated in 17 children with myocardial infarction and 78 children without myocardial infarction after Kawasaki disease; sensitivity and specificity of the ECG infarction criteria were determined. The presence or absence of myocardial infarction was determined from either clinical examination results (coronary angiography, ventriculography, and thallium-201 myocardial imaging) or autopsy findings. Of seven patients with inferior infarction, abnormally deep Q waves in lead II, III, or aVF were observed in six, but the duration was greater than 0.04 second in only one (14%). The sensitivity and specificity of inferior infarction criteria based on Q wave amplitude were 86% and 97%, respectively. Of eight patients with anterior infarction, seven (88%) had abnormally deep and wide (greater than or equal to 0.04 second) Q waves in anterior chest leads. The sensitivity and specificity of the infarction criteria based on the amplitude and duration of the Q wave were 75% and 99%, respectively. Of seven patients with lateral infarction, Q waves were observed in lead I, aVL, or both in four patients, and in all of these patients Q waves were wider than 0.04 second. In two patients with both inferior and anterior infarction, Q waves were observed only in leads II, III, and aVF; in only one patient were the Q waves wider than 0.04 second. Thus deep Q waves in lead II, III, or aVF that are not wider than 0.04 second may indicate inferior infarction in children. Q waves in lead I, aVL, and chest leads associated with anterolateral infarction are in most instances deep and wide.

  16. Optical Coherence Tomography Angiography Findings in Stargardt Disease

    PubMed Central

    Borrelli, Enrico; Di Antonio, Luca; Mattei, Peter A.; Senatore, Alfonso; Di Nicola, Marta; Mariotti, Cesare

    2017-01-01

    Background to assess vessel density of superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) in advanced Stargardt disease (STGD) using optical coherence tomography angiography (OCTA) and correlate these findings with macular function using pattern electroretinogram (PERG) and multifocal electroretinogram (mfERG). Methods Twelve patients (24 eyes) with advanced STGD underwent vessel densities and macular thickness measurements using OCTA. A control group of 24 healthy controls (24 eyes) was chosen for comparison. In the STGD group correlation between vessel density and macular thickness and between macular function and morphologic parameters were evaluated. Results Whole parafoveal vessel density (VD) of SCP was significantly lower in STGD group compared to the control group (p<0.05). Foveal VD and whole parafoveal VD of the DCP were significantly lower in STGD group compared to the controls (p<0.05). CC was significantly decreased in STGD compared to controls (p<0.05). Foveal macular thickness (MT), full parafoveal MT, and inner limiting membrane (ILM)-inner plexiform layer (IPL) parafoveal MT thickness were decreased in STGD eyes compared to controls (p<0.001). PERG and mfERG were both significantly reduced in STGD compared to controls (p<0.001). A direct correlation was found between full parafoveal MT and vessel density in the STGD group. Conclusions Patients with advanced STGD showed a reduction of SCP, DCP and CC compared to healthy eyes related to a reduction of total and ILM-IPL macular thickness. These results suggest that both retinal capillaris plexuses and choriocapillaris reduction occur in STDG along with inner and outer retinal thinning. PMID:28151966

  17. Allergies and Disease Severity in Childhood Narcolepsy: Preliminary Findings.

    PubMed

    Aydinoz, Secil; Huang, Yu-Shu; Gozal, David; Inocente, Clara O; Franco, Patricia; Kheirandish-Gozal, Leila

    2015-12-01

    Narcolepsy frequently begins in childhood, and is characterized by excessive daytime sleepiness, with the presence of cataplexy reflecting a more severe phenotype. Narcolepsy may result from genetic predisposition involving deregulation of immune pathways, particularly involving T helper 2 cells (Th2). Increased activation of Th2 cells is usually manifested as allergic conditions such as rhinitis, atopic dermatitis, and asthma. We hypothesized that the presence of allergic conditions indicative of increased Th2 balance may dampen the severity of the phenotype in children with narcolepsy. A retrospective chart review of childhood narcolepsy patients was conducted at three major pediatric sleep centers. Patients were divided into those with narcolepsy without cataplexy (NC-) and narcolepsy with cataplexy (NC+). Demographics, polysomnographic and multiple sleep latency test data, and extraction of information on the presence of allergic diseases such allergic rhinitis, atopic dermatitis, and asthma was performed. There were 468 children identified, with 193 children in NC- group and 275 patients in the NC+ group. Overall, NC+ children were significantly younger, had higher body mass index, and had shorter mean sleep latencies and increased sleep onset rapid eye movement events. The frequency of allergic conditions, particularly asthma and allergic rhinitis, was markedly lower in NC+ (58/275) compared to NC- patients (94/193; P < 0.0001). Involvement of the immune system plays an important role in the pathophysiology of narcolepsy. Current findings further suggest that an increased shift toward T helper 2 cells, as indicated by the presence of allergic conditions, may modulate the severity of the phenotype in childhood narcolepsy, and reduce the prevalence of cataplexy in these patients. © 2015 Associated Professional Sleep Societies, LLC.

