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Sample records for multidetector computed tomographic

  1. Multidetector Computed Tomographic Angiography (MDCTA) for Penetrating Neck Injuries.

    PubMed

    Pasley, Jason; Berg, Regan J; Inaba, Kenji

    2012-07-01

    Evaluation of patients after penetrating neck injury has evolved over time. Previously, location of injury and symptoms were used to determine management. The contemporary management of penetrating neck injuries relies on physical examination. Patients with hard signs of vascular or aerodigestive tract injury require immediate operation, regardless of location of injury. Those with no signs can be observed. For the remainder with soft signs, multidetector computed tomographic angiography (MDCTA) is a highly sensitive and specific screening modality for evaluating the vasculature and aerodigestive structures in the neck. Utilizing MDCTA, the patient can be safely directed towards operative intervention, observation, or further investigation.

  2. Multidetector Computed Tomographic Angiography (MDCTA) for Penetrating Neck Injuries

    PubMed Central

    Pasley, Jason; Berg, Regan J.; Inaba, Kenji

    2012-01-01

    Evaluation of patients after penetrating neck injury has evolved over time. Previously, location of injury and symptoms were used to determine management. The contemporary management of penetrating neck injuries relies on physical examination. Patients with hard signs of vascular or aerodigestive tract injury require immediate operation, regardless of location of injury. Those with no signs can be observed. For the remainder with soft signs, multidetector computed tomographic angiography (MDCTA) is a highly sensitive and specific screening modality for evaluating the vasculature and aerodigestive structures in the neck. Utilizing MDCTA, the patient can be safely directed towards operative intervention, observation, or further investigation. PMID:23908840

  3. 64-MULTIDETECTOR COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF THE CANINE CORONARY ARTERIES

    PubMed Central

    Drees, Randi; Frydrychowicz, Alex; Reeder, Scott B.; Pinkerton, Marie E.; Johnson, Rebecca

    2012-01-01

    Canine coronary artery angiography (CTA) was performed in four anesthetized healthy dogs using 64-multi-detector computed tomography. Esmolol, a β-1 adrenergic receptor antagonist, and sodium nitroprusside, an arteriolar and venous dilator, were administered to enhance visualization of the coronary arteries by reducing heart rate and creating vasodilation. The left main coronary artery with its three main branches and the right coronary artery were visualized and subdivided in 13 segments for evaluation. Optimal reconstruction interval, expressed as percentage of the R-to-R interval, was determined at 5% in 2.9%, 35% in 1%, 75% in 21.2%, 85% in 43.3%, and 95% in 31.7% of the segments. Overall image quality was good in 41.3% of the segments and excellent in 14.4%. There was blur in 98.1%, motion in 17.3%, and stair step in 6.7% of the evaluated segments, but these artifacts did not interfere with anatomic depiction of the arteries. Cross-sectional anatomy of the coronary arteries as evaluated from the coronary CTA agreed well with gross anatomic evaluation and published information. The use of esmolol did not lead to the target heart rate of 60–65 beats/min. Nitroprusside had no significant effect on visualized length or diameter of the coronary artery branches. Coronary CTA is useful for the anatomic depiction of coronary artery branches in the dog. PMID:21521398

  4. Multidetector computed tomographic pulmonary angiography in patients with a high clinical probability of pulmonary embolism.

    PubMed

    Moores, L; Kline, J; Portillo, A K; Resano, S; Vicente, A; Arrieta, P; Corres, J; Tapson, V; Yusen, R D; Jiménez, D

    2016-01-01

    ESSENTIALS: When high probability of pulmonary embolism (PE), sensitivity of computed tomography (CT) is unclear. We investigated the sensitivity of multidetector CT among 134 patients with a high probability of PE. A normal CT alone may not safely exclude PE in patients with a high clinical pretest probability. In patients with no clear alternative diagnosis after CTPA, further testing should be strongly considered. Whether patients with a negative multidetector computed tomographic pulmonary angiography (CTPA) result and a high clinical pretest probability of pulmonary embolism (PE) should be further investigated is controversial. This was a prospective investigation of the sensitivity of multidetector CTPA among patients with a priori clinical assessment of a high probability of PE according to the Wells criteria. Among patients with a negative CTPA result, the diagnosis of PE required at least one of the following conditions: ventilation/perfusion lung scan showing a high probability of PE in a patient with no history of PE, abnormal findings on venous ultrasonography in a patient without previous deep vein thrombosis at that site, or the occurrence of venous thromboembolism (VTE) in a 3-month follow-up period after anticoagulation was withheld because of a negative multidetector CTPA result. We identified 498 patients with a priori clinical assessment of a high probability of PE and a completed CTPA study. CTPA excluded PE in 134 patients; in these patients, the pooled incidence of VTE was 5.2% (seven of 134 patients; 95% confidence interval [CI] 1.5-9.0). Five patients had VTEs that were confirmed by an additional imaging test despite a negative CTPA result (five of 48 patients; 10.4%; 95% CI 1.8-19.1), and two patients had objectively confirmed VTEs that occurred during clinical follow-up of at least 3 months (two of 86 patients; 2.3%; 95% CI 0-5.5). None of the patients had a fatal PE during follow-up. A normal multidetector CTPA result alone may not safely

  5. Stature estimation from skull measurements using multidetector computed tomographic images: A Japanese forensic sample.

    PubMed

    Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Yajima, Daisuke; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Yamaguchi, Rutsuko; Hashimoto, Mari; Hoshioka, Yumi; Iwase, Hirotaro

    2016-01-01

    The aim of this study was to assess the correlation between stature and cranial measurements in a contemporary Japanese population, using three-dimensional (3D) computed tomographic (CT) images. A total of 228 cadavers (123 males, 105 females) underwent postmortem CT scanning and subsequent forensic autopsy between May 2011 and April 2015. Five cranial measurements were taken from 3D CT reconstructed images that extracted only cranial data. The correlations between stature and each of the cranial measurements were assessed with Pearson product-moment correlation coefficients. Simple and multiple regression analyses showed significant correlations between stature and cranial measurements. In conclusion, cranial measurements obtained from 3D CT images may be useful for forensic estimation of the stature of Japanese individuals, particularly in cases where better predictors, such as long bones, are not available. Copyright © 2015. Published by Elsevier Ireland Ltd.

  6. Isolation of the left subclavian artery-origin from the left pulmonary artery by way of ductus arteriosus: multidetector row computed tomographic angiographic imaging.

    PubMed

    Jesudian, Vimala; Ravikumar, Radhakrishnan; Kumar, R Suresh

    2009-05-01

    Right aortic arch with isolation of the left subclavian artery is a rare anomaly. It has been reported to occur with conotruncal anomalies and may be associated with 22q11 deletion. Multidetector-row computed tomographic angiogram images of a 15-year-old African boy with Tetralogy of Fallot who had right aortic arch and isolated left subclavian artery arising from the left pulmonary artery by way of ductus arteriosus are presented.

  7. Prediction of Small Bowel Obstruction Caused by Bezoars Using Risk Factor Categories on Multidetector Computed Tomographic Findings

    PubMed Central

    Kuang, Lian-qin; Cheng, Cheng

    2016-01-01

    Objectives. The aim of this study was to detect factors associated with small bowel obstruction (SBO) caused by bezoars on multidetector computed tomographic findings. Methods. We retrospectively reviewed 61 patients who had bezoars in the small bowels on MDCT. The patients were divided into SBO patients group and non-SBO patients group. The mean values of the diameter, volume, and CT attenuation as well as location and characteristics of the bezoars were compared between the two groups. Multivariate analysis was performed to determine factors associated with SBO. Results. There were 32 patients (52.5%) in the SBO group and 29 patients (47.5%) in the non-SBO group. The bezoars in the SBO group had greater values of each mean diameter and mean volume than those in the non-SBO group (3.2 ± 0.5 cm versus 1.6 ± 0.7 cm, P < 0.0001, 14.9 ± 6.4 cm3 versus 2.5 ± 2.7 cm3, P < 0.0001, resp.) and had a lower CT attenuation than the non-SBO group (55.5 ± 23.4 versus 173.0 ± 68.0, P < 0.0001). The SBO group had higher prevalence of phytobezoar appearance (75.0% versus 10.3%, P < 0.0001). Major diameters of bezoar and phytobezoar were significant independent risk factors associated with SBO (odds ratio = 36.09, 8.26, resp., and P = 0.0004, 0.044, resp.). Conclusions. Major diameter of bezoar or phytobezoar is a potential risk factor associated with SBO. PMID:27403434

  8. Comparison of three-dimensional volume-targeted thin-slab FIESTA magnetic resonance angiography and 64-multidetector computed tomographic angiography for the identification of proximal coronary stenosis.

    PubMed

    Cheng, Liuquan; Ma, Lin; Schoenhagen, Paul; Ye, Huiyi; Lou, Xin; Gao, Yuangui; Zhao, Xihai; Wang, Xinjiang; Dong, Wei

    2013-09-10

    Based on recent clinical data, an imaging strategy of identifying proximal coronary disease allows further management decisions in patients with stable angina pectoris. We aimed to compare diagnostic accuracy of non-contrast fast steady-state (FIESTA) magnetic resonance angiography (MRA) with 64-multidetector computed tomographic angiography (CTA), using conventional coronary angiography (CA) as the reference standard. Thirty patients with suspected coronary artery disease consented to participate in an institutional review board-approved protocol. Coronary MRA was performed at 1.5 T using a respiratory navigator and electrocardiogram-gated three-dimensional FIESTA pulse sequence. CTA images were acquired using a 64-multidetector computed tomographic scanner, using beta blockade to reduce the heart rate to less than 70 bpm. Coronary luminal stenosis >50% was identified. Plaques were classified as non-calcified, mixed, or calcified on CTA, and as high-, intermediate-, or low-signal on FIESTA MRA. Compared to CA, the sensitivity, specificity, and overall accuracy for detection of >50% proximal coronary stenoses were 83.0%, 86.9%, and 86.1% for MRA and 85.1%, 87.2%, and 86.8% for CTA, respectively. For the 24 calcified stenoses, MRA corrected 16 segments that overestimated on CTA and MRA had an accuracy of 75% in evaluating calcified plaques. High-resolution three-dimensional FIESTA MRA and CTA have a similar accuracy in detecting proximal coronary stenosis. The clinical impact of identification of proximal disease in patients with stable CAD needs to be examined in future studies. Copyright © 2012. Published by Elsevier Ireland Ltd.

  9. Multidetector computed tomography for acute pulmonary embolism.

    PubMed

    Stein, Paul D; Fowler, Sarah E; Goodman, Lawrence R; Gottschalk, Alexander; Hales, Charles A; Hull, Russell D; Leeper, Kenneth V; Popovich, John; Quinn, Deborah A; Sos, Thomas A; Sostman, H Dirk; Tapson, Victor F; Wakefield, Thomas W; Weg, John G; Woodard, Pamela K

    2006-06-01

    The accuracy of multidetector computed tomographic angiography (CTA) for the diagnosis of acute pulmonary embolism has not been determined conclusively. The Prospective Investigation of Pulmonary Embolism Diagnosis II trial was a prospective, multicenter investigation of the accuracy of multidetector CTA alone and combined with venous-phase imaging (CTA-CTV) for the diagnosis of acute pulmonary embolism. We used a composite reference test to confirm or rule out the diagnosis of pulmonary embolism. Among 824 patients with a reference diagnosis and a completed CT study, CTA was inconclusive in 51 because of poor image quality. Excluding such inconclusive studies, the sensitivity of CTA was 83 percent and the specificity was 96 percent. Positive predictive values were 96 percent with a concordantly high or low probability on clinical assessment, 92 percent with an intermediate probability on clinical assessment, and nondiagnostic if clinical probability was discordant. CTA-CTV was inconclusive in 87 of 824 patients because the image quality of either CTA or CTV was poor. The sensitivity of CTA-CTV for pulmonary embolism was 90 percent, and specificity was 95 percent. CTA-CTV was also nondiagnostic with a discordant clinical probability. In patients with suspected pulmonary embolism, multidetector CTA-CTV has a higher diagnostic sensitivity than does CTA alone, with similar specificity. The predictive value of either CTA or CTA-CTV is high with a concordant clinical assessment, but additional testing is necessary when the clinical probability is inconsistent with the imaging results. Copyright 2006 Massachusetts Medical Society.

  10. Multidetector computed tomographic study of amulets, jewelry, and other foreign objects in royal Egyptian mummies dated from the 18th to 20th dynasties.

    PubMed

    Saleem, Sahar N; Hawass, Zahi

    2014-01-01

    The objective of this study was to study the role of multidetector computed tomography (MDCT) in the analysis of foreign objects found within or on the royal Egyptian mummies. We studied MDCT images of 15 royal Egyptian mummies (1493-1156 BC) for the presence of foreign objects. We studied each found object for its location, morphology, dimensions, and density in correlation with the archeologic literature. We detected 14 objects in 6 mummies: a heart amulet, 3 Eye of Horus, 4 Sons of Horus, a crowned-Osiris amulet, 2 bracelets, 2 sets of beads/stones, and an arrowhead that may be linked to injury. The MDCT images suggested the material of the objects to be metal (n = 6), semiprecious stone (n = 1), quartzlike (faience) (n = 2), and fired clay (n = 5). Placement of an amulet within the heart supports our knowledge that its funeral purpose was meant for the purpose of protection. Multidetector computed tomography offers a detailed noninvasive analysis of objects on/in mummies and differentiates funerary objects from those that may be related to cause of death.

  11. Bony landmarks on computed tomographic localizer radiographs to prescribe a reduced scan range in patients undergoing multidetector computed tomography for suspected urolithiasis.

    PubMed

    Corwin, Michael T; Bekele, Wosen; Lamba, Ramit

    2014-01-01

    The objective of this study was to determine bony landmarks that can be used on computed tomographic (CT) localizer radiographs to prescribe a reduced scan range for noncontrast CT (NCCT) for suspected urolithiasis. This retrospective review comprised 243 patients who underwent NCCT for suspected urolithiasis. Scout line mode was used to correlate axial images with the z-axis location on CT localizer radiographs. The most inferior vertebral body end plate (superior or inferior) that was above the superiormost aspect of the highest kidney was recorded. The superior or inferior border of the pubic symphysis was determined to be below the inferiormost aspect of the bladder. The CT studies were then viewed to identify any findings that would be missed above or below the defined bony landmarks. Using the top or bottom of T10 included both kidneys in their entirety in 243 (100%) of 243 cases. Using the top or bottom of T11 included both kidneys in 241 (99%) of the 243 and 189 (78%) of the 243 cases, respectively. Using the top or bottom of the pubic symphysis included the entire bladder in 158 (65%) of the 243 and 243 (100%) of the 243 cases, respectively. The mean reduction in scan length was 5.17 cm (11.3%) above the bottom of T10 and 2.89 cm (6.3%) below the pubic symphysis, for a total reduction of 8.06 cm (17.7%). Reducing the scan length is an effective technique to reduce radiation dose in patients undergoing NCCT for suspected urolithiasis. The bottom of T10 and the bottom of the pubic symphysis should be used as landmarks on the CT localizer radiograph.

  12. Differences in episode-based care costs for multidetector computed tomographic coronary angiography versus myocardial perfusion imaging for the diagnosis of coronary artery disease.

    PubMed

    Min, James K; Robinson, Matthew; Shaw, Leslee J; Lin, Fay; Legorreta, Antonio P; Gilmore, Amanda

    2008-01-01

    Multidetector computed tomography (MDCT) is a novel method for diagnosis and prognosis of coronary artery disease (CAD). The opportunity costs that favour MDCT over other CAD diagnostic methods is currently unknown. This study used an episodes of care cost model based on epidemiologic and economic data evaluating individuals without known CAD undergoing MDCT or myocardial perfusion scintigraphy (MPS). It was a multicenter retrospective database review of medical and pharmacy-related claims linked by episodes of care from 2002 to 2005. CAD-related episodes of care costs were examined 1-year downstream for patients after initial MDCT that were matched to patients who underwent MPS. After adjustment for patient factors, 1-year total CAD-related episodes of care costs for MDCT were 16.4% lower than MPS, by an average of $682 (95% confidence interval $14, $1,350) per patient. While costs per CAD-related episode were similar between MDCT and MPS groups ($4,284 vs. $4,277, p=0.08). Patients without known CAD who undergo MDCT as an initial diagnostic test, compared to MPS, incurred fewer CAD-related episodes of care and lower overall CAD-related costs.

  13. Relationship between routine multi-detector cardiac computed tomographic angiography prior to reoperative cardiac surgery, length of stay, and hospital charges.

    PubMed

    Goldstein, Matthew A; Roy, Sion K; Hebsur, Shinivas; Maluenda, Gabriel; Weissman, Gaby; Weigold, Guy; Landsman, Marc J; Hill, Peter C; Pita, Francisco; Corso, Paul J; Boyce, Steven W; Pichard, Augusto D; Waksman, Ron; Taylor, Allen J

    2013-03-01

    While multi-detector cardiac computed tomography angiography (MDCCTA) prior to reoperative cardiac surgery (RCS) has been associated with improved clinical outcomes, its impact on hospital charges and length of stay remains unclear. We studied 364 patients undergoing RCS at Washington Hospital Center between 2004 and 2008, including 137 clinically referred for MDCCTA. Baseline demographics, procedural data, and perioperative outcomes were recorded at the time of the procedure. The primary clinical endpoint was the composite of perioperative death, myocardial infarction (MI), stroke, and hemorrhage-related reoperation. Secondary clinical endpoints included surgical procedural variables and the perioperative volume of bleeding and transfusion. Length of stay was determined using the hospital's electronic medical record. Cost data were extracted from the hospital's billing summary. Analysis was performed on individual categories of care, as well as on total hospital charges. Data were compared between subjects with and without MDCCTA, after adjustment for the Society of Thoracic Surgeons score. Baseline characteristics were similar between the two groups. MDCCTA was associated with shorter procedural times, shorter intensive care unit stays, fewer blood transfusions, and less frequent perioperative MI. There was additionally a trend towards a lower incidence of the primary endpoint (17.5 vs. 24.2 %, p = 0.13) primarily due to a lower incidence of perioperative MI (0 vs. 5.7 %, p = 0.002). MDCCTA was also associated with lower median recovery room [$1,325 (1,250-3,302) vs. $3,217 (1,325-5,353) p < 0.001] and nursing charges [$6,335 (3,623-10,478) vs. $6,916 (3,915-14,499) p = 0.03], although operating room charges were higher [$24,100 (22,300-29,700) vs. $23,500 (19,900-27,700) p < 0.05]. Median total charges [$127,000 (95,000-188,000) vs. $123,000 (86,800-226,000) p = 0.77] and length of stay [9 days (6-19) vs. 11 days (7-19), p = 0.21] were similar. Means analysis

  14. Computed tomographic versus catheterization angiography in tetralogy of Fallot.

    PubMed

    Garg, Naveen; Walia, Rohit; Neyaz, Zafar; Kumar, Sunil

    2015-02-01

    To compare multidetector computed tomographic angiography with the gold standard cardiac catheterization and angiography in tetralogy of Fallot. In 40 consecutive patients over 5 years of age with tetralogy of Fallot, multidetector computed tomographic angiography and catheterization angiography studies were compared for intracardiac anatomy, pulmonary anatomy and indices, coronaries and collaterals. Safety parameters, relative advantages and limitations were also analyzed. All catheterization studies required hospitalization whereas all tomographic studies were performed as outpatient procedures. The need for sedation and amount of contrast used were significantly greater in catheterization than in tomographic studies. Complications noted during catheterization were access site complications in 4 patients, cyanotic spells in 2, transient complete heart block requiring temporary pacing in 2, and air embolism in one. No complication was observed during tomographic studies. All tomographic studies were adequate, but 2 catheterization studies were inadequate. Ventricular septal defects, aortic override, level of right ventricular outflow tract obstruction, and pulmonary artery anatomy were equally assessed by both imaging modalities. However, tomographic studies missed additional small muscular ventricular septal defects. There was a linear correlation between tomographic and catheterization studies for pulmonary annulus size, artery sizes, Z-score, and Nakata index. There was complete concordance with respect to side of aortic arch and detection of collaterals. Coronary anatomy was better delineated in tomographic studies. For preoperative evaluation of tetralogy of Fallot patients, multidetector computed tomographic angiography can be used as a reliable noninvasive alternative to cardiac catheterization angiography. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. MULTIDETECTOR COMPUTED TOMOGRAPHIC AND LOW-FIELD MAGNETIC RESONANCE IMAGING ANATOMY OF THE QUADRIGEMINAL CISTERN AND CHARACTERIZATION OF SUPRACOLLICULAR FLUID ACCUMULATIONS IN DOGS.

    PubMed

    Bertolini, G; Ricciardi, M; Caldin, M

    2016-05-01

    Focal fluid accumulations in the supracollicular region are commonly termed quadrigeminal cysts and may be either subclinical or associated with neurologic deficits in dogs. Little published information is available on normal imaging anatomy and anatomic relationships for the canine quadrigeminal cistern. Objectives of this observational, cross-sectional study were to describe normal quadrigeminal cistern anatomy and determine the prevalence and characteristics of supracollicular fluid accumulations in dogs. Normal descriptions were accomplished using computed tomographic (CT) cisternography in one canine cadaver, and CT and magnetic resonance imaging (MRI) studies of the brain in four prospectively recruited dogs with no evidence of intracranial disease. Prevalence and characteristics descriptions were accomplished using a retrospective review of brain CT or MRI studies performed during the period of 2005-2015. The normal quadrigeminal cistern consistently exhibited a complex H shape and was separated from the third ventricle by a thin membrane. Prevalence of supracollicular fluid accumulations (SFAs) was 2.19% among CT studies (n = 4427) and 2.2% among MRI studies (n = 626). Dogs with SFA were significantly younger than control dogs (P < 0.0001). Shih-tzu (OR = 111.6), Chihuahua (OR = 81.1), and Maltese (OR = 27.6) breed dogs were predisposed (P < 0.0001). Among dogs with SFAs, the following three patterns were defined: (1) third ventricle (49.54%), (2) quadrigeminal cistern (13.51%), and (3) both third ventricle and quadrigeminal cistern (36.93%). Authors recommend that the term supracollicular fluid accumulation (SFA) should be used rather than the term quadrigeminal cyst to describe these focal fluid accumulations in dogs.

  16. Leiomyosarcoma: computed tomographic findings

    SciTech Connect

    McLeod, A.J.; Zornoza, J.; Shirkhoda, A.

    1984-07-01

    The computed tomographic (CT) findings in 118 patients with the diagnosis of leiomyosarcoma were reviewed. The tumor masses visualized in these patients were often quite large; extensive necrotic or cystic change was a frequent finding. Calcification was not observed in these tumors. The liver was the most common site of metastasis in these patients, with marked necrosis of the liver lesions a common finding. Other manifestations of tumor spread included pulmonary metastases, mesenteric or omental metastases, retroperitoneal lymphadenopathy, soft-tissue metastases, bone metastases, splenic metastases, and ascites. Although the CT appearance of leiomyosarcoma is not specific, these findings, when present, suggest consideration of this diagnosis.

  17. Bladder trauma: multidetector computed tomography cystography.

    PubMed

    Ishak, Charbel; Kanth, Nalini

    2011-08-01

    Multidetector computed tomography (MDCT) cystography is rapidly becoming the most recommended study for evaluation of the bladder for suspected trauma. This article reviews the bladder trauma with emphasis on the application of MDCT cystography to traumatic bladder injuries using a pictorial essay based on images collected in our level I trauma center.

  18. Automatic liver segmentation method featuring a novel filter for multiphase multidetector-row helical computed tomography.

    PubMed

    Hirose, Tomohiro; Nitta, Norihisa; Tsudagawa, Masaru; Takahashi, Masashi; Murata, Kiyoshi

    2011-01-01

    To introduce an automatic liver segmentation method that includes a novel filter for multiphase multidetector-row helical computed tomography. We acquired 3-phase multidetector-row computed tomographic scans that included unenhanced, arterial, and portal phases. The liver was segmented using our novel adaptive linear prediction filter designed to reduce the difference between filter input and output values in the liver region and to increase these values outside the liver region. The segmentation algorithm produced a mean dice similarity coefficient (DSC) value of 91.4%. The application of our adaptive linear prediction filter was effective in automatically extracting liver regions.

  19. Coronary artery imaging with multidetector computed tomography: a call for an evidence-based, multidisciplinary approach.

    PubMed

    Schoenhagen, Paul; Stillman, Arthur E; Garcia, Mario J; Halliburton, Sandra S; Tuzcu, E Murat; Nissen, Steven E; Modic, Michael T; Lytle, Bruce W; Topol, Eric J; White, Richard D

    2006-05-01

    Modern multidetector computed tomography systems are capable of a comprehensive assessment of the cardiovascular system, including noninvasive assessment of coronary anatomy. Multidetector computed tomography is expected to advance the role of noninvasive imaging for coronary artery disease, but clinical experience is still limited. Clinical guidelines are necessary to standardize scanner technology and appropriate clinical applications for coronary computed tomographic angiography. Further evaluation of this evolving technology will benefit from cooperation between different medical specialties, imaging scientists, and manufacturers of multidetector computed tomography systems, supporting multidisciplinary teams focused on the diagnosis and treatment of early and advanced stages of coronary artery disease. This cooperation will provide the necessary education, training, and guidelines for physicians and technologists assuring standard of care for their patients.

  20. Multidetector computed tomography angiography of the abdomen.

    PubMed

    Güven, Koray; Acunaş, Bülent

    2004-10-01

    Multidetector computed tomography (MDCT) angiography has provided excellent opportunities for advancement of computed tomography (CT) technology and clinical applications. It has a wide range of applications in the abdomen including vascular pathologies either occlusive or aneurysmal; enables the radiologist to produce vascular mapping that clearly show tumor invasion of vasculature and the relationship of vessels to mass lesions. MDCTA can be used in preoperative planning for hepatic resection, preoperative evaluation and planning for liver transplantation. MDCTA can also provide extremely valuable information in the evaluation of ischemic bowel disease, active Crohn disease, the extent and location of collateral vessels in cirrhosis.

  1. Ovarian metastases: Computed tomographic appearances

    SciTech Connect

    Megibow, A.J.; Hulnick, D.H.; Bosniak, M.A.; Balthazar, E.J.

    1985-07-01

    Computed tomographic scans of 34 patients with ovarian metastases were reviewed to assess the radiographic appearances and to correlate these with the primary neoplasms. Primary neoplasms were located in the colon (20 patients), breast (six), stomach (five), small bowel (one), bladder (one), and Wilms tumor of the kidney (one). The radiographic appearance of the metastatic lesions could be described as predominantly cystic (14 lesions), mixed (12 lesions), or solid (seven lesions). The cystic and mixed lesions tended to be larger in overall diameter than the solid. The metastases from gastric carcinoma appeared solid in four of five cases. The metastases from the other neoplasms had variable appearances simulating primary ovarian carcinoma.

  2. [Valvular heart disease: multidetector computed tomography evaluation].

    PubMed

    Franco, A; Fernández-Pérez, G C; Tomás-Mallebrera, M; Badillo-Portugal, S; Orejas, M

    2014-01-01

    Heart valve disease is a clinical problem that has been studied with classical imaging techniques like echocardiography and MRI. Technological advances in CT make it possible to obtain static and dynamic images that enable not only a morphological but also a functional analysis in many cases. Although it is currently indicated only in patients with inconclusive findings at echocardiography and MRI or those in whom these techniques are contraindicated, multidetector CT makes it possible to diagnose stenosis or regurgitation through planimetry, to evaluate and quantify valvular calcium, and to show the functional repercussions of these phenomena on the rest of the structures of the heart. Given that multidetector CT is being increasingly used in the diagnosis of ischemic heart disease, we think it is interesting for radiologists to know its potential for the study of valvular disease. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  3. High Energy Computed Tomographic Inspection of Munitions

    DTIC Science & Technology

    2016-11-01

    UNCLASSIFIED UNCLASSIFIED AD-E403 815 Technical Report AREIS-TR-16006 HIGH ENERGY COMPUTED TOMOGRAPHIC INSPECTION OF MUNITIONS...REPORT DATE (DD-MM-YYYY) November 2016 2. REPORT TYPE Final 3. DATES COVERED (From – To) 4. TITLE AND SUBTITLE HIGH ENERGY COMPUTED...otherwise be accomplished by other nondestructive testing methods. 15. SUBJECT TERMS Radiography High energy Computed tomography (CT

  4. [Evaluation of left ventricular function with a 16-slice multidetector tomograph (MDCT-16): correlation with cardiovascular magnetic resonance imaging].

    PubMed

    de la Peña-Almaguer, Erasmo; Azpiri López, José Ramón; González-Camid, Felipe de Jesús; Ponce de León, Enrique; Flores-Ramírez, Ramiro; Zamarripa, Rafael; Loera, Javier; Rodríguez, Daniel; González Quijano, Rafael; Azpiri-Magallanes, Marcela; Jaramillo Estrada, Samuel; Assad Morell, José Luis

    2005-01-01

    The evaluation of Left ventricular function has both prognostic as well as therapeutic implications in patients with heart disease. Non-invasive coronary angiography with computed tomography using 16 slices (MDCT-16) allows to obtain images of the coronary anatomy due to its high spatial and temporal resolution, and also, to obtain data regarding Left ventricular function. The objective of this study was to correlate the use of MDCT-16 for the evaluation of the Left ventricular parameters using MRI as the Standard of reference. MRI: Se A 1.5 Tesla GE CvI Scanner optimized for cardiovascular applications was used. Using an ECG gated steady state fast precession sequence (SSFP, Thickness 10 mm, Flip Angle 45, FOV 36 cm. NEX 1, Frequency 256, Phase 128, Partial FOV 0.75, 16VPS), 6 to 8 short axis images of from base to apex of the left ventricle were obtained. Tomography: Using a 16 slice Multidetector tomograph (GE Lightspeed) and using ECG synchronization, images of the heart were obtained after the administration of 80 mls. of no-ionic contrast. The images were reconstructed off-line to obtain from 6 to 8 slices in a similar fashion to that of MR. Both studies were independently analyzed by 2 operators who obtained the ventricular function data. Linear correlation and a Paired T Student test was used to analyze the data and was considered significant when p < 0.05. 20 consecutive patients were evaluated with MDCT-16 and MRI, 18 males, mean age 52 +/- 15 years. There was no significant difference among the measurements for cardiac CT and MRI of the end-diastolic volume (EDV) and end-sistolic volume (ESV), stroke volume (SV), LV Mass or LV ejection fraction (LVEF). This results show a high correlation among the clinically relevant ventricular function parameters evaluated by cardiovascular CT and MRI. This findings suggest that ventricular function can be successfully evaluated along with the coronary anatomy using MDCT-16.

  5. Congenital abnormalities of the ribs: evaluation with multidetector computed tomography.

    PubMed

    Davran, Ramazan; Bayarogullari, Hanifi; Atci, Nesrin; Kayali, Alperen; Ozturk, Fatma; Burakgazi, Gulen

    2017-02-01

    To evaluate congenital abnormalities of ribs using multidetector computed tomography. The retrospective study was conducted at Mustafa Kemal University Research Hospital, Hatay, Turkey and comprised data of patients aged 1-45 years who attended the Radiology Department for computed tomography of the thorax between January 2010 and July 2013. Multiplanar reconstructions, maximum intensity projections, and 3-dimensional images were acquired to investigate numerical and structural abnormalities of the ribs of the patients who underwent multidetector computed tomography for a variety of indications. The study comprised 650 patients. Of them, 231(35.5%) were female and 419(64.5%) male. The overall mean age was 20.9± 5.1years. However, data of 90(13.8%) patients was excluded from cervical rib evaluation and of 120(18.5%) from lumbar rib evaluation as these regions were out of the section because of the positioning. Finally, 560(86.5%) patients were included in the cervical rib evaluations, and 530(81.5%) in the lumbar rib evaluations. All the 650(100%) patients were included in the thoracic rib evaluations. Numerical abnormalities were observed in cervical ribs in 19(3.6%), in thoracic ribs in 1(0.15%) and in lumbar ribs in 7(1.3%) cases. The structural abnormalities were bifid rib in 44(6.7%) and fused type in 17(2.6%) cases. Multidetector computed tomography enabled evaluation of the thoracic cage as a whole.

  6. Computed tomographic findings in bilateral adrenal tuberculosis

    SciTech Connect

    Wilms, G.E.; Baert, A.L.; Kint, E.J.; Pringot, J.H.; Goddeeris, P.G.

    1983-03-01

    The computed tomographic (CT) features of bilateral adrenal tuberculosis are reported in two cases that demonstrate two typical different clinical and morphological manifestations of the disease. The incidence and CT appearance of adrenal tuberculosis are discussed, with emphasis on differential diagnosis.

  7. Usefulness of multidetector spiral computed tomography according to age and gender for diagnosis of acute pulmonary embolism.

    PubMed

    Stein, Paul D; Beemath, Afzal; Quinn, Deborah A; Olson, Ronald E; Goodman, Lawrence R; Gottschalk, Alexander; Hales, Charles A; Hull, Russell D; Leeper, Kenneth V; Sostman, H Dirk; Weg, John G; Woodard, Pamela K

    2007-05-01

    Data from the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) were evaluated to test the hypothesis that the performance of multidetector computed tomographic (CT) pulmonary angiography and CT venography is independent of a patient's age and gender. In 773 patients with adequate CT pulmonary angiography and 737 patients with adequate CT pulmonary angiography and CT venography, the sensitivity and specificity for pulmonary embolism for groups of patients aged 18 to 59, 60 to 79, and 80 to 99 years did not differ to a statistically significant extent, nor were there significant differences according to gender. Overall, however, the specificity of CT pulmonary angiography was somewhat greater in women, but in men and women, it was > or =93%. In conclusion, the results indicate that multidetector CT pulmonary angiography and CT pulmonary angiography and CT venography may be used with various diagnostic strategies in adults of all ages and both genders.

  8. Multidetector computer tomography: evaluation of blunt chest trauma in adults.

    PubMed

    Palas, João; Matos, António P; Mascarenhas, Vasco; Herédia, Vasco; Ramalho, Miguel

    2014-01-01

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  9. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    PubMed Central

    Matos, António P.; Mascarenhas, Vasco; Herédia, Vasco

    2014-01-01

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall. PMID:25295188

  10. Computed tomographic evaluation of laryngoceles

    SciTech Connect

    Silverman, P.M.; Korobkin, M.

    1982-10-01

    Computed tomography (CT) of the larynx was used in three patients with laryngoceles. One of the cases is described. CT was able to define the extent of the laryngocele more precisely than either clinical examination or conventional radiographic techniques.

  11. Pediatric computed tomographic angiography: imaging the cardiovascular system gently.

    PubMed

    Hellinger, Jeffrey C; Pena, Andres; Poon, Michael; Chan, Frandics P; Epelman, Monica

    2010-03-01

    Whether congenital or acquired, timely recognition and management of disease is imperative, as hemodynamic alterations in blood flow, tissue perfusion, and cellular oxygenation can have profound effects on organ function, growth and development, and quality of life for the pediatric patient. Ensuring safe computed tomographic angiography (CTA) practice and "gentle" pediatric imaging requires the cardiovascular imager to have sound understanding of CTA advantages, limitations, and appropriate indications as well as strong working knowledge of acquisition principles and image post processing. From this vantage point, CTA can be used as a useful adjunct along with the other modalities. This article presents a summary of dose reduction CTA methodologies along with techniques the authors have employed in clinical practice to achieve low-dose and ultralow-dose exposure in pediatric CTA. CTA technical principles are discussed with an emphasis on the low-dose methodologies and safe contrast medium delivery strategies. Recommended parameters for currently available multidetector-row computed tomography scanners are summarized alongside recommended radiation and contrast medium parameters. In the second part of the article an overview of pediatric CTA clinical applications is presented, illustrating low-dose and ultra-low dose techniques, with an emphasis on the specific protocols. Copyright 2010 Elsevier Inc. All rights reserved.

  12. Fast tomographic reconstruction on multicore computers.

    PubMed

    Agulleiro, J I; Fernandez, J J

    2011-02-15

    Tomo3D implements a multithreaded vectorized approach to tomographic reconstruction that takes full advantage of the computer power in modern multicore computers. Full resolution tomograms are generated at high speed on standard computers with no special system requirements. Tomo3D has the most common reconstruction methods implemented, namely weighted Back-projection (WBP) and simultaneous iterative reconstruction technique (SIRT). It proves to be competitive with current graphic processor unit solutions in terms of processing time, in the order of a few seconds with WBP or minutes with SIRT. The program is compatible with standard packages, which easily allows integration in the electron tomography workflow.

  13. Invited review-Computed tomographic angiography (CTA) of the thoracic cardiovascular system in companion animals.

    PubMed

    Drees, Randi; François, Christopher J; Saunders, Jimmy H

    2014-01-01

    Computed tomographic angiography (CTA) of the thoracic cardiovascular system is offering new diagnostic opportunities in companion animal patients with the increasing availability of multidetector-row computed tomographic (MDCT) units in veterinary facilities. Optimal investigation of the systemic, pulmonary, and coronary circulation provides unique challenges due to the constant movement of the heart, the small size of several of the structures of interest, and the dependence of angiographic quality on various contrast bolus design and patient factors. Technical and practical aspects of thoracic cardiovascular CTA are reviewed in light of the currently available veterinary literature and future opportunities given utilizing MDCT in companion animal patients with suspected thoracic cardiovascular disease. © 2014 American College of Veterinary Radiology.

  14. Cranial computed tomographic abnormalities in leptomeningeal metastasis

    SciTech Connect

    Lee, Y.Y.; Glass, J.P.; Geoffray, A.; Wallace, S.

    1984-11-01

    Sixty-four (57.6%) of 111 cancer patients with cerebrospinal fluid cytology positive for malignant cells had cranial computed tomographic (CT) scans within 2 weeks before or after a lumbar puncture. Twenty-two (34.3%) of the 64 had abnormal CT findings indicative of leptomeningeal metastasis. Thirteen (59.6%) of these 22 patients had associated parenchymal metastases. Recognition of leptomeningeal disease may alter the management of patients with parenchymal metastases. Communicating hydrocephalus in cancer patients should be considered to be related to leptomeningeal metastasis until proven otherwise.

  15. Computed Tomographic Angiography of the Abdominal Aorta.

    PubMed

    Hansen, Neil J

    2016-01-01

    Computed tomographic (CT) angiography (CTA) has become the preferred imaging test of choice for various aortic conditions because of its excellent spatial resolution, rapid image acquisition, and its wide availability. CTA provides a robust tool for planning aortic interventions and diagnosing acute and chronic vascular diseases in the abdomen. CTA is the standard for imaging aneurysms before intervention and evaluating the aorta in the acute setting to assess traumatic injury, dissection, and aneurysm rupture. Knowledge of the imaging features of these disease processes, inflammatory vasculitides, and occlusive atherosclerotic disease is essential for guiding surgical and medical management of patients.

  16. Jugular foramen: anatomic and computed tomographic study

    SciTech Connect

    Daniels, D.L.; Williams, A.L.; Haughton, V.M.

    1984-01-01

    The computed tomographic (CT) appearance of the jugular foramen was examined in detail, and anatomic and CT sections were correlated. The pars nervosa and pars vascularis were identified, and, with intravenous contrast enhancement, a rapid sequence of scans at a gantry angle of +30/sup 0/ to the canthomeatal line demonstrated cranial nerves IX, X, and XI. The osseous margins of the jugular foramen were best shown by CT at planes of sections parallel and positive (0/sup 0/-30/sup 0/) to the canthomeatal line. CT can be used to evaluate osseous anatomy and the jugular foramen with precision sufficient to confidently exclude an intracanalicular mass.

  17. Multidetector Computed Tomography for Congenital Anomalies of the Aortic Arch: Vascular Rings.

    PubMed

    García-Guereta, Luis; García-Cerro, Estefanía; Bret-Zurita, Montserrat

    2016-07-01

    The development of multidetector computed tomography has triggered a revolution in the study of the aorta and other large vessels and has replaced angiography in the diagnosis of congenital anomalies of the aortic arch, particularly vascular rings. The major advantage of multidetector computed tomography is that it permits clear 3-dimensional assessment of not only vascular structures, but also airway and esophageal compression. The current update aims to summarize the embryonic development of the aortic arch and the developmental anomalies leading to vascular ring formation and to discuss the current diagnostic and therapeutic role of multidetector computed tomography in this field.

  18. [The different manifestations of pulmonary aspergillosis: multidetector computed tomography findings].

    PubMed

    Koren Fernández, L; Alonso Charterina, S; Alcalá-Galiano Rubio, A; Sánchez Nistal, M A

    2014-01-01

    Pulmonary aspergillosis is a fungal infection usually caused by inhaling Aspergillus fumigatus spores. However, when we talk about aspergillosis, we normally refer to the spectrum of clinical and radiological findings that depend directly on the patient's immune status, on the prior existence of lung disease, and on the virulence of the infective organism. There are four types of pulmonary aspergillosis (aspergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing pulmonary aspergillosis, and invasive aspergillosis), and each type has its own distinct radiologic findings. We review the signs of pulmonary aspergillosis on multidetector computed tomography and we correlate them with patients' symptoms and immune responses. Likewise, we discuss the differential diagnoses. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

  19. Multidetector computed tomography findings in deaths with severe burns.

    PubMed

    Levy, Angela D; Harcke, Howard T; Getz, John M; Mallak, Craig T

    2009-06-01

    This study compared autopsy with postmortem multidetector computed tomography (MDCT) findings in charred remains. Seventeen consecutive male subjects (mean age, 29.4 years) who perished in a fire-related event resulting in charred remains underwent total body MDCT immediately prior to routine autopsy that included serum carboxyhemoglobin measurement. MDCT showed all thermal tissue changes (skin and subcutaneous fat loss, skeletal muscle retraction, pugilistic attitude, cortical fractures, bone and organ destruction, thermal epidural hematoma, and thermal amputation) and established all fracture patterns that were lethal, but autopsy added the fire as a contributory cause of death when there was carboxyhemoglobin elevation. MDCT had limited value in determination of lethal vascular and visceral injuries. MDCT is an effective complement to autopsy in the setting of charred remains and may serve to augment a limited autopsy. This may be particularly useful in mass casualty scenarios.

  20. Multidetector computed tomography of temporomandibular joint: A road less travelled.

    PubMed

    Pahwa, Shivani; Bhalla, Ashu Seith; Roychaudhary, Ajoy; Bhutia, Ongkila

    2015-05-16

    This article reviews the imaging anatomy of temporomandibular joint (TMJ), describes the technique of multi-detector computed tomography (MDCT) of the TMJ, and describes in detail various osseous pathologic afflictions affecting the joint. Traumatic injuries affecting the mandibular condyle are most common, followed by joint ankylosis as a sequel to arthritis. The congenital anomalies are less frequent, hemifacial microsomia being the most commonly encountered anomaly involving the TMJ. Neoplastic afflictions of TMJ are distinctly uncommon, osteochondroma being one of the most common lesions. MDCT enables comprehensive evaluation of osseous afflictions of TMJ, and is a valuable tool for surgical planning. Sagittal, coronal and 3D reformatted images well depict osseous TMJ lesions, and their relationship to adjacent structures.

  1. [Computer-tomographic cisternography with amipaque].

    PubMed

    Kornienko, V N; Saakian, O A

    1984-01-01

    As compared to ordinary computer tomography, computer-aided tomographic cisternography (CTC) demonstrates better the anatomy of the brain cisterns and at the same time gives an idea of the processes of c.s.f. circulation in dynamic examination. The article discusses the results of examination of 112 patients with various neurosurgical diseases by means of CTC. A detailed classification of the brain cisterns is given. The authors show the advantages of the method in examination of patients with small three-dimentional processes in the chiasma-sellar region, cerebellopontine angle, and posterior cranial fossa, with the syndrome of an "empty" sella turcica, cystic structures, and disorders of c.s.f. circulation.

  2. Petamenophis (Padiamenemipet), an Egyptian Child Mummy Protected for Eternity: Revelation by Multidetector Computed Tomography.

    PubMed

    Martina, Maria Cristina; Cesarani, Federico; Boano, Rosa; Fiore Marochetti, Elisa; Gandini, Giovanni

    2017-08-03

    The objective of our work was to report the most recent findings obtained with multidetector computed tomography of a child mummy from the Roman period (119-123 CE) housed at the Egyptian Museum in Turin, Italy. Multidetector computed tomography and postprocessing were applied to understand the embalming techniques, the nature of a foreign object, and anthropometrical values. The information was compared with that from other mummies that were buried in the same tomb, but today housed in different museums. New information regarding the embalming technique was revealed. Multidetector computed tomography allowed the identification of a knife-like metallic object, probably an amulet for the child's protection in the afterlife. Multidetector computed tomography and image postprocessing confirm their valuable role in noninvasive studies in ancient mummies and provided evidence of a unique cultural practice in the late history of Ancient Egypt such as placing a knife possibly as an amulet.

  3. Role of cardiac multidetector computed tomography beyond coronary angiography.

    PubMed

    Sato, Akira; Aonuma, Kazutaka

    2015-01-01

    Cardiac multidetector computed tomography (MDCT) has become a useful noninvasive modality for anatomical imaging of coronary artery disease (CAD). Currently, the main clinical advantage of coronary computed tomography angiography (CCTA) appears to be related to its high negative predictive value at low or intermediate pretest probability for CAD. With the development of technical aspects of MDCT, clinical practice and research are increasingly shifting toward defining the clinical implication of plaque morphology, myocardial perfusion, and patient outcomes. The presence of positive vessel remodeling, low-attenuation plaques, napkin-ring sign, or spotty calcification on CCTA could be useful information on high-risk vulnerable plaques. The napkin-ring sign, especially, showed higher accuracy for the detection of thin-cap fibroatheroma. Recently, it was reported that cardiac 3D single-photon emission tomography/CT fusion imaging, noninvasive fractional flow reserve computed from CT, and integrated CCTA and CT myocardial perfusion were associated with improved diagnostic accuracy for the detection of hemodynamically significant CAD. Furthermore, several randomized, large clinical trials have evaluated the clinical value of CCTA for chest pain triage in the emergency department or long-term reduction in death, myocardial infarction, or hospitalization for unstable angina. In this review we discuss the role of cardiac MDCT beyond coronary angiography, including a comparison with other currently available imaging modalities used to examine atherosclerotic plaque and myocardial perfusion.

  4. Computed tomographic analysis of meteorite inclusions

    NASA Technical Reports Server (NTRS)

    Arnold, J. R.; Testa, J. P., Jr.; Friedman, P. J.; Kambic, G. X.

    1983-01-01

    The feasibility of obtaining nondestructively a cross-sectional display of very dense heterogeneous rocky specimens, whether lunar, terrestrial or meteoritic, by using a fourth generation computed tomographic (CT) scanner, with modifications to the software only, is discussed. A description of the scanner, and of the experimental and analytical procedures is given. Using this technique, the interior of heterogeneous materials such as Allende can be probed nondestructively. The regions of material with high and low atomic numbers are displayed quickly; the object can then be cut to obtain for analysis just the areas of interest. A comparison of this technique with conventional industrial and medical techniques is made in terms of image resolution and density distribution display precision.

  5. Computed tomographic analysis of meteorite inclusions

    NASA Technical Reports Server (NTRS)

    Arnold, J. R.; Testa, J. P., Jr.; Friedman, P. J.; Kambic, G. X.

    1983-01-01

    The feasibility of obtaining nondestructively a cross-sectional display of very dense heterogeneous rocky specimens, whether lunar, terrestrial or meteoritic, by using a fourth generation computed tomographic (CT) scanner, with modifications to the software only, is discussed. A description of the scanner, and of the experimental and analytical procedures is given. Using this technique, the interior of heterogeneous materials such as Allende can be probed nondestructively. The regions of material with high and low atomic numbers are displayed quickly; the object can then be cut to obtain for analysis just the areas of interest. A comparison of this technique with conventional industrial and medical techniques is made in terms of image resolution and density distribution display precision.

  6. Computed tomographic recognition of gastric varices

    SciTech Connect

    Balthazar, E.J.; Megibow, A.; Naidich, D.; LeFleur, R.S.

    1984-06-01

    The computed tomographic (CT) findings in 13 consecutive patients with proven gastric varices were analyzed and correlated with the radiographic, angiographic, and gastroscopic evaluations. In 11 patients, CT clearly identified large (five) or smaller (six) varices located mainly along the posteromedial wall of the gastric fundus and proximal body of the stomach. Well defined rounded or tubular densities that enhanced during intravenous administration of contrast material and could not be distinguished from the gastric wall were identified. Dense, enhancing, round or tubular, intraluminal filling defects were seen in the cases where the stomach was distended with water. In seven patients, the CT examination correctly diagnosed the pathogenesis of gastric varices by identifying hepatic cirrhosis, calcific pancreatis, and carcinoma of the pancreas.

  7. Prognostic utility of coronary computed tomographic angiography

    PubMed Central

    Otaki, Yuka; Berman, Daniel S.; Min, James K.

    2013-01-01

    Coronary computed tomographic angiography (CCTA) employing CT scanners of 64-detector rows or greater represents a noninvasive method that enables accurate detection and exclusion of anatomically obstructive coronary artery disease (CAD), providing excellent diagnostic information when compared to invasive angiography. There are numerous potential advantages of CCTA beyond simply luminal stenosis assessment including quantification of atherosclerotic plaque volume as well as assessment of plaque composition, extent, location and distribution. In recent years, an array of studies has evaluated the prognostic utility of CCTA findings of CAD for the prediction of major adverse cardiac events, all-cause death and plaque instability. This prognostic information enhances risk stratification and, if properly acted upon, may improve medical therapy and/or behavioral changes that may enhance event-free survival. The goal of the present article is to summarize the current status of the prognostic utility of CCTA findings of CAD. PMID:23809386

  8. Common carotid artery pseudoaneurysm after neck dissection: colour Doppler ultrasound and multidetector computed tomography findings.

    PubMed

    Flor, N; Sardanelli, F; Ghilardi, G; Tentori, A; Franceschelli, G; Felisati, G; Cornalba, G P

    2007-05-01

    Common carotid artery pseudoaneurysm is a rare disease, which has been previously unreported in association with neck dissection. We describe the Doppler ultrasound and multidetector computed tomography (CT) findings of a case of carotid pseudoaneurysm, one month after pharyngolaryngectomy with bilateral neck dissection. Multidetector CT confirmed the diagnosis made on the basis of Doppler ultrasound; the high image quality of axial and three-dimensional reconstructions avoided the need for pre-operative conventional angiography. In the presence of a pulsatile cervical mass after neck surgery, pseudoaneurysm of the carotid artery should be included in the differential diagnosis, and multidetector CT can be the sole pre-operative diagnostic imaging modality.

  9. Computed tomographic anatomy of the equine foot.

    PubMed

    Claerhoudt, S; Bergman, E H J; Saunders, J H

    2014-10-01

    This study describes a detailed computed tomographic reference of the normal equine foot. Ten forefeet of five adult cadavers, without evidence of orthopaedic disease, were used. Computed tomography (CT) was performed on all feet. Two-millimetre thick transverse slices were obtained, and sagittal and dorsal planes were reformatted. The CT images were matched with the corresponding anatomic slices. The phalanges and the distal sesamoid bone showed excellent detail. The extensor and flexor tendons (including their attachments) could be clearly evaluated. The collateral (sesamoidean) ligaments could be readily located, but were difficult to delineate at their proximal attachment. The distal digital annular ligament could only be distinguished from the deep digital flexor tendon proximal to the distal sesamoid bone, and its proximal attachment could be identified, but not its distal insertion. Small ligaments (impar ligament, chondrosesamoidean, chondrocoronal and chondrocompedal ligaments, axial and abaxial palmar ligaments of the proximal inter-phalangeal joint) were seen with difficulty and not at all slices. The joint capsules could not be delineated from the surrounding soft tissue structures. The lateral and medial proprius palmar digital artery and vein could be visualized occasionally on some slices. The ungular cartilages, corium and hoof wall layering were seen. The nerves, the articular and fibrocartilage of the distal sesamoid bone and the chondroungular ligament could not be assessed. Computed tomography of the equine foot can be of great value when results of radiography and ultrasonography are inconclusive. Images obtained in this study may serve as reference for CT of the equine foot.

  10. [Assessment of neoplastic pancreatic focal injury by multidetector computed tomography].

    PubMed

    Ramírez Gaspar, Alberto Motta; Morató López Alberto, Emilio; Valenzuela Tamaris, Jorge; Castillo González, Federico Armando

    2012-01-01

    pancreatic focal neoplastic lesions (PFNL) should be characterized through image methods to differentiate from no neoplastic lesions, suggesting one or more probable diagnosis, and staging of malignant lesions, in order to help define the estrategy of medial or surgical management. The multidetector computed tomography (MDCT) offers multiple properties and advantages that enable adequate characterization of the PFNL. The objective of this study is to evaluate de usefulness of MDCT in characterizing PFNL. a descriptive, retrospective caseseries study has been conducted. It consisted of reviewing MDCT studies in which PFNL were found, over a period of 4 years 11 months from January 2006 to November 2010. we obtained 54 cases of PFNL which were characterized by MDCT; 75.9% for a specific diagnosis, and were categorized as indeterminate 24.1%, considering more than one possible diagnosis. The most frequent PFNL type was pancreatic ductal adenocarcinoma in 51.9%. Pancreatic cystic neoplasms accounted for 16.7%. MDCT is useful for identifying and characterizing LFNP, this means the possibility of establishing one or more diagnostic possibilities and guide medical management.

  11. Multidetector computerized tomographic fistulography in the evaluation of congenital branchial cleft fistulae and sinuses.

    PubMed

    Sun, Zhipeng; Fu, Kaiyuan; Zhang, Zuyan; Zhao, Yanping; Ma, Xuchen

    2012-05-01

    The aim of this study was to primarily investigate the usefulness of computerized tomographic (CT) fistulography in the diagnosis and management of branchial cleft fistulae and sinuses. Fifteen patients with confirmed branchial fistulae or sinuses who had undergone CT fistulography were included. The diagnoses were confirmed by clinical, radiologic, or histopathologic examinations. The internal openings, distribution, and neighboring relationship of the lesions presented by CT fistulography were analyzed to evaluate the usefulness in comparison with x-ray fistulography. Nine patients were diagnosed with first branchial fistulae or sinuses, 2 with second branchial fistulae, and 4 with third or fourth branchial fistulae. The presence and location of the lesions could be seen on x-ray fistulography. The distribution of the lesions, internal openings, and neighboring relationship with parotid gland, carotid sheath, and submandibular gland could be clearly demonstrated on CT cross-sectional or volume-rendering images. CT fistulography could provide valuable information and benefit surgical planning by demonstrating the courses of branchial anomalies in detail. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Computed tomographic imaging of stapes implants.

    PubMed

    Warren, Frank M; Riggs, Sterling; Wiggins, Richard H

    2008-08-01

    Computed tomographic (CT) imaging of stapes prostheses is inaccurate. Clinical situations arise in which it would be helpful to determine the depth of penetration of a stapes prosthesis into the vestibule. The accuracy of CT imaging for this purpose has not been defined. This study was aimed to determine the accuracy of CT imaging to predict the depth of intrusion of stapes prostheses into the vestibule. The measurement of stapes prostheses by CT scan was compared with physical measurements in 8 cadaveric temporal bones. The depth of intrusion into the vestibule of the piston was underestimated in specimens with the fluoroplastic piston by a mean of 0.5 mm when compared with the measurements obtained in the temporal bones. The depth of penetration of the stainless steel implant was overestimated by 0.5 mm when compared with that in the temporal bone. The type of implant must be taken into consideration when estimating the depth of penetration into the vestibule using CT scanning because the imaging characteristics of the implanted materials differ. The position of fluoroplastic pistons cannot be accurately measured in the vestibule. Metallic implants are well visualized, and measurements exceeding 2.2 mm increase the suspicion of otolithic impingement. Special reconstructions along the length of the piston may be more accurate in estimating the position of stapes implants.

  13. Computed tomographic findings in orbital Mucor

    SciTech Connect

    Greenberg, M.R.; Lippman, S.M.; Grinnell, V.S.; Colman, M.F.; Edwards, J.E. Jr.

    1985-07-01

    Mucormycosis is an increasingly important infection in immunocompromised patients; knowledge regarding the variability of its clinical manifestations is expanding steadily. The infection is of paranasal sinus origin and may involve the orbit secondarily via freely communicating foramina and venous channels. Death often ensues when the infection spreads either into the cavernous sinus or the central nervous system. Early diagnosis of rhinocerebral mucormycosis is crucial for a successful outcome. Computed tomographic (CT) scanning is used to visualize many intraorbital pathologic abnormalities. The patient discussed in this paper had extensive orbital Mucor that appeared minimal on a CT scan. This inability of the scan to reflect the severity of infection prompted a review of the literature describing the use of CT scans for detecting this potentially fatal, opportunistic infection. The search showed that a disparity between scan findings and the severity of the disease is the rule rather than the exception. Recognition of this disparity has significant implications for appropriate diagnosis and management of orbital Mucor.

  14. Evaluation of posterior clinoid process pneumatization by multidetector computed tomography.

    PubMed

    Burulday, Veysel; Akgül, Mehmet Hüseyin; Muluk, Nuray Bayar; Ozveren, Mehmet Faik; Kaya, Ahmet

    2016-10-21

    In the present study, we investigated the types and ratio of posterior clinoid process (PCP) pneumatization in paranasal sinus multidetector computed tomography (MDCT). Paranasal MDCT images of 541 subjects (227 males, 314 females), between 15 and 65 years old, were included into the study. Pneumatization of anterior clinoid process and pneumatization types (I, II, or III) were evaluated in the males and females. PCP pneumatization was detected in 20.7 % of the males and 11.5 % of the females. Right, left, and bilateral PCP pneumatizations were detected in 7.9, 5.7, and 7.0 % of the males and 2.9, 3.2, and 4.5 % of the females, respectively. PCP pneumatization of the males is significantly higher than the females. The most detected type of pneumatization was type I (61.2 %) for all groups. In right, left, and bilateral pneumatizations separately, type I pneumatization was the most detected pneumatization type with the ratio of the 70.4, 65.2, and 50.0 %, respectively. In males, type I (61.7 %), and similarly in females, type I (60.6 %) pneumatization were detected more. Type II and type III pneumatizations were detected in decreasing order in both groups. In younger subjects, pneumatization of posterior clinoid process was found as higher, and in older subjects, PCP pneumatization was found as lower. Sclerosis process related to the aging may be responsible for the lower pneumatization ratios in older subjects. Structure of the surrounding regions of PCP is important for surgical procedures related to cavernous sinus, basilar apex aneurysms, and mass lesions. Preoperative radiological examinations are useful for operative planning. Any anomalies to PCP can cause unnecessary injury to the neurovascular complex structure around the cavernous sinus or postclinoidectomy CSF fistulas. Posterior clinoidectomies should be avoided in patients with type III PCP pneumatization to prevent CSF fistulas.

  15. Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography: a report by the Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils in collaboration with the Society of Cardiovascular Computed Tomography.

    PubMed

    Voros, Szilard; Rivera, Juan J; Berman, Daniel S; Blankstein, Ron; Budoff, Matthew J; Cury, Ricardo C; Desai, Milind Y; Dey, Damini; Halliburton, Sandra S; Hecht, Harvey S; Nasir, Khurram; Santos, Raul D; Shapiro, Michael D; Taylor, Allen J; Valeti, Uma S; Young, Phillip M; Weissman, Gaby

    2011-01-01

    Coronary artery calcium (CAC) scanning is an important tool for risk stratification in intermediate-risk, asymptomatic subjects without previous coronary disease. However, the clinical benefit of improved risk prediction needs to be balanced against the risk of the use of ionizing radiation. Although there is increasing emphasis on the need to obtain CAC scans at low-radiation exposure to the patient, very few practical documents exist to aid laboratories and health care professionals on how to obtain such low-radiation scans. The Tomographic Imaging Council of the Society for Atherosclerosis Imaging and Prevention, in collaboration with the Prevention Council and the Society of Cardiovascular Computed Tomography, created a task force and writing group to generate a practical document to address parameters that can be influenced by careful attention to image acquisition. Patient selection for CAC scanning should be based on national guidelines. It is recommended that laboratories performing CAC examinations monitor radiation exposure (dose-length-product [DLP]) and effective radiation dose (E) in all patients. DLP should be <200 mGy × cm; E should average 1.0-1.5 mSv and should be <3.0 mSv. On most scanner platforms, CAC imaging should be performed in an axial mode with prospective electrocardiographic triggering, using tube voltage of 120 kVp. Tube current should be carefully selected on the basis of patient size, potentially using chest lateral width measured on the topogram. Scan length should be limited for the coverage of the heart only. When patients and imaging parameters are selected appropriately, CAC scanning can be performed with low levels of radiation exposure.

  16. Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it.

    PubMed

    Paulus, Elena M; Fabian, Timothy C; Savage, Stephanie A; Zarzaur, Ben L; Botta, Vandana; Dutton, Wesley; Croce, Martin A

    2014-02-01

    Aggressive screening to diagnose blunt cerebrovascular injury (BCVI) results in early treatment, leading to improved outcomes and reduced stroke rates. While computed tomographic angiography (CTA) has been widely adopted for BCVI screening, evidence of its diagnostic sensitivity is marginal. Previous work from our institution using 32-channel multidetector CTA in 684 patients demonstrated an inadequate sensitivity of 51% (Ann Surg. 2011,253: 444-450). Digital subtraction angiography (DSA) continues to be the reference standard of diagnosis but has significant drawbacks of invasiveness and resource demands. There have been continued advances in CT technology, and this is the first report of an extensive experience with 64-channel multidetector CTA. Patients screened for BCVI using CTA and DSA (reference) at a Level 1 trauma center during the 12-month period ending in May 2012 were identified. Results of CTA and DSA, complications, and strokes were retrospectively reviewed and compared. A total of 594 patients met criteria for BCVI screening and underwent both CTA and DSA. One hundred twenty-eight patients (22% of those screened) had 163 injured vessels: 99 (61%) carotid artery injuries and 64 (39%) vertebral artery injuries. Sixty-four-channel CTA demonstrated an overall sensitivity per vessel of 68% and specificity of 92%. The 52 false-negative findings on CTA were composed of 34 carotid artery injuries and 18 vertebral artery injuries; 32 (62%) were Grade I injuries. Overall, positive predictive value was 36.2%, and negative predictive value was 97.5%. Six procedure-related complications (1%) occurred with DSA, including two iatrogenic dissections and one stroke. Sixty-four-channel CTA demonstrated a significantly improved sensitivity of 68% versus the 51% previously reported for the 32-channel CTA (p = 0.0075). Sixty-two percent of the false-negative findings occurred with low-grade injuries. Considering complications, cost, and resource demand associated with

  17. Computed tomographic features of feline nasopharyngeal polyps.

    PubMed

    Oliveira, Cintia R; O'Brien, Robert T; Matheson, Jodi S; Carrera, Inés

    2012-01-01

    The computed tomographic (CT) findings of histopathologically confirmed nasopharyngeal polyps are described in 13 cats. Most polyps were mildly hypoattenuating to adjacent muscles and isoattenuating to soft-tissue (n= 13), homogeneous (n = 12) and with ill-defined borders (n = 10) on precontrast images. After contrast medium administration, the polyps were homogeneous (n = 11), with well-defined borders (n = 13), oval (n = 13), and had rim enhancement (n = 13). Nasopharyngeal polyps were pedunculated in 11 cats with a stalk-like structure connecting the polyp through the auditory tube to an affected tympanic bulla. All cats had at least one tympanic bulla severely affected, with CT images identifying: (1) complete (n = 12) or partial (n = 1) obliteration of either the dorsal or ventral compartments with soft-tissue attenuating material; (2) pathologic expansion (n = 13) with wall thickening (n = 10) that was asymmetric in nine cats; and (3) identification of a polyp-associated stalk-like structure (n = 11). Nine cats had unilateral tympanic bulla disease ipsilateral to the polyp, and four cats had bilateral tympanic bulla disease, most severe ipsilateral to the polyp with milder contralateral pathologic changes. Two cats had minimal osteolysis of the tympanic bulla. Enlargement of the medial retropharyngeal lymph node was seen commonly (n = 8), and in all cats it was ipsilateral to the most affected tympanic bulla. One cat had bilateral lymphadenopathy. CT is an excellent imaging tool for the supportive diagnosis of nasopharyngeal polyps in cats. CT findings of a well-defined mass with strong rim enhancement, mass-associated stalk-like structure, and asymmetric tympanic bulla wall thickening with pathologic expansion of the tympanic bullae are highly indicative of an inflammatory polyp.

  18. A Study of Internal Thoracic Arteriovenous Principal Perforators by Using Multi-detector Row Computed Tomography Angiography.

    PubMed

    Okumura, Ko; Hashikawa, Kazunobu; Sakakibara, Shunsuke; Onishi, Hiroyuki; Terashi, Hiroto

    2016-01-01

    There are numerous reports of perforating branches from the intercostal spaces of the internal thoracic vessels. These branches have varying diameters, and a main perforating branch, the principal perforator, most often found in the second or third intercostal space. We report different results based on multi-detector row computed tomography. We evaluated 121 sides from 70 women scheduled for breast reconstruction with free lower abdominal skin flaps who underwent preoperative multi-detector row computed tomographic scan between June 2008 and June 2015. For primary reconstruction, we analyzed both sides, and for 1-sided secondary reconstruction, we analyzed only the unaffected side. We evaluated both early arterial phase and late venous phase 5-mm horizontal, cross-sectional, and volume-rendering images for perforation sites and internal thoracic arteriovenous perforating branches' intercostal space thickness. We analyzed differences in thickness between the internal thoracic arteries and veins and symmetry in cases involving both sides. Venous principal perforators nearly always perforated the same intercostal spaces as accompanying veins of arterial principal perforators (99.2%), forming arteriovenous principal perforators. We found 49 principal perforators in the first intercostal space (37.4%), 52 in the second intercostal space (39.7%), 23 in the third intercostal space (17.6%), 6 in the fourth intercostal space (4.6%), and 1 in the fifth intercostal space (0.7%). Of the 51 cases in which we studied both sides, 25 cases (49%) had principal perforators with bilateral symmetry. In contrast to findings from past reports, we found that internal thoracic arteriovenous principal perforators were often present in almost the same numbers in the first and second intercostal spaces.

  19. A Study of Internal Thoracic Arteriovenous Principal Perforators by Using Multi-detector Row Computed Tomography Angiography

    PubMed Central

    Hashikawa, Kazunobu; Sakakibara, Shunsuke; Onishi, Hiroyuki; Terashi, Hiroto

    2016-01-01

    Objective: There are numerous reports of perforating branches from the intercostal spaces of the internal thoracic vessels. These branches have varying diameters, and a main perforating branch, the principal perforator, most often found in the second or third intercostal space. We report different results based on multi-detector row computed tomography. Methods: We evaluated 121 sides from 70 women scheduled for breast reconstruction with free lower abdominal skin flaps who underwent preoperative multi-detector row computed tomographic scan between June 2008 and June 2015. For primary reconstruction, we analyzed both sides, and for 1-sided secondary reconstruction, we analyzed only the unaffected side. We evaluated both early arterial phase and late venous phase 5-mm horizontal, cross-sectional, and volume-rendering images for perforation sites and internal thoracic arteriovenous perforating branches’ intercostal space thickness. We analyzed differences in thickness between the internal thoracic arteries and veins and symmetry in cases involving both sides. Results: Venous principal perforators nearly always perforated the same intercostal spaces as accompanying veins of arterial principal perforators (99.2%), forming arteriovenous principal perforators. We found 49 principal perforators in the first intercostal space (37.4%), 52 in the second intercostal space (39.7%), 23 in the third intercostal space (17.6%), 6 in the fourth intercostal space (4.6%), and 1 in the fifth intercostal space (0.7%). Of the 51 cases in which we studied both sides, 25 cases (49%) had principal perforators with bilateral symmetry. Conclusions: In contrast to findings from past reports, we found that internal thoracic arteriovenous principal perforators were often present in almost the same numbers in the first and second intercostal spaces. PMID:26958104

  20. A COMPUTED TOMOGRAPHIC STUDY OF SCHIZOPHRENIA

    PubMed Central

    Siddharatha; Lal, Narottam; Tewari, S.C.; Dalal, P.K.; Kohli, Neera; Srivastava, Shrikant

    1997-01-01

    Fifty schizophrenic patients fulfilling DSM-III-R criteria, and group matched normal healthy controls were selected for the study The case and control groups have been compared in terms of VBR, WSF and WTF. In the study schizophrenics have been divided into positive, negative and mixed subgroups on basis of SAPS and SANS, and these subgroups are compared with each other for VBR, WSF & WTF. Tomographic abnormalities were noted in schizophrenics, particularly with negative and mixed subtypes, when compared to controls. PMID:21584057

  1. Myocardial bridging assessed by multidetector computed tomography: likely cause of chest pain in younger patients with low prevalence of dyslipidemia.

    PubMed

    de Agustín, José Alberto; Marcos-Alberca, Pedro; Fernández-Golfín, Covadonga; Bordes, Sara; Feltes, Gisela; Almería, Carlos; Rodrigo, José Luis; Arrazola, Juan; Pérez de Isla, Leopoldo; Macaya, Carlos; Zamorano, José

    2012-10-01

    The relationship between myocardial bridging and symptoms is still unclear. The purpose of our study was to assess the relationship between myocardial bridging detected by multidetector computed tomography and symptoms in a patient population with chest pain syndrome. The study enrolled 393 consecutive patients without previous coronary artery disease studied for chest pain and referred to multidetector computed tomography between January 2007 and December 2010. Noninvasive coronary angiography was performed using multidetector computed tomography. Myocardial bridging was defined as part of a coronary artery completely surrounded by myocardium on axial and multiplanar reformatted images. Mean age was 64.6 (12.4) years and 44.8% were male. Multidetector computed tomography detected 86 myocardial bridging images in 82 of the 393 patients (20.9%). Left anterior descending was the most frequent coronary artery involved (87.2%). The prevalence of myocardial bridging was significantly higher in patients without significant atherosclerotic coronary stenosis on multidetector computed tomography (24.9% vs 15.0%; P=.02). Patients with myocardial bridging were younger (60.3 [13.8] vs 65.8 [11.9]; P<.001), had less prevalence of hyperlipidemia (29.3% vs 41.8%; P=.03), and more prevalence of cardiomyopathy (6.1% vs 1.6%, P=.02) compared with patients without myocardial bridging on multidetector computed tomography. Multidetector computed tomography is an easy and reliable tool for comprehensive in vivo diagnosis of myocardial bridging. The results of the present study suggest myocardial bridging is the cause of chest pain in a subgroup of younger aged patients with less prevalence of hyperlipidemia and more prevalence of cardiomyopathy than patients with significant atherosclerotic coronary artery disease on multidetector computed tomography. Full English text available from:www.revespcardiol.org. Copyright © 2011 Sociedad Española de Cardiología. Published by Elsevier

  2. Computer-aided marginal artery detection on computed tomographic colonography

    NASA Astrophysics Data System (ADS)

    Wei, Zhuoshi; Yao, Jianhua; Wang, Shijun; Liu, Jiamin; Summers, Ronald M.

    2012-03-01

    Computed tomographic colonography (CTC) is a minimally invasive technique for colonic polyps and cancer screening. The marginal artery of the colon, also known as the marginal artery of Drummond, is the blood vessel that connects the inferior mesenteric artery with the superior mesenteric artery. The marginal artery runs parallel to the colon for its entire length, providing the blood supply to the colon. Detecting the marginal artery may benefit computer-aided detection (CAD) of colonic polyp. It can be used to identify teniae coli based on their anatomic spatial relationship. It can also serve as an alternative marker for colon localization, in case of colon collapse and inability to directly compute the endoluminal centerline. This paper proposes an automatic method for marginal artery detection on CTC. To the best of our knowledge, this is the first work presented for this purpose. Our method includes two stages. The first stage extracts the blood vessels in the abdominal region. The eigenvalue of Hessian matrix is used to detect line-like structures in the images. The second stage is to reduce the false positives in the first step. We used two different masks to exclude the false positive vessel regions. One is a dilated colon mask which is obtained by colon segmentation. The other is an eroded visceral fat mask which is obtained by fat segmentation in the abdominal region. We tested our method on a CTC dataset with 6 cases. Using ratio-of-overlap with manual labeling of the marginal artery as the standard-of-reference, our method yielded true positive, false positive and false negative fractions of 89%, 33%, 11%, respectively.

  3. Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps.

    PubMed

    Iannaccone, Riccardo; Laghi, Andrea; Catalano, Carlo; Mangiapane, Filippo; Lamazza, Antonietta; Schillaci, Alberto; Sinibaldi, Giovanni; Murakami, Takamichi; Sammartino, Paolo; Hori, Masatoshi; Piacentini, Francesca; Nofroni, Italo; Stipa, Vincenzo; Passariello, Roberto

    2004-11-01

    We prospectively compared the performance of low-dose multidetector computed tomographic colonography (CTC) without cathartic preparation with that of colonoscopy for the detection of colorectal polyps. A total of 203 patients underwent low-dose CTC without cathartic preparation followed by colonoscopy. Before CTC, fecal tagging was achieved by adding diatrizoate meglumine and diatrizoate sodium to regular meals. No subtraction of tagged feces was performed. Colonoscopy was performed 3-7 days after CTC. Three readers interpreted the CTC examinations separately and independently using a primary 2-dimensional approach using multiplanar reconstructions and 3-dimensional images for further characterization. Colonoscopy with segmental unblinding was used as reference standard. The sensitivity of CTC was calculated both on a per-polyp and a per-patient basis. For the latter, specificity, positive predictive values, and negative predictive values were also calculated. CTC had an average sensitivity of 95.5% (95% confidence interval [CI], 92.1%-99%) for the identification of colorectal polyps > or =8 mm. With regard to per-patient analysis, CTC yielded an average sensitivity of 89.9% (95% CI, 86%-93.7%), an average specificity of 92.2% (95% CI, 89.5%-94.9%), an average positive predictive value of 88% (95% CI, 83.3%-91.5%), and an average negative predictive value of 93.5% (95% CI, 90.9%-96%). Interobserver agreement was high on a per-polyp basis (kappa statistic range, .61-.74) and high to excellent on a per-patient basis (kappa statistic range, .79-.91). Low-dose multidetector CTC without cathartic preparation compares favorably with colonoscopy for the detection of colorectal polyps.

  4. Non-invasive coronary angiography with multi-detector computed tomography: comparison to conventional X-ray angiography.

    PubMed

    Schoenhagen, Paul; Stillman, Arthur E; Halliburton, Sandy S; Kuzmiak, Stacie A; Painter, Tracy; White, Richard D

    2005-02-01

    Selective coronary angiography introduced clinical coronary imaging in the late 1950s. The angiographic identification of high-grade coronary lesions in patients with acute and chronic symptomatic coronary artery disease (CAD) led to the development of surgical and percutaneous coronary revascularization. However, the fact that CAD remains the major cause of death in North America and Europe demonstrates the need for novel, complementary diagnostic strategies. These are driven by the need to characterize both increasingly advanced disease stages but also early, asymptomatic disease development. Complex revascularization techniques for patients with advanced disease stages will initiate a growing demand for 3-dimensional coronary imaging and integration of imaging modalities with new mechanical therapeutic devices. An emerging focus is atherosclerosis imaging with the goal to identify subclinical disease stages as the basis for pharmacological intervention aimed at disease stabilization or reversal. Non-invasive coronary imaging with coronary multidetector computed tomographic angiography (MDCTA) allows both assessment of luminal stenosis and subclinical disease of the arterial wall. Its complementary role in the assessment of early and advanced stages of CAD is increasingly recognized.

  5. Soil structure characterized using computed tomographic images

    Treesearch

    Zhanqi Cheng; Stephen H. Anderson; Clark J. Gantzer; J. W. Van Sambeek

    2003-01-01

    Fractal analysis of soil structure is a relatively new method for quantifying the effects of management systems on soil properties and quality. The objective of this work was to explore several methods of studying images to describe and quantify structure of soils under forest management. This research uses computed tomography and a topological method called Multiple...

  6. Computed tomographic findings in penetrating peptic ulcer

    SciTech Connect

    Madrazo, B.L.; Halpert, R.D.; Sandler, M.A.; Pearlberg, J.L.

    1984-12-01

    Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a convenient diagnosis of this important complication of peptic ulcer disease.

  7. Computed tomographic findings in 15 dogs with eosinophilic bronchopneumopathy.

    PubMed

    Mesquita, Luis; Lam, Richard; Lamb, Christopher R; McConnell, J Fraser

    2015-01-01

    Eosinophilic bronchopneumopathy is a disease characterized by the infiltration of the lung and bronchial mucosa by eosinophils. The aim of the present study was to describe the CT findings in a large series of dogs with confirmed diagnosis of eosinophilic bronchopneumopathy. Computed tomographic scans of 15 dogs with confirmed diagnosis of eosinophilic bronchopneumopathy were evaluated retrospectively by two boarded radiologists who reached a consensus. Abnormalities were identified in 14/15 (93%) dogs, including pulmonary parenchymal abnormalities in 14/15 (93%) dogs, bronchial wall thickening in 13 (87%) dogs, which was considered marked in eight (53%), plugging of the bronchial lumen by mucus/debris in 11 (73%) dogs, and bronchiectasis in nine (60%) dogs. Pulmonary nodules were identified in 5/15 (33%) dogs including one dog with a mass. All dogs with a nodular lung pattern had additional abnormalities. Lymphadenopathy was present in 10 dogs (67%). Lesions associated with eosinophilic bronchopneumopathy are variable and heterogeneous and encompass a wider variety of computed tomographic features than reported previously. Computed tomographic images were abnormal in the majority of affected dogs, hence CT is a useful modality to characterize the nature and distribution of thoracic lesions in dogs with eosinophilic bronchopneumopathy.

  8. 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.

  9. Hepatocellular carcinoma: prediction of blood supply from an intercostal artery with multidetector row computed tomography.

    PubMed

    Kim, Min-Uk; Kim, Hyo-Cheol; Chung, Jin Wook; An, Sangbu; Seong, Nak Jong; Jae, Hwan Jun; Park, Jae Hyung

    2011-10-01

    To evaluate the ability of multidetector row computed tomography (CT) to detect blood supply from the intercostal artery in patients with hepatocellular carcinoma (HCC). Between January 2003 and December 2007, angiography of the intercostal artery was performed in 93 patients (76 men and 17 women, mean age 58 years) with HCC who had also undergone multidetector row CT. CT scans and digital subtraction angiograms of these patients were retrospectively reviewed by two investigators in consensus to evaluate tumor feeding vessels. Multiple logistic regression analysis was used to identify factors that predict the presence of an HCC blood supply from an intercostal artery. Tumor staining fed by an intercostal artery was noted in 65 patients (70%; 112 tumor feeding vessels) by intercostal angiography. Readers interpreted that tumor feeding vessels were evident by CT in 35 (54%) of these 65 patients with tumor staining supplied by an intercostal artery by angiography. Multiple logistic regression analysis showed that a visible tumor feeding vessel by CT (P = .003) and hepatic artery attenuation by angiography (P = .014) were significantly related to the presence of a blood supply from an intercostal artery. Visualization of a tumor feeding vessel from the intercostal artery by multidetector row CT is an important sign of parasitic supply to an HCC. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  10. Computed tomographic measurement of canine urine concentration.

    PubMed

    Zwingenberger, Allison L; Carrade Holt, Danielle D

    2017-02-01

    Computed tomography (CT) is able to measure the attenuation of urine in Hounsfield units (HU) on abdominal imaging studies. This study was designed to measure the correlation of urine attenuation with urine specific gravity in urine samples of 40 dogs, providing a noninvasive measure of urine concentration. The HU of urine explained 72% of the variance in measured urine specific gravity [R(2) = 0.72, F(1,38) = 95.55, P < 0.001]. This noninvasive measurement can be used to estimate urine concentration in dogs undergoing abdominal CT imaging.

  11. Advances and perspectives in lung cancer imaging using multidetector row computed tomography.

    PubMed

    Coche, Emmanuel

    2012-10-01

    The introduction of multidetector row computed tomography (CT) into clinical practice has revolutionized many aspects of the clinical work-up. Lung cancer imaging has benefited from various breakthroughs in computing technology, with advances in the field of lung cancer detection, tissue characterization, lung cancer staging and response to therapy. Our paper discusses the problems of radiation, image visualization and CT examination comparison. It also reviews the most significant advances in lung cancer imaging and highlights the emerging clinical applications that use state of the art CT technology in the field of lung cancer diagnosis and follow-up.

  12. Bosniak classification of renal cystic lesions according to multidetector computed tomography findings*

    PubMed Central

    de Miranda, Christiana Maia Nobre Rocha; Maranhão, Carol Pontes de Miranda; dos Santos, Carla Jotta Justo; Padilha, Igor Gomes; de Farias, Lucas de Pádua Gomes; da Rocha, Milzi Sarmento

    2014-01-01

    Renal cystic lesions are usually diagnosed in the radiologists’ practice and therefore their characterization is crucial to determine the clinical approach to be adopted and prognosis. The Bosniak classification based on computed tomography findings has allowed for standardization and categorization of lesions in increasing order of malignancy (I, II, IIF, III and IV) in a simple and accurate way. The present iconographic essay developed with multidetector computed tomography images of selected cases from the archives of the authors’ institution, is aimed at describing imaging findings that can help in the diagnosis of renal cysts. PMID:25741060

  13. Lymphadenopathy in celiac disease: computed tomographic observations

    SciTech Connect

    Jones, B.; Bayless, T.M.; Fishman, E.K.; Siegelman, S.S.

    1984-06-01

    Lymphadenopathy in patients with celiac disease is generally viewed with alarm due to the association between celiac disease and intestinal lymphoma. Four patients with celiac disease are described in whom significant mesenteric and paraaortic adenopathy was demonstrated by computed tomogrophy (CT). The subsequent clinical course of these patients revealed no evidence of lymphoma. In two patients with longstanding celiac disease and recent relapse, exploratory laparotomy revealed reactive hyperplasia in the enlarged glands; in one patient this was associated with intestinal ulceration, and in the other no underlying pathology was found. Follow-up CT scans in both these patients demonstrated regression of the findings with clinical improvement. In the other two patients, CT was performed as part of the initial evaluation.

  14. Computed tomographic appearance of resectable pancreatic carcinoma

    SciTech Connect

    Itai, Y.; Araki, T.; Tasaka, A.; Maruyama, M.

    1982-06-01

    Thirteen patients with resectable pancreatic carcinoma were examined by computed tomography (CT). Nine had a mass, 2 had dilatation of the main pancreatic duct, 1 appeared to have ductal dilatation, and 1 had no sign of abnormality. Resectable carcinoma was diagnosed retrospectively in 8 cases, based on the following criteria: a mass with a distinct contour, frequently containing a tiny or irregular low-density area and accompanied by dilatation of the caudal portion of the main pancreatic duct without involvement of the large vessels, liver, or lymph nodes. Including unresectable cancer, chronic pancreatitis, and obstructive jaundice from causes other than cancer, the false-positive rate was less than 6%. However, a small cancer without change in pancreatic contour is difficult to detect with CT.

  15. A computed tomographic imaging system for experimentation

    NASA Astrophysics Data System (ADS)

    Lu, Yanping; Wang, Jue; Liu, Fenglin; Yu, Honglin

    2008-03-01

    Computed tomography (CT) is a non-invasive imaging technique, which is widely applied in medicine for diagnosis and surgical planning, and in industry for non-destructive testing (NDT) and non-destructive evaluation (NDE). So, it is significant for college students to understand the fundamental of CT. In this work, A CT imaging system named CD-50BG with 50mm field-of-view has been developed for experimental teaching at colleges. With the translate-rotate scanning mode, the system makes use of a 7.4×10 8Bq (20mCi) activity 137Cs radioactive source which is held in a tungsten alloy to shield the radiation and guarantee no harm to human body, and a single plastic scintillator + photomultitude detector which is convenient for counting because of its short-time brightness and good single pulse. At same time, an image processing software with the functions of reconstruction, image processing and 3D visualization has also been developed to process the 16 bits acquired data. The reconstruction time for a 128×128 image is less than 0.1 second. High quality images with 0.8mm spatial resolution and 2% contrast sensitivity can be obtained. So far in China, more than ten institutions of higher education, including Tsinghua University and Peking University, have already applied the system for elementary teaching.

  16. Technical innovation: Multidimensional computerized software enabled subtraction computed tomographic angiography.

    PubMed

    Bhatia, Mona; Rosset, Antoine; Platon, Alexandra; Didier, Dominique; Becker, Christoph D; Poletti, Pierre-Alexandre

    2010-01-01

    Computed tomographic angiography (CTA) is a frequent noninvasive alternative to digital subtraction angiography. We previously reported the development of a new subtraction software to overcome limitations of adjacent bone and calcification in CT angiographic subtraction. Our aim was to further develop and improve this fast and automated computerized software, universally available for free use and compatible with most CT scanners, thus enabling better delineation of vascular structures, artifact reduction, and shorter reading times with potential clinical benefits. This computer-based free software will be available as an open source in the next release of OsiriX at the Web site http://www.osirix-viewer.com.

  17. Multiplanar and two-dimensional imaging of central airway stenting with multidetector computed tomography

    PubMed Central

    2012-01-01

    Background Multidetector computed tomography (MDCT) provides guidance for primary screening of the central airways. The aim of our study was assessing the contribution of multidetector computed tomography- two dimensional reconstruction in the management of patients with tracheobronchial stenosis prior to the procedure and during a short follow up period of 3 months after the endobronchial treatment. Methods This is a retrospective study with data collected from an electronic database and from the medical records. Patients evaluated with MDCT and who had undergone a stenting procedure were included. A Philips RSGDT 07605 model MDCT was used, and slice thickness, 3 mm; overlap, 1.5 mm; matrix, 512x512; mass, 90 and kV, 120 were evaluated. The diameters of the airways 10 mm proximal and 10 mm distal to the obstruction were measured and the stent diameter (D) was determined from the average between D upper and D lower. Results Fifty-six patients, 14 (25%) women and 42 (75%) men, mean age 55.3 ± 13.2 years (range: 16-79 years), were assessed by MDCT and then treated with placement of an endobronchial stent. A computed tomography review was made with 6 detector Philips RSGDT 07605 multidetector computed tomography device. Endobronchial therapy was provided for the patients with endoluminal lesions. Stents were placed into the area of stenosis in patients with external compression after dilatation and debulking procedures had been carried out. In one patient the migration of a stent was detected during the follow up period by using MDCT. Conclusions MDCT helps to define stent size, length and type in patients who are suitable for endobronchial stinting. This is a non-invasive, reliable method that helps decisions about optimal stent size and position, thus reducing complications. PMID:22958300

  18. [Efficacy of multidetector computed angiotomography in the diagnosis of limb arterial injuries].

    PubMed

    Suárez Poveda, Tatiana; Morales Uribe, Carlos H; Cruz Vásquez, Ricardo; Montoya Arango, María del Pilar; Ochoa Escudero, Martín

    2013-04-01

    To determine the diagnostic usefulness of multidetector computed angiotomography in the diagnosis limb arterial injuries in patients with suspicion of arterial injury with no indication of immediate surgery. Non-invasive 64-channel multidetector computed tomography (MDCT) was performed on 99 limbs suspected of having a traumatic vascular injury over a 44-month period between August 2004 and April 2008. The results were interpreted by the duty radiologist and his findings were compared with those from surgery or clinical follow-up. Inter-observer variability was evaluated by comparing the reading of the MDCT by the duty radiologists with the retrospective reading by radiology specialist in trauma. MDCT as a diagnostic method of vascular injury of the limbs, interpreted by a general radiologist showed a sensitivity of 98% (95% CI: 93-100), a specificity of 88% (5% CI: 77-99), a positive predictive value of 91% (95% CI: 82-99), a negative predictive value of 97% (95% CI: 90-100), a positive likelihood radio of 8.24 (3.6-18.7), and a negative likelihood radio of 0.02 (0-0.15). The inter-observer variability by comparing the interpretation of the MDCT by the duty radiologist with that of the radiology specialist in trauma had a kappa of 0.869. Multidetector computed angiotomography is a high precision diagnostic imaging method in arterial injury of the limbs, offering a suitable and appropriate therapeutic approach, and could be considered as new gold standard for the diagnosis of arterial injuries of the limbs. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  19. Tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography: association with N categories

    PubMed Central

    Li, Hang; Chen, Xiao-li; Li, Jun-ru; Li, Zhen-lin; Chen, Tian-wu; Pu, Hong; Yin, Long-lin; Xu, Guo-hui; Li, Zhen-wen; Reng, Jing; Zhou, Peng; Cheng, Zhu-zhong; Cao, Ying

    2016-01-01

    OBJECTIVE: To determine whether the gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict the presence of regional lymph node metastasis and could determine N categories. MATERIALS AND METHODS: A total of 202 consecutive patients with gastric adenocarcinoma who had undergone gastrectomy 1 week after contrast-enhanced multidetector computed tomography were retrospectively identified. The gross tumor volume was evaluated on multidetector computed tomography images. Univariate and multivariate analyses were performed to determine whether the gross tumor volume could predict regional lymph node metastasis, and the Mann-Whitney U test was performed to compare the gross tumor volume among N categories. Additionally, a receiver operating characteristic analysis was performed to identify the accuracy of the gross tumor volume in differentiating N categories. RESULTS: The gross tumor volume could predict regional lymph node metastasis (p<0.0001) in the univariate analysis, and the multivariate analyses indicated that the gross tumor volume was an independent risk factor for regional lymph node metastasis (p=0.005, odds ratio=1.364). The Mann-Whitney U test showed that the gross tumor volume could distinguish N0 from the N1-N3 categories, N0-N1 from N2-N3, and N0-N2 from N3 (all p<0.0001). In the T1-T4a categories, the gross tumor volume could differentiate N0 from the N1-N3 categories (cutoff, 12.3 cm3), N0-N1 from N2-N3 (cutoff, 16.6 cm3), and N0-N2 from N3 (cutoff, 24.6 cm3). In the T4a category, the gross tumor volume could differentiate N0 from the N1-N3 categories (cutoff, 15.8 cm3), N0-N1 from N2-N3 (cutoff, 17.8 cm3), and N0-N2 from N3 (cutoff, 24 cm3). CONCLUSION: The gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict regional lymph node metastasis and N categories. PMID:27166769

  20. Identification of Cardiac and Aortic Injuries in Trauma with Multi-detector Computed Tomography.

    PubMed

    Shergill, Arvind K; Maraj, Tishan; Barszczyk, Mark S; Cheung, Helen; Singh, Navneet; Zavodni, Anna E

    2015-01-01

    Blunt and penetrating cardiovascular (CV) injuries are associated with a high morbidity and mortality. Rapid detection of these injuries in trauma is critical for patient survival. The advent of multi-detector computed tomography (MDCT) has led to increased detection of CV injuries during rapid comprehensive scanning of stabilized major trauma patients. MDCT has the ability to acquire images with a higher temporal and spatial resolution, as well as the capability to create multiplanar reformats. This pictorial review illustrates several common and life-threatening traumatic CV injuries from a regional trauma center.

  1. Identification of Cardiac and Aortic Injuries in Trauma with Multi-detector Computed Tomography

    PubMed Central

    Shergill, Arvind K; Maraj, Tishan; Barszczyk, Mark S; Cheung, Helen; Singh, Navneet; Zavodni, Anna E

    2015-01-01

    Blunt and penetrating cardiovascular (CV) injuries are associated with a high morbidity and mortality. Rapid detection of these injuries in trauma is critical for patient survival. The advent of multi-detector computed tomography (MDCT) has led to increased detection of CV injuries during rapid comprehensive scanning of stabilized major trauma patients. MDCT has the ability to acquire images with a higher temporal and spatial resolution, as well as the capability to create multiplanar reformats. This pictorial review illustrates several common and life-threatening traumatic CV injuries from a regional trauma center. PMID:26430541

  2. Extraperitoneal Rupture of a Bladder Diverticulum and the Role of Multidetector Computed Tomography Cystography.

    PubMed

    Kodama, Koichi; Takase, Yasukazu; Saito, Katsuhiko

    2016-11-01

    Nontraumatic rupture of the bladder is less widely recognized than traumatic rupture, with a challenging early diagnosis due to high variability in clinical presentations. We report a case of extraperitoneal rupture of a bladder diverticulum in a patient with diabetes mellitus who presented with paralytic ileus. Despite conservative management, the patient developed sepsis requiring surgical treatment. Urinary tract infection and bladder outlet obstruction were considered to be potential mechanisms of the rupture. Multidetector computed tomography cystography should be used as the first-line modality when evaluating for a suspected bladder rupture, even in patients with nontraumatic bladder rupture.

  3. Multidetector computed tomography of pediatric large airway diseases: state-of-the-art.

    PubMed

    Lee, Edward Y; Greenberg, S Bruce; Boiselle, Phillip M

    2011-09-01

    Advances in multidetector computed tomography (MDCT) technology have given rise to improvements in the noninvasive and comprehensive assessment of the large airways in pediatric patients. Superb two-dimensional and three-dimensional reconstruction MDCT images have revolutionized the display of large airways and enhanced the ability to diagnose large airway diseases in children. The 320-MDCT scanner, which provides combined detailed anatomic and dynamic functional information assessment of the large airways, is promising for the assessment of dynamic large airway disease such as tracheobronchomalacia. This article discusses imaging techniques and clinical applications of MDCT for assessing large airway diseases in pediatric patients.

  4. Absence of a sphenoid wing in neurofibromatosis type 1 disease: imaging with multidetector computed tomography.

    PubMed

    Onbas, Omer; Aliagaoglu, Cihangir; Calikoglu, Cagatay; Kantarci, Mecit; Atasoy, Mustafa; Alper, Fatih

    2006-01-01

    Neurofibromatosis type 1 disease is characterized by pigmented cutaneous lesions and generalized tumors of a neural crest origin and it may affect all the systems of the human body. Sphenoid dysplasia is one of the characteristics of this syndrome and it occurs in 5-10% of the cases; further, abnormalities of the sphenoid wings are often considered pathognomonic. However, complete agenesis of a sphenoid wing is very rare. We report here on an unusual case of neurofibromatosis type 1 disease with the associated absence of a sphenoid wing that was diagnosed by using multidetector computed tomography.

  5. Multidetector computed tomography-spectrum of blunt chest wall and lung injuries in polytraumatized patients.

    PubMed

    Peters, S; Nicolas, V; Heyer, C M

    2010-04-01

    Accidental injuries are the leading cause of death in the 15 to 44-year-old age group. Blunt chest trauma is often encountered in these patients and is associated with a mortality of up to 25%. Although conventional radiography still plays an important role in the initial emergency room setting, for follow-up in the intensive care unit, multidetector computed tomography has established itself as the standard imaging method for the evaluation of chest trauma patients. The following review presents salient radiological findings of the chest wall and shoulder girdle, thoracic spine, pleural space, and lung in polytraumatized patients.

  6. Neurologic applications of whole-brain volumetric multidetector computed tomography.

    PubMed

    Snyder, Kenneth V; Mokin, Maxim; Bates, Vernice E

    2014-02-01

    The introduction of computed tomography (CT) scanning in the 1970s revolutionized the way clinicians could diagnose and treat stroke. Subsequent advances in CT technology significantly reduced radiation dose, reduced metallic artifact, and achieved speeds that enable dynamic functional studies. The recent addition of whole-brain volumetric CT perfusion technology has given clinicians a powerful tool to assess parenchymal perfusion parameters as well as visualize dynamic changes in blood vessel flow throughout the brain during a single cardiac cycle. This article reviews clinical applications of volumetric multimodal CT that helped to guide and manage care.

  7. Patient doses using multidetector computed tomography scanners in Kenya.

    PubMed

    Korir, G K; Wambani, J S; Korir, I K

    2012-08-01

    Assessment of patient dose attributed to multislice computed tomography (CT) examination. A questionnaire method was developed and used in recording the patient dose and scanning parameters for the head, chest, abdomen and lumbar spine examinations. The patient doses due to brain, chest and abdomen examination were above the international diagnostic reference levels (DRLs) by factors of between one and four. The study demonstrated that the use of multislice CT elevates patient radiation dose, justifying the need for local optimised scanning protocols and the use of institutional DRL for dose management without affecting diagnostic image quality.

  8. Pineal region tumors: computed tomographic-pathologic spectrum

    SciTech Connect

    Futrell, N.N.; Osborn, A.G.; Cheson. B.D.

    1981-11-01

    While several computed tomographic (CT) studies of posterior third ventricular neoplasms have included descriptions of pineal tumors, few reports have concentrated on these uncommon lesions. Some authors have asserted that the CT appearance of many pineal tumors is virtually pathognomonic. A series of nine biopsy-proved pineal gland and eight other presumed tumors is presented that illustrates their remarkable heterogeneity in both histopathologic and CT appearance. These tumors included germinomas, teratocarcinomas, hamartomas, and other varieties. They had variable margination, attentuation, calcification, and suprasellar extension. Germinomas have the best response to radiation therapy. Biopsy of pineal region tumors is now feasible and is recommended for treatment planning.

  9. Computed tomographic spectrum of intracranial mycosis: correlation with histopathology

    SciTech Connect

    Whelan, M.A.; Stern, J.; deNapoli, R.A.

    1981-12-01

    Four cases of intracerebral fungal infection are reviewed. The clinical course is outlined, and the computed tomographic (CT) characteristics are analyzed in light of known pathological data. The CT appearance of intracranial mycosis is dependent on the type of fungus as well as the dominant infecting form, i.e., yeast or hyphae. The hyphal form leads predominantly to a CT pattern consistent with vascular occlusion and secondary abscess formation; the yeast form generally results in noncaseating granulomas, which appear on CT scan as nodular enhancing lesions. If the patient survives the acute infective process, these fungal lesions undergo a prolonged subacute phase, and may eventually calcify.

  10. Coronary computed tomographic angiography: current and future uses

    PubMed Central

    Kantor, Birgit; Kuzo, Ronald S.; Gerber, Thomas C.

    2009-01-01

    Coronary computed tomographic angiography (CCTA) is a direct but minimally invasive method of visualizing coronary arteries. Acceptable indications for this technique include the assessment of suspected or known coronary artery anomalies, the evaluation of chest pain syndromes in patients with non diagnostic stress tests or who are unable to exercise, and exclusion of an ischemic etiology in patients with unexplained left ventricular dysfunction. Assessment of coronary stents with a diameter of <3.0 mm and imaging of asymptomatic patients with a goal of establishing prognosis are currently not accepted indications for CCTA. PMID:20011235

  11. The UF series of tomographic computational phantoms of pediatric patients

    SciTech Connect

    Lee, Choonik; Williams, Jonathan L.; Lee, Choonsik; Bolch, Wesley E.

    2005-12-15

    Two classes of anthropomorphic computational phantoms exist for use in Monte Carlo radiation transport simulations: tomographic voxel phantoms based upon three-dimensional (3D) medical images, and stylized mathematical phantoms based upon 3D surface equations for internal organ definition. Tomographic phantoms have shown distinct advantages over the stylized phantoms regarding their similarity to real human anatomy. However, while a number of adult tomographic phantoms have been developed since the early 1990s, very few pediatric tomographic phantoms are presently available to support dosimetry in pediatric diagnostic and therapy examinations. As part of a larger effort to construct a series of tomographic phantoms of pediatric patients, five phantoms of different ages (9-month male, 4-year female, 8-year female, 11-year male, and 14-year male) have been constructed from computed tomography (CT) image data of live patients using an IDL-based image segmentation tool. Lungs, bones, and adipose tissue were automatically segmented through use of window leveling of the original CT numbers. Additional organs were segmented either semiautomatically or manually with the aid of both anatomical knowledge and available image-processing techniques. Layers of skin were created by adding voxels along the exterior contour of the bodies. The phantoms were created from fused images taken from head and chest-abdomen-pelvis CT exams of the same individuals (9-month and 4-year phantoms) or of two different individuals of the same sex and similar age (8-year, 11-year, and 14-year phantoms). For each model, the resolution and slice positions of the image sets were adjusted based upon their anatomical coverage and then fused to a single head-torso image set. The resolutions of the phantoms for the 9-month, 4-year, 8-year, 11-year, and 14-year are 0.43x0.43x3.0 mm, 0.45x0.45x5.0 mm, 0.58x0.58x6.0 mm, 0.47x0.47x6.00 mm, and 0.625x0.625x6.0 mm, respectively. While organ masses can be

  12. The UF series of tomographic computational phantoms of pediatric patients.

    PubMed

    Lee, Choonik; Williams, Jonathan L; Lee, Choonsik; Bolch, Wesley E

    2005-12-01

    Two classes of anthropomorphic computational phantoms exist for use in Monte Carlo radiation transport simulations: tomographic voxel phantoms based upon three-dimensional (3D) medical images, and stylized mathematical phantoms based upon 3D surface equations for internal organ definition. Tomographic phantoms have shown distinct advantages over the stylized phantoms regarding their similarity to real human anatomy. However, while a number of adult tomographic phantoms have been developed since the early 1990s, very few pediatric tomographic phantoms are presently available to support dosimetry in pediatric diagnostic and therapy examinations. As part of a larger effort to construct a series of tomographic phantoms of pediatric patients, five phantoms of different ages (9-month male, 4-year female, 8-year female, 11-year male, and 14-year male) have been constructed from computed tomography (CT) image data of live patients using an IDL-based image segmentation tool. Lungs, bones, and adipose tissue were automatically segmented through use of window leveling of the original CT numbers. Additional organs were segmented either semiautomatically or manually with the aid of both anatomical knowledge and available image-processing techniques. Layers of skin were created by adding voxels along the exterior contour of the bodies. The phantoms were created from fused images taken from head and chest-abdomen-pelvis CT exams of the same individuals (9-month and 4-year phantoms) or of two different individuals of the same sex and similar age (8-year, 11-year, and 14-year phantoms). For each model, the resolution and slice positions of the image sets were adjusted based upon their anatomical coverage and then fused to a single head-torso image set. The resolutions of the phantoms for the 9-month, 4-year, 8-year, 11-year, and 14-year are 0.43 x 0.43 x 3.0 mm, 0.45 x 0.45 x 5.0 mm, 0.58 x 0.58 x 6.0 mm, 0.47 X 0.47 x 6.00 mm, and 0.625 x 0.625 x 6.0 mm, respectively. While organ

  13. Sex estimation from sternal measurements using multidetector computed tomography.

    PubMed

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Inci, Ercan; Bilgili, Mustafa Gokhan; Solmaz, Dilek; Erdil, Irem; Can, Ismail Ozgur

    2014-12-01

    We aimed to show the utility and reliability of sternal morphometric analysis for sex estimation.Sex estimation is a very important step in forensic identification. Skeletal surveys are main methods for sex estimation studies. Morphometric analysis of sternum may provide high accuracy rated data in sex discrimination. In this study, morphometric analysis of sternum was evaluated in 1 mm chest computed tomography scans for sex estimation. Four hundred forty 3 subjects (202 female, 241 male, mean age: 44 ± 8.1 [distribution: 30-60 year old]) were included the study. Manubrium length (ML), mesosternum length (2L), Sternebra 1 (S1W), and Sternebra 3 (S3W) width were measured and also sternal index (SI) was calculated. Differences between genders were evaluated by student t-test. Predictive factors of sex were determined by discrimination analysis and receiver operating characteristic (ROC) analysis. Male sternal measurement values are significantly higher than females (P < 0.001) while SI is significantly low in males (P < 0.001). In discrimination analysis, MSL has high accuracy rate with 80.2% in females and 80.9% in males. MSL also has the best sensitivity (75.9%) and specificity (87.6%) values. Accuracy rates were above 80% in 3 stepwise discrimination analysis for both sexes. Stepwise 1 (ML, MSL, S1W, S3W) has the highest accuracy rate in stepwise discrimination analysis with 86.1% in females and 83.8% in males. Our study showed that morphometric computed tomography analysis of sternum might provide important information for sex estimation.

  14. Sex Estimation From Sternal Measurements Using Multidetector Computed Tomography

    PubMed Central

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Inci, Ercan; Bilgili, Mustafa Gokhan; Solmaz, Dilek; Erdil, Irem; Can, Ismail Ozgur

    2014-01-01

    Abstract We aimed to show the utility and reliability of sternal morphometric analysis for sex estimation. Sex estimation is a very important step in forensic identification. Skeletal surveys are main methods for sex estimation studies. Morphometric analysis of sternum may provide high accuracy rated data in sex discrimination. In this study, morphometric analysis of sternum was evaluated in 1 mm chest computed tomography scans for sex estimation. Four hundred forty 3 subjects (202 female, 241 male, mean age: 44 ± 8.1 [distribution: 30–60 year old]) were included the study. Manubrium length (ML), mesosternum length (2L), Sternebra 1 (S1W), and Sternebra 3 (S3W) width were measured and also sternal index (SI) was calculated. Differences between genders were evaluated by student t-test. Predictive factors of sex were determined by discrimination analysis and receiver operating characteristic (ROC) analysis. Male sternal measurement values are significantly higher than females (P < 0.001) while SI is significantly low in males (P < 0.001). In discrimination analysis, MSL has high accuracy rate with 80.2% in females and 80.9% in males. MSL also has the best sensitivity (75.9%) and specificity (87.6%) values. Accuracy rates were above 80% in 3 stepwise discrimination analysis for both sexes. Stepwise 1 (ML, MSL, S1W, S3W) has the highest accuracy rate in stepwise discrimination analysis with 86.1% in females and 83.8% in males. Our study showed that morphometric computed tomography analysis of sternum might provide important information for sex estimation. PMID:25501090

  15. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations*

    PubMed Central

    de Mello Júnior, Carlos Fernando; Araujo Neto, Severino Aires; de Carvalho Junior, Arlindo Monteiro; Rebouças, Rafael Batista; Negromonte, Gustavo Ramalho Pessoa; de Oliveira, Carollyne Dantas

    2016-01-01

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations. PMID:27403020

  16. Visibility of sutures of the orbit and periorbital region using multidetector computed tomography.

    PubMed

    Gufler, Hubert; Preiß, Markus; Koesling, Sabrina

    2014-01-01

    Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube current from 25 to 370 mAs, depending on the CT indication. The visibility of sutures was estimated according to a 4-point scale from "not visible" to "well visible". The chi-squared test was used to test the association of the visibility of sutures with the slice thickness, tube current, and age of patients. Statistical significance was assumed at p < 0.05. Overall, best visibility was found for the sutura frontozygomatica (98%), sutura frontonasalis (88.5%), and sutura sphenozygomatica (71.5%), followed by the sutura zygomaticomaxillaris (65.8%), sutura temporozygomatica (41.8%), sutura frontomaxillaris (44.5%), and sutura sphenofrontalis (31%). Poor visibility was found for the sutura frontolacrimalis (16.8%) and sutura frontoethmoidalis (1.3%). The sutura ethmoidomaxillaris, sutura lacrimomaxillaris, and sutura ethmoidolacrimalis were not visible. Although the sutures of the superior, lateral, and inferior orbit are well visible, those of the medial orbit are poorly visible on CT scans.

  17. Visibility of Sutures of the Orbit and Periorbital Region Using Multidetector Computed Tomography

    PubMed Central

    Preiß, Markus; Koesling, Sabrina

    2014-01-01

    Objective Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. Materials and Methods Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube current from 25 to 370 mAs, depending on the CT indication. The visibility of sutures was estimated according to a 4-point scale from "not visible" to "well visible". The chi-squared test was used to test the association of the visibility of sutures with the slice thickness, tube current, and age of patients. Statistical significance was assumed at p < 0.05. Results Overall, best visibility was found for the sutura frontozygomatica (98%), sutura frontonasalis (88.5%), and sutura sphenozygomatica (71.5%), followed by the sutura zygomaticomaxillaris (65.8%), sutura temporozygomatica (41.8%), sutura frontomaxillaris (44.5%), and sutura sphenofrontalis (31%). Poor visibility was found for the sutura frontolacrimalis (16.8%) and sutura frontoethmoidalis (1.3%). The sutura ethmoidomaxillaris, sutura lacrimomaxillaris, and sutura ethmoidolacrimalis were not visible. Conclusion Although the sutures of the superior, lateral, and inferior orbit are well visible, those of the medial orbit are poorly visible on CT scans. PMID:25469093

  18. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations.

    PubMed

    de Mello Júnior, Carlos Fernando; Araujo Neto, Severino Aires; de Carvalho Junior, Arlindo Monteiro; Rebouças, Rafael Batista; Negromonte, Gustavo Ramalho Pessoa; de Oliveira, Carollyne Dantas

    2016-01-01

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations.

  19. Computed tomographic arthrography of the normal dromedary camel carpus.

    PubMed

    Badawy, Adel M; Marzok, Mohamed A; Eshra, Eman A

    2016-05-18

    The aim of this prospective cadaveric study was to provide a detailed computed tomographic (CT) reference of the carpal joint in healthy dromedary camels. Twelve forelimbs of six apparently healthy camels were used. Computed tomographic imaging of 12 normal cadaveric camel carpal joints was performed before and after intra-articular administration of iodinated contrast medium. Transverse CT images were reconstructed in dorsal and parasagittal planes. The six carpal bones, the radial trochlea, and the proximal articular surface of the metacarpal bones were clearly visible on CT images with the bone setting window. Radiocarpal, carpometacarpal, transverse intercarpal, medial and lateral palmer intercarpal, middle intercarpal, accessory carpoulnar and medial and lateral collateral ligaments, carpal canal, joint capsule, and the extensor and flexor tendons were identified on CT images with the soft-tissue setting window. Postcontrast CT images provided better delineation of intercarpal ligaments, the capsular compartments and recesses. Results indicated that the osseous and the clinically important soft tissue structures of the dromedary camel carpal joint could be identified using CT and CT arthrography. The CT data of this study will serve as a basis for diagnosis of carpal problems in camels.

  20. Visual phrase learning and its application in computed tomographic colonography.

    PubMed

    Wang, Shijun; McKenna, Matthew; Wei, Zhuoshi; Liu, Jiamin; Liu, Peter; Summers, Ronald M

    2013-01-01

    In this work, we propose a visual phrase learning scheme to learn an optimal visual composite of anatomical components/parts from CT colonography images for computer-aided detection. The key idea is to utilize the anatomical parts of human body from medical images and associate them with biological targets of interest (organs, cancers, lesions, etc.) for joint detection and recognition. These anatomical parts of the human body are not necessarily near each other regarding their physical locations, and they serve more like a human body navigation system for detection and recognition. To show the effectiveness of the proposed learning scheme, we applied it to two sub-problems in computed tomographic colonography: teniae detection and classification of colorectal polyp candidates. Experimental results showed its efficacy.

  1. Computer-aided interpretation approach for optical tomographic images

    NASA Astrophysics Data System (ADS)

    Klose, Christian D.; Klose, Alexander D.; Netz, Uwe J.; Scheel, Alexander K.; Beuthan, Jürgen; Hielscher, Andreas H.

    2010-11-01

    A computer-aided interpretation approach is proposed to detect rheumatic arthritis (RA) in human finger joints using optical tomographic images. The image interpretation method employs a classification algorithm that makes use of a so-called self-organizing mapping scheme to classify fingers as either affected or unaffected by RA. Unlike in previous studies, this allows for combining multiple image features, such as minimum and maximum values of the absorption coefficient for identifying affected and not affected joints. Classification performances obtained by the proposed method were evaluated in terms of sensitivity, specificity, Youden index, and mutual information. Different methods (i.e., clinical diagnostics, ultrasound imaging, magnet resonance imaging, and inspection of optical tomographic images), were used to produce ground truth benchmarks to determine the performance of image interpretations. Using data from 100 finger joints, findings suggest that some parameter combinations lead to higher sensitivities, while others to higher specificities when compared to single parameter classifications employed in previous studies. Maximum performances are reached when combining the minimum/maximum ratio of the absorption coefficient and image variance. In this case, sensitivities and specificities over 0.9 can be achieved. These values are much higher than values obtained when only single parameter classifications were used, where sensitivities and specificities remained well below 0.8.

  2. Computer-aided interpretation approach for optical tomographic images.

    PubMed

    Klose, Christian D; Klose, Alexander D; Netz, Uwe J; Scheel, Alexander K; Beuthan, Jurgen; Hielscher, Andreas H

    2010-01-01

    A computer-aided interpretation approach is proposed to detect rheumatic arthritis (RA) in human finger joints using optical tomographic images. The image interpretation method employs a classification algorithm that makes use of a so-called self-organizing mapping scheme to classify fingers as either affected or unaffected by RA. Unlike in previous studies, this allows for combining multiple image features, such as minimum and maximum values of the absorption coefficient for identifying affected and not affected joints. Classification performances obtained by the proposed method were evaluated in terms of sensitivity, specificity, Youden index, and mutual information. Different methods (i.e., clinical diagnostics, ultrasound imaging, magnet resonance imaging, and inspection of optical tomographic images), were used to produce ground truth benchmarks to determine the performance of image interpretations. Using data from 100 finger joints, findings suggest that some parameter combinations lead to higher sensitivities, while others to higher specificities when compared to single parameter classifications employed in previous studies. Maximum performances are reached when combining the minimum/maximum ratio of the absorption coefficient and image variance. In this case, sensitivities and specificities over 0.9 can be achieved. These values are much higher than values obtained when only single parameter classifications were used, where sensitivities and specificities remained well below 0.8.

  3. Computed tomography angiography: state-of-the-art imaging using multidetector-row technology.

    PubMed

    Napoli, Alessandro; Fleischmann, Dominik; Chan, Frandics P; Catalano, Carlo; Hellinger, Jeffrey C; Passariello, Roberto; Rubin, Geoffrey D

    2004-01-01

    Multidetector-row computed tomography (MDCT) is an essential diagnostic modality for many clinical algorithms. This is particularly true with regard to the evaluation of cardiovascular disease. As a result of increased image acquisition speed, improved spatial resolution, and greater scan volume, MDCT angiography (computed tomography angiography [CTA]) has become an excellent noninvasive imaging technique, replacing intra-arterial digital subtraction angiography for most vascular territories. The clinical success of CTA depends on precise synchronization of image acquisition with optimal vascular enhancement. As technology continuously evolves, however, this task can be challenging. It remains important to have a fundamental knowledge of the principles behind technical parameters and contrast medium administration. This article reviews these essential principles, followed by an overview of current clinical applications.

  4. An Unusual Left Ventricular Outflow Pseudoaneurysm: Usefulness of Echocardiography and Multidetector Computed Tomography for Surgical Repair

    SciTech Connect

    Da Col, Uberto; Ramoni, Enrico Di Bella, Isidoro; Ragni, Temistocle

    2009-01-15

    Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and it arises posteriorly to the aortic root. Due to these anatomical features, its imaging assessment is challenging and surgical repair requires complex procedures. An unusual case of LVOT pseudoaneurysm is described. It was detected by transthoracic ecocardiography 7 months after aortic root replacement for acute endocarditis. Multidetector computed tomography (MDCT) confirmed the presence of a pouch located between the aortic root and the right atrium. Computed tomography also detected the origin of the pseudoaneurysm from the muscular interventricular septum of the LVOT, rather below the aortic valve plane. It was repaired with an extracardiac surgical approach, sparing the aortic root bioprosthesis previously implanted. The high-resolution three-dimensional details provided by the preoperative MDCT allowed us to plan a simple and effective surgical strategy.

  5. Cystic tumors of the fetal and neonatal cerebrum: ultrasound and computed tomographic evaluation

    SciTech Connect

    Sauerbrei, E.E.; Cooperberg, P.L.

    1983-06-01

    Three patients (two infants and one fetus) had complex (partially cystic and partially solid) supratentorial tumors involving the brain. The sonographic and computed tomographic appearance in each of these lesions is described and discussed. The cystic component of each lesion was equally well delineated by the two modalities, whereas the peripheral solid component was better defined by contrast-enhanced computed tomographic scans.

  6. Evaluation of contraindications and efficacy of oral Beta blockade before computed tomographic coronary angiography.

    PubMed

    de Graaf, Fleur R; Schuijf, Joanne D; van Velzen, Joëlla E; Kroft, Lucia J; de Roos, Albert; Sieders, Allard; Jukema, J Wouter; Schalij, Martin J; van der Wall, Ernst E; Bax, Jeroen J

    2010-03-15

    Multidetector computed tomographic coronary angiography (CTA) image quality is inversely related to the heart rate (HR). As a result beta-blocking medication is routinely administered before investigation. In the present study, the use, contraindications, and efficacy of prescan beta blockade with regard to HR reduction and CTA image quality were assessed. In 537 patients referred for CTA, the baseline HR and blood pressure were measured on arrival, and contraindications for beta blockade were noted. Unless contraindicated, a single dose of metoprolol was administered orally 1 hour before data acquisition in patients with a HR of > or =65 beats/min according to a predefined medication protocol. After 1 hour, the HR was remeasured. A total of 283 patients (53%) had a HR of > or =65 beats/min. In this group, beta blockade was contraindicated in 46 patients (16%). Metoprolol was administered to the remaining 237 patients. However, 26 patients (11%) received suboptimal (lower dose than prescribed by protocol) beta blockade because of contraindications. Of the 211 patients receiving optimal beta blockade, 57 (27%) did not achieve the target HR. Of the patients with contraindications to beta blockade, 43 (60%) did not achieve the target HR. Compared to patients with optimal HR control, those receiving no or suboptimal beta blockade because of contraindications had significantly fewer examinations of good image quality (40% vs 74%, p <0.001), and significantly more examinations of poor image quality (20% vs 6%, p <0.001). In conclusion, most patients require HR reduction before CTA. Contraindications to beta blockade are present in a substantial proportion of patients. This results in suboptimal HR control and image quality, indicating the need for alternative approaches for HR reduction.

  7. Computed tomographic study of hormone-secreting microadenomas

    SciTech Connect

    Hemminghytt, S.; Kalkhoff, R.K.; Daniels, D.L.; Williams, A.L.; Grogan, J.P.; Haughton, V.M.

    1983-01-01

    A review was made of the computed tomographic (CT) studies of 33 patients with hormone-secreting microadenomas that had been verified by transsphenoidal surgery and endocrinologic evaluation. In previous studies in small series of patients, the CT appearance of pituitary microadenomas has been reported as hypodense, isodense, and hyperdense. In this study, CT showed a region of diminished enhancement and ususally an enlarged pituitary gland in cases of prolactin-secreting adenomas. HGH- or ACTH-secreting adenomas were less consistently hypodense. It is concluded that hypodensity and enlargement in the pituitary gland are the most useful criteria for identification of microadenomas. Some technical factors that may affect the CT appearance of microadenomas and lead to conflicting reports are discussed.

  8. Central nervous system leukemia and lymphoma: computed tomographic manifestations

    SciTech Connect

    Pagani, J.J.; Libshitz, H.I.; Wallace, S.; Hayman, L.A.

    1981-12-01

    Computed tomographic (CT) abnormalities in the brain were identified in 31 of 405 patients with leukemia or lymphoma. Abnormalities included neoplastic masses (15), hemorrhage (nine), abscess (two), other brain tumors (four), and methotrexate leukoencephalopathy (one). CT was normal in 374 patients including 148 with meningeal disease diagnosed by cerebrospinal fluid cytologic examination. Prior to treatment, malignant masses were isodense or of greater density with varying amounts of edema. Increase in size or number of the masses indicated worsening. Response to radiation and chemotherapy was manifested by development of a central low density region with an enhancing rim. CT findings correlated with clinical and cerebrospinal fluid findings. The differential diagnosis of the various abnormalities is considered.

  9. [Evaluation of cardiac tumors by multidetector computed tomography and magnetic resonance imaging].

    PubMed

    Mercado-Guzman, Marcela P; Meléndez-Ramírez, Gabriela; Castillo-Castellon, Francisco; Kimura-Hayama, Eric

    Cardiac tumors, are a rare pathology (0.002-0.3%) in all age groups, however, they have a clinic importance, due the affected organ. They are classified in primary (benign or malignant) and secondary (metastasis) types. Among primary type, mixoma, is the most common benign tumor, and sarcoma represents most of the malignant injuries. Cardiac metastasis are more frequent than primary tumors. Clinic effects of cardiac tumors are unspecific and vary according their location, size and agresivity. The use of Multidetector Computed Tomography (MDCT) and Magnetic Resonance Imaging (MRI) assist on the location, sizing, anatomical relationships and the compromise of adyacents structures, besides, MRI is useful for tissue characterization of the tumor. Due to the previous reasons, studies based on noninvasive cardiovascular imaging, have an important role on the characterization of these lesions and the differential diagnosis among them.

  10. [Review of pre- and post-treatment multidetector computed tomography findings in abdominal aortic aneurysms].

    PubMed

    Casula, E; Lonjedo, E; Cerverón, M J; Ruiz, A; Gómez, J

    2014-01-01

    The increase in the frequency of abdominal aortic aneurysms (AAA) and the widely accepted use of endovascular aneurysm repair (EVAR) as a first-line treatment or as an alternative to conventional surgery make it necessary for radiologists to have thorough knowledge of the pre- and post-treatment findings. The high image quality provided by multidetector computed tomography (MDCT) enables CT angiography to play a fundamental role in the study of AAA and in planning treatment. The objective of this article is to review the cases of AAA in which CT angiography was the main imaging technique, so that radiologists will be able to detect the signs related to this disease, to diagnose it, to plan treatment, and to detect complications in the postoperative period.

  11. [Multidetector computed tomography assessment of cardiac comorbidity in patients with chronic obstructive pulmonary disease].

    PubMed

    Bastarrika, G; Simón-Yarza, I; Viteri-Ramírez, G; Etxano, J; Slon, P J

    2013-01-01

    Cardiac comorbidity is one of the most important prognostic factors in lung disease, especially in chronic obstructive pulmonary disease (COPD). The imaging techniques available for the study of this systemic manifestation concomitant with COPD include heart catheterization, transthoracic echocardiography, and magnetic resonance imaging. Multidetector computed tomography (MDCT) represents a significant advance in this field because it enables the acquisition of simultaneous studies of the cardiopulmonary anatomy that go beyond anatomic and morphologic analysis to include a functional approach to this condition. In this article, we review the practical aspects necessary to evaluate cardiac comorbidity in patients with COPD, both from the point of view of pulmonary hypertension and of the analysis of ventricular dysfunction and coronary heart disease. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  12. Diagnostic Yield of Multidetector Computed Tomography in Patients with Acute Spondylodiscitis.

    PubMed

    Rausch, Vanessa Hanna; Bannas, Peter; Schoen, Gerhard; Froelich, Andreas; Well, Lennart; Regier, Marc; Adam, Gerhard; Henes, Frank Oliver Gerhard

    2017-03-01

    Purpose To determine the value of multidetector computed tomography (MDCT) in patients with acute spondylodiscitis. Methods and Materials For data acquisition, we searched our radiological database for all patients who had undergone magnetic resonance imaging (MRI) for suspected spondylodiscitis between 2007 and 2015 (n = 325). For further analyses, we included all patients (n = 67) who initially underwent MDCT prior to MRI. Overall accuracy, sensitivity, specificity and positive and negative predictive values were calculated for MDCT and, separately, for contrast-enhanced CT (CECT, n = 36) and for non-enhanced CT (NECT, n = 31). MRI together with clinical evaluation served as the standard of reference.

  13. Focused assessment with sonography for trauma (FAST) versus multidetector computed tomography in hemodynamically stable emergency patients.

    PubMed

    Fornell Pérez, R

    2017-02-10

    This critically appraised topic (CAT) study aims to evaluate the quality and extent of the scientific evidence that supports the use of focused assessment with sonography for trauma (FAST) versus multidetector computed tomography (MDCT) in hemodynamically stable trauma patients in the emergency room. An efficient search of the literature yielded several recent articles with a high level of evidence. The CAT study concludes that FAST is an acceptable initial imaging test in hemodynamically stable patients, although its performance is limited in certain circumstances. The decision whether to use MDCT should be determined by evaluating the patient's degree of instability and the distance to the MDCT scanner. Nevertheless, few articles address the question of the distance to MDCT scanners in emergency departments.

  14. [Multidetector computed angiography: a new era in the evaluation of pulmonary thromboembolism].

    PubMed

    Kimura-Hayama, Eric; Canseco-León, Nadia; Santiago-Serra, Rogerio

    2011-01-01

    Pulmonary embolism is a major cause of worldwide morbidity and mortality. It is a common cause of cardiovascular care, second only to ischemic heart disease and cerebrovascular events, with a prevalence of 3 to 15%, and its diagnosis remains crucial in the early hours of symptom onset. Given its clinical variability, it has become a diagnostic challenge in the emergency rooms, thus a fast and accurate paraclinical evaluation is needed. The aim of the present manuscript is to review the current role of imaging methods, in particular multidetector computed tomography, their advantages and limitations and the imaging findings of acute or chronic pulmonary thromboembolism. Finally, diagnostic algorithms based on the Thoracic Fleischner Society and the group of PIOPED II study investigators, are shown.

  15. Sex differences in aortic valve calcification measured by multidetector computed tomography in aortic stenosis.

    PubMed

    Aggarwal, Shivani R; Clavel, Marie-Annick; Messika-Zeitoun, David; Cueff, Caroline; Malouf, Joseph; Araoz, Philip A; Mankad, Rekha; Michelena, Hector; Vahanian, Alec; Enriquez-Sarano, Maurice

    2013-01-01

    Aortic valve calcification (AVC) is the intrinsic mechanism of valvular obstruction leading to aortic stenosis (AS) and is measurable by multidetector computed tomography. The link between sex and AS is controversial and that with AVC is unknown. We prospectively performed multidetector computed tomography in 665 patients with AS (aortic valve area, 1.05±0.35 cm(2); mean gradient, 39±19 mm Hg) to measure AVC and to assess the impact of sex on the AVC-AS severity link in men and women. AS severity was comparable between women and men (peak aortic jet velocity: 4.05±0.99 versus 3.93±0.91 m/s, P=0.11; aortic valve area index: 0.55±0.20 versus 0.56±0.18 cm(2)/m(2); P=0.46). Conversely, AVC load was lower in women versus men (1703±1321 versus 2694±1628 arbitrary units; P<0.0001) even after adjustment for their smaller body surface area or aortic annular area (both P<0.0001). Thus, odds of high-AVC load were much greater in men than in women (odds ratio, 5.07; P<0.0001). Although AVC showed good associations with hemodynamic AS severity in men and women (all r>0.67; P<0.0001), for any level of AS severity measured by peak aortic jet velocity or aortic valve area index, AVC load, absolute or indexed, was higher in men versus women (all P≤0.01). In this large AS population, women incurred similar AS severity than men for lower AVC loads, even after indexing for their smaller body size. Hence, the relationship between valvular calcification process and AS severity differs in women and men, warranting further pathophysiological inquiry. For AS severity diagnostic purposes, interpretation of AVC load should be different in men and in women.

  16. Impact of Calcium Score on Agreement Between Multidetector Computed Tomography and Invasive Coronary Angiography.

    PubMed

    de Agustín, José Alberto; Gómez de Diego, José Juan; Marcos-Alberca, Pedro; Mahía, Patricia; Rodrigo, José Luis; Luaces, María; Núñez-Gil, Iván Javier; Ferreiros, Joaquín; Bustos, Ana; Cabeza, Beatriz; García-Fernández, Miguel Ángel; Macaya, Carlos; Pérez de Isla, Leopoldo

    2017-05-18

    Multidetector computed tomography (MDCT) has been demonstrated as a feasible alternative to invasive coronary angiography (ICA). However, contradictory results have been reported regarding the effect of coronary artery calcium score (CS) on the diagnostic accuracy of MDCT. Our aim was to assess the agreement of MDCT and ICA and to evaluate the influence of CS on this agreement. We enrolled 266 consecutive patients who underwent evaluation with 64-slice MDCT and ICA. Standard CS software tools were used to calculate the Agatston score. Stenosis was qualitatively classified as mild, moderate, or severe by 1 blinded observer and the results were compared with those of ICA, which was used as the gold standard. The mean age of the patients was 65.4 ± 11.2 years, and 188 patients (70.3%) were men. A total of 484 segments with coronary stenosis ≥ mild were qualitatively evaluated and quantified with MDCT. Noninvasive measurements were concordant with ICA in 402 stenoses (83.05%; Kappa, 0.684), with no significant differences between vessels and with no statistically significant influence of CS on this agreement (OR, 0.93; 95%CI, 0.76-1.09; P = .21). Multidetector computed tomography had high sensitivity, specificity, positive predictive value, and negative predictive value on a per-segment, per-vessel, and per-patient basis. Non-ICA using MDCT showed good agreement with ICA in the qualitative quantification coronary stenosis and CS had no significant impact on this agreement. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  17. Regional Comparison of Multiphase Computed Tomographic Angiography and Computed Tomographic Perfusion for Prediction of Tissue Fate in Ischemic Stroke.

    PubMed

    d'Esterre, Christopher D; Trivedi, Anurag; Pordeli, Pooneh; Boesen, Mari; Patil, Shivanand; Hwan Ahn, Seong; Najm, Mohamed; Fainardi, Enrico; Shankar, Jai Jai Shiva; Rubiera, Marta; Almekhlafi, Mohammed A; Mandzia, Jennifer; Khaw, Alexander V; Barber, Philip; Coutts, Shelagh; Hill, Michael D; Demchuk, Andrew M; Sajobi, Tolulope; Forkert, Nils D; Goyal, Mayank; Lee, Ting-Yim; Menon, Bijoy K

    2017-04-01

    Within different brain regions, we determine the comparative value of multiphase computed tomographic angiography (mCTA) and computed tomographic perfusion (CTP) in predicting follow-up infarction. Patients with M1-middle cerebral artery occlusions were prospectively included in this multicenter study. Regional analysis was performed for each patient within Alberta Stroke Program Early CT Score regions M2 to M6. Regional pial vessel filling was assessed on mCTA in 3 ways: (1) Washout of contrast within pial vessels; (2) Extent of maximal pial vessel enhancement compared with contralateral hemisphere; (3) Delay in maximal pial vessel enhancement compared with contralateral hemisphere. Cerebral blood flow, cerebral blood volume, and Tmax data were extracted within these Alberta Stroke Program Early CT Score regions. Twenty-four- to 36-hour magnetic resonance imaging/CT was assessed for infarct in each Alberta Stroke Program Early CT Score region (defined as >20% infarction within that region). Mixed effects logistic regression models were used to compare mCTA and CTP parameters when predicting brain infarction. Area under the receiver operating characteristics was used to assess discriminative value of statistical models. Seventy-seven patients were included. mCTA parameter washout and CTP parameter Tmax were significantly associated with follow-up infarction in all models (P<0.05). The area under the receiver operating characteristic for mCTA models ranged from 92% to 94% and was not different compared with all CTP models (P>0.05). Mean Tmax and cerebral blood volume values were significantly different between each washout score (P<0.01) and each delay score category (P<0.01). Mean Tmax, cerebral blood flow, and cerebral blood volume values were significantly different between each extent score category (P<0.05). Similar to CTP, multiphase CTA can be used to predict tissue fate regionally in acute ischemic stroke patients. © 2017 American Heart Association, Inc.

  18. An interactive, computer-based atlas of neurologic positron emission tomographic studies for use in teaching.

    PubMed

    Berlangieri, S U; Schifter, T; Hoffman, J M; Hawk, T C; Hamblen, S M; Coleman, R E

    1993-06-01

    Recent developments in personal computer hardware and software allow the manipulation of radiologic images. We developed an interactive, computer-based atlas of clinical neurologic positron emission tomographic studies for use as an educational resource. A personal computer and multimedia software were used to assemble the clinical case studies. For each clinical case, the user had available the clinical history, positron emission tomographic and correlative anatomic images, study interpretation, discussion, and references. The clinical cases were selected for their educational value, either as a representative example of an abnormality or for their ability to illustrate a common pitfall in positron emission tomographic imaging of the brain.

  19. Computed Tomographic Exploration of the Middle Ethmoidal Artery

    PubMed Central

    Mason, Eric; Solares, C. Arturo; Carrau, Ricardo L.; Figueroa, Ramon

    2015-01-01

    Objectives The integral involvement of sinus and skull base surgeries in the field of otolaryngology makes the endonasal vasculature including the ethmoidal arteries important to consider. The anterior ethmoidal artery (AEA) and posterior ethmoidal artery (PEA) are well-known entities, yet the relatively recent notion of accessory or middle ethmoidal vessels complicates our understanding of this arterial system. Study Design Radiographic study. Methods Fifty computed tomographic angiographies were studied for the presence of accessory/middle ethmoidal arteries (MEAs). If contrasted arteries were not visualized reliably, foramina were accepted as evidence of arteries. The accessory arteries/foramina were then compared with the locations of the AEA and PEA. Results A total of 19 of the 50 patient samples studied had evidence of a right, left, or bilateral middle ethmoidal vessels (38%). Overall, 26 arteries total were identified out of the 100 sides (26%). Unilateral middle arteries were more common than bilateral, and right sided were more common than left. There was no evidence of multiple MEAs on a given side. Conclusion The endonasal surgeon must be cognizant of the possible presence of MEAs. These arteries should be considered when working in the medial orbit and anterior skull base region. PMID:26401479

  20. Adoption of Computed Tomographic Colonography by U.S. Hospitals

    PubMed Central

    McHugh, Megan; Osei-Anto, Awo; Klabunde, Carrie N.; Galen, Barbara A.

    2010-01-01

    Purpose Computed tomographic colonography (CTC) is a new non-invasivetechnology proposed as an option for colorectal cancer screening. The purpose of this study was to identify the percent of U.S. hospitals that offered CTC between 2005 and 2008 and factors that motivated or impeded adoption. Methods We analyzed data on the provision of colorectal cancer screening services by non-federal, general hospitals using the 2005 – 2008 American Hospital Association Annual Surveys. Additionally, in 2009, we conducted exploratory interviews with representatives from radiology departments at nine hospitals – six that provided CTC and three that did not. Results In 2008, 17% of hospitals offered CTC, up from 13% in 2005. Sixty-nine percent of hospitals that offered CTC in 2008 also offered optical colonoscopy services. Factors motivating adoption of CTC included a desire to provide an alternative screening option for frail, elderly patients and patients with a failed optical colonoscopy; long waits for optical colonoscopy; and promising evidence on CTC published in peer-reviewed literature. Lack of reimbursement was a commonly-cited barrier. Conclusion Growth of CTC services at U.S. hospitals occurred even in the absence of Medicare coverage or agreement among national guideline-setting organizations regarding CTC’s use in screening. Almost one-third of hospitals that offer CTC do not offer optical colonoscopy, and may not be prepared to provide adequate follow-up for patients with failed CTCs. PMID:21371666

  1. Current experience with computed tomographic cystography and blunt trauma.

    PubMed

    Deck, A J; Shaves, S; Talner, L; Porter, J R

    2001-12-01

    We present our experience with computed tomographic (CT) cystography for the diagnosis of bladder rupture in patients with blunt abdominal and pelvic trauma and compare the results of CT cystography to operative exploration. We identified all blunt trauma patients diagnosed with bladder rupture from January 1992 to September 1998. We also reviewed the radiology computerized information system (RIS) for all CT cystograms performed for the evaluation of blunt trauma during the same time period. The medical records and pertinent radiographs of the patients with bladder rupture who underwent CT cystography as part of their admission evaluation were reviewed. Operative findings were compared to radiographic findings. Altogether, 316 patients had CT cystograms as part of an initial evaluation for blunt trauma. Of these patients, 44 had an ultimate diagnosis of bladder rupture; 42 patients had CT cystograms indicating bladder rupture. A total of 28 patients underwent formal bladder exploration; 23 (82%) had operative findings that exactly (i.e., presence and type of rupture) matched the CT cystogram interpretation. The overall sensitivity and specificity of CT cystography for detection of bladder rupture were 95% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 78% and 99%, respectively. CT cystography provides an expedient evaluation for bladder rupture caused by blunt trauma and has an accuracy comparable to that reported for plain film cystography. We recommend CT cystography over plain film cystography for patients undergoing CT evaluation for other blunt trauma-related injuries.

  2. Computed tomographic characteristics of eosinophilic pulmonary granulomatosis in five dogs.

    PubMed

    Fina, Caroline; Vignoli, Massimo; Terragni, Rossella; Rossi, Federica; Wisner, Erik; Saunders, Jimmy H

    2014-01-01

    Canine pulmonary eosinophilic granulomatosis is a rare inflammatory pulmonary disease characterized by formation of eosinophilic granulomas that tend to obliterate the normal pulmonary architecture. The purpose of this retrospective study was to describe the CT characteristics of confirmed idiopathic pulmonary eosinophilic granulomatosis in a group of dogs. Five dogs met inclusion criteria. All patients were young adult dogs of variable breeds. No dog had concurrent occult heartworm disease. Computed tomographic characteristics most commonly included pulmonary masses and nodules of variable size, and lesions were most commonly located in the caudal lung lobes. Four dogs had large pulmonary masses with or without additional nodules and one dog had nodular lesions disseminated throughout the entire lung parenchyma. All large eosinophilic granulomas were smoothly margined, heterogeneous pulmonary masses displaying heterogeneous contrast enhancement. A honeycomb-like enhancement pattern was observed in all but one mass and consisted of multiple hyperattenuating rims delineating central hypoattenuating areas, suggestive of bronchiectatic lung with peripheral enhancing airway walls and fluid-filled, necrotic bronchial lumen. One dog had evidence of tracheobronchial lymphadenopathy. Findings indicated that canine eosinophilic pulmonary granulomatosis should be included as a differential diagnosis for dogs with CT characteristics of multiple pulmonary masses and/or nodules in caudal lung lobes, and a honeycomb-like enhancement pattern in masses after intravenous administration of iodinated contrast medium.

  3. Automatic delineation of the diaphragm in computed tomographic images.

    PubMed

    Rangayyan, Rangaraj M; Vu, Randy H; Boag, Graham S

    2008-10-01

    Segmentation of the internal organs in medical images is a difficult task. By incorporating a priori information regarding specific organs of interest, results of segmentation may be improved. Landmarking (i.e., identifying stable structures to aid in gaining more knowledge concerning contiguous structures) is a promising segmentation method. Specifically, segmentation of the diaphragm may help in limiting the scope of segmentation methods to the abdominal cavity; the diaphragm may also serve as a stable landmark for identifying internal organs, such as the liver, the spleen, and the heart. A method to delineate the diaphragm is proposed in the present work. The method is based upon segmentation of the lungs, identification of the lower surface of the lungs as an initial representation of the diaphragm, and the application of least-squares modeling and deformable contour models to obtain the final segmentation of the diaphragm. The proposed procedure was applied to nine X-ray computed tomographic (CT) exams of four pediatric patients with neuroblastoma. The results were evaluated against the boundaries of the diaphragm as identified independently by a radiologist. Good agreement was observed between the results of segmentation and the reference contours drawn by the radiologist, with an average mean distance to the closest point of 5.85 mm over a total of 73 CT slices including the diaphragm.

  4. Optimization of radiation dose reduction in cardiac computed tomographic angiography.

    PubMed

    Entrikin, Daniel W; Leipsic, Jonathon A; Carr, J Jeffrey

    2011-01-01

    Cardiac computed tomographic angiography (CCTA) has evolved at an unprecedented pace over the past decade, during which time it has proven to be an accurate and effective tool for imaging of the heart in a growing list of clinical applications. However, the rapid growth in the use of CT imaging in general has prompted appropriate concerns regarding increasing medical radiation exposure to patients, particularly with regard to potential long-term risks of radiation-induced malignancy on both individual and population levels. As with all medical imaging modalities, imaging the heart with CCTA should be performed in a manner that achieves diagnostic image quality while maintaining patient radiation exposure as low as reasonably achievable (As Low As Reasonably Achievable [ALARA] principle). The goal of this article is to provide the reader with a wide-ranging review of both primary and secondary techniques that are currently available to minimize patient radiation exposure. Some of the techniques described in this article are universal, whereas others may be scanner specific. By gaining a thorough understanding of the various tools and methodologies employed for reduction of radiation exposure, the cardiac imager should be able to formulate CCTA protocols appropriate for their equipment and their clinical applications, in a manner that optimally preserves diagnostic image quality and minimizes patient radiation dose.

  5. Computed tomographic findings of fungal rhinitis and sinusitis in cats.

    PubMed

    Karnik, Ketaki; Reichle, Jean K; Fischetti, Anthony J; Goggin, Justin M

    2009-01-01

    The computed tomographic (CT) findings of fungal rhinitis/sinusitis in cats were characterized. The CT images of 10 cats ranging in age from 7 to 13 years were examined. The mean age was 10.8 years and all were neutered males. Nasal aspergillosis was diagnosed in five cats, cryptococcosis in three cats, hyalohyphomycosis in one cat, and trichosporonosis in one cat. Bilateral disease was present in eight cats, seven had abnormal soft tissue attenuation in two-thirds of the nasal cavity, and six had turbinate lysis. Seven cats had also lysis of the hard palate, nasal septum, or frontal bone. One cat had lysis of the cribriform plate. Five of the nine cats whose lymph nodes were imaged had lymph node enlargement. There was contrast medium enhancement in the nasal cavity in all cats, with either a primarily peripheral rim or heterogeneous pattern. There appears to be an overlap of clinical signs, age, and CT features of cats with nasal neoplasia and those with fungal rhinitis/ sinusitis.

  6. Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography

    PubMed Central

    Soukup, Jason W.; Drees, Randi; Koenig, Lisa J.; Snyder, Christopher J.; Hetzel, Scott; Miles, Chanda R.; Schwarz, Tobias

    2016-01-01

    Summary The objective of this blinded study was to validate the use of cone beam computed tomography (CT) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT. Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methyl methacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxilla segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored. In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting, cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT. PMID:26415384

  7. Comparison of the Diagnostic Image Quality of the Canine Maxillary Dentoalveolar Structures Obtained by Cone Beam Computed Tomography and 64-Multidetector Row Computed Tomography.

    PubMed

    Soukup, Jason W; Drees, Randi; Koenig, Lisa J; Snyder, Christopher J; Hetzel, Scott; Miles, Chanda R; Schwarz, Tobias

    2015-01-01

    The objective of this blinded study was to validate the use of cone beam computed tomography (C) for imaging of the canine maxillary dentoalveolar structures by comparing its diagnostic image quality with that of 64-multidetector row CT Sagittal slices of a tooth-bearing segment of the maxilla of a commercially purchased dog skull embedded in methylmethacrylate were obtained along a line parallel with the dental arch using a commercial histology diamond saw. The slice of tooth-bearing bone that best depicted the dentoalveolar structures was chosen and photographed. The maxillary segment was imaged with cone beam CT and 64-multidetector row CT. Four blinded evaluators compared the cone beam CT and 64-multidetector row CT images and image quality was scored as it related to the anatomy of dentoalveolar structures. Trabecular bone, enamel, dentin, pulp cavity, periodontal ligament space, and lamina dura were scored In addition, a score depicting the evaluators overall impression of the image was recorded. Images acquired with cone beam CT were found to be significantly superior in image quality to images acquired with 64-multidetector row CT overall, and in all scored categories. In our study setting cone beam CT was found to be a valid and clinically superior imaging modality for the canine maxillary dentoalveolar structures when compared to 64-multidetector row CT.

  8. Quadricuspid pulmonary valve in an adult patient identified by transthoracic echocardiography and multi-detector computed tomography.

    PubMed

    Jung, Soo-Yeon

    2015-01-01

    Quadricuspid pulmonary valve is a rare congenital heart disease. It is infrequently associated with significant clinical complications and tends to be clinically silent. Because of its benign nature, it has been diagnosed mainly post mortem. Its diagnosis by transthoracic echocardiography is very difficult because of the anatomical features. We describe a case of quadricuspid pulmonary valve diagnosed by transthoracic echocardiography and electrocardiography-gated multi-detector row computed tomography.

  9. Uncommon causes of acute abdominal pain: multidetector computed tomography pearls and pitfalls for the radiologist on call.

    PubMed

    Mellado, José María; Martín, Joaquín; Solanas, Susana; Yanguas, Nerea; Salceda, Javier; Cozcolluela, María Rosa

    2012-01-01

    We review uncommon causes of acute abdominal pain in which inconclusive multidetector computed tomography (MDCT) studies were followed by emergency surgery and unexpected diagnoses. Despite dedicated protocols and technical advances, MDCT of uncommon causes of acute abdominal pain still represents a significant challenge for the radiologist on call. We emphasize diagnostic pearls and pitfalls that may help the radiologist on call identify or suspect these uncommon causes of acute abdominal pain on MDCT. Copyright © 2012 Mosby, Inc. All rights reserved.

  10. Angiomatous lymphoid hamartoma of the pelvis: characteristic calcification and computed tomographic appearance

    SciTech Connect

    Goodman, K.; Baim, R.S.; Clair, M.R.; Perkes, E.A.

    1983-03-01

    A case of angiomatous lymphoid hamartoma of the female pelvis is reported. A description of the computed tomographic appearance is included and an apparently common and characteristic form of calcification is described.

  11. Computed tomographic appearance of canine tonsillar neoplasia: 14 cases.

    PubMed

    Thierry, Florence; Longo, Maurizio; Pecceu, Evi; Zani, Davide D; Schwarz, Tobias

    2017-09-19

    The palatine tonsil is an uncommon site of oral canine neoplasia. For affected tonsils, squamous cell carcinoma is the most frequent type of neoplasia, followed by melanoma and lymphoma. Computed tomography (CT) is increasingly used for investigation of canine oropharyngeal pathology; however, limited information is available on the CT appearance of tonsillar neoplasms. Objectives of this retrospective descriptive case series were to characterize the CT features of canine tonsillar neoplasia and determine whether specific CT features differentiate nonneoplastic from neoplastic tonsils. Computed tomographic studies of 14 dogs diagnosed with tonsillar neoplasia were retrieved from two referral hospitals and reviewed by two observers. Diagnosis was based on histology or cytology. Carcinoma was diagnosed in 11 dogs, melanoma in two and lymphoma in one dog. Specific CT features of the tonsil and regional lymph nodes did not differentiate neoplastic from nonneoplastic tonsillar diseases, but regional lymph node CT features were useful for diagnosis in some cases. Marked enlargement (width ≥ 18 mm, 12/18), heterogeneity (16/18), and loss of the hypoattenuating hilus (18/18) of the medial retropharyngeal lymph node were common concomitant features of tonsillar neoplasia. The medial retropharyngeal and mandibular lymphadenomegaly was ipsilateral to the neoplastic tonsil in 8/12 and 6/9 dogs, respectively. Five dogs demonstrated little or no enlargement of the tonsil despite the associated metastatic lymphadenomegaly. Tonsillar neoplasia should therefore be considered as a differential diagnosis for dogs with CT evidence of isolated medial retropharyngeal lymphadenomegaly (regardless of normally sized tonsils), or of any enlarged tonsil with no associated lymphadenomegaly. © 2017 The Authors. Veterinary Radiology & Ultrasound published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Radiology.

  12. "Pseudostring sign" on carotid computed tomographic angiography: collateralization by vasa vasorum.

    PubMed

    Ahmed, Manzoor; Kang, Preet; Pinault, Gilles; Jean-Claude, Jessie

    2009-01-01

    We present 3 cases of unilateral internal carotid artery (ICA) occlusions with prominent single collateralizing vessel of vasa vasorum on computed tomographic angiography. The features on axial source and 3-dimensional images of computed tomographic angiography include "pseudostring sign," serpigenous course of the vasa vasorum, eccentric dot appearance in the wall of chronically thrombosed ICA, and termination in the neck or reconstituting into the ICA at or below the skull base.

  13. Risk stratification of coronary artery disease in asymptomatic diabetic subjects using multidetector computed tomography.