  18. Spatial epidemiology of dry eye disease: findings from South Korea.

    PubMed

    Um, Sun-Bi; Kim, Na Hyun; Lee, Hyung Keun; Song, Jong Suk; Kim, Hyeon Chang

    2014-08-15

    DED rate maps from diverse regions may allow us to understand world-wide spreading pattern of the disease. Only few studies compared the prevalence of DED between geographical regions in non-spatial context. Therefore, we examined the spatial epidemiological pattern of DED prevalence in South Korea using a nationally representative sample. We analyzed 16,431 Korean adults aged 30 years or older of the 5th Korea National Health and Nutrition Examination Survey. DED was defined as previously diagnosed by an ophthalmologist as well as symptoms experienced. Multiple logistic regression analysis was used to assess the spatial pattern in the prevalence of DED, and effects of environmental factors. Among seven metropolitan cities and nine provinces, three metropolitan cities located in the southeast of Korea revealed the highest prevalence of DED. After adjusting for sex, age and survey year, people living in urban areas had higher risk of having DED. Adjusted odds ratio for having previously diagnosed DED was 1.677 (95% CI 1.299-2.166) for metropolitan cities and 1.580 (95% CI 1.215-2.055) for other cities compared to rural areas. Corresponding odds ratio for presenting DED symptoms was 1.388 (95% CI 1.090-1.766) for metropolitan cities and 1.271 (95% CI 0.999-1.617) for other cities. Lower humidity and longer sunshine duration were significantly associated with DED. Among air pollutants, SO2 was associated with DED, while NO2, O3, CO, and PM10 were not. Our findings suggest that prevalence of DED can be affected by the degree of urbanization and environmental factors such as humidity and sunshine duration.

  19. Dual-Energy CT of Incidental Findings in the Abdomen: Can We Reduce the Need for Follow-Up Imaging?

    PubMed

    Wortman, Jeremy R; Bunch, Paul M; Fulwadhva, Urvi P; Bonci, Gregory A; Sodickson, Aaron D

    2016-07-06

    The purpose of this article is to review the added value of dual-energy CT for characterization of incidental lesions discovered during routine abdominal CT. Dual-energy CT allows acquisition of virtual unenhanced images, iodine maps, and virtual monochromatic images, all of which can aid in characterizing incidental lesions at the time of detection. Virtual unenhanced images and iodine maps are used for assessment of enhancement of incidental lesions, which can help differentiate suspicious enhancing lesions from benign nonenhancing lesions. Virtual monochromatic images can be obtained at low energy to improve conspicuity and detection of subtle lesions. Routine use of dual-energy CT may eliminate the need for additional imaging in the workup of some of these incidental lesions.

  20. DIAGNOSTIC ACCURACY OF BARIUM ENEMA FINDINGS IN HIRSCHSPRUNG'S DISEASE.

    PubMed

    Peyvasteh, Mehran; Askarpour, Shahnam; Ostadian, Nasrollah; Moghimi, Mohammad-Reza; Javaherizadeh, Hazhir

    2016-01-01

    Hirschsprung's disease is the most common cause of pediatric intestinal obstruction. Contrast enema is used for evaluation of the patients with its diagnosis. To evaluate sensitivity, specificity, positive predictive value, and negative predictive value of radiologic findings for diagnosis of Hirschsprung in patients underwent barium enema. This cross sectional study was carried out in Imam Khomeini Hospital for one year starting from 2012, April. Sixty patients were enrolled. Inclusion criteria were: neonates with failure to pass meconium, abdominal distention, and refractory constipation who failed to respond with medical treatment. Transitional zone, delay in barium evacuation after 24 h, rectosigmoid index (maximum with of the rectum divided by maximum with of the sigmoid; abnormal if <1), and irregularity of mucosa (jejunization) were evaluated in barium enema. Biopsy was obtained at three locations apart above dentate line. PPV, NPV, specificity , and sensitivity was calculated for each finding. Mean age of the cases with Hirschsprung's disease and without was 17.90±18.29 months and 17.8±18.34 months respectively (p=0.983). It was confirmed in 30 (M=20, F=10) of cases. Failure to pass meconium was found in 21(70%) cases. Sensitivity, specificity, PPV, and NPV were 90%, 80%, 81.8% and 88.8% respectively for transitional zone in barium enema. Sensitivity, specificity, PPV, and NPV were 76.7%, 83.3%, 78.1% and 82.1% respectively for rectosigmoid index .Sensitivity, specificity, PPV, and NPV were 46.7%, 100%, 100% and 65.2% respectively for irregular contraction detected in barium enema. Sensitivity, specificity, PPV, and NPV were 23.3%, 100%, 100% and 56.6% respectively for mucosal irregularity in barium enema. The most sensitive finding was transitional zone. The most specific findings were irregular contraction, mucosal irregularity, and followed by cobblestone appearance. A doença de Hirschsprung é a causa mais comum de obstrução intestinal pedi

  1. Response monitoring to bisphosphonate therapy in monostotic paget disease using (18)F-FDG PET/CT.

    PubMed

    Sharma, Punit; Chatterjee, Piyali

    2015-06-01

    Paget disease is a benign bone disorder characterized by abnormal bone absorption and mineralization, resulting in bone deformity and fragility. Currently, bisphosphonates form the cornerstone of treatment for Paget disease. We report the case of a 67-year-old man with monostotic Paget disease, where F-FDG PET/CT was used for assessment of response to bisphosphonate therapy.

  2. Forkhead box C2 Promoter Variant c.-512C>T Is Associated with Increased Susceptibility to Chronic Venous Diseases

    PubMed Central

    Surendran, Sumi; Girijamma, Athira; Nair, Radhakrishnan; Ramegowda, Kalpana S.; Nair, Divya H.; Thulaseedharan, Jissa V.; Lakkappa, Ravikumar B.; Kamalapurkar, Giridhar; Kartha, Chandrasekharan C.