    PubMed

    Shimabukuro, Michio; Saito, Taro; Higa, Toru; Nakamura, Keita; Masuzaki, Hiroaki; Sata, Masataka

    2015-01-01

    Patients with type 2 diabetes mellitus (T2DM) show a greater risk for coronary artery disease (CAD), but the risk stratification in asymptomatic CAD patients has not been established. This study investigated the prevalence and severity for asymptomatic CAD and predictors in T2DM patients. In a multiclinic group, diabetic patients (320 men, 186 women) without known symptoms suggestive of CAD were recruited for multidetector computed tomography (MDCT). Patients were categorized according to severity of coronary atherosclerosis: Grade 1 (normal findings), Grade 2 (mild atherosclerosis without significant stenosis), Grade 3 (moderate stenosis/atherosclerosis, 50-74% stenosis), Grade 4 (moderate stenosis/atherosclerosis, 75-89% stenosis), Grade 5 (severe stenosis/atherosclerosis, ≥90% stenosis). The trend for severity grade of CAD was slightly higher in men than women (P=0.054). For critical lesions (combined Grades 3-5), the prevalence was almost equal (men 44% vs. women 37%; P=0.113). Multivariate models showed that in men, HbA1c≥7.4%, dyslipidemia, duration of diabetes, retinopathy, and other type of cardiovascular diseases were predictors of critical lesions and in women, duration of diabetes and retinopathy were predictors. The prevalence and severity of asymptomatic CAD are comparably high in men and women with T2DM. Risk stratification by using MDCT might be useful to predict asymptomatic coronary lesions requiring coronary revascularization.

  14. [Weighted-averaging multi-planar reconstruction method for multi-detector row computed tomography].

    PubMed

    Aizawa, Mitsuhiro; Nishikawa, Keiichi; Sasaki, Keita; Kobayashi, Norio; Yama, Mitsuru; Sano, Tsukasa; Murakami, Shin-ichi

    2012-01-01

    Development of multi-detector row computed tomography (MDCT) has enabled three-dimensions (3D) scanning with minute voxels. Minute voxels improve spatial resolution of CT images. At the same time, however, they increase image noise. Multi-planar reconstruction (MPR) is one of effective 3D-image processing techniques. The conventional MPR technique can adjust slice thickness of MPR images. When a thick slice is used, the image noise is decreased. In this case, however, spatial resolution is deteriorated. In order to deal with this trade-off problem, we have developed the weighted-averaging multi-planar reconstruction (W-MPR) technique to control the balance between the spatial resolution and noise. The weighted-average is determined by the Gaussian-type weighting function. In this study, we compared the performance of W-MPR with that of conventional simple-addition-averaging MPR. As a result, we could confirm that W-MPR can decrease the image noise without significant deterioration of spatial resolution. W-MPR can adjust freely the weight for each slice by changing the shape of the weighting function. Therefore, W-MPR can allow us to select a proper balance of spatial resolution and noise and at the same time produce suitable MPR images for observation of targeted anatomical structures.

  15. Usefulness of multidetector computed tomography before and after pulmonary vein isolation.

    PubMed

    Revilla Orodea, Ana; Sánchez Lite, Israel; Gallego Beuth, Julio César; Sevilla Ruiz, Teresa; Sandín Fuentes, María G; Amat Santos, Ignacio Jesús; San Román Calvar, José Alberto

    To analyze the usefulness of multidetector computed tomography (MDCT) in the preprocedural evaluation and follow-up of patients undergoing radiofrequency ablation of pulmonary veins and the impact of the MDCT findings on the approach to treatment. We retrospectively analyzed 92 consecutive MDCT studies done in 80 patients between January 2011 and June 2013; 70 (76%) studies were done before a first ablation procedure and 22 (24%) were done in patients who had undergone an ablation procedure. Findings were useful in 34% of the patients who underwent MDCT before the first ablation procedure and in 68% of the studies done after a procedure. The incidence of stroke associated with the ablation procedure was 3%, similar to the incidence recorded in our center before we started to use MDCT to evaluate the anatomy of the left atrium. All symptomatic patients had some pulmonary vein stenosis, and 80% had significant stenosis. Furthermore, the stenoses progressed very rapidly; treatment with balloon angioplasty was associated with early restenosis. Stenting was an alternative in cases of failed angioplasty. In the preprocedural evaluation and postprocedural follow-up of patients undergoing pulmonary vein isolation, MDCT is useful for guiding treatment and detecting complications. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Endoscopic ultrasound versus multidetector computed tomography in preoperative gastric cancer staging.

    PubMed

    Cimavilla Román, Marta; de la Serna Higuera, Carlos; Loza Vargas, Luz Andrea; Benito Fernández, César; Barrio Andrés, Jesús; Madrigal Rubiales, Beatriz; Fernández Pérez, Gabriel; Pérez-Miranda, Manuel

    2017-09-25

    Endoscopic ultrasonography (EUS) is the gold standard technique in loco-regional staging of gastric adenocarcinoma (GAC). Nevertheless, the introduction of multidetector-row computed tomography (MDCT) allows accurate studies to be performed. To compare the diagnostic yield of EUS and MDCT in loco-regional preoperative staging of gastric adenocarcinoma. This was a retrospective and comparative study of all surgical patients with GAC and preoperative staging by EUS and 64-row MDCT. The results for each case were compared with the histological data. Seventy seven surgical patients with GAC were identified and forty two had a complete preoperative staging and were finally included in the study. With regard to overall accuracy of T staging, EUS was superior to MDCT (62% vs 50%). In a subanalysis of early stages (T1-T2) and advanced stages (T3-T4), accuracy and sensitivity (S) were higher for EUS than for MDTC (83.3% vs 64.29% and 84.4% vs 59.5% respectively), although this did not reach statistical significance. The overall accuracy and sensitivity of EUS for N staging was lower than that for MDCT, although neither comparison reached statistical significance (57% vs 64% and 29% vs 55%). EUS diagnostic yield is similar to new MDCT with regard to T and N preoperative staging of GAC. Nevertheless, both techniques should be considered as complementary until more extensive and randomized studies can confirm these results.

  17. Multidetector computed tomography shows reverse cardiac remodeling after double lung transplantation for pulmonary hypertension.

    PubMed

    Mandich Crovetto, D; Alonso Charterina, S; Jiménez López-Guarch, C; Pont Vilalta, M; Pérez Núñez, M; de Pablo Gafas, A; Escribano Subías, P

    2016-01-01

    To use multidetector computed tomography (MDCT) to evaluate the structural changes in the right heart and pulmonary arteries that occur in patients with severe pulmonary hypertension treated by double lung transplantation. This was a retrospective study of 21 consecutive patients diagnosed with severe pulmonary hypertension who underwent double lung transplantation at our center between 2010 and 2014. We analyzed the last MDCT study done before lung transplantation and the first MDCT study done after lung transplantation. We recorded the following variables: diameter of the pulmonary artery trunk, ratio of the diameter of the pulmonary artery trunk to the diameter of the ascending aorta, diameter of the right ventricle, ratio of the diameter of the left ventricle to the diameter of the right ventricle, and eccentricity index. Statistical analysis consisted of the comparison of the means of the variables recorded. In all cases analyzed, the MDCT study done a mean of 24±14 days after double lung transplantation showed a significant reduction in the size of the right heart chambers, with improved indices of ventricular interdependency index, and reduction in the size of the pulmonary artery trunk (p<0.001 for all the variables analyzed). Patients with pulmonary hypertension treated by double lung transplantation present early reverse remodeling of the changes in the structures of the right heart and pulmonary arterial tree. MDCT is useful for detecting these changes. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma

    PubMed Central

    Tsili, Athina C; Argyropoulou, Maria I

    2015-01-01

    Renal cell carcinoma (RCC) accounts for approximately 90%-95% of kidney tumors. With the widespread use of cross-sectional imaging modalities, more than half of RCCs are detected incidentally, often diagnosed at an early stage. This may allow the planning of more conservative treatment strategies. Computed tomography (CT) is considered the examination of choice for the detection and staging of RCC. Multidetector CT (MDCT) with the improvement of spatial resolution and the ability to obtain multiphase imaging, multiplanar and three-dimensional reconstructions in any desired plane brought about further improvement in the evaluation of RCC. Differentiation of RCC from benign renal tumors based on MDCT features is improved. Tumor enhancement characteristics on MDCT have been found closely to correlate with the histologic subtype of RCC, the nuclear grade and the cytogenetic characteristics of clear cell RCC. Important information, including tumor size, localization, and organ involvement, presence and extent of venous thrombus, possible invasion of adjacent organs or lymph nodes, and presence of distant metastases are provided by MDCT examination. The preoperative evaluation of patients with RCC was improved by depicting the presence or absence of renal pseudocapsule and by assessing the possible neoplastic infiltration of the perirenal fat tissue and/or renal sinus fat compartment. PMID:26120380

  19. Multidetector row computed tomography evaluation of potential living laparoscopic renal donors: the story so far.

    PubMed

    Namasivayam, Saravanan; Kalra, Mannudeep K; Small, William C; Torres, William E; Mittal, Pardeep K

    2006-01-01

    Renal transplantation is the treatment of choice for end-stage renal disease. Living related kidney donation is the major source of renal grafts due to limited availability of cadaveric kidneys. Open nephrectomy was used to harvest donor kidneys. However, the laparoscopic approach is associated with less postoperative pain and quick recovery. So, most centers now prefer a laparoscopic approach to explant donor kidneys. Laparoscopic approach is technically challenging due to limited operative visibility. Hence, accurate preoperative detection of renal arterial and venous anomalies is imperative to avoid inadvertent vascular injury and bleeding. The preoperative workup of renal donors includes clinical evaluation, laboratory tests, and imaging. Traditionally, the renal donors were evaluated with conventional imaging techniques, which included renal catheter angiography and intravenous urography. However, conventional imaging is invasive, expensive, and less accurate for evaluation of complex renal venous anomalies, small calculi, and diffuse or focal renal parenchymal lesions. The introduction of multidetector row computed tomography (MDCT) revolutionized the CT technology by enabling isotropic resolution with faster scan coverage in a single, short breath-hold. Consequently, MDCT has now replaced conventional imaging for comprehensive imaging of potential living renal donors. MDCT is a minimally invasive technique that can accurately detect urolithiasis, renal arterial and venous anomalies, renal parenchymal lesions, and urinary tract anomalies. Renal vascular anomalies detected by MDCT can help the surgeon in planning donor nephrectomy. MDCT with three-dimensional CT angiography enables accurate preoperative renal vascular mapping. This article reviews the role of MDCT in preoperative evaluation of potential laparoscopic renal donors.

  20. Role of Multidetector Computed Tomography for Evaluation of Living Kidney Donors

    PubMed Central

    Asghari, Baratali; Babaei, Mansour; Pakroshan, Bijan; Vaziriniya, Alireza; Babamahmoodi, Abdolreza

    2013-01-01

    Background Kidney transplantation from living donors has been increased recently. Preoperative evaluation of living donor is important to select the appropriate kidney for transplantation and to decrease donor surgical complications. Objectives The aim of this study was to compare the accuracy of the use of multidetector computed tomography (MDCT) to evaluate vascular anatomy in living kidney donors with traditional angiography. Patients and Methods A total number of 60 living kidney donors who underwent open surgical approach for transplantation were selected: Kidney anatomy of donors evaluated by CT angiography (group 1) or traditional angiographic examination (group 2). Renal vessels anatomy was compared with surgical findings in both groups. Results The accuracy for detecting number of main renal arteries were not different in both groups which were 96.7% in CT angiography group and 90% in traditional angiography group (P = 0.15). The accuracy for detection of main renal veins were 100% in group 1 and 96.7% in group 2 (P = 0.31). Conclusions MDCT has the same accuracy as traditional angiography to detect renal abnormalities in living kidney donors. PMID:24350084

  1. Multidetector computed tomography in the adolescent and young adult with congenital heart disease.

    PubMed

    Cook, Stephen C; Raman, Subha V

    2008-01-01

    As a result of improved postoperative management and transcatheter interventions, the number of adults with congenital heart disease in the United States has grown exponentially. Consequently, noninvasive imaging has taken an essential role in the evaluation of this patient population. Although standard noninvasive imaging tools such as transthoracic echocardiography and cardiovascular magnetic resonance may be invaluable to this group, occasionally there may be contraindications to their use or limitations in their utility. Multidetector computed tomography (MDCT) has only recently been used in the assessment of the adult with congenital heart disease. The ever-increasing availability of MDCT, along with its increased spatial and temporal resolution and rapidity of postprocessing, makes this an attractive first-choice to study this complex group. A successful scan requires familiarity with the complexity of the underlying anatomy and prior palliative or complete surgical repairs. It is with this knowledge in mind that MDCT provides exquisite detail of complex, 3-dimensional anatomic relations. This review illustrates the spectrum of MDCT findings in the adult with simple and complex forms of congenital heart disease.

  2. Anomalous origin of the right coronary artery evaluated with multidetector computed tomography and its clinical relevance.

    PubMed

    Hirono, Keiichi; Hata, Yukiko; Miyao, Naruaki; Nakaoka, Hideyuki; Saito, Kazuyoshi; Ibuki, Keijiro; Watanabe, Kazuhiro; Ozawa, Sayaka; Higuma, Tomonori; Yoshimura, Naoki; Nishida, Naoki; Ichida, Fukiko

    2016-09-01

    Anomalous origin of the right coronary artery (AORCA) is a rare congenital anomaly that may cause myocardial ischemia and sudden death. We reviewed the clinicopathological records of three cases of AORCA, and compared these with two cases of sudden cardiac death with AORCA revealed by autopsy. We report three juvenile cases with an AORCA originating above the commissural junction between the left and right aortic sinuses, with interarterial and intramural compression. They presented with exertional symptoms and were diagnosed with an AORCA by multidetector computed tomography (MDCT), which successfully delineated the spatial resolution of the anomalous origin and course of the right coronary artery (RCA), in the operating room. All three underwent successful surgical unroofing of the RCA. Two cases of sudden cardiac death with AORCA revealed by autopsy showed a slit-like orifice, acute-angled take-off, and long intramural course of the RCA, resembling the RCAs of three juvenile cases. It is crucial to be alert to the presentation of exertional symptoms, as sudden death may be the first manifestation of an anomalous coronary artery, such as those observed in these three cases. MDCT provided an excellent definition and spatial resolution of the unusual origin and intramural course of the RCA, facilitating the correct surgical remedy and resulting in a good outcome for the patients. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  3. Assessment of acute thoracolumbar fractures: challenges in multidetector computed tomography and added value of emergency MRI.

    PubMed

    Pizones, Javier; Castillo, Ernesto

    2013-09-01

    Acute thoracolumbar fractures are commonly diagnosed by clinical symptoms and X-ray plain films. Computed tomography (CT) is used to assess vertebral body damage, posterior wall canal intrusion, and posterior column injury. Both of these imaging tools have helped to develop classifications systems that aid the clinician in differentiating stable versus unstable spinal injuries. Multidetector CT has become the standard of care in polytrauma patients. It provides superior evaluation of bony anatomy and has been reported to be more cost effective than X-ray plain films, particularly in the cervicothoracic junction and in thoracolumbar unstable burst fractures. One disadvantage might be the increase in radiation exposure. Another important limitation remains the inability to provide adequate assessment for ligamentous injury and spinal cord lesions. Disc and ligaments play an important role in fracture stability because the failure of the posterior tension band may lead to progressive kyphosis. The integrity of the posterior ligamentous complex has been included in recent fracture classification systems and treatment algorithms. MR imaging becomes essential for soft tissue injury assessment, especially when including T2-weighted sequences with fat suppression. MRI can now be considered key to accurate fracture classification, detection of occult and distant injuries, and as the basis for therapeutic decision making. It is therefore strongly recommended in the early assessment of spine trauma patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Morphometric analysis of sex differences in contemporary Japanese pelves using multidetector computed tomography.

    PubMed

    Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Yajima, Daisuke; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Yamaguchi, Rutsuko; Hashimoto, Mari; Hoshioka, Yumi; Iwase, Hirotaro

    2015-12-01

    Sex estimation of decomposed or skeletal remains is clearly important in forensic contexts. Recently, contemporary population-specific data has been obtained using multidetector computed tomography (MDCT) scanning. The main purpose of this study was to investigate skeletal pelvic dimorphism in a contemporary Japanese forensic sample and to quantify the accuracy of sex estimation using various pelvic measurements obtained from three-dimensional (3D) CT images. This study used a total of 208 cadavers (104 males, 104 females) of which postmortem CT scanning and subsequent forensic autopsy were conducted between December 2011 and August 2014. Eleven measurements of each pelvis were obtained from 3D CT reconstructed images that extracted only bone data. The measurements were analyzed using descriptive statistics and discriminant function analyses. All except one measurement were dimorphic in terms of sex differences. Univariate discriminant function analyses using these measurements provided sex classification accuracy rates of 62.0-98.1%. The subpubic angle was found to contribute most significantly to accurate sex estimation. Multivariate discriminant functions yielded sex prediction accuracy rates of 63.9-98.1%. In conclusion, the pelvic measurements obtained from 3D CT images of a contemporary Japanese population successfully demonstrated sexual dimorphism and may be useful for the estimation of skeletal sex in the field of forensic anthropology.

  5. A Structural and Functional Assessment of the Lung via Multidetector-Row Computed Tomography

    PubMed Central

    Hoffman, Eric A.; Simon, Brett A.; McLennan, Geoffrey

    2006-01-01

    With advances in multidetector-row computed tomography (MDCT), it is now possible to image the lung in 10 s or less and accurately extract the lungs, lobes, and airway tree to the fifth- through seventh-generation bronchi and to regionally characterize lung density, texture, ventilation, and perfusion. These methods are now being used to phenotype the lung in health and disease and to gain insights into the etiology of pathologic processes. This article outlines the application of these methodologies with specific emphasis on chronic obstructive pulmonary disease. We demonstrate the use of our methods for assessing regional ventilation and perfusion and demonstrate early data that show, in a sheep model, a regionally intact hypoxic pulmonary vasoconstrictor (HPV) response with an apparent inhibition of HPV regionally in the presence of inflammation. We present the hypothesis that, in subjects with pulmonary emphysema, one major contributing factor leading to parenchymal destruction is the lack of a regional blunting of HPV when the regional hypoxia is related to regional inflammatory events (bronchiolitis or alveolar flooding). If maintaining adequate blood flow to inflamed lung regions is critical to the nondestructive resolution of inflammatory events, the pathologic condition whereby HPV is sustained in regions of inflammation would likely have its greatest effect in the lung apices where blood flow is already reduced in the upright body posture. PMID:16921136

  6. Structural Comparison between the Right and Left Atrial Appendages Using Multidetector Computed Tomography

    PubMed Central

    Shinoda, Koichi; Fukuoka, Daisuke; Torii, Ryo; Watanabe, Tsuneo; Nakano, Takashi

    2016-01-01

    The three-dimensional (3D) structures of the right atrial appendage (RAA) and left atrial appendage (LAA) were compared to clarify why thrombus formation less frequently occurs in RAA than in LAA. Morphological differences between RAA and LAA of 34 formalin-preserved cadaver hearts were investigated. Molds of RAA and LAA specimens were made and the neck areas, volumes of the atrial appendages (AA), and amount of pectinate muscles (PMs) were analyzed using multidetector computed tomography. In RAA, most PMs were connected to one another and formed a “dendritic” appearance and the inner surface area was smaller than in LAA. RAA had smaller volumes and larger neck areas than LAA. The ratios of the neck area/volume were larger and the amounts of PMs were smaller in RAA than in LAA. The volumes, neck areas, and amount of PMs of RAA were significantly correlated with those of LAA. According to the 3D structure, RAA appears to be suited for a more favorable blood flow, which may explain why the thrombus formation is less common in RAA than in LAA. Examining not only LAA but also RAA by transesophageal echocardiography may be useful in high-risk patients of thrombus formation in LAA because the volume, neck area, and amount of PMs of LAA reflect the shape of RAA. PMID:27900330

  7. Diagnostic accuracy of intra-abdominal fluid collection characterization in the era of multidetector computed tomography.

    PubMed

    Allen, Brian C; Barnhart, Huiman; Bashir, Mustafa; Nieman, Christopher; Breault, Steven; Jaffe, Tracy A

    2012-02-01

    The purpose of this study was to test the hypothesis that with improved technology, the presence of abscess in a postoperative fluid collection may be prospectively made. This is an Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective review of computed tomography (CT)-guided intra-abdominal fluid collection drainages. The diagnostic CT scans of 95 consecutive patients performed on 16- and 64-multidetector CT (MDCT) were reviewed by four readers with varying abdominal imaging expertise. Readers were asked to determine fluid content, to document whether infection was present, and to rate reader confidence for infection. A fifth radiologist reviewed the collections for imaging characteristics. The gold standard for presence of infection was microbiological Gram stain and culture. The logistic regression model showed that both fluid collections containing gas or high attenuation fluid (average CT density 20 or greater Hounsfield units) are significant predictors of infection (P = 0.001). The average sensitivity over the four readers for determining presence of infection was 83.4 per cent and specificity was 39.3 per cent. Even in the era of MDCT, the ability to predict whether or not a fluid collection is infected or not, based on imaging findings alone, is limited. Presence of gas is a strong indicator of infection, but no imaging finding is characteristic of a sterile fluid collection.

  8. A case of bilateral tracheal bronchus: report of a rare association in multidetector computed tomography bronchoscopy.

    PubMed

    Wooten, Candace; Doros, Caius; Miclaus, Gratian D; Matusz, Petru; Loukas, Marios

    2015-08-01

    Bilateral tracheal bronchus is a rare variation of the tracheobronchial tree. We present a 1-year 7-month-old male patient who presented with sepsis following endotracheal intubation. Upon review of multidetector computed tomography images, the patient was diagnosed with displaced bilateral tracheal bronchus. Imaging showed a right-sided anomalous bronchus arising 0.9 cm proximal to the carina. The left-sided anomalous bronchus arose 0.7 cm proximal to the carina, mimicking a tracheal trifurcation. When viewed together, the close proximity of both the right and left tracheal bronchi to the carina created a distinct tracheal quadrifurcation. This rare anatomic variation was additionally associated with an anorectal malformation (anal atresia). Unrecognized tracheal bronchus in patients undergoing endotracheal intubation can lead to serious complications. While bilateral tracheal bronchus is described in the literature, we are unaware of any case similar to this patient presentation. We present and analyze this unusual case of bilateral tracheal bronchus. The anatomy and clinical significance of this variation is then discussed.

  9. Colonic perforation by a transmural and transvalvular migrated retained sponge: multi-detector computed tomography findings.

    PubMed

    Camera, Luigi; Sagnelli, Marco; Guadagno, Paolo; Mainenti, Pier Paolo; Marra, Teresa; Scotto di Santolo, Maria; Fei, Landino; Salvatore, Marco

    2014-04-21

    Transmural migrated retained sponges usually impact at the level of the ileo-cecal valve leading to a small bowel obstruction. Once passed through the ileo-cecal valve, a retained sponge can be propelled forward by peristaltic activity and eliminated with feces. We report the case of a 52-year-old female with a past surgical history and recurrent episodes of abdominal pain and constipation. On physical examination, a generalized resistance was observed with tenderness in the right flank. Contrast-enhanced multi-detector computed tomography findings were consistent with a perforated right colonic diverticulitis with several out-pouchings at the level of the ascending colon and evidence of free air in the right parieto-colic gutter along with an air-fluid collection within the mesentery. In addition, a ring-shaped hyperdense intraluminal material was also noted. At surgery, the ascending colon appeared irregularly thickened and folded with a focal wall interruption and a peri-visceral abscess at the level of the hepatic flexure, but no diverticula were found. A right hemi-colectomy was performed and on dissection of the surgical specimen a retained laparotomy sponge was found in the bowel lumen.

  10. Associations Between Cardio-Ankle Vascular Index and Aortic Structure and Sclerosis Using Multidetector Computed Tomography.

    PubMed

    Horinaka, Shigeo; Yagi, Hiroshi; Fukushima, Hiromichi; Shibata, Yoshimasa; Takeshima, Hiroshi; Ishimitsu, Toshihiko

    2017-04-01

    Aortic pulse wave velocity (PWV) has been accepted as the gold standard for arterial stiffness measurement. However, PWV depends on blood pressure (BP). To eliminate the BP dependency of PWV, the cardio-ankle vascular index (CAVI) was developed. This study aimed to define the relationship between CAVI and aortic atherosclerosis or structure on multidetector computed tomography (MDCT). Patients with (n = 49) or without (n = 49) coronary artery disease were studied. The lumen and vessel diameters and wall thickness were calculated from the cross-sectional area at the pulmonary bifurcation level by 64-slice MDCT. The CAVI was measured within 3 days before MDCT. Multivariate analysis showed that the vessel diameter of the ascending and descending aorta on MDCT depends on age, body surface area, and diastolic BP. The CAVI significantly correlated with the vessel diameter ( r = .453) and wall thickness ( r = .387) of the thoracic descending aorta ( P < .001, respectively). The CAVI was an independent predictor of the descending aortic wall thickness on multiple stepwise regression analysis. These data suggest that CAVI, a simple index, is useful for evaluating thoracic aortic atherosclerosis.

  11. Magnetic resonance imaging of pulmonary infection in immunocompromised children: comparison with multidetector computed tomography.

    PubMed

    Ozcan, H Nursun; Gormez, Ayşegul; Ozsurekci, Yasemin; Karakaya, Jale; Oguz, Berna; Unal, Sule; Cetin, Mualla; Ceyhan, Mehmet; Haliloglu, Mithat

    2017-02-01

    Computed tomography (CT) is commonly used to detect pulmonary infection in immunocompromised children. To compare MRI and multidetector CT findings of pulmonary abnormalities in immunocompromised children. Seventeen neutropaenic children (6 girls; ages 2-18 years) were included. Non-contrast-enhanced CT was performed with a 64-detector CT scanner. Axial and coronal non-enhanced thoracic MRI was performed using a 1.5-T scanner within 24 h of the CT examination (true fast imaging with steady-state free precession, fat-saturated T2-weighted turbo spin echo with motion correction, T2-weighted half-Fourier single-shot turbo spin echo [HASTE], fat-saturated T1-weighted spoiled gradient echo). Pulmonary abnormalities (nodules, consolidations, ground glass opacities, atelectasis, pleural effusion and lymph nodes) were evaluated and compared among MRI sequences and between MRI and CT. The relationship between MRI sequences and nodule sizes was examined by chi- square test. Of 256 CT lesions, 207 (81%, 95% confidence interval [CI] 76-85%) were detected at MRI. Of 202 CT-detected nodules, 157 (78%, 95% CI 71-83%) were seen at motion-corrected MRI. Of the 1-5-mm nodules, 69% were detected by motion-corrected T2-weighted MRI and 38% by HASTE MRI. Sensitivity of MRI (both axial fat-saturated T2-weighted turbo spin echo with variable phase encoding directions (BLADE) images and HASTE sequences) to detect pulmonary abnormalities is promising.

  12. Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis.

    PubMed

    Zhu, Caisong; Liu, Wei; Yang, Jun; Yang, Jing; Shao, Kangwei; Yuan, Lixin; Chen, Hairong; Lu, Wei; Zhu, Ying

    2016-07-01

    The aim of the present study was to compare the multidetector computed tomography (MDCT) features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis (CLT). MDCT findings, including the size, solid percentage, calcification, margin, capsule, anteroposterior-transverse diameter ratio as well as the mode and the degree of enhancement of 137 thyroid nodules in 127 CLT cases were retrospectively analyzed. Furthermore, the correlation between MDCT findings and pathological results combined with the CT perfusion imaging was analyzed for the differences between benign and malignant nodules. A total of 77.5% (31/40) of malignant nodules were completely solid, and 33% (32/97) of benign nodules were predominantly cystic. Compared with the benign nodules, micro-calcification and internal calcification were more frequently observed in the malignant nodules (P<0.05). MDCT features such as ill-defined margin, absence of capsule or incomplete capsule or homogeneous enhancement were more likely to be present in the malignant nodules (P<0.05). Nevertheless, no significant difference was observed in the enhancement degree at arterial or venous phase between benign and malignant nodules (P>0.05). MDCT features are useful in differentiating the benign and malignant nodules in CLT patients, and it may be essential for a radiologist to review the MDCT characteristics of nodules in the clinical practice.

  13. Evaluation of cardiovascular anomalies in patients with asymptomatic turner syndrome using multidetector computed tomography.

    PubMed

    Lee, Sun Hee; Jung, Ji Mi; Song, Min Seob; Choi, Seok jin; Chung, Woo Yeong

    2013-08-01

    Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

  14. Computed tomographic findings in 57 cats with primary pulmonary neoplasia.

    PubMed

    Aarsvold, Stacie; Reetz, Jennifer A; Reichle, Jean K; Jones, Ian D; Lamb, Christopher R; Evola, Maria G; Keyerleber, Michele A; Marolf, Angela J

    2015-01-01

    Primary pulmonary neoplasia is relatively uncommon in cats and generally has a poor prognosis. In this multicenter, retrospective study of 57 cats with pulmonary neoplasia, the most frequent presenting signs were anorexia/inappetence (39%) and cough (37%). The pulmonary tumors were considered to be incidental findings in 9% cats. In computed tomographic (CT) images, primary pulmonary tumors appeared as a pulmonary mass in 55 (96%) cats and as a disseminated pulmonary lesion without a defined mass in two (4%) cats. Most pulmonary tumors were in the caudal lobes, with 28 (49%) in the right caudal lobe and 17 (30%) in the left caudal lobe. CT features associated with pulmonary tumors included mass in contact with visceral pleura (96%), irregular margins (83%), well-defined borders (79%), bronchial compression (74%), gas-containing cavities (63%), foci of mineral attenuation (56%), and bronchial invasion (19%). The mean (range) maximal dimension of the pulmonary masses was 3.5 cm (1.1-11.5 cm). Additional foci of pulmonary disease compatible with metastasis were observed in 53% cats. Pleural fluid was evident in 30% cats and pulmonary thrombosis in 12% cats. The histologic diagnoses were 47 (82%) adenocarcinomas, six (11%) tumors of bronchial origin, three (5%) adenosquamous cell carcinomas, and one (2%) squamous cell carcinoma. In this series, adenocarcinoma was the predominant tumor type, but shared many features with less common tumor types. No associations were identified between tumor type and CT features. Prevalence of suspected intrapulmonary metastasis was higher than in previous radiographic studies of cats with lung tumors.

  15. Pulmonary emphysema in cystic fibrosis detected by densitometry on chest multidetector computed tomography.

    PubMed

    Wielpütz, Mark O; Weinheimer, Oliver; Eichinger, Monika; Wiebel, Matthias; Biederer, Jürgen; Kauczor, Hans-Ulrich; Heußel, Claus P; Mall, Marcus A; Puderbach, Michael

    2013-01-01

    Histopathological studies on lung specimens from patients with cystic fibrosis (CF) and recent results from a mouse model indicate that emphysema may contribute to CF lung disease. However, little is known about the relevance of emphysema in patients with CF. In the present study, we used computationally generated density masks based on multidetector computed tomography (MDCT) of the chest for non-invasive characterization and quantification of emphysema in CF. Volumetric MDCT scans were acquired in parallel to pulmonary function testing in 41 patients with CF (median age 20.1 years; range 7-66 years) and 21 non-CF controls (median age 30.4 years; range 4-68 years), and subjected to dedicated software. The lung was segmented, low attenuation volumes below a threshold of -950 Hounsfield units were assigned to emphysema volume (EV), and the emphysema index was computed (EI). Results were correlated with forced expiratory volume in 1 s percent predicted (FEV1%), residual volume (RV), and RV/total lung capacity (RV/TLC). We show that EV was increased in CF (457±530 ml) compared to non-CF controls (78±90 ml) (P<0.01). EI was also increased in CF (7.7±7.5%) compared to the control group (1.2±1.4%) (P<0.05). EI correlated inversely with FEV1% (rs=-0.66), and directly with RV (rs=0.69) and RV/TLC (rs=0.47) in patients with CF (P<0.007), but not in non-CF controls. Emphysema in CF was detected from early adolescence (~13 years) and increased with age (rs=0.67, P<0.001). Our results indicate that early onset emphysema detected by densitometry on chest MDCT is a characteristic pathology that contributes to airflow limitation and may serve as a novel endpoint for monitoring lung disease in CF.

  16. Pulmonary Emphysema in Cystic Fibrosis Detected by Densitometry on Chest Multidetector Computed Tomography

    PubMed Central

    Wielpütz, Mark O.; Weinheimer, Oliver; Eichinger, Monika; Wiebel, Matthias; Biederer, Jürgen; Kauczor, Hans-Ulrich; Heußel, Claus P.

    2013-01-01

    Background Histopathological studies on lung specimens from patients with cystic fibrosis (CF) and recent results from a mouse model indicate that emphysema may contribute to CF lung disease. However, little is known about the relevance of emphysema in patients with CF. In the present study, we used computationally generated density masks based on multidetector computed tomography (MDCT) of the chest for non-invasive characterization and quantification of emphysema in CF. Methods Volumetric MDCT scans were acquired in parallel to pulmonary function testing in 41 patients with CF (median age 20.1 years; range 7-66 years) and 21 non-CF controls (median age 30.4 years; range 4-68 years), and subjected to dedicated software. The lung was segmented, low attenuation volumes below a threshold of -950 Hounsfield units were assigned to emphysema volume (EV), and the emphysema index was computed (EI). Results were correlated with forced expiratory volume in 1 s percent predicted (FEV1%), residual volume (RV), and RV/total lung capacity (RV/TLC). Results We show that EV was increased in CF (457±530 ml) compared to non-CF controls (78±90 ml) (P<0.01). EI was also increased in CF (7.7±7.5%) compared to the control group (1.2±1.4%) (P<0.05). EI correlated inversely with FEV1% (rs=-0.66), and directly with RV (rs=0.69) and RV/TLC (rs=0.47) in patients with CF (P<0.007), but not in non-CF controls. Emphysema in CF was detected from early adolescence (~13 years) and increased with age (rs=0.67, P<0.001). Conclusions Our results indicate that early onset emphysema detected by densitometry on chest MDCT is a characteristic pathology that contributes to airflow limitation and may serve as a novel endpoint for monitoring lung disease in CF. PMID:23991177

  17. Managing patient dose in multi-detector computed tomography(MDCT). ICRP Publication 102.

    PubMed

    Valentin, J

    2007-01-01

    Computed tomography (CT) technology has changed considerably in recent years with the introduction of increasing numbers of multiple detector arrays. There are several parameters specific to multi-detector computed tomography (MDCT) scanners that increase or decrease patient dose systematically compared to older single detector computed tomography (SDCT) scanners. This document briefly reviews the MDCT technology, radiation dose in MDCT, including differences from SDCT and factors that affect dose, radiation risks, and the responsibilities for patient dose management. The document recommends that users need to understand the relationship between patient dose and image quality and be aware that image quality in CT is often higher than that necessary for diagnostic confidence. Automatic exposure control (AEC) does not totally free the operator from selection of scan parameters, and awareness of individual systems is important. Scanning protocols cannot simply be transferred between scanners from different manufacturers and should be determined for each MDCT. If the image quality is appropriately specified by the user, and suited to the clinical task, there will be a reduction in patient dose for most patients. Understanding of some parameters is not intuitive and the selection of image quality parameter values in AEC systems is not straightforward. Examples of some clinical situation shave been included to demonstrate dose management, e.g. CT examinations of the chest, the heart for coronary calcium quantification and non-invasive coronary angiography, colonography, the urinary tract, children, pregnant patients, trauma cases, and CT guided interventions. CT is increasingly being used to replace conventional x-ray studies and it is important that patient dose is given careful consideration, particularly with repeated or multiple examinations.

  18. Clinical significance of multidetector-row computed tomography in breast surgery.

    PubMed

    Doihara, Hiroyoshi; Fujita, Takeo; Takabatake, Daisuke; Takahashi, Hirotoshi; Ogasawara, Yutaka; Shimizu, Nobuyoshi

    2006-01-01

    Several reports support the association of higher ipsilateral breast tumor recurrence rates with positive or intermediate margins compared with negative pathologic margins. Precise evaluation of tumor extension and adequate surgical margin are important factors affecting tumor recurrence after breast-conserving surgery (BCS). Many studies have reported the utility of magnetic resonance imaging (MRI) for diagnosing the tumor extension of breast cancer, but few have evaluated the utility of multidetector-row computed tomography (MDCT). The results of this study show the clinical significance of MDCT for detecting cancer extension and demonstrate the clinical role of MDCT in BCS. Subjects comprised 136 patients grouped into two categories based on whether or not tumor extension was evaluated with MDCT preoperatively. The positive surgical margin rate and breast conservation rate were analyzed in each group and the clinical role of MDCT in BCS was evaluated. Moreover, evaluation of intraductal extension was done both with MDCT and histologically, and computed tomography (CT)-pathologic correlations were examined retrospectively. Finally, the margin-positive cases were analyzed in relation to their clinical characteristics. Sensitivity, specificity, positive predictive value, and negative predictive value for detection of the intraductal component were 71.8%, 85.7%, 82.1%, and 76.9%, respectively. The positive surgical margin rate and conservation rate are 7.46% and 81.9%, respectively, for those who were diagnosed with MDCT preoperatively; their corresponding rates without MDCT were 16.67% and 67.9%. Most margin-positive patients have remarkable lymphatic space invasion. Positive surgical margins were often recognized toward the nipple. For diagnosing the intraductal extension, MDCT shows sufficient diagnosability. Moreover, MDCT can provide appropriate information for the determination of adequate surgical margins and contribute to increases in breast conservation

  19. Multidetector computed tomography angiography of the celiac trunk and hepatic arterial system: normal anatomy and main variants *

    PubMed Central

    Araujo Neto, Severino Aires; de Mello Júnior, Carlos Fernando; Franca, Henrique Almeida; Duarte, Cláudia Martina Araújo; Borges, Rafael Farias; de Magalhães, Ana Guardiana Ximenes

    2016-01-01

    Although digital angiography remains as the gold standard for imaging the celiac arterial trunk and hepatic arteries, multidetector computed tomography in association with digital images processing by software resources represents a useful tool particularly attractive for its non invasiveness. Knowledge of normal anatomy as well as of its variations is helpful in images interpretation and to address surgical planning on a case-by-case basis. The present essay illustrates several types of anatomical variations of celiac trunk, hepatic artery and its main branches, by means of digitally reconstructed computed tomography images, correlating their prevalence in the population with surgical implications. PMID:26929461

  20. Multidetector computed tomography angiography of the celiac trunk and hepatic arterial system: normal anatomy and main variants.

    PubMed

    Araujo Neto, Severino Aires; de Mello Júnior, Carlos Fernando; Franca, Henrique Almeida; Duarte, Cláudia Martina Araújo; Borges, Rafael Farias; de Magalhães, Ana Guardiana Ximenes

    2016-01-01

    Although digital angiography remains as the gold standard for imaging the celiac arterial trunk and hepatic arteries, multidetector computed tomography in association with digital images processing by software resources represents a useful tool particularly attractive for its non invasiveness. Knowledge of normal anatomy as well as of its variations is helpful in images interpretation and to address surgical planning on a case-by-case basis. The present essay illustrates several types of anatomical variations of celiac trunk, hepatic artery and its main branches, by means of digitally reconstructed computed tomography images, correlating their prevalence in the population with surgical implications.

  1. Preoperative imaging for DIEA perforator flaps: a comparative study of computed tomographic angiography and Doppler ultrasound.

    PubMed

    Rozen, Warren M; Phillips, Timothy J; Ashton, Mark W; Stella, Damien L; Gibson, Robert N; Taylor, G Ian

    2008-01-01

    Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Doppler and color duplex sonography have been used with varying results, and the quest continues for optimal preoperative assessment. Computed tomographic angiography has recently been proposed as a noninvasive modality for this purpose. This is the first study to formally compare preoperative Doppler ultrasound with computed tomographic angiography for imaging the DIEA. Eight consecutive patients undergoing DIEA perforator flap surgery for breast reconstruction underwent both computed tomographic angiography and Doppler ultrasound preoperatively. All investigations and procedures were performed at the same institution with the same primary and assisting surgeons and the same radiology team. Computed tomographic angiography was superior to Doppler ultrasound at identifying the course of the DIEA and its branching pattern, and in visualizing its perforators. Preoperative computed tomographic angiography was highly specific (100 percent) and more sensitive in mapping and visualizing perforators (p = 0.0078). It was also proficient at identifying the superficial epigastric arterial system and for effectively displaying the results intraoperatively. It was substantially quicker and removed the interobserver error associated with Doppler ultrasonography. The study was ceased after eight patients because of the overwhelming benefit of computed tomographic angiography over Doppler ultrasonography. Computed tomographic angiography is a valuable imaging modality for the preoperative assessment of the donor-site vascular supply for TRAM and DIEA perforator flaps.

  2. Preoperative imaging for DIEA perforator flaps: a comparative study of computed tomographic angiography and doppler ultrasound.

    PubMed

    Rozen, Warren M; Phillips, Timothy J; Ashton, Mark W; Stella, Damien L; Gibson, Robert N; Taylor, G Ian

    2008-01-01

    Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essential for preoperative planning and reducing intraoperative error. Doppler and color duplex sonography have been used with varying results, and the quest continues for optimal preoperative assessment. Computed tomographic angiography has recently been proposed as a noninvasive modality for this purpose. This is the first study to formally compare preoperative Doppler ultrasound with computed tomographic angiography for imaging the DIEA. Eight consecutive patients undergoing DIEA perforator flap surgery for breast reconstruction underwent both computed tomographic angiography and Doppler ultrasound preoperatively. All investigations and procedures were performed at the same institution with the same primary and assisting surgeons and the same radiology team. Computed tomographic angiography was superior to Doppler ultrasound at identifying the course of the DIEA and its branching pattern, and in visualizing its perforators. Preoperative computed tomographic angiography was highly specific (100 percent) and more sensitive in mapping and visualizing perforators (p = 0.0078). It was also proficient at identifying the superficial epigastric arterial system and for effectively displaying the results intraoperatively. It was substantially quicker and removed the interobserver error associated with Doppler ultrasonography. The study was ceased after eight patients because of the overwhelming benefit of computed tomographic angiography over Doppler ultrasonography. Computed tomographic angiography is a valuable imaging modality for the preoperative assessment of the donor-site vascular supply for TRAM and DIEA perforator flaps.

  3. Multidetector computed tomography urography for diagnosing upper urinary tract urothelial tumour.

    PubMed

    Cowan, Nigel C; Turney, Ben W; Taylor, Nia J; McCarthy, Catherine L; Crew, Jeremy P

    2007-06-01

    To evaluate multidetector computed tomography urography (MDCTU) for diagnosing upper urinary tract (UUT) urothelial tumour by comparison with retrograde ureteropyelography (RUP). MDCTU and RUP were used in a selected series of adult patients presenting with haematuria. Entry criteria were based on findings on intravenous urography and were chosen to ensure a high prevalence of UUT urothelial tumour to allow a valid retrospective comparison of the diagnostic techniques. MDCTU and RUP studies were scored for the presence and absence of UUT urothelial tumour by two radiologists, retrospectively and independently, and while unaware of the demographic and clinical information. The reference standards were the histopathology and clinical follow-up. MDCTU and RUP were used in 106 patients over a 24-month period. RUP was attempted in 151 of 212 UUTs; the corresponding MDCTU for each UUT was reviewed. MDCTU was a true-positive (TP) for urothelial tumour in 31, true-negative (TN) in 111, false-positive (FP) in eight and false-negative (FN) in one UUT, giving a sensitivity of 0.97, a specificity of 0.93, a positive predictive value (PPV) of 0.79 and a negative PV (NPV) of 0.99. RUP was technically successful and diagnostic in 96% of the UUTs (143/151). For diagnosing urothelial tumour, RUP was TP in 26, TN in 112, FP in four and FN in one UUT, giving a sensitivity of 0.97, specificity of 0.93, a PPV of 0.79 and NPV of 0.99. This study validates quantitatively the use of MDCTU for diagnosing UUT urothelial tumour.

  4. Multiphase Multi-Detector Row Computed Tomography Imaging Characteristics of Large (>5 cm) Focal Hepatocellular Carcinoma.

    PubMed

    Blaschke, Eric M; Rao, Vijaya L; Xiong, Lingyun; Te, Helen S; Hart, John; Reddy, K Gautham; Oto, Aytekin

    2016-01-01

    The aim of this study was to describe the multiphase multi-detector row computed tomography (MDCT) imaging findings of large (>5 cm) focal hepatocellular carcinoma (HCC). Following review of the medical records of 321 patients with newly diagnosed HCC who underwent MDCT within the radiology database from January 2007 to November 2014, 27 patients (20 men and 7 women; mean age, 69 [SD, 10.1] years [range, 49-87 years]) with histologically confirmed HCC greater than 5 cm were included in this institutional review board-approved study. Multiphase, dedicated liver MDCT images of these cases were retrospectively reviewed by 2 radiologists in consensus to describe the enhancement characteristics of these lesions. Mean tumor diameter was 8.4 (SD, 2.4) cm (range, 5.2-13.5 cm). Cirrhosis was present in 16 (59%) of 27 patients. Seventeen (85%) of 20 patients with available laboratory data presented with elevated alpha-fetoprotein (median, 97 ng/mL). Twenty-three (85%) of 27 demonstrated either heterogeneous enhancement with gradual fill-in (14/27 [52%]) or peripheral enhancement with centripetal fill-in (9/27 [33%]). Twenty-two (81%) of 27 lacked washout on delayed phase images, and 21 (78%) of 27 demonstrated a pseudocapsule. Twenty-seven of 27 lesions were well defined, 8 (30%) of 27 were exophytic, 15 (56%) of 27 were unifocal, 5 (25%) of 20 cases demonstrated vascular invasion, and 7 (26%) of 27 cases presented with extrahepatic metastases. Large (>5 cm) focal HCC may present as a dominant mass with a pseudocapsule and initial heterogeneous or peripheral enhancement with gradual or centripetal fill-in without washout on multiphase MDCT. Awareness of this variant is important to allow distinction from other benign (eg, hemangioma) and malignant (eg, cholangiocarcinoma) focal liver lesions.

  5. Exercise echocardiography and multidetector computed tomography for the evaluation of acute chest pain.

    PubMed

    Mas-Stachurska, Aleksandra; Miró, Oscar; Sitges, Marta; de Caralt, Teresa M; Perea, Rosario J; López, Beatriz; Sánchez, Miquel; Paré, Carles; Bosch, Xavier; Ortiz-Pérez, José T

    2015-01-01

    Up to 4% of patients with acute chest pain, normal electrocardiogram, and negative troponins present major adverse cardiac events as a result of undiagnosed acute coronary syndrome. Our aim was to compare the diagnostic performance of multidetector computed tomography and exercise echocardiography in patients with a low-to-intermediate probability of coronary artery disease. We prospectively included 69 patients with acute chest pain, normal electrocardiogram, and negative troponins who underwent coronary tomography angiography and exercise echocardiography. Patients with coronary stenosis ≥ 50% or Agatston calcium score ≥ 400 on coronary tomography angiography or positive exercise echocardiography, or with inconclusive results, were admitted to rule out acute coronary syndrome. An acute coronary syndrome was confirmed in 17 patients (24.6%). This was lower than the suspected 42% based on coronary tomography angiography (P<.05) and not significantly different than the suspected 29% based on the results of exercise echocardiography (P=.56). Exercise echocardiography was normal in up to 37% of patients with pathological findings on coronary tomography angiography. The latter technique provided a higher sensitivity (100% vs 82.3%; P=.21) but lower specificity (76.9% vs 88.4%; P=.12) than exercise echocardiography for the diagnosis of acute coronary syndrome, although without reaching statistical significance. Increasing the stenosis cutoff point to 70% increased the specificity of coronary tomography angiography to 88.4%, while maintaining high sensitivity. Coronary tomography angiography offers a valid alternative to exercise echocardiography for the diagnosis of acute coronary syndrome among patients with low-to-intermediate probability of coronary artery disease. A combination of both techniques could improve the diagnosis of acute coronary syndrome. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  6. Hyperdense middle cerebral artery sign in multidetector computed tomography: definition, occurrence, and reliability analysis.

    PubMed

    Abul-Kasim, Kasim; Selariu, Eufrozina; Brizzi, Marco; Petersson, Jesper

    2009-01-01

    The hyperdense middle cerebral artery sign (HMCAS) is one of the early changes seen on the computed tomography in acute ischemic stroke of MCA territory. To evaluate the reliability of subjective evaluation of HMCAS on CT performed at multidetector CT (MDCT) and evaluated in the Picture Archiving Communication Systems, to define objective criteria for HMCAS and to find out if there are any predictors for the occurrence of HMCAS. CTs of 121 consecutive patients (mean age of 70 years) treated with thrombolytic therapy were retrospectively evaluated by two neuroradiologists both subjectively and objectively with respect to HMCAS. HMCAS was subjectively found in 32% of study population. The interobserver and intraobserver agreement were substantial (K value of 0.69 and 0.80, respectively) and increased to almost perfect (K value of 0.86) when the reader provided with clinical information. The HMCAS was found twice as often in male patients. Patients with HMCAS were three years younger than those whose baseline CT did not show HMCAS. A 100% sensitivity achieved when objective criteria were defined as combination of MCA attenuation >or= 46 HU and MCA ratio > 1.2 (using oval ROIs) and MCA attenuation >or= 50 HU and MCA ratio of > 1.4 (using pixel sized ROIs). Performing CT examinations on MDCT and assessment of the images in PACS might have contributed to improvement of the reliability of evaluating HMCAS on CT by enabling an objective evaluation of this sign with measurements of attenuation value in the course of MCA using oval or pixel sized ROIs as well as estimation of MCA ratio.

  7. Multidetector computed tomography in the evaluation of pediatric acute abdominal pain in the emergency department.

    PubMed

    Lin, Wei-Ching; Lin, Chien-Heng

    2016-06-01

    The accurate diagnosis of pediatric acute abdominal pain is one of the most challenging tasks in the emergency department (ED) due to its unclear clinical presentation and non-specific findings in physical examinations, laboratory data, and plain radiographs. The objective of this study was to evaluate the impact of abdominal multidetector computed tomography (MDCT) performed in the ED on pediatric patients presenting with acute abdominal pain. A retrospective chart review of children aged <18 years with acute abdominal pain who visited the emergency department and underwent MDCT between September 2004 and June 2007 was conducted. Patients with a history of trauma were excluded. A total of 156 patients with acute abdominal pain (85 males and 71 females, age 1-17 years; mean age 10.9 ± 4.6 years) who underwent abdominal MDCT in the pediatric ED during this 3-year period were enrolled in the study. One hundred and eighteen patients with suspected appendicitis underwent abdominal MDCT. Sixty four (54.2%) of them had appendicitis, which was proven by histopathology. The sensitivity of abdominal MDCT for appendicitis was found to be 98.5% and the specificity was 84.9%. In this study, the other two common causes of nontraumatic abdominal emergencies were gastrointestinal tract (GI) infections and ovarian cysts. The most common etiology of abdominal pain in children that requires imaging with abdominal MDCT is appendicitis. MDCT has become a preferred and invaluable imaging modality in evaluating uncertain cases of pediatric acute abdominal pain in ED, in particular for suspected appendicitis, neoplasms, and gastrointestinal abnormalities.

  8. ECG-gated multidetector computed tomography for the assessment of the postoperative ascending aorta.

    PubMed

    Runza, G; Fattouch, K; Cademartiri, F; La Fata, A; Damiani, L; La Grutta, L; Tedeschi, C; Basile, A; Mollet, N R; Bartolotta, T V; Pisani, G; Ruvolo, G; Midiri, M; Lagalla, R

    2009-08-01

    This study was undertaken to define the role of electrocardiographically (ECG)-gated multidetector computed tomography (MDCT) in the assessment of the postoperative ascending aorta. From November 2006 to June 2007, 21 patients, [11 men, ten women; age +/- standard deviation (SD): 62.7+/-10.8 years] with a history of ascending aorta replacement underwent ECG-gated MDCT and were prospectively included in our study. Ascending aorta replacement had been performed with different surgical techniques: Bentall-De Bono (four patients, 19%), Tirone-David (five patients, 23%), and modified Tirone-David with creation of aortic neosinuses (12 patients, 57%). Two patients were excluded from MDCT evaluation because they failed to fulfil the inclusion criteria. Transthoracic echocardiography was used as the reference standard. All patients provided informed consent. In all patients, ECG-gated MDCT provided a clear depiction of the aortic annulus, aortic root and ascending aorta, enabling accurate measurements in all cases. The aortic valve area (3.4+/-0.2 cm(2)), the diameter of the sinotubular junction (31.6+/-1.8 mm), the diameter of the neosinuses in the case of modified Tirone-David procedures (37.3+/-2.1 mm) and the distance between the cusps and the graft wall during systole (3.1+/-0.7 mm) fell within standard ranges and showed a good correlation (r=0.89) with the values obtained with transthoracic echocardiography. MDCT is currently considered a compulsory diagnostic step in patients with suspected or known aortic pathology. MDCT is a reliable technique for anatomical and functional assessment of the postoperative aortic root and provides cardiac surgeons with new and detailed information, enabling them to formulate a prognostic opinion regarding the outcome of the surgical procedure.

  9. Automated assessment of the aortic root dimensions with multidetector row computed tomography.

    PubMed

    Delgado, Victoria; Ng, Arnold C T; Schuijf, Joanne D; van der Kley, Frank; Shanks, Miriam; Tops, Laurens F; van de Veire, Nico R L; de Roos, Albert; Kroft, Lucia J M; Schalij, Martin J; Bax, Jeroen J

    2011-03-01

    Accurate aortic root measurements and evaluation of spatial relationships with coronary ostia are crucial in preoperative transcatheter aortic valve implantation assessments. Standardization of measurements may increase intraobserver and interobserver reproducibility to promote procedural success rate and reduce the frequency of procedurally related complications. This study evaluated the accuracy and reproducibility of a novel automated multidetector row computed tomography (MDCT) imaging postprocessing software, 3mensio Valves (version 4.1.sp1, Medical Imaging BV, Bilthoven, The Netherlands), in the assessment of patients with severe aortic stenosis candidates for transcatheter aortic valve implantation. Ninety patients with aortic valve disease were evaluated with 64-row and 320-row MDCT. Aortic valve annular size, aortic root dimensions, and height of the coronary ostia relative to the aortic valve annular plane were measured with the 3mensio Valves software. The measurements were compared with those obtained manually by the Vitrea2 software (Vital Images, Minneapolis, MN). Assessment of aortic valve annulus and aortic root dimensions were feasible in all the patients using the automated 3mensio Valves software. There were excellent agreements with minimal bias between automated and manual MDCT measurements as demonstrated by Bland-Altman analysis and intraclass correlation coefficients ranging from 0.97 to 0.99. The automated 3mensio Valves software had better interobserver reproducibility and required less image postprocessing time than manual assessment. Novel automated MDCT postprocessing imaging software (3mensio Valves) permits reliable, reproducible, and automated assessments of the aortic root dimensions and spatial relations with the surrounding structures. This has important clinical implications for preoperative assessments of patients undergoing transcatheter aortic valve implantation. Copyright © 2011 The Society of Thoracic Surgeons. Published by

  10. Automated 3-dimensional aortic annular assessment by multidetector computed tomography in transcatheter aortic valve implantation.

    PubMed

    Watanabe, Yusuke; Morice, Marie-Claude; Bouvier, Erik; Leong, Tora; Hayashida, Kentaro; Lefèvre, Thierry; Hovasse, Thomas; Romano, Mauro; Chevalier, Bernard; Donzeau-Gouge, Patrick; Farge, Arnaud; Cormier, Bertrand; Garot, Philippe

    2013-09-01

    This study sought to evaluate the accuracy, reproducibility, and predictive value for post-procedural aortic regurgitation (AR) of an automated multidetector computed tomography (MDCT) post-processing imaging software, 3mensio Valves (version 5.1.sp1, 3mensio Medical Imaging BV, the Netherlands), in the assessment of patients undergoing transcatheter aortic valve implantation (TAVI). Accurate pre-operative aortic annulus measurements are crucial for patients undergoing TAVI. One hundred five patients undergoing MDCT screening before TAVI were evaluated. Aortic annular measurement was compared between automated 3mensio Valves software and manual data post-processing software on a dedicated workstation; we analyzed the discrimination value of annulus measurement for post-procedural AR in 44 recipients of a self-expanding valve. The automated 3mensio Valves software showed good concordance with manual MDCT measurements as demonstrated by Bland-Altman analysis. The automated software provided equally good reproducibility as manual measurement, especially for measurement of aortic annulus area (intraobserver intraclass correlation coefficients 0.98 vs. 0.97, interobserver 0.98 vs. 0.95). In 44 patients after implantation of a self-expanding valve, the valve diameter/CT-measured geometric mean annulus diameter ratio by automated 3mensio Valves software showed moderate and better discrimination ability in predicting post-procedural AR compared with manual measurement (p = 0.12, area under the curve 0.77, 95% confidence interval: 0.63 to 0.91, area under the curve 0.68, 95% confidence interval: 0.50 to 0.86, respectively). The automated 3mensio Valves software demonstrated reliable, reproducible aortic annulus measurement and better predictive value for post-procedural AR, suggesting important clinical implications for pre-operative assessment of patients undergoing TAVI. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights

  11. Quantitative analysis of vascular dimension and plaque composition in coronary multidetector computed tomography images

    NASA Astrophysics Data System (ADS)

    Olszewski, Mark E.; Wahle, Andreas; Vembar, Mani; Ciancibello, Les; Kerner, Arthur; Beyar, Rafael; Ghersin, Eduard; Subramanyan, Krishna; Sonka, Milan

    2006-03-01

    The noninvasive assessment of coronary atherosclerosis holds great promise for the future of cardiovascular medicine, and multidetector computed tomography (MDCT) has recently taken the lead in this area. Earlier studies have shown the ability of MDCT to visualize the coronary lumen and various types of atherosclerotic plaque. The aims of this project are to design, implement, and validate a complete system for the automated, quantitative analysis of coronary MDCT images. The developed system uses graph algorithms and knowledge-based cost functions to automatically segment the lumen and wall, and then uses pattern classification techniques to identify and quantify the tissue types found within the detected vascular wall. The system has been validated in comparison with expert tracings and labels, as well as in comparison with intravascular ultrasound (IVUS). In the former, the radial position of the lumen and adventitia were compared at 360 corresponding angular locations in 299 vascular cross sections (from 13 vessels in 5 patients: 5 RCA, 4 LAD, 4 LCX). Results show a border positioning error of 0.150 +/- 0.090 mm unsigned / 0.007 +/- 0.001 mm signed for the lumen, and 0.210 +/- 0.120 mm unsigned / 0.020 +/- 0.030 mm signed for the vessel wall. In the comparison with IVUS, the luminal and vascular cross sectional areas were compared in 7 vessels; good correlation was shown for both the lumen (R=0.83) and the vessel wall (R=0.76). The plaque characterization algorithm correctly classified 92% of calcified plaques and 87% of non-calcified plaques.

  12. Multidetector Computed Tomography and Magnetic Resonance Imaging Evaluation of Craniovertebral junction Abnormalities

    PubMed Central

    Dhadve, Rajshree U.; Garge, Shaileshkumar S.; Vyas, Pooja D.; Thakker, Nirav R.; Shah, Sonali H.; Jaggi, Sunila T.; Talwar, Inder A.

    2015-01-01

    Background: Craniovertebral junction (CVJ) abnormalities constitute an important group of treatable neurological disorders with diagnostic dilemma. Their precise diagnosis, identification of probable etiology, and pretreatment evaluation significantly affects prognosis and quality of life of patients. Aims: The study was to classify various craniovertebral junction disorders according to their etiology and to define the importance of precise diagnosis for pretreatment evaluation with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI). Materials and Methods: This is a prospective observational study of 62 patients referred to our department between October 2012 and September 2014. All patients suspected to have a craniovertebral junction disorder were included in the study, from all age groups and both genders. Detailed clinical history was taken. Radiographs of cervical spine were collected if available. All patients were subjected to MDCT and/or MRI. Results: In our study of 62 patients; 39 were males and 23 were females, with male to female ratio of 1.6:1. Most common age group was 2nd -3rd decade (19 patients, 30.64%). Developmental anomalies (33 patients, 53.22%) were the most common etiology group followed by traumatic (10 patients, 16.12%), degenerative (eight patients, 12.90%), infective (four patients, 6.45%), inflammatory and neoplastic (three patients each, 4.8%), and no cause found in one patient. Conclusions: CVJ abnormalities constitute an important group of treatable neurological disorders, especially in certain ethnic groups and are approached with much caution by clinicians. Thus, it is essential that radiologists should be able to make a precise diagnosis of craniovertebral junction abnormalities, classify them into etiological group, and rule out important mimickers on MDCT and/or MRI, as this information ultimately helps determine the management of such abnormalities, prognosis, and quality of life of patients. PMID

  13. Is multidetector computed tomography comparable to magnetic resonance imaging for assessment of lumbar foraminal stenosis?

    PubMed

    Kang, Woo Young; Ahn, Joong Mo; Lee, Joon Woo; Lee, Eugene; Bae, Yun Jung; Seo, Jiwoon; Kim, Junghoon; Kang, Heung Sik

    2017-02-01

    Background Both multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are used for assessment of lumbar foraminal stenosis (LFS). Therefore, it is relevant to assess agreement between these imaging modalities. Purpose To determine intermodality, inter-, and intra-observer agreement for assessment of LFS on MDCT and MRI. Material and Methods A total of 120 foramina in 20 patients who visited our institution in January and February 2014 were evaluated by six radiologists with different levels of experience. Radiologists evaluated presence and severity of LFS on sagittal CT and MR images according to a previously published LFS grading system. Intermodality agreement was analyzed by using weighted kappa statistics, while inter- and intra-observer agreement were analyzed by using intraclass correlation coefficients (ICCs) and kappa statistics. Results Overall intermodality agreement was moderate to good (kappa, 0.478-0.765). In particular, two professors and one fellow tended to overestimate the degree of LFS on CT compared with MRI. For inter-observer agreement of all six observers, ICCs indicated excellent agreement for both CT (0.774) and MRI (0.771), while Fleiss' kappa values showed moderate agreement for CT (0.482) and MRI (0.575). There was better agreement between professors and fellows compared with residents. For intra-observer agreement, ICCs indicated excellent agreement, while kappa values showed good to excellent agreement for both CT and MRI. Conclusion MDCT was comparable to MRI for diagnosis and assessment of LFS, especially for experienced observers. However, there was a tendency to overestimate the degree of LFS on MDCT compared with MRI.

  14. 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.

  15. Using the 320-Multidetector Computed Tomography scanner for four-dimensional functional assessment of the elbow joint.

    PubMed

    Goh, Yin Peng; Lau, Kenneth K

    2012-02-01

    As described in this case report, the use of the 320-Multidetector Computed Tomography scanner (Aquilion One, Toshiba Medical Systems, Japan) to produce continuous 3-dimensional images in real time, over a distance of 16 cm in the z-axis, proved to aid in the diagnosis of a patient's restrictive elbow joint. This state-of-the-art scanner allows fast and noninvasive dynamic-kinematic functional evaluation of the elbow joint in vivo. It will also be applicable to kinematic studies of other joints.

  16. Significance of PQ interval in acquisition of coronary multidetector row computed tomography.

    PubMed

    Sano, Tomonari; Kondo, Takeshi; Matsutani, Hideyuki; Morita, Hitomi; Arai, Takehiro; Sekine, Takako; Takase, Shinichi; Oida, Akitsugu; Fukazawa, Hiroshi; Kodama, Takahide; Kondo, Makoto; Orihara, Tadaaki; Yamada, Norikazu; Narula, Jagat

    2009-12-01

    Since image quality obtained in the mid-diastolic [or slow filling (SF)] phase is generally superior to end-systolic image in coronary multidetector row computed tomography (MDCT), low heart rate (HR) comprises the most important factor for acquisition of high-quality images. However, despite HR <70 and optimum breath-hold, sometimes high quality images cannot be obtained in SF. We assessed the significance of PQ interval in acquisition of coronary MDCT. Of 541 consecutive patients who underwent coronary MDCT, 7 patients with incomplete breath-hold, 62 HR ≥70, and 70 arrhythmias were excluded. The remaining 402 patients (M: 222, 66±11 years), including 38 with first-degree atrioventricular block (1° AVB, PQ >200 ms) were evaluated. RR and PQ were measured on electrocardiogram and systolic and SF phase with 4-chamber cine cardiac computed tomography. SF significantly (p<0.0001) correlated with RR (SF=-471+0.720RR, r=0.887) in all subjects. The SF of without 1° AVB (292±97 ms) was significantly (p<0.0147) longer than that of with 1° AVB (251±121 ms), although RR was not significantly different between the two groups. The SF/RR of without 1° AVB (27.2±6.1%) was also significantly (p<0.0001) higher than that of with 1° AVB (22.7±8.0%). The coefficient of correlation between (RR-PQ) and SF [r=0.915, p<0.0001, SF=-362+0.742(RR-PQ)] was significantly (p<0.034) higher than that of correlation between RR and SF in all subjects. The SF of rank A image quality was significantly longer than that of rank B (p<0.0001) or rank C (p=0.0042). In critical HR (60-69 bpm), the optimum phase was ES in 7/139 patients without 1° AVB, and SF in 3/13 patients with 1° AVB (chi(2), p<0.0416). Since SF depends on (RR-PQ), if PQ is long in critical HR, it might be difficult to reconstruct high quality images in the SF phase.

  17. Dynamic multidetector computed tomography findings of hepatocellular carcinoma of hepatitis B virus-positive and -negative patients

    PubMed Central

    2014-01-01

    Background The objective of this study was to retrospectively investigate and compare multidetector computed tomography findings of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive and -negative patients. Methods Triphasic (arterial, portal venous, and delayed phases) dynamic multidetector computed tomography (CT) was performed in 83 patients with HCC, 48 of whom were HBV-positive. The diagnosis of HCC was established with typical CT imaging findings (68 patients) or histopathological evaluation (15 patients). Distribution of solitary, multiple, and diffuse HCC, portal/hepatic vein thrombosis, metastasis, and patients with high alpha-fetoprotein levels in the HBV-positive and -negative groups were compared using the Kolmogorov–Smirnov test. Lesion size, alpha-fetoprotein levels, arterial, portal, delayed enhancement, and washout of lesions were compared using the Student’s t-test. Results Hypervascular tumors were observed in 72 (87%) patients, and hypovascular tumors were found in 11 (13%) patients. The mean alpha-fetoprotein value of HBV-positive patients with HCC was significantly higher than the mean alpha-fetoprotein value of HBV-negative patients (P < 0.05). Portal/hepatic vein thrombosis and metastasis were more frequently observed in HBV-positive patients (P < 0.05). The frequencies of solitary, multiple, and diffuse lesions in HBV-positive and -negative patients were not significantly different (P > 0.05). The mean diameters, arterial, portal, and delayed phase attenuations, and washout of HCC were not significantly different (P > 0.05). Conclusions Multidetector CT imaging findings of HCC in HBV-positive and -negative patients are alike. Portal/hepatic vein thrombosis and metastasis are more frequently observed in HBV-positive patients. Alpha-fetoprotein levels are higher in HBV-positive patients. PMID:25608603

  18. [Study of renal veins by multidetector-row computed tomography scans].

    PubMed

    Bouali, O; Mouttalib, S; Labarre, D; Munzer, C; Lopez, R; Lauwers, F; Moscovici, J

    2014-12-01

    To determine the prevalence of renal vein variants. To investigate the distribution of renal veins. We retrospectively reviewed spiral computed tomography (CT) scans of the abdomen performed during a two-month period. The same protocol was used for all CT scans: same multidetector-row CT scanner (Siemens(®)), 1 to 2-mm section thickness, injection of intravenous iomeprol. The study group included 121 patients, aged 21.7 to 93.4 years (mean age 60.9 ± 15.4 years). The sex ratio was 2/1, with 80 men and 41 women. Seventy-three percent of the study group (88 patients) had no variants of the renal veins. Indeed almost 40% (48 patients) had one artery and one vein on each side, with typical course, and 33% (40 patients) had course and/or number variants of the renal arteries. Variants of the right renal vein consisted in multiple veins in 20.6% (25 cases). We detected no case of multiple left renal veins, but we described variations of its course in 9.1% (11 cases): 5 cases of retroaortic left renal vein (4.1%) and 6 cases of circumaortic left renal vein (5%). Three of these 11 patients had an associated double right renal vein. The probability to have a right renal vein variant was significantly higher than a left one (OR = 2.6, P = 0.01). And we found a significantly higher risk of having a venous variant in women (OR = 2.4, P = 0.04). We detected no case of inferior vena cava variant. In our study, prevalence of a circum- or retroaortic left renal vein appeared higher than previously reported in the literature (9.1%). Knowledge of anatomical variants of renal vasculature is crucial and this study puts the emphasis on variations of course and number of renal vessels. Those variations are not so uncommon and should be known by radiologists and also by surgeons. Their knowledge has major clinical implications in practice and it contributes to the safety of renal and retroperitoneal surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Precision of dosimetry-related measurements obtained on current multidetector computed tomography scanners

    SciTech Connect

    Mathieu, Kelsey B.; McNitt-Gray, Michael F.; Zhang, Di; Kim, Hyun J.; Cody, Dianna D.

    2010-08-15

    Purpose: Computed tomography (CT) intrascanner and interscanner variability has not been well characterized. Thus, the purpose of this study was to examine the within-run, between-run, and between-scanner precision of physical dosimetry-related measurements collected over the course of 1 yr on three different makes and models of multidetector row CT (MDCT) scanners. Methods: Physical measurements were collected using nine CT scanners (three scanners each of GE VCT, GE LightSpeed 16, and Siemens Sensation 64 CT). Measurements were made using various combinations of technical factors, including kVp, type of bowtie filter, and x-ray beam collimation, for several dosimetry-related quantities, including (a) free-in-air CT dose index (CTDI{sub 100,air}); (b) calculated half-value layers and quarter-value layers; and (c) weighted CT dose index (CTDI{sub w}) calculated from exposure measurements collected in both a 16 and 32 cm diameter CTDI phantom. Data collection was repeated at several different time intervals, ranging from seconds (for CTDI{sub 100,air} values) to weekly for 3 weeks and then quarterly or triannually for 1 yr. Precision of the data was quantified by the percent coefficient of variation (%CV). Results: The maximum relative precision error (maximum %CV value) across all dosimetry metrics, time periods, and scanners included in this study was 4.33%. The median observed %CV values for CTDI{sub 100,air} ranged from 0.05% to 0.19% over several seconds, 0.12%-0.52% over 1 week, and 0.58%-2.31% over 3-4 months. For CTDI{sub w} for a 16 and 32 cm CTDI phantom, respectively, the range of median %CVs was 0.38%-1.14% and 0.62%-1.23% in data gathered weekly for 3 weeks and 1.32%-2.79% and 0.84%-2.47% in data gathered quarterly or triannually for 1 yr. Conclusions: From a dosimetry perspective, the MDCT scanners tested in this study demonstrated a high degree of within-run, between-run, and between-scanner precision (with relative precision errors typically well

  20. Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion.

    PubMed

    Ippolito, Davide; Drago, Silvia Girolama; Franzesi, Cammillo Talei; Fior, Davide; Sironi, Sandro

    2016-05-28

    To assess the diagnostic accuracy of multidetector-row computed tomography (MDCT) as compared with conventional magnetic resonance imaging (MRI), in identifying mesorectal fascia (MRF) invasion in rectal cancer patients. Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner (ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 mAs. Imaging data were reviewed as axial and as multiplanar reconstructions (MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images (DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed. According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91 (41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged (45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value (PPV) 80.4%, negative predictive value (NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the

  1. Stature estimation in a contemporary Japanese population based on clavicular measurements using multidetector computed tomography.

    PubMed

    Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Yajima, Daisuke; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Yamaguchi, Rutsuko; Hashimoto, Mari; Hoshioka, Yumi; Iwase, Hirotaro

    2017-03-08

    The aims of this study was to assess the correlation between stature and clavicular measurements in a contemporary Japanese population using three-dimensional (3D) computed tomographic (CT) images, and to establish regression equations for predicting stature. A total of 249 cadavers (131 males, 118 females) underwent postmortem CT scanning and subsequent forensic autopsy between October 2011 and May 2016 in our department. Four clavicular variables (linear distances between the superior margins of the left and right sternal facets to the anterior points of the left and right acromial ends and between the superior margins of the left and right sternal facets to the left and right conoid tubercles) were measured using 3D CT reconstructed images that extracted only bone data. The correlations between stature and each of the clavicular measurements were assessed with Pearson product-moment correlation coefficients. These clavicular measurements correlated significantly with stature in both sexes. The lowest standard error of estimation value in all, male, and female subjects was 3.62cm (r(2)=0.836), 3.55cm (r(2)=0.566), and 3.43cm (r(2)=0.663), respectively. In conclusion, clavicular measurements obtained from 3D CT images may be useful for stature estimation of Japanese individuals, particularly in cases where better predictors, such as long bones, are not available.

  2. [Hardware-software system for monitoring parameters and characteristics of X-ray computer tomographs under operation conditions].

    PubMed

    Blinov, N N; Zelikman, M I; Kruchinin, S A

    2007-01-01

    The results of testing of hardware and software for monitoring parameters (mean number of CT units, noise, field uniformity, high-contrast spatial resolution, layer width, dose) and characteristics (modulation transfer function) of X-ray computer tomographs are presented. The developed hardware and software are used to monitor the stability of X-ray computer tomograph parameters under operation conditions.