    2014-01-01

    Chronic venous disease (CVD) is one of the most prevalent yet underrated disorders worldwide. High heritability estimates of CVD indicate prominent genetic components in its etiology and pathology. Mutations in human forkhead box C2 (FoxC2) gene are strongly associated with valve failure in saphenous and deep veins of lower extremities. We explored the association of genetic variants of FoxC2 as well as FoxC2 mRNA and protein expression levels with CVD of lower limbs. We systematically sequenced the single coding exon, 5′ and 3′ flanking regions of FoxC2 gene in 754 study subjects which includes 382 patients with CVD and 372 healthy subjects. Four novel and three reported polymorphisms were identified in our cohort. Three variants in 5′ flanking region and one in 3′ flanking region of FoxC2 gene were significantly associated with CVD risk. FoxC2 mRNA in vein tissues from 22 patients was 4±1.42 fold increased compared to saphenous veins from 20 normal subjects (p<0.01). FoxC2 protein was also significantly upregulated in varicose veins compared to control samples. The c.-512C>T (rs34221221: C>T) variant which is located in the FoxC2 putative promoter region was further analyzed. Functional analysis of c.-512C>T revealed increased mRNA and protein expression in patients with homozygous TT genotype compared to heterozygous CT and wild CC genotypes. Luciferase assay indicated higher transcriptional activity of mutant compared to wild genotype of this variant. These findings suggested that c.-512C>T variant of FoxC2 was strongly associated with susceptibility to CVD and also that this variant resulted in FoxC2 overexpression. To obtain a mechanistic insight into the role of upregulated FoxC2 in varicosities, we overexpressed FoxC2 in venous endothelial cells and observed elevated expression of arterial markers Dll4 and Hey2 and downregulation of venous marker COUP-TFII. Our study indicates altered FoxC2-Notch signaling in saphenous vein wall remodeling in

  3. NLR in Human Diseases: Role and Laboratory Findings.

    PubMed

    Carta, Sonia; Gattorno, Marco; Rubartelli, Anna

    2016-01-01

    Autoinflammatory diseases are a group of inherited and multifactorial disorders characterized by an overactivation of innate immune response. In most cases, the clinical manifestations are due to increased activity of the NLRP3 inflammasome resulting in increased IL-1β secretion. Investigating inflammatory cells from subjects affected by autoinflammatory diseases presents a number of technical difficulties related to the rarity of the diseases, to the young age of most patients, and to the difficult modulation of gene expression in primary cells. However, since cell stress is involved in the pathophysiology of these diseases, the study of freshly drawn blood monocytes from patients affected by IL-1-mediated diseases strongly increases the chances that the observed phenomena is indeed pertinent to the pathogenesis of the disease and not influenced by the long-term cell culture conditions (e.g., the high O2 tension) or gene transfection in continuous cell lines that may lead to artifacts.

  4. Garden type I fractures myth or reality? A prospective study comparing CT scans with X-ray findings in Garden type I femoral neck fractures.

    PubMed

    Chen, Wei; Li, Zhiyong; Su, Yanling; Hou, Zhiyong; Zhang, Qi; Zhang, Yingze

    2012-11-01

    The Garden type I femoral neck fracture is defined as an incomplete fracture of the neck of the femur as seen on the antero-posterior (AP) radiograph of the injured hip. The diagnosis of incomplete femoral neck fractures has decreased in recent years with the development of improved radiographic imaging. We hypothesized that incomplete femoral neck fractures seen on radiographs are in fact complete fractures on computed tomography (CT). The study aims to test this hypothesis by comparing CT scan images to X-ray findings in patients diagnosed with Garden type I femoral neck fractures. From January 2008 to October 2010, our management of femoral neck fractures included a CT scan of the injured hip for all Garden type I fractures. CT findings were reported by a musculoskeletal radiologist. A classification of the fracture was performed by an orthopedic surgeon. Eight hundred and twenty five femoral neck fractures were admitted during the study period. Seventeen of these fractures (2.1%) were considered incomplete based on radiographic evaluation. In 17 cases (100%), the CT scan demonstrated a complete fracture extending through the medial cortex. Subsequently, all 17 fractures were fixed with standard cannulated screw technique on a fracture table. Secondary displacement occurred in one patient prior to fixation. All fractures healed well and no avascular necrosis was noted. In summary, our study shows that incomplete femoral neck fractures identified on X-rays are actually complete fractures based on CT scans. If confirmed by a larger study population, our findings can simplify the Garden classification by eliminating an inaccurate subcategory. The clinical implications are that Garden type I fractures should all likely be fixed with cannulated screws and with an effort to prevent displacement during treatment. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Serial changes and prognostic implications of CT findings in combined pulmonary fibrosis and emphysema: comparison with fibrotic idiopathic interstitial pneumonias alone.

    PubMed

    Lee, Geewon; Kim, Ki Uk; Lee, Ji Won; Suh, Young Ju; Jeong, Yeon Joo

    2017-05-01

    Background Although fibrotic idiopathic interstitial pneumonias (IIPs) alone and those combined with pulmonary emphysema are naturally progressive diseases, the process of deterioration and outcomes are variable. Purpose To evaluate and compare serial changes of computed tomography (CT) abnormalities and prognostic predictive factors in fibrotic IIPs alone and those combined with pulmonary emphysema. Material and Methods A total of 148 patients with fibrotic IIPs alone (82 patients) and those combined with pulmonary emphysema (66 patients) were enrolled. Semi-quantitative CT analysis was used to assess the extents of CT characteristics which were evaluated on initial and follow-up CT images. Univariate and multivariate analyses were performed to assess the effects of clinical and CT variables on survival. Results Significant differences were noted between fibrotic scores, as determined using initial CT scans, in the fibrotic IIPs alone (21.22 ± 9.83) and those combined with pulmonary emphysema groups (14.70 ± 7.28) ( P < 0.001). At follow-up CT scans, changes in the extent of ground glass opacities (GGO) were greater ( P = 0.031) and lung cancer was more prevalent ( P = 0.001) in the fibrotic IIPs combined with pulmonary emphysema group. Multivariate Cox proportional hazards analysis showed changes in the extent of GGO (hazard ratio, 1.056) and the presence of lung cancer (hazard ratio, 4.631) were predictive factors of poor survivals. Conclusion Although patients with fibrotic IIPs alone and those combined with pulmonary emphysema have similar mortalities, lung cancer was more prevalent in patients with fibrotic IIPs combined with pulmonary emphysema. Furthermore, changes in the extent of GGO and the presence of lung cancer were independent prognostic factors of poor survivals.

  6. PET-CT in presurgical lymph node staging in non-small cell lung cancer: the importance of false-negative and false-positive findings.

    PubMed

    Bustos García de Castro, A; Ferreirós Domínguez, J; Delgado Bolton, R; Fernández Pérez, C; Cabeza Martínez, B; García García-Esquinas, M; Carreras Delgado, J L

    To assess the importance of false-negative and false-positive findings in computed tomography (CT) and (18)F-FDG positron emission tomography (PET) in mediastinal lymph node staging in patients undergoing surgery for non-small cell lung cancer (NSCLC). This retrospective study included 113 consecutive patients and 120 resected NSCLCs; 22 patients received neoadjuvant treatment. We compared the findings on preoperative (18)F-FDG PET-CT studies with the postoperative pathology findings. Lymph node size and primary tumor size were measured with CT, and lymph nodes and primary tumors were evaluated qualitatively and semiquantitatively (using standardized uptake values (SUVmax)) with PET. Metastatic lymph nodes were found in 26 (21.7%) of the 120 tumors and in 41 (7.7%) of the 528 lymph node stations analyzed. (18)F-FDG PET-CT yielded 53.8% sensitivity, 76.6% specificity, 38.9% positive predictive value, 85.7% negative predictive value, and 71.7% diagnostic accuracy. The false-negative rate was 14.2%. Multivariable analysis found that the factors associated with false-negative findings were a moderate degree of differentiation in the primary tumor (p = 0.005) and an SUVmax of the primary tumor >4 (p = 0.027). The false-positive rate was 61.1%, and the multivariable analysis found that lymph node size >1cm was associated with false-positive findings (p < 0.001). In mediastinal lymph node staging in patients with NSCLC, (18)F-FDG PET-CT improves the specificity and negative predictive value and helps clinicians to select the patients that will benefit from surgery. Given the high rate of false positives, histological confirmation of positive cases is recommendable. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Association between LGALS2 3279C>T and coronary artery disease: A case-control study and a meta-analysis

    PubMed Central

    LIAN, JIANGFANG; FANG, PEILIANG; DAI, DONGJUN; BA, YANNA; YANG, XI; HUANG, XIAOYAN; LI, JUNXIN; CHEN, XIAOLIANG; GUO, JIAN; GUAN, FENG; PENG, PING; ZHAO, RUOCHI; ZHANG, SHANGSHI; GAO, FANG; TANG, LINLIN; ZHANG, CHENG; JI, HUIHUI; HONG, QINGXIAO; YE, HUADAN; XU, LIMIN; ZHONG, QILONG; LIU, PANPAN; ZHOU, JIANQING; DUAN, SHIWEI

    2014-01-01

    Coronary artery disease (CAD) has become the main cause of mortality worldwide. Lectin galactoside-binding soluble-2 (LGALS2) is involved in the cytokine lymphotoxin-α (LTA) cascade that may influence the progress of CAD. The aim of the present study was to assess the association between the LGALS2 3279C>T (rs7291467) polymorphism and CAD. A total of 562 cases and 572 controls were recruited to examine the association. A systematic meta-analysis was performed to evaluate the contribution of LGALS2 3279C>T polymorphism to the risk of CAD among 12,093 cases and 11,020 controls. There was no significant association found in the present case-control study. However, the meta-analysis showed that LGALS2 3279C>T played a protective role in CAD [P=0.008, odds ratio (OR), 0.90; 95% confidence interval (95% CI), 0.82–0.97] and particularly in the Asian population (P=0.006; OR, 0.82; 95% CI, 0.71–0.94). The present case-control study did not find a significant association between LGALS2 3279C>T and CAD in the Eastern Han Chinese population. However, the meta-analysis indicated that LGALS2 3279C>T played a protective role in CAD, suggesting an ethnic difference in the association of the locus with CAD. PMID:25279163

  8. MR enterography findings in abdominopelvic extraintestinal complications of Crohn's disease.

    PubMed

    Mazziotti, Silvio; Blandino, Alfredo; Scribano, Emanuele; Gaeta, Michele; Mileto, Achille; Fries, Walter; Bombaci, Francesco; Ascenti, Giorgio