  3. Detection of root perforations using conventional and digital intraoral radiography, multidetector computed tomography and cone beam computed tomography

    PubMed Central

    Eskandarloo, Amir; Noruzi-Gangachin, Maruf; Khajeh, Samira

    2015-01-01

    Objectives This study aimed to compare the accuracy of conventional intraoral (CI) radiography, photostimulable phosphor (PSP) radiography, cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) for detection of strip and root perforations in endodontically treated teeth. Materials and Methods Mesial and distal roots of 72 recently extracted molar were endodontically prepared. Perforations were created in 0.2, 0.3, or 0.4 mm diameter around the furcation of 48 roots (strip perforation) and at the external surface of 48 roots (root perforation); 48 roots were not perforated (control group). After root obturation, intraoral radiography, CBCT and MDCT were taken. Discontinuity in the root structure was interpreted as perforation. Two observers examined the images. Data were analyzed using Stata software and Chi-square test. Results The sensitivity and specificity of CI, PSP, CBCT and MDCT in detection of strip perforations were 81.25% and 93.75%, 85.42% and 91.67%, 97.92% and 85.42%, and 72.92% and 87.50%, respectively. For diagnosis of root perforation, the sensitivity and specificity were 87.50% and 93.75%, 89.58% and 91.67%, 97.92% and 85.42%, and 81.25% and 87.50%, respectively. For detection of strip perforation, the difference between CBCT and all other methods including CI, PSP and MDCT was significant (p < 0.05). For detection of root perforation, only the difference between CBCT and MDCT was significant, and for all the other methods no statistically significant difference was observed. Conclusions If it is not possible to diagnose the root perforations by periapical radiographs, CBCT is the best radiographic technique while MDCT is not recommended. PMID:25671214

  4. Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography.

    PubMed

    Yamashita, K; Shimizu, K

    2008-02-01

    Video-assisted breast surgery (VABS) is a less invasive and aesthetically better option for benign and malignant breast diseases and for sentinel lymph node biopsy (SLNB). The authors have performed 150 VABS procedures since December 2001. They have examined the usefulness of three-dimensional computed tomographic (3D-CT) lymphography for detecting sentinel lymph nodes (SLNs) precisely, as well as the cosmetic and treatment results of VABS. In this study, VABS was performed with a 2.5-cm skin incision in the axilla or periareola (1 cm in the axilla for SLNB), using a retraction method, for mammary gland resection, SLNB, axillary lymph node dissection, and breast reconstruction under video assistance. On the day before the surgery, 3D-CT lymphography was performed to mark SLN on the skin. Above the tumor and near the areola, 2 ml of Iopamiron 300 was injected subcutaneously. A 16-channnel multidetector-row helical CT scan image was taken after 1 min and reconstructed to produce a 3D image. Sentinel lymph node biopsy was performed by the VABS technique using the Visiport. The VABS procedure was performed for 19 benign and 131 malignant diseases, and 115 SLNBs (74 with 3D-CT) were performed. The SLNs were shown precisely by 3D-CT lymphography, as proved by a case of lymph node metastasis, in which accurate relationships between lymph ducts and SLNs were shown. These were classified into four patterns: a single duct to single node (40 cases), multiple ducts to a single node (13 cases), a single duct to multiple nodes (1 case), and multiple ducts to multiple nodes (12 cases). The SLNB procedure can be performed safely by 3D-CT lymphography and less invasively by VABS. The findings show that 3D-CT lymphography is useful for performing precise SLNB using VABS.

  5. Computed tomographic findings of cerebral fat embolism following multiple bone fractures.

    PubMed

    Law, Huong Ling; Wong, Siong Lung; Tan, Suzet

    2013-02-01

    Fat embolism to the lungs and brain is an uncommon complication following fractures. Few reports with descriptions of computed tomographic (CT) findings of emboli to the brain or cerebral fat embolism are available. We report a case of cerebral fat embolism following multiple skeletal fractures and present its CT findings here.

  6. Computed tomographic enteroclysis with air and virtual enteroscopy: protocol and feasibility for small bowel evaluation.

    PubMed

    Yoshikawa, Toshiyuki; Takehara, Yasuo; Kikuyama, Masataka; Takeuchi, Ken; Hanai, Hiroyuki

    2012-04-01

    We describe our optimized protocol for computed tomographic enteroclysis using air as the contrast material and report an early assessment of its clinical performance. Thirty-one examinations of computed tomographic enteroclysis with air were performed in 30 patients in our hospital from September 2008 to September 2010. The volume of injected air and intra-intestinal pressure were monitored in 16 cases. The data were reviewed for ratios of successful whole small bowel depictions out of the total number of examinations for patients without stenosis. Efforts were made to confirm depicted abnormal findings when possible by other imaging techniques, intra-operative findings, histopathological findings, and subsequent history. The injected air volume and final intra-intestinal pressure were 2925 ± 686 ml and 24.5 ± 7.1cm H₂O in cases without stenosis. In 19 examinations with anterograde air injection for patients without stenosis, whole small bowel depiction was achieved in 16 (84.2%). Computed tomographic enteroclysis with air was useful for detecting strictures (in Crohn's disease, malignant lymphoma, metastatic carcinoma), Meckel's diverticulum, and for excluding other obstructive conditions in ileus. Computed tomographic enteroclysis with air has a potential to enable the exploration of the whole small bowel, thereby providing information of small bowel lesions that complements other techniques. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. The interface sign: a computed tomographic sign for distinguishig pleural and intra-abdominal fluid

    SciTech Connect

    Teplick, J.G.; Teplick, S.K.; Goodman, L.; Haskin, M.E.

    1982-07-01

    On computed tomographic scans of the upper abdomen the interface sign can help distinguish pleural and intra-abdominal fluid readily and accurately.A hazy interface between the fluid and liver or spleen is characteristic of pleural fluid. A sharp interface is characteristic of ascites. The interface sign has proved to be accurate in 30 consecutive cases.

  8. Parallel computing for simultaneous iterative tomographic imaging by graphics processing units

    NASA Astrophysics Data System (ADS)

    Bello-Maldonado, Pedro D.; López, Ricardo; Rogers, Colleen; Jin, Yuanwei; Lu, Enyue

    2016-05-01

    In this paper, we address the problem of accelerating inversion algorithms for nonlinear acoustic tomographic imaging by parallel computing on graphics processing units (GPUs). Nonlinear inversion algorithms for tomographic imaging often rely on iterative algorithms for solving an inverse problem, thus computationally intensive. We study the simultaneous iterative reconstruction technique (SIRT) for the multiple-input-multiple-output (MIMO) tomography algorithm which enables parallel computations of the grid points as well as the parallel execution of multiple source excitation. Using graphics processing units (GPUs) and the Compute Unified Device Architecture (CUDA) programming model an overall improvement of 26.33x was achieved when combining both approaches compared with sequential algorithms. Furthermore we propose an adaptive iterative relaxation factor and the use of non-uniform weights to improve the overall convergence of the algorithm. Using these techniques, fast computations can be performed in parallel without the loss of image quality during the reconstruction process.

  9. A study of temporomandibular joint osteoarthritis using computed tomographic imaging.

    PubMed

    Massilla Mani, F; Sivasubramanian, S Satha

    2016-06-01

    This study aimed to determine the various bony changes in osteoarthritis (OA) of elderly patients who are suffering from temporomandibular joint dysfunction (TMD) and to find if all the changes manifesting in generalized OA were presented in temporomandibular joint (TMJ). Thirty TMJs of fifteen elderly patients who were diagnosed with TMD were selected for the study. Patient with TMD were subjected to computerized tomographic (CT) imaging, and the various bony changes in the TMJ were recorded. CT study of TMJ showed that there is a positive evidence of joint involvement in 80% of the cases. In this study, female patients were more commonly affected by OA than the males. The condylar changes (69.93%) are more common than the changes in the articular eminence (6.6%) and condylar fossa (10%). About 56.6% of TMJ in the study was affected by the early manifestations of the OA. CT study showed that there is a positive evidence of TMJ involvement in the elderly patients with TMD. The results show that condylar changes are more common than the changes in the articular eminence and condylar fossa. The study also shows that most of the patients are affected by early TMJ OA; hence, initiating treatment at early stages may prevent the disease progression. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  10. Primary pontine haemorrhage: clinical and computed tomographic correlations.

    PubMed Central

    Weisberg, L A

    1986-01-01

    The clinical and computerised tomographic findings in 40 patients with primary pontine haemorrhage were reviewed. Twenty-nine patients were hypertensive. Four patients had angiographic or necropsy evidence of vascular malformations. In 33 cases, there was rapid deterioration to maximal neurological deficit; whereas in seven cases, there was sudden onset but subsequent progression to maximal deficit 24 hours to 5 days following the initial ictus. Seven patients had clinical features considered atypical for pontine haemorrhage. Five patients survived and four of these were capable of performing activities of daily living within 3 months of the haemorrhage. In all cases CT showed a hyperdense non-enhancing brain stem haematoma. There was evidence of ventricular extension in 27 cases. There was CT evidence of subarachnoid blood in only two patients who also had vascular malformations. In 26 cases, there was CT evidence that the haematoma extended to the midbrain and in four cases to the thalamic region. In six cases CT was repeated 6 to 21 days after the initial scan and it showed resolution of the haematoma in size and density; none of the haematomas showed post-contrast enhancement on initial or follow-up CT. Images PMID:3701344

  11. Mapping epicardial fat with multi-detector computed tomography to facilitate percutaneous transepicardial arrhythmia ablation.

    PubMed

    Abbara, Suhny; Desai, Jay C; Cury, Ricardo C; Butler, Javed; Nieman, Koen; Reddy, Vivek

    2006-03-01

    A sizable portion of ventricular tachycardia circuits are epicardial, especially in patients with non-ischemic cardiomyopathy, e.g. Chagas disease. Thus there is a growing interest among the electrophysiologists in transepicardial mapping and myocardial ablation for treatment of arrhythmias. However, increased epicardial fat can be a significant hindrance in procedural success as it can mimic infarct during mapping and can also decrease the effectiveness of ablation. Quantitative knowledge of epicardial fat pre-procedure can potentially significantly facilitate the conduct and outcomes of these procedures. In this study we assessed the epicardial fat distribution and thickness in vivo in 59 patients who underwent multi-detector computed tomography (MDCT) for coronary artery assessment using a 16-slice scanner. Multiplanar reconstructions were obtained in the ventricular short axis at the basal, mid ventricular, and near the apex level, and in a four-chamber view. In the short axis slices, we measured epicardial fat diameter in nine segments, and in the four-chamber view, it was measured in five segments. In grooved segments the maximum fat thickness was recorded, while in non-grooved segments thickness at three equally spaced points were averaged. The results were as follows starting clockwise: superior inter-ventricular (IV) groove (all measurements are in mm, in basal, mid ventricular, and apical levels, respectively) (11.2, 8.6, 7.3), left ventricular (LV) superior lateral wall (1.0, 1.5, 1.7), LV inferior lateral wall (1.3, 2.2, 3.5), inferior IV groove (9.2, 6.5, 6.1), right ventricular (RV) diaphragmatic wall (1.4, 0.2, 1.0), acute margin (9.2, 7.3, 7.8), RV anterior free wall inferior (6.8, 4.0, 4.7), RV anterior free wall superior (6.5, 3.2, 3.1), RV superior wall (5.6, 2.7, 4.0), We measured the following four-chamber segments: LV apex (2.8 mm), left atrio-ventricular (AV) groove (12.7), right AV groove (14.8), RV apex (4.8), and anterior IV groove (7

  12. Role of cardiac multidetector computed tomography in the exclusion of ischemic etiology in heart failure patients.

    PubMed

    Sousa, Pedro A; Bettencourt, Nuno; Dias Ferreira, Nuno; Carvalho, Mónica; Leite, Daniel; Ferreira, Wilson; de Jesus, Ilídio; Gama, Vasco

    2014-10-01

    Differentiation of ischemic from non-ischemic etiology in heart failure (HF) patients has both therapeutic and prognostic implications. One possible approach to this differentiation is direct visualization of the coronary tree. Multidetector computed tomography (MDCT) has emerged as an alternative to invasive coronary angiography (ICA), but its performance and additional clinical value are still not well validated in patients with left ventricular (LV) dysfunction. We aimed to assess the value of coronary MDCT angiography (CTA) in the exclusion of ischemic etiology in HF patients and to determine whether the Agatston calcium score could be used as a gatekeeper for CTA in this context. We retrospectively selected symptomatic HF patients with LV ejection fraction (LVEF) <50%, as assessed by echocardiography, referred for CTA between April 2006 and May 2013. Patients with previously known CAD or valvular disease were excluded. The performance of MDCT in the detection of coronary artery disease (CAD) and/or exclusion of an ischemic etiology for HF was studied. Obstructive CAD was defined as the presence of ≥50% luminal stenosis in at least one epicardial coronary artery as assessed by CTA and was assumed in patients with an Agatston coronary artery calcium (CAC) score >400. In patients referred for ICA, an ischemic etiology was assumed in the presence of ≥75% stenosis in two or more epicardial vessels or ≥75% stenosis in the left main or proximal left anterior descending artery. During this period 100 patients (mean age 57.3±10.5 years, 64% men) with HF and systolic dysfunction were referred for MDCT to exclude CAD. Median effective radiation dose was 4.8 mSv (interquartile range 5.8 mSv). Mean LVEF was 35±7.7% (range 20-48%) and median CAC score was 13 (interquartile range 212). Seven patients were in atrial fibrillation. Almost half of the patients (40%) had no CAC and none of these had significant stenosis on CTA. In an additional group of 33 patients CTA

  13. Detection of various anatomic patterns of root canals in mandibular incisors using digital periapical radiography, 3 cone-beam computed tomographic scanners, and micro-computed tomographic imaging.

    PubMed

    Paes da Silva Ramos Fernandes, Luciana Maria; Rice, Dwight; Ordinola-Zapata, Ronald; Alvares Capelozza, Ana Lucia; Bramante, Clovis Monteiro; Jaramillo, David; Christensen, Heidi

    2014-01-01

    The purpose of this study was to compare the accuracy of digital periapical (PA) radiography and 3 cone-beam computed tomographic (CBCT) scanners in the identification of various internal anatomic patterns in mandibular incisors. Forty mandibular incisors were scanned using micro-computed tomographic imaging as the gold standard to establish the internal anatomic pattern. The number of root canals and internal patterns were classified into type I (single canal, n = 12), type Ia (single oval canal, n = 12), and type III (2 canals, n = 16). The teeth were placed in a human mandible, and digital PA radiography and 3 CBCT scans (Kodak 9000 3D [Carestream Health, Rochester, NY], Veraviewepocs 3De [J Morita MFG Corp, Kyoto, Japan], NewTom 5G [QR Srl, Verona, Italy]) were performed. Two blinded examiners classified each tooth's anatomic pattern, which were then compared with the micro-computed tomographic determinations. Considering type I and type Ia, which both presented with 1 root canal, there was a high degree of accuracy for all methods used (P > .05). The same result was found for type III. When identifying the shape of single canals (type I), CBCT imaging was more accurate compared with PA radiography. Concerning oval canals (type Ia), there was a significant difference between PA radiography and NewTom CBCT (PA radiography = 44%, NewTom = 88%). However, there were no significant differences between the 3 CBCT units. Double-exposure digital PA radiography for mandibular incisors is sufficient for the identification of the number of root canals. All CBCT devices showed improved accuracy in the identification of single root canal anatomy when a narrow canal was present. However, the identification of oval canals was improved only with the NewTom CBCT device. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  14. Validation of a paediatric thyroid phantom using different multidetector computed tomography models

    NASA Astrophysics Data System (ADS)

    Alsabbagh, M.; Ng, L. Y.; Tajuddin, A. A.; Manap, M. A.; Zainon, R.

    2016-03-01

    The aim of this study was to compare the attenuation values of a fabricated paediatric thyroid phantom material using different MDCT models. A paediatric thyroid phantom was designed to mimic the shape and size of a paediatric patient with an age of 9 years using high- density Polyethylene as the phantom material. The fabricated phantom was scanned using two different multidetector CT scanners (16- and 128-row detectors). The CT numbers were evaluated and the mass attenuation coefficients (μ/ρ) of the phantom material were obtained at each applied energy from each scanner. The results were compared with the tables of the National Institute of Standards and Technology (NIST). The CTs of 16- and 128-row detectors showed that the obtained attenuation values are very similar to the NIST's values. However, the CT of the 128-row detectors showed a slightly much closer match to the NIST's values. This refers to the type and quality of the electronic connections between the detectors. Furthermore, the type and number of detectors (16- and 128-detectors) could affect the details and quality of the output images. The results show that different multidetector CTs can be used to validate the phantom and determine the mass attenuation coefficients of its material.

  15. [Usefulness of multidetector computed tomography in transcatheter aortic valve implantation. Advantage of a tridimentional imaging modality].

    PubMed

    Escobedo-Uribe, Carlos; Schoenhagen, Paul

    2015-01-01

    Aortic stenosis is the most common valvular disorder in the United States and Europe. Nowadays, surgical aortic valve replacement remains the standard treatment for patients with severe aortic stenosis; however, transcatheter aortic valve implantation represents a less invasive treatment option for aortic stenosis patients considered as high-risk or not suitable for surgical management. Because of the lack of direct visualization of the operative field in transcatheter aortic valve implantation, there is an increased need for precise pre-operative assessment of vascular anatomy. Therefore, in order to improve outcome and avoid complications, multidetector tomography is part of the routine evaluation of patients considered for this treatment. The data obtained covering the aorta and iliac arteries, allows the physician a precise planning prior to the intervention. In this review, we described basic aspects of the procedure, and the clinical relevance of the multidetector tomography. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  16. Congenital Variants and Anomalies of the Pancreas and Pancreatic Duct: Imaging by Magnetic Resonance Cholangiopancreaticography and Multidetector Computed Tomography

    PubMed Central

    Erden, Ayşe; Türkoğlu, Mehmet Akif; Yener, Özlem

    2013-01-01

    Though congenital anomalies of the pancreas and pancreatic duct are relatively uncommon and they are often discovered as an incidental finding in asymptomatic patients, some of these anomalies may lead to various clinical symptoms such as recurrent abdominal pain, nausea and vomiting. Recognition of these anomalies is important because these anomalies may be a surgically correctable cause of recurrent pancreatitis or the cause of gastric outlet obstruction. An awareness of these anomalies may help in surgical planning and prevent inadvertent ductal injury. The purpose of this article is to review normal pancreatic embryology, the appearance of ductal anatomic variants and developmental anomalies of the pancreas, with emphasis on magnetic resonance cholangiopancreaticography and multidetector computed tomography. PMID:24265565

  17. Adrenal lesions: spectrum of imaging findings with emphasis on multi-detector computed tomography and magnetic resonance imaging.

    PubMed

    Guerrisi, Antonino; Marin, Daniele; Baski, Mahbubeh; Guerrisi, Pietro; Capozza, Federica; Catalano, Carlo

    2013-01-01

    The adrenal gland is a common site of a large spectrum of abnormalities like primary tumors, hemorrhage, metastases, and enlargement of the gland from external hormonal stimulation. Most of these lesions represent nonfunctioning adrenal adenomas and thus warrant a conservative management. Multi-detector computed tomography (CT) and magnetic resonance (MR) imaging are still considered highly specific and complementary techniques for the detection and characterization of adrenal abnormalities. Radiologist can establish a definitive diagnosis for most adrenal masses (i.e., carcinoma, hemorrhage) based on imaging alone. Imaging therefore can differentiate malignant lesions from those benign and avoid unnecessary aggressive management of benign lesions. The article gives an overview of the adrenal lesions and their imaging characteristics seen on CT and MR imaging.

  18. Observational case series: an algorithm incorporating multidetector computed tomography in the medicolegal investigation of human remains after a natural disaster.

    PubMed

    Berran, Philip J; Mazuchowski, Edward L; Marzouk, Abubakr; Harcke, H Theodore

    2014-07-01

    An algorithm incorporating multidetector computed tomography (MDCT), digital radiographs, and external examination was used to triage cases for noninvasive or complete autopsy after a natural disaster. The algorithm was applied to 27 individuals who died during or soon after the earthquake that struck the Republic of Haiti on January 12, 2010. Of the 27 cases reviewed, 7 (26%) required a complete autopsy to determine cause and manner of death. In the remaining 20 (74%), cause and manner of death were determined with a reasonable degree of medical certainty after review of circumstances, an external examination, and postmortem imaging by MDCT and digital radiography (noninvasive autopsy). MDCT was particularly useful in detecting skeletal fractures caused by blunt force injury which were not evident on digital radiographs. The algorithm incorporating postmortem MDCT can be useful in the triage of human remains for autopsy after a natural disaster. © 2014 American Academy of Forensic Sciences.

  19. The case for computed tomographic angiography for initial management of lower gastrointestinal hemorrhage

    PubMed Central

    Cura, Marco

    2017-01-01

    Lower gastrointestinal hemorrhage remains a common disease, frequently presenting with acute life-threatening symptoms. Although prompt detection and treatment are imperative, it is difficult to diagnose lower gastrointestinal hemorrhage in an accurate and efficient manner. Most available modalities are time consuming. Computed tomographic angiography of the abdomen and pelvis, on the other hand, has the unique capability of rapidly detecting whether life-threatening hemorrhage is occurring and accurately localizing it, thus facilitating definitive treatment. We present a case in which computed tomographic angiography was invaluable in the detection and subsequent empirical transarterial embolization of a lower gastrointestinal hemorrhage and offer evidence as to why it should be a first-line tool in the management of these patients. PMID:28670085

  20. The case for computed tomographic angiography for initial management of lower gastrointestinal hemorrhage.

    PubMed

    Gupton, Theodore; Cura, Marco

    2017-07-01

    Lower gastrointestinal hemorrhage remains a common disease, frequently presenting with acute life-threatening symptoms. Although prompt detection and treatment are imperative, it is difficult to diagnose lower gastrointestinal hemorrhage in an accurate and efficient manner. Most available modalities are time consuming. Computed tomographic angiography of the abdomen and pelvis, on the other hand, has the unique capability of rapidly detecting whether life-threatening hemorrhage is occurring and accurately localizing it, thus facilitating definitive treatment. We present a case in which computed tomographic angiography was invaluable in the detection and subsequent empirical transarterial embolization of a lower gastrointestinal hemorrhage and offer evidence as to why it should be a first-line tool in the management of these patients.

  1. Gouda frame redesigned specifically for computed tomographic compatibility.

    PubMed

    Gouda, K I; Freidberg, S R; Baker, R A; Larsen, C R; Silverman, M L

    1986-01-01

    The Gouda stereotactic frame has been redesigned for use with computed tomography. The patient is attached to the frame, is scanned, and is moved to the operating room for stereotactic biopsy. The Gouda frame permits accurate biopsy of otherwise inaccessible tumors of the brain.

  2. Spiral computed tomographic evaluation and endodontic management of a mandibular first molar with three distal canals.

    PubMed

    Mushtaq, Mubashir; Farooq, Riyaz; Rashid, Aamir; Robbani, Irfan

    2011-04-01

    The use of spiral computed tomography serves as a boon in endodontic diagnosis of complex anatomic variations. The present case demonstrates the spiral tomographic evaluation and endodontic management of a mandibular first molar with 5 canals (2 mesial and 3 distal canals), which is a very rare anatomic variant. Such anatomic variations should be taken into account in day to day endodontic practice to ensure a high degree of clinical success.

  3. Optimal Computed Tomographic Perfusion Scan Duration for Assessment of Acute Stroke Lesion Volumes.

    PubMed

    Kasasbeh, Aimen S; Christensen, Søren; Straka, Matus; Mishra, Nishant; Mlynash, Michael; Bammer, Roland; Albers, Gregory W; Lansberg, Maarten G

    2016-12-01

    The minimal scan duration needed to obtain reliable lesion volumes with computed tomographic perfusion (CTP) has not been well established in the literature. We retrospectively assessed the impact of gradual truncation of the scan duration on acute ischemic lesion volume measurements. For each scan, we identified its optimal scan time, defined as the shortest scan duration that yields measurements of the ischemic lesion volumes similar to those obtained with longer scanning, and the relative height of the fitted venous output function at its optimal scan time. We analyzed 70 computed tomographic perfusion scans of acute stroke patients. An optimal scan time could not be determined in 11 scans (16%). For the other 59 scans, the median optimal scan time was 32.7 seconds (90th percentile 52.6 seconds; 100th percentile 68.9 seconds), and the median relative height of the fitted venous output function at the optimal scan times was 0.39 (90th percentile 0.02; 100th percentile 0.00). On the basis of a linear model, the optimal scan time was T0 plus 1.6 times the width of the venous output function (P<0.001; R(2)=0.49). This study shows how the optimal duration of a computed tomographic perfusion scan relates to the arrival time and width of the contrast bolus. This knowledge can be used to optimize computed tomographic perfusion scan protocols and to determine whether a scan is of sufficient duration. Provided a baseline (T0) of 10 seconds, a total scan duration of 60 to 70 seconds, which includes the entire downslope of the venous output function in most patients, is recommended. © 2016 American Heart Association, Inc.

  4. Development of an electrical impedance computed tomographic two-phase flows analyzer. Annual technical report for program renewal

    SciTech Connect

    Jones, O.C.

    1993-05-01

    This progress report details the theoretical development, numerical results, experimental design (mechanical), experimental design (electronic), and experimental results for the research program for the development of an electrical impedance computed tomographic two-phase flow analyzer.

  5. Computed tomographic beam-hardening artefacts: mathematical characterization and analysis.

    PubMed

    Park, Hyoung Suk; Chung, Yong Eun; Seo, Jin Keun

    2015-06-13

    This paper presents a mathematical characterization and analysis of beam-hardening artefacts in X-ray computed tomography (CT). In the field of dental and medical radiography, metal artefact reduction in CT is becoming increasingly important as artificial prostheses and metallic implants become more widespread in ageing populations. Metal artefacts are mainly caused by the beam-hardening of polychromatic X-ray photon beams, which causes mismatch between the actual sinogram data and the data model being the Radon transform of the unknown attenuation distribution in the CT reconstruction algorithm. We investigate the beam-hardening factor through a mathematical analysis of the discrepancy between the data and the Radon transform of the attenuation distribution at a fixed energy level. Separation of cupping artefacts from beam-hardening artefacts allows causes and effects of streaking artefacts to be analysed. Various computer simulations and experiments are performed to support our mathematical analysis.

  6. Computed tomographic beam-hardening artefacts: mathematical characterization and analysis

    PubMed Central

    Park, Hyoung Suk; Chung, Yong Eun; Seo, Jin Keun

    2015-01-01

    This paper presents a mathematical characterization and analysis of beam-hardening artefacts in X-ray computed tomography (CT). In the field of dental and medical radiography, metal artefact reduction in CT is becoming increasingly important as artificial prostheses and metallic implants become more widespread in ageing populations. Metal artefacts are mainly caused by the beam-hardening of polychromatic X-ray photon beams, which causes mismatch between the actual sinogram data and the data model being the Radon transform of the unknown attenuation distribution in the CT reconstruction algorithm. We investigate the beam-hardening factor through a mathematical analysis of the discrepancy between the data and the Radon transform of the attenuation distribution at a fixed energy level. Separation of cupping artefacts from beam-hardening artefacts allows causes and effects of streaking artefacts to be analysed. Various computer simulations and experiments are performed to support our mathematical analysis. PMID:25939628

  7. Computed tomographic identification of calcified optic nerve drusen

    SciTech Connect

    Ramirez, H.; Blatt, E.S.; Hibri, N.S.

    1983-07-01

    Four cases of optic disk drusen were accurately diagnosed with orbital computed tomography (CT). The radiologist should be aware of the characteristic CT finding of discrete calcification within an otherwise normal optic disk. This benign process is easily differentiated from lesions such as calcific neoplastic processes of the posterior globe. CT identification of optic disk drusen is essential in the evaluation of visual field defects, migraine-like headaches, and pseudopapilledema.

  8. V/Q SPECT and computed tomographic pulmonary angiography.

    PubMed

    Leblanc, Michel; Paul, Narinder

    2010-11-01

    Planar ventilation and perfusion (V/Q) scintigraphy has been largely displaced by computed tomography pulmonary angiography (CTPA) in recent years for the diagnosis of pulmonary embolism (PE). This change can be attributed to multiple studies that demonstrate CTPA has a reasonable sensitivity and good prognostic value in negative cases, associated with the ability to deliver few indeterminate results and provide an alternate diagnosis in a significant number of patients. However, the technique has significant limitations. The Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) study has shown a sensitivity of 83%, which is not optimal. However, CT technology has greatly progressed since this time, and therefore it is likely that this number has improved. The PIOPED II study has also shown that there may be a problem in positive or negative predictive value when the imaging results are discordant with the clinical probability. Additional concerns include allergies, contrast nephropathy associated with the use of intravenous contrast in patients with impaired creatinine clearance, suboptimal results in pregnant women, and high radiation exposure. In recent years, V/Q single-photon emission computed tomography has emerged as a mature technique for the diagnosis of PE and has been shown to be clearly superior to planar V/Q. The technique has excellent sensitivity for PE and is not associated with most of the limitations of CTPA, although it has its own set of limitations in patients with very severe chronic obstructive pulmonary disease or with a severely abnormal chest x-ray. V/Q single-photon emission computed tomography can be used as the initial modality for PE diagnosis in a wide variety of situations although CTPA remains invaluable in specific scenarios. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. Computed tomographic images of discospondylitis in a calf

    PubMed Central

    TSUKA, Takeshi; YAMAMOTO, Naoki; SANESHIGE, Makoto; MORITA, Takehito; SUNDEN, Yuji; MURAHATA, Yusuke; AZUMA, Kazuo; OSAKI, Tomohiro; ITO, Norihito; OKAMOTO, Yoshiharu; IMAGAWA, Tomohiro

    2015-01-01

    A 2-month-old male Japanese Black calf was presented with a 30-day history of progressive ataxia. Antemortem examination using computed tomography (CT) revealed narrowing of the disc spaces due to destruction of intervertebral structures between the first and second thoracic vertebrae and between the second and third thoracic vertebrae. Osteolysis was evident as irregular hypoattenuating lesions within the opposing end plates of the first, second and third thoracic vertebrae. Pseudomonas aeruginosa was detected as the causative bacteria, and discospondylitis was diagnosed. To the best of our knowledge, this is the first bovine case report describing the application of CT for the diagnosis of discospondylitis. PMID:26256229

  10. Computed tomographic diagnosis of nongastrointestinal foreign bodies in dogs.

    PubMed

    Jones, Jeryl C; Ober, Christopher P

    2007-01-01

    Clinical data and computed tomography (CT) studies were reviewed for 13 dogs with confirmed nongastrointestinal foreign bodies. Locations of foreign bodies were the nasal cavity, thoracic wall, retropharyngeal region, and cerebellum. Types of foreign bodies included small plant components, blades of grass, wooden sticks, cloth fibers, and a needle. Foreign bodies in five dogs were not identified on CT, and secondary reactions resembled neoplastic or fungal disease. In eight dogs, foreign bodies were recognized by their shape and/or internal architecture. In two dogs, three-dimensional reformatting helped demonstrate foreign bodies in relation to palpable bony landmarks.

  11. Recent Advances in Computed Tomographic Technology: Cardiopulmonary Imaging Applications.

    PubMed

    Tabari, Azadeh; Lo Gullo, Roberto; Murugan, Venkatesh; Otrakji, Alexi; Digumarthy, Subba; Kalra, Mannudeep

    2017-03-01

    Cardiothoracic diseases result in substantial morbidity and mortality. Chest computed tomography (CT) has been an imaging modality of choice for assessing a host of chest diseases, and technologic advances have enabled the emergence of coronary CT angiography as a robust noninvasive test for cardiac imaging. Technologic developments in CT have also enabled the application of dual-energy CT scanning for assessing pulmonary vascular and neoplastic processes. Concerns over increasing radiation dose from CT scanning are being addressed with introduction of more dose-efficient wide-area detector arrays and iterative reconstruction techniques. This review article discusses the technologic innovations in CT and their effect on cardiothoracic applications.

  12. Pediatric ophthalmic computed tomographic scanning and associated cancer risk.

    PubMed

    Mills, David M; Tsai, Salina; Meyer, Dale R; Belden, Clifford

    2006-12-01

    To review pediatric neuroimaging studies of the head and orbit and the radiation-induced cancer risk associated with computed tomography in light of recent attention to pediatric radioimaging by the US Food and Drug Administration, the National Cancer Institute, pediatricians, and radiologists. Perspective. Literature review. Institutional. Pediatric ophthalmic patients requiring neuroimaging studies. INTERVENTION/PROCEDURE: Review of the current literature. After review of the current literature and discussion of the related issues, recommendations are made for pediatric neuroimaging studies of the head and orbit. Computed tomography (CT) of the head and orbit may be performed in children with the appropriate indications as long as the radiation exposure is minimized. Information obtained from CT scans of the head and orbit may determine or affect management in the pediatric ophthalmic population. Because of the concern of cancer induced by radiation exposure in children, neuroimaging modalities without radiation exposure, such as magnetic resonance imaging or ultrasound, may be considered. However, when CT is indicated, it is reasonable and acceptable to perform CT of the head and orbit while minimizing the radiation exposure, thereby adhering to the "ALARA" (as low as reasonably achievable) policy recommended by the US Food and Drug Administration. Further studies of the actual radiation dose delivered during pediatric CT of the head and orbit and the true incidence of radiation-induced cancers after scans are warranted.

  13. Hybrid computing: CPU+GPU co-processing and its application to tomographic reconstruction.

    PubMed

    Agulleiro, J I; Vázquez, F; Garzón, E M; Fernández, J J

    2012-04-01

    Modern computers are equipped with powerful computing engines like multicore processors and GPUs. The 3DEM community has rapidly adapted to this scenario and many software packages now make use of high performance computing techniques to exploit these devices. However, the implementations thus far are purely focused on either GPUs or CPUs. This work presents a hybrid approach that collaboratively combines the GPUs and CPUs available in a computer and applies it to the problem of tomographic reconstruction. Proper orchestration of workload in such a heterogeneous system is an issue. Here we use an on-demand strategy whereby the computing devices request a new piece of work to do when idle. Our hybrid approach thus takes advantage of the whole computing power available in modern computers and further reduces the processing time. This CPU+GPU co-processing can be readily extended to other image processing tasks in 3DEM. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Dissecting aortic aneurysms: accuracy of computed tomographic diagnosis

    SciTech Connect

    Thorsen, M.K.; San Dretto, M.A.; Lawson, T.L.; Foley, W.D.; Smith, D.F.; Berland, L.L.

    1983-09-01

    During a three-year period, fifty patients were evaluated for the possibility of dissecting aortic aneurysm using high-resolution computed tomography (CT). The diagnosis of dissection was made if two contrast-medium-filled channels were identified within the aortic lumen. Eighteen patients were diagnosed with CT as having dissecting aortic aneurysms. Eight patients were evaluated postoperatively and five of these patients had persistence of the double channel. Twenty-four patients had no evidence on CT of aortic dissection. Follow-up was obtained in all patients. There were no known false-negative diagnoses and one false-positive diagnosis. High-resolution CT offers an accurate, noninvasive means to evaluate patients for suspected dissecting aortic aneurysms.

  15. Computed tomographic analysis of calvarial hyperostosis in captive lions.

    PubMed

    Gross-Tsubery, Ruth; Chai, Orit; Shilo, Yael; Miara, Limor; Horowitz, Igal H; Shmueli, Ayelet; Aizenberg, Itzhak; Hoffman, Chen; Reifen, Ram; Shamir, Merav H

    2010-01-01

    Osseous malformations in the skull and cervical vertebrae of lions in captivity are believed to be caused by hypovitaminosis A. These often lead to severe neurologic abnormalities and may result in death. We describe the characterization of these abnormalities based on computed tomography (CT). CT images of two affected and three healthy lions were compared with define the normal anatomy of the skull and cervical vertebrae and provide information regarding the aforementioned osseous malformations. Because bone structure is influenced by various factors other than the aforementioned disease, all values were divided by the skull width that was not affected. The calculated ratios were compared and the most pronounced abnormalities in the affected lions were, narrowing of the foramen magnum, thickening of the tentorium osseus cerebelli and thickening of the dorsal arch of the atlas. CT is useful for detection of the calvarial abnormalities in lions and may be useful in further defining this syndrome.

  16. Computed tomographic diagnosis of intraventricular hemorrhage: etiology and prognosis

    SciTech Connect

    Graeb, D.A.; Robertson, W.D.; Lapointe, J.S.; Nugent, R.A.; Harrison, P.B.

    1982-04-01

    Sixty-eight patients with intraventricular hemorrhage (IVH) diagnosed by computed tomography (CT) were reviewed retrospectively to determine the etiology and prognosis, relationship to delayed hydrocephalus, and effect on neurological outcome. The most common causes were a ruptured aneurysm, trauma, and hypertensive hemorrhage. Ruptured aneurysms of the anterior communicating artery can often be predicted from the nonenhanced CT scan. The total mortality rate was 50%; however, 21% of patients returned to normal or had only mild disability. Patients in whom no cause was identified had a better prognosis. Delayed hydrocephalus was related to the effects of subarachnoid hemorrahage rather than obstruction of the ventricular system by blood. IVH per se is seldon a major factor in the neurological outcome.

  17. Temporomandibular joints: high-resolution computed tomographic evaluation

    SciTech Connect

    Thompson, J.R.; Christiansen, E.; Hasso, A.N.; Hinshaw, D.B. Jr.

    1984-01-01

    High-resolution computed tomography of the temporomandibular joint (TMJ) was performed in 43 patients. Exquisite detail of the face, skull base, and TMJs was obtained with CT using soft tissue and bone algorithms, narrow collimation, and multiplanar images. In 10 patients clinically suspected of joint derangement, CT results were in close agreement with surgical findings and arthrography in 13/15 joints. CT showed indirect signs of disc dislocation, and the dislocated disc itself in 81% of affected joints. In two patients, arthrography with CT proved to be more helpful than conventional arthrography alone. CT without intra-articular contrast material provided information not appreciated on conventional radiogaphs in 28 patients (65%) and was particularly helpful in evaluating patients with disc pathosis and trauma. Early experience with CT of the TMJ shows that it is an excellent method of evaluation at acceptable radiation exposure levels that adds essential information not seen on standard radiographs.

  18. Maturation of normal primate white matter: computed tomographic correlation

    SciTech Connect

    Quencer, R.M.

    1982-09-01

    Five infant baboons were examined with computed tomography (CT) during the first year of their lives to determine the rate and degree of normal white matter maturation in frontal, occipital, and parietal areas. The increase in CT numbers with age was correlated with gross and histologic specimens. Two phases of maturation were identified: a rapid phase (first 8-12 weeks) and a gradual phase (after 12 weeks). Frontal white matter was the most immature in the immediate postnatal period but it became equal in attenuation to the other regions by 4 weeks of age. Knowledge of white matter maturation rates may be particularly useful in cases of neonatal hypoxia/ischemia where zones of periventricular hypodensity are identified. The failure of such regions to follow a normal rate of maturation may indicate damage to the white matter and have significant prognostic implications.

  19. Recurrent largngeal nerve paralysis: a laryngographic and computed tomographic study

    SciTech Connect

    Agha, F.P.

    1983-07-01

    Vocal cord paralysis is a relatively common entity, usually resulting from a pathologic process of the vagus nerve or its recurrent larynegeal branch. It is rarely caused by intralargngeal lesions. Four teen patients with recurrent laryngeal nerve paralysis (RLNP) were evaluated by laryngography, computed tomography (CT), or both. In the evaluation of the paramedian cord, CT was limited in its ability to differentiate between tumor or RLNP as the cause of the fixed cord, but it yielded more information than laryngography on the structural abnormalities of the larynx and pre-epiglottic and paralaryngeal spaces. Laryngography revealed distinct features of RLNP and is the procedure of choice for evaluation of functional abnormalities of the larynx until further experience with faster CT scanners and dynamic scanning of the larynx is gained.

  20. Limitations of multidetector computed tomography angiography for the diagnosis of blunt cerebrovascular injury.

    PubMed

    Grandhi, Ramesh; Weiner, Gregory M; Agarwal, Nitin; Panczykowski, David M; Ares, William J; Rodriguez, Jesse S; Gelfond, Jonathan A; Myers, John G; Alarcon, Louis H; Okonkwo, David O; Jankowitz, Brian T

    2017-08-11

    OBJECTIVE Blunt cerebrovascular injuries (BCVIs) following trauma carry risk for morbidity and mortality. Since patients with BCVI are often asymptomatic at presentation and neurological sequelae often occur within 72 hours, timely diagnosis is essential. Multidetector CT angiography (CTA) has been shown to be a noninvasive, cost-effective, reliable means of screening; however, the false-positive rate of CTA in diagnosing patients with BCVI represents a key drawback. Therefore, the authors assessed the role of DSA in the screening of BCVI when utilizing CTA as the initial screening modality. METHODS The authors performed a retrospective analysis of patients who experienced BCVI between 2013 and 2015 at 2 Level I trauma centers. All patients underwent CTA screening for BCVI according to the updated Denver Screening Criteria. Patients who were diagnosed with BCVI on CTA underwent confirmatory digital subtraction angiography (DSA). Patient demographics, screening indication, BCVI grade on CTA and DSA, and laboratory values were collected. Comparison of false-positive rates stratified by BCVI grade on CTA was performed using the chi-square test. RESULTS A total of 140 patients (64% males, mean age 50 years) with 156 cerebrovascular blunt injuries to the carotid and/or vertebral arteries were identified. After comparison with DSA findings, CTA findings were incorrect in 61.5% of vessels studied, and the overall CTA false-positive rates were 47.4% of vessels studied and 47.9% of patients screened. The positive predictive value (PPV) for CTA was higher among worse BCVI subtypes on initial imaging (PPV 76% and 97%, for BCVI Grades II and IV, respectively) compared with Grade I injuries (PPV 30%, p < 0.001). CONCLUSIONS In the current series, multidetector CTA as a screening test for blunt cerebrovascular injury had a high-false positive rate, especially in patients with Grade I BCVI. Given a false-positive rate of 47.9% with an estimated average of 132 patients per year

  1. Computer-aided teniae coli detection using height maps from computed tomographic colonography images

    NASA Astrophysics Data System (ADS)

    Wei, Zhuoshi; Yao, Jianhua; Wang, Shijun; Summers, Ronald M.

    2011-03-01

    Computed tomographic colonography (CTC) is a minimally invasive technique for colonic polyps and cancer screening. Teniae coli are three bands of longitudinal smooth muscle on the colon surface. They are parallel, equally distributed on the colon wall, and form a triple helix structure from the appendix to the sigmoid colon. Because of their characteristics, teniae coli are important anatomical meaningful landmarks on human colon. This paper proposes a novel method for teniae coli detection on CT colonography. We first unfold the three-dimensional (3D) colon using a reversible projection technique and compute the two-dimensional (2D) height map of the unfolded colon. The height map records the elevation of colon surface relative to the unfolding plane, where haustral folds corresponding to high elevation points and teniae to low elevation points. The teniae coli are detected on the height map and then projected back to the 3D colon. Since teniae are located where the haustral folds meet, we break down the problem by first detecting haustral folds. We apply 2D Gabor filter banks to extract fold features. The maximum response of the filter banks is then selected as the feature image. The fold centers are then identified based on piecewise thresholding on the feature image. Connecting the fold centers yields a path of the folds. Teniae coli are finally extracted as lines running between the fold paths. Experiments were carried out on 7 cases. The proposed method yielded a promising result with an average normalized RMSE of 5.66% and standard deviation of 4.79% of the circumference of the colon.

  2. Magnetic resonance imaging and multi-detector computed tomography assessment of extracellular compartment in ischemic and non-ischemic myocardial pathologies

    PubMed Central

    Saeed, Maythem; Hetts, Steven W; Jablonowski, Robert; Wilson, Mark W

    2014-01-01

    Myocardial pathologies are major causes of morbidity and mortality worldwide. Early detection of loss of cellular integrity and expansion in extracellular volume (ECV) in myocardium is critical to initiate effective treatment. The three compartments in healthy myocardium are: intravascular (approximately 10% of tissue volume), interstitium (approximately 15%) and intracellular (approximately 75%). Myocardial cells, fibroblasts and vascular endothelial/smooth muscle cells represent intracellular compartment and the main proteins in the interstitium are types I/III collagens. Microscopic studies have shown that expansion of ECV is an important feature of diffuse physiologic fibrosis (e.g., aging and obesity) and pathologic fibrosis [heart failure, aortic valve disease, hypertrophic cardiomyopathy, myocarditis, dilated cardiomyopathy, amyloidosis, congenital heart disease, aortic stenosis, restrictive cardiomyopathy (hypereosinophilic and idiopathic types), arrythmogenic right ventricular dysplasia and hypertension]. This review addresses recent advances in measuring of ECV in ischemic and non-ischemic myocardial pathologies. Magnetic resonance imaging (MRI) has the ability to characterize tissue proton relaxation times (T1, T2, and T2*). Proton relaxation times reflect the physical and chemical environments of water protons in myocardium. Delayed contrast enhanced-MRI (DE-MRI) and multi-detector computed tomography (DE-MDCT) demonstrated hyper-enhanced infarct, hypo-enhanced microvascular obstruction zone and moderately enhanced peri-infarct zone, but are limited for visualizing diffuse fibrosis and patchy microinfarct despite the increase in ECV. ECV can be measured on equilibrium contrast enhanced MRI/MDCT and MRI longitudinal relaxation time mapping. Equilibrium contrast enhanced MRI/MDCT and MRI T1 mapping is currently used, but at a lower scale, as an alternative to invasive sub-endomyocardial biopsies to eliminate the need for anesthesia, coronary

  3. Prediction of Clinical Outcome After Acute Ischemic Stroke: The Value of Repeated Noncontrast Computed Tomography, Computed Tomographic Angiography, and Computed Tomographic Perfusion.

    PubMed

    Dankbaar, Jan W; Horsch, Alexander D; van den Hoven, Andor F; Kappelle, L Jaap; van der Schaaf, Irene C; van Seeters, Tom; Velthuis, Birgitta K

    2017-09-01

    Early prediction of outcome in acute ischemic stroke is important for clinical management. This study aimed to compare the relationship between early follow-up multimodality computed tomographic (CT) imaging and clinical outcome at 90 days in a large multicenter stroke study. From the DUST study (Dutch Acute Stroke Study), patients were selected with (1) anterior circulation occlusion on CT angiography (CTA) and ischemic deficit on CT perfusion (CTP) on admission, and (2) day 3 follow-up noncontrast CT, CTP, and CTA. Follow-up infarct volume on noncontrast CT, poor recanalization on CTA, and poor reperfusion on CTP (mean transit time index ≤75%) were related to unfavorable outcome after 90 days defined as modified Rankin Scale 3 to 6. Four multivariable models were constructed: (1) only baseline variables (model 1), (2) model 1 with addition of infarct volume, (3) model 1 with addition of recanalization, and (4) model 1 with addition of reperfusion. Area under the curves of the receiver operating characteristic curves of the models were compared using the DeLong test. A total of 242 patients were included. Poor recanalization was found in 21%, poor reperfusion in 37%, and unfavorable outcome in 44%. The area under the curve of the receiver operating characteristic curve without follow-up imaging was 0.81, with follow-up noncontrast CT 0.85 (P=0.02), CTA 0.86 (P=0.01), and CTP 0.86 (P=0.01). All 3 follow-up imaging modalities improved outcome prediction compared with no imaging. There was no difference between the imaging models. Follow-up imaging after 3 days improves outcome prediction compared with prediction based on baseline variables alone. CTA recanalization and CTP reperfusion do not outperform noncontrast CT at this time point. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00880113. © 2017 American Heart Association, Inc.

  4. [Recurrence paralysis: computed tomographic analysis of intrathoracic findings].

    PubMed

    Delorme, S; Knopp, M V; Kauczor, H U; Zuna, I; Trost, U; Haberkorn, U; van Kaick, G

    1992-09-01

    The long and singular course of the inferior (recurrent) laryngeal nerve makes it very vulnerable to infiltration by tumors of various locations. In particular, mediastinal and pulmonary lesions must be considered in the case of left vocal chord palsy. Recurrent nerve paralysis caused by a tumor indicates advanced disease. We retrospectively reviewed the computed tomography (CT) findings in 29 patients with bronchogenic carcinoma or mediastinal tumors and recurrent nerve paralysis with respect to the site, size and extent of the tumor and the lymph node status. The review revealed a marked predominance of left upper lobe tumors with extensive lymph node metastases to the anterior mediastinum and the aortopulmonary window. The extent of mediastinal involvement exceeded the average involvement in a control group of 30 randomly selected patients with bronchogenic carcinoma at the time of presentation. In all patients CT demonstrated tumor tissue which could have caused the paralysis at one or more sites along the anatomical course of the recurrent nerve. In most cases the tumor was located at the aortic arch. The left paratracheal region, right paratracheal region and right pulmonary apex were affected in one case each. We conclude that in patients with cancer, CT is a suitable method for localizing a recurrent nerve lesion.

  5. Computed Tomographic Evaluation of Presumptively Normal Canine Sternal Lymph Nodes.

    PubMed

    Iwasaki, Ryota; Mori, Takashi; Ito, Yusuke; Kawabe, Mifumi; Murakmi, Mami; Maruo, Kohji

    The sternal lymph nodes receive drainage from a wide variety of structures in the thoraco-abdominal region. Evaluation of these lymph nodes is essential, especially in cancer patients. Computed tomography (CT) can detect sternal lymph nodes more accurately than radiography or ultrasonography, and the criteria of the sternal lymphadenopathy are unknown. The purpose of this retrospective study was to describe the CT characteristics of the sternal lymph nodes in dogs considered unlikely to have lymphadenopathy. The ratio of the short axis dimension of the sternal lymph nodes to the thickness of the second sternebra was also investigated. At least one sternal lymph node was identified in each of the 152 dogs included in the study. The mean long axis and short axis dimensions were 0.700 cm and 0.368 cm, respectively. The mean ratio of the sternal lymph nodes to the second sternebrae was 0.457, and the 95% prediction interval ranged from 0.317 to 0.596 (almost a fixed value independent of body weight). These findings will be useful when evaluating sternal lymphadenopathy using CT.

  6. The computed tomographic appearance of equine temporohyoid osteoarthropathy.

    PubMed

    Hilton, Hugo; Puchalski, Sarah M; Aleman, Monica

    2009-01-01

    Equine temporohyoid osteoarthropathy is characterized by progressive osseous proliferation of the temporohyoid articulation and surrounding structures. The diagnosis has generally been made using radiography and endoscopy of the guttural pouch. Recently, computed tomography (CT) has been used in the diagnosis of temporohyoid osteoarthropathy. This study was performed to determine the CT imaging characteristics of temporohyoid osteoarthropathy and to compare these to radiographic and endoscopic findings. CT scans from 16 horses with a final diagnosis of temporohyoid osteoarthropathy were reviewed. Five horses that had undergone CT scan for reasons other than temporohyoid osteoarthropathy were included as controls. Qualitative and quantitative data were used to describe the magnitude of the CT findings. Osseous proliferation of the stylohyoid bone and temporohyoid articulation was found to be a consistent feature of temporohyoid osteoarthropathy. Thickening of the ceratohyoid bone and proliferation of its articulation with the stylohyoid bone was frequently identified and this finding may have surgical implications. Horses with neurologic deficits had increased stylohyoid width that was significantly different than the subclinically affected side. CT evaluation also allowed the identification of subclinical bilateral disease in horses thought to be unilaterally affected based on clinical examination.

  7. Vertebrobasilar system computed tomographic angiography in central vertigo.

    PubMed

    Paşaoğlu, Lale

    2017-03-01

    The incidence of vertigo in the population is 20% to 30% and one-fourth of the cases are related to central causes. The aim of this study was to evaluate computed tomography angiography (CTA) findings of the vertebrobasilar system in central vertigo without stroke.CTA and magnetic resonance images of patients with vertigo were retrospectively evaluated. One hundred twenty-nine patients suspected of having central vertigo according to history, physical examination, and otological and neurological tests without signs of infarction on diffusion-weighted magnetic resonance imaging were included in the study. The control group included 120 patients with similar vascular disease risk factors but without vertigo. Vertebral and basilar artery diameters, hypoplasias, exit-site variations of vertebral artery, vertebrobasilar tortuosity, and stenosis of ≥50% detected on CTA were recorded for all patients. Independent-samples t test was used in variables with normal distribution, and Mann-Whitney U test in non-normal distribution. The difference of categorical variable distribution according to groups was analyzed with χ and/or Fisher exact test.Vertebral artery hypoplasia and ≥50% stenosis were seen more often in the vertigo group (P = 0.000, <0.001). Overall 78 (60.5%) vertigo patients had ≥50% stenosis, 54 (69.2%) had stenosis at V1 segment, 9 (11.5%) at V2 segment, 2 (2.5%) at V3 segment, and 13 (16.6%) at V4 segment. Both vertigo and control groups had similar basilar artery hypoplasia and ≥50% stenosis rates (P = 0.800, >0.05).CTA may be helpful to clarify the association between abnormal CTA findings of vertebral arteries and central vertigo.This article reveals the opportunity to diagnose posterior circulation abnormalities causing central vertigo with a feasible method such as CTA.

  8. Vertebrobasilar system computed tomographic angiography in central vertigo

    PubMed Central

    Paşaoğlu, Lale

    2017-01-01

    Abstract The incidence of vertigo in the population is 20% to 30% and one-fourth of the cases are related to central causes. The aim of this study was to evaluate computed tomography angiography (CTA) findings of the vertebrobasilar system in central vertigo without stroke. CTA and magnetic resonance images of patients with vertigo were retrospectively evaluated. One hundred twenty-nine patients suspected of having central vertigo according to history, physical examination, and otological and neurological tests without signs of infarction on diffusion-weighted magnetic resonance imaging were included in the study. The control group included 120 patients with similar vascular disease risk factors but without vertigo. Vertebral and basilar artery diameters, hypoplasias, exit-site variations of vertebral artery, vertebrobasilar tortuosity, and stenosis of ≥50% detected on CTA were recorded for all patients. Independent-samples t test was used in variables with normal distribution, and Mann–Whitney U test in non-normal distribution. The difference of categorical variable distribution according to groups was analyzed with χ2 and/or Fisher exact test. Vertebral artery hypoplasia and ≥50% stenosis were seen more often in the vertigo group (P = 0.000, <0.001). Overall 78 (60.5%) vertigo patients had ≥50% stenosis, 54 (69.2%) had stenosis at V1 segment, 9 (11.5%) at V2 segment, 2 (2.5%) at V3 segment, and 13 (16.6%) at V4 segment. Both vertigo and control groups had similar basilar artery hypoplasia and ≥50% stenosis rates (P = 0.800, >0.05). CTA may be helpful to clarify the association between abnormal CTA findings of vertebral arteries and central vertigo. This article reveals the opportunity to diagnose posterior circulation abnormalities causing central vertigo with a feasible method such as CTA. PMID:28328808

  9. Accuracy of the typical computed tomographic appearances of fibrosing alveolitis.

    PubMed Central

    Tung, K T; Wells, A U; Rubens, M B; Kirk, J M; du Bois, R M; Hansell, D M

    1993-01-01

    BACKGROUND--Open lung biopsy is often performed to confirm the diagnosis in patients with suspected fibrosing alveolitis. The superior sensitivity and specificity of high resolution computed tomography (CT) over chest radiography in various diffuse lung diseases suggest that the characteristic appearance of fibrosing alveolitis on high resolution CT might render biopsy confirmation unnecessary. METHODS--The chest radiographs and high resolution CT scans of 86 patients (41 with fibrosing alveolitis and 45 with various other diffuse lung diseases) were examined individually and independently by two observers. No clinical information was given and the observers gave a level of confidence when the diagnosis was thought to be fibrosing alveolitis. RESULTS--The observers correctly and confidently discriminated between fibrosing alveolitis and other diffuse lung diseases on high resolution CT with an accuracy of 88% and on chest radiography with an accuracy of 76%. The false negative rate for fibrosing alveolitis diminished from 29% on chest radiography to 11% on high resolution CT. The false positive rate on chest radiography was 19% and on high resolution CT 13%; the false positive diagnoses on CT were the result of a few conditions (extrinsic allergic alveolitis, sarcoidosis, cryptogenic organising pneumonia, and pulmonary eosinophilia) which mimicked some of the CT features of fibrosing alveolitis. The superficial similarity of the CT patterns of these conditions are discussed. CONCLUSIONS--High resolution CT is superior to chest radiography in establishing the diagnosis of fibrosing alveolitis and the typical CT appearances are virtually pathognomonic. The diagnostic advantages of CT over chest radiography should further reduce the need for open lung biopsy in this condition. Images PMID:8135910

  10. Computed tomographic evaluation of head diseases in the horse: 15 cases.

    PubMed

    Tietje, S; Becker, M; Böckenhoff, G

    1996-03-01

    The rapid development of software and technology now allows a large amount of diagnostic information to be obtained from a computed tomographic examination. This imaging technique can also be usefully applied to the horse, given appropriate premises and a custom built table for accurate positioning. Computed tomography of the skull has considerable advantages over other techniques, as structures are viewed without superimposition. Fifteen cases are used to demonstrate how through high image quality (precise detail, reduction in artefacts) and objective measurement of density, various pathological changes can be analysed and exact diagnoses achieved. In particular, short measurement and examination times allow preoperative imaging under general anaesthesia giving significant information to assist subsequent surgery.

  11. Facial nerve between the stylomastoid foramen and the parotid: computed tomographic imaging

    SciTech Connect

    Curtin, H.D.; Wolfe, P.; Snyderman, N.

    1983-10-01

    A small segment of the facial nerve between its exit from the stylomastoid foramen and its entrance into the parotid is surrounded by fat and, therefore, can be imaged well using modern computed tomography. A small dot can be seen surrounded by fat just beneath the stylomastoid foramen on computed tomographic scan. To verify that this indeed represented the facial nerve, tissue sections and an injection into the mastoid segment of the intratemporal facial nerve were performed. The anatomic correlation and clinical material demonstrating involvement of the facial nerve in this region are presented.

  12. Ossification in the caudal attachments of the ligamentum flavum: an anatomic and computed tomographic study

    SciTech Connect

    Williams, D.M.; Gabrielson, T.O.; Latack, J.T.

    1982-12-01

    A review of anatomic specimens and routine computed tomographic (CT) scans of the chest and abdomen demonstrated that ossification in the caudal attachments of the ligamentum flavum is a common anatomic finding, but a much less common CT finding. Its characteristic location should help prevent confusion with other entities. The present study was prompted by a case of thoracic spine trauma, reported here, in which areas of bone density in the spinal canal simulated fracture fragments. The true nature of these bony projections, namely ossification in the ligamentum flavum, was established by computer reconstruction of axial CT images.

  13. Organ dose measurements from multiple-detector computed tomography using a commercial dosimetry system and tomographic, physical phantoms

    NASA Astrophysics Data System (ADS)

    Lavoie, Lindsey K.

    The technology of computed tomography (CT) imaging has soared over the last decade with the use of multi-detector CT (MDCT) scanners that are capable of performing studies in a matter of seconds. While the diagnostic information obtained from MDCT imaging is extremely valuable, it is important to ensure that the radiation doses resulting from these studies are at acceptably safe levels. This research project focused on the measurement of organ doses resulting from modern MDCT scanners. A commercially-available dosimetry system was used to measure organ doses. Small dosimeters made of optically-stimulated luminescent (OSL) material were analyzed with a portable OSL reader. Detailed verification of this system was performed. Characteristics studied include energy, scatter, and angular responses; dose linearity, ability to erase the exposed dose and ability to reuse dosimeters multiple times. The results of this verification process were positive. While small correction factors needed to be applied to the dose reported by the OSL reader, these factors were small and expected. Physical, tomographic pediatric and adult phantoms were used to measure organ doses. These phantoms were developed from CT images and are composed of tissue-equivalent materials. Because the adult phantom is comprised of numerous segments, dosimeters were placed in the phantom at several organ locations, and doses to select organs were measured using three clinical protocols: pediatric craniosynostosis, adult brain perfusion and adult cardiac CT angiography (CTA). A wide-beam, 320-slice, volumetric CT scanner and a 64-slice, MDCT scanner were used for organ dose measurements. Doses ranged from 1 to 26 mGy for the pediatric protocol, 1 to 1241 mGy for the brain perfusion protocol, and 2-100 mGy for the cardiac protocol. In most cases, the doses measured on the 64-slice scanner were higher than those on the 320-slice scanner. A methodology to measure organ doses with OSL dosimeters received from CT

  14. [Computed tomographic anatomy of the salivary glands in the cat].

    PubMed

    Fromme, V; Köhler, C; Piesnack, S; Oechtering, G; Ludewig, E

    2016-01-01

    The aim of the study was to define anatomical characteristics of the feline salivary glands in cross-sectional images obtained by unenhanced computed tomography (CT) and to describe landmarks for a reliable identification. Heads of adult normocephalic cats without indications of cephalic disease were examined. Cats were included in the prospective part of the study when examined no later than 1 hour post mortem (n = 16). In the retrospective part of the study, previous CT-studies were evaluated (n = 25). The results of both groups were evaluated separately. Initially, the possibility of identifying and delineating the salivary glands from the surrounding tissue was assessed. Anatomical structures of the head were then defined as landmarks. Dimensions and density (Hounsfield units, HU) of the salivary glands were determined based on transversal and reconstructed sagittal images. In total, 94.3% of the parotid glands, 90.7% of the mandibular glands and 96.8% of the zygomatic glands could be delineated. The remaining salivary glands could not be identified. Anatomical landmarks, including the external ear canal, the musculus (M.) masseter, the M. pterygoideus medialis and the bulbus oculi facilitated the identification. Comparing the size of the salivary glands of both groups revealed differences (measured lateromedially and rostrocaudally) in size of ≤   2 mm. The definable salivary glands varied significantly in their density. The mean density of the glandula (Gl.) parotis was 65 HU, of the Gl. mandibularis 62 HU and of the Gl. zygomatica 57 HU. The comparisons of densities of both sides of the glands did not show statistically significant differences. The large salivary glands (Gl. parotis and Gl. mandibularis) and the Gl. zygomatica of the cat can be reliably identified in CT-images. CT landmarks and data regarding the size and density of each gland could be gathered. The remaining minor salivary glands could not be delineated accurately. The difference in

  15. Quantification of Vasa Vasorum Density in Multi-Slice Computed Tomographic Coronary Angiograms: Role of Computed Tomographic Image Voxel Size

    SciTech Connect

    Moritz, R.; Eaker, D; Langheinrich, A; Jorgensen, S; Bohle, R; Ritman, E

    2010-01-01

    This study is motivated by the possibility of using computed tomography (CT) to detect early coronary atherosclerosis by the increased CT values within the arterial wall resulting from vasa vasorum proliferation. Coronary arteries (n = 5) with early atherosclerotic changes were injected with Microfil and scanned (micro-CT). Noise was added to the CT projection data sets (to represent the radiation exposure of current clinical CT scanners) and then reconstructed to generate 3-dimensional images at different voxel sizes. Higher CT values were detected because of contrast agent in vasa vasorum if voxel size was less than (150 {micro}m){sup 3}. Contrast in the main lumen increased the CT values dramatically at voxels greater than (100 {micro}m){sup 3}, whereas CT values of the same specimen without contrast in the main lumen remained constant. Voxel sizes less than (200 {micro}m){sup 3} are needed to quantitate arterial wall opacification due to vasa vasorum proliferation.

  16. 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

  17. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography*

    PubMed Central

    Araujo Neto, Severino Aires; Franca, Henrique Almeida; de Mello Júnior, Carlos Fernando; Silva Neto, Eulâmpio José; Negromonte, Gustavo Ramalho Pessoa; Duarte, Cláudia Martina Araújo; Cavalcanti Neto, Bartolomeu Fragoso; Farias, Rebeca Danielly da Fonseca

    2015-01-01

    Objective To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery. Materials and Methods Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients. Results The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery. Conclusion The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS. PMID:26811552

  18. Thoracic wall trauma—misdiagnosed lesions on radiographs and usefulness of ultrasound, multidetector computed tomography and magnetic resonance imaging

    PubMed Central

    Facenda, Catherine; Vaz, Nuno; Castañeda, Edgar Augusto; del Amo, Montserrat; Garcia-Diez, Ana Isabel; Pomes, Jaime

    2017-01-01

    Blunt injuries to the chest wall are an important chapter on emergency room (ER) departments, being the third most common injuries in trauma patients which ominous complications could appear. This article describes different types of traumatic events affecting the chest wall, which maybe misdiagnosed with conventional X-ray. Special emphasis has been done in computed tomography (CT) and multidetector CT (MDCT) imaging. This technique is considered the “gold-standard” for those traumatic patients, due to its fast acquisition covering the whole area of interest in axial plane, reconstructing multiplanar (2D, 3D) volume-rendered images with a superb quality and angiographic CT capabilities for evaluating vascular damage. Complementary techniques such as ultrasonography (US) and magnetic resonance imaging (MRI) may improve the diagnostic accuracy due to its great capacity in visualising soft-tissue trauma (muscle-tendinous tears) and subtle fractures. All these imaging methods have an important role in quantifying the severity of chest wall trauma. The findings of this study have been exposed with cases of our archives in a didactic way. PMID:28932697

  19. Evaluation of the pelvic apophysis with multi-detector computed tomography for legal age estimation in living individuals

    PubMed Central

    Karami, Mehdi; Rabiei, Meisam; Riahinezhad, Maryam

    2015-01-01

    Background: Legal age estimations of living individuals are gaining increasing importance for radiologists involved in delivering expert opinions. The present study aimed to assess the correlation between chronological age and apophyseal centers distance from pelvic bone. Materials and Methods: This was a cross-sectional study carried out on 2013. Subjects were chosen from 15 to 25 years old people who had previous pelvic multi-detector computed tomography for any reason. The distance of iliac crest apophysis to iliac bone, and pubic apophysis to pubic bone were assessed. Results: There was a reverse linear correlation between chronological age and distance of iliac crest apophysis (P < 0.001, r = 0.899) and pubic apophysis to pelvic bone (P < 0.001, r = 0.898). Pubic apophysis was not appeared in subjects before 16 years old and it was appeared in all of the subjects with 18 years old and more. Subjects with age of 21 had near ossification of iliac or pubic apophysis and subjects with age of 24 had full ossification of iliac or pubic apophysis. Conclusion: skeletalage can be estimated by assessing the apophyseal centers distance from the pelvic bone in adolescents 15-25 years old. PMID:26109964

  20. Preoperative evaluation value of aortic arch lesions by multidetector computed tomography angiography in type A aortic dissection

    PubMed Central

    Huang, Fang; Chen, Qiang; Lai, Qing-quan; Huang, Wen-han; Wu, Hong; Li, Wei-cheng

    2016-01-01

    Abstract The purpose of this study was to preoperatively evaluate the value of aortic arch lesions by multidetector computed tomography (MDCT) angiography in type A aortic dissection (AD). From January 2013 to December 2015, we enrolled 42 patients with type A AD who underwent MDCT angiography in our hospital. The institutional database of patients was retrospectively reviewed to identify MDCT angiography examinations for type A AD. Surgical corrections were conducted in all patients to confirm diagnostic accuracy. In this study, the diagnostic accuracy of MDCT angiography was 100% in all 42 patients. The intimal tear site locations that were identified in patients included the ascending aorta (n = 25), aortic arch (n = 12), and all other sites (n = 5). Compared with the control group, there were significant differences in the aortic arch anatomy among the cases. Regarding the distance between the left common carotid and left subclavian arteries, compared with the control group, most cases with type A AD had a significant variation. MDCT angiography plays an important role in detecting aortic arch lesions of type A AD, especially in determining the location of the intimal entry site and change of branch blood vessels. Surgeons can formulate an appropriate operating plan, according to the preoperative MDCT diagnosis information. PMID:27684852

  1. MULTIDETECTOR-ROW COMPUTED TOMOGRAPHY PATTERNS OF BRONCHOESPHAGEAL ARTERY HYPERTROPHY AND SYSTEMIC-TO-PULMONARY FISTULA IN DOGS.

    PubMed

    Ledda, Gianluca; Caldin, Marco; Mezzalira, Giorgia; Bertolini, Giovanna

    2015-01-01

    Anomalies involving arterial branches in the lungs are one of the causes of hemoptysis in humans and dogs. Congenital and acquired patterns of bronchoesophageal artery hypertrophy have been reported in humans based on CT characteristics. The purpose of this retrospective study was to describe clinical, echocardiographic, and multidetector computed tomography features of bronchoesophageal artery hypertrophy and systemic-to-pulmonary arterial communications in a sample of 14 dogs. Two main vascular patterns were identified in dogs that resembled congenital and acquired conditions reported in humans. Pattern 1 appeared as an aberrant origin of the right bronchoesophageal artery, normal origin of the left one, and enlargement of both the bronchial and esophageal branches that formed a dense network terminating in a pulmonary artery through an orifice. Pattern 2 appeared as a normal origin of both right and left bronchoesophageal arteries, with an enlarged and tortuous course along the bronchi to the periphery of the lung, where they communicated with subsegmental pulmonary arteries. Dogs having Pattern 1 also had paraesophageal and esophageal varices, with the latter being confirmed by videoendoscopy examination. Authors conclude that dogs with Pattern 1 should be differentiated from dogs with other congenital vascular systemic-to-pulmonary connections. Dogs having Pattern 2 should be evaluated for underlying pleural or pulmonary diseases. Bronchoesophageal artery hypertrophy can be accompanied by esophageal venous engorgement and should be included in the differential diagnosis for esophageal and paraesophageal varices in dogs.

  2. Use of spiral computed tomographic angiography in monitoring abdominal aortic aneurysms after transfemoral endovascular repair.

    PubMed Central

    Balm, R; Jacobs, M J

    1997-01-01

    Transfemoral endovascular repair of abdominal aortic aneurysms has proved to be technically feasible in a selected group of patients. However, long-term efficacy has not been proved. Graft performance after implantation can be monitored by a single imaging technique: spiral computed tomographic angiography. With this technique, the parameters for continuing clinical success of the procedure-graft patency, endoleaks, graft migration, attachment site diameter, attachment system failure, and aneurysm diameter-can be monitored. Only in selected cases will an additional imaging technique be necessary. PMID:9339508

  3. Conventional metrizamide myelography (MM) and computed tomographic metrizamide myelography (CTMM) in scoliosis: a comparative study

    SciTech Connect

    Pettersson, H.; Harwood-Nash, D.C.; Fitz, C.R.; Chuang, H.S.; Armstrong, E.

    1982-01-01

    A retrospective examination was performed to assess the accuracy of metrizamide myelography (MM) and computed tomographic metrizamide myelography (CTMM) in scoliosis. Of 81 consecutive scoliotic children studied by myelography, 30 had only MM while the remaining 51 had CTMM immediately afterward. CTMM added esential diagnostic information in 13 cases of dysraphism and 4 cases, both methods gave the same imformation. The outhors conclude that in patients with severe scoliosis, dysraphism, and scoliosis with localized neurological disturbances, CTMM should always be added to MM or be the only examination; while in idiopathic scoliosis with vague neurological disturbances a survey of the entire spine is essential, preferably with MM.

  4. Automating the segmentation of medical images for the production of voxel tomographic computational models.

    PubMed

    Caon, M; Mohyla, J

    2001-12-01

    Radiation dosimetry for the diagnostic medical imaging procedures performed on humans requires anatomically accurate, computational models. These may be constructed from medical images as voxel-based tomographic models. However, they are time consuming to produce and as a consequence, there are few available. This paper discusses the emergence of semi-automatic segmentation techniques and describes an application (iRAD) written in Microsoft Visual Basic that allows the bitmap of a medical image to be segmented interactively and semi-automatically while displayed in Microsoft Excel. iRAD will decrease the time required to construct voxel models.

  5. Computed tomographic mammography. Diagnosis of mammographically and clinically occult carcinoma of the breast.

    PubMed

    Sibala, J L; Chang, C H; Lin, F; Jewell, W R

    1981-01-01

    If breast cancer can be detected early, while it is still localized and before it can be palpated, the prognosis for cure is excellent. Heretofore, conventional mammography has been the only means available to detect cancer at such an early stage. Two cases of minimal breast carcinoma measuring less than 5 mm in diameter have been detected and correctly diagnosed using computed tomographic mammography (CT/M). Both cases occurred in fatty breasts and were clinically and mammographically occult. These cases demonstrate the value of CT/M in the diagnosis of minimal breast carcinoma that would have been missed otherwise.

  6. Integrative computed tomographic imaging of cardiac structure, function, perfusion, and viability.

    PubMed

    Thilo, Christian; Hanley, Michael; Bastarrika, Gorka; Ruzsics, Balazs; Schoepf, U Joseph

    2010-01-01

    Recent advances in multidetector-row computed tomography (MDCT) technology have created new opportunities in cardiac imaging and provided new insights into a variety of disease states. Use of 64-slice coronary computed tomography angiography has been validated for the evaluation of clinically relevant coronary artery stenosis with high negative predictive values for ruling out significant obstructive disease. This technology has also advanced the care of patients with acute chest pain by simultaneous assessment of acute coronary syndrome, pulmonary embolism, and acute aortic syndrome ("triple rule out"). Although MDCT has been instrumental in the advancement of cardiac imaging, there are still limitations in patients with high or irregular heart rates. Newer MDCT scanner generations hold promise to improve some of these limitations for noninvasive cardiac imaging. The evaluation of coronary artery stenosis remains the primary clinical indication for cardiac computed tomography angiography. However, the use of MDCT for simultaneous assessment of coronary artery stenosis, atherosclerotic plaque formation, ventricular function, myocardial perfusion, and viability with a single modality is under intense investigation. Recent technical developments hold promise for accomplishing this goal and establishing MDCT as a comprehensive stand-alone test for integrative imaging of coronary heart disease.