    2013-05-01

    MR of the small bowel is a useful technique for the evaluation of both intraluminal and extraluminal pathologic involvement of the small bowel in patients with Crohn's disease. Crohn's disease is associated with a range of extraintestinal complications that sometimes may be the initial presenting symptoms. Some of these extraintestinal complications may not correlate with disease activity, but in general, they tend to follow the clinical course of disease and may have a high impact on life quality, morbidity, and even mortality in these patients. Our purpose is to describe some abdominopelvic extraintestinal complications of Crohn's disease, such as hepatopancreatobiliary, genitourinary, musculoskeletal, peritoneal, and lymph-nodal, detectable at MR enterography. Copyright © 2012 Wiley Periodicals, Inc.

  9. Correlation of clinical outcomes with bremsstrahlung and Y-90 PET/CT imaging findings following Y-90 radiosynoviorthesis: a prospective study.

    PubMed

    Barber, Thomas W; Cherk, Martin H; Powell, Anne; Yap, Kenneth S K; Billah, Baki; Kalff, Victor

    2016-12-01

    It is unclear how to predict which patients will respond to Y-90 radiosynoviorthesis. The aim of this study is to correlate clinical outcomes following Y-90 radiosynoviorthesis with bremsstrahlung and Y-90 PET/CT imaging findings. Fifty-one joints underwent bremsstrahlung planar and Y-90 PET/CT imaging following Y-90 radiosynoviorthesis. The Y-90 distribution pattern on bremsstrahlung planar imaging was classified as diffuse or non-diffuse and compared with the intra or extra-articular location of activity on Y-90 PET/CT. Treatment response was assessed by patients and clinicians at 6 months. In patients who underwent bremsstrahlung SPECT, side-by-side comparison with PET was performed with image quality/resolution scored using a five-point-scale. Bremsstrahlung planar images were classified as diffuse in 33/51 (65 %) and non-diffuse in 18/51 (35 %) scans. There was no association between treatment response and the bremsstrahlung planar imaging pattern. PET/CT confirmed an intra-articular location in all 33/33 (100 %) diffuse scans and an extra-articular location in 3/18 (17 %) non-diffuse scans. Of the three joints with extra-articular activity, none had any treatment response. Excluding these three joints, there remained no association between the bremsstrahlung planar imaging pattern and treatment response. Of the 42 joints imaged with SPECT, PET image quality/resolution was classified as superior in 40 (95 %). In one patient with extra-articular activity on PET/CT, SPECT/CT was unable to definitively localise the activity to the intra or extra-articular space. The distribution pattern on bremsstrahlung planar imaging did not correlate with clinical outcome following Y-90 radiosynoviorthesis in our study population. However, in patients with non-diffuse planar imaging patterns, Y-90 PET/CT should be considered to exclude extra-articular activity with PET providing superior image quality compared to SPECT.

  10. Automated segmentation of lungs with severe interstitial lung disease in CT.

    PubMed

    Wang, Jiahui; Li, Feng; Li, Qiang

    2009-10-01

    Accurate segmentation of lungs with severe interstitial lung disease (ILD) in thoracic computed tomography (CT) is an important and difficult task in the development of computer-aided diagnosis (CAD) systems. Therefore, we developed in this study a texture analysis-based method for accurate segmentation of lungs with severe ILD in multidetector CT scans. Our database consisted of 76 CT scans, including 31 normal cases and 45 abnormal cases with moderate or severe ILD. The lungs in three selected slices for each CT scan were first manually delineated by a medical physicist, and then confirmed or revised by an expert chest radiologist, and they were used as the reference standard for lung segmentation. To segment the lungs, we first employed a CT value thresholding technique to obtain an initial lung estimate, including normal and mild ILD lung parenchyma. We then used texture-feature images derived from the co-occurrence matrix to further identify abnormal lung regions with severe ILD. Finally, we combined the identified abnormal lung regions with the initial lungs to generate the final lung segmentation result. The overlap rate, volume agreement, mean absolute distance (MAD), and maximum absolute distance (dmax) between the automatically segmented lungs and the reference lungs were employed to evaluate the performance of the segmentation method. Our segmentation method achieved a mean overlap rate of 96.7%, a mean volume agreement of 98.5%, a mean MAD of 0.84 mm, and a mean dmax of 10.84 mm for all the cases in our database; a mean overlap rate of 97.7%, a mean volume agreement of 99.0%, a mean MAD of 0.66 mm, and a mean dmax of 9.59 mm for the 31 normal cases; and a mean overlap rate of 96.1%, a mean volume agreement of 98.1%, a mean MAD of 0.96 mm, and a mean dmax of 11.71 mm for the 45 abnormal cases with ILD. Our lung segmentation method provided accurate segmentation results for abnormal CT scans with severe ILD and would be useful for developing CAD systems

  11. Hydroxyapatite deposition disease around the hip: outcomes of CT-guided treatment

    PubMed Central

    Klontzas, Michail E.; Vassalou, Evangelia E.; Zibis, Aristeidis H.; Karantanas, Apostolos H.

    2016-01-01

    PURPOSE Hydroxyapatite deposition disease (HADD) around the hip joint is a self-limiting condition usually treated conservatively. The aim of the present study is to directly compare the outcomes of CT-guided and conservative treatments in cases of refractory hip HADD. METHODS Two groups of patients with refractory hip HADD were prospectively constructed from a pool of 484 patients referred for greater trochanter pain syndrome, based on the presence of calcifications around the hip and the failure of conservative treatment. Study group included 22 hips, which underwent CT-guided barbotage and steroid injection treatment, whereas control group consisted of 28 hips that were treated conservatively. Evaluation of the outcome of both groups was performed over a one-year follow-up period with the use of a score measuring clinical improvement in terms of pain and functional impairment. RESULTS Three weeks after the initiation of treatment, study group exhibited significantly higher scores compared with the control group (P < 0.001). Improvement scores of the control group were similar to the study group after three months of treatment (P > 0.1). CONCLUSION CT-guided treatment provides relief of debilitating symptoms in the acute phase. PMID:27537854

  12. Computer-aided detection of early interstitial lung diseases using low-dose CT images.

    PubMed

    Park, Sang Cheol; Tan, Jun; Wang, Xingwei; Lederman, Dror; Leader, Joseph K; Kim, Soo Hyung; Zheng, Bin

    2011-02-21

    This study aims to develop a new computer-aided detection (CAD) scheme to detect early interstitial lung disease (ILD) using low-dose computed tomography (CT) examinations. The CAD scheme classifies each pixel depicted on the segmented lung areas into positive or negative groups for ILD using a mesh-grid-based region growth method and a multi-feature-based artificial neural network (ANN). A genetic algorithm was applied to select optimal image features and the ANN structure. In testing each CT examination, only pixels selected by the mesh-grid region growth method were analyzed and classified by the ANN to improve computational efficiency. All unselected pixels were classified as negative for ILD. After classifying all pixels into the positive and negative groups, CAD computed a detection score based on the ratio of the number of positive pixels to all pixels in the segmented lung areas, which indicates the likelihood of the test case being positive for ILD. When applying to an independent testing dataset of 15 positive and 15 negative cases, the CAD scheme yielded the area under receiver operating characteristic curve (AUC = 0.884 ± 0.064) and 80.0% sensitivity at 85.7% specificity. The results demonstrated the feasibility of applying the CAD scheme to automatically detect early ILD using low-dose CT examinations.

  13. Computer-aided detection of early interstitial lung diseases using low-dose CT images

    NASA Astrophysics Data System (ADS)

    Park, Sang Cheol; Tan, Jun; Wang, Xingwei; Lederman, Dror; Leader, Joseph K.; Kim, Soo Hyung; Zheng, Bin

    2011-02-01

    This study aims to develop a new computer-aided detection (CAD) scheme to detect early interstitial lung disease (ILD) using low-dose computed tomography (CT) examinations. The CAD scheme classifies each pixel depicted on the segmented lung areas into positive or negative groups for ILD using a mesh-grid-based region growth method and a multi-feature-based artificial neural network (ANN). A genetic algorithm was applied to select optimal image features and the ANN structure. In testing each CT examination, only pixels selected by the mesh-grid region growth method were analyzed and classified by the ANN to improve computational efficiency. All unselected pixels were classified as negative for ILD. After classifying all pixels into the positive and negative groups, CAD computed a detection score based on the ratio of the number of positive pixels to all pixels in the segmented lung areas, which indicates the likelihood of the test case being positive for ILD. When applying to an independent testing dataset of 15 positive and 15 negative cases, the CAD scheme yielded the area under receiver operating characteristic curve (AUC = 0.884 ± 0.064) and 80.0% sensitivity at 85.7% specificity. The results demonstrated the feasibility of applying the CAD scheme to automatically detect early ILD using low-dose CT examinations.

  14. Automated CT segmentation of diseased hip using hierarchical and conditional statistical shape models.

    PubMed

    Yokota, Futoshi; Okada, Toshiyuki; Takao, Masaki; Sugano, Nobuhiko; Tada, Yukio; Tomiyama, Noriyuki; Sato, Yoshinobu

    2013-01-01

    Segmentation of the femur and pelvis is a prerequisite for patient-specific planning and simulation for hip surgery. Accurate boundary determination of the femoral head and acetabulum is the primary challenge in diseased hip joints because of deformed shapes and extreme narrowness of the joint space. To overcome this difficulty, we investigated a multi-stage method in which the hierarchical hip statistical shape model (SSM) is initially utilized to complete segmentation of the pelvis and distal femur, and then the conditional femoral head SSM is used under the condition that the regions segmented during the previous stage are known. CT data from 100 diseased patients categorized on the basis of their disease type and severity, which included 200 hemi-hips, were used to validate the method, which delivered significantly increased segmentation accuracy for the femoral head.

  15. Computed Tomographic Findings of Syphilitic Aortitis: A Case Report

    SciTech Connect

    Kimura, Fumiko; Satoh, Hideyuki; Sakai, Fumikazu; Nishii, Noriko; Tohda, Joe; Fujimura, Mikihiko; Haruta, Shoji; Yamazaki, Kenji; Endo, Masahiro; Sakomura, Yasunari; Kurosama, Hiromi; Kasanuki, Hiroshi

    2004-03-15

    We describe the computerized tomographic (CT) findings of the aortic wall in a case of acute-phase syphilitic arteritis. The delayed phase of the contrast-enhanced CT shows a double-ring configuration of the thick thoracic aortic wall, which is similar to CT findings previously reported for Takayasu arteritis. We speculate that the resemblance of the CT findings for these two diseases accounts for their similar histopathological features.