  7. Airway remodeling measured by multidetector computed tomography is increased in severe asthma and correlates with pathology

    PubMed Central

    Aysola, Ravi S.; Hoffman, Eric A.; Gierada, David; Wenzel, Sally; Cook-Granroth, Janice; Tarsi, Jaime; Zheng, Jie; Schechtman, Kenneth B.; Ramkumar, Thiruvamoor P.; Cochran, Rebecca; E, Xueping; Christie, Chandrika; Newell, John; Fain, Sean; Altes, Talissa A.; Castro, Mario

    2010-01-01

    Background To prospectively apply an automated, quantitative 3-D approach to imaging and airway analysis to assess airway remodeling in asthma. Methods Using the Pulmonary Workstation (VIDA Diagnostics) that enables quantitative airway segment measurements of low-dose, thin section (0.625-1.25 mm) multidetector-row CT (MDCT), we compared airway wall thickness (WT) and area (WA) in 123 subjects participating in a prospective multicenter cohort study, NIH Severe Asthma Research Program (SARP): severe asthma (n=63), mild-moderate asthma (n=35), and normal (n=25). A subset of these subjects underwent fiberoptic bronchoscopy and endobronchial biopsies (n=32). WT and WA were corrected for total airway diameter and area - WT%, WA%. Results Subjects with severe asthma had significantly greater WT% than mild-moderate asthma and normals [17.2±1.5 v 16.5±1.6, p=0.014 and 16.3±1.2, p=0.031, respectively] and greater WA% compared to mild-moderate asthma and normal [56.6±2.9 v 54.7±3.3, p=.005 and 54.6±2.4, p=0.003, respectively]. Both WT% and WA% were inversely correlated with baseline FEV1% (r=-0.39, p<0.0001 and -0.40, p<0.0001, respectively) and positively correlated with response to bronchodilator (r=0.28, p=0.002 and r=0.35, p<0.0001, respectively). Airway epithelial thickness on biopsy correlated with WT% (r=0.47, p=0.007) and WA% (r=0.52, p=0.003). In the same individual, there is considerable regional heterogeneity in airway wall thickness. Conclusion Severe asthmatics have thicker airway walls on MDCT than mild asthmatics or normals, which correlates with pathologic measures of remodeling and the degree of airflow obstruction. MDCT may be a useful technique for assessing airway remodeling in asthma, but overlap among groups limits the diagnostic value in individual subjects. PMID:18641116

  8. [Visualization of pulmonary vein stenosis after radio frequency ablation for treatment of atrial fibrillation using multidetector computed tomography with retrospective gating].

    PubMed

    Trabold, T; Küttner, A; Heuschmid, M; Burgstahler, C; Mewis, C; Kopp, A F; Schröder, S; Kühlkamp, V; Claussen, C D

    2003-01-01

    With the number of radio frequency ablations (RFA) for treatment of chronic atrial fibrillation increasing, the diagnostic evaluation for RFA associated pulmonary vein stenosis is getting more important. This study investigates the feasibility of the visualization of pulmonary vein stenosis using non-invasive multidetector computed tomography. Twenty-eight patients were examined following RFA-treatment. A 4-slice (20 patients) and a 16-slice (8 patients) multidetector CT scanner (SOMATOM Volume Zoom and Sensation 16, Siemens, Forchheim, Germany) with retrospective gating was used to assess the pulmonary veins. Lesion severity was determined on a semi-quantitative scale (< 30 %, 30 - 50 %, > 50 %). CT was performed without any complications in all patients. Diagnostic image quality could be obtained in all examinations. The pulmonary veins showed lesions < 30 % in four patients, lesions of 30 -, 50 % in five patients and a stenosis > 50 % in one patient. Eighteen patients showed no lesions. Multidetector CT of the pulmonary veins seems to be able to visualize high-grade and low-grade lesions, but larger catheter-controlled studies are needed for further assessment of the diagnostic accuracy and clinical reliability of this noninvasive method.

  9. The clinical outcome of occult pulmonary contusion on multidetector-row computed tomography in blunt trauma patients.

    PubMed

    Deunk, Jaap; Poels, Tielke C; Brink, Monique; Dekker, Helena M; Kool, Digna R; Blickman, Johan G; van Vugt, Arie B; Edwards, Michael John Richard

    2010-02-01

    Multidetector-row computed tomography (MDCT) is a more sensitive modality as compared with conventional radiography (CR) in detecting pulmonary injuries. MDCT often detects pulmonary contusion that is not visualized by CR, defined as occult pulmonary contusion (OPC). The aim of this study was to investigate whether OPC on MDCT has implications for the outcome in blunt trauma patients. We used prospectively collected data from 1,040 adult high-energy blunt trauma patients who were primarily presented at our emergency department and who underwent CR and MDCT of the chest. All patients with pulmonary contusion were identified and divided into two groups: The "CR/computed tomography (CT) group" consisted of patients with pulmonary contusion visible on both CR and MDCT. The "CT-only" group consisted of patients with OPC, visible exclusively on MDCT. The control group consisted of blunt trauma patients without pulmonary contusion. These groups were compared with respect to difference in mortality and other outcome measures. In addition, a multivariate analysis was performed. Two hundred fifty-five patients suffered pulmonary contusion: The CT-only group consisted of 157 and the CR/CT group of 98 patients. The CT-only group did not differ from the control group with respect to mortality rate and other outcome measures. However, compared with the CR/CT group, mortality rate was significantly lower (8% versus 16%, p = 0.039) and most other outcome measures were significantly better in the CT-only group. OPC on MDCT is not associated with a worse outcome as compared with patients without pulmonary contusion. OPC has a better outcome as compared with pulmonary contusion visible on both CR and MDCT.

  10. Multidetector-row computed tomography of thoracic aortic anomalies in dogs and cats: Patent ductus arteriosus and vascular rings

    PubMed Central

    2011-01-01

    Background Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. We postulated that accurate characterization of malformations of the aorta would benefit from 3-dimensional assessment. Therefore, multidetector-row computed tomography (MDCT) was chosen as a 3-dimensional, new, and noninvasive imaging technique. The purpose of this study was to evaluate patients with 2 common diseases of the intrathoracic aorta, either patent ductus arteriosus or vascular ring anomaly, by contrast-enhanced 64-row computed tomography. Results Electrocardiography (ECG)-gated and thoracic nongated MDCT images were reviewed in identified cases of either a patent ductus arteriosus or vascular ring anomaly. Ductal size and morphology were determined in 6 dogs that underwent ECG-gated MDCT. Vascular ring anomalies were characterized in 7 dogs and 3 cats by ECG-gated MDCT or by a nongated thoracic standard protocol. Cardiac ECG-gated MDCT clearly displayed the morphology, length, and caliber of the patent ductus arteriosus in 6 affected dogs. Persistent right aortic arch was identified in 10 animals, 8 of which showed a coexisting aberrant left subclavian artery. A mild dilation of the proximal portion of the aberrant subclavian artery near its origin of the aorta was present in 4 dogs, and a diverticulum analogous to the human Kommerell's diverticulum was present in 2 cats. Conclusions Contrast-enhanced MDCT imaging of thoracic anomalies gives valuable information about the exact aortic arch configuration. Furthermore, MDCT was able to characterize the vascular branching patterns in dogs and cats with a persistent right aortic arch and the morphology and size of the patent ductus arteriosus in affected dogs. This additional information can be of help

  11. Assessment of aortic valve calcium load by multidetector computed tomography. Anatomical validation, impact of scanner settings and incremental diagnostic value.

    PubMed

    Boulif, Jamila; Gerber, Bernhard; Slimani, Alisson; Lazam, Siham; de Meester, Christophe; Piérard, Sophie; Pasquet, Agnès; Pouleur, Anne-Catherine; Vancraeynest, David; El Khoury, Gébrine; de Kerchove, Laurent; Noirhomme, Philippe; Vanoverschelde, Jean-Louis

    2017-07-29

    To validate aortic valve calcium (AVC) load measurements by multidetector row computed tomography (MDCT), to evaluate the impact of tube potential and slice thickness on AVC scores, to examine the accuracy of AVC load in distinguishing severe from nonsevere aortic stenosis (AS) and to investigate its effectiveness as an alternative diagnosis method when echocardiography remains inconclusive. We prospectively studied 266 consecutive patients with moderate to severe AS who underwent MDCT to measure AVC load and a comprehensive echocardiographic examination to assess AS severity. AVC load was validated against valve weight in 57 patients undergoing aortic valve replacement. The dependence of AVC scores on tube potential and slice thickness was also tested, as well as the relationship between AVC load and echocardiographic criteria of AS severity. MDCT Agatston score correlated well with valve weight (r = 0.82, p < 0.001) and hemodynamic indices of AS severity (all p < 0.001). Ex-vivo Agatston scores decreased significantly with increasing tube potential and slice thickness (repeated measures ANOVA p < 0.001). Multivariate analysis identified mean gradient, the indexed effective orifice area, male gender and left ventricular outflow tract cross-sectional area as independent correlates of the in-vivo AVC load. MDCT-derived AVC load correlated well with valve weight and hemodynamic indices of AS severity. It also depends on tube potential and slice thickness, thus suggesting that these parameters should be standardized to optimize reproducibility and accuracy. Copyright © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  12. Absence of coronary sinus tributaries in ischemic cardiomyopathy: An insight from multidetector computed tomography cardiac venographic study.

    PubMed

    Boonyasirinant, Thananya; Halliburton, Sandra S; Schoenhagen, Paul; Lieber, Michael L; Flamm, Scott D

    2016-01-01

    Cardiac resynchronization therapy (CRT) is an important therapeutic strategy in heart failure. However, there is a high incidence of lead implantation failure and suboptimal response, particularly in ischemic cardiomyopathy. This failure rate may partly be secondary to lack of suitable coronary sinus branches for lead implantation. We sought to assess the presence of coronary sinus (CS) tributaries in patients with ischemic and non-ischemic cardiomyopathy. Multidetector computed tomography (MDCT) was performed in 100 patients: 25 coronary artery bypass graft (CABG) patients with impaired left ventricular ejection fraction (LVEF), 25 CABG patients with preserved LVEF, 25 patients with non-ischemic cardiomyopathy, and 25 controls. The presence of the CS and its tributaries, including the posterior interventricular vein (PIV), posterolateral vein (PLV), left marginal vein (LMV), and the anterior interventricular vein (AIV) was assessed. The CS, PIV, and AIV were demonstrated in all patients, whereas presence of a PLV and LMV was identified in 68% and 48% of CABG patients with impaired LVEF, 96% and 68% of CABG patients with preserved LVEF, 92% and 80% of patients with non-ischemic cardiomyopathy, and 100% and 80% of controls (p = 0.001 and 0.046 for PLV and LMV, respectively). This is the first report to demonstrate that the posterolateral vein and left middle vein, branches of the coronary sinus, are detectable in a significantly smaller number of CABG patients with impaired LVEF compared to controls, CABG with preserved LVEF, and non-ischemic cardiomyopathy. The absence of CS tributary veins in ischemic cardiomyopathy potentially hinders proper lead implantation and results in suboptimal CRT response. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  13. Anatomical variation of celiac axis, superior mesenteric artery, and hepatic artery: Evaluation with multidetector computed tomography angiography

    PubMed Central

    Farghadani, Maryam; Momeni, Mohammad; Hekmatnia, Ali; Momeni, Fateme; Baradaran Mahdavi, Mohammad Mehdi

    2016-01-01

    Background: The celiac axis, superior mesenteric artery (SMA), and hepatic artery are the most important branches of abdominal aorta due to their vascularization field. The aim of our study was to evaluate the prevalence of different anatomical variation of celiac axis, SMA, hepatic artery, and its branches with multidetector computed tomography (MDCT) angiography of upper abdomen arteries. Materials and Methods: MDCT of 607 kidney donor and traumatic patients that referred to MDCT unit at Al Zahra Hospital in Isfahan from 2012 to 2015 were retrospectively evaluated. We excluded patients with history of abdominal vascular surgery and hepatic or pancreatic surgery. Computed tomography images of the patient were obtained with 64-row MDCT scanner and anatomical variations were analyzed. Results: Three hundred and eighty-eight (63.9%) of the 607 patients had classic arterial anatomy and 219 (36.1%) patients had variant types. The most common type of variation was the origin of the right hepatic artery (RHA) from SMA (9.6%), and the next common variation was the origin of the left hepatic artery (LHA) from the left gastric artery (6.9%). Variations in the origin of the common hepatic artery (CHA) were seen in 16 (2.6%) patients. Buhler arc was identified in two patients. The RHA originated from the celiac axis in 11 (1.8%) patients and from the aorta in 8 (1.3%) patients. Trifurcation of CHA into gastroduodenal artery, RHA, and LHA was detected in 11 (1.8%) patients. Conclusion: The results of the present study showed that anatomical variation occurs in a high percentage of patients. Detection of these variations can guide surgical and radiological interventional planning.

  14. Computed tomographic findings in three dogs naturally infected with Crenosoma vulpis.

    PubMed

    Mortier, Jeremy R; Fina, Caroline J; Edery, Elsa; White, Crystal L; Dhumeaux, Marc P

    2017-09-10

    Crenosoma vulpis is a nematode lungworm found in wild and domestic canids in some parts of North America and Europe. Reported radiographic findings are nonspecific and consist of a combination of bronchial and interstitial changes of variable severity. This retrospective, case series study aimed to describe thoracic computed tomographic (CT) findings for a group of dogs with confirmed crenosomosis. Selection criteria were presentation with a chronic cough during the period of January 2016 to February 2017, evaluation by thoracic CT, and final diagnosis of C. vulpis infection based on bronchoscopic findings, bronchoalveolar lavage fluid analysis, and quantitative polymerase chain reaction. Medical records and CT images were retrieved and reviewed by a board-certified veterinary internist, a veterinary internal medicine resident, two board-certified veterinary radiologists, and a veterinary radiology intern, and findings were recorded. Three dogs met inclusion criteria. Thoracic CT findings for all dogs included the following: diffuse bronchial wall thickening, multifocal peribronchial ground glass attenuation, consolidation of the pulmonary parenchyma, and cylindrical bronchiectasis. In two dogs, the bronchial wall thickening was irregular to nodular, which was consistent with the bronchoscopic findings. Two dogs showed pulmonary parenchymal bands. Thoracic computed tomographic changes in dogs with C. vulpis are consistent with those seen on thoracic radiographs and crenosomosis should be considered in dogs with these findings. © 2017 American College of Veterinary Radiology.

  15. PATHOLOGIC BASIS FOR RIM ENHANCEMENT OBSERVED IN COMPUTED TOMOGRAPHIC IMAGES OF FELINE NASOPHARYNGEAL POLYPS.

    PubMed

    Lamb, Christopher R; Sibbing, Kendall; Priestnall, Simon L

    2016-01-01

    In postcontrast computed tomographic (CT) images, feline nasopharyngeal polyps typically demonstrate enhancement of the peripheral rim. Computed tomographic images and histologic specimens of a case series of 22 cats with surgically removed nasopharyngeal polyps were reviewed retrospectively in an attempt to elucidate the origin of rim enhancement. Polyps were present in the tympanic cavity in 15 (68%) cats (three with extension into the nasopharynx), only in the nasopharynx in four (18%) cats, and only in the external ear canal in the remaining three (14%) cats. All polyps had variable degrees of epithelial injury. Hemorrhage and inflammatory infiltration were significantly more marked in the superficial stroma whereas edema was significantly more marked in the core stroma. In noncontrast CT images (n = 22), the tympanic bulla was thickened in all 15 cats with a polyp in the tympanic cavity and enlarged in eight (53%) of these cats. In postcontrast CT images (n = 15), an outer zone of relatively increased attenuation compatible with a rim was observed in 11 (73%) polyps. The magnitude and extent of rim enhancement in CT images was positively correlated with the histologic grade of inflammation in the superficial stroma and negatively correlated with the grade of edema in the superficial stroma. It appears that inflammation is the major determinant of contrast medium accumulation in feline nasopharyngeal polyps, and the tendency for inflammation to affect predominantly the superficial layers explains the frequent observation of a rim in postcontrast CT images.

  16. 64-Slice Computed Tomographic Angiography for the Diagnosis of Intermediate Risk Coronary Artery Disease

    PubMed Central

    2010-01-01

    Executive Summary In July 2009, the Medical Advisory Secretariat (MAS) began work on Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease (CAD), an evidence-based review of the literature surrounding different cardiac imaging modalities to ensure that appropriate technologies are accessed by patients suspected of having CAD. This project came about when the Health Services Branch at the Ministry of Health and Long-Term Care asked MAS to provide an evidentiary platform on effectiveness and cost-effectiveness of non-invasive cardiac imaging modalities. After an initial review of the strategy and consultation with experts, MAS identified five key non-invasive cardiac imaging technologies for the diagnosis of CAD. Evidence-based analyses have been prepared for each of these five imaging modalities: cardiac magnetic resonance imaging, single photon emission computed tomography, 64-slice computed tomographic angiography, stress echocardiography, and stress echocardiography with contrast. For each technology, an economic analysis was also completed (where appropriate). A summary decision analytic model was then developed to encapsulate the data from each of these reports (available on the OHTAC and MAS website). The Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease series is made up of the following reports, which can be publicly accessed at the MAS website at: www.health.gov.on.ca/mas or at www.health.gov.on.ca/english/providers/program/mas/mas_about.html Single Photon Emission Computed Tomography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography with Contrast for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis 64-Slice Computed Tomographic Angiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Cardiac

  17. Computed Tomographic Angiography-Based Planning of Bipedicled DIEP Flaps with Intraflap Crossover Anastomosis: An Anatomical and Clinical Study.

    PubMed

    Kim, So Young; Lee, Kyeong-Tae; Mun, Goo-Hyun

    2016-09-01

    When using deep inferior epigastric artery perforator (DIEP) flaps in breast reconstruction, harvesting bipedicled flaps can be a valuable option in cases requiring the transfer of a large portion of harvested flaps. Connecting the bilateral deep inferior epigastric arteries (DIEAs) by intraflap crossover anastomosis is one of the most popular methods of constructing bipedicled DIEP flaps. Planning the primary and secondary pedicle configurations for reliable intraflap crossover anastomosis is crucial. To achieve this, detailed anatomical DIEA information might be helpful. However, meticulous planning of bipedicled DIEP flaps based on computed tomographic angiography has not been reported. Detailed anatomical investigation of DIEA branches was conducted using computed tomographic angiographs of 100 hemiabdomens. Thirty-eight prospectively collected patients who underwent breast reconstruction using bipedicled DIEP flaps with intraflap crossover under computed tomographic angiography-based planning were reviewed. Three intramuscular DIEA branching patterns with distinct branch point topography, branch diameters, and superior continuations cranial to sizable perforators were observed. In the prospective clinical study, a primary pedicle with a recipient branch for intraflap crossover anastomosis could be specified preoperatively using computed tomographic angiography-based anatomical data of the pedicles, including size of DIEA branches or their superior continuation and size of perforators. In all cases, the bipedicle configuration was easily achieved as planned on computed tomographic angiography, and secure perfusion of the entire flap was achieved. The authors' results suggest that computed tomographic angiography provides detailed anatomical DIEA information, and comprehensive analysis of these data allows precise planning of bipedicle configurations with intraflap crossover anastomosis in DIEP flaps. Therapeutic, IV.

  18. Non-Hodgkin lymphoma: computed tomographic demonstration of unusual extranodal involvement.

    PubMed

    Glazer, H S; Lee, J K; Balfe, D M; Mauro, M A; Griffith, R; Sagel, S S

    1983-10-01

    With the advent of computed tomography, lymphomatous involvement of sites other than lymph nodes is being seen with increasing frequency. Review of computed tomographic scans in 400 patients with newly diagnosed or recurrent non-Hodgkin lymphoma revealed 37 patients to have involvement of 56 unusual sites below the diaphragm: psoas/iliacus muscle (16 patients), kidney (13 patients), pancreas (5 patients), adrenal (4 patients), skin/subcutaneous tissue (4 patients), abdominal wall musculature (4 patients), peritoneum (4 patients), omentum (3 patients), and female reproductive tract (3 patients). These were mostly seen in patients with lymphomas of diffuse architecture, especially diffuse histiocytic lymphoma. Concomitant retroperitoneal and/or mesenteric adenopathy was very common; extranodal involvement was rarely the only site of initial or recurrent lymphoma.

  19. Simple load frame for in situ computed tomography and x-ray tomographic microscopy

    SciTech Connect

    Breunig, T.M. ); Stock, S.R.; Brown, R.C. )

    1993-05-01

    In many instances, the response of a sample to external stimuli must be observed repeatedly during the course of an experiment. The sequence in which features are formed is often critical to proper identification of the mechanisms operating, for example, in fatigue and fracture. Merely observing what is visible at the surface of the sample can be misleading or can provide inadequate information about what governs fatigue crack growth or about what controls the fracture process. X-ray imaging allows one to observe the interior of samples and is an attractive technique to use with in situ stressing of test specimens. Here, a simple compact, inexpensive load frame is described for in situ x-ray computed tomography and for very high resolution computed tomography, termed x-ray tomographic microscopy. The load frame is evaluated, and its use is illustrated by observations of crack closure as a function of load in a notched tensile sample of Al-Li-2090.

  20. Non-Hodgkin lymphoma: computed tomographic demonstration of unusual extranodal involvement

    SciTech Connect

    Glazer, H.S.; Lee, J.K.T.; Balfe, D.M.; Mauro, M.A.; Griffith, R.; Sagel, S.S.

    1983-10-01

    With the advent of computed tomography, lymphomatous involvement of sites other than lymph nodes is being seen with increasing frequency. Review of computed tomographic scans in 400 patients with newly diagnosed or recurrent non-Hodgkin lymphoma revealed 37 patients to have involvement of 56 unusual sites below the diaphragm: psoas/iliacus muscle (16 patients), kidney (13 patients), pancreas (5 patients), adrenal (4 patients), skin/subcutaneous tissue (4 patients), abdominal wall musculature (4 patients), peritoneum (4 patients), omentum (3 patients), and female reproductive tract (3 patients). These were mostly seen in patients with lymphomas of diffuse architecture, especially diffuse histiocytic lymphoma. Concomitant retroperitoneal and/or mesenteric adenopathy was very common; extraodal involvement was rarely the only site of initial or recurrent lymphoma.

  1. Effect of age and plaque morphology on diagnostic accuracy of dual source multidetector computed tomography coronary angiography

    PubMed Central

    Sunman, Hamza; Aytemir, Kudret; Yorgun, Hikmet; Canpolat, Uğur; Taher, Ali; Demiri, Edis; Hazırolan, Tuncay; Şahiner, Levent; Kaya, Ergün B.; Kabakçı, Giray; Tokgözoğlu, Lale; Oto, Ali

    2014-01-01

    Background Multidetector computed tomography (MDCT) coronary angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. The purpose of this study is to investigate the effect of age and coronary plaque calcification on diagnostic accuracy of MDCT. Methods The patients were examined by using dual-source MDCT and conventional coronary angiography. MDCT results were analyzed with regard to the severity (> 50% stenosis) and morphology (non-calcified, mixed, or calcified) of coronary atherosclerotic plaques evaluated in a 16-segment model. Results In total, 181 patients (94 men and 87 women) with 2,687 coronary artery segments were examined with MDCT. Ninety three patients were older than 65 years of age (group A, 42 men) and 88 were younger (group B, 52 men). Two-hundred nine coronary artery segments (7.2%) were excluded because of small distal coronary vessel segments and/or motion artifacts. The overall number of segments with non-diagnostic image quality was similar in both groups of patients. Of the 2,687 evaluated segments, 157 (5.8%) were significantly diseased, and 144 of them were correctly detected by MDCT. Diagnostic evaluation showed that the sensitivity, positive predictive value, specificity, and negative predictive value were 89.5%, 62.5%, 96.0%, and 99.2%, respectively in group A, and 95.2%, 64.8%, 97.5%, and 99.8% in group B, respectively. In addition, detailed segment-based analyses in coronary segments with non-calcified, mixed and calcified plaques in both groups were similar diagnostic accuracy. Conclusions Very high diagnostic accuracy observed in this study suggests that MDCT coronary angiography could be a suitable diagnostic tool for not only younger patients but also for older patients. PMID:25009559

  2. Transmural myocardial perfusion gradients in relation to coronary artery stenoses severity assessed by cardiac multidetector computed tomography.

    PubMed

    Linde, Jesper James; Kühl, Jørgen Tobias; Hove, Jens Dahlgaard; Sørgaard, Mathias; Kelbæk, Henning; Nielsen, Walter Bjørn; Kofoed, Klaus Fuglsang

    2015-01-01

    To assess the relationship between epicardial coronary artery stenosis severity and the corresponding regional transmural perfusion at rest and during adenosine stress, using multidetector computed tomography (MDCT). We evaluated the relationship between the severity of coronary artery diameter stenosis assessed by MDCT angiography and semi-quantitative myocardial MDCT perfusion in 200 symptomatic patients. The perfusion index (PI = mean myocardial attenuation density/mean left ventricular lumen attenuation density) at rest and during adenosine stress, the myocardial perfusion reserve (MPR = stress - PI/rest - PI), and the transmural perfusion ratio (TPR = subendocardium/subepicardium) were calculated. A coronary artery stenosis ≥50 % was present in 49 patients (25 %). Rest-PI and rest-TPR values were similar in patients with and without a coronary artery stenosis ≥50 %, whereas stress-PI, stress-TPR and MPR were significantly reduced in patients with a stenosis ≥50 % (p < 0.001, p < 0.0001 and p = 0.02, respectively). Subendocardial PI was significantly higher than subepicardial PI at rest and during stress for patients without a significant stenosis, whereas this difference was blurred during stress in patients with ≥50 % stenosis. In a broad spectrum of stenosis severity groups, TPR at rest remained unchanged until the group of patients with total occlusions, whereas TPR during stress decreased progressively when a threshold of 50 % was superseded. In this study we establish the relationship between semi-quantitative perfusion measurements by MDCT and severity of coronary artery stenoses and find the transmural myocardial perfusion ratio to be a potential strong functional index of the hemodynamic significance of coronary artery atherosclerotic lesions.

  3. Efficacy of Multidetector Computed Tomography to Predict Periprocedural Myocardial Injury After Percutaneous Coronary Intervention for Chronic Total Occlusion.

    PubMed

    Usui, Eisuke; Lee, Tetsumin; Murai, Tadashi; Kanaji, Yoshihisa; Matsuda, Junji; Araki, Makoto; Yonetsu, Taishi; Yamakami, Yosuke; Kimura, Shigeki; Kakuta, Tsunekazu

    2017-02-07

    Specific signatures of culprit lesions detected on multidetector computed tomography (MDCT) were identified as predictors of periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) in patients with stable angina; PMI has been shown to be associated with a worse prognosis. We investigated the association between preprocedural culprit lesion characteristics, assessed by MDCT, and PMI after PCI for chronic total occlusion (CTO). From three medical centers, 81 patients who underwent pre-PCI MDCT and CTO PCI, and systematic cardiac troponin (cTn) sampling before and after PCI, were included. Patients were divided into two groups according to the presence or absence of post-PCI cTn elevation. Patient characteristics, MDCT findings, and procedural variables were compared between the two groups. Procedure success was observed in 65 patients (80.2%) and was not associated with PMI. The incidence of PMI was higher in patients treated with the retrograde versus the antegrade approach. On MDCT, lesion length and the presence of the napkin-ring sign were significantly associated with PMI. Multivariate analysis revealed that the lesion length (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.01-1.08; P < 0.05), napkin-ring sign (OR: 5.41; 95% CI: 1.01-29.0; P < 0.05), and retrograde approach (OR: 4.78; 95% CI: 1.28-15.4; P < 0.05) were significant predictors of PMI. PMI is not uncommon in patients undergoing elective CTO PCI, regardless of procedure success or failure. Pre-PCI MDCT may help identify patients at high risk for PMI after CTO PCI.

  4. Denver screening protocol for blunt cerebrovascular injury reduces the use of multi-detector computed tomography angiography.

    PubMed

    Beliaev, Andrei M; Barber, P Alan; Marshall, Roger J; Civil, Ian

    2014-06-01

    Blunt cerebrovascular injury (BCVI) occurs in 0.2-2.7% of blunt trauma patients and has up to 30% mortality. Conventional screening does not recognize up to 20% of BCVI patients. To improve diagnosis of BCVI, both an expanded battery of screening criteria and a multi-detector computed tomography angiography (CTA) have been suggested. The aim of this study is to investigate whether the use of CTA restricted to the Denver protocol screen-positive patients would reduce the unnecessary use of CTA as a pre-emptive screening tool. This is a registry-based study of blunt trauma patients admitted to Auckland City Hospital from 1998 to 2012. The diagnosis of BCVI was confirmed or excluded with CTA, magnetic resonance angiography and, if these imaging were non-conclusive, four-vessel digital subtraction angiography. Thirty (61%) BCVI and 19 (39%) non-BCVI patients met eligibility criteria. The Denver protocol applied to our cohort of patients had a sensitivity of 97% (95% confidence interval (CI): 83-100%) and a specificity of 42% (95% CI: 20-67%). With a prevalence of BCVI in blunt trauma patients of 0.2% and 2.7%, post-test odds of a screen-positive test were 0.03 (95% CI: 0.002-0.005) and 0.046 (95% CI: 0.314-0.068), respectively. Application of the CTA to the Denver protocol screen-positive trauma patients can decrease the use of CTA as a pre-emptive screening tool by 95-97% and reduces its hazards. © 2013 Royal Australasian College of Surgeons.

  5. Planning deep inferior epigastric perforator flaps for breast reconstruction: a comparison between multidetector computed tomography and magnetic resonance angiography.

    PubMed

    Cina, A; Barone-Adesi, L; Rinaldi, P; Cipriani, A; Salgarello, M; Masetti, R; Bonomo, L

    2013-08-01

    Deep inferior epigastric perforator (DIEP) flaps have become the state of the art in breast reconstruction. We compared the diagnostic performance of multidetector computed tomography (CTA) and magnetic resonance angiography (MRA) in DIEP flap planning. Twenty-three women (mean age 48.0 years, range 26-72 years) underwent preoperative blinded evaluation using 64-slice CTA and 1.5-T MRA. Perforator identification, measurement of their calibre, intramuscular course (IMC), assessment of direct venous connections (DVC) with main superficial veins, superficial venous communications (SVC) between the right and left hemi-abdomen and deep inferior epigastric artery (DIEA) branching type were performed. Surgery was carried out by the same team. Intraoperative findings were the standard of reference. Accuracy in identifying dominant perforators was 91.3 % for both techniques and mean error in calibre measurement 1.18 ± 0.35 mm for CTA and 1.63 ± 0.39 mm for MRA. Accuracy in assessing perforator IMCs was 97.1 % for CTA and 88.4 % for MRA, DVC 94.4 % for both techniques, SVC 91.3 % as well, and DIEA branching type 100 % for CTA and 91.3 % for MRA. Image acquisition and interpretation time was 21 ± 3 min for CTA (35 ± 5 min for MRA). In a strategy to optimise DIEP flap planning avoiding radiation exposure, MRA can be proposed alternatively to CTA. • Identification of deep inferior epigastric perforators (DIEP) is important before breast reconstruction. • Both CT and MR angiography are accurate in identifying DIEA perforator branches. • CTA and MRA are equivalent in demonstrating perforator-venous connections. • MRA can be proposed as an alternative to CTA in DIEP planning.

  6. Tomosynthesis for the early detection of pulmonary emphysema: diagnostic performance compared with chest radiography, using multidetector computed tomography as reference.

    PubMed

    Yamada, Yoshitake; Jinzaki, Masahiro; Hashimoto, Masahiro; Shiomi, Eisuke; Abe, Takayuki; Kuribayashi, Sachio; Ogawa, Kenji

    2013-08-01

    To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA-950. The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. • Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography. • Interobserver agreement for tomosynthesis was significantly higher than that for radiography. • Sensitivity increased with increasing LAA -950 in both tomosynthesis and radiography. • Tomosynthesis imparts a similar radiation dose to two projection chest radiography. • Radiation dose and cost of tomosynthesis are lower than those of MDCT.

  7. The measurement of opening angle and orifice area of a bileaflet mechanical valve using multidetector computed tomography.

    PubMed

    Lee, Dong-Hyeon; Youn, Ho-Joong; Shim, Sung-Bo; Lee, Sun-Hee; Jung, Jung-Im; Jung, Seung-Eun; Choi, Yun-Seok; Park, Chul-Soo; Oh, Yong-Seog; Chung, Wook-Sung; Kim, Jae-Hyung

    2009-04-01

    The aim of this study was to assess mechanical valve function using 64-slice multidetector computed tomography (MDCT). In 20 patients (mean age, 50+/-12 years; male-to-female ratio, 10:10), 30 St. Jude bileaflet mechanical valves (15 aortic and 15 mitral valves) were evaluated using MDCT. We selected images vertical and parallel to the mechanical valve. The valve orifice area (OA) and valve length were determined by manual tracing and the opening and closing angles were measured using a protractor. The OA and length of the mechanical valves were compared with the manufacturer's values. The geometric orifice areas (GOAs) based on the manufacturer's values and the OAs determined by MDCT were 3.4+/-0.2 cm(2) and 3.4+/-0.3 cm(2) for the mitral valves and 2.1+/-0.3 cm(2) and 2.1+/-0.4 cm(2) for the aortic valves, respectively. The correlation coefficients between the OA measures were 0.433 for the mitral valves and 0.874 for the aortic valves (both p<0.001). The lengths based on the manufacturer's values and determined by MDCT were 29.3+/-1.99 mm and 29.6+/-1.65 mm for the mitral valves and 21.5+/-2.1 mm and 20.7+/-2.3 mm for the aortic valves, respectively. The correlation coefficients between the measures were 0.651 for the mitral valve and 0.846 for the aortic valve (both p<0.001). The opening and closing angles determined by MDCT were 10.9+/-0.6 degrees and 131.1+/-3.2 degrees for the mitral valves and 11.1+/-0.9 degrees and 120.6+/-1.7 degrees for the aortic valves, respectively. MDCT is an accurate modality with which to assess the function and morphology of bileaflet mechanical valves.

  8. Diagnostic nomogram for gallbladder wall thickening mimicking malignancy: using contrast-enhanced ultrasonography or multi-detector computed tomography?

    PubMed

    Chen, Li-Da; Huang, Yang; Xie, Xiao-Hua; Chen, Wei; Shan, Quan-Yuan; Xu, Ming; Liu, Jin-Ya; Nie, Zhi-Qiang; Xie, Xiao-Yan; Lu, Ming-De; Shen, Shun-Li; Wang, Wei

    2017-04-26

    To establish a diagnostic nomogram using contrast-enhanced ultrasonography (CEUS) in gallbladder wall thickening mimicking malignancy and compare with multi-detector computed tomography (MDCT). Seventy-two patients with gallbladder wall thickening on B-mode ultrasonography (BUS) were examined by CEUS to develop independent predictors for diagnosing gallbladder carcinoma. Among the 72 cases, 48 patients underwent both CEUS and MDCT. The diagnostic performances of different sets of CEUS criteria and MDCT were compared. A prediction model of malignancy using CEUS was developed. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. Multivariate logistic regression indicated that inhomogeneous enhancement in the arterial phase was the strongest independent predictor of malignancy (odds ratio, OR 51.162), followed by interrupted inner layer (OR 19.788), washout time ≤40 s (OR 16.686), and wall thickness >1.6 cm (OR 3.019), which were all selected into the nomogram. Combined with the above significant features, the diagnostic performance of CEUS (AUC = 0.917) was higher than that of MDCT (AUC = 0.788, P = 0.070). The predictive model using CEUS showed good discrimination, with a concordance index of 0.974 (0.950 through internal validation), and good calibration. Decision curve analysis demonstrated that the nomogram was clinically useful. CEUS could accurately differentiate between malignant and benign gallbladder wall thickening with equivalent efficacy compared to MDCT. The proposed nomogram could be conveniently used to facilitate the preoperative individualized prediction of malignancy in patients with gallbladder wall thickening.

  9. Myocardial perfusion defect in patients with coronary artery disease demonstrated by 64-multidetector computed tomography at rest.

    PubMed

    Iwasaki, Kohichiro; Matsumoto, Takeshi

    2011-07-01

    The first-pass imaging of 64-multidetector computed tomography (MDCT) using pharmacological stress has been used to assess myocardial perfusion. However, detection of myocardial ischemia at rest using MDCT has yet to be elucidated. We studied the incidence of myocardial perfusion defect (MPD) by 64-MDCT at rest and the effect of coronary revascularization therapy on MPD in patients with coronary artery disease. MPD by 64-MDCT at rest indicates myocardial ischemia. We studied 76 patients with coronary artery disease who underwent 64-MDCT before and after revascularization therapy and 55 patients who did not undergo revascularization therapy. According to percent diameter stenosis, we defined group A, B, C, and D to have stenosis between 70% and 90%, 50% and 69%, 30% and 49%, and 10% and 29%, respectively. We evaluated regional myocardial contrast enhancement by long and short axis planes. MPD was defined as hypoenhancement area of some extent with CT value <50 HU during diastole. MPD was found in 60.0% and 32.4% of group A and B patients, respectively (P = 0.0176). The incidence was 4.8% and 0% in group C and D patients, respectively (P<0.0001 compared with group A and B). All patients in group A and B and 2 patients with MPD in group C underwent coronary revascularization therapy. MPD disappeared after revascularization therapy in all but 3 group A patients. No patients showed new MPD after revascularization therapy. Our results demonstrate that a significant percentage of patients with significant coronary artery stenosis show MPD by 64-MDCT at rest, and these MPDs may represent myocardial ischemia. © 2011 Wiley Periodicals, Inc.

  10. Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study.

    PubMed

    Sibileau, E; Ridereau-Zins, Catherine; Vanel, D; Pavageau, A H; Bertrais, S; Metivier-Cesbron, E; Venara, A; Aubé, C

    2014-10-01

    To assess the accuracy of water-enema multidetector computed tomography (WE-MDCT) in extra-rectal colon cancer staging. Fifty-three patients (mean age 70 years) with extra-rectal colon cancer proven by colonoscopy and biopsy were prospectively evaluated by preoperative WE-MDCT. CT scans were both intraluminal (water enema or WE) and intravenous (iodinated) contrast enhanced (CE). All patients underwent surgery. Tumors were classified with the TNM staging system. Noted CT features were: tumor size and location; tumor form and edges; spread to the pericolic fat or neighboring organs; thickening of retroperitoneal fascia; number, size, and enhancement of the peritumoral lymph nodes. Tumors were classified on CT into 3 T-stage groups: T1/T2, T3, and T4. Lymph nodes were classified by their density after injection [positive over 100 Hounsfield units (HU)]. Tumor localization to the specific colon segment was correct in all the cases. The agreement between WE-MDCT staging and histopathology staging was good (k = 0.64). An irregular and bowl-shaped aspect of the external edges of tumor provided excellent sensitivity for T3/T4 inclusion (Se 97.7%, NPV 85.7%). Thickening of a fascia or the abdominal wall provided good specificity for T4 stage (Sp 88.1%, NPV 94.9%). Enhancement over 100 HU of at least one peritumoral lymph node was the best criterion of N+ staging (Sp 67.7%, NPV 87.5%). WE-MDCT permits good staging of colon cancer based on objective features.

  11. Improvement in the quality of the cardiac vein images by optimizing the scan protocol of multidetector-row computed tomography.

    PubMed

    Hara, Tetsuya; Yamashiro, Kohei; Okajima, Katsunori; Hayashi, Takatoshi; Kajiya, Teishi

    2009-11-01

    The present study aimed at optimizing the scan protocol for multidetector-row computed tomography (MDCT) to adequately visualize coronary veins. Circulation time (Cir.T) was defined as the time period from the injection of contrast media into the coronary artery to the pervasion of the contrast media into the coronary sinus as observed by coronary angiography. We investigated the relation between the Cir.T and echocardiographic parameters in 64 patients. The left ventricular end-diastolic diameter (LVDd) and left ventricular end-systolic diameter (LVDs) were correlated with the Cir.T (r = 0.58, P < 0.0001, and r = 0.60, P < 0.0001 respectively). In addition, the left ventricular ejection fraction (LVEF) was negatively correlated with the Cir.T (r = 0.48, P < 0.0001). The average Cir. T was longer in patients with LVEF < 35% (8.0 s vs 6.7 s; P < 0.05) or LVDd > 55 mm (7.9 s vs 6.2 s; P < 0.05) than in the other patients. The quality of the MDCT images of the coronary veins obtained at different scan timings (coronary artery phase and 10 s or 15 s after the coronary artery phase) were graded and classified into four categories (0 = worst, 3 = best) in 25 patients with LVEF < 35%. The delays of 10 and 15 s after the coronary artery phase significantly improved the mean image quality (P < 0.05). The Cir.T was prolonged in patients with low LVEF and LV dilation. An appropriate delay improved the quality of the MDCT images of the coronary veins in patients with LV dysfunction.

  12. Assessment of modified Blalock-Taussig shunt in children with congenital heart disease using multidetector-row computed tomography.

    PubMed

    Nabo, Manal Mohamed Helmy; Hayabuchi, Yasunobu; Inoue, Miki; Watanabe, Noriko; Sakata, Miho; Kagami, Shoji

    2010-11-01

    The purpose of this study was to assess the feasibility of multidetector-row computed tomography (MDCT) for the evaluation of modified Blalock-Taussig (B-T) shunt in children with congenital heart disease associated with reduced pulmonary blood flow. A total of 25 consecutive patients (mean age, 2.6 ± 3.6 years; range, 2 months-16 years) underwent MDCT angiography of the thorax with a 16-detector row scanner prior to cardiac catheterization. A total of 39 shunts (right, 22; left, 17) were included in the study. Conventional angiographic findings were used as the gold standard for the detection of B-T shunts. Shunt diameter was measured quantitatively and independently at four sites (the subclavian artery site, the pulmonary artery site, the widest site, and the stenotic site) on MDCT and on conventional invasive angiography. All B-T shunts were depicted on multiplanar reconstruction (MPR), maximum intensity projection (MIP), curved planar reconstruction (CPR), and three-dimensional volume-rendered (VR) images, enabling evaluation in all patients except for one with occluded shunt. There were excellent correlations between MDCT- and conventional angiography-based measurements of shunt diameter at the subclavian artery site, pulmonary artery site, and the widest site (R² = 0.46, 0.74 and 0.64, respectively; p < 0.0001 for each), although systematic overestimation was observed for MDCT (mean percentage of overestimation, 23.1 ± 32.4%). Stenotic site diameter and degree of stenosis showed a mild correlation (R² = 010 and 0.25, respectively; p < 0.01 for each). This study demonstrates that MDCT is a promising tool for the detection of lesions in B-T shunts.

  13. Time-Dependent Computed Tomographic Perfusion Thresholds for Patients With Acute Ischemic Stroke.

    PubMed

    d'Esterre, Christopher D; Boesen, Mari E; Ahn, Seong Hwan; Pordeli, Pooneh; Najm, Mohamed; Minhas, Priyanka; Davari, Paniz; Fainardi, Enrico; Rubiera, Marta; Khaw, Alexander V; Zini, Andrea; Frayne, Richard; Hill, Michael D; Demchuk, Andrew M; Sajobi, Tolulope T; Forkert, Nils D; Goyal, Mayank; Lee, Ting Y; Menon, Bijoy K

    2015-12-01

    Among patients with acute ischemic stroke, we determine computed tomographic perfusion (CTP) thresholds associated with follow-up infarction at different stroke onset-to-CTP and CTP-to-reperfusion times. Acute ischemic stroke patients with occlusion on computed tomographic angiography were acutely imaged with CTP. Noncontrast computed tomography and magnectic resonance diffusion-weighted imaging between 24 and 48 hours were used to delineate follow-up infarction. Reperfusion was assessed on conventional angiogram or 4-hour repeat computed tomographic angiography. Tmax, cerebral blood flow, and cerebral blood volume derived from delay-insensitive CTP postprocessing were analyzed using receiver-operator characteristic curves to derive optimal thresholds for combined patient data (pooled analysis) and individual patients (patient-level analysis) based on time from stroke onset-to-CTP and CTP-to-reperfusion. One-way ANOVA and locally weighted scatterplot smoothing regression was used to test whether the derived optimal CTP thresholds were different by time. One hundred and thirty-two patients were included. Tmax thresholds of >16.2 and >15.8 s and absolute cerebral blood flow thresholds of <8.9 and <7.4 mL·min(-1)·100 g(-1) were associated with infarct if reperfused <90 min from CTP with onset <180 min. The discriminative ability of cerebral blood volume was modest. No statistically significant relationship was noted between stroke onset-to-CTP time and the optimal CTP thresholds for all parameters based on discrete or continuous time analysis (P>0.05). A statistically significant relationship existed between CTP-to-reperfusion time and the optimal thresholds for cerebral blood flow (P<0.001; r=0.59 and 0.77 for gray and white matter, respectively) and Tmax (P<0.001; r=-0.68 and -0.60 for gray and white matter, respectively) parameters. Optimal CTP thresholds associated with follow-up infarction depend on time from imaging to reperfusion. © 2015 American Heart

  14. Aortic valve area assessment: multidetector CT compared with cine MR imaging and transthoracic and transesophageal echocardiography.

    PubMed

    Pouleur, Anne-Catherine; le Polain de Waroux, Jean-Benoît; Pasquet, Agnès; Vanoverschelde, Jean-Louis J; Gerber, Bernhard L

    2007-09-01

    To prospectively compare the accuracy of multidetector computed tomographic (CT) measurements of the aortic valve area (AVA) with transesophageal echocardiography (TEE) and cine magnetic resonance (MR) measurements of this area for preoperative examination of patients undergoing cardiac surgery, with transthoracic echocardiography (TTE) as the reference standard. After giving informed consent for the institutional review board-approved study protocol, 48 patients (33 men, 15 women; mean age, 62 years+/-13 [standard deviation]) with (n=27) or without (n=21) aortic stenosis underwent multidetector CT, cine MR, TTE, and TEE before undergoing cardiac surgery. AVAs derived with manual planimetry by using cine short-axis multidetector CT, MR, and TEE images obtained through the aortic valve were compared among each other and with AVAs measured by using continuity equation TTE at regression and Bland-Altman analyses. The diagnostic accuracy of multidetector CT for detection of aortic stenosis was compared with that of TTE by using kappa statistics and receiver operating characteristic curves. Multidetector CT-derived AVA correlated highly with MR-derived (r=0.98, P<.001), TEE-derived (r=0.98, P<.001), and TTE-derived (r=0.96, P<.001) AVA. Multidetector CT planimetry AVAs (mean AVA+/-standard deviation, 2.5 cm2+/-1.7) were not significantly different from MR planimetry (2.4 cm2+/-1.8, P>.99) or TEE planimetery (2.5 cm2+/-1.7, P=.21) AVAs, but they were significantly larger than TTE-derived AVAs (2.0 cm2+/-1.5, P<.001). With TTE as the reference standard, multidetector CT correctly (kappa=0.88, P<.001) depicted all 21 normal, six of eight mildly stenotic (AVA>or=1.2 cm2 and <2.0 cm2), seven of eight moderately stenotic (AVA>or= 0.8 cm2 and <1.2 cm2), and 10 of 11 severely stenotic (AVA<0.8 cm2) valves. It also correctly depicted all 14 bicuspid valves identified with TEE, eight of which were missed with TTE. Multidetector CT enables accurate noninvasive assessment of the

  15. Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars.

    PubMed

    Kurthukoti, Ameet J; Sharma, Pranjal; Swamy, Dinesh Francis; Shashidara, R; Swamy, Elaine Barretto

    2015-01-01

    Need for the study: The most important procedure for a successful endodontic treatment is the cleaning and shaping of the canal system. Understanding the internal anatomy of teeth provides valuable information to the clinician that would help him achieve higher clinical success during endodontic therapy. To evaluate by computed tomography-the internal anatomy of mandibular second primary molars with respect to the number of canals, cross-sectional shape of canals, cross-sectional area of canals and the root dentin thickness. A total of 31 mandibular second primary molars were subjected to computed-tomographic evaluation in the transverse plane, after mounting them in a prefabricated template. The images, thus, obtained were analyzed using De-winter Bio-wizard® software. All the samples demonstrated two canals in the mesial root, while majority of the samples (65.48%) demonstrated two canals in the distal root. The cross-sectional images of the mesial canals demonstrated a round shape, while the distal canals demonstrated an irregular shape. The root dentin thickness was highly reduced on the distal aspect of mesial and mesial aspect of distal canals. The mandibular second primary molars demonstrated wide variation and complexities in their internal anatomy. A thorough understanding of the complexity of the root canal system is essential for understanding the principles and problems of shaping and cleaning, determining the apical limits and dimensions of canal preparations, and for performing successful endodontic procedures. How to cite this article: Kurthukoti AJ, Sharma P, Swamy DF, Shashidara R, Swamy EB. Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars. Int J Clin Pediatr Dent 2015;8(3):202-207.

  16. Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists

    PubMed Central

    Neubauer, Jakob; Benndorf, Matthias; Reidelbach, Carolin; Krauß, Tobias; Lampert, Florian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Fiebich, Martin; Goerke, Sebastian M.

    2016-01-01

    Purpose To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. Methods As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging. Three raters independently evaluated the resulting images for fractures and the level of confidence for each finding. Gold standard was evaluated by consensus reading of a high-dose MDCT. Results Pooled sensitivity was higher in RED-MDCT with 0.89 and RED-MDCT with 0.81 compared to radiography with 0.54 (P = < .004). No significant differences were detected concerning the modalities’ specificities (with values between P = .98). Raters' confidence was higher in RED-MDCT and RED-CBCT compared to radiography (P < .001). Conclusion The diagnostic accuracy of RED-MDCT and RED-CBCT for wrist fractures proved to be similar and in some parts even higher compared to radiography. Readers are more confident in their reporting with the cross sectional modalities. Dose equivalent cross sectional computed tomography of the wrist could replace plain radiography for fracture diagnosis in the long run. PMID:27788215

  17. Myocardial stunning in hypertrophic cardiomyopathy: recovery predicted by single photon emission computed tomographic thallium-201 scintigraphy

    SciTech Connect

    Fine, D.G.; Clements, I.P.; Callahan, M.J.

    1989-05-01

    A young woman with hypertrophic cardiomyopathy confirmed by echocardiography and cardiac catheterization presented with chest pain and features of a large left ventricular aneurysm. The initial diagnosis was myocardial ischemia with either an evolving or an ancient myocardial infarction. Subsequently, verapamil therapy was associated with complete resolution of the extensive left ventricular wall motion abnormalities, normalization of left ventricular ejection fraction and a minimal myocardial infarction. Normal thallium uptake on single photon emission computed tomographic scintigraphy early in the hospital course predicted myocardial viability in the region of the aneurysm. Thus, orally administered verapamil may reverse spontaneous extensive myocardial ischemia in hypertrophic cardiomyopathy and possibly limit the extent of myocardial infarction in such circumstances.

  18. Optical tomographic detection of rheumatoid arthritis with computer-aided classification schemes

    NASA Astrophysics Data System (ADS)

    Klose, Christian D.; Klose, Alexander D.; Netz, Uwe; Beuthan, Jürgen; Hielscher, Andreas H.

    2009-02-01

    A recent research study has shown that combining multiple parameters, drawn from optical tomographic images, leads to better classification results to identifying human finger joints that are affected or not affected by rheumatic arthritis RA. Building up on the research findings of the previous study, this article presents an advanced computer-aided classification approach for interpreting optical image data to detect RA in finger joints. Additional data are used including, for example, maximum and minimum values of the absorption coefficient as well as their ratios and image variances. Classification performances obtained by the proposed method were evaluated in terms of sensitivity, specificity, Youden index and area under the curve AUC. Results were compared to different benchmarks ("gold standard"): magnet resonance, ultrasound and clinical evaluation. Maximum accuracies (AUC=0.88) were reached when combining minimum/maximum-ratios and image variances and using ultrasound as gold standard.

  19. Computed tomographic evidence of atherosclerosis in the mummified remains of humans from around the world.

    PubMed

    Thompson, Randall C; Allam, Adel H; Zink, Albert; Wann, L Samuel; Lombardi, Guido P; Cox, Samantha L; Frohlich, Bruno; Sutherland, M Linda; Sutherland, James D; Frohlich, Thomas C; King, Samantha I; Miyamoto, Michael I; Monge, Janet M; Valladolid, Clide M; El-Halim Nur El-Din, Abd; Narula, Jagat; Thompson, Adam M; Finch, Caleb E; Thomas, Gregory S

    2014-06-01

    Although atherosclerosis is widely thought to be a disease of modernity, computed tomographic evidence of atherosclerosis has been found in the bodies of a large number of mummies. This article reviews the findings of atherosclerotic calcifications in the remains of ancient people-humans who lived across a very wide span of human history and over most of the inhabited globe. These people had a wide range of diets and lifestyles and traditional modern risk factors do not thoroughly explain the presence and easy detectability of this disease. Nontraditional risk factors such as the inhalation of cooking fire smoke and chronic infection or inflammation might have been important atherogenic factors in ancient times. Study of the genetic and environmental risk factors for atherosclerosis in ancient people may offer insights into this common modern disease.

  20. Nephroureterectomy and ureteroneocystostomy in an alpaca with bilateral ectopic ureters diagnosed by computed tomographic excretory urography.

    PubMed

    Polf, Holly D; Smith, Shasta; Simpson, Katharine M; Rochat, Mark C

    2015-01-01

    To report diagnosis and treatment of urinary incontinence in a female Huacaya alpaca. Clinical case report. Female intact Huacaya alpaca (n = 1) METHODS: Computed tomographic (CT) excretory urography and vaginourethrography were performed to diagnose the cause of urinary incontinence. Bilateral ectopic ureters and left hydronephrosis and hydroureter were diagnosed. Left nephroureterectomy and right ureteroneocystostomy were performed with subsequent resolution of clinical signs. Pyelonephritis was identified by culture of the resected left kidney. CT excretory urography was helpful in the diagnosis of bilateral ectopic ureters in an alpaca and provided information for surgical planning. Surgical repair by ureteroneocystostomy and unilateral nephroureterectomy was successful in resolving clinical signs. © Copyright 2014 by The American College of Veterinary Surgeons.

  1. Coronary computed tomographic angiography in the emergency room: state of the art.

    PubMed

    Cheezum, Michael K; Bittencourt, Marcio S; Hulten, Edward A; Scirica, Benjamin M; Villines, Todd C; Blankstein, Ron

    2014-02-01

    Chest pain is a common complaint in the emergency department often necessitating testing to exclude underlying obstructive coronary artery disease. While the traditional evaluation of patients with suspected acute coronary syndrome often consists of serial electrocardiograms and cardiac biomarkers, followed by selective use of stress testing for further risk stratification, this approach is costly and inefficient. Recently, coronary computed tomographic angiography (CTA) has offered an alternative approach with a high sensitivity and negative predictive value to exclude obstructive coronary artery disease that can rapidly identify patients with low rates of downstream major adverse cardiac events. In this review, the authors provide an overview of available data on the use of CTA for evaluating acute chest pain, while emphasizing its advantages and disadvantages compared to existing strategies. In addition, we provide a suggested algorithm to identify how CTA can be incorporated into the evaluation of acute chest pain and discuss tips for successful implementation of CTA in the emergency department.

  2. Shining Pearls Sign: A New Identity for Venous Malformations on Computed Tomographic Imaging.

    PubMed

    Bhat, Venkatraman; Bhat, Varun

    2016-12-01

    Vascular malformations, in particular venous malformations (VM), are common lesions involving the pediatric and adolescent population. VM occur at approximately 1:5,000 to 10,000; approximately 40% of them occur in the head and neck regions. Classical appearance of VM on imaging is a demonstration of near-normal-sized or mildly dilated feeding arteries which subsequently lead to dilated venous structures of varying caliber, thus constituting the malformation. Phleboliths are the hallmark of VM. Plain radiography has been an established modality for demonstrating phleboliths. The emergence of computed tomographic (CT) as a preferred imaging modality for the evaluation of a complex vascular malformation necessitates familiarity with the spectrum of CT appearances of this lesion. This presentation illustrates an additional CT sign, "shining pearls sign," highlighting the striking display of phleboliths in the vascular malformations, prompting correct diagnosis.

  3. The use of helical computed tomographic scan to assess bony physeal bridges.

    PubMed

    Loder, R T; Swinford, A E; Kuhns, L R

    1997-01-01

    Coronal and sagittal reformatted images of the physis obtained with the helical computed tomography (CT) scanner were studied in five children. This technique allows tomographic slices at 1.0-mm thickness and can be performed in approximately 20 s. The distal femora were studied in two children, the distal tibia in two children, and the distal radius in one child. In three children, after physeal mapping, bar resections were performed. In all cases, the location and size of the bar was accurately predicted by the map constructed from the helical CT scan. We recommend the helical CT scan to prepare physeal maps to determine the extent and location of physeal bony bars because of excellent bony detail, radiation doses one half to one quarter those of conventional tomography, and the rapidity of scanning, which bypasses the need for sedation.

  4. Is coronary computed tomographic angiography the "gold standard" for coronary artery disease?

    PubMed

    Hecht, Harvey S

    2009-01-01

    The proliferation of noninvasive diagnostic tests has been accompanied by validation of each technology by a "gold standard." The anatomic "gold standard" of catheter angiography has been uniformly employed to validate the functional technologies of nuclear, echocardiographic and magnetic resonance stress testing and fractional flow reserve, which are then paradoxically used to judge the anatomic findings. Catheter angiography has also been used as the "gold standard" for the newest technology, coronary computed tomographic angiography (CCTA). By virtue of similar three dimensional characteristics, intravascular ultrasound may be the more appropriate standard for CCTA. However, because of the paradoxical interdependence of the validations, there can be no true "gold standard" for any technology; clinical, outcomes may ultimately be the best option. In the interim, clinical judgment and common sense should be substituted for slavish adherence to an absolute "gold standard" for diagnostic imaging and total reliance on a single diagnostic test.

  5. Health technology assessment: a review of international activity and examples of approaches with computed tomographic colonography.

    PubMed

    Husereau, Don; Morrison, Andra; Battista, Renaldo; Goeree, Ron

    2009-05-01

    The growth of health technology assessment (HTA) internationally is currently reflected in the growing membership of the International Network of Agencies for Health Technology Assessment. Many national and regional HTA institutions emerged in the 1980s and 1990s, and more recently, HTA has emerged in newly industrialized countries and in European Union member states in transition. Health technology assessment activities are becoming an increasingly important part of health care culture, with the appearance of HTA units in hospitals and hospital departments. This article provides a brief overview of who conducts HTA internationally and looks at how HTA is conducted and how this information is used. To highlight the different structures, processes, and methods available, a portion of this article is dedicated to describing different approaches that have been observed with respect to the assessment of computed tomographic colonography in North America for population-based colorectal cancer screening.

  6. The spine in 3D. Computed tomographic reformation from 2D axial sections.

    PubMed

    Virapongse, C; Gmitro, A; Sarwar, M

    1986-01-01

    A new program (3D83, General Electric) was used to reformat three-dimensional (3D) images from two-dimensional (2D) computed tomographic axial scans in 18 patients who had routine scans of the spine. The 3D spine images were extremely true to life and could be rotated around all three principle axes (constituting a movie), so that an illusion of head-motion parallax was created. The benefit of 3D reformation with this program is primarily for preoperative planning. It appears that 3D can also effectively determine the patency of foraminal stenosis by reformatting in hemisections. Currently this program is subject to several drawbacks that require user interaction and long reconstruction time. With further improvement, 3D reformation will find increasing clinical applicability.

  7. Rare Root Canal Configuration of Bilateral Maxillary Second Molar Using Cone-beam Computed Tomographic Scanning.

    PubMed

    Zeng, Chang; Shen, Ya; Guan, Xiaoyue; Wang, Xin; Fan, Mingwen; Li, Yuhong

    2016-04-01

    The aim of this article was to present a right maxillary second molar with an unusual root canal morphology of 4 roots and 5 canals as confirmed by cone-beam computed tomographic (CBCT) imaging. The tooth had a C-shaped mesiobuccal root (CBCT imaging revealed that the root was closer to the palate than the buccal side) with 2 canals, 2 fused distobuccal roots with 2 separate canals, and 1 normal bulky palatal root with 1 canal. After thoroughly examining the rare anatomy, root canal treatment was applied on the tooth. This article shows the complexity of maxillary second molar variation and shows the significance of CBCT imaging in the confirmation of the 3-dimensional anatomy of teeth and endodontic treatment. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  8. Ultrasound-guided mesenteric lymph node iohexol injection for thoracic duct computed tomographic lymphography in cats.

    PubMed

    Kim, Mieun; Lee, Hyeyeon; Lee, Namsoon; Choi, Mihyeon; Kim, Junyoung; Chang, Dongwoo; Choi, Mincheol; Yoon, Junghee

    2011-01-01

    Computed tomographic (CT) lymphography was performed in cats using percutaneous ultrasound-guided injection of contrast medium into a mesenteric lymph node. The thoracic duct and its branches were clearly delineated in CT images of seven cats studied. The thoracic duct was characterized by anatomic variation and appeared as single or multiple branches. The thoracic duct and the cisterna chyli were identified along the ventral or left ventral aspect of the vertebrae from the level of the cranial lumbar to the caudal cervical vertebrae. The thoracic duct was identified in the central caudal mediastinum, deviated to the left in the cranial mediastinum, and finally moved toward the venous system. Small volumes of extranodal contrast medium leakage were identified in all cats. After injection, the mesenteric lymph nodes were cytologically normal. Ultrasound-guided CT lymphography via percutaneous mesenteric lymph node injection appears safe and effective in cats.

  9. Development of the two Korean adult tomographic computational phantoms for organ dosimetry

    SciTech Connect

    Lee, Choonsik; Lee, Choonik; Park, Sang-Hyun; Lee, Jai-Ki

    2006-02-15

    Following the previously developed Korean tomographic phantom, KORMAN, two additional whole-body tomographic phantoms of Korean adult males were developed from magnetic resonance (MR) and computed tomography (CT) images, respectively. Two healthy male volunteers, whose body dimensions were fairly representative of the average Korean adult male, were recruited and scanned for phantom development. Contiguous whole body MR images were obtained from one subject exclusive of the arms, while whole-body CT images were acquired from the second individual. A total of 29 organs and tissues and 19 skeletal sites were segmented via image manipulation techniques such as gray-level thresholding, region growing, and manual drawing, in which each of segmented image slice was subsequently reviewed by an experienced radiologist for anatomical accuracy. The resulting phantoms, the MR-based KTMAN-1 (Korean Typical MAN-1) and the CT-based KTMAN-2 (Korean Typical MAN-2), consist of 300x150x344 voxels with a voxel resolution of 2x2x5 mm{sup 3} for both phantoms. Masses of segmented organs and tissues were calculated as the product of a nominal reference density, the prevoxel volume, and the cumulative number of voxels defining each organs or tissue. These organs masses were then compared with those of both the Asian and the ICRP reference adult male. Organ masses within both KTMAN-1 and KTMAN-2 showed differences within 40% of Asian and ICRP reference values, with the exception of the skin, gall bladder, and pancreas which displayed larger differences. The resulting three-dimensional binary file was ported to the Monte Carlo code MCNPX2.4 to calculate organ doses following external irradiation for illustrative purposes. Colon, lung, liver, and stomach absorbed doses, as well as the effective dose, for idealized photon irradiation geometries (anterior-posterior and right lateral) were determined, and then compared with data from two other tomographic phantoms (Asian and Caucasian), and

  10. Bone Mineral Density Estimations From Routine Multidetector Computed Tomography: A Comparative Study of Contrast and Calibration Effects

    PubMed Central

    Kaesmacher, Johannes; Liebl, Hans; Baum, Thomas; Kirschke, Jan Stefan

    2017-01-01

    Introduction Phantom-based (synchronous and asynchronous) and phantomless (internal tissue calibration based) assessment of bone mineral density (BMD) in routine MDCT (multidetector computed tomography) examinations potentially allows for diagnosis of osteoporosis. Although recent studies investigated the effects of contrast-medium application on phantom-calibrated BMD measurements, it remains uncertain to what extent internal tissue-calibrated BMD measurements are also susceptible to contrast-medium associated density variation. The present study is the first to systemically evaluate BMD variations related to contrast application comparing different calibration techniques. Purpose To compare predicative performance of different calibration techniques for BMD measurements obtained from triphasic contrast-enhanced MDCT. Materials and Methods Bone mineral density was measured on nonenhanced (NE), arterial (AR) and portal-venous (PV) contrast phase MDCT images of 46 patients using synchronous (SYNC) and asynchronous (ASYNC) phantom calibration as well as internal calibration (IC). Quantitative computed tomography (QCT) served as criterion standard. Density variations were analyzed for each contrast phase and calibration technique, and respective linear fitting was performed. Results Both asynchronous calibration-derived BMD values (NE-ASYNC) and values estimated using IC (NE-IC) on NE MDCT images did reasonably well in predicting QCT BMD (root-mean-square deviation, 8.0% and 7.8%, respectively). Average NE-IC BMD was 2.7% lower when compared with QCT (P = 0.017), whereas no difference could be found for NE-ASYNC (P = 0.957). All average BMD estimates derived from contrast-enhanced scans differed significantly from QCT BMD (all P < 0.005) and led to notable systemic BMD biases (mean difference at least > 6.0 mg/mL). All regression fits revealed a consistent linear dependency (R2 range, 0.861–0.963). Overall accuracy and goodness of fit tended to decrease from AR to

  11. Differentiation of Lymphoma Presenting as Retroperitoneal Mass and Retroperitoneal Fibrosis: Evaluation with Multidetector-row Computed Tomography

    PubMed Central

    Zhang, Shuai; Chen, Min; Li, Chun-Mei; Song, Guo-Dong; Liu, Ying

    2017-01-01

    Background: Retroperitoneal fibrosis (RPF) and lymphoma presenting as retroperitoneal mass may closely resemble each other and misdiagnosis may occur. This study investigated the differential imaging features of RPF and lymphoma which presented as a retroperitoneal soft tissue using multidetector-row computed tomography (MDCT). Methods: The 42 consecutive patients were included in this retrospective review, including 19 RPF patients (45.2%; including 13 males and 6 females; mean age: 56.7 ± 6.2 years) and 23 patients with lymphoma (54.8%; including 14 males and 9 females; mean age: 57.4 ± 12.3 years). An array of qualitative computed tomography (CT) features of lesions in 42 consecutive patients with newly diagnosed untreated RPF and lymphoma were retrospectively analyzed. The quantitative size of the lesion at the para-aortic region and attenuation in the precontrast, arterial, and portal phases were calculated in regions of interest and compared between the patients with newly diagnosed untreated RPF and with lymphoma. Receiver operating characteristic curve analysis was used to assess the potential diagnostic value of each quantitative parameter. Inter-reader concordance was also calculated. Results: Mean ages between patients with RPF and lymphoma were not significantly different (56.7 ± 6.2 years vs. 57.4 ± 12.3 years P = 0.595). Compared to those in patients with lymphoma, homogeneous enhancement (65.2% vs. 94.7%, P = 0.027) and pelvic extension (52.2% vs. 89.5%, P = 0.017) were significantly more common while the involvement of additional nodes (78.3% vs. 5.3%, P < 0.001), suprarenal extension (60.9% vs. 15.8%, P = 0.004), and aortic displacement (43.5% vs. 5.3%, P = 0.006) were significantly less common in patients with RPF. Lesion size at the para-aorta was significantly greater in patients with lymphoma, compared with RPF patients (3.9 ± 1.2 cm vs. 1.8 ± 0.6 cm; P < 0.001). The attenuation values in three phases were not significantly different

  12. Differentiation of Lymphoma Presenting as Retroperitoneal Mass and Retroperitoneal Fibrosis: Evaluation with Multidetector-row Computed Tomography.

    PubMed

    Zhang, Shuai; Chen, Min; Li, Chun-Mei; Song, Guo-Dong; Liu, Ying

    2017-03-20

    Retroperitoneal fibrosis (RPF) and lymphoma presenting as retroperitoneal mass may closely resemble each other and misdiagnosis may occur. This study investigated the differential imaging features of RPF and lymphoma which presented as a retroperitoneal soft tissue using multidetector-row computed tomography (MDCT). The 42 consecutive patients were included in this retrospective review, including 19 RPF patients (45.2%; including 13 males and 6 females; mean age: 56.7 ± 6.2 years) and 23 patients with lymphoma (54.8%; including 14 males and 9 females; mean age: 57.4 ± 12.3 years). An array of qualitative computed tomography (CT) features of lesions in 42 consecutive patients with newly diagnosed untreated RPF and lymphoma were retrospectively analyzed. The quantitative size of the lesion at the para-aortic region and attenuation in the precontrast, arterial, and portal phases were calculated in regions of interest and compared between the patients with newly diagnosed untreated RPF and with lymphoma. Receiver operating characteristic curve analysis was used to assess the potential diagnostic value of each quantitative parameter. Inter-reader concordance was also calculated. Mean ages between patients with RPF and lymphoma were not significantly different (56.7 ± 6.2 years vs. 57.4 ± 12.3 years P = 0.595). Compared to those in patients with lymphoma, homogeneous enhancement (65.2% vs. 94.7%, P = 0.027) and pelvic extension (52.2% vs. 89.5%, P = 0.017) were significantly more common while the involvement of additional nodes (78.3% vs. 5.3%, P < 0.001), suprarenal extension (60.9% vs. 15.8%, P = 0.004), and aortic displacement (43.5% vs. 5.3%, P = 0.006) were significantly less common in patients with RPF. Lesion size at the para-aorta was significantly greater in patients with lymphoma, compared with RPF patients (3.9 ± 1.2 cm vs. 1.8 ± 0.6 cm; P < 0.001). The attenuation values in three phases were not significantly different between patients with RPF and

  13. Three-dimensional image reconstruction of an anorectal malformation with multidetector-row helical computed tomography technology.

    PubMed

    Watanabe, Yoshio; Ando, Hisami; Seo, Takahiko; Kaneko, Kentaro; Katsuno, Shinsuke; Shinohara, Tsuyoshi; Mori, Kensaku; Toriwaki, Junichiro

    2003-05-01

    The presentation of the surgical anatomy of anorectal malformation by standard anatomical figures is not suitable for individual anorectoplasty. It is essential to understand the anatomy of the pelvic muscle (striated muscle complex: SMC) including the external anal sphincter and their three-dimensional (3D) configuration in each patient. Thus, we studied the SMC three-dimensionally with multidetector-row helical computed tomography (MRH-CT) preoperatively, and evaluated its usefulness. Fourteen patients with anorectal malformations before anorectoplasty (types: high n=6, intermediate n=2, low n=6) and two patients without anorectal malformations as controls (total: male n=8, female n=8) were investigated. An image of pelvic region was prepared with a slice thickness of 0.5 mm and a reconstruction pitch of 0.5 mm. A 3D reconstruction on a conventional personal computer (PC) was made with a volume rendering method, and assisted by our own software. The SMC was analyzed with three modified modes of 3D reconstruction corresponding to the surrounding tissues. A length of the parasagittal muscle, and both the sagittal and transverse width of the vertical fibers in the SMC at the connection to the parasagittal muscle were measured on a 3D image and then compared among three different types and controls. To eliminate variations in age, a length index was used to allow comparison. The 3D configuration of the SMC was different in every case. The arranged image mode, which displayed the SMC and the pelvic bones simultaneously, enabled to use conventional knowledge in cysto-urethrography. The length of the parasagittal muscle was longest in the high type but the width of the vertical fibers was smallest. Anatomical figures of the SMC including the external anal sphincter were clearly demonstrated on a PC in every anorectal malformation by our program. A 3D reconstruction image provides positional information on the SMC for the body surface and pelvic bone at the same time

  14. Fractional Flow Reserve and Coronary Computed Tomographic Angiography: A Review and Critical Analysis.

    PubMed

    Hecht, Harvey S; Narula, Jagat; Fearon, William F

    2016-07-08

    Invasive fractional flow reserve (FFR) is now the gold standard for intervention. Noninvasive functional imaging analyses derived from coronary computed tomographic angiography (CTA) offer alternatives for evaluating lesion-specific ischemia. CT-FFR, CT myocardial perfusion imaging, and transluminal attenuation gradient/corrected contrast opacification have been studied using invasive FFR as the gold standard. CT-FFR has demonstrated significant improvement in specificity and positive predictive value compared with CTA alone for predicting FFR of ≤0.80, as well as decreasing the frequency of nonobstructive invasive coronary angiography. High-risk plaque characteristics have also been strongly implicated in abnormal FFR. Myocardial computed tomographic perfusion is an alternative method with promising results; it involves more radiation and contrast. Transluminal attenuation gradient/corrected contrast opacification is more controversial and may be more related to vessel diameter than stenosis. Important considerations remain: (1) improvement of CTA quality to decrease unevaluable studies, (2) is the diagnostic accuracy of CT-FFR sufficient? (3) can CT-FFR guide intervention without invasive FFR confirmation? (4) what are the long-term outcomes of CT-FFR-guided treatment and how do they compare with other functional imaging-guided paradigms? (5) what degree of stenosis on CTA warrants CT-FFR? (6) how should high-risk plaque be incorporated into treatment decisions? (7) how will CT-FFR influence other functional imaging test utilization, and what will be the effect on the practice of cardiology? (8) will a workstation-based CT-FFR be mandatory? Rapid progress to date suggests that CTA-based lesion-specific ischemia will be the gatekeeper to the cardiac catheterization laboratory and will transform the world of intervention. © 2016 American Heart Association, Inc.

  15. Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients With Coronary Computed Tomographic Angiography.