  16. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass

    PubMed Central

    Ayaz, Sevin; Ayaz, Ümit Yaşar

    2016-01-01

    Summary Background We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Case Report Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUVmax) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. Conclusions FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy. PMID:28058074

  17. Myocardial CT perfusion for the prediction of obstructive coronary artery disease, valuable or not?

    PubMed

    van Rosendael, Alexander R; de Graaf, Michiel A; Scholte, Arthur J

    2015-02-01

    Adenosine stress myocardial computed tomography perfusion (CTP) is a relatively new myocardial perfusion imaging technique. Together with coronary CT angiography (CTA) it provides anatomic and functional information of coronary artery disease (CAD). In previous studies, the combination of these techniques demonstrated to be valuable for identifying hemodynamically significant stenoses. George et al., performed a secondary analysis on the CORE320 study and compared the diagnostic performance of CTP to single positron emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to diagnose obstructive CAD (defined as ≥50% luminal stenosis). In this editorial the results and limitations of the study are discussed, as well as opportunities that this new perfusion technique brings with it.

  18. Early Detection of Amyloid Plaque in Alzheimer’s Disease via X-Ray Phase CT

    DTIC Science & Technology

    2013-06-01

    project’s progression has been in pace with the project timeline specified in statement of work (SOW). 15. SUBJECT TERMS Alzheimer disease, Amyloid plaque...the Aβ1-40 and Aβ1-42 fibrils filled and sealed will be installed in the rotation stage of the prototype x-ray phase contrast CT in the way...subsystems and components, including the micro-focus x-ray tube, CMOS x-ray detector at 48µm detector cell dimension, rotation stage , gratings G1 and

  19. C2 spondylotic radiculopathy: the nerve root impingement mechanism investigated by para-sagittal CT/MRI, dynamic rotational CT, intraoperative microscopic findings, and treated by microscopic posterior foraminotomy.

    PubMed

    Fujiwara, Yasushi; Izumi, Bunichiro; Fujiwara, Masami; Nakanishi, Kazuyoshi; Tanaka, Nobuhiro; Adachi, Nobuo; Manabe, Hideki

    2017-04-01

    C2 radiculopathy is known to cause occipito-cervical pain, but their pathology is unclear because of its rarity and unique anatomy. In this paper, we investigated the mechanism of C2 radiculopathy that underwent microscopic cervical foraminotomies (MCF). Three cases with C2 radiculopathy treated by MCF were investigated retrospectively. The mean follow-up period was 24 months. Pre-operative symptoms, imaging studies including para-sagittal CT and MRI, rotational dynamic CT, and intraoperative findings were investigated. There were 1 male and 2 females. The age of patients were ranged from 50 to 79 years. All cases had intractable occipito-cervical pain elicited by the cervical rotation. C2 nerve root block was temporally effective. There was unilateral spondylosis in symptomatic side without obvious atlatoaxial instability. Para-sagittal MRI and CT showed severe foraminal stenosis at C1-C2 due to the bony spur derived from the lateral atlanto-axial joints. In one case, dynamic rotational CT showed that the symptomatic foramen became narrower on rotational position. MCF was performed in all cases, and the C2 nerve root was impinged between the inferior edge of the C1 posterior arch and bony spur from the C1-C2 joint. After surgery, occipito-cervical pain disappeared. This study demonstrated that mechanical impingement of the C2 nerve root is one of the causes of occipito-cervical pain and it was successfully treated by microscopic resection of the inferior edge of the C1 posterior arch. Para-sagittal CT and MRI, rotational dynamic CT, and nerve root block were effective for diagnosis.

  20. Cardiovascular Disease and Diet: Research Findings for Classroom Use.

    ERIC Educational Resources Information Center

    Roush, Robert E.

    1980-01-01

    Cardiovascular disease (CVD) is the major public health problem in the U.S. today. Health education teachers should take the initiative to teach others about the relationships of diet, personal attributes, metabolic disorders, and lifestyle characteristics to CVD. (JN)

  1. Scientists adopt new strategy to find Huntington's disease therapies

    MedlinePlus

    ... Rigor & Reproducibility Scientific Resources Animal Models Cell/Tissue/DNA Clinical and Translational Resources Gene Expression Research Reagents ... 4,000 Huntington’s disease patients and found that DNA repair genes may determine when the neurological symptoms ...

  2. Cardiovascular Disease and Diet: Research Findings for Classroom Use.

    ERIC Educational Resources Information Center

    Roush, Robert E.

    1980-01-01

    Cardiovascular disease (CVD) is the major public health problem in the U.S. today. Health education teachers should take the initiative to teach others about the relationships of diet, personal attributes, metabolic disorders, and lifestyle characteristics to CVD. (JN)

  3. Paraneoplastic pemphigus as a first sign of metastatic retroperitoneal inflammatory myofibroblastic tumor: (18)F-FDG PET/CT findings.