    PubMed

    Nakanishi, Rine; Baskaran, Lohendran; Gransar, Heidi; Budoff, Matthew J; Achenbach, Stephan; Al-Mallah, Mouaz; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; DeLago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Cury, Ricardo; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Kaufmann, Philipp A; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J; Villines, Todd C; Dunning, Allison; Marques, Hugo; Pontone, Gianluca; Andreini, Daniele; Rubinshtein, Ronen; Bax, Jeroen; Jones, Erica; Hindoyan, Niree; Gomez, Millie; Lin, Fay Y; Min, James K; Berman, Daniel S

    2017-08-01

    Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17 181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent ≥64-detector row coronary computed tomographic angiography, we identified 14 803 patients without known coronary artery disease. Of these, 1434 hypertensive patients were matched to 1434 patients without hypertension. Major adverse cardiac events risk of hypertension and non-hypertensive patients was evaluated with Cox proportional hazards models. The prognostic associations between hypertension and no-hypertension with increasing degree of coronary stenosis severity (nonobstructive or obstructive ≥50%) and extent of coronary artery disease (segment involvement score of 1-5, >5) was also assessed. Hypertension patients less commonly had no coronary atherosclerosis and more commonly had nonobstructive and 1-, 2-, and 3-vessel disease than the no-hypertension group. During a mean follow-up of 5.2±1.2 years, 180 patients experienced cardiac events, with 104 (2.0%) occurring in the hypertension group and 76 (1.5%) occurring in the no-hypertension group (hazard ratios, 1.4; 95% confidence intervals, 1.0-1.9). Compared with no-hypertension patients without coronary atherosclerosis, hypertension patients with no coronary atherosclerosis and obstructive coronary disease tended to have higher risk of cardiac events. Similar trends were observed with respect to extent of coronary artery disease. Compared with no-hypertension patients, hypertensive patients have increased presence, extent, and severity of coronary atherosclerosis and tend to have an increase in major adverse cardiac events. © 2017 American Heart Association, Inc.

  16. Predictors of internal mammary vessel diameter: A computed tomographic angiography-assisted anatomic analysis.

    PubMed

    Cook, Julia A; Tholpady, Sunil S; Momeni, Arash; Chu, Michael W

    2016-10-01

    The internal mammary vessels are the most common recipient vessels in free flap breast reconstruction. The literature on internal mammary vascular anatomy is limited by small sample sizes, cadaveric studies, or intraoperative changes. The purpose of this study is to analyze internal mammary anatomy using computed tomographic angiography. A retrospective review of 110 consecutive computed tomographic angiography studies of female patients was performed. Measurements of vessel caliber, distance of internal mammary vessels to sternum, location of internal mammary vein bifurcation, intercostal space height, and chest width were analyzed. Patient demographics and comorbidities were reviewed. The right internal mammary artery and vein were larger than the left in all intercostal spaces (p = 0.02 and p < 0.001, respectively). A significant correlation was found between both skeletal chest width and body mass index with internal mammary vessel caliber at the third intercostal space (p ≤ 0.02). The internal mammary vein bifurcated at the third intercostal space bilaterally, 4.3 and 1.2 mm caudal to the third rib on the right and left sides, respectively. The third intercostal space was <1.5 cm in 25% of patients. Understanding the anatomy, bifurcation, and caliber of internal mammary vessels can aid preoperative planning of autologous, free flap breast reconstruction. On average, the internal mammary vein bifurcates at the third intercostal space; patients with larger chest widths and body mass index had larger caliber internal mammary vessels, and 25% of patients had third intercostal space <1.5 cm and, thus, may not be suitable candidates for rib-sparing techniques. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Automatic detection of myocardial contours in cine-computed tomographic images

    SciTech Connect

    Philip, K.P.; Dove, E.L.; Stanford, W.; Chandran, K.B. . Dept. of Biomedical Engineering); McPherson, D.D.; Gotteiner, N.L.; Vonesh, M.J. . Dept. of Internal Medicine); Reed, J.E.; Rumberger, J.A. . Dept. of Cardiovascular Diseases)

    1994-06-01

    Quantitative evaluation of cardiac function from cardiac images requires the identification of the myocardial walls. This generally requires the clinician to view the image and interactively trace the contours. This method is susceptible to great variability that depends on the experience and knowledge of the particular operator tracing the contours. The particular imaging modality that is used may also add tracing difficulties. Cine-computed tomography (cine-CT) is an imaging modality capable of providing high quality cross-sectional images of the heart. CT images, however, are cluttered. To decrease this variability, investigators have developed computer-assisted or near-automatic techniques for tracing these contours. All of these techniques, however, require some operator intervention to confidently identify myocardial borders. The authors present a new algorithm that automatically finds the heart within the chest, and then proceeds to outline the myocardial contours. Information at each tomographic slice is used to estimate the contours at the next tomographic slice, thus allowing the algorithm to work in near-apical cross-sectional images where the myocardial borders are often difficult to identify. The algorithm does not require operator input and can be used in a batch mode to process large quantities of data. An evaluation and correction phase is included to allow an operator to view the results and selectively correct portions of contours. They tested the algorithm by automatically identifying the myocardial borders of 27 cardiac images obtained from three human subjects and quantitatively comparing these automatically determined borders with those traced by an experienced cardiologist.

  18. Validation of cone-beam computed tomography and magnetic resonance imaging of the porcine spine: a comparative study with multidetector computed tomography and anatomical specimens.

    PubMed

    de Freitas, Ricardo Miguel Costa; Andrade, Celi Santos; Caldas, José Guilherme Mendes Pereira; Kanas, Alexandre Fligelman; Cabral, Richard Halti; Tsunemi, Miriam Harumi; Rodríguez, Hernán Joel Cervantes; Rabbani, Said Rahnamaye

    2015-05-01

    New spinal interventions or implants have been tested on ex vivo or in vivo porcine spines, as they are readily available and have been accepted as a comparable model to human cadaver spines. Imaging-guided interventional procedures of the spine are mostly based on fluoroscopy or, still, on multidetector computed tomography (MDCT). Cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) are also available methods to guide interventional procedures. Although some MDCT data from porcine spines are available in the literature, validation of the measurements on CBCT and MRI is lacking. To describe and compare the anatomical measurements accomplished with MDCT, CBCT, and MRI of lumbar porcine spines to determine if CBCT and MRI are also useful methods for experimental studies. An experimental descriptive-comparative study. Sixteen anatomical measurements of an individual vertebra from six lumbar porcine spines (n=36 vertebrae) were compared with their MDCT, CBCT, and MRI equivalents. Comparisons were made for the absolute values of the parameters. Similarities were found in all imaging methods. Significant correlation (p<.05) was observed with all variables except those that included cartilaginous tissue from the end plates when the anatomical study was compared with the imaging methods. The CBCT and MRI provided imaging measurements of the lumbar porcine spines that were similar to the anatomical and MDCT data, and they can be useful for specific experimental research studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Comparison of Multidetector Computed Tomography and Flat-Panel Computed Tomography Regarding Visualization of Cortical Fractures, Cortical Defects, and Orthopedic Screws

    PubMed Central

    Neubauer, Jakob; Benndorf, Matthias; Lang, Hannah; Lampert, Florian; Kemna, Lars; Konstantinidis, Lukas; Neubauer, Claudia; Reising, Kilian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Goerke, Sebastian M.

    2015-01-01

    Abstract To compare the visualization of cortical fractures, cortical defects, and orthopedic screws in a dedicated extremity flat-panel computed tomography (FPCT) scanner and a multidetector computed tomography (MDCT) scanner. We used feet of European roe deer as phantoms for cortical fractures, cortical defects, and implanted orthopedic screws. FPCT and MDCT scans were performed with equivalent dose settings. Six observers rated the scans according to number of fragments, size of defects, size of defects opposite orthopedic screws, and the length of different screws. The image quality regarding depiction of the cortical bone was assessed. The gold standard (real number of fragments) was evaluated by autopsy. The correlation of reader assessment of fragments, cortical defects, and screws with the gold standard was similar for FPCT and MDCT. Three readers rated the subjective image quality of the MDCT to be higher, whereas the others showed no preferences. Although the image quality was rated higher in the MDCT than in the FPCT by 3 out of 6 observers, both modalities proved to be comparable regarding the visualization of cortical fractures, cortical defects, and orthopedic screws and of use to musculoskeletal radiology regarding fracture detection and postsurgical evaluation in our experimental setting. PMID:26252281

  20. Noncontrast computed tomographic Hounsfield unit evaluation of cerebral venous thrombosis: a quantitative evaluation.

    PubMed

    Besachio, David A; Quigley, Edward P; Shah, Lubdha M; Salzman, Karen L

    2013-08-01

    Our objective is to determine the utility of noncontrast Hounsfield unit values, Hounsfield unit values corrected for the patient's hematocrit, and venoarterial Hounsfield unit difference measurements in the identification of intracranial venous thrombosis on noncontrast head computed tomography. We retrospectively reviewed noncontrast head computed tomography exams performed in both normal patients and those with cerebral venous thrombosis, acquiring Hounsfield unit values in normal and thrombosed cerebral venous structures. Also, we acquired Hounsfield unit values in the internal carotid artery for comparison to thrombosed and nonthrombosed venous structures and compared the venous Hounsfield unit values to the patient's hematocrit. A significant difference is identified between Hounsfield unit values in thrombosed and nonthrombosed venous structures. Applying Hounsfield unit threshold values of greater than 65, a Hounsfield unit to hematocrit ratio of greater than 1.7, and venoarterial difference values greater than 15 alone and in combination, the majority of cases of venous thrombosis are identifiable on noncontrast head computed tomography. Absolute Hounsfield unit values, Hounsfield unit to hematocrit ratios, and venoarterial Hounsfield unit value differences are a useful adjunct in noncontrast head computed tomographic evaluation of cerebral venous thrombosis.

  1. Noninvasive imaging of coronary arteries: current and future role of multi-detector row CT.

    PubMed

    Schoenhagen, Paul; Halliburton, Sandra S; Stillman, Arthur E; Kuzmiak, Stacie A; Nissen, Steven E; Tuzcu, E Murat; White, Richard D

    2004-07-01

    While invasive imaging techniques, especially selective conventional coronary angiography, will remain vital to planning and guiding catheter-based and surgical treatment of significantly stenotic coronary lesions, the comprehensive and serial assessment of asymptomatic or minimally symptomatic stages of coronary artery disease (CAD) for preventive purposes will eventually need to rely on noninvasive imaging techniques. Cardiovascular imaging with tomographic modalities, including computed tomography (CT) and magnetic resonance imaging, has great potential for providing valuable information. This review article will describe the current and future role of cardiac CT, and in particular that of multi-detector row CT, for imaging of atherosclerotic and other pathologic changes of the coronary arteries. It will describe how tomographic coronary imaging may eventually supplement traditional angiographic techniques in understanding the patterns of atherosclerotic CAD development.

  2. Analysis of the venous channel within the clivus using multidetector computed tomography digital subtraction venography.

    PubMed

    Mizutani, Katsuhiro; Toda, Masahiro; Kurasawa, Jun; Akiyama, Takenori; Fujiwara, Hirokazu; Jinzaki, Masahiro; Yoshida, Kazunari

    2017-03-01

    Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus. Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively. Eighteen emissary veins were identified in 14 (28.0%) cases. A half of the emissary veins connected the inferior petrosal sinus with the inferior petro-occipital vein (IPOV) in the middle clivus. The clival diploic vein (CDV) was identified in 14.0% of cases, 42.9% of which had the clivus of the presellar type. The CDV was connected to the posterior intercavernous sinus or the rostral end of the basilar plexus superiorly, and was connected to the IPOV, anterior condylar vein, marginal sinus, or the anterior condylar confluence. The CDV provides collateral channels between the cavernous sinus and the internal jugular vein and the inferior petrosal sinus and the IPOV. Understanding of the emissary veins in the clivus and the CDV is valuable for skull base surgery, especially for endonasal endoscopic skull base procedures.

  3. Criteria for establishing shielding of multi-detector computed tomography (MDCT) rooms.

    PubMed

    Verdun, F R; Aroua, A; Baechler, S; Schmidt, S; Trueb, P R; Bochud, F O

    2010-01-01

    The aim of this work is to compare two methods used for determining the proper shielding of computed tomography (CT) rooms while considering recent technological advances in CT scanners. The approaches of the German Institute for Standardisation and the US National Council on Radiation Protection and Measurements were compared and a series of radiation measurements were performed in several CT rooms at the Lausanne University Hospital. The following three-step procedure is proposed for assuring sufficient shielding of rooms hosting new CT units with spiral mode acquisition and various X-ray beam collimation widths: (1) calculate the ambient equivalent dose for a representative average weekly dose length product at the position where shielding is required; (2) from the maximum permissible weekly dose at the location of interest, calculate the transmission factor F that must be taken to ensure proper shielding and (3) convert the transmission factor into a thickness of lead shielding. A similar approach could be adopted to use when designing shielding for fluoroscopy rooms, where the basic quantity would be the dose area product instead of the load of current (milliampere-minute).

  4. Evaluation of diagnostic utility of multidetector computed tomography and magnetic resonance imaging in blunt pancreatic trauma: a prospective study.

    PubMed

    Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Bhalla, Ashu Seith; Sharma, Raju; Kumar, Subodh; Mishra, Biplab

    2015-04-01

    Blunt pancreatic trauma is an uncommon injury with high morbidity and mortality. Retrospective analyses of computed tomography (CT) performance report CT to have variable sensitivity in diagnosing pancreatic injury. Both a prospective analysis of multidetector CT (MDCT) performance and diagnostic utility of magnetic resonance imaging (MRI) in acute blunt pancreatic injury remain unexplored. To prospectively evaluate the utility of MDCT with MRI correlation in patients with blunt pancreatic trauma using intraoperative findings as the gold standard for analysis. The contrast-enhanced CT (CECT) scans of patients admitted with blunt abdominal trauma were prospectively evaluated for CT signs of pancreatic injury. Patients detected to have pancreatic injury on CT were assigned a CT grade of injury according to American Association for Surgery of Trauma classification. MRI was performed in patients not undergoing immediate laparotomy and MRI grade independent of CT grade was assigned. Surgical grade was taken as gold standard and accuracy of CT and MRI for grading pancreatic injury and pancreatic ductal injury (PDI) was calculated. A quantitative and qualitative comparison of MRI was also done with CT to determine the performance of MRI in acute pancreatic injury. Thirty out of 1198 patients with blunt trauma abdomen were detected to have pancreatic injury on CT, which was surgically confirmed in 24 patients. Seventeen underwent MRI and surgical correlation was available in 14 patients. CT and MRI correctly identified the grade of pancreatic injury in 91.7% (22/24) and 92.86% (13/14) patients, respectively. Both CT and MRI correctly identified PDI in 18/19 and 11/12 patients, respectively, with good inter-modality agreement of 88.9% (kappa value of 0.78). MRI also qualitatively added to the information provided by CT and increased diagnostic confidence in 58.8% of patients. MDCT performs well in grading pancreatic injury and evaluating pancreatic ductal injury. MRI is

  5. Contribution of diffusion weighted MRI to diagnosis and staging in gastric tumors and comparison with multi-detector computed tomography

    PubMed Central

    Fatih Özbay, Mehmet; Çallı, İskan; Doğan, Erkan; Çelik, Sebahattin; Batur, Abdussamet; Bora, Aydın; Yavuz, Alpaslan; Bulut, Mehmet Deniz; Özgökçe, Mesut; Çetin Kotan, Mehmet

    2017-01-01

    Abstract Background Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy

  6. A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi-detector computed tomography study in adults.

    PubMed

    Chen, Yanxi; Qiang, Minfei; Zhang, Kun; Li, Haobo; Dai, Hao

    2015-01-01

    Syndesmotic injury may be difficult to diagnose, and radiological evaluation is very important. The purpose of this study was to offer a series of reliable and repeatable normal tibiofibular syndesmosis parameters in diagnosing injuries of the syndesmosis. Multi-detector computed tomography (MDCT) and radiographs of the distal tibiofibular syndesmosis in 484 cases were retrospectively reviewed. Relevant parameters included the tibiofibular clear space (TCS), the tibiofibular overlap (TFO), the depth of the incisura fibularis (IFD), and the height of the incisura fibularis (IFH), which were measured by novel three-dimensional (3-D) and two-dimensional (2-D) techniques. The distance between the measuring plane of the distal tibiofibular syndesmosis and the tibial plafond was measured. Intra- and inter-rater reliability was assessed by intraclass correlation coefficient (ICC) and the root mean square standard deviation (RMS-SD), to determine measurement precision. Sex differences of parameters were analyzed using analysis of covariance (ANCOVA) with body height as the covariate. Paired sample t-testing was used to compare parameters in different image modalities, including radiography, and 2-D and 3-D CT. The reliability of the 3-D images measurement (ICC range, 0.907 to 0.972) was greater than that for the 2-D axial images (ICC range, 0.895 to 0.927), and the AP view radiographs (ICC range, 0.742 to 0.838). The intra-rater RMS-SD of the 3-D CT, 2-D CT and radiographic measurements were less than 0.94 mm, 0.26 mm, and 2.87 mm, respectively. The measuring plane of the distal tibiofibular syndesmosis showed the sex difference, which was 12.1 mm proximal to the tibial plafond in the male group and 7.8 mm in the female group. In this plane, the parameters for tibiofibular syndesmosis were measured in different image modalities. All variables were significantly different between females and males (p < 0.05). 3-D measurement technique could be helpful to identify

  7. Earthquake-related versus non-earthquake-related injuries in spinal injury patients: differentiation with multidetector computed tomography

    PubMed Central

    2010-01-01

    Introduction In recent years, several massive earthquakes have occurred across the globe. Multidetector computed tomography (MDCT) is reliable in detecting spinal injuries. The purpose of this study was to compare the features of spinal injuries resulting from the Sichuan earthquake with those of non-earthquake-related spinal trauma using MDCT. Methods Features of spinal injuries of 223 Sichuan earthquake-exposed patients and 223 non-earthquake-related spinal injury patients were retrospectively compared using MDCT. The date of non-earthquake-related spinal injury patients was collected from 1 May 2009 to 22 July 2009 to avoid the confounding effects of seasonal activity and clothing. We focused on anatomic sites, injury types and neurologic deficits related to spinal injuries. Major injuries were classified according to the grid 3-3-3 scheme of the Magerl (AO) classification system. Results A total of 185 patients (82.96%) in the earthquake-exposed cohort experienced crush injuries. In the earthquake and control groups, 65 and 92 patients, respectively, had neurologic deficits. The anatomic distribution of these two cohorts was significantly different (P < 0.001). Cervical spinal injuries were more common in the control group (risk ratio (RR) = 2.12, P < 0.001), whereas lumbar spinal injuries were more common in the earthquake-related spinal injuries group (277 of 501 injured vertebrae; 55.29%). The major types of injuries were significantly different between these cohorts (P = 0.002). Magerl AO type A lesions composed most of the lesions seen in both of these cohorts. Type B lesions were more frequently seen in earthquake-related spinal injuries (RR = 1.27), while we observed type C lesions more frequently in subjects with non-earthquake-related spinal injuries (RR = 1.98, P = 0.0029). Conclusions Spinal injuries sustained in the Sichuan earthquake were located mainly in the lumbar spine, with a peak prevalence of type A lesions and a high occurrence of

  8. Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures.

    PubMed

    Nosewicz, Tomasz L; Beerekamp, M Suzan H; De Muinck Keizer, Robert-Jan O; Schepers, Tim; Maas, Mario; Niek van Dijk, C; Goslings, J Carel

    2016-08-01

    Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. 100 ankle fractures requiring operative treatment were prospectively included (46 men, 54 women; mean age 44 ± 14 years, range 20-77). All ankle fractures (conventional radiography; 71 Weber B, 22 Weber C, 1 Weber A, 4 isolated medial malleolus and 2 isolated posterior malleolus fractures) were treated by open reduction and internal fixation. Multidetector computed tomography (CT) was performed postoperatively. For each OCL, the location, size, and Loomer OCL classification (CT modified Berndt and Harty classification) were determined. The subjective Foot and Ankle Outcome Scoring (FAOS) was used for clinical outcome at 1 year. OCLs were found in 10/100 ankle fractures (10.0%). All OCLs were solitary talar lesions. Four OCLs were located posteromedial, 4 posterolateral, 1 anterolateral, and 1 anteromedial. There were 2 type I OCLs (subchondral compression), 6 type II OCLs (partial, nondisplaced fracture) and 2 type IV OCLs (displaced fracture). Mean OCL size (largest diameter) was 4.4 ± 1.7 mm (range, 1.7 mm to 6.2 mm). Chi-square analysis showed no significant association between ankle fracture type and occurrence of OCLs. OCLs did occur only in Lauge-Hansen stage III/IV ankle fractures. There were no significant differences in FAOS outcome between patients with or without OCLs. Ten percent of investigated ankle fractures had associated OCLs on CT. Although no significant association between fracture type and OCL was found, OCLs only occurred in Lauge-Hansen stage III/IV ankle fractures. With the numbers available, OCLs did not significantly affect clinical outcome at 1 year according to FAOS. Level IV, observational study. © The Author(s) 2016.

  9. Use of 320-detector computed tomographic angiography for infants and young children with congenital heart disease.

    PubMed

    Al-Mousily, Faris; Shifrin, Roger Y; Fricker, Frederick J; Feranec, Nicholas; Quinn, Nancy S; Chandran, Arun

    2011-04-01

    Pediatric patients with complex congenital heart disease (CHD) face a lifetime of treatment with interventional therapeutic and palliative procedures. Echocardiography remains the mainstay for noninvasive imaging of congenital heart lesions. This often is supplemented with diagnostic cardiac catheterization for additional anatomic and physiologic characterization. However, recent technological improvements in computed tomography (CT) and magnetic resonance imaging (MRI) have led to an increased focus on the use of these techniques given their better safety profile. This study aimed to review the authors' experience with a 320-slice multidetector CT scanner in the evaluation of CHD in children. This retrospective case study investigated 22 infants and young children with a provisional diagnosis of CHD. Their anatomic evaluation was performed using a 320-slice Aquilon ONE CT scanner. Of these 22 patients, 14 were examined without cardiac gating. This was subsequently modified to a prospective gated, targeted protocol to decrease the radiation dose. The images were interpreted by an experienced radiologist and a pediatric cardiologist. Continuous variables were expressed as mean and standard deviation or range, and the two imaging protocols were compared. A comparison of exposure rates with those from other pediatric studies that had used the 64-slice CT angiography also was performed. For the first group of patients, with nongated CT examinations, the mean effective whole-body radiation dose was 1.8 ± 0.71 millisieverts (mSv) (range, 0.96-3.2 mSv). For the second group, the mean was 0.8 ± 0.39 mSv (range, 0.4-1.5 mSv). Although the radiation dose was reduced dramatically, clinicians must be vigilant about the cumulative risk of radiation exposure.

  10. Calcium score of small coronary calcifications on multidetector computed tomography: results from a static phantom study.

    PubMed

    Groen, J M; Kofoed, K F; Zacho, M; Vliegenthart, R; Willems, T P; Greuter, M J W

    2013-02-01

    Multi detector computed tomography (MDCT) underestimates the coronary calcium score as compared to electron beam tomography (EBT). Therefore clinical risk stratification based on MDCT calcium scoring may be inaccurate. The aim of this study was to assess the feasibility of a new phantom which enables establishment of a calcium scoring protocol for MDCT that yields a calcium score comparable to the EBT values and to the physical mass. A phantom containing 100 small calcifications ranging from 0.5 to 2.0mm was scanned on EBT using a standard coronary calcium protocol. In addition, the phantom was scanned on a 320-row MDCT scanner using different scanning, reconstruction and scoring parameters (tube voltage 80-135 kV, slice thickness 0.5-3.0mm, reconstruction kernel FC11-FC15 and threshold 110-150 HU). The Agatston and mass score of both modalities was compared and the influence of the parameters was assessed. On EBT the Agatston and mass scores were between 0 and 20, and 0 and 3mg, respectively. On MDCT the Agatston and mass scores were between 0 and 20, and 0 and 4 mg, respectively. All parameters showed an influence on the calcium score. The Agatston score on MDCT differed 52% between the 80 and 135kV, 65% between 0.5 and 3.0mm and 48% between FC11 and FC15. More calcifications were detected with a lower tube voltage, a smaller slice thickness, a sharper kernel and a lower threshold. Based on these observations an acquisition protocol with a tube voltage of 100 kV and two reconstructions protocols were defined with a FC12 reconstruction kernel; one with a slice thickness of 3.0mm and a one with a slice thickness of 0.5mm. This protocol yielded an Agatston score as close to the EBT as possible, but also a mass score as close to the physical phantom value as possible, respectively. With the new phantom one acquisition protocol and two reconstruction protocols can be defined which produces Agatston scores comparable to EBT values and to the physical mass. Copyright

  11. Anterior cervical fusion assessment using reconstructed computed tomographic scans: surgical confirmation of 254 segments.

    PubMed

    Song, Kwang-Sup; Chaiwat, Piyaskulkaew; Kim, Han Jo; Mesfin, Addisu; Park, Sang-Min; Riew, K Daniel

    2013-12-01

    Retrospective study developing diagnostic criteria. To validate 2 computed tomography-based findings, extragraft bone bridging (ExGBB) and intragraft bone bridging (InGBB), as diagnostic criteria for anterior cervical fusion using subsequent surgical confirmation and to demonstrate the different diagnostic accuracy on the basis of the graft material used. The accuracy and the methodology for evaluating bone bridging on computed tomographic scans to determine anterior cervical fusion status have not been validated or standardized. One hundred ten patients with 254 surgically explored segments along with reconstructed computed tomographic scans were included. Bone bridging at each cervical level was assessed for ExGBB and InGBB. ExGBB was defined as complete cortical bridging at any peripheral margins (anterior, posterior, left, or right) of the operated disc space, outside of the graft. InGBB was defined as cortical or trabecular bridging within the confines of the graft only. ExGBB and InGBB were serially evaluated on reformatted coronal and sagittal views by 3 independent raters. The reliabilities and validities correlated with surgical exploration were evaluated. Surgical exploration revealed 123 fused and 131 pseudarthrosis segments. The reliability of 3 raters showed near perfect agreement for ExGBB and substantial agreement for InGBB. ExGBB also had higher validity for all raters than did InGBB. The autocortical graft group had the highest accuracy for both InGBB and ExGBB, with both values being nearly identical. The allograft group had the next highest validity values. For the cage group, InGBB had the lowest specificity (53.2%) and positive predictive value (35.5%), whereas ExGBB had 100% sensitivity and negative predictive value. ExGBB seems to be a far more reliable and accurate to determine anterior cervical fusion. The diagnostic criteria using bone bridging should be different based on the intradiscal materials. With cages in particular, InGBB seems

  12. Evaluation of Cervical Spine Clearance by Computed Tomographic Scan Alone in Intoxicated Patients With Blunt Trauma.

    PubMed

    Bush, Lisa; Brookshire, Robert; Roche, Breanna; Johnson, Amelia; Cole, Frederic; Karmy-Jones, Riyad; Long, William; Martin, Matthew J

    2016-09-01

    cervical collar for intoxication had no missed CSIs but were kept immobilized for a mean (SD) of 12 (19) hours. Computed tomographic scans had an overall negative predictive value of 99.2% for patients with CSIs and a negative predictive value of 99.8% for ruling out CSIs that required immobilization or stabilization. In this study, alcohol or drug intoxication was common and resulted in significant delays to cervical spine clearance. Computed tomographic scans were highly reliable for identifying all clinically significant CSIs. Spine clearance based on a normal CT scan among intoxicated patients with no gross motor deficits appears to be safe and avoids prolonged and unnecessary immobilization.

  13. Seeing is believing: video classification for computed tomographic colonography using multiple-instance learning.

    PubMed

    Wang, Shijun; McKenna, Matthew T; Nguyen, Tan B; Burns, Joseph E; Petrick, Nicholas; Sahiner, Berkman; Summers, Ronald M

    2012-05-01

    In this paper, we present development and testing results for a novel colonic polyp classification method for use as part of a computed tomographic colonography (CTC) computer-aided detection (CAD) system. Inspired by the interpretative methodology of radiologists using 3-D fly-through mode in CTC reading, we have developed an algorithm which utilizes sequences of images (referred to here as videos) for classification of CAD marks. For each CAD mark, we created a video composed of a series of intraluminal, volume-rendered images visualizing the detection from multiple viewpoints. We then framed the video classification question as a multiple-instance learning (MIL) problem. Since a positive (negative) bag may contain negative (positive) instances, which in our case depends on the viewing angles and camera distance to the target, we developed a novel MIL paradigm to accommodate this class of problems. We solved the new MIL problem by maximizing a L2-norm soft margin using semidefinite programming, which can optimize relevant parameters automatically. We tested our method by analyzing a CTC data set obtained from 50 patients from three medical centers. Our proposed method showed significantly better performance compared with several traditional MIL methods.

  14. Determination of planning target volume for whole stomach irradiation using daily megavoltage computed tomographic images.

    PubMed

    Johnson, Matthew E; Pereira, Gisele C; El Naqa, Issam M; Goddu, S Murty; Al-Lozi, Rawan; Apte, Aditya; Mansur, David B

    2012-01-01

    Whole stomach radiation therapy is often used in the management of gastric lymphoma. However, very limited data exist with regard to planning target volume requirements for the whole stomach. This study retrospectively analyzed daily megavoltage computed tomographic (CT) scans of gastric lymphoma patients in order to help determine the interfraction variation of the stomach position. Forty-one daily megavoltage CT images from 3 gastric lymphoma patients were used for stomach contouring. Each patient's megavoltage CT images were rigidly registered to their CT simulation data sets, and the margin in each direction that covered at least 95% of the daily stomach volumes was computed using a simple grid search. Patient setup variation was also calculated from the daily patient shifts. The organ motion margin was then added to the setup margin to render the total margin. A uniform margin of 2.2 cm is required to cover 95% of the stomach over the treatment course. However, direction-specific margins were observed from 1.72, 1.88, 0.92, 2.23, 1.90, and 0.86 cm for the right, left, posterior, anterior, superior, and inferior directions, respectively. The results of this study provide helpful 3-dimensional volumetric information to the limited existing data on margin requirements for whole stomach radiation therapy. Copyright © 2012 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  15. Two methods of Haustral fold detection from computed tomographic virtual colonoscopy images

    NASA Astrophysics Data System (ADS)

    Chowdhury, Ananda S.; Tan, Sovira; Yao, Jianhua; Linguraru, Marius G.; Summers, Ronald M.

    2009-02-01

    Virtual colonoscopy (VC) has gained popularity as a new colon diagnostic method over the last decade. VC is a new, less invasive alternative to the usually practiced optical colonoscopy for colorectal polyp and cancer screening, the second major cause of cancer related deaths in industrial nations. Haustral (colonic) folds serve as important landmarks for virtual endoscopic navigation in the existing computer-aided-diagnosis (CAD) system. In this paper, we propose and compare two different methods of haustral fold detection from volumetric computed tomographic virtual colonoscopy images. The colon lumen is segmented from the input using modified region growing and fuzzy connectedness. The first method for fold detection uses a level set that evolves on a mesh representation of the colon surface. The colon surface is obtained from the segmented colon lumen using the Marching Cubes algorithm. The second method for fold detection, based on a combination of heat diffusion and fuzzy c-means algorithm, is employed on the segmented colon volume. Folds obtained on the colon volume using this method are then transferred to the corresponding colon surface. After experimentation with different datasets, results are found to be promising. The results also demonstrate that the first method has a tendency of slight under-segmentation while the second method tends to slightly over-segment the folds.

  16. Seeing is Believing: Video Classification for Computed Tomographic Colonography Using Multiple-Instance Learning

    PubMed Central

    Wang, Shijun; McKenna, Matthew T.; Nguyen, Tan B.; Burns, Joseph E.; Petrick, Nicholas; Sahiner, Berkman

    2012-01-01

    In this paper we present development and testing results for a novel colonic polyp classification method for use as part of a computed tomographic colonography (CTC) computer-aided detection (CAD) system. Inspired by the interpretative methodology of radiologists using 3D fly-through mode in CTC reading, we have developed an algorithm which utilizes sequences of images (referred to here as videos) for classification of CAD marks. For each CAD mark, we created a video composed of a series of intraluminal, volume-rendered images visualizing the detection from multiple viewpoints. We then framed the video classification question as a multiple-instance learning (MIL) problem. Since a positive (negative) bag may contain negative (positive) instances, which in our case depends on the viewing angles and camera distance to the target, we developed a novel MIL paradigm to accommodate this class of problems. We solved the new MIL problem by maximizing a L2-norm soft margin using semidefinite programming, which can optimize relevant parameters automatically. We tested our method by analyzing a CTC data set obtained from 50 patients from three medical centers. Our proposed method showed significantly better performance compared with several traditional MIL methods. PMID:22552333

  17. Assessment of the Radiation Effects of Cardiac Computed Tomographic Angiography Using Protein and Genetic Biomarkers

    PubMed Central

    Nguyen, Patricia K.; Lee, Won Hee; Li, Yong Fuga; Hong, Wan Xing; Hu, Shijun; Chan, Charles; Liang, Grace; Nguyen, Ivy; Ong, Sang-Ging; Churko, Jared; Wang, Jia; Altman, Russ B.; Fleischmann, Dominik; Wu, Joseph C.

    2016-01-01

    Objectives To evaluate whether radiation exposure from cardiac computed tomographic angiography is associated with DNA damage and whether damage leads to programmed cell death and activation of genes involved in apoptosis and DNA repair. Background Exposure to radiation from medical imaging has become a public health concern, but whether it causes significant cell damage remains unclear. Methods We conducted a prospective cohort study in 67 patients undergoing cardiac computed tomographic angiography (CTA) between January 2012 and December 2013 in two US medical centers. Median blood radiation exposure was estimated using phantom dosimetry. Biomarkers of DNA damage and apoptosis were measured by flow cytometry, whole genome sequencing, and single cell polymerase chain reaction. Results The median DLP was 1535.3 mGy·cm (969.7 – 2674.0 mGy·cm). The median radiation dose to the blood was 29.8 milliSieverts (18.8 – 48.8 mSv). Median DNA damage increased 3.39% (1.29 – 8.04%, P<0.0001) post-radiation. Median apoptosis increased 3.1-fold (1.4 – 5.1-fold, P<0.0001) post-radiation. Whole genome sequencing revealed changes in the expression of 39 transcription factors involved in the regulation of apoptosis, cell cycle, and DNA repair. Genes involved in mediating apoptosis and DNA repair were significantly changed post-radiation, including DDB2 [1.9-fold (1.5 – 3.0-fold), P<0.001], XRCC4 [3.0-fold (1.1 – 5.4-fold), P=0.005], and BAX [1.6-fold (0.9 – 2.6-fold), P<0.001]. Exposure to radiation was associated with DNA damage [OR: 1.8 (1.2 – 2.6), P=0.003]. DNA damage was associated with apoptosis [OR: 1.9 (1.2 – 5.1), P<0.0001] and gene activation [OR: 2.8 (1.2 – 6.2), P=0.002]. Conclusions Patients exposed to radiation from cardiac CTA had evidence of DNA damage, which was associated with programmed cell death and activation of genes involved in apoptosis and DNA repair. PMID:26210695

  18. Selective computed tomographic angiography in traumatic subarachnoid hemorrhage: a pilot study.

    PubMed

    Balinger, Kathryn J; Elmously, Adham; Hoey, Brian A; Stehly, Christy D; Stawicki, Stanislaw Peter; Portner, Marc E

    2015-11-01

    Computed tomographic angiography (CTA) tends to be overused in patients with traumatic subarachnoid hemorrhage (tSAH) to rule out intracranial aneurysmal disease. We hypothesized that there are two exclusive subsets of patients with tSAH that maybe at increased risk for aneurysm and thus should undergo CTA, those "found down" with an unknown mechanism of injury and those with "central subarachnoid hemorrhage" (CSH, in the subarachnoid cisterns and Sylvian fissures). This pilot study was performed to provide more information on the validity of our hypothesis. A retrospective analysis was performed on trauma patients with tSAH who underwent CTA of the brain. Patients presented to a level I trauma center from January 2008-December 2012. Our principal outcome was the diagnosis of an intracranial aneurysm. Student t-test, chi-squared test, Mann-Whitney U test, and binary logistic regression were used for statistical analysis, with significance set at alpha = 0.05. Of 617 total patients with tSAH, 186 patients underwent CTA. Majority of patients were male (64%), with median age of 56 y. Median Glasgow coma scale on presentation was 15, and the median injury severity score was 16. Thirteen patients (6.99%) had an aneurysm on the follow-up CTA. Of those, 8 of 13 (61.5%) were felt to have presented with a ruptured aneurysm. Among those, 5 of 8 (62.5%) sustained a fall and 3 of 8 (37.5%) resulted from a motor vehicle crash. Among the 14 patients (7.5%) "found down", none had an aneurysm. All eight patients with a ruptured aneurysm (100%) had CSH, whereas none of the five patients with unruptured aneurysm had CSH. On multivariate analysis, suprasellar cistern hemorrhage was the most predictive noncontrast computed tomographic finding with regard to aneurysm presence (odds ratio, 4.78; 95% confidence interval, 1.33-17.1). Patients with an aneurysmal disease had a significantly higher mean arterial pressure on presentation (median, 115 mm Hg) than those without an aneurysm

  19. Preliminary application of high-definition computed tomographic Gemstone Spectral Imaging in lung cancer.

    PubMed

    Wang, Guangli; Zhang, Chengqi; Li, Mingying; Deng, Kai; Li, Wei

    2014-01-01

    To evaluate the feasibility of multiparameter quantitative measurement lung cancer by Gemstone Spectral Imaging (GSI) high-definition computed tomography. Seventy-seven patients who were found to have a lung mass or a nodule by CT plain scan for the first time received chest contrast CT scan with GSI mode on high-definition computed tomography. The GSI viewer was used to display the spectral curve, iodine-based images, water-based images, and 101 sets of monochromatic images of a selected region of interest from the relative homogeneous area of the mass or nodule. Iodine concentration, water concentration, spectral curve slope, and CT values at 40 keV of the region of interest were measured. Finally, 68 eligible patients were divided into a pneumonia group (n = 24) and a malignant tumor group (n = 44, including squamous carcinoma, n = 29, and adenocarcinoma, n = 15). Significant differences existed in iodine concentration (t = 6.459), spectral curve slope (t = 6.276), and CT values at 40 keV (t = 6.698) between the pneumonia group and the malignant tumor group (P < 0.05), as well as between squamous carcinoma and adenocarcinoma (t = 6.494, 5.634, 6.091, respectively, P < 0.05), whereas water concentrations were found to have no difference between the 2 groups (t = 0.082, P > 0.05) and between the 2 types of malignant tumors (t = 1.234, P > 0.05). High-definition computed tomographic GSI technique might be helpful to differentiate lung cancer from lung benign lesions by providing qualitative and quantitative information.

  20. Cardiac computed tomographic angiography for detection of cardiac sources of embolism in stroke patients.

    PubMed

    Hur, Jin; Kim, Young Jin; Lee, Hye-Jeong; Ha, Jong-Won; Heo, Ji Hoe; Choi, Eui-Young; Shim, Chi-Young; Kim, Tae Hoon; Nam, Ji Eun; Choe, Kyu Ok; Choi, Byoung Wook

    2009-06-01

    We assessed the diagnostic performance of 2-phase 64-slice cardiac computed tomographic angiography (CCTA) for the detection of a cardiac source of embolism in stroke patients using transesophageal echocardiography (TEE) as the reference standard. We selected 137 patients who had experienced a recent episode of stroke and had undergone both 2-phase 64-slice CCTA and TEE within a period of 5 days. A potential cardiac source of embolism detected at both CCTA and TEE was recorded, and echocardiographic findings were categorized into high- and medium-risk sources based on the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification. Of 137 patients, 100 abnormal findings in 91 patients were found on TEE, and 46 patients had no abnormal finding on TEE. The overall sensitivity, specificity, positive predictive value, and negative predictive value of the 64-slice CCTA for detecting cardiac sources of embolism were 89% (95% CI, 82%, 95%), 100% (95% CI, 90%, 100%), 100% (95% CI, 95%, 100%), and 81% (95% CI, 70%, 92%), respectively. TEE detected a total of 47 high-risk sources of embolism, whereas CT detected 44 lesions. For medium-risk sources of cardiac embolic stroke, TEE detected a total of 53 abnormal findings, whereas CT detected 44 abnormal findings. Of 53 lesions, there were 8 false-negative results on CT (5 patent foramen ovale and 3 atrial septal aneurysm). Two-phase 64-slice CCTA is a noninvasive and useful modality for detecting high-risk cardiac sources of embolism in stroke patients.

  1. Whole-Brain Computed Tomographic Perfusion Imaging in Acute Cerebral Venous Sinus Thrombosis

    PubMed Central

    Mokin, Maxim; Ciambella, Chelsey C.; Masud, Muhammad W.; Levy, Elad I.; Snyder, Kenneth V.; Siddiqui, Adnan H.

    2016-01-01

    Background Acute cerebral venous sinus thrombosis (VST) can be difficult to diagnose because of its diverse clinical presentation. The utility of perfusion imaging for diagnosing VST is not well understood. Summary We retrospectively reviewed cases of acute VST in patients who underwent whole-brain (320-detector-row) computed tomographic (CT) perfusion imaging in combination with craniocervical CT venography. Perfusion maps that were analyzed included cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time, and time to peak. Among the 10 patients with acute VST included in this study, 9 had perfusion abnormalities. All perfusion abnormalities were localized in areas adjacent to the occluded sinus and did not match typical anterior or posterior circulation arterial territories. Bilateral perfusion deficits were seen in 4 cases. In 2 cases, parenchymal hemorrhage was diagnosed on noncontrast CT imaging; in those cases, focal CBV and CBF were reduced. Key Messages Whole-brain CT perfusion imaging with 320-detector-row scanners can further assist in establishing the diagnosis of VST by detecting perfusion abnormalities corresponding to venous and not arterial territories. CT perfusion could assist in the differentiation between focal reversible changes, such as those caused by vasogenic edema, and irreversible changes due to infarction. PMID:27051406

  2. Value of computed tomographic angiography in neck and extremity pediatric vascular trauma.

    PubMed

    Hogan, Anthony R; Lineen, Edward B; Perez, Eduardo A; Neville, Holly L; Thompson, William R; Sola, Juan E

    2009-06-01

    We sought to define the sensitivity and specificity of computed tomographic angiography (CTA) in pediatric vascular injuries. All neck and extremity CTAs performed in pediatric patients at a level 1 trauma center were reviewed from 2001 to 2007. Overall, 78 patients were identified with an average age of 15.0 +/- 4.0 (0-18 years). Males outnumbered females 3.6:1. CTA was performed for 41 penetrating and 37 blunt traumas. Most penetrating injuries were due to missile wounds (71%) or stab wounds (17%). Eleven major vascular injuries resulted from penetrating trauma. For penetrating trauma, CTA was 100% sensitive and 93% specific. CTA for penetrating trauma had a positive predictive value (PPV) of 85% and negative predictive value (NPV) of 100%. Most blunt injuries were due to motor vehicle accidents (57%), followed by pedestrian hit by car (27%). Eight major vascular injuries resulted from blunt trauma. For blunt trauma, CTA was 88% sensitive and 100% specific. CTA for blunt trauma had a PPV of 100% and an NPV of 97%. The accuracy for penetrating and blunt trauma was 95% and 97%, respectively. CTA is highly sensitive, specific, and accurate for pediatric neck and extremity vascular trauma.

  3. Computer tomographic evaluation of talar edge configuration for osteochondral graft transplantation.

    PubMed

    Wiewiorski, Martin; Hoechel, Sebastian; Wishart, Katarina; Leumann, André; Müller-Gerbl, Magdalena; Valderrabano, Victor; Nowakowski, Andrej Maria

    2012-09-01

    To successfully surgically reconstruct osteochondral lesions of the talus, the exact three-dimensional (3D) configuration of the upper articular surface of the talus has to be respected. We assessed the talar geometry by measuring the coronal and sagittal talar edge radius and the frontal talar profile in multiplanar reconstructions of computer tomographic (CT) studies of 79 patients (83 feet) with a healthy ankle joint. An image visualization software designated for coordinate measurement was used to perform the measurement. In the coronal plane, the mean lateral talar edge radius was 4.0 mm and the medial 4.5 mm. In the sagittal planes the mean lateral talar edge radius was 20.3 mm, the radius of the sulcus 20.7 mm and the medial talar edge radius 20.4 mm. The talus showed a concave shape in coronal cuts. These results show a significant difference between medial and lateral talar edge configuration in coronal planes. The measurements of the lateral and medial sagittal radius and the mid-sagittal radius in the sulcus tali show no statistically significant difference. The depth of the talar sulcus shows no correlation to age or sex. Different sizes of custom-made tissue-engineered grafts according to the location of the osteochondral lesion at the talus are needed for exact surgical reconstruction of the anatomy. Osteochondral lesions are three dimensional; therefore, a 3D preoperative planning tool by CT scan or MRI is mandatory. Copyright © 2012 Wiley Periodicals, Inc.

  4. A Novel Colon Wall Flattening Model for Computed Tomographic Colonography: Method and Validation

    PubMed Central

    Wang, Huafeng; Chen, Yuexi; Li, Lihong; Pan, Haixia; Gu, Xianfeng

    2014-01-01

    Computed tomographic colonography (CTC) has been developed for screening of colon cancer. Flattening the three-dimensional (3D) colon wall into two-dimensional (2D) image is believed to (1) provide supplementary information to the endoscopic views and further (2) facilitate colon registration, taniae coli (TC) detection, and haustral fold segmentation. Though the previously-used conformal mapping-based flattening methods can preserve the angular geometry, they have the limitations in providing accurate information of the 3D inner colon wall due to the lack of undulating topography. In this paper, we present a novel colon-wall flattening method using a strategy of 2.5D approach. Coupling with the conformal flattening model, the presented new approach builds an elevation distance map to depict the neighborhood characteristics of the inner colon wall. We validated the new method via two CTC applications: TC detection and haustral fold segmentation. Experimental results demonstrated the effectiveness of our strategy for CTC studies. PMID:25642397

  5. Histologic and micro-computed tomographic analyses of replanted teeth stored in different kind of media.

    PubMed

    de Paula Reis, Manuella Verdinelli; Moura, Camilla Christian Gomes; Soares, Priscilla Barbosa Ferreira; Leoni, Graziela Bianchi; Souza-Neto, Manoel Damião; Barbosa, Darceny Zanetta; Soares, Carlos José

    2014-05-01

    Coconut water (CW) and soy milk (SM) have been proposed as storage media for avulsed teeth because of their nutrients that preserve cell viability. The present study investigated the periodontal healing process of dog teeth replanted after storage in CW, SM, and whole milk (WM) using micro-computed tomographic (μCT) and histologic analyses compared with immediate tooth replantation. Forty roots of 10 adult beagle dogs were extracted and subjected to the following protocols: immediate replantation after extraction (control), stored in CW with an adjusted pH, and SM and WM for 50 minutes before replantation. The animals were euthanized 28 days postoperatively, and the obtained specimens were scanned using a μCT scanner and subjected to routine processing for histometric analyses under an optical microscope. CW and SM performed similarly to WM; however, SM showed significantly higher ankylosis than the control group. Additionally, this study showed that the combined use of histologic analysis and μCT is a promising method to better identify tooth resorption and the repair process and to evaluate the total extension of the periodontium. CW as a storage medium is a promising transport media for avulsed teeth. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. Prophylactic appendectomy: unnecessary in children with incidental appendicoliths detected by computed tomographic scan.

    PubMed

    Rollins, Michael D; Andolsek, William; Scaife, Eric R; Meyers, Rebecka L; Duke, Tonya H; Lilyquist, Michael; Barnhart, Douglas C

    2010-12-01

    Controversy exists regarding the clinical significance of an isolated appendicolith on computed tomographic (CT) scan. We sought to determine the risk of developing appendicitis in children with an incidentally noted appendicolith. We retrospectively reviewed all pelvic CT scans in patients 18 years or younger at a tertiary care children's hospital from October 2005 to September 2008. Patients with an appendicolith and no radiographic evidence of acute appendicitis were selected for further review. Written questionnaire and telephone follow-up were attempted in all patients. Two thousand nine hundred thirteen pelvic CT scans were performed during the study period. The incidence of an isolated appendicolith during the study period was 2.6% (n = 75). Seven patients underwent appendectomy at initial presentation. Nine children underwent appendectomy subsequently: 3 electively and 6 at the time of return with abdominal pain. Only 6 of these 16 appendectomy specimens had histologic evidence of appendicitis, whereas only 3 demonstrated an appendicolith. Subsequent appendicitis developed in 5.8% (n = 4) of patients with an isolated appendicolith. Follow-up was achieved in 50% of patients who did not have an appendectomy (median, 2.8 years). Children with an incidental appendicolith are at low risk for developing appendicitis. The appendicoliths were often a transient finding not confirmed on surgical pathologic condition or subsequent imaging. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. Hyperspectral Computed Tomographic Imaging Spectroscopy of Vascular Oxygen Gradients in the Rabbit Retina In Vivo

    PubMed Central

    Kashani, Amir H.; Kirkman, Erlinda; Martin, Gabriel; Humayun, Mark S.

    2011-01-01

    Diagnosis of retinal vascular diseases depends on ophthalmoscopic findings that most often occur after severe visual loss (as in vein occlusions) or chronic changes that are irreversible (as in diabetic retinopathy). Despite recent advances, diagnostic imaging currently reveals very little about the vascular function and local oxygen delivery. One potentially useful measure of vascular function is measurement of hemoglobin oxygen content. In this paper, we demonstrate a novel method of accurately, rapidly and easily measuring oxygen saturation within retinal vessels using in vivo imaging spectroscopy. This method uses a commercially available fundus camera coupled to two-dimensional diffracting optics that scatter the incident light onto a focal plane array in a calibrated pattern. Computed tomographic algorithms are used to reconstruct the diffracted spectral patterns into wavelength components of the original image. In this paper the spectral components of oxy- and deoxyhemoglobin are analyzed from the vessels within the image. Up to 76 spectral measurements can be made in only a few milliseconds and used to quantify the oxygen saturation within the retinal vessels over a 10–15 degree field. The method described here can acquire 10-fold more spectral data in much less time than conventional oximetry systems (while utilizing the commonly accepted fundus camera platform). Application of this method to animal models of retinal vascular disease and clinical subjects will provide useful and novel information about retinal vascular disease and physiology. PMID:21931729

  8. Utility of Computed Tomographic Enteroclysis/Enterography for the Assessment of Mucosal Healing in Crohn's Disease

    PubMed Central

    Hashimoto, Shinichi; Shimizu, Kensaku; Shibata, Hiroaki; Kanayama, Satoko; Tanabe, Ryo; Onoda, Hideko; Matsunaga, Naohumi; Sakaida, Isao

    2013-01-01

    Aim. When determining therapeutic strategy, it is important to diagnose small intestinal lesions in Crohn's disease (CD) precisely and to evaluate mucosal healing as well as clinical remission in CD. The purpose of this study was to compare findings from computed tomographic enteroclysis/enterography (CTE) with those from the mucosal surface and to determine whether the state of mucosal healing can be determined by CTE. Materials and Methods. Of the patients who underwent CTE for CD, 39 patients were examined whose mucosal findings could be confirmed by colonoscopy, capsule endoscopy, balloon endoscopy, or with the resected surgical specimens. Results. According to the CTE findings, patients were determined to be in the active CD group (n = 31) or inactive CD group (n = 8). The proportion of previous surgery, clinical remission, stenosis, and CDAI score all showed significant difference between groups. Mucosal findings showed an association with ulcer in 93.6% of active group patients but in only 12.5% of inactive group patients (P < 0.0001), whereas mucosal healing was found in 62.5% of inactive group patients but in only 3.2% of active group patients (P < 0.0001). Conclusion. CTE appeared to be a useful diagnostic method for assessment of mucosal healing in Crohn's disease. PMID:23710169

  9. Splanchnic vein thrombosis in necrotizing acute pancreatitis: Detection by computed tomographic venography

    PubMed Central

    Jiang, Wei; Zhou, Jing; Ke, Lu; Li, Gang; Tong, Zhi-Hui; Li, Wei-Qin; Li, Jie-Shou

    2014-01-01

    AIM: To assess the diagnostic accuracy of computed tomographic venography (CTV) for splanchnic vein thrombosis (SVT) detection in necrotizing acute pancreatitis (AP) patients. METHODS: Forty-three patients with necrotizing AP who underwent both CTV and digital subtraction angiography (DSA) within 3 d were analyzed in this retrospective comparative study. All CTV procedures were performed with a dual-source CT scanner. The presence and location of SVT were determined via blinded imaging data analyses. RESULTS: According to the DSA results, 17 (39.5%) of the total 43 patients had SVT. The sensitivity, specificity, positive and negative predictive values of CTV for SVT detection were 100% (95%CI: 77.1%-100%), 92.3% (95%CI: 73.4%-98.7%), 89.5% (95%CI: 65.5%-98.2%) and 100% (95%CI: 82.8%-100%), respectively. CONCLUSION: CTV is an effective examination for SVT detection in patients with necrotizing AP with high positive and negative predictive values. PMID:25469039

  10. Semiquantitative Computed Tomographic Characteristics for Lung Adenocarcinoma and Their Association with Lung Cancer Survival

    PubMed Central

    Wang, Hua; Schabath, Matthew B.; Liu, Ying; Berglund, Anders E.; Bloom, Gregory C.; Kim, Jongphil; Stringfield, Olya; Eikman, Edward A.; Klippenstein, Donald L.; Heine, John J.; Eschrich, Steven A.; Ye, Zhaoxiang; Gillies, Robert J.

    2015-01-01

    Background Computed tomographic (CT) characteristics derived from noninvasive images that represent the entire tumor may have diagnostic and prognostic value. The purpose of this study was to assess the association of a standardized set of semiquantitative CT characteristics of lung adenocarcinoma with overall survival. Patients and Methods An initial set of CT descriptors was developed to semiquantitatively assess lung adenocarcinoma in patients (n=117) who underwent resection. Survival analyses were used to determine the association between each characteristic and overall survival. Principle component analysis (PCA) was used to determine characteristics that may differentiate histological subtypes. Results Characteristics significantly associated with overall survival included pleural attachment (p < 0.001), air bronchogram (p = 0.03), and lymphadenopathy (p = 0.02). Multivariate analyses revealed pleural attachment was significantly associated with an increased risk of death overall (hazard ratio [HR] = 3.21; 95% confidence interval [CI] 1.53 – 6.70) and among patients with lepidic predominant adenocarcinomas (HR = 5.85; 95% CI 1.75 – 19.59), while lymphadenopathy was significantly associated with an increased risk of death among patients with adenocarcinomas without a predominant lepidic component (HR = 3.07; 95% CI 1.09 – 8.70). A PCA model showed that texture (ground-glass opacity component) was most important for separating the two subtypes. Conclusion A subset of the semiquantitative characteristics described herein has prognostic importance and ability to distinguish between different histological subtypes of lung adenocarcinoma. PMID:26077095

  11. Stereotactic interstitial brachytherapy of malignant astrocytomas with remarks on postimplantation computed tomographic appearance

    SciTech Connect

    Willis, B.K.; Heilbrun, M.P.; Sapozink, M.D.; McDonald, P.R.

    1988-09-01

    Seventeen patients were treated with stereotactically implanted high activity iodine-125 seeds, 12 patients for recurrent malignant astrocytomas (Protocol I) and 5 patients for newly diagnosed glioblastomas (Protocol II). Total radiation dosage to the recurrent tumors in Protocol I, including prior external beam irradiation, averaged 13,500 cGy. In the follow-up period of 6 to 50 months, the survival rate was 93% at 6 months, 60% at 12 months, 50% at 18 months, and 38% at 24 months after implantation. In Protocol II, brachytherapy was used as an interstitial radiation boost to the conventional treatment of newly diagnosed glioblastomas. External beam therapy and interstitial brachytherapy provided 11,000 cGy to these tumors. In the follow-up period of 15 to 27 months, there was a 100% survival at 12 months, 75% at 18 months, and 25% at 24 months after implantation. Eight of our 17 patients required reoperation for persistent or recurrent mass lesions at 6 to 15 months postimplantation; 7 were found to harbor masses of radionecrosis containing nests of anaplastic astrocytes; 1 had frank tumor recurrence. Median survival in this group of patients requiring reoperation was 18.7 months postimplantation. In a review of postimplantation computed tomographic scans, significant mass effect and crossover of hypodensity or enhancement into the corpus callosum or opposite hemisphere were found to have prognostic significance; persistent areas of contrast enhancement and excessive peritumoral hypodensity did not.

  12. Performance of computed tomographic colonography improved by total quality management techniques

    NASA Astrophysics Data System (ADS)

    Garry, John L.; Reed, Judd E.; Johnson, C. Daniel

    2000-04-01

    Our institution has been using an internally developed system for the analysis of Computed Tomographic Colonography (CTC) since 1994. This system has gone through several major revisions during that period. Careful application of 'total quality management' (TQM) principles have been utilized to enhance such aspects of performance as patient comfort, latency between examination and reporting of results, capability and reliability of 'picture archive system' (PACS) and network components, as well as reliability of results. CTC is now being practiced at our institution for clinical screening and research applications. To date, 1500 patients have been scanned. On an average day, six patients are scanned for research and/or clinical purposes. Research patient data remain on the CTC workstation for future analysis by the Radiologists while clinical patient data are analyzed as soon as the data have been received at the CTC workstation. An enlarged dynamic axial stack augmented by multiple interactive, off axis reformatted and perspective volume rendered endoluminal views have proven to be the most effective reading mode. Well over 1000 patient scans have been analyzed utilizing this specific protocol. When compared to corresponding patient BE and/or Colonoscopy procedures, CTC findings of potential cancers and polyps have compared very favorably.

  13. Normal morphometry of the thoracic aorta in the german shepherd dog: a computed tomographic study.

    PubMed

    Dabanoglu, I

    2007-06-01

    Computed tomographic images of the thoracic aorta of 14 German shepherd dogs were examined in order to determine the morphometry of the thoracic aorta. Examinations were carried out in the transverse plane at both intervertebral and mid-vertebral levels of each thoracic vertebra between T(5) and T(13). The dorsoventral and transversal diameters as well as cross-section area of the thoracic aorta were measured. The widest transversal diameter was observed at T(4-5), whereas the largest dorsoventral diameter was detected at T(5). The maximum cross-section area was detected at T(4-5). When dorsoventral and transversal diameters were compared between males and females, the aortic diameter was found to be smaller in males than in females. Although the shape of the thoracic aorta was transversal oval in the majority of the examined females, the shape of the thoracic aorta was dorsoventral oval in the majority of the males. There were significant differences between all levels measured for transversal (P < 0.001), dorsoventral (P < 0.001) diameters and cross-section area (P < 0.001) of the thoracic aorta. And there was a significant correlation between the three parameters examined. However, the correlation coefficient was highest in females.

  14. A novel colonic polyp volume segmentation method for computer tomographic colonography

    NASA Astrophysics Data System (ADS)

    Wang, Huafeng; Li, Lihong C.; Han, Hao; Song, Bowen; Peng, Hao; Wang, Yunhong; Wang, Lihua; Liang, Zhengrong

    2014-03-01

    Colorectal cancer is the third most common type of cancer. However, this disease can be prevented by detection and removal of precursor adenomatous polyps after the diagnosis given by experts on computer tomographic colonography (CTC). During CTC diagnosis, the radiologist looks for colon polyps and measures not only the size but also the malignancy. It is a common sense that to segment polyp volumes from their complicated growing environment is of much significance for accomplishing the CTC based early diagnosis task. Previously, the polyp volumes are mainly given from the manually or semi-automatically drawing by the radiologists. As a result, some deviations cannot be avoided since the polyps are usually small (6~9mm) and the radiologists' experience and knowledge are varying from one to another. In order to achieve automatic polyp segmentation carried out by the machine, we proposed a new method based on the colon decomposition strategy. We evaluated our algorithm on both phantom and patient data. Experimental results demonstrate our approach is capable of segment the small polyps from their complicated growing background.

  15. Quantitative evaluation of cervical cord compression by computed tomographic myelography in Thoroughbred foals

    PubMed Central

    YAMADA, Kazutaka; SATO, Fumio; HADA, Tetsuro; HORIUCHI, Noriyuki; IKEDA, Hiroki; NISHIHARA, Kahori; SASAKI, Naoki; KOBAYASHI, Yoshiyasu; NAMBO, Yasuo

    2016-01-01

    ABSTRACT Five Thoroughbred foals (age, 8–33 weeks; median age, 31 weeks; weight, 122–270 kg; median weight, 249 kg) exhibiting ataxia with suspected cervical myelopathy (n=4) and limb malformation (n=1) were subjected to computed tomographic (CT) myelography. The areas of the subarachnoid space and cervical cord were measured on transverse CT images. The area of the cervical cord was divided by the area of subarachnoid space, and stenosis ratios were quantitatively evaluated and compared on the basis of histopathological examination. The sites with a ratio above 52.8% could have been primary lesion sites in the histopathological examination, although one site with a ratio of 54.1% was not a primary lesion site. Therefore, in this study, a ratio between 52.8–54.1% was suggested to be borderline for physical compression that damages the cervical cord. All the cervical vertebrae could not be scanned in three of the five cases. Therefore, CT myelography is not a suitable method for locating the site of compression, but it should be used for quantitative evaluation of cervical stenosis diagnosed by conventional myelography. In conclusion, the stenosis ratios determined using CT myelography could be applicable for detecting primary lesion sites in the cervical cord. PMID:27974873

  16. Evaluation of radiographic, computed tomographic, and cadaveric anatomy of the head of boa constrictors.

    PubMed

    Banzato, Tommaso; Russo, Elisa; Di Toma, Anna; Palmisano, Giuseppe; Zotti, Alessandro

    2011-12-01

    To evaluate the radiographic, computed tomographic (CT), and cadaveric anatomy of the head of boa constrictors. 4 Boa constrictor imperator cadavers. Cadavers weighed 3.4 to 5.6 kg and had a body length ranging from 189 to 221 cm. Radiographic and CT images were obtained with a high-detail screen-film combination, and conventional CT was performed with a slice thickness of 1.5 mm. Radiographic images were obtained in ventrodorsal, dorsoventral, and left and right laterolateral recumbency; CT images were obtained with the animals positioned in ventral recumbency directly laying on a plastic support. At the end of the radiographic and CT imaging session, 2 heads were sectioned following a stratigraphic approach; the other 2, carefully maintained in the same position on the plastic support, were moved into a freezer (-20°C) until completely frozen and then sectioned into 3-mm slices, respecting the imaging protocol. The frozen sections were cleaned and then photographed on each side. Anatomic structures were identified and labeled on gross anatomic images and on the corresponding CT or radiographic image with the aid of available literature. Radiographic and CT images provided high detail for visualization of bony structures; soft tissues were not easily identified on radiographic and CT images. Results provide an atlas of stratigraphic and cross-sectional gross anatomy and radiographic and CT anatomy of the heads of boa constrictors that might be useful in the interpretation of any imaging modality in this species.

  17. Computed tomographic findings and treatment of a bull with pituitary gland abscess.

    PubMed

    Braun, Ueli; Malbon, Alexandra; Kochan, Manon; Riond, Barbara; Janett, Fredi; Iten, Cornelia; Dennler, Matthias

    2017-01-13

    In cattle, the prognosis of brain abscess is unfavourable and treatment is therefore not recommended. To the knowledge of the authors, there has been no report of successful treatment of a brain abscess in cattle.This report describes the clinical, computed tomographic and postmortem findings in a Holstein-Friesian bull with a hypophyseal abscess. The main clinical findings were generalised ataxia, ptyalism, prolapse of the tongue, dropped jaw, dysphagia, head tilt and unilateral ptosis. Cerebrospinal fluid evaluation revealed 2437 leukocytes/µl and severe pleocytosis. CT examination of the head showed a cavitary lesion consistent with an abscess in the hypophysis. Treatment consisted of gentamicin and flunixin meglumine for 3 days and amoxicillin for 40 days. The neurological signs resolved within 8 days of the start of treatment. The bull was slaughtered 11 months later because of infertility, and a postmortem examination was carried out. Histologically, a mild chronic non suppurative meningoencephalitis restricted to the ventral diencephalon was diagnosed. In addition, there was mild to moderate multifocal chronic lymphoplasmacytic hypophysitis with mild multifocal fibrosis. This case report stresses the significance of CT in confirming the clinical and laboratory diagnosis of central nervous system disorders in cattle and for localising brain lesions. Treatment of the brain abscess resulted, with respect to the central nervous disorder, in a successful outcome and was encouraging considering that most cases have an unfavourable prognosis.

  18. Radiographic and computed tomographic demonstration of pseudotumor cerebri due to rapid weight gain in a child with pelvic rhabdomyosarcoma

    SciTech Connect

    Berdon, W.E.; Barker, D.H.; Barash, F.S.

    1982-06-01

    Rapid weight gain in a malnourished child can be associated with suture diastasis in the pattern of pseudotumor cerebri; this has been previously reported in deprivational dwarfism and cystic fibrosis. In a child with pelvic rhabdomyosarcoma, skull radiographs and cranial computed tomographic (CT) scans were available prior to a period of rapid weight gain induced by hyperalimentation. Suture diastasis developed and repeat CT scans showed this to be accompanied by smaller ventricles.

  19. Arterial Obstruction on Computed Tomographic or Magnetic Resonance Angiography and Response to Intravenous Thrombolytics in Ischemic Stroke

    PubMed Central

    Mair, Grant; von Kummer, Rüdiger; Adami, Alessandro; White, Philip M.; Adams, Matthew E.; Yan, Bernard; Demchuk, Andrew M.; Farrall, Andrew J.; Sellar, Robin J.; Sakka, Eleni; Palmer, Jeb; Perry, David; Lindley, Richard I.; Sandercock, Peter A.G.

    2017-01-01

    Background and Purpose— Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. Methods— We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase. Readers, masked to clinical, treatment, and outcome data, assessed prerandomization computed tomographic angiography and magnetic resonance angiography for presence, extent, location, and completeness of obstruction and collaterals. We compared angiography findings to 6-month functional outcome (Oxford Handicap Scale) and tested for interactions with alteplase, using ordinal regression in adjusted analyses. We also meta-analyzed all available angiography data from other randomized controlled trials of intravenous thrombolytics. Results— In IST-3, 300 patients had prerandomization angiography (computed tomographic angiography=271 and magnetic resonance angiography=29). On multivariable analysis, more extensive angiographic obstruction and poor collaterals independently predicted poor outcome (P<0.01). We identified no significant interaction between angiography findings and alteplase effect on Oxford Handicap Scale (P≥0.075) in IST-3. In meta-analysis (5 trials of alteplase or desmoteplase, including IST-3, n=591), there was a significantly increased benefit of thrombolytics on outcome (odds ratio>1 indicates benefit) in patients with (odds ratio, 2.07; 95% confidence interval, 1.18–3.64; P=0.011) versus without (odds ratio, 0.88; 95% confidence interval, 0.58–1.35; P=0.566) arterial obstruction (P for interaction 0.017). Conclusions— Intravenous thrombolytics provide benefit to stroke patients with computed tomographic angiography or magnetic

  20. Arterial Obstruction on Computed Tomographic or Magnetic Resonance Angiography and Response to Intravenous Thrombolytics in Ischemic Stroke.

    PubMed

    Mair, Grant; von Kummer, Rüdiger; Adami, Alessandro; White, Philip M; Adams, Matthew E; Yan, Bernard; Demchuk, Andrew M; Farrall, Andrew J; Sellar, Robin J; Sakka, Eleni; Palmer, Jeb; Perry, David; Lindley, Richard I; Sandercock, Peter A G; Wardlaw, Joanna M

    2017-02-01

    Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase. Readers, masked to clinical, treatment, and outcome data, assessed prerandomization computed tomographic angiography and magnetic resonance angiography for presence, extent, location, and completeness of obstruction and collaterals. We compared angiography findings to 6-month functional outcome (Oxford Handicap Scale) and tested for interactions with alteplase, using ordinal regression in adjusted analyses. We also meta-analyzed all available angiography data from other randomized controlled trials of intravenous thrombolytics. In IST-3, 300 patients had prerandomization angiography (computed tomographic angiography=271 and magnetic resonance angiography=29). On multivariable analysis, more extensive angiographic obstruction and poor collaterals independently predicted poor outcome (P<0.01). We identified no significant interaction between angiography findings and alteplase effect on Oxford Handicap Scale (P≥0.075) in IST-3. In meta-analysis (5 trials of alteplase or desmoteplase, including IST-3, n=591), there was a significantly increased benefit of thrombolytics on outcome (odds ratio>1 indicates benefit) in patients with (odds ratio, 2.07; 95% confidence interval, 1.18-3.64; P=0.011) versus without (odds ratio, 0.88; 95% confidence interval, 0.58-1.35; P=0.566) arterial obstruction (P for interaction 0.017). Intravenous thrombolytics provide benefit to stroke patients with computed tomographic angiography or magnetic resonance angiography evidence of arterial obstruction, but the sample was

  1. Contrast-Enhanced High-Pitch Computed Tomography in Pediatric Patients Without Electrocardiography Triggering and Sedation: Comparison of Cardiac Image Quality With Conventional Multidetector Computed Tomography.

    PubMed

    Esser, Michael; Gatidis, Sergios; Teufel, Matthias; Ketelsen, Inés; Nikolaou, Konstantin; Schäfer, Jürgen F; Tsiflikas, Ilias

    2017-01-01

    The aim of this study was to compare image quality of anatomical cardiac details without electrocardiography triggering, sedation, or heart rate-regulating drugs in contrast-enhanced pediatric chest computed tomography (CT), using high-pitch CT (HPCT) versus conventional pitch-mode technique (multidetector CT [MDCT]). After written informed consent, 55 patients (median age, 11 years; range, 3-17 years) were prospectively included in this institutional review board-approved study. Patients underwent clinically indicated, contrast-enhanced MDCT or HPCT of the chest.Image quality was assessed evaluating morphological criteria on a 3-point scale (from 1, high, to 3, low detail) and summed up in a global score (from 4, best, to 12, poor image quality). Artifacts were analyzed correspondingly (from 3, low, to 9, severe artifacts). Effective dose and size-specific dose estimate were calculated for all scans. Cardiac image quality was higher in HPCT than in MDCT (7.1 [1.6] vs 8.8 [1.9], P < 0.001). Nevertheless, HPCT showed limitations in image quality, especially concerning the heart valves (2.5 [0.6] and 1.7 [0.5]) and coronary arteries (1.8 [0.6). Artifact score (3.4 [0.6 vs 5.1 [0.9, P < 0.001), effective dose (1.6 [1.3] vs 2.3 [1.6] mSv, P = 0.047), and size-specific dose estimate (2.5 [1.7] vs 4.1 [2.3] mGy, P = 0.002) were lower in HPCT compared with those in MDCT. In pediatric patients, contrast-enhanced HPCT of the chest provides high image quality without electrocardiography triggering or sedation, although image quality is somewhat limited for a detailed depiction of cardiac anatomy.

  2. Texture analysis of computed tomographic images in osteoporotic patients with sinus lift bone graft reconstruction.

    PubMed

    Marchand-Libouban, Hélène; Guillaume, Bernard; Bellaiche, Norbert; Chappard, Daniel

    2013-05-01

    Bone implants are now widely used to replace missing teeth. Bone grafting (sinus lift) is a very useful way to increase the bone volume of the maxilla in patients with bone atrophy. There is a 6- to 9-month delay for the receiver grafted site to heal before the implants can be placed. Computed tomography is a useful method to measure the amount of remaining bone before implantation and to evaluate the quality of the receiver bone at the end of the healing period. Texture analysis is a non-invasive method useful to characterize bone microarchitecture on X-ray images. Ten patients in which a sinus lift surgery was necessary before implantation were analyzed in the present study. All had a bone reconstruction with a combination of a biomaterial (beta tricalcium phosphate) and autograft bone harvested at the chin. Computed tomographic images were obtained before grafting (t0), at mid-interval (t1, 4.2 ± 0.7 months) and before implant placement (t2, 9.2 ± 0.6 months). Texture analysis was done with the run-length method. A significant increase of texture parameters at t1 reflected a gain of homogeneity due to the graft and the beginning of bone remodeling. At t2, some parameters remained high and corresponded to the persistence of bone trabeculae while the resorption of biomaterials was identified by other parameters which tended to return to pregraft values. Texture analysis identified changes during the healing of the receiver site. The method is known to correlate with microarchitectural changes in bone and could be a useful approach to characterized osseointegrated grafts.

  3. Radiographic, computed tomographic, and ultrasonographic findings with migrating intrathoracic grass awns in dogs and cats.

    PubMed

    Schultz, Ryan M; Zwingenberger, Allison

    2008-01-01

    The purpose of this study was to describe the clinical, radiographic, and computed tomographic findings in dogs and cats with migrating intrathoracic grass awns. Thirty-five dogs and five cats with visual confirmation of a grass awn following surgery, endoscopy or necropsy, and histology were assessed. The medical records and all diagnostic imaging studies were reviewed retrospectively. Labrador Retrievers or English Pointers < 5 years of age, with a history of coughing and hyperthermia, were the most common presentations. Seventeen animals had an inflammatory leukogram of which 14 had a left shift or toxic neutrophils. Radiographs were performed in 38 animals and computed tomography (CT) in 14. Thoracic radiographs were characterized by focal pulmonary interstitial to alveolar opacities (n = 26) that occurred most commonly in the caudal (n = 19) or accessory lobes (n = 8). Additional findings included pneumothorax (n = 9), pleural effusion (n = 8), and pleural thickening (n = 7). Pulmonary opacities identified on radiographs correlated to areas of pneumonia and foreign body location. CT findings included focal interstitial to alveolar pulmonary opacities (n = 12) most commonly in the right caudal lung lobe (n = 9), pleural thickening (n = 11), mildly enlarged intrathoracic lymph nodes (n = 10), soft tissue tracking (n = 7) with enhancing margins (n = 4), pneumothorax (n = 6), pleural effusion (n = 4), and foreign body visualization (n = 4). Histologic diagnoses included pulmonary and mediastinal granulomas or abscesses, bronchopneumonia, and pleuritis. Migrating intrathoracic grass awns should be considered as a differential diagnosis in coughing, febrile animals with focal interstitial to alveolar pulmonary opacities, pleural effusion, pleural thickening, and/or pneumothorax on radiographs or CT.

  4. Image display system for synchronous interpretaion of supine and prone computed tomographic colography

    NASA Astrophysics Data System (ADS)

    Reed, Judd E.; Johnson, C. Daniel

    1998-06-01

    Computed tomographic colography (CTC or virtual colonoscopy) is a new technique for imaging the colon for the detection of colorectal neoplasms. Early clinical assessment of this procedure has shown that the performance of this test is acceptable for colorectal screening examinations. The current version of CTC utilizes an interactive combination of axial, reformatted 2D and 3D images (from an endoluminal perspective) that are generated in real time. Retained fluid in the lumen of the colon is a commonly encountered problem that can obscure lesions. Prone imaging in addition to standard supine views are often required to visualize obscured colonic segments. Although the colorectum is often seen optimally with combined supine and prone views, twice as much interpretation time is required with both acquisitions. The purpose of this study is to describe a novel system of synchronous display of supine and prone images of the colon. Simultaneous display of synchronized (anatomically registered) views of the colon eliminates the need for two separate readings of the colon and shortens interpretation time. This tool has all of the features of the original CTC interpretation system (presented in 1995) and includes recent innovations such as virtual pathology which is present in another paper within this Proceeding. The anatomic levels are indexed to match each other and advanced synchronously as the radiologist interprets the data set. Axial, reformatted 2D and 3D images are displayed and simultaneously updated for both prone and supine images on the same computer screen. The colon only needs to be reviewed once with the diagnostic benefit of both scans. In many cases, the two scans can be interpreted nearly as quickly as one. Conclusion: Synchronous display of prone and supine images of the colon is a new enhancement for CTC that combines with advantages of prone and supine views without the added interpretations time of reviewing two separate scans.

  5. Three-dimensional multidetector computed tomography may aid preoperative planning of the transmanubrial osteomuscular-sparing approach to completely resect superior sulcus tumor.

    PubMed

    Saji, Hisashi; Kato, Yasufumi; Shimada, Yoshihisa; Kudo, Yujin; Hagiwara, Masaru; Matsubayashi, Jun; Nagao, Toshitaka; Ikeda, Norihiko

    2015-11-01

    The anterior transcervical-thoracic approach clearly exposes the subclavian vessels and brachial plexus. We believe that this approach is optimal when a superior sulcus tumor (SST) invades the anterior part of the thoracic inlet. However, this approach is not yet widely applied because anatomical relationships in this procedure are difficult to visualize. Three-dimensional tomography can considerably improve preoperative planning, enhance the surgeon's skill and simplify the approach to complex surgical procedures. We applied preoperative 3-dimensional multidetector computed tomography to a case where an SST had invaded the anterior part of the thoracic inlet including the clavicle, sternoclavicular joint, first rib, subclavian vessels and brachial plexus. After the patient underwent induction chemotherapy, we performed the transmanubrial osteomuscular-sparing approach and added a third anterolateral thoracotomy with a hemi-clamshell incision and completely resected the tumor.

  6. Dataset of calcified plaque condition in the stenotic coronary artery lesion obtained using multidetector computed tomography to indicate the addition of rotational atherectomy during percutaneous coronary intervention.

    PubMed

    Akutsu, Yasushi; Hamazaki, Yuji; Sekimoto, Teruo; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Suyama, Jumpei; Gokan, Takehiko; Sakai, Koshiro; Kosaki, Ryota; Yokota, Hiroyuki; Tsujita, Hiroaki; Tsukamoto, Shigeto; Sakurai, Masayuki; Sambe, Takehiko; Oguchi, Katsuji; Uchida, Naoki; Kobayashi, Shinichi; Aoki, Atsushi; Kobayashi, Youichi

    2016-06-01

    Our data shows the regional coronary artery calcium scores (lesion CAC) on multidetector computed tomography (MDCT) and the cross-section imaging on MDCT angiography (CTA) in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI). CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany) before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan) and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions.

  7. Dataset of calcified plaque condition in the stenotic coronary artery lesion obtained using multidetector computed tomography to indicate the addition of rotational atherectomy during percutaneous coronary intervention

    PubMed Central

    Akutsu, Yasushi; Hamazaki, Yuji; Sekimoto, Teruo; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Suyama, Jumpei; Gokan, Takehiko; Sakai, Koshiro; Kosaki, Ryota; Yokota, Hiroyuki; Tsujita, Hiroaki; Tsukamoto, Shigeto; Sakurai, Masayuki; Sambe, Takehiko; Oguchi, Katsuji; Uchida, Naoki; Kobayashi, Shinichi; Aoki, Atsushi; Kobayashi, Youichi

    2016-01-01

    Our data shows the regional coronary artery calcium scores (lesion CAC) on multidetector computed tomography (MDCT) and the cross-section imaging on MDCT angiography (CTA) in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI). CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany) before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan) and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions. PMID:26977441

  8. Surgically Cured, Relapsed Pneumococcal Meningitis Due to Bone Defects, Non-invasively Identified by Three-dimensional Multi-detector Computed Tomography

    PubMed Central

    Akimoto, Takayoshi; Morita, Akihiko; Shiobara, Keiji; Hara, Makoto; Minami, Masayuki; Shijo, Katsunori; Nomura, Yasuyuki; Shigihara, Shuntaro; Haradome, Hiroki; Abe, Osamu; Kamei, Satoshi

    2016-01-01

    A 43-year-old Japanese man presented with a history of bacterial meningitis (BM). He was admitted to our department with a one-day history of headache and was diagnosed with relapse of BM based on the cerebrospinal fluid findings. The conventional imaging studies showed serial findings suggesting left otitis media, a temporal cephalocele, and meningitis. Three-dimensional multi-detector computed tomography (3D-MDCT) showed left petrous bone defects caused by the otitis media, and curative surgical treatment was performed. Skull bone structural abnormalities should be considered a cause of relapsed BM. 3D-MDCT was useful for revealing the causal minimal bone abnormality and performing pre-surgical mapping. PMID:27980270

  9. Computed Tomographic Perfusion Selection and Clinical Outcomes After Endovascular Therapy in Large Vessel Occlusion Stroke.

    PubMed

    Bouslama, Mehdi; Haussen, Diogo C; Grossberg, Jonathan A; Dehkharghani, Seena; Bowen, Meredith T; Rebello, Leticia C; Bianchi, Nicolas A; Frankel, Michael R; Nogueira, Raul G

    2017-05-01

    Different imaging paradigms have been used to select patients for endovascular therapy in stroke. We sought to determine whether computed tomographic perfusion (CTP) selection improves endovascular therapy outcomes compared with noncontrast computed tomography alone. Review of a prospectively collected registry of anterior circulation stroke patients undergoing stent-retriever thrombectomy at a tertiary care center between September 2010 and March 2016. Patients undergoing CTP were compared with those with noncontrast computed tomography alone. The primary outcome was the shift in the 90-day modified Rankin scale (mRS). A total of 602 patients were included. CTP-selected patients (n=365, 61%) were younger (P=0.02) and had fewer comorbidities. CTP selection (n=365, 61%) was associated with a favorable 90-day mRS shift (adjusted odds ratio [aOR]=1.49; 95% confidence interval [CI], 1.06-2.09; P=0.02), higher rates of good outcomes (90-day mRS score 0-2: 52.9% versus 40.4%; P=0.005), modified Thrombolysis in Cerebral Infarction-3 reperfusion (54.8% versus 40.1%; P<0.001), smaller final infarct volumes (24.7 mL [9.8-63.1 mL] versus 34.6 mL [13.1-88 mL]; P=0.017), and lower mortality (16.6% versus 26.8%; P=0.005). When matched on age, National Institutes of Health Stroke Scale (NIHSS) score, and glucose (n=424), CTP remained associated with a favorable 90-day mRS shift (P=0.016), lower mortality (P=0.02), and higher rates of reperfusion (P<0.001). CTP better predicted functional outcomes in patients presenting after 6 hours (as assessed by comparison of logistic regression models: Akaike information criterion: 199.35 versus 287.49 and Bayesian information criterion: 196.71 versus 283.27) and those with an Alberta Stroke Program Early Computed Tomography Score ≤7 (Akaike information criterion: 216.69 versus 334.96 and Bayesian information criterion: 213.6 versus 329.94). CTP selection is associated with a favorable mRS shift in patients undergoing stent

  10. Computed 3D visualisation of an extinct cephalopod using computer tomographs

    PubMed Central

    Lukeneder, Alexander

    2012-01-01

    The first 3D visualisation of a heteromorph cephalopod species from the Southern Alps (Dolomites, northern Italy) is presented. Computed tomography, palaeontological data and 3D reconstructions were included in the production of a movie, which shows a life reconstruction of the extinct organism. This detailed reconstruction is according to the current knowledge of the shape and mode of life as well as habitat of this animal. The results are based on the most complete shell known thus far of the genus Dissimilites. Object-based combined analyses from computed tomography and various computed 3D facility programmes help to understand morphological details as well as their ontogentical changes in fossil material. In this study, an additional goal was to show changes in locomotion during different ontogenetic phases of such fossil, marine shell-bearing animals (ammonoids). Hence, the presented models and tools can serve as starting points for discussions on morphology and locomotion of extinct cephalopods in general, and of the genus Dissimilites in particular. The heteromorph ammonoid genus Dissimilites is interpreted here as an active swimmer of the Tethyan Ocean. This study portrays non-destructive methods of 3D visualisation applied on palaeontological material, starting with computed tomography resulting in animated, high-quality video clips. The here presented 3D geometrical models and animation, which are based on palaeontological material, demonstrate the wide range of applications, analytical techniques and also outline possible limitations of 3D models in earth sciences and palaeontology. The realistic 3D models and motion pictures can easily be shared amongst palaeontologists. Data, images and short clips can be discussed online and, if necessary, adapted in morphological details and motion-style to better represent the cephalopod animal. PMID:24850976

  11. Computed 3D visualisation of an extinct cephalopod using computer tomographs

    NASA Astrophysics Data System (ADS)

    Lukeneder, Alexander

    2012-08-01

    The first 3D visualisation of a heteromorph cephalopod species from the Southern Alps (Dolomites, northern Italy) is presented. Computed tomography, palaeontological data and 3D reconstructions were included in the production of a movie, which shows a life reconstruction of the extinct organism. This detailed reconstruction is according to the current knowledge of the shape and mode of life as well as habitat of this animal. The results are based on the most complete shell known thus far of the genus Dissimilites. Object-based combined analyses from computed tomography and various computed 3D facility programmes help to understand morphological details as well as their ontogentical changes in fossil material. In this study, an additional goal was to show changes in locomotion during different ontogenetic phases of such fossil, marine shell-bearing animals (ammonoids). Hence, the presented models and tools can serve as starting points for discussions on morphology and locomotion of extinct cephalopods in general, and of the genus Dissimilites in particular. The heteromorph ammonoid genus Dissimilites is interpreted here as an active swimmer of the Tethyan Ocean. This study portrays non-destructive methods of 3D visualisation applied on palaeontological material, starting with computed tomography resulting in animated, high-quality video clips. The here presented 3D geometrical models and animation, which are based on palaeontological material, demonstrate the wide range of applications, analytical techniques and also outline possible limitations of 3D models in earth sciences and palaeontology. The realistic 3D models and motion pictures can easily be shared amongst palaeontologists. Data, images and short clips can be discussed online and, if necessary, adapted in morphological details and motion-style to better represent the cephalopod animal.

  12. Association between renal dysfunction and the mixed plaque of coronary artery on computed tomographic angiography.

    PubMed

    Sung, Jiyoon; Chang, Jae Hyun; Chung, Wook-Jin; Jung, Ji Yong; Na, Sun Young; Lee, Hyun Hee; Sung, Yon Mi; Moon, Chan Il; Hwang, Young-Hwan; Chung, Wookyung; Kim, Sejoong

    2011-01-01

    Coronary artery plaque is related to development of coronary artery disease (CAD), and chronic kidney disease is associated with CAD. However, the association of renal dysfunction (RD) with coronary artery plaque characteristics has not been fully elucidated. We evaluated the association between RD and coronary artery plaque characteristics in patients with suspected CAD, who underwent multislice computed tomographic angiography (CTA). A total of 918 patients were classified into 4 groups: group with no plaque (NP) (48.9%), group with calcified plaque (CP) (16.0%), group with noncalcified plaque (NCP) (22.4%), and group with mixed plaque (MP) (12.7%). NCP is considered as rupture-prone soft plaque, and CP as more stable lesion. The mean of estimated glomerular filtration rate (eGFR) was 82.5 ± 15.4 mL/min/1.73 m(2), and the prevalence of RD (defined as eGFR < 60 mL/min/1.73 m(2)) was 6.3%. The prevalence of RD was 3.3% in the NP group, 10.2% in the CP group, 5.3% in the NCP group, and 14.5% in the MP group (P < 0.001 by ANOVA tests). The adjusted odds ratio for RD was 3.38 (95% confidence interval, 1.27-9.04) for the MP group, compared with the NP group. The presence of RD showed an independent association with the MP counts (r = 0.155, P < 0.001); however, there was no association between RD and other plaque characteristics. In conclusion, RD is associated with MP rather than CP or NCP, compared with NP, which may reflect one of the developmental processes of CAD in patients with RD.

  13. Identification of the distinguishing features of Crohn's disease and ischemic colitis using computed tomographic enterography.

    PubMed

    Chen, Min; Remer, Erick M; Liu, Xiuli; Lopez, Rocio; Shen, Bo

    2017-08-01

    Background and aims: The differential diagnosis between Crohn's disease (CD) and ischemic colitis (ISC) is important as their clinical management is different. ISC can easily be misdiagnosed as CD, especially in elderly populations. The distinctive radiographic features of the two disease entities have not been investigated. The aim of this study is to assess the utility of computed tomographic enterography (CTE) in the differential diagnosis between CD and ISC. Methods: Patients with confirmed CD and ISC were identified through an electronic medical record search of the Cleveland Clinic Foundation. Patients who had undergone CTE, with or without concurrent colonoscopy and histopathological specimens, were included in this study. CTE images were blindly re-reviewed by an expert gastrointestinal radiologist. The sensitivities, specificities, accuracies and positive and negative predictive values for each of the CTE findings in differentiating CD from ISC were estimated. Kappa coefficients (κ) were calculated to measure diagnosis agreement between CTE and the reference standard. Results: A total of 34 eligible patients were included in this study with 17 having CD and 17 having ISC. In differentiating CD from ISC, the presence of mucosal hyperenhancement and absence of the "target sign" on CTE showed a sensitivity of 100% each for CD, while the two radiographic features yielded a low specificity of 35.3% and 76.5%, respectively. The presence of stricture had a lower sensitivity of 64.7% for the detection of CD but had a high specificity of 100%. In distinguishing CD from ISC, the accuracy of presence of mucosal hyperenhancement, stricture and absence of target sign were 67.7%, 82.4% and 88.2%, respectively. The combination of the presence of mucosal hyperenhancement and the absence of the target sign achieved an accuracy of 100% for distinguishing CD from ISC. There was a good correlation between CTE and the reference standard for distinguishing CD from ISC (κ

  14. Micro-computed Tomographic Analysis of Mandibular Second Molars with C-shaped Root Canals.

    PubMed

    Amoroso-Silva, Pablo Andrés; Ordinola-Zapata, Ronald; Duarte, Marco Antonio Hungaro; Gutmann, James L; del Carpio-Perochena, Aldo; Bramante, Clovis Monteiro; de Moraes, Ivaldo Gomes

    2015-06-01

    The goal of the present study was to evaluate the morphometric aspects of the internal anatomy of the root canal system of mandibular second molars with C-shaped canals. Fifty-two extracted second mandibular molars with C-shaped canals, fused roots, and radicular grooves were selected from a Brazilian population. The samples were scanned with a micro-computed tomographic scanner at a voxel size of 19.6 μm. The root canal cross sections were recorded as C1, C2, C3, and C4 root canal configurations according to the modified Melton classification. Morphometric parameters, including the major and minor diameters of the root canals, the aspect ratio, the roundness, and the tridimensional configuration (merging, symmetric, and asymmetric), were evaluated. The 3-dimensional reconstruction images of the teeth indicated an even distribution within the sample. The analysis of the prevalence of the different cross-sectional configurations of the C-shaped molars revealed that these were predominantly of the C4 and C3 configurations (1 mm from the apex) and the C1 and C2 configurations in the cervical third. According to the morphometric parameters, the C1 and the distal aspect of the C2 configurations exhibited the lowest roundness values and higher values for the area, major diameter, and aspect ratio in the apical third. Mandibular molars with C-shaped root canals exhibited similar distributions of symmetric, asymmetric, and merging type canals. The C1 configuration and the distal aspect of the C2 configuration exhibited the highest area values, low roundness values, and large apical diameters. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  15. Coronary computed tomographic angiographic findings in asymptomatic patients with type 2 diabetes mellitus.

    PubMed

    Park, Gyung-Min; Lee, Seung-Whan; Cho, Young-Rak; Kim, Chan Joon; Cho, Jung Sun; Park, Mahn-Won; Her, Sung Ho; Ahn, Jung-Min; Lee, Jong-Young; Park, Duk-Woo; Kang, Soo-Jin; Kim, Young-Hak; Lee, Cheol Whan; Koh, Eun Hee; Lee, Woo Je; Kim, Min-Seon; Lee, Ki-Up; Kang, Joon-Won; Lim, Tae-Hwan; Park, Seong-Wook; Park, Seung-Jung; Park, Joong-Yeol

    2014-03-01

    There are limited data regarding the role of coronary computed tomographic angiography (CCTA) in asymptomatic patients with type 2 diabetes mellitus. We analyzed 557 asymptomatic type 2 diabetic patients who underwent CCTA. Cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, acute coronary syndrome requiring hospitalization, or late revascularization. Atherosclerotic plaques were observed in 395 patients (70.9%), and 170 patients (30.5%) showed significant coronary artery disease (CAD) on CCTA. Ninety-two patients (16.5%) were associated with a significant stenosis in the left main or proximal left anterior descending artery. During the follow-up period (33.7 ± 7.8 months), although an excellent prognosis was observed in patients without significant CAD on CCTA, those with significant CAD showed more cardiac events (7.1% vs 0.5%) and lower 3-year event-free survival rates (99.2 ± 0.6% vs 90.9 ± 2.6%, p <0.001). Furthermore, in group with significant CAD, patients with significant CAD in the left main or proximal left anterior descending artery had more cardiac events (10.9% vs 2.6%) and lower 3-year event-free survival rates (97.4 ± 1.8% vs 86.1 ± 4.2%, p = 0.049). On multivariate analysis, family history of premature CAD, previous history of stroke, higher UK Prospective Diabetes Study 10-year risk scores, neuropathy, and retinopathy were independent clinical predictors of having significant CAD and left main or proximal left anterior descending artery significant CAD on CCTA. In conclusion, about 1/3 of asymptomatic type 2 diabetic patients had significant CAD on CCTA with a subsequent high risk for cardiac events. These findings suggest that CCTA may have a potential role in identifying patients with high cardiovascular risks in asymptomatic type 2 diabetes.

  16. Saddle Pulmonary Embolism: Laboratory and Computed Tomographic Pulmonary Angiographic Findings to Predict Short-term Mortality.

    PubMed

    Liu, Min; Miao, Ran; Guo, Xiaojuan; Zhu, Li; Zhang, Hongxia; Hou, Qing; Guo, Youmin; Yang, Yuanhua

    2017-02-01

    Saddle pulmonary embolism (SPE) is rare type of acute pulmonary embolism and there is debate about its treatment and prognosis. Our aim is to assess laboratory and computed tomographic pulmonary angiographic (CTPA) findings to predict short-term mortality in patients with SPE. This was a five-centre, retrospective study. The clinical information, laboratory and CTPA findings of 88 consecutive patients with SPE were collected. One-month mortality after diagnosis of SPE was the primary end-point. The correlation of laboratory and CTPA findings with one-month mortality was analysed with area under curve (AUC) of receiver operating characteristic (ROC) curves and logistic regression analysis. Eighteen patients with SPE died within one month. Receiver operating characteristic curves revealed that the cutoff values for the right and left atrial diameter ratio, the right ventricular area and left ventricular area ratio (RVa/LVa ratio), Mastora score, septal angle, N-terminal pro-brain natriuretic peptide and cardiac troponin I (cTnI) for detecting early mortality were 2.15, 2.13, 69%, 57°, 3036 pg/mL and 0.18ng/mL, respectively. Using logistic regression analysis of laboratory and CTPA findings with regard to one-month mortality of SPE, RVa/LVa ratio and cTnI were shown to be independently associated with early death. A combination of cTnI and RVa/LVa ratio revealed an increase in the AUC value, but the difference did not reach significance compared with RVa/LVa or cTnI, alone (P>0.05). In patients with SPE, both the RVa/LVa ratio on CTPA and cTnI appear valuable for the prediction of short-term mortality. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  17. Computed tomographic and radiographic examination of dental structures in South American camelid specimen of different ages

    PubMed Central

    2014-01-01

    Background Tooth root problems and periodontal diseases are common in South American camelids (SAC). The objective was to evaluate and optimize the imaging technique for dental radiography in SAC and to describe the radiographic and computed tomographic (CT) anatomy of normal teeth at different ages. In this study, the heads of 20 healthy SAC slaughtered for meat production or euthanized for reasons not related to dental problems included 7 female and 10 male llamas and 3 male alpacas. Using a standardized protocol, radiographs and CT scans of the 20 specimen were performed. Results The most useful radiographic projections for mandibular and maxillary cheek teeth evaluation turned out to be lateral30°ventral - laterodorsal and lateral30°dorsal - lateroventral with slight separation of the dental arcades respectively. Digital radiographic and CT appearance of the mandibular and maxillary teeth were described from the beginning of mineralization till maturity. In addition the normal range of the CT radio density of different cheek teeth and different dental tissues were measured. Hounsfield units of different dental tissues of SAC turned out to be similar to equids. Deviation, shortening and partial destruction of the distal tooth root of mandibular 09′s and 10′s and of maxillary 09′s was observed and the existence of a common pulp chamber in younger teeth was revealed. Conclusions The present study provides information about the dental imaging morphology in clinically healthy SAC. This basic information provides fundamental knowledge for evaluating images and planning treatments in clinically affected animals. PMID:24393365

  18. A Cone-Beam Computed Tomographic Study on Mandibular First Molars in a Chinese Subpopulation

    PubMed Central

    Ma, Yue; Han, Ting; Chen, Xinyu; Wan, Fang; Lu, Yating; Yan, Songhe; Wang, Yan

    2015-01-01

    The purpose of this study was to conduct a cone-beam computed tomographic (CBCT) investigation on the root and canal configuration of the mandibular first molars, especially the morphology of the disto-lingual (DL) root, in a Chinese subpopulation. A total of 910 CBCT images of the mandibular first molars were collected from 455 patients who underwent CBCT examinations as a preoperative assessment for implants or orthodontic treatment. The following information was analyzed and evaluated: tooth position, gender, root and root canal number per tooth, root canal type of the mesial root(s) and distal root(s), angle of the DL root canal curvature, distance between two distal canal orifices in the teeth with DL root, and angle of disto-buccal canal orifice–disto-lingual canal orifice–mesio-lingual canal orifice (DB-DL-ML). Most of the mandibular first molars (64.9%, n = 591) had two roots with three root canals, and most of the mesial root canals (87.7%, n = 798) were type VI. The prevalence of the DL root was 22.1% (n = 201). The right side had a higher prevalence of DL root than the left side (p<0.05). Additionally, the curvature of the DL root canal were greater in the bucco-lingual (BL) orientation (30.10°±14.02°) than in the mesio-distal (MD) orientation (14.03°± 8.56°) (p<0.05). Overall there was a high prevalence of DL root in the mandibular first molars, and most of the DL roots were curved in different degrees. This study provided detailed information about the root canal morphology of the mandibular first molars in a Chinese subpopulation. PMID:26241480

  19. Computed tomographic angiography as a useful adjunct in the diagnosis of brain death.

    PubMed

    Welschehold, Stefan; Kerz, Thomas; Boor, Stephan; Reuland, Katharina; Thömke, Frank; Reuland, Andre; Beyer, Christian; Tschan, Christoph; Wagner, Wolfgang; Müller-Forell, Wibke; Giese, Alf

    2013-05-01

    Because of its widespread accessibly, computed tomographic angiography (CT-A) is a promising technique in the detection of intracranial circulatory arrest in brain death (BD). Several studies assessed this tool, but neither have standardized evaluation parameters been developed nor has information about specificity become available. We conducted a prospective study between January 2008 and April 2012. Thirty patients were admitted to our University Hospital (16 men and 14 women; age, 18-88 years) and underwent CT-A scanning at two occasions: immediately after the first signs of loss of brain stem reflexes and after definitive determination of brain. The results of CT-A were compared with transcranial Doppler ultrasonography and electroencephalogram. In 3 of 30 patients, we observed a termination of contrast flow at the level of the skull base and foramen magnum in arterial scanning series before the clinical determination of BD. After the clinical determination of BD, the opacification of all vascular territories in arterial phase scanning was found in one case, but venous phase scanning revealed no blood return in internal cerebral veins. In all other cases, contrast filling ceased at level of skull base or below. The specificity of CT-A in the detection of intracranial circulatory arrest was 90%, and sensitivity was 97%. CT-A is reliable and appropriate technical investigation to detect intracranial circulatory arrest in BD. The evaluation of contrast enhancement in arterial phase scanning seems to be more reliable than that in venous phase. An international consensus about a uniformly applied CT-A protocol for the evaluation of BD should be established.

  20. Volumetric Planning Using Computed Tomographic Angiography Improves Clinical Outcomes in DIEP Flap Breast Reconstruction.

    PubMed

    Lee, Kyeong-Tae; Mun, Goo-Hyun

    2016-05-01

    The present study evaluated outcomes of deep inferior epigastric perforator (DIEP) flap breast reconstruction using volumetric planning-which is preoperative planning based on volumetric data of the breast and flap estimated from computed tomographic angiography. A prospective review of three patient cohorts undergoing DIEP flap breast reconstruction from June of 2009 to February of 2015 was performed. Cohort 1 comprised 48 cases in which no volumetric planning was used. Cohort 2 included the next 101 consecutive cases undergoing breast reconstruction according to an algorithm based on volumetric planning. Cohort 3 consisted of the next 109 consecutive cases using a modified algorithm. The inset rate (weight ratio of the inset flap to harvested flap) was estimated during volumetric planning, and specific surgical strategies, such as incorporating multiple perforators, conducting venous augmentation (cohort 2), or harvesting bipedicled flaps (cohort 3), were used with reference to it. Rates of perfusion-related complications were compared. All but one flap survived completely. Fat necrosis occurred in 9.7 percent. Overall, the perfusion-related complication rate was 22.9 percent of cohort 1, 10.9 percent in cohort 2, and 5.6 percent in cohort 3 (p = 0.006). The fat necrosis rates were 19.1, 9.9, and 5.6 percent in cohorts 1, 2, and 3, respectively (p = 0.032). A multivariate analysis demonstrated that volumetric planning had independent benefits for preventing perfusion-related complications (p = 0.003). The authors' results suggest that volumetric planning can facilitate elaborate planning and reduce perfusion-related complications, enabling reliable breast reconstruction using DIEP flaps. Therapeutic, III.

  1. Pulmonary Leptospirosis With Diffuse Alveolar Hemorrhage: High-Resolution Computed Tomographic Findings in 16 Patients.

    PubMed

    von Ranke, Felipe Mussi; Zanetti, Gláucia; Escuissato, Dante Luiz; Hochhegger, Bruno; Marchiori, Edson

    2016-01-01

    The aim of this study was to evaluate the high-resolution computed tomographic (HRCT) findings from patients with leptospirosis and diffuse alveolar hemorrhage (DAH). We retrospectively reviewed HRCT findings from 16 patients diagnosed as having leptospirosis causing DAH. The patient sample was composed of 13 men and 3 women aged 22 to 53 years (mean age, 34.5 years). Diagnosis was established with confirmation of leptospirosis infection by serologic microagglutination test. Histopathological study was performed in 8 patients. Two chest radiologists analyzed the HRCT images and reached decisions by consensus. The predominant HRCT findings were ground-glass opacities and airspace nodules (both n = 12, 75%), ground-glass nodules (n = 9, 56.25%), consolidations (n = 7, 43.75%), "crazy-paving" pattern (n = 3, 18.75%), and interlobular septal thickening without ground-glass opacity (n = 3, 18.75%). Bilateral pleural effusion was an associated finding in 2 (12.5%) patients. Analysis of the axial distribution of the lesions revealed diffuse distribution in 11 (68.75%) patients and peripheral lung zone predominance in 5 (31.25%) patients. Abnormalities were bilateral in all 16 (100%) patients. Analysis of the craniocaudal distribution of the lesions revealed lower zone predominance in 9 (56.25%) patients, diffuse distribution in 5 (31.25%) patients, middle zone predominance in 1 (6.25%) patient, and upper zone predominance in 1 (6.25%) patient. The most frequent HRCT findings in patients with leptospirosis causing DAH were ground-glass opacities, airspace nodules, ground-glass nodules, and consolidations. The lesions showed symmetrical distribution with lower zone predominance in most cases.

  2. Radiation dose to patients and image quality evaluation from coronary 256-slice computed tomographic angiography

    NASA Astrophysics Data System (ADS)

    Chen, Liang-Kuang; Wu, Tung-Hsin; Yang, Ching-Ching; Tsai, Chia-Jung; Lee, Jason J. S.

    2010-07-01

    The aim of this study is to assess radiation dose and the corresponding image quality from suggested CT protocols which depends on different mean heart rate and high heart rate variability by using 256-slice CT. Fifty consecutive patients referred for a cardiac CT examination were included in this study. All coronary computed tomographic angiography (CCTA) examinations were performed on a 256-slice CT scanner with one of five different protocols: retrospective ECG-gating (RGH) with full dose exposure in all R-R intervals (protocol A), RGH of 30-80% pulsing window with tube current modulation (B), RGH of 78±5% pulsing window with tube current modulation (C), prospective ECG-triggering (PGT) of 78% R-R interval with 5% padding window (D) and PGT of 78% R-R interval without padding window (E). Radiation dose parameters and image quality scoring were determined and compared. In this study, no significant differences were found in comparison on image quality of the five different protocols. Protocol A obtained the highest radiation dose comparing with those of protocols B, C, D and E by a factor of 1.6, 2.4, 2.5 and 4.3, respectively ( p<0.001), which were ranged between 2.7 and 11.8 mSv. The PGT could significantly reduce radiation dose delivered to patients, as compared to the RGH. However, the use of PGT has limitations and is only good in assessing cases with lower mean heart rate and stable heart rate variability. With higher mean heart rate and high heart rate variability circumstances, the RGH within 30-80% of R-R interval pulsing window is suggested as a feasible technique for assessing diagnostic performance.

  3. Terminal digit preference biases polyp size measurements at endoscopy, computed tomographic colonography, and histopathology.

    PubMed

    Plumb, Andrew A; Nickerson, Claire; Wooldrage, Katherine; Bassett, Paul; Taylor, Stuart A; Altman, Douglas; Atkin, Wendy; Halligan, Steve

    2016-10-01

    Terminal digit preference bias for "pleasing" numbers has been described in many areas of medicine. The aim of this study was to determine whether endoscopists, radiologists, and pathologists exhibit such bias when measuring colorectal polyp diameters. Colorectal polyp diameters measured at endoscopy, computed tomographic colonography (CTC), and histopathology were collated from a colorectal cancer screening program and two parallel multicenter randomized trials. Smoothing models were fitted to the data to estimate the expected number of polyps at 1-mm increments, assuming no systematic measurement bias. The difference between the expected and observed numbers of polyps was calculated for each terminal digit using statistical modeling. The impact of measurement bias on per-patient detection rates of polyps ≥ 10 mm was estimated for each modality. A total of 92 124 individual polyps were measured by endoscopy (91 670 screening and 454 from trials), 2385 polyps were measured by CTC (1664 screening, 721 trials), and 79 272 were measured by histopathology (78 783 screening, 489 trials). Clustering of polyp diameter measurements at 5-mm intervals was demonstrated for all modalities, both in the screening program and the trials. The statistical models estimated that per-patient detection rates of polyps ≥ 10 mm were over-inflated by 2.4 % for endoscopy, 3.1 % for CTC, and 3.3 % for histopathology in the screening program, with similar trends in the randomized trials. Endoscopists, radiologists, and pathologists all exhibit terminal digit preference when measuring colorectal polyps. This will bias trial data, referral rates for further testing, adenoma surveillance regimens, and comparisons between tests. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Tendon transfer around the shoulder in obstetric brachial plexus paralysis: clinical and computed tomographic study.

    PubMed

    El-Gammal, Tarek Abdalla; Saleh, Waleed Riad; El-Sayed, Amr; Kotb, Mohammed M; Imam, Hesham Mostafa; Fathi, Nihal Ahmad

    2006-01-01

    One hundred nine obstetrical palsy patients with defective shoulder abduction and external rotation had subscapularis release and transfer of teres major to infraspinatus with or without pedicle transfer of the clavicular head of pectoralis major to deltoid. The age at surgery averaged 67 months (11-192) and follow-up averaged 36 months (12-80). Thirty-nine cases had follow-up CT scan of both shoulders. Improvement of abduction averaged 64 degrees and that of external rotation 50 degrees, 100% and 290% gain, respectively. Both negatively correlated with the age at surgery (P < 0.001), and were significantly higher in patients operated younger than 4 years. On computed tomographic scans, the degree of glenoid retroversion positively correlated (P < 0.001) with the age at surgery, and was significantly higher in patients operated older than 4 years. The degree of posterior subluxation showed no significant difference between different ages. There was no significant difference between the operated and normal sides in patients operated younger than 4years with regard to glenoid retroversion and in those operated younger than 2 years with regard to posterior subluxation. The operation is useful for correction of defective shoulder abduction and external rotation in obstetric palsy. It is best performed before the age of 2 to get maximal improvement in motion and prevent secondary bone changes. Between the ages of 2 and 4, it also resulted in significant improvement in motion and prevented glenoid retroversion, but not posterior subluxation. After the age of 4, the improvement in motion was not significant and secondary bone changes were not prevented.

  5. Computed tomographic morphometry of thoracic pedicles: safety margin of transpedicular screw fixation in malaysian malay population.

    PubMed

    Liau, Kai Ming; Yusof, Mohd Imran; Abdullah, Mohd Shafie; Abdullah, Sarimah; Yusof, Abdul Halim

    2006-07-15

    A cross-sectional study of thoracic pedicle morphometry (T1-T12) of 180 Malaysian Malay patients obtained from computed tomographic scan. To determine the safety margin in the placement of thoracic transpedicular screw in the Malay population. Previous studies have shown a significantly smaller thoracic pedicular parameters in Asians compared with whites. The safety margin in the placement of thoracic transpedicular screw in our population therefore needs to be defined. T1-T12 vertebral pedicles were studied in 180 Malay ethnic patients (age range, 18-80 years). The following parameters were studied: transverse outer pedicle diameter, transverse inner pedicle diameter, transverse pedicle angle, chord length, pedicle length, and pedicle cortical thickness. The data obtained were statistically analyzed using Student's t test and ANOVA test. Female patients have significantly smaller dimensions in most of the parameters measured compared with male patients. However, no significant difference was found between age groups. Transverse outer pedicle diameter were widest at T1 (male, 8.42 mm; female, 7.56 mm) and narrowest at T4 (male, 4.56 mm; female, 3.95 mm). Pedicle diameters of less than 5.5 mm were commonly seen at T4 followed by T5, T6, T7, T8, and T9. A significant percentage of patients have an outer diameter of less than 4.5 mm from T4-T7. The medial cortices were 50% thicker than the lateral cortices at most levels. Chord lengths were maximum at T8 and minimum at T1. Transverse pedicle angle were widest at T1 and less than 5 degrees from T7-T12. The results suggest that the current pedicle screw system is not suitable for the majority of Malay population, especially at midthoracic level. The smaller pedicle measurements in Malays may be attributed to their shorter body built compared with whites.

  6. Computed tomographic differences of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-Klebsiella pneumoniae.

    PubMed

    Kim, Sung-Bum; Je, Bo-Kyung; Lee, Kee Yeol; Lee, Seung Hwa; Chung, Hwan-Hoon; Cha, Sang Hoon

    2007-01-01

    To investigate the distinctive computed tomographic(CT) features of pyogenic liver abscess (PLA) caused by Klebsiella pneumoniae (KLA). 114 PLA patients (62 men, 52 women, age range 25-89 years, mean age 60.9 years) with positive yield of blood or pus cultures were divided into 2 groups; KLA group (n = 58) and non-KLA group (n = 56). We retrospectively reviewed the CT images. The independent-sample t-test, X2 test, or Fisher's exact test were used with SPSS for windows version 11.0. Gas formation showed no significant difference between two groups (P = 0.284), but air-fluid pattern was found only in KLA group (P = 0.027). The rim on dynamic CT was showed less frequently in KLA group than non-KLA group (P < 0.001), and smooth and regular rim was more common in non-KLA group (P < 0.001). The septation and septal breakage were more common in KLA group (P < 0.001). The turquoise sign was found significantly more in KLA group (P < 0.001). The hairball sign was detected only in KLA group (P < 0.001). The cluster sign was less frequent in KLA group (P < 0.001). KLA had a series of characteristic intra-abscess features; septal breakage, turquoise-like structure, hairball-like content, air-fluid level, and no enhanced rim. When turquoise/hairball sign or air-fluid level is present in abscess, KLA would be a probable diagnosis in the clinical field.

  7. Stent sizing by coronary computed tomographic angiography: comparison with conventional coronary angiography in an experienced setting.

    PubMed

    de Silva, Ramesh; Mussap, Christian J; Hecht, Harvey S; van Mieghem, Nicolas M; Matarazzo, Thomas J; Roubin, Gary S; Panagopoulos, Georgia

    2011-11-01

    The goal was to compare stent sizing by coronary computed tomographic angiography (CCTA) with that deployed in an experienced setting based upon conventional coronary angiography (CA). Stent sizing is currently performed by visual estimation, with infrequent guidance by intravascular ultrasound. CCTA permits quantitative determination of stent length (Stent L) and diameter (Stent D). Projected L (CTA-Stent L) and D (CTA-Stent D) were determined from CCTA obtained in 248 patients with 352 lesions undergoing percutaneous coronary intervention within 4 months of the CCTA, and were compared to the Stent-L and Stent-D of the actually deployed stents. The effects of lesion modification and calcified plaque were also evaluated. There were significant correlations between CTA-Stent L and Stent L (r = 0.656, P < 0.0001) and between CTA-Stent D and Stent D (r = 0.40, P < 0.001). Median predicted CTA-Stent L was slightly longer (20 mm vs. 18 mm, P < 0.0001) and predicted CTA-Stent D was slightly smaller (3.0 mm vs. 3.2 mm, P < 0.0001) than Stent-L and Stent-D, respectively. The differences were unchanged in stents with lesion modification by pre-dilation or intracoronary nitroglycerin. CTA Stent-L and CTA Stent-D increased significantly with increasing calcium (P < 0.0001 and P = 0.019, respectively). (1) There are significant correlations between CCTA and CA based stent sizing in an experienced setting. (2) CCTA projects slightly longer and slightly smaller diameter stents than those deployed during PCI irrespective of lesion modification; the small differences are unlikely to have clinical significance. (3) CCTA may offer a noninvasive alternative to intravascular ultrasound for stent planning. Copyright © 2011 Wiley-Liss, Inc.

  8. Pediatric small bowel intussusception disease: feasibility of screening for surgery with early computed tomographic evaluation.

    PubMed

    Ko, Sheung-Fat; Tiao, Mao-Meng; Hsieh, Chie-Song; Huang, Fu-Chen; Huang, Chung-Cheng; Ng, Shu-Hang; Lee, Shin-Yee; Chen, Min-Chi

    2010-04-01

    This study investigated the feasibility of early computed tomographic (CT) evaluation and the operative results of pediatric small bowel intussusception with deteriorating ischemic or obstructive symptoms, so-called small bowel intussusception disease (SBID). Between 1988 and 1999, among 18 patients surgically proven SBID (conventional group), 12 mimicked ileocolic intussusception and were conventionally managed with abdominal radiography, ultrasonography, reduction enema, and eventually operation. Between 2000 and 2008, we applied a modified approach with inclusion of early CT evaluation if ultrasonography showed a target lesion suspicious for SBID (diameter

  9. Computed tomographic evaluation of dynamic alteration of the canine lumbosacral intervertebral neurovascular foramina.

    PubMed

    Worth, Andrew J; Hartman, Angela; Bridges, Janis P; Jones, Boyd R; Mayhew, Joe I G

    2017-02-01

    To develop a computed tomographic (CT) method to measure the volume of the lumbosacral intervertebral neurovascular foramina (IVF) in dogs, and determine the effect of the range of motion of the lumbosacral (LS) junction on this measurement in German shepherd dogs (GSDs) with degenerative lumbosacral stenosis (DLSS) compared to unaffected controls. In vivo analysis and retrospective case series. Twenty-four working Police GSDs, 12 diagnosed with DLSS and 12 unaffected by DLSS were compared to 10 Greyhounds without DLSS. Three-dimensional renderings of CT data were used to measure the lumbosacral foraminal volume of dogs positioned in dorsal recumbency with the LS junction alternately positioned in extension, neutral position, and flexion. Volumetric analysis of the IVF was found repeatable for the extended and neutral positions (interclass correlation coefficient of 0.89 and 0.8, respectively). The mean lumbosacral IVF volume was decreased by 74% between LS flexion and extension in Greyhounds, compared to 79 and 85% reductions in GSDs unaffected and affected by DLSS, respectively. The lumbosacral IVF volume was decreased by 23% when comparing extended to neutral LS positions in Greyhounds, 29% in unaffected GSDs, and 31% in affected GSDs. IVF volumes were smaller in affected GSDs compared to unaffected GSDs (P < .05) and Greyhounds (P < .01). Positioning the LS junction in full extension decreases the volume of the lumbosacral IVF. This dynamic narrowing was more pronounced in GSDs with signs of DLSS than in GSDs not overtly affected by DLSS. © 2017 The American College of Veterinary Surgeons.

  10. A method for visualizing high-density porous polyethylene (medpor, porex) with computed tomographic scanning.

    PubMed

    Vendemia, Nicholas; Chao, Jerry; Ivanidze, Jana; Sanelli, Pina; Spinelli, Henry M

    2011-01-01

    Medpor (Porex Surgical, Inc, Newnan, GA) is composed of porous polyethylene and is commonly used in craniofacial reconstruction. When complications such as seroma or abscess formation arise, diagnostic modalities are limited because Medpor is radiolucent on conventional radiologic studies. This poses a problem in situations where imaging is necessary to distinguish the implant from surrounding tissues. To present a clinically useful method for imaging Medpor with conventional computed tomographic (CT) scanning. Eleven patients (12 total implants) who have undergone reconstructive surgery with Medpor were included in the study. A retrospective review of CT scans done between 1 and 16 months postoperatively was performed using 3 distinct CT window settings. Measurements of implant dimensions and Hounsfield units were recorded and qualitatively assessed. Of the 3 distinct window settings studied, namely, "bone" (W1100/L450), "soft tissue"; (W500/L50), and "implant" (W800/L200), the implant window proved the most ideal, allowing the investigators to visualize and evaluate Medpor in all cases. Qualitative analysis revealed that Medpor implants were able to be distinguished from surrounding tissue in both the implant and soft tissue windows, with a density falling between that of fat and fluid. In 1 case, Medpor could not be visualized in the soft tissue window, although it could be visualized in the implant window. Quantitative analysis demonstrated a mean (SD) density of -38.7 (7.4) Hounsfield units. Medpor may be optimally visualized on conventional CT scans using the implant window settings W800/L200, which can aid in imaging Medpor and diagnosing implant-related complications.

  11. A Cone-Beam Computed Tomographic Study on Mandibular First Molars in a Chinese Subpopulation.

    PubMed

    Zhang, Xin; Xiong, Shijiang; Ma, Yue; Han, Ting; Chen, Xinyu; Wan, Fang; Lu, Yating; Yan, Songhe; Wang, Yan

    2015-01-01

    The purpose of this study was to conduct a cone-beam computed tomographic (CBCT) investigation on the root and canal configuration of the mandibular first molars, especially the morphology of the disto-lingual (DL) root, in a Chinese subpopulation. A total of 910 CBCT images of the mandibular first molars were collected from 455 patients who underwent CBCT examinations as a preoperative assessment for implants or orthodontic treatment. The following information was analyzed and evaluated: tooth position, gender, root and root canal number per tooth, root canal type of the mesial root(s) and distal root(s), angle of the DL root canal curvature, distance between two distal canal orifices in the teeth with DL root, and angle of disto-buccal canal orifice-disto-lingual canal orifice-mesio-lingual canal orifice (DB-DL-ML). Most of the mandibular first molars (64.9%, n = 591) had two roots with three root canals, and most of the mesial root canals (87.7%, n = 798) were type VI. The prevalence of the DL root was 22.1% (n = 201). The right side had a higher prevalence of DL root than the left side (p<0.05). Additionally, the curvature of the DL root canal were greater in the bucco-lingual (BL) orientation (30.10°±14.02°) than in the mesio-distal (MD) orientation (14.03°± 8.56°) (p<0.05). Overall there was a high prevalence of DL root in the mandibular first molars, and most of the DL roots were curved in different degrees. This study provided detailed information about the root canal morphology of the mandibular first molars in a Chinese subpopulation.

  12. Association of Multiorgan Computed Tomographic Phenomap With Adverse Cardiovascular Health Outcomes: The Framingham Heart Study.

    PubMed

    Shah, Ravi V; Yeri, Ashish S; Murthy, Venkatesh L; Massaro, Joe M; D'Agostino, Ralph; Freedman, Jane E; Long, Michelle T; Fox, Caroline S; Das, Saumya; Benjamin, Emelia J; Vasan, Ramachandran S; O'Donnell, Christopher J; Hoffmann, Udo

    2017-09-20

    Increased ability to quantify anatomical phenotypes across multiple organs provides the opportunity to assess their cumulative ability to identify individuals at greatest susceptibility for adverse outcomes. To apply unsupervised machine learning to define the distribution and prognostic importance of computed tomography-based multiorgan phenotypes associated with adverse health outcomes. This asymptomatic community-based cohort study included 2924 Framingham Heart Study participants between July 2002 and April 2005 undergoing computed tomographic imaging of the chest and abdomen. Participants are from the offspring and third-generation cohorts. Eleven computed tomography-based measures of valvular/vascular calcification, adiposity, and muscle attenuation. All-cause mortality and cardiovascular disease (myocardial infarction, stroke, or cardiovascular death). The median age of the participants was 50 years (interquartile range, 43-60 years), and 1422 (48.6%) were men. Principal component analysis identified 3 major anatomic axes: (1) global calcification (defined by aortic, thoracic, coronary, and valvular calcification); (2) adiposity (defined by pericardial, visceral, hepatic, and intrathoracic fat); and (3) muscle attenuation that explained 65.7% of the population variation. Principal components showed different evolution with age (continuous increase in global calcification, decrease in muscle attenuation, and U-shaped association with adiposity) but similar patterns in men and women. Using unsupervised clustering approaches in the offspring cohort (n = 1150), we identified a cohort (n = 232; 20.2%) with an unfavorable multiorgan phenotype across all 3 anatomic axes as compared with a favorable multiorgan phenotype. Membership in the unfavorable phenotypic cluster was associated with a greater prevalence of cardiovascular disease risk factors and with increased all-cause mortality (hazard ratio, 2.61; 95% CI, 1.74-3.92; P < .001), independent of

  13. Cost-Effectiveness of Computed Tomographic Colonography Screening for Colorectal Cancer in the Medicare Population

    PubMed Central

    Lansdorp-Vogelaar, Iris; Rutter, Carolyn M.; Savarino, James E.; van Ballegooijen, Marjolein; Kuntz, Karen M.; Zauber, Ann G.

    2010-01-01

    Background The Centers for Medicare and Medicaid Services (CMS) considered whether to reimburse computed tomographic colonography (CTC) for colorectal cancer screening of Medicare enrollees. To help inform its decision, we evaluated the reimbursement rate at which CTC screening could be cost-effective compared with the colorectal cancer screening tests that are currently reimbursed by CMS and are included in most colorectal cancer screening guidelines, namely annual fecal occult blood test (FOBT), flexible sigmoidoscopy every 5 years, flexible sigmoidoscopy every 5 years in conjunction with annual FOBT, and colonoscopy every 10 years. Methods We used three independently developed microsimulation models to assess the health outcomes and costs associated with CTC screening and with currently reimbursed colorectal cancer screening tests among the average-risk Medicare population. We assumed that CTC was performed every 5 years (using test characteristics from either a Department of Defense CTC study or the National CTC Trial) and that individuals with findings of 6 mm or larger were referred to colonoscopy. We computed incremental cost-effectiveness ratios for the currently reimbursed screening tests and calculated the maximum cost per scan (ie, the threshold cost) for the CTC strategy to lie on the efficient frontier. Sensitivity analyses were performed on key parameters and assumptions. Results Assuming perfect adherence with all tests, the undiscounted number life-years gained from CTC screening ranged from 143 to 178 per 1000 65-year-olds, which was slightly less than the number of life-years gained from 10-yearly colonoscopy (152–185 per 1000 65-year-olds) and comparable to that from 5-yearly sigmoidoscopy with annual FOBT (149–177 per 1000 65-year-olds). If CTC screening was reimbursed at $488 per scan (slightly less than the reimbursement for a colonoscopy without polypectomy), it would be the most costly strategy. CTC screening could be cost-effective at

  14. Should computed tomographic colonography replace optical colonoscopy in screening for colorectal cancer?

    PubMed

    Veerappan, Ganesh R; Cash, Brooks D

    2009-04-01

    Clinical evidence amassed over the last several decades indicates that routine colorectal cancer (CRC) screening, compared to no screening, detects CRC at an earlier stage, reduces the incidence of CRC or the progression early CRC through polypectomy, and reduces CRC mortality. Computed tomographic colonography (CTC) is a minimally invasive, structural evaluation of the entire colorectum that has recently been advocated by multiple American professional medical societies as an effective alternative for CRC screening. The potential advantages of CTC, including rapid image acquisition and processing, non-invasiveness, and decreased procedural risks of perforation, bleeding, and sedation complications may serve to improve the low rates of colorectal cancer screening that are currently observed in our society. Several large studies of CTC as a CRC screening test have reported excellent results but have been criticized because of the expertise of CTC interpreters participating in those trials. As a response to these criticisms, the long-awaited results of the American College of Radiology Imaging Network (ACRIN) National CT Colonography Trial were recently published. The purpose of this study was to assess the accuracy of CTC in a "community based" environment to determine if previous results obtained at expert sites could be replicated. All CTC were confirmed and compared to conventional colonoscopy, the gold-standard colorectal cancer screening test. For polyps >10 mm, the results obtained in the ACRIN trial were comparable to previous studies with a mean CTC sensitivity of 90% and a mean CTC specificity of 86%. The sensitivity of CTC fell to 78% for lesions >6 mm, a value that some studies have suggested is comparable to the detection rate of conventional colonoscopy. This study adds to the body of literature regarding the efficacy of CTC and will likely be cited by many as evidence supporting CTC as an acceptable CRC screening test, in the same league as colonoscopy

  15. Physiological and computed tomographic predictors of outcome from lung volume reduction surgery.

    PubMed

    Washko, George R; Martinez, Fernando J; Hoffman, Eric A; Loring, Stephen H; Estépar, Raúl San José; Diaz, Alejandro A; Sciurba, Frank C; Silverman, Edwin K; Han, MeiLan K; Decamp, Malcolm; Reilly, John J

    2010-03-01

    Previous investigations have identified several potential predictors of outcomes from lung volume reduction surgery (LVRS). A concern regarding these studies has been their small sample size, which may limit generalizability. We therefore sought to examine radiographic and physiologic predictors of surgical outcomes in a large, multicenter clinical investigation, the National Emphysema Treatment Trial. To identify objective radiographic and physiological indices of lung disease that have prognostic value in subjects with chronic obstructive pulmonary disease being evaluated for LVRS. A subset of the subjects undergoing LVRS in the National Emphysema Treatment Trial underwent preoperative high-resolution computed tomographic (CT) scanning of the chest and measures of static lung recoil at total lung capacity (SRtlc) and inspiratory resistance (Ri). The relationship between CT measures of emphysema, the ratio of upper to lower zone emphysema, CT measures of airway disease, SRtlc, Ri, the ratio of residual volume to total lung capacity (RV/TLC), and both 6-month postoperative changes in FEV(1) and maximal exercise capacity were assessed. Physiological measures of lung elastic recoil and inspiratory resistance were not correlated with improvement in either the FEV(1) (R = -0.03, P = 0.78 and R = -0.17, P = 0.16, respectively) or maximal exercise capacity (R = -0.02, P = 0.83 and R = 0.08, P = 0.53, respectively). The RV/TLC ratio and CT measures of emphysema and its upper to lower zone ratio were only weakly predictive of postoperative changes in both the FEV(1) (R = 0.11, P = 0.01; R = 0.2, P < 0.0001; and R = 0.23, P < 0.0001, respectively) and maximal exercise capacity (R = 0.17, P = 0.0001; R = 0.15, P = 0.002; and R = 0.15, P = 0.002, respectively). CT assessments of airway disease were not predictive of change in FEV(1) or exercise capacity in this cohort. The RV/TLC ratio and CT measures of emphysema and its distribution are weak but statistically significant

  16. A Survey of Cone-beam Computed Tomographic Use among Endodontic Practitioners in the United States.

    PubMed

    Setzer, Frank C; Hinckley, Nathan; Kohli, Meetu R; Karabucak, Bekir

    2017-05-01

    Cone-beam computed tomographic (CBCT) imaging is an emerging technology for clinical endodontic practice. The aim of this study was to investigate the acceptance, accessibility, and usage of CBCT imaging among American Association of Endodontists members in the United States by means of an online survey. An invitation to participate in a web-based survey was sent to 3076 members of the American Association of Endodontists. The survey consisted of 8 questions on demographics, access to CBCT machines, field of view (FOV), frequency of use for particular applications, and reasons in case CBCT was not used. A total of 1083 participants completed the survey, giving an overall completed response rate of 35.2%; 80.30% of the participants had access to a CBCT scan, of which 50.69% (n = 443) were on-site and 49.31% (n = 431) were off-site, and 19.30% of all respondents denied having access to CBCT imaging. Limited FOV was used by 55.26% participants, 22.37% used larger FOV formats, and the remaining 22.37% were not sure about the format. There was a significantly greater usage of CBCT technology in residency programs (n = 78/84 [92.86%]) compared with practitioners who had finished an endodontic specialty program (n = 796/999 [79.68%]) (χ(2) = 10.30, P = .02). Practitioners used CBCT imaging "frequent" or "always" for internal or external resorptions (47.28%), preoperatively for surgical retreatment or intentional replantation (45.34%), missing canals (25.39%), preoperatively for nonsurgical retreatments (24.91%), differential diagnosis (21.16%), identifying periradicular lesions (18.26%), calcified cases (13.54%), immature teeth (4.71%), and to assess healing (3.87%). There was a significant difference in on-site and off-site CBCT imaging use for any of these applications (P < .001). Prevalent reasons for not using CBCT technology were cost (53.79%) and lack of installation space (8.29%). General concerns were expressed about resolution limitations, radiation

  17. Virtual pathology: a new paradigm for interpretation of computed tomographic colonography

    NASA Astrophysics Data System (ADS)

    Reed, Judd E.; Johnson, C. Daniel

    1998-06-01

    Computed tomographic colonography (CTC or virtual colonoscopy) is a new technique for imaging the colon for the detection of colorectal neoplasm. Early clinical assessment of this procedure has shown that the performance of this test is acceptable for colorectal screening examinations. The current version of CTC utilizes an interactive combination of axial, reformatted 2D and 3D images (from an endoluminal perspective) that are generated in real time. Navigating the colorectum within the virtual endoscopy (VE) metaphor is tedious. To alleviate this problem and free the radiologist to concentrate on diagnosis, a two pass approach has been adopted. In the first pass, the colon is semiautomatically navigated and its midline is recorded. Then in a second pass, the radiologist moves the view point (virtual endoscope tip) along this midline. This second pass alone takes from 15 to 40 minutes per scan. Additional volume rendered displays have been developed which show longer segments of the colon in formats analogous to views which may be seen at autopsy. These include a technique called planar virtual pathology' (PVP) which uses image planes of the two longitudinal transcolonic sections as cut planes within isometric volume rendered images. Scenes are rendered with rays passing orthogonally through these planes from both sides. Each of the four resulting images depicts approximately one half of the inner surface of a 12 cm bowel segment. Interpretation is performed by viewing these colon segments at approximately 8 cm intervals. In this way, the entire colon can be rapidly examined with a minimum of navigational input from the radiologist. Other virtual pathology views have also been developed. These include cylindrical virtual pathology (CVP) and mercator virtual pathology (MVP). CVP views are formed by casting rays perpendicular to a straight line which approximates a segment of the colon midline. These views are analogous to the result of splitting a segment of

  18. Physiological and Computed Tomographic Predictors of Outcome from Lung Volume Reduction Surgery

    PubMed Central

    Washko, George R.; Martinez, Fernando J.; Hoffman, Eric A.; Loring, Stephen H.; Estépar, Raúl San José; Diaz, Alejandro A.; Sciurba, Frank C.; Silverman, Edwin K.; Han, MeiLan K.; DeCamp, Malcolm; Reilly, John J.

    2010-01-01

    Rationale: Previous investigations have identified several potential predictors of outcomes from lung volume reduction surgery (LVRS). A concern regarding these studies has been their small sample size, which may limit generalizability. We therefore sought to examine radiographic and physiologic predictors of surgical outcomes in a large, multicenter clinical investigation, the National Emphysema Treatment Trial. Objectives: To identify objective radiographic and physiological indices of lung disease that have prognostic value in subjects with chronic obstructive pulmonary disease being evaluated for LVRS. Methods: A subset of the subjects undergoing LVRS in the National Emphysema Treatment Trial underwent preoperative high-resolution computed tomographic (CT) scanning of the chest and measures of static lung recoil at total lung capacity (SRtlc) and inspiratory resistance (Ri). The relationship between CT measures of emphysema, the ratio of upper to lower zone emphysema, CT measures of airway disease, SRtlc, Ri, the ratio of residual volume to total lung capacity (RV/TLC), and both 6-month postoperative changes in FEV1 and maximal exercise capacity were assessed. Measurements and Main Results: Physiological measures of lung elastic recoil and inspiratory resistance were not correlated with improvement in either the FEV1 (R = −0.03, P = 0.78 and R = –0.17, P = 0.16, respectively) or maximal exercise capacity (R = –0.02, P = 0.83 and R = 0.08, P = 0.53, respectively). The RV/TLC ratio and CT measures of emphysema and its upper to lower zone ratio were only weakly predictive of postoperative changes in both the FEV1 (R = 0.11, P = 0.01; R = 0.2, P < 0.0001; and R = 0.23, P < 0.0001, respectively) and maximal exercise capacity (R = 0.17, P = 0.0001; R = 0.15, P = 0.002; and R = 0.15, P = 0.002, respectively). CT assessments of airway disease were not predictive of change in FEV1 or exercise capacity in this cohort. Conclusions: The RV/TLC ratio and CT measures

  19. Evaluating the Toxicity Reduction With Computed Tomographic Ventilation Functional Avoidance Radiation Therapy.

    PubMed

    Faught, Austin M; Miyasaka, Yuya; Kadoya, Noriyuki; Castillo, Richard; Castillo, Edward; Vinogradskiy, Yevgeniy; Yamamoto, Tokihiro

    2017-10-01

    Computed tomographic (CT) ventilation imaging is a new modality that uses 4-dimensional (4D) CT information to calculate lung ventilation. Although retrospective studies have reported on the reduction in dose to functional lung, no work to our knowledge has been published in which the dosimetric improvements have been translated to a reduction in the probability of pulmonary toxicity. Our work estimates the reduction in toxicity for CT ventilation-based functional avoidance planning. Seventy previously treated lung cancer patients who underwent 4DCT imaging were used for the study. CT ventilation maps were calculated with 4DCT deformable image registration and a density change-based algorithm. Pneumonitis was graded on the basis of imaging and clinical presentation. Maximum likelihood methods were used to generate normal tissue complication probability (NTCP) models predicting grade 2 or higher (2+) and grade 3+ pneumonitis as a function of dose (V5 Gy, V10 Gy, V20 Gy, V30 Gy, and mean dose) to functional lung. For 30 patients a functional plan was generated with the goal of reducing dose to the functional lung while meeting Radiation Therapy Oncology Group 0617 constraints. The NTCP models were applied to the functional plans and the clinically used plans to calculate toxicity reduction. By the use of functional avoidance planning, absolute reductions in grade 2+ NTCP of 6.3%, 7.8%, and 4.8% were achieved based on the mean fV20 Gy, fV30 Gy, and mean dose to functional lung metrics, respectively. Absolute grade 3+ NTCP reductions of 3.6%, 4.8%, and 2.4% were achieved with fV20 Gy, fV30 Gy, and mean dose to functional lung. Maximum absolute reductions of 52.3% and 16.4% were seen for grade 2+ and grade 3+ pneumonitis for individual patients. Our study quantifies the possible toxicity reduction from CT ventilation-based functional avoidance planning. Reductions in grades 2+ and 3+ pneumonitis were 7.1% and 4.7% based on mean dose-function metrics, with

  20. Dual-source computed tomographic coronary angiography: image quality and stenosis diagnosis in patients with high heart rates.

    PubMed

    Zheng, Minwen; Li, Jiayi; Xu, Jian; Chen, Kang; Zhao, Hongliang; Huan, Yi

    2009-01-01

    We sought to evaluate prospectively the effects of heart rate and heart-rate variability on dual-source computed tomographic coronary image quality in patients whose heart rates were high, and to determine retrospectively the accuracy of dual-source computed tomographic diagnosis of coronary artery stenosis in the same patients.We compared image quality and diagnostic accuracy in 40 patients whose heart rates exceeded 70 beats/min with the same data in 40 patients whose heart rates were 70 beats/min or slower. In both groups, we analyzed 1,133 coronary arterial segments. Five hundred forty-five segments (97.7%) in low-heart-rate patients and 539 segments (93.7%) in high-heart-rate patients were of diagnostic image quality. We considered P < 0.05 to be statistically significant. No statistically significant differences between the groups were found in diagnostic-image quality scores of total segments or of any coronary artery, nor were any significant differences found between the groups in the accurate diagnosis of angiographically significant stenosis.Calcification was the chief factor that affected diagnostic accuracy. In high-heart-rate patients, heart-rate variability was significantly related to the diagnostic image quality of all segments (P = 0.001) and of the left circumflex coronary artery (P = 0.016). Heart-rate variability of more than 5 beats/min most strongly contributed to an inability to evaluate segments in both groups. When heart rates rose, the optimal reconstruction window shifted from diastole to systole.The image quality of dual-source computed tomographic coronary angiography at high heart rates enables sufficient diagnosis of stenosis, although variability of heart rates significantly deteriorates image quality.

  1. Collateral Status on Baseline Computed Tomographic Angiography and Intra-Arterial Treatment Effect in Patients With Proximal Anterior Circulation Stroke.

    PubMed

    Berkhemer, Olvert A; Jansen, Ivo G H; Beumer, Debbie; Fransen, Puck S S; van den Berg, Lucie A; Yoo, Albert J; Lingsma, Hester F; Sprengers, Marieke E S; Jenniskens, Sjoerd F M; Lycklama À Nijeholt, Geert J; van Walderveen, Marianne A A; van den Berg, René; Bot, Joseph C J; Beenen, Ludo F M; Boers, Anna M M; Slump, Cornelis H; Roos, Yvo B W E M; van Oostenbrugge, Robert J; Dippel, Diederik W J; van der Lugt, Aad; van Zwam, Wim H; Marquering, Henk A; Majoie, Charles B L M

    2016-03-01

    Recent randomized trials have proven the benefit of intra-arterial treatment (IAT) with retrievable stents in acute ischemic stroke. Patients with poor or absent collaterals (preexistent anastomoses to maintain blood flow in case of a primary vessel occlusion) may gain less clinical benefit from IAT. In this post hoc analysis, we aimed to assess whether the effect of IAT was modified by collateral status on baseline computed tomographic angiography in the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN). MR CLEAN was a multicenter, randomized trial of IAT versus no IAT. Primary outcome was the modified Rankin Scale at 90 days. The primary effect parameter was the adjusted common odds ratio for a shift in direction of a better outcome on the modified Rankin Scale. Collaterals were graded from 0 (absent) to 3 (good). We used multivariable ordinal logistic regression analysis with interaction terms to estimate treatment effect modification by collateral status. We found a significant modification of treatment effect by collaterals (P=0.038). The strongest benefit (adjusted common odds ratio 3.2 [95% confidence intervals 1.7-6.2]) was found in patients with good collaterals (grade 3). The adjusted common odds ratio was 1.6 [95% confidence intervals 1.0-2.7] for moderate collaterals (grade 2), 1.2 [95% confidence intervals 0.7-2.3] for poor collaterals (grade 1), and 1.0 [95% confidence intervals 0.1-8.7] for patients with absent collaterals (grade 0). In MR CLEAN, baseline computed tomographic angiography collateral status modified the treatment effect. The benefit of IAT was greatest in patients with good collaterals on baseline computed tomographic angiography. Treatment benefit appeared less and may be absent in patients with absent or poor collaterals. URL: http://www.trialregister.nl and http://www.controlled-trials.com. Unique identifier: (NTR)1804 and ISRCTN10888758, respectively. © 2016

  2. Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery.

    PubMed

    Pouleur, Anne-Catherine; le Polain de Waroux, Jean-Benoît; Kefer, Joëlle; Pasquet, Agnès; Coche, Emmanuel; Vanoverschelde, Jean-Louis; Gerber, Bernhard L

    2007-12-01

    Preoperative identification of significant coronary artery disease (CAD) in patients prior to valve surgery requires systematic invasive coronary angiography. The purpose of this current prospective study was to evaluate whether exclusion of CAD by multi-detector CT (MDCT) might potentially avoid systematic cardiac catheterization in these patients. Eighty-two patients (53 males, 62 +/- 13 years) scheduled to undergo valve surgery underwent 40-slice MDCT before invasive quantitative coronary angiography (QCA). According to QCA, 15 patients had CAD (5 one-vessel, 6 two-vessel and 4 three-vessel disease). The remaining 67 patients had no CAD. On a per-vessel basis, MDCT correctly identified 27/29 (sensitivity 93%) vessels with and excluded 277/299 vessels (specificity 93%) without CAD. On a per-patient basis, MDCT correctly identified 14/15 patients with (sensitivity 93%) and 60/67 patients without CAD (specificity 90%). Positive and negative predictive values of MDCT were 67% and 98%. Performing invasive angiography only in patients with abnormal MDCT might have avoided QCA in 60/82 (73%). MDCT could be potentially useful in the preoperative evaluation of patients with valve disease. By selecting only those patients with coronary lesions to undergo invasive coronary angiography, it could avoid cardiac catheterization in a large number of patients without CAD.

  3. Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography.

    PubMed

    Shen, Quanli; Yao, Qiong; Hu, Xihong

    2016-09-01

    Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40-97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66-100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography.

  4. Costs and clinical outcomes after coronary multidetector CT angiography in patients without known coronary artery disease: comparison to myocardial perfusion SPECT.

    PubMed

    Min, James K; Kang, Ning; Shaw, Leslee J; Devereux, Richard B; Robinson, Matthew; Lin, Fay; Legorreta, Antonio P; Gilmore, Amanda

    2008-10-01

    To assess costs and clinical outcomes in individuals without known coronary artery disease (CAD) who underwent multidetector computed tomographic (CT) angiography compared with those in matched patients who underwent myocardial perfusion single photon emission computed tomography (SPECT). Data were captured from a deidentified, HIPAA-compliant data warehouse. We examined 1-year CAD costs (additional diagnostic coronary testing, CAD hospitalization, and coronary procedural and revascularization costs) and clinical outcomes in individuals without known CAD who underwent multidetector CT (n = 1647) compared with those in a matched cohort of patients who underwent myocardial perfusion SPECT (n = 6588). Cox proportional hazards models were employed for clinical outcome measures, including CAD hospitalization, myocardial infarction, and angina. Adjusted CAD costs in the multidetector CT group were 25.9% lower than in the myocardial perfusion SPECT group, by an average of $1075 (95% confidence interval [CI]: $243, $2570) per patient. Those in the multidetector CT group were more likely to undergo downstream testing with myocardial perfusion SPECT (odds ratio, 6.65; 95% CI: 5.05, 8.75; P < .001), while those in the myocardial perfusion SPECT group were more likely to undergo downstream testing with invasive angiography (odds ratio, 6.25; 95% CI: 4.35, 9.09; P < .001). The multidetector CT group was less likely to undergo coronary revascularization (hazard ratio, 0.76; 95% CI: 0.75, 0.77; P < .001) than the myocardial perfusion SPECT group. There was no significant difference between multidetector CT and myocardial perfusion SPECT groups for rates of myocardial infarction (0.4% for both) or CAD hospitalization (0.7% vs 1.1%, respectively), while rates of angina were significantly lower in the multidetector CT group (4.3% vs 6.4%, P < .001). Individuals without known CAD who underwent multidetector CT as an initial diagnostic test, compared with those who underwent

  5. Root Canal Treatment of Mandibular Second Premolar with Three Separate Roots and Canals Using Spiral Computed Tomographic

    PubMed Central

    Hariharavel, V. P.; Kumar, A. Ashok; Ganesh, C.; Aravindhan, R.

    2014-01-01

    Anatomic and internal morphology of a root canal system is more complex and differs for each individual tooth of which mandibular premolars have earned the reputation for having aberrant anatomy. The occurrence of three canals with three separate foramina in mandibular second premolars is very rare. A wider knowledge on both clinical and radiological anatomy especially spiral computed tomographic is absolutely essential for the success of endodontic treatment. These teeth may require skillful and special root canal special shaping and obturating techniques. This paper reports an unusual case of a mandibular second premolar with atypical canal pattern that was successfully treated endodontically. PMID:25101187

  6. Good visibility of TITAN-2 coronary stents demonstrable on cardiac computer tomographic angiography: a report of 2 cases.

    PubMed

    Ong, Paul Jau; Jau, Ong Paul; Ho, Hee Hwa; Hwa, Ho Hee; Jafary, Fahim Haider; Haider, Jafary Fahim; Loh, Kwok Kong; Kong, Loh Kwok; Ooi, Yau Wei; Wei, Ooi Yau; Wong, Chun Pong; Pong, Wong Chun; Foo, David; David, Foo

    2011-09-01

    Numerous studies have sought to assess stent patency by cardiac computer tomographic angiography (CCTA) in comparison with invasive coronary angiography in patients who had undergone percutaneous coronary stenting. Even with newer generation scanners, CCTA has been of limited value in the assessment of the revascularized patient. The main reason being blooming artifact from metallic stents often obscures stent luminal dimension, making the stented segment unassessable. We report on a novel finding of good visibility of TITAN-2 coronary stents demonstrable on CCTA for 2 patients and discuss the possible mechanism and potential implications of this observation.

  7. Organ dose assessment in pediatric fluoroscopy and CT via a tomographic computational phantom of the newborn patient

    NASA Astrophysics Data System (ADS)

    Staton, Robert J.

    Of the various types of imaging modalities used in pediatric radiology, fluoroscopy and computed tomography (CT) have the highest associated radiation dose. While these examinations are commonly used for pediatric patients, little data exists on the magnitude of the organ and effective dose values for these procedures. Calculation of these dose values is necessary because of children's increased sensitivity to radiation and their long life expectancy for which to express radiation's latent effects. In this study, a newborn tomographic phantom has been implemented in a radiation transport code to evaluate organ and effective doses for newborn patients in commonly performed fluoroscopy and CT examinations. Organ doses were evaluated for voiding cystourethrogram (VCUG) fluoroscopy studies of infant patients. Time-sequence analysis was performed for videotaped VCUG studies of five different patients. Organ dose values were then estimated for each patient through Monte Carlo (MC) simulations. The effective dose values of the VCUG examination for five patients ranged from 0.6 mSv to 3.2 mSv, with a mean of 1.8 +/- 0.9 mSv. Organ doses were also assessed for infant upper gastrointestinal (UGI) fluoroscopy exams. The effective dose values of the UGI examinations for five patients ranged from 1.05 mSv to 5.92 mSv, with a mean of 2.90 +/- 1.97 mSv. MC simulations of helical multislice CT (MSCT) exams were also completed using, the newborn tomographic phantom and a stylized newborn phantom. The helical path of the source, beam shaping filter, beam profile, patient table, were all included in the MC simulations of the helical MSCT scanner. Organ doses and effective doses and their dependence on scan parameters were evaluated for newborn patients. For all CT scans, the effective dose was found to range approximately 1-13 mSv, with the largest values occurring for CAP scans. Tube current modulation strategies to reduce patient dose were also evaluated for newborn patients

  8. Pericardial fat amount is an independent risk factor of coronary artery stenosis assessed by multidetector-row computed tomography: the Korean Atherosclerosis Study 2.