    PubMed

    Dhull, V S; Passah, A; Rana, N; Arora, S; Mallick, S; Kumar, R

    2016-01-01

    A 30-year-old female presented with a 3-month history of erosive stomatitis and bullous lesions, along with recurrent episodes of abdominal pain. She was found to have a retroperitoneal lump in left lumbar region. Skin biopsy revealed bullous disorder. CT guided biopsy of the retroperitoneal mass was suggestive of inflammatory myofibroblastic tumor (IMT). She was started on oral steroids and supportive care, and surgery was being planned when she developed respiratory failure. CT chest revealed vertebral metastases. PET/CT for whole body work up revealed a left para-aortic mass along with multiple skeletal metastases. The patient was kept on conservative management. After 3 months, the patient has shown clinical improvement, and an exploratory laparotomy is now being planned for the excision of the tumor, followed by chemotherapy. This case of retroperitoneal IMT is rare in terms of skeletal metastases with paraneoplastic pemphigus.

  4. Is abdominal CT useful for the management of patients with severe acute colitis complicating inflammatory bowel disease? A study in 54 consecutive patients.

    PubMed

    Mege, D; Monsinjon, M; Zappa, M; Stefanescu, C; Treton, X; Maggiori, L; Bouhnik, Y; Panis, Y

    2017-04-01

    To evaluate the contribution of CT for the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD); in particular, its contribution to surgical decision making. All patients who were admitted to our institution for SAC complicating IBD were divided into two groups: group A (those who received surgical treatment); and group B (those who received medical treatment). Admission CT results were compared between groups. From 2006 to 2015, 54 patients [26 male; median age 39 (17-71) years] presenting with SAC were placed in either group A (n = 41; 76%) or group B (n = 13; 24%). Surgical patients in group A more frequently had altered general status (50 vs 17%; P = 0.01). Physical examination, Lichtiger score, endoscopic findings and laboratory results were similar between the groups. There was no significant difference in CT data between the groups with respect to extent of the colitis (pan-colitis in 54 and 69%, respectively, P = 0.35), median colonic thickness [10 (4-16) vs 8 (6-11) mm, P = 0.15], target enhancement (88 vs 77%, P = 0.38) and occurrence of toxic megacolon (2 vs 0%). Admission CT is not helpful in surgical decision making in SAC. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  5. Added Value of SPECT/CT in the Evaluation of Benign Bone Diseases of the Appendicular Skeleton.

    PubMed

    Abikhzer, Gad; Srour, Saher; Keidar, Zohar; Bar-Shalom, Rachel; Kagna, Olga; Israel, Ora; Militianu, Daniela

    2016-04-01

    Bone scintigraphy is a sensitive technique to detect altered bone mineralization but has limited specificity. The use of SPECT/CT has improved significantly the diagnostic accuracy of bone scintigraphy, in patients with cancer as well as in evaluation of benign bone disease. It provides precise localization and characterization of tracer-avid foci, shortens the diagnostic workup, and decreases patient anxiety. Through both the SPECT and the CT components, SPECT/CT has an incremental value in characterizing benign bone lesions, specifically in the appendicular skeleton, as illustrated by present case series.

  6. Pathways of extrapelvic spread of pelvic disease: imaging findings.

    PubMed

    Tan, Cher Heng; Vikram, Raghunandan; Boonsirikamchai, Piyaporn; Faria, Silvana C; Charnsangavej, Chusilp; Bhosale, Priya R

    2011-01-01

    The complex extraperitoneal anatomy of the pelvis includes various outlets for the transit of organs and neurovascular structures to the rest of the body. These outlets include the greater sciatic foramen, lesser sciatic foramen, inguinal canal, femoral triangle, obturator canal, anal and genitourinary hiatuses of the pelvic floor, prevesical space, and iliopsoas compartment. All of these structures serve as conduits for the dissemination of malignant and benign inflammatory diseases from the pelvic cavity and into the soft-tissue structures of the abdominal wall, buttocks, and upper thigh. Knowledge of the pelvic anatomy is crucial to understand these patterns of disease spread. Cross-sectional imaging provides important anatomic information and depicts the extent of disease and its involvement of surrounding extrapelvic structures, information that is important for planning surgery and radiation therapy. RSNA, 2011

  7. CT Findings of Risk Factors for Persistent Type II Endoleak from Inferior Mesenteric Artery to Determine Indicators of Preoperative IMA Embolization.

    PubMed

    Fukuda, Tetsuya; Matsuda, Hitoshi; Sanda, Yoshihiro; Morita, Yoshiaki; Minatoya, Kenji; Kobayashi, Junjiro; Naito, Hiroaki

    2014-01-01

    To identify the computed tomography (CT) findings of persistent type II endoleak from the inferior mesenteric artery (IMA) which indicate the need for preoperative IMA embolization. Included were 120 patients (96 males, 49-93 years old, mean: 77.7) who underwent endovascular aortic aneurysm repair (EVAR) between June 2007 and October 2010. The relationship between persistent type II endoleak and CT findings of IMA orifice was examined. CT showed no type II endoleak from IMA in 106 patients (89%; Group N), and transient type II endoleak from IMA in 10 patients (8.3%; Group T). CT showed persistent type II endoleak from IMA in 4 patients (3.3%; Group P) and three of them underwent reintervention. Univariate Cox-Mantel test analysis indicated that stenosis (p = 0.0003) and thrombus (p = 0.043) in IMA orifice were significant factors for persistent type II endoleak. The ratios of patients with proximal IMA more than 2.5 mm diameter in Groups N, Y, and P were 26/106 (24%), 5/10 (50%) and 4/4 (100%), respectively. Indicators for embolization of IMA prior to EVAR for the prevention of type II endoleak appear to be: (1) more than 2.5 mm in diameter and (2) no stenosis due to calcification or mural thrombus i