    PubMed

    Kim, Tae Hyuk; Yu, Sung Hoon; Choi, Sung Hee; Yoon, Ji Won; Kang, Seon Mee; Chun, Eun Ju; Choi, Sang Il; Shin, Hayley; Lee, Hong Kyu; Park, Kyong Soo; Jang, Hak Chul; Lim, Soo

    2011-05-01

    Pericardial fat surrounding the heart and coronary arteries might aggravate vessel wall inflammation and stimulate the progression of coronary atherosclerosis. However, there has been little comprehensive evaluation of the effects of pericardial fat on coronary artery disease (CAD). We investigated the relationship between pericardial fat volume and the severity of coronary artery stenosis assessed by computed tomography and angiography among patients with suspected CAD. Participants from the cohort of the Korean Atherosclerosis Study 2 (n = 402, mean age of 54 years, 57.0% men) underwent 64-slice multidetector-row computed tomography (MDCT) to assess pericardial fat amount, coronary artery calcium score (CACS), severity of coronary artery stenosis, and plaque characteristics. Patients with atherosclerotic lesion had significantly larger volume of pericardial fat than patients without atherosclerosis (308 ± 96 cm(3) vs. 251 ± 93 cm(3); P < 0.01). In a multivariate regression analysis adjusting for age, gender and BMI, subjects with more pericardial fat had a higher risk for significant (>50%) stenosed coronary vessels (odds ratio (OR) = 1.012; 95% confidence interval (CI) 1.001-1.030; P = 0.017). This association remained after adjusting for hypertension, diabetes, smoking status, and lipid profiles (OR = 1.007; 95% CI 1.001-1.014; P = 0.042). In conclusion, an increased pericardial fat volume was an independent risk factor for stenotic CAD and could be helpful in assessing subclinical CADs.

  9. Does the Degree of Perihepatitis Have Any Relevance to the Severity of the Manifestations of Pelvic Inflammatory Disease on Multidetector Computed Tomography?

    PubMed

    Kim, Ji Su; Kim, Hyun Cheol; Kim, Sang Won; Yang, Dal Mo; Rhee, Sun Jung; Shin, Jong Soo

    2015-01-01

    This study aimed to evaluate the relationship between the degree of perihepatitis and the severity of pelvic inflammatory disease (PID) on multidetector computed tomography (MDCT). A total of 177 women with PID who underwent biphasic abdominal computed tomography (CT) scans were enrolled. Two reviewers retrospectively reviewed the CT scans with consensus and subjectively categorized the severity of PID into 4 grades (normal, mild, moderate, and severe). Another reviewer independently assigned the extent (grades 0 to 4) and the depth (grades 0 to 4) of hepatic surface enhancement in terms of the degree of perihepatitis. Relationships between the degree of perihepatitis and the CT severity as well as each CT manifestation of PID were evaluated using the χ test or a cumulative logistic regression analysis. Of the 177 patients, 99 (55.9%) showed hepatic surface enhancement. The severity of PID on MDCT was significantly related with the degree of perihepatitis (all P < 0.001). Salpingitis, oophoritis, pelvic fat haziness, complicated ascites, and omental/mesenteric fat infiltration were significantly related with the degree of perihepatitis (all P < 0.05). Among these variables, omental/mesenteric fat infiltration (odds ratio = 10.9) and salpingitis (odds ratio = 6.0) were the CT manifestations that were most associated with the presence of perihepatitis in PID. The degree of perihepatitis seems to show a relationship with the severity of PID on MDCT. Omental/mesenteric fat infiltration and salpingitis can be strongly related with perihepatitis in PID.

  10. Sex Differences in Patients With CAM Deformities With Femoroacetabular Impingement: 3-Dimensional Computed Tomographic Quantification.

    PubMed

    Yanke, Adam B; Khair, M Michael; Stanley, Robert; Walton, David; Lee, Simon; Bush-Joseph, Charles A; Espinoza Orías, Alejandro; Espinosa Orias, Alejandro A; Inoue, Nozomu; Nho, Shane J

    2015-12-01

    To determine if significant differences exist between male and female CAM deformities using quantitative 3-dimensional (3D) volume and location analysis. Retrospective analysis of preoperative computed tomographic (CT) scans for 138 femurs (69 from male patients and 69 from female patients) diagnosed with impingement from November 2009 to November 2011 was completed. Those patients who presented with hip complaints and had a history, physical examination (limited range of motion, positive impingement signs), plain radiographs (anteroposterior pelvis, 90° Dunn view, false profile view), and magnetic resonance images consistent with femoroacetabular impingement (FAI) and in whom a minimum of 6 months of conservative therapy (oral anti-inflammatory agents, physical therapy, and activity modification) had failed were indicated for arthroscopic surgery and had a preoperative CT scan. Scans were segmented, converted to point cloud data, and analyzed with a custom-written computer program. Analysis included mean CAM height and volume, head radius, and femoral version. Differences were analyzed using an unpaired t test with significance set at P < .05. Female patients had greater femoral anteversion compared with male patients (female patients, 15.5° ± 8.3°; male patients, 11.3° ± 9.0°; P = .06). Male femoral head radii were significantly larger than female femoral heads (female patients, 22.0 ± 1.3 mm; male patients, 25.4 ± 1.3 mm; P < .001). Male CAM height was significantly larger than that in female patients (female patients, 0.66 ± 0.61 mm; male patients, 1.51 ± 0.75 mm; P < .001). Male CAM volume was significantly larger as well (male patients, 433 ± 471 mm(3); female patients, 89 ± 124 mm(3); P < .001). These differences persisted after normalizing height (P < .001) and volume (P < .001) to femoral head radius. Average clock face distribution was from the 1:09 o'clock position ± the 2:51 o'clock position to the 3:28 o'clock position ± the 1:59 o

  11. Computer-aided detection of pulmonary embolism in computed tomographic pulmonary angiography (CTPA): performance evaluation with independent data sets.

    PubMed

    Zhou, Chuan; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M; Chughtai, Aamer; Patel, Smita; Wei, Jun; Cascade, Philip N; Kazerooni, Ella A

    2009-08-01

    The authors are developing a computer-aided detection system for pulmonary emboli (PE) in computed tomographic pulmonary angiography (CTPA) scans. The pulmonary vessel tree is extracted using a 3D expectation-maximization segmentation method based on the analysis of eigen-values of Hessian matrices at multiple scales. A parallel multiprescreening method is applied to the segmented vessels to identify volume of interests (VOIs) that contained suspicious PE. A linear discriminant analysis (LDA) classifier with feature selection is designed to reduce false positives (FPs). Features that characterize the contrast, gray level, and size of PE are extracted as input predictor variables to the LDA classifier. With the IRB approval, 59 CTPA PE cases were collected retrospectively from the patient files (UM cases). With access permission, 69 CTPA PE cases were randomly selected from the data set of the prospective investigation of pulmonary embolism diagnosis (PIOPED) II clinical trial. Extensive lung parenchymal or pleural diseases were present in 22/59 UM and 26/69 PIOPED cases. Experienced thoracic radiologists manually marked 595 and 800 PE as the reference standards in the UM and PIOPED data sets, respectively. PE occlusion of arteries ranged from 5% to 100%, with PE located from the main pulmonary artery to the subsegmental artery levels. Of the 595 PE identified in the UM cases, 245 and 350 PE were located in the subsegmental arteries and the more proximal arteries, respectively. The detection performance was assessed by free response ROC (FROC) analysis. The FROC analysis indicated that the PE detection system could achieve an overall sensitivity of 80% at 18.9 FPs/case for the PIOPED cases when the LDA classifier was trained with the UM cases. The test sensitivity with the UM cases was 80% at 22.6 FPs/cases when the LDA classifier was trained with the PIOPED cases. The detection performance depended on the arterial level where the PE was located and on the

  12. Computer-aided detection of pulmonary embolism in computed tomographic pulmonary angiography (CTPA): Performance evaluation with independent data sets

    PubMed Central

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

    2009-01-01

    The authors are developing a computer-aided detection system for pulmonary emboli (PE) in computed tomographic pulmonary angiography (CTPA) scans. The pulmonary vessel tree is extracted using a 3D expectation-maximization segmentation method based on the analysis of eigenvalues of Hessian matrices at multiple scales. A parallel multiprescreening method is applied to the segmented vessels to identify volume of interests (VOIs) that contained suspicious PE. A linear discriminant analysis (LDA) classifier with feature selection is designed to reduce false positives (FPs). Features that characterize the contrast, gray level, and size of PE are extracted as input predictor variables to the LDA classifier. With the IRB approval, 59 CTPA PE cases were collected retrospectively from the patient files (UM cases). With access permission, 69 CTPA PE cases were randomly selected from the data set of the prospective investigation of pulmonary embolism diagnosis (PIOPED) II clinical trial. Extensive lung parenchymal or pleural diseases were present in 22∕59 UM and 26∕69 PIOPED cases. Experienced thoracic radiologists manually marked 595 and 800 PE as the reference standards in the UM and PIOPED data sets, respectively. PE occlusion of arteries ranged from 5% to 100%, with PE located from the main pulmonary artery to the subsegmental artery levels. Of the 595 PE identified in the UM cases, 245 and 350 PE were located in the subsegmental arteries and the more proximal arteries, respectively. The detection performance was assessed by free response ROC (FROC) analysis. The FROC analysis indicated that the PE detection system could achieve an overall sensitivity of 80% at 18.9 FPs∕case for the PIOPED cases when the LDA classifier was trained with the UM cases. The test sensitivity with the UM cases was 80% at 22.6 FPs∕cases when the LDA classifier was trained with the PIOPED cases. The detection performance depended on the arterial level where the PE was located and on the

  13. Visualisation of passive middle ear implants by cone beam and multi-detector computed tomography: a comparative in vitro study.

    PubMed

    Nguyen, T D; Kösling, S; Mlynski, R; Plontke, S K

    2016-12-01

    Modern passive middle ear titanium prostheses are filigree structures, resulting in poorer depiction on CT compared to prostheses used in the past. We compared the visibility of newer prostheses on cone beam CT (CBCT) to multi-detector CT (MDCT) with standard and lower dose in vitro, and analysed image noise and metal artefacts. Six different titanium middle ear prostheses (three partial and one total ossicular replacement prostheses, two stapes prostheses) were implanted twice in formalin-fixed head specimens-first correctly and then with displacement. Imaging was performed using standard CBCT and MDCT as well as MDCT with lower dose (36 single imaging investigations). Images were analysed with knowledge of the used types of middle ear prostheses, but blinded with respect to the positioning in the specific case. On all images the type of prostheses and their positions could be clearly recognized. Their identifiability including their details was rated as statistically significantly higher for all CBCT investigations than for MDCT. MDCT with lower dose showed the worst results. No statistical differences were found in image noise and metal artefacts. If available, CBCT should be preferred over MDCT in diagnostic evaluation of passive middle ear prostheses. • Middle ear prostheses became more filigree, leading to poorer visibility on CT. • High spatial resolution and paraxial reconstructions are necessary requirements for imaging evaluation. • CBCT and MDCT can identify type and positioning of titanium prostheses. • Metal artefacts play a minor part in filigree titanium prostheses. • Regarding visualisation of prostheses details, cone beam CT aids the evaluation.

  14. [Extra-organic primary tumor in pelvis: correlation of multi-detector row computed tomography, anatomy and pathology].

    PubMed

    Dong, Zhihui; Yang, Zhigang; Li, Yuan; Min, Pengqiu; Zhang, Xiaochun

    2009-02-01

    The purpose of this study was to investigate the correlation between multi-detector row CT (MDCT) features, pathological findings and the anatomic basis of extra-organic primary tumors in pelvis so as to improve the document diagnosis of these entities. We retrospectively analyzed the MDCT manifestations of 20 cases with surgically and/or pathologically evidenced diagnoses of extra-organic primary tumors in pelvis. The results showed that, in 14 cases, the tumors were located in the pelvis, and 6 of them involved both pelvis and hypogastric zone. There were 8 tumors located in the peritoneal cavity of the pelvis, and 3 of them also involved the extraperitoneal space of the pelvis. In the peritoneal cavity, 2 tumors of male patients were located in the rectovesical pouch while 3 tumors of female patients were located in the rectouterine pouch. The majority of entities in these 2 pouches were germ cell tumors (3/5 cases, 60.0%). In the extraperitoneal space, 5 of 12 tumors were located in the pararectal space and 5 of them were located in the retrorectal space. The majority entities of these 10 cases were germ cell tumors (7/10 cases, 70.0%). Lymphoma mainly involved paravesical and pararectal space in disorder. Calcification occurred in 6 cases, including 4 cases of teratoma, 1 case of neurilemmoma, and 1 case of malignant teratoma. The fatty element occurred in 7 masses, including 4 cases of teratoma, 1 case of malignant teratoma, 1 case of mixed germ cell tumor, and 1 case of liposarcoma. MDCT with multi-planar reconstruction (MPR) could more clearly reveal the anatomic location of the extra-organic primary tumor in pelvis, could unveil the tumor's relationship with its surrounding organs, and could help to differentiate benign tumors from malignant tumors.

  15. Can computed tomographic gastrography and multiplanar reformatting aid the laparoscopic surgeon in planning a gastric resection? A pictorial essay.

    PubMed

    Zalev, Arthur H; Grantcharov, Teodor; Deitel, Wayne

    2013-02-01

    To assess the value and feasibility of computed tomographic gastrography and multiplanar reformatting in the preoperative evaluation of patients undergoing laparoscopic gastric resection. Fourteen patients with gastric lesions were included in the study. A supine scan was performed after a hypotonic drug, an effervescent agent, and intravenous contrast. This was followed by delayed prone and decubitus scans. We created multiplanar reformats, transparency rendered images, and endoluminal images. The tumours were localized, and distances were measured to the esophagogastric junction and the pylorus. Eleven patients underwent resections. Seven had laparoscopic wedge resections for aberrant pancreas (1 patient), carcinoid (1), Castleman disease (1), and gastrointestinal stromal tumours (GISTs) (4). One patient had an open subtotal gastrectomy for carcinoma due to adhesions. One had a hand-assisted sleeve resection for a gastrointestinal stromal tumour. Two had hand-assisted total gastrectomies for carcinoma and a GIST. For surgical planning, the surgeon rated the imaging extremely useful in 7 and useful in 4. Imaging was extremely useful or useful to localize laparoscopically invisible tumours in 6 patients and to relate tumours to the esophagogastric junction or pylorus and to assess localized vs extensive resection in 8. Correlation was excellent between the preoperative imaging and the intraoperative findings. Computed tomographic gastrography and multiplanar reformatting are useful aids in preoperative planning of laparoscopic gastric resections. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  16. Tuning the cache memory usage in tomographic reconstruction on standard computers with Advanced Vector eXtensions (AVX).

    PubMed

    Agulleiro, Jose-Ignacio; Fernandez, Jose-Jesus

    2015-06-01

    Cache blocking is a technique widely used in scientific computing to minimize the exchange of information with main memory by reusing the data kept in cache memory. In tomographic reconstruction on standard computers using vector instructions, cache blocking turns out to be central to optimize performance. To this end, sinograms of the tilt-series and slices of the volumes to be reconstructed have to be divided into small blocks that fit into the different levels of cache memory. The code is then reorganized so as to operate with a block as much as possible before proceeding with another one. This data article is related to the research article titled Tomo3D 2.0 - Exploitation of Advanced Vector eXtensions (AVX) for 3D reconstruction (Agulleiro and Fernandez, 2015) [1]. Here we present data of a thorough study of the performance of tomographic reconstruction by varying cache block sizes, which allows derivation of expressions for their automatic quasi-optimal tuning.

  17. The early development of medial coronoid disease in growing Labrador retrievers: radiographic, computed tomographic, necropsy and micro-computed tomographic findings.

    PubMed

    Lau, S F; Wolschrijn, C F; Hazewinkel, H A W; Siebelt, M; Voorhout, G

    2013-09-01

    Medial coronoid disease (MCD) encompasses lesions of the entire medial coronoid process (MCP), both of the articular cartilage and the subchondral bone. To detect the earliest signs of MCD, radiography and computed tomography were used to monitor the development of MCD in 14 Labrador retrievers, from 6 to 7 weeks of age until euthanasia. The definitive diagnosis of MCD was based on necropsy and micro-computed tomography findings. The frequency of MCD in the dogs studied was 50%. Radiographic findings did not provide evidence of MCD, ulnar subtrochlear sclerosis or blunting of the cranial edge of the MCP. Computed tomography was more sensitive (30.8%) than radiography (0%) in detecting early MCD, with the earliest signs detectable at 14 weeks of age. A combination of the necropsy and micro-computed tomography findings of the MCP showed that MCD was manifested as a lesion of only the subchondral bone in dogs <18 weeks of age. In all dogs (affected and unaffected), there was close contact between the base of the MCP and the proximal radial head in the congruent joints. Computed tomography and micro-computed tomography findings indicated that the lesions of MCD probably originated at the base of the MCP. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Optimizing contrast media injection protocols in state-of-the art computed tomographic angiography.

    PubMed

    Lell, Michael M; Jost, Gregor; Korporaal, Johannes Georg; Mahnken, Andreas Horst; Flohr, Thomas G; Uder, Michael; Pietsch, Hubertus

    2015-03-01

    Very short acquisition times and the increasing use of low-kilovolt protocols in standard computed tomographic (CT) angiography (CTA) examinations demand modifications in the contrast media (CM) injection regimen. The aim of this study was to optimize the use of tube voltage-adjusted CM delivery parameters, especially injection duration and iodine delivery rate (IDR), in thoracoabdominal CTA in a porcine model. Eight pigs (53-72 kg) were examined with a third-generation dual-source CT system with a dynamic CTA protocol (4-dimensional spiral, 454-mm scan length, 2.5-second temporal resolution, 70-second total acquisition time). Six CM injection protocols were applied in randomized order and intraindividually compared. The standard CTA protocol was performed at 120 kV, with an injection of 300 mg iodine/kg body weight and a flow of 5 mL/s (IDR, 1.5 g/s). On the basis of phantom measurements for the low-kilovolt CTA protocols, the iodine dosage was adjusted to 150 mg iodine/kg (70 kV) and 210 mg iodine/kg (90 kV). Therefore, either the IDR was kept constant and the injection time was reduced, or the injection time was kept constant and the IDR was reduced by modifying the CM flow or concentration. Time attenuation curves, time to peak, and peak enhancement were calculated for different locations within the aorta, renal arteries, and large veins. The heart rates were comparable among the different injection protocols (66.9-78.1 beats per minute). The average injection peak pressure depended on the flow rate and CM concentration and ranged from 42.9 to 114.7 psi. The average arterial peak enhancement was comparable for protocols with identical injection times and reduced IDR (362.4 HU [standard 120-kV protocol; 300 mg iodine/kg; IDR, 1.5 g/s], 360.0 HU [70 kV; 150 mg iodine/kg; IDR, 0.75 g/s], 365.4 HU [70 kV; 150 mg iodine/kg; IDR, 0.75 g/s; CM, 150 mg iodine/mL], 344.3 HU [90 kV; 210 mg iodine/kg; IDR, 1.1 g/s]). Higher peak enhancements could be achieved by applying

  19. Use of CA-125 Tests and Computed Tomographic Scans for Surveillance in Ovarian Cancer.

    PubMed

    Esselen, Katharine M; Cronin, Angel M; Bixel, Kristin; Bookman, Michael A; Burger, Robert A; Cohn, David E; Cristea, Mihaela; Griggs, Jennifer J; Levenback, Charles F; Mantia-Smaldone, Gina; Meyer, Larissa A; Matulonis, Ursula A; Niland, Joyce C; Sun, Charlotte; O'Malley, David M; Wright, Alexi A

    2016-11-01

    A 2009 randomized clinical trial demonstrated that using cancer antigen 125 (CA-125) tests for routine surveillance in ovarian cancer increases the use of chemotherapy and decreases patients' quality of life without improving survival, compared with clinical observation. The Society of Gynecologic Oncology guidelines categorize CA-125 testing as optional and discourage the use of radiographic imaging for routine surveillance. To date, few studies have examined the use of CA-125 tests in clinical practice. To examine the use of CA-125 tests and computed tomographic (CT) scans in clinical practice before and after the 2009 randomized clinical trial and to estimate the economic effect of surveillance testing. A prospective cohort of 1241 women with ovarian cancer in clinical remission after completion of primary cytoreductive surgery and chemotherapy at 6 National Cancer Institute-designated cancer centers between January 1, 2004, and December 31, 2011, was followed up through December 31, 2012, to study the use of CA-125 tests and CT scans before and after 2009. Data analysis was conducted from April 9, 2014, to March 28, 2016. The use of CA-125 tests and CT scans before and after 2009. Secondary outcomes included the time from CA-125 markers doubling to retreatment among women who experienced a rise in CA-125 markers before and after 2009, and the costs associated with surveillance testing using 2015 Medicare reimbursement rates. Among 1241 women (mean [SD] age 59 [12] years; 1112 white [89.6%]), the use of CA-125 testing and CT scans was similar during the study period. During 12 months of surveillance, the cumulative incidence of patients undergoing 3 or more CA-125 tests was 86% in 2004-2009 vs 91% in 2010-2012 (P = .95), and the cumulative incidence of patients undergoing more than 1 CT scan was 81% in 2004-2009 vs 78% in 2010-2012 (P = .50). Among women whose CA-125 markers doubled (n = 511), there was no significant difference in the time to

  20. Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma

    PubMed Central

    Nishida, Y; Matsue, Y; Suehara, Y; Fukumoto, K; Fujisawa, M; Takeuchi, M; Ouchi, E; Matsue, K

    2015-01-01

    Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and −44.5 , −20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7% P=0.002) and extramedullary disease (10.4% vs 0% P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival. PMID:26230953

  1. Incidence of Venous Thromboembolism Using 64 Channel Multidetector Row Computed Tomography-Indirect Venography and Anti-Coagulation Therapy after Total Knee Arthroplasty in Korea

    PubMed Central

    Park, Kyung-Hyun; Cheon, Sang-Ho; Lee, Ji-Ho

    2012-01-01

    Purpose This study evaluated the incidence of a venous thromboembolism (VTE) after total knee arthroplasty (TKA) using multidetector row computed tomography-indirect venography (MDCT-indirect venography) and assessed the efficacy of anti-coagulation therapy. Materials and Methods We enrolled 118 patients with 126 cases of TKA. The average age of the patients was 68.4 years. We used 64 channel MDCT-indirect venography for the detection of VTE. We treated selectively proximal deep vein thrombosis (DVT) or pulmonary thromboembolism (PTE) cases according to the results of MDCT-indirect venography. We re-evaluated the change in VTE using follow-up MDCT-indirect venography after 3 months. Results We identified VTE in 35.7%. DVT only was identified in 22.2% including 8 cases of proximal DVT and 20 cases of distal DVT. PTE without DVT was identified in 4.8%, and combined DVT and PTE in 8.7%. All patients with PTE were asymptomatic, but 4 DVT patients had signs of leg swelling. After anti-coagulation therapy, 20 patients showed complete resolution in 16 cases, improvement in 3 cases and one case showed a new distal DVT. Conclusions The incidence of VTE after primary TKA was 35.7% in Korea. Furthermore, anti-coagulation therapy for proximal DVT and PTE patients may be a useful method for preventing the occurrence of a fatal PTE. PMID:22570848

  2. The Role of Multidetector Computed Tomography in the Early Diagnosis of Invasive Pulmonary Aspergillosis in Patients with Febrile Neutropenia Undergoing Hematopoietic Stem Cell Transplantation

    PubMed Central

    Çiledağ, Nazan; Arda, Kemal; Arıbaş, Bilgin Kadri; Tekgündüz, Ali Irfan Emre; Altuntaş, Fevzi

    2012-01-01

    Objective: To evaluate vessel involvement and the role of multidetector computed tomography (MDCT) in the earlydiagnosis of invasive pulmonary aspergillosis (IPA) in patients with febrile neutropenia and antibiotic-resistant feverundergoing autologous bone morrow transplantation. Material and Methods: In all, 74 pulmonary MDCT examinations in 37 consecutive hematopoietic stem celltransplantation patients with febrile neutropenia and clinically suspected IPA were retrospectively evaluated. Results: Diagnosis of IPA was based on Fungal Infections Cooperative Group, and National Institute of Allergy andInfectious Diseases Mycoses Study Consensus Group criteria. In all, 0, 14, and 11 patients were diagnosed as proven,probable, and possible IPA, respectively. Among the 25 patients accepted as probable and possible IPA, all had pulmonaryMDCT findings consistent with IPA. The remaining 12 patients were accepted as having fever of unknown origin (FUO)and had patent vessels based on MDCT findings.In the patients with probable and possible IPA, 72 focal pulmonary lesions were observed; in 41 of the 72 (57%) lesionsvascular occlusion was noted and the CT halo sign was observed in 25 of these 41 (61%) lesions. Resolution of feveroccurred following antifungal therapy in 19 (76%) of the 25 patients with probable and possible IPA. In all, 6 (25%)of the patients diagnosed as IPA died during follow-up. Transplant-related mortality 100 d post transplant in patientswith IPA and FUO was 24% and 0%, respectively. Conclusion: In conclusion, MDCT has a potential role in the early diagnosis of IPA via detection of vessel occlusion. PMID:24744620

  3. Optic Strut and Para-clinoid Region – Assessment by Multi-detector Computed Tomography with Multiplanar and 3 Dimensional Reconstructions

    PubMed Central

    Ravikiran, S.R.; Kumar, Ashvini; Chavadi, Channabasappa; Pulastya, Sanyal

    2015-01-01

    Purpose To evaluate thickness, location and orientation of optic strut and anterior clinoid process and variations in paraclinoid region, solely based on multidetector computed tomography (MDCT) images with multiplanar (MPR) and 3 dimensional (3D) reconstructions, among Indian population. Materials and Methods Ninety five CT scans of head and paranasal sinuses patients were retrospectively evaluated with MPR and 3D reconstructions to assess optic strut thickness, angle and location, variations like pneumatisation, carotico-clinoid foramen and inter-clinoid osseous ridge. Results Mean optic strut thickness was 3.64mm (±0.64), optic strut angle was 42.67 (±6.16) degrees. Mean width and length of anterior clinoid process were 10.65mm (±0.79) and 11.20mm (±0.95) respectively. Optic strut attachment to sphenoid body was predominantly sulcal as in 52 cases (54.74%) and was most frequently attached to anterior 2/5th of anterior clinoid process, seen in 93 sides (48.95%). Pneumatisation of optic strut occurred in 23 sides. Carotico-clinoid foramen was observed in 42 cases (22.11%), complete foramen in 10 cases (5.26%), incomplete foramen in 24 cases (12.63%) and contact type in 8 cases (4.21%). Inter-clinoid osseous bridge was seen unilaterally in 4 cases. Conclusion The study assesses morphometric features and anatomical variations of paraclinoid region using MDCT 3D and multiplanar reconstructions in Indian population. PMID:26557589

  4. Sensitivity of endoscopic ultrasound, multidetector computed tomography, and magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum: a tertiary center experience.

    PubMed

    Kushnir, Vladimir M; Wani, Sachin B; Fowler, Kathryn; Menias, Christine; Varma, Rakesh; Narra, Vamsi; Hovis, Christine; Murad, Faris M; Mullady, Daniel K; Jonnalagadda, Sreenivasa S; Early, Dayna S; Edmundowicz, Steven A; Azar, Riad R

    2013-04-01

    There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent endoscopic retrograde pancreatography and cross-sectional imaging. The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than the sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) (P < 0.001 for each). On review by expert radiologists, the sensitivity of MDCT increased to 83.3% in cases where the pancreatic duct was visualized, with fair IOA (κ = 0.34). Expert review of MRCPs did not identify any additional cases of pancreas divisum; IOA was moderate (κ = 0.43). Endoscopic ultrasound is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum.

  5. SENSITIVITY OF ENDOSCOPIC ULTRASOUND, MULTIDETECTOR COMPUTER TOMOGRAPHY AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY IN THE DIAGNOSIS OF PANCREAS DIVISUM: A TERTIARY CENTER EXPERIENCE

    PubMed Central

    Kushnir, Vladimir M.; Wani, Sachin B.; Fowler, Kathryn; Menias, Christine; Varma, Rakesh; Narra, Vamsi; Hovis, Christine; Murad, Faris; Mullady, Daniel; Jonnalagadda, Sreenivasa S.; Early, Dayna S.; Edmundowicz, Steven A.; Azar, Riad R.

    2014-01-01

    OBJECTIVES There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: 1. Evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP) and multi-detector computed tomography (MDCT) for pancreas divisum. 2. Assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. METHODS For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography (ERP) who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent ERP and cross-sectional imaging. RESULTS The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) [p<0.001 for each]. On review by expert radiologists the sensitivity of MDCT increased to 83.3% in cases where the pancreatic duct was visualized, with fair IOA (қ=0.34). Expert review of MRCPs did not identify any additional cases of pancreas divisum; IOA was moderate (қ=0.43). CONCLUSIONS EUS is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum. PMID:23211370

  6. Multidetector computed tomography for the evaluation of coronary artery disease; the diagnostic accuracy in calcified coronary arteries, comparing with IVUS imaging.

    PubMed

    Park, Jong Kwan; Kim, Jong Youn; Kwon, Hyuck Moon; Kim, Tae Hoon; Oh, Seung-Jin; Hong, Bum-Kee; Yoon, Young Won; Min, Pil-Ki; Kwon, Sung Woo; Lee, Byoung Kwon

    2014-05-01

    Contrast enhanced multidetector computed tomography (MDCT) has been used as an alternative to coronary angiography for the assessment of coronary artery disease in the patient of the intermediate risk group. However, coronary calcium is a known limiting factor for MDCT evaluation. We investigated the diagnostic accuracy of 64-channel MDCT with each coronary artery calcium score (CACS) by compared with intravascular ultrasound (IVUS) imaging. A total of 54 symptomatic patients with intermediate-risk (10 females, mean age 59.9±6.9 years, Framingham point scores 9-20) with 162 sites who had a culprit lesion on 64-channel MDCT before performing coronary angiography with IVUS were enrolled. Patients were divided into 4 subgroups depending on CACS: 0, 1-99, 100-399, and >400. Lesion length, external elastic membrane (EEM) cross sectional area (CSA), minimal luminal area, and plaque area were measured and compared between IVUS and MDCT. The correlation coefficients for the measurements of the EEM CSA, lumen CSA, and plaque area were r=0.514, r=0.837, and r=0.578, respectively. Furthermore, there were close correlation of plaque area between four subgroups of CACS (r=0.671, r=0.623, r=0.562, r=0.571, respectively). Despite the increase in CACS, the geometric analysis of coronary arteries using with 64-channel MDCT was comparable with IVUS in symptomatic patient of the intermediate risk group.

  7. Multidetector Computed Tomography for the Evaluation of Coronary Artery Disease; The Diagnostic Accuracy in Calcified Coronary Arteries, Comparing with IVUS Imaging

    PubMed Central

    Park, Jong Kwan; Kim, Jong Youn; Kwon, Hyuck Moon; Kim, Tae Hoon; Oh, Seung-Jin; Hong, Bum-Kee; Yoon, Young Won; Min, Pil-Ki; Kwon, Sung Woo

    2014-01-01

    Purpose Contrast enhanced multidetector computed tomography (MDCT) has been used as an alternative to coronary angiography for the assessment of coronary artery disease in the patient of the intermediate risk group. However, coronary calcium is a known limiting factor for MDCT evaluation. We investigated the diagnostic accuracy of 64-channel MDCT with each coronary artery calcium score (CACS) by compared with intravascular ultrasound (IVUS) imaging. Materials and Methods A total of 54 symptomatic patients with intermediate-risk (10 females, mean age 59.9±6.9 years, Framingham point scores 9-20) with 162 sites who had a culprit lesion on 64-channel MDCT before performing coronary angiography with IVUS were enrolled. Patients were divided into 4 subgroups depending on CACS: 0, 1-99, 100-399, and >400. Lesion length, external elastic membrane (EEM) cross sectional area (CSA), minimal luminal area, and plaque area were measured and compared between IVUS and MDCT. Results The correlation coefficients for the measurements of the EEM CSA, lumen CSA, and plaque area were r=0.514, r=0.837, and r=0.578, respectively. Furthermore, there were close correlation of plaque area between four subgroups of CACS (r=0.671, r=0.623, r=0.562, r=0.571, respectively). Conclusion Despite the increase in CACS, the geometric analysis of coronary arteries using with 64-channel MDCT was comparable with IVUS in symptomatic patient of the intermediate risk group. PMID:24719125

  8. Pulmonary vein morphology by free-breathing whole heart magnetic resonance imaging at 3 Tesla versus breathhold multi-detector computed tomography.

    PubMed

    Fodi, Eszter; McAreavey, Dorothea; Abd-Elmoniem, Khaled Z; Ohayon, Jacques; Saba, Magdi; Elagha, Abdalla; Pettigrew, Roderic I; Gharib, Ahmed M

    2013-04-01

    To compare pulmonary vein and left atrial anatomy using three-dimensional free-breathing whole-heart magnetic resonance imaging (MR) at 3 Tesla (T) and multi-detector computed tomography (MDCT). Thirty-three subjects (19 male, age 49 ± 12 years) underwent free-breathing 3T MR and contrast-enhanced MDCT during inspiratory breath hold. Pulmonary vein parameters (ostial areas, diameters, angles) were measured. All pulmonary veins and anomalies were identified by 3T MR and by MDCT. The right-sided pulmonary veins were directed more posteriorly, the right superior pulmonary vein more inferiorly, and the right inferior pulmonary vein more superiorly by 3T MR when compared with MDCT. The cross-sectional area, perimeters and minimum diameters of right-sided pulmonary vein ostia were significantly larger by MR, as were the maximum diameters of right and left inferior pulmonary veins. There were no significant differences between techniques in distance to first pulmonary vein branch. Pulmonary vein measurements demonstrated significant differences in angulations and dimensions when 3T MR is compared with MDCT. These differences likely represent hemodynamic and respiratory variation during free-breathing with MR versus breath-holding with MDCT. MR imaging at 3T during free-breathing offers an alternate method to define pulmonary vein and left atrial anatomy without exposure to radiation. Copyright © 2012 Wiley Periodicals, Inc.

  9. SU-F-207-01: Comparison of Beam Characteristics and Organ Dose From Four Commercial Multidetector Computed Tomography Scanners

    SciTech Connect

    Ohno, T; Araki, F

    2015-06-15

    Purpose: To compare dosimetric properties and patient organ doses from four commercial multidetector CT (MDCT) using Monte Carlo (MC) simulation based on the absorbed dose measured using a Farmer chamber and cylindrical water phantoms according to AAPM TG-111. Methods: Four commercial MDCT were modeled using the GMctdospp (IMPS, Germany) based on the EGSnrc user code. The incident photon spectrum and bowtie filter for MC simulations were determined so that calculated values of aluminum half-value layer (Al-HVL) and off-center ratio (OCR) profile in air agreed with measured values. The MC dose was calibrated from absorbed dose measurements using a Farmer chamber and cylindrical water phantoms. The dose distributions of head, chest, and abdominal scan were calculated using patient CT images and mean organ doses were evaluated from dose volume histograms. Results: The HVLs at 120 kVp of Brilliance, LightSpeed, Aquilion, and SOMATOM were 9.1, 7.5, 7.2, and 8.7 mm, respectively. The calculated Al-HVLs agreed with measurements within 0.3%. The calculated and measured OCR profiles agreed within 5%. For adult head scans, mean doses for eye lens from Brilliance, LightSpeed, Aquilion, and SOMATOM were 21.7, 38.5, 47.2 and 28.4 mGy, respectively. For chest scans, mean doses for lung from Brilliance, LightSpeed, Aquilion, and SOMATOM were 21.1, 26.1, 35.3 and 24.0 mGy, respectively. For adult abdominal scans, the mean doses for liver from Brilliance, LightSpeed, Aquilion, and SOMATOM were 16.5, 21.3, 22.7, and 18.0 mGy, respectively. The absorbed doses increased with decreasing Al-HVL. The organ doses from Aquilion were two greater than those from Brilliance in head scan. Conclusion: MC dose distributions based on absorbed dose measurement in cylindrical water phantom are useful to evaluate individual patient organ doses.

  10. Acetabular Cartilage Thickness: Accuracy of Three-Dimensional Reconstructions from Multidetector CT Arthrograms in a Cadaver Study1

    PubMed Central

    Allen, Bryce C; Peters, Christopher L.; Brown, Nicholas A. T.; Anderson, Andrew E.

    2010-01-01

    Purpose: To prospectively quantify the accuracy of hip cartilage thickness estimated from three-dimensional (3D) surfaces, generated by segmenting multidetector computed tomographic (CT) arthrograms by using direct physical measurements of cartilage thickness as the reference standard. Materials and Methods: Four fresh-frozen cadaver hip joints from two male donors, ages 43 and 46 years, were obtained; institutional review board approval for cadaver research was also obtained. Sixteen holes were drilled perpendicular to the cartilage of four cadaveric acetabula (two specimens). Hip capsules were surgically closed, injected with contrast material, and scanned by using multidetector CT. After scanning, 5.3-mmcores were harvested concentrically at each drill hole and cartilage thickness was measured with a microscope. Cartilage was reconstructed in 3D by using commercial software. Segmentations were repeated by two authors. Reconstructed cartilage thickness was determined by using a published algorithm. Bland-Altman plots and linear regression were used to assess accuracy. Repeatability was quantified by using the coefficient of variation, intraclass correlation coefficient (ICC), repeatability coefficient, and percentage variability. Results: Cartilage was reconstructed to a bias of −0.13 mm and a repeatability coefficient of ±0.46 mm. Regression of the scatterplots indicated a tendency for multidetector CT to overestimate thickness. Intra- and interobserver repeatability were very good. For intraobserver correlation, the coefficient of variation was 14.80%, the ICC was 0.88, the repeatability coefficient was 0.55 mm, and the percentage variability was 11.77%. For interobserver correlation, the coefficient of variation was 13.47%, the ICC was 0.90, the repeatability coefficient was 0.52 mm, and the percentage variability was 11.63%. Conclusion: Assuming that an accuracy of approximately ±0.5 mm is sufficient, reconstructions of cartilage geometry from

  11. Comparison of enhancement and image quality: different iodine concentrations for liver on 128-slice multidetector computed tomography in the same chronic liver disease patients.

    PubMed

    Jo, Byoung Goo; Song, Yun Gyu; Shim, Sang Goon; Kim, Young Wook

    2016-05-01

    The objective of this study was to compare the degree of hepatic enhancement and image quality using contrast media of different iodine concentrations with the same iodine dose. From July 2011 to June 2013, 50 patients with chronic liver disease who underwent baseline and follow-up 128-slice multidetector computed tomography(MDCT) using contrast media with 350 mg I/mL (group A) and 400 mg I/mL (group B) iodine concentrations were included in this prospective study. The patients were randomly allocated to one of two protocols: 350 mg I/mL initially and then 400 mg I/mL; and 400 mg I/mL initially and then 350 mg I/mL. The bolus tracking technique was used to initiate the arterial phase scan. The computed tomography values of hepatic parenchyma, abdominal aorta and portal vein were measured. The degrees of hepatic and vascular enhancement were rated on a 4-point scale for qualitative assessment. The paired Student t test was used to compare outcome variables. The mean hepatic enhancement was significantly higher in group B than in group A during the portal (p = 0.025) and equilibrium phases (p = 0.021). In all phases, group B had significantly higher mean liver-to-aorta contrast (p < 0.05) and mean visual scores for hepatic and vascular enhancement (p < 0.001). This study showed that a higher iodine concentration (400 mg I/mL) in contrast media was more effective at improving hepatic enhancement in portal and equilibrium phase images and overall image quality using 128-slice MDCT in chronic liver disease patients.

  12. Evaluation of reperfused myocardial infarction by low-dose multidetector computed tomography using prospective electrocardiography (ECG)-triggering: comparison with magnetic resonance imaging.

    PubMed

    Gweon, Hye Mi; Kim, Sang Jin; Kim, Tae Hoon; Lee, Sang Min; Hong, Yoo Jin; Rim, Se-Joong; Hong, Bum Ki; Min, Phil Ki; Yoon, Young Won; Kwon, Hyuck Moon

    2010-09-01

    To evaluate the potential of prospective electrocardiography (ECG)- gated 64-slice multidetector computed tomography (MDCT) for evaluation of myocardial enhancement, infarct size, and stent patency after percutaneous coronary intervention (PCI) with stenting in patients with myocardial infarction. Seventeen patients who were admitted with acute myocardial infarction were examined with prospective ECG-gated 64-slice cardiac MDCT and magnetic resonance (MR) imaging after reperfusion using PCI with stenting. Cardiac MDCT was performed with two different phases: arterial and delayed phases. We evaluated the stent patency on the arterial phase, and nonviable myocardium on the delayed phase of computed tomography (CT) image, and they were compared with the results from the delayed MR images. Total mean radiation dose was 7.7 +/- 0.5 mSv on the two phases of CT images. All patients except one showed good patency of the stent at the culprit lesion on the arterial phase CT images. All patients had hyperenhanced area on the delayed phase CT images, which correlated well with those on the delayed phase MR images, with a mean difference of 1.6% (20 +/- 10% vs. 22 +/- 10%, r = 0.935, p = 0.10). Delayed MR images had a better contrast-to-noise ratio (CNR) than delayed CT images (27.1 +/- 17.8% vs. 4.3 +/- 2.1%, p < 0.001). Prospective ECG-gated 64-slice MDCT provides the potential to evaluate myocardial viability on delayed phase as well as for stent patency on arterial phase with an acceptable radiation dose after PCI with stenting in patients with myocardial infarction.

  13. Detection of Cement Leakage After Vertebroplasty with a Non-Flat-Panel Angio Unit Compared to Multidetector Computed Tomography - An Ex Vivo Study

    SciTech Connect

    Baumann, Clemens Fuchs, Heiko; Westphalen, Kerstin; Hierholzer, Johannes

    2008-11-15

    The purpose of this study was to investigate the detection of cement leakages after vertebroplasty using angiographic computed tomography (ACT) in a non-flat-panel angio unit compared to multidetector computed tomography (MDCT). Vertebroplasty was performed in 19 of 33 cadaver vertebrae (23 thoracic and 10 lumbar segments). In the angio suite, ACT (190{sup o}; 1.5{sup o} per image) was performed to obtain volumetric data. Another volumetric data set of the specimen was obtained by MDCT using a standard algorithm. Nine multiplanar reconstructions in standardized axial, coronal, and sagittal planes of every vertebra were generated from both data sets. Images were evaluated on the basis of a nominal scale with 18 criteria, comprising osseous properties (e.g., integrity of the end plate) and cement distribution (e.g., presence of intraspinal cement). MDCT images were regarded as gold standard and analyzed by two readers in a consensus mode. Rotational acquisitions were analyzed by six blinded readers. Results were correlated with the gold standard using Cohen's {kappa}-coefficient analysis. Furthermore, interobserver variability was calculated. Correlation with the gold standard ranged from no correlation (osseous margins of the neuroforamen, {kappa} = 0.008) to intermediate (trace of vertebroplasty canula; {kappa} = 0.615) for criteria referring to osseous morphology. However, there was an excellent correlation for those criteria referring to cement distribution, with {kappa} values ranging from 0.948 (paravertebral cement distribution) to 0.972 (intraspinal cement distribution). With a minimum of {kappa} = 0.768 ('good correlation') and a maximum of {kappa} = 0.91 ('excellent'), interobserver variability was low. In conclusion, ACT in an angio suite without a flat-panel detector depicts a cement leakage after vertebroplasty as well as MDCT. However, the method does not provide sufficient depiction of osseous morphology.

  14. 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.

  15. Multidetector CT angiography in evaluation of prosthetic heart valve dysfunction.

    PubMed

    Habets, Jesse; Mali, Willem P T M; Budde, Ricardo P J

    2012-01-01

    Prosthetic heart valves (PHVs) are commonly implanted to replace diseased native heart valves. PHV dysfunction is an infrequent but potentially life-threatening condition. In daily clinical practice, transthoracic and transesophageal echocardiography and fluoroscopy are the imaging modalities used for diagnostic evaluation of suspected PHV dysfunction. These modalities may not allow determination of the cause of PHV dysfunction, mostly because of acoustic shadowing. Multidetector computed tomographic (CT) angiography is a promising complementary technique for evaluation of PHVs, especially in patients with PHV obstruction and endocarditis. The CT image quality of PHVs mainly depends on their composition, with most causing only limited artifacts. Retrospectively electrocardiographically gated acquisition is advisable for PHV imaging because it enables dynamic leaflet evaluation and anatomic assessment in both systole and diastole. For accurate image interpretation, dedicated reconstruction in plane with and perpendicular to the PHV leaflets is mandatory. Besides PHV assessment, CT also provides information on the coronary arteries, the location and patency of bypass grafts, the dimensions of the aorta, and the distance between the sternum and right ventricle, information valuable for planning repeat surgery. To achieve the optimal diagnostic yield in PHV imaging, multidisciplinary cooperation between the departments of cardiology, cardiothoracic surgery, and radiology is crucial.

  16. The Emerging Roles of Coronary Computed Tomographic Angiography: Acute Chest Pain Evaluation and Screening for Asymptomatic Individuals

    PubMed Central

    Chien, Ning; Wang, Tzung-Dau; Chang, Yeun-Chung; Lin, Po-Chih; Tseng, Yao-Hui; Lee, Yee-Fan; Ko, Wei-Chun; Lee, Bai-Chin; Lee, Wen-Jeng

    2016-01-01

    Coronary computed tomographic angiography (CCTA) has been widely available since 2004. After that, the diagnostic accuracy of CCTA has been extensively validated with invasive coronary angiography for detection of coronary arterial stenosis. In this paper, we reviewed the updated evidence of the role of CCTA in both scenarios including acute chest pain and screening in asymptomatic adults. Several large-scale studies have been conducted to evaluate the diagnostic value of CCTA in the context of acute chest pain patients. CCTA could play a role in delivering more efficient care. For risk stratification of asymptomatic patients using CCTA, latest studies have revealed incremental benefits. Future studies evaluating the totality of plaque characteristics may be useful for determining the role of noncalcified plaque for risk stratification in asymptomatic individuals. PMID:27122947

  17. Clinical, histologic, and computed tomographic features of oral papillary squamous cell carcinoma in dogs: 9 cases (2008- 2011).

    PubMed

    Soukup, Jason W; Snyder, Christopher J; Simmons, Betsie T; Pinkerton, Marie E; Chun, Ruthanne

    2013-01-01

    Medical records of dogs diagnosed with oral papillary squamous cell carcinoma between December 2008 and April 2011 were reviewed. Information abstracted included signalment, tumor location, tumor size, computed tomographic (CT) features, evidence of metastatic disease based on cytologic examination of lymph node aspirates and thoracic radiography, treatment, surgical margins, histologic features, and treatment outcome. Dogs included in the study were all sexually altered, predominantly large breed dogs with a mean age of 3.9-years (range, 0.5 to 9.0-years). The most common location was the rostral maxilla. Invasion of underlying bone and lymphadenopathy were evident on CT imaging in most dogs. No evidence of metastasis was found on mandibular lymph node cytology and thoracic radiography. Histologic analysis revealed similar morphologic findings for all surgically resected tumors. Surgical excision with 1-2 cm margins was complete in all cases, with a mean tumor-free interval of 12.1-months.

  18. Laparoscopic Sentinel Node Biopsy Using Real-time 3-dimensional Single-photon Emission Computed Tomographic Guidance in Endometrial Cancer.

    PubMed

    Fernandez-Prada, Sara; Delgado-Sanchez, Elsa; De Santiago, Javier; Zapardiel, Ignacio

    2015-01-01

    In endometrial cancer, the histopathological analysis of the lymphatic nodes is essential to establish a correct prognosis and tailored adjuvant treatment. It is well-known that patients with early-stage endometrial cancer have a low incidence of nodal disease. In this group, systematic lymphadenectomy is not recommended. To improve the detection rate of sentinel nodes in clinical practice, new techniques are emerging like real-time 3-dimensional single-photon emission computed tomographic (SPECT) imaging. We report our experience using this innovative technique for intraoperative detection of sentinel nodes in endometrial cancer. The real-time 3-dimensional SPECT sentinel node biopsy seems to be feasible and accurate in endometrial cancer although further studies are needed to set the precision and predictive values compared with the current differed SPECT techniques and blue dye techniques. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  19. IMAGING DIAGNOSIS: COMPUTED TOMOGRAPHIC FINDINGS IN A CASE OF ADENOSQUAMOUS CARCINOMA OF THE HEAD AND NECK IN A CAT.

    PubMed

    Chow, Kathleen Ella; Krockenberger, Mark; Collins, David

    2016-01-01

    A 15-year-old female spayed domestic long-haired cat was referred for trismus, hypersalivation, and bilateral ocular discharge. On examination, the cat showed pain on palpation of the left zygomatic arch, palpable crepitus of the frontal region, and limited retropulsion of both globes. A contrast-enhanced sinonasal computed tomographic study was performed, showing facial distortion and extensive osteolysis of the skull, extending beyond the confines of the sinonasal and paranasal cavities. Additionally, soft tissue and fluid accumulation were observed in the nasal cavities and paranasal sinuses. Postmortem biopsy samples acquired from the calvarium yielded a histologic diagnosis of sinonasal adenosquamous carcinoma, a rare and particularly aggressive neoplasm previously only reported in the esophagus of one cat.

  20. Removal of filling materials from oval-shaped canals using laser irradiation: a micro-computed tomographic study.

    PubMed

    Keleş, Ali; Arslan, Hakan; Kamalak, Aliye; Akçay, Merve; Sousa-Neto, Manoel D; Versiani, Marco Aurélio

    2015-02-01

    The aim of this study was to assess the efficacy of lasers in removing filling remnants from oval-shaped canals after retreatment procedures with rotary instruments using micro-computed tomographic imaging. The root canals of 42 mandibular canines were prepared and obturated using the warm vertical compaction technique. Retreatment was performed with rotary instruments, and the specimens were distributed in 3 groups (n = 14) according to the laser device used in a later stage of retreatment procedure: Er:YAG, Er:YAG laser-based photon-induced photoacoustic streaming, and Nd:YAG. The specimens were scanned in a micro-computed tomographic device after root canal filling and each stage of retreatment at a resolution of 13.68 μm. The percentage differences of the remaining filling material before and after laser application within and between groups were statistically compared using the paired sample t test and 1-way analysis of variance test, respectively. Significance level was set at 5%. Overall, filling residues were located mainly in the apical third and into canal irregularities after the retreatment procedures. After using rotary instruments, the mean percentage volume of the filling remnants ranged from 13%-16%, with no statistical significant difference between groups (P > .05). Within groups, additional laser application had a significant reduction in the amount of the remaining filling materials (P < .05). A comparison between groups showed that Er:YAG laser application after the use of rotary instruments had a significantly higher removal of filling remnants (~13%) than Er:YAG laser-based photon-induced photoacoustic streaming (~4%) and Nd:YAG (~3%) (P < .05). None of the retreatment procedures completely removed the filling materials. The additional use of lasers improved the removal of filling material after the retreatment procedure with rotary instruments. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights

  1. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar.

    PubMed

    Filpo-Perez, Carolina; Bramante, Clovis Monteiro; Villas-Boas, Marcelo Haas; Húngaro Duarte, Marco Antonio; Versiani, Marco Aurélio; Ordinola-Zapata, Ronald

    2015-02-01

    The aim of this study was to evaluate the morphologic aspects of the root canal anatomy of the distal root of a mandibular first molar using micro-computed tomographic analysis. One-hundred distal roots of mandibular first molars were scanned using a micro-computed tomographic device at an isotropic resolution of 19.6 μm. The percentage frequency distribution of the morphologic configuration of the root canal was performed according to the Vertucci classification system. Two-dimensional parameters (area, perimeter, roundness, aspect ratio, and major and minor diameters) and the cross-sectional shape of the root canal were analyzed in the apical third at every 1-mm interval from the main apical foramen in roots presenting Vertucci types I and II configurations (n = 79). Data were statistically compared using the Kruskal-Wallis and Dunn tests with a significance level set at 5%. Seventy-six percent of the distal roots had a single root canal. Two, three, and four canals were found in 13%, 8%, and 3% of the sample, respectively. In 13 specimens, the configuration of the root canal did not fit into Vertucci's classification. Overall, 2-dimensional parameter values significantly increased at the 3-mm level (P < .05). The prevalence of oval canals was higher at the 1-mm level and decreased at the 5-mm level in which long oval and flattened canals were more prevalent. The distal roots of the mandibular first molars showed a high prevalence of single root canals. The prevalence of long oval and flattened canals increased in the coronal direction. In 13% of the samples, canal configurations that were not included in Vertucci's configuration system were found. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. COMPARISON OF TRANSVERSE COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IMAGES AND MAXIMUM INTENSITY PROJECTION IMAGES FOR DIAGNOSING ECTOPIC URETERS IN DOGS.

    PubMed

    Secrest, Scott; Bugbee, Andrew; Waller, Kenneth; Jiménez, David A

    2017-03-01

    Computed tomographic maximum intensity projection (MIP) images have been shown to improve reader confidence in their diagnoses and to improve detection of vascular structures and pulmonary nodules. The objectives of this method comparison study were to compare transverse source computed tomographic excretory urography (CTEU) images to two, five, and 10 slab thick MIP images for diagnosing canine ectopic ureters, compare reader confidence, and evaluate interobserver agreement. Two board-certified veterinary radiologists and a board-certified small animal internist blindly reviewed transverse source CTEU and two, five, and 10 slab thick MIP images of 24 dogs enrolled in the study. Inclusion criteria included a diagnostic CTEU and either cystoscopic or surgical confirmation of the presence or absence of ureteral ectopia. Eleven dogs were confirmed to have 17 ectopic ureters at surgery and/or cystoscopically. There was no significant difference in reader diagnoses between viewing methods or between viewing methods and the surgical/cystoscopic findings (P < 0.001). Reader confidence was significantly greater on two (P = 0.0080) and five (P = 0.0009) slab thick MIP images with significant interobserver agreement between readers for all viewing methods (P values ranging between 0.0363 and <0.001). In addition, the diagnostic accuracy of MIP images was similar to or better than transverse source CTEU images, when assessed by a radiologist. The study results suggest that CTEU is a reliable imaging technique for diagnosing canine ectopic ureters among specialists of varied experience. In addition, thin slice reconstructed MIP images improve reader confidence and potentially diagnostic accuracy, and thus their use should be considered, especially in more challenging cases.

  3. Preexisting Dentinal Microcracks in Nonendodontically Treated Teeth: An Ex Vivo Micro-computed Tomographic Analysis.

    PubMed

    PradeepKumar, Angambakkam Rajasekaran; Shemesh, Hagay; Chang, Jeffrey Wen-Wei; Bhowmik, Ahendita; Sibi, Swamy; Gopikrishna, Velayutham; Lakshmi-Narayanan, Lakshmikanthanbharathi; Kishen, Anil

    2017-06-01

    This study evaluated the prevalence, location, and pattern of preexisting dentinal microcracks in roots of extracted teeth without endodontic treatment in patients from 2 age groups using micro-computed tomographic imaging. Six hundred thirty-three nonendodontically treated teeth extracted using an atraumatic procedure because of reasons unrelated to this study were collected and divided based on the patient age. Teeth were scanned with micro-computed tomographic imaging (resolution of 26.7 μm) to examine the presence of preexisting dentinal microcracks in roots. The characteristic features of preexisting dentinal microcracks determined were location, extent, length, and coronoapical distribution. Chi-square bivariate analysis was performed to assess the association between various parameters. Forty-five of 633 nonendodontically treated teeth exhibited preexisting microcracks in roots with a prevalence of 7.1%. The prevalence of preexisting microcracks was found to be 8.3% in older patients (40-70 years) compared with 3.7% in younger patients (20-39 years) (P < .050). A significant association was found between the preexisting microcracks in mandibular teeth (10.3%) when compared with maxillary teeth (2.9%) (P < .001). All preexisting microcracks were located mesiodistally; 66% occurred in the cervical and middle thirds of root. Only 33% of the preexisting microcracks were complete in nature, showing canal involvement. Complete dentinal microcracks exhibited a mean length of 6.9 mm, whereas incomplete cracks had a mean length of 3.75 mm (P < .001). Preexisting dentinal microcracks in roots of nonendodontically treated teeth occurred more often in older patients (40-70 years) in the mesiodistal direction. They were predominantly found in the cervical and middle thirds of root and were more likely to be incomplete in nature. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Computed tomographic features of apical infection of equine maxillary cheek teeth: a retrospective study of 49 horses.

    PubMed

    Bühler, M; Fürst, A; Lewis, F I; Kummer, M; Ohlerth, S

    2014-07-01

    Computed tomographic (CT) studies evaluating the relevance of individual CT features of apical infection in maxillary cheek teeth are lacking. To study the prevalence and relationship of single CT features in horses with and without clinical evidence of apical infection in maxillary cheek teeth. Retrospective case-control study. Multislice CT scans of the head of 49 horses were evaluated retrospectively. Changes of the infundibulum, pulp, root, lamina dura, periodontal space and alveolar bone in maxillary cheek teeth were recorded. Single CT changes were much more prevalent in the 28 horses with clinical signs. However, infundibular changes and a nondetectable lamina dura were also common in the 21 horses without clinical evidence of apical infection. Computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space and the presence of a tooth fracture were significantly related. Infundibular changes were not associated with other CT signs of apical infection. Although nondetectable lamina dura was the most frequent CT change in all teeth in both studied groups, it was most commonly a solitary feature in otherwise normal teeth. Apical infections, defined as ≥3 CT changes, occurred mainly in the 108/208, 109/209 and 110/210 (Triadan numbers) and were found only in horses with clinical evidence of apical infection, except in one horse without clinical signs that had one affected root. Combined CT changes of the pulp, root, lamina dura, periapical bone and periodontal space and the presence of a tooth fracture appear to be reliable features to diagnose apical infection in maxillary cheek teeth. As a solitary feature, a nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality. © 2013 EVJ Ltd.

  5. Preoperative Computed Tomographic Angiogram Measurement of Abdominal Muscles Is a Valuable Risk Assessment for Bulge Formation after Microsurgical Abdominal Free Flap Breast Reconstruction.

    PubMed

    Kappos, Elisabeth A; Jaskolka, Jeff; Butler, Kate; O'Neill, Anne C; Hofer, Stefan O P; Zhong, Toni

    2017-07-01

    A major shortcoming associated with abdominal tissue breast reconstruction is long-term abdominal wall morbidity. Although abdominal muscle size on computed tomographic angiography has been correlated with morbidity following many abdominal operations, it has not been studied for breast reconstruction. Therefore, the authors evaluated the association between preoperative computed tomography angiography-derived measurements of abdominal core muscles and postoperative abdominal wall morbidity after abdominal tissue breast reconstruction. In this retrospective matched case-control study of women who underwent microsurgical abdominal flap breast reconstruction at one institution between January 2011 and June 2015, the authors evaluated all cases of postoperative bulge/hernia, matched by type of abdominal flap and body mass index in a ratio of 1:2 to controls without bulge/hernia. The authors obtained morphometric measurements of abdominal core muscles on preoperative computed tomographic angiographs. Using univariable and multivariable logistic regressions, the authors examined the effects of clinical risk factors and computed tomographic angiography morphometric measurements on postoperative bulge/hernia formation. Of the 589 patients who underwent abdominal free flap breast reconstruction, symptomatic bulges/hernias were identified in 35 patients (5.9 percent). When compared to the 70 matched controls, multivariable analysis showed that decreased area of rectus abdominis muscle (OR, 0.18; p < 0.01) and increased inter-rectus abdominis distance (OR, 1.14; p < 0.01) on computed tomographic angiography were significant risk factors associated with postoperative bulge/hernia. Preoperative computed tomographic angiography allows objective measurements of the patient's abdominal muscle anatomy that provide valuable prognostic information on the risk of bulge/hernia formation following abdominally based microsurgical breast reconstruction. Risk, III.

  6. Metallic artifacts from internal scaphoid fracture fixation screws: comparison between C-arm flat-panel, cone-beam, and multidetector computed tomography.

    PubMed

    Finkenstaedt, Tim; Morsbach, Fabian; Calcagni, Maurizio; Vich, Magdalena; Pfirrmann, Christian W A; Alkadhi, Hatem; Runge, Val M; Andreisek, Gustav; Guggenberger, Roman

    2014-08-01

    The aim of this study was to compare image quality and extent of artifacts from scaphoid fracture fixation screws using different computed tomography (CT) modalities and radiation dose protocols. Imaging of 6 cadaveric wrists with artificial scaphoid fractures and different fixation screws was performed in 2 screw positions (45° and 90° orientation in relation to the x/y-axis) using multidetector CT (MDCT) and 2 flat-panel CT modalities, C-arm flat-panel CT (FPCT) and cone-beam CT (CBCT), the latter 2 with low and standard radiation dose protocols. Mean cartilage attenuation and metal artifact-induced absolute Hounsfield unit changes (= artifact extent) were measured. Two independent radiologists evaluated different image quality criteria using a 5-point Likert-scale. Interreader agreements (Cohen κ) were calculated. Mean absolute Hounsfield unit changes and quality ratings were compared using Friedman and Wilcoxon signed-rank tests. Artifact extent was significantly smaller for MDCT and standard-dose FPCT compared with CBCT low- and standard-dose acquisitions (all P < 0.05). No significant differences in artifact extent among different screw types and scanning positions were noted (P > 0.05). Both MDCT and FPCT standard-dose protocols showed equal ratings for screw bone interface, fracture line, and trabecular bone evaluation (P = 0.06, 0.2, and 0.2, respectively) and performed significantly better than FPCT low- and CBCT low- and standard-dose acquisitions (all P < 0.05). Good interreader agreement was found for image quality comparisons (Cohen κ = 0.76-0.78). Both MDCT and FPCT standard-dose acquisition showed comparatively less metal-induced artifacts and better overall image quality compared with FPCT low-dose and both CBCT acquisitions. Flat-panel CT may provide sufficient image quality to serve as a versatile CT alternative for postoperative imaging of internally fixated wrist fractures.

  7. Comparison between survey radiography, B-mode ultrasonography, contrast-enhanced ultrasonography and contrast-enhanced multi-detector computed tomography findings in dogs with acute abdominal signs.

    PubMed

    Shanaman, Miriam M; Schwarz, Tobias; Gal, Arnon; O'Brien, Robert T

    2013-01-01

    Contrast-enhanced multi-detector computed tomography (CE-MDCT) is used routinely in evaluating human patients with acute abdominal symptoms. Contrast-enhanced ultrasound (CEUS) continues to be in its infancy as it relates to evaluation of the acute abdomen. The purpose of this study was to compare survey radiography, B-mode ultrasound, CEUS, and CE-MDCT findings in canine patients presenting with acute abdominal signs; with a focus on the ability to differentiate surgical from non-surgical conditions. Nineteen dogs were prospectively enrolled. Inclusion required a clinical diagnosis of acute abdominal signs and confirmed surgical or non-surgical causes for the clinical signs. Agreement for the majority of recorded imaging features was at least moderate. There was poor agreement in the identification of pneumoperitoneum and in the comparison of pancreatic lesion dimensions for B-mode vs. CEUS. The CT feature of fat stranding was detected in cases including, but not limited to, gastric neoplasia with perforation, pancreatitis, and small intestinal foreign body. Ultrasound underestimated the size and number of specific lesions when compared with CE-MDCT. Contrast-enhanced ultrasound was successful in detecting bowel and pancreatic perfusion deficits that CE-MDCT failed to identify. Accuracy for differentiation of surgical vs. non-surgical conditions was high for all modalities; 100%, 94%, and 94% for CE-MDCT, ultrasonography and survey radiography respectively. Findings indicated that CE-MDCT is an accurate screening test for differentiating surgical from non-surgical acute abdominal conditions in dogs. Focused CEUS following CE-MDCT or B-mode ultrasonography may be beneficial for identifying potentially significant hypoperfused lesions. © 2013 Veterinary Radiology & Ultrasound.

  8. Multidetector-row computed tomography for prosthetic heart valve dysfunction: is concomitant non-invasive coronary angiography possible before redo-surgery?

    PubMed

    Tanis, Wilco; Suchá, Dominika; Laufer, Ward; Habets, Jesse; van Herwerden, Lex A; Symersky, Petr; Chamuleau, Steven; Budde, Ricardo P J

    2015-06-01

    Retrospective ECG-gated multidetector-row computed tomography (MDCT) is increasingly used for the assessment of prosthetic heart valve (PHV) dysfunction, but is also hampered by PHV-related artefacts/cardiac arrhythmias. Furthermore, it is performed without nitroglycerine or heart rate correction. The purpose was to determine whether MDCT performed before potential redo-PHV surgery is feasible for concomitant coronary artery stenosis assessment and can replace invasive coronary angiography (CAG). PHV patients with CAG and MDCT were identified. Based on medical history, two groups were created: (I) patients with no known coronary artery disease (CAD), (II) patients with known CAD. All images were scored for the presence of significant (>50 %) stenosis. CAG was the reference test. Fifty-one patients were included. In group I (n = 38), MDCT accurately ruled out significant stenosis in 19/38 (50 %) patients, but could not replace CAG in the remaining 19/38 (50 %) patients due to non-diagnostic image quality (n = 16) or significant stenosis (n = 3) detection. In group II (n = 13), MDCT correctly found no patients without significant stenosis, requiring CAG imaging in all. MDCT assessed patency in 16/19 (84 %) grafts and detected a hostile anatomy in two. MDCT performed for PHV dysfunction assessment can replace CAG (100 % accurate) in approximately half of patients without previously known CAD. • Retrospective MDCT is increasingly used for prosthetic heart valve dysfunction assessment • In case of PHV reoperation, invasive coronary angiography is also required • MDCT can replace CAG in 50 % of patients without coronary artery disease • When conclusive for coronary assessment, MDCT stenosis rule out is highly accurate • Replacing CAG saves associated risks of distant embolization of thrombi or vegetations.

  9. Fast scanning tomosynthesis for the detection of pulmonary nodules: diagnostic performance compared with chest radiography, using multidetector-row computed tomography as the reference.

    PubMed

    Yamada, Yoshitake; Jinzaki, Masahiro; Hasegawa, Ichiro; Shiomi, Eisuke; Sugiura, Hiroaki; Abe, Takayuki; Sato, Yuji; Kuribayashi, Sachio; Ogawa, Kenji

    2011-08-01

    : To evaluate the diagnostic performance of fast scanning tomosynthesis in comparison with that of chest radiography for the detection of pulmonary nodules, using multidetector-row computed tomography (MDCT) as the reference, and to assess the association of the true-positive fraction (TPF) with the size, CT attenuation value, and location of the nodules. : The institutional review board approved this study, and written informed consent was obtained from all patients. Fifty-seven patients with and 59 without pulmonary nodules underwent chest MDCT, fast scanning tomosynthesis, and radiography. The images of tomosynthesis and radiography were randomly read by 3 blinded radiologists; MDCT served as the reference standard. Free-response receiver-operating characteristic (FROC) and receiver-operating characteristic (ROC) analyses, Cochran-Armitage trend or Fisher exact test, a conditional logistic regression model, and McNemar test were used. : Both FROC and ROC analyses revealed significantly better performance (P < 0.01) of fast scanning tomosynthesis than radiography for the detection of pulmonary nodules. For fast scanning tomosynthesis, the average TPF and false-positive rate as determined by FROC analysis were 0.80 and 0.10, respectively. For both fast scanning tomosynthesis and radiography, the average TPF increased with increasing nodule size and CT attenuation values, and was lower for subpleural nodules (all P < 0.01). : The diagnostic performance of fast scanning tomosynthesis for the detection of pulmonary nodules was significantly superior to that of radiography. The TPF was affected by the size, CT attenuation value, and location of the nodule, in both fast scanning tomosynthesis and radiography.

  10. Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: a case report.

    PubMed

    Camera, Luigi; Calabrese, Milena; Romeo, Valeria; Scordino, Fabrizio; Mainenti, Pier Paolo; Clemente, Marco; Rapicano, Gaetano; Salvatore, Marco

    2013-11-11

    Peptic ulcer disease is still the major cause of gastrointestinal perforation despite major improvements in both diagnostic and therapeutic strategies. While the diagnosis of a perforated ulcer is straightforward in typical cases, its clinical onset may be subtle because of comorbidities and/or concurrent therapies. We report the case of a 53-year-old Caucasian man with a history of chronic myeloid leukemia on maintenance therapy (100mg/day) with imatinib who was found to have a subphrenic abscess resulting from a perforated duodenal ulcer that had been clinically overlooked. Our patient was febrile (38.5°C) with abdominal tenderness and hypoactive bowel sounds. On the abdominal plain X-ray films, a right subphrenic abscess could be seen. On contrast-enhanced multi-detector computed tomography, a huge air-fluid collection extending from the subphrenic to the subhepatic anterior space was observed. After oral administration of 500cm3 of 3 percent diluted diatrizoate meglumine, an extraluminal leakage of the water-soluble iodinated contrast media could then be appreciated as a result of a perforated duodenal ulcer. During surgery, the abscess was drained and extensive adhesiolysis had to be performed to expose the duodenal bulb where the ulcer was first identified by methylene blue administration and then sutured. While subphrenic abscesses are well known complications of perforated gastric or duodenal ulcers, they have nowadays become rare thanks to advances in both diagnostic and therapeutic strategies for peptic ulcer disease. However, when peptic ulcer disease is not clinically suspected, the contribution of imaging may be substantial.

  11. Pulmonary adenocarcinomas presenting as ground-glass opacities on multidetector CT: three-dimensional computer-assisted analysis of growth pattern and doubling time

    PubMed Central

    Borghesi, Andrea; Farina, Davide; Michelini, Silvia; Ferrari, Matteo; Benetti, Diego; Fisogni, Simona; Tironi, Andrea; Maroldi, Roberto

    2016-01-01

    PURPOSE We aimed to evaluate the growth pattern and doubling time (DT) of pulmonary adenocarcinomas exhibiting ground-glass opacities (GGOs) on multidetector computed tomography (CT). METHODS The growth pattern and DT of 22 pulmonary adenocarcinomas exhibiting GGOs were retrospectively analyzed using three-dimensional semiautomatic software. Analysis of each lesion was based on calculations of volume and mass changes and their respective DTs throughout CT follow-up. Three-dimensional segmentation was performed by a single radiologist on each CT scan. The same observer and another radiologist independently repeated the segmentation at the baseline and the last CT scan to determine the variability of the measurements. The relationships among DTs, histopathology, and initial CT features of the lesions were also analyzed. RESULTS Pulmonary adenocarcinomas presenting as GGOs exhibited different growth patterns: some lesions grew rapidly and some grew slowly, whereas others alternated between periods of growth, stability, or shrinkage. A significant increase in volume and mass that exceeded the coefficient of repeatability of interobserver variability was observed in 72.7% and 84.2% of GGOs, respectively. The volume-DTs and mass-DTs were heterogeneous throughout the follow-up CT scan (range, −4293 to 21928 and −3113 to 17020 days, respectively), and their intra- and interobserver variabilities were moderately high. The volume-DTs and mass-DTs were not correlated with the initial CT features of GGOs; however, they were significantly shorter in invasive adenocarcinomas (P = 0.002 and P = 0.001, respectively). CONCLUSION Pulmonary adenocarcinomas exhibiting GGOs show heterogeneous growth patterns with a trend toward a progressive increase in size. DTs may be useful for predicting tumor aggressiveness. PMID:27682741

  12. [Reconstruction of coronary 64-multidetector-row computed tomography angiography in patients with atrial fibrillation: delete short RR intervals using electorocardiogram].

    PubMed

    Matsutani, Hideyuki; Sano, Tomonari; Kondo, Takeshi; Fujimoto, Shinichiro; Sekine, Takako; Arai, Takehiro; Morita, Hitomi; Takase, Shinichi

    2012-01-01

    The image qualities of coronary 64-multidetector-row computed tomography angiography (CCTA) in patients with atrial fibrillation (Afib) are often not enough. This study clarifies how to use electrocardiogram (ECG) -editing in Afib. We performed CCTA (Aquilion 64 with beam pitch: 0.125, 0.35 s/r) in 33 patients (M/F=24/9, age: 71±9 yr, mean heart rate: 71±12 bpm) with Afib. We injected 5 mg of verapamil into the vein when the mean HR was ≥80 bpm. First, we reconstructed images after deleting short RR (<800, 750, 700, 650, or 600). Second, we reconstructed images in 4 different methods: (1) end-systolic images with Phase Navi (automatically selecting an optimal phase) (ES-Navi), (2) Mid-diastolic images with Phase Navi (MD-Navi), (3) Mid-diastolic images reconstructed by the "R+absolute time method" [Edit-MD (R+)], and (4) Mid-diastolic images reconstructed by the "R-absolute time method" [Edit-MD (R-)]. We reconstructed 1 and 2 without ECG-editing, and 3 and 4 were reconstructed after ECG-editing without a data deficit. The quality of the images was classified into 3 ranks: no artifact (3), mild artifact (2), and severe artifact (1). The image quality point of CCTA, reconstructed after deleting RR<750, was similar to RR<800, and RR<750 was even higher than that after deleting HR<600, 650, or 700. The mean image quality point of CCTA that was reconstructed by Edit-MD (R-) or Edit-MD (R+) was significantly higher than ES-Navi or MD-Navi. The high image quality of CCTA could be reconstructed after deleting RR<750 in 76% or after deleting RR<800 in 70% of Afib. The reconstruction using Edit-MD (R-) or Edit-MD (R+) without a data deficit could provide a better quality CCTA than using PhaseNavi in Afib.

  13. Perforated duodenal ulcer presenting with a subphrenic abscess revealed by plain abdominal X-ray films and confirmed by multi-detector computed tomography: a case report

    PubMed Central

    2013-01-01

    Introduction Peptic ulcer disease is still the major cause of gastrointestinal perforation despite major improvements in both diagnostic and therapeutic strategies. While the diagnosis of a perforated ulcer is straightforward in typical cases, its clinical onset may be subtle because of comorbidities and/or concurrent therapies. Case presentation We report the case of a 53-year-old Caucasian man with a history of chronic myeloid leukemia on maintenance therapy (100mg/day) with imatinib who was found to have a subphrenic abscess resulting from a perforated duodenal ulcer that had been clinically overlooked. Our patient was febrile (38.5°C) with abdominal tenderness and hypoactive bowel sounds. On the abdominal plain X-ray films, a right subphrenic abscess could be seen. On contrast-enhanced multi-detector computed tomography, a huge air-fluid collection extending from the subphrenic to the subhepatic anterior space was observed. After oral administration of 500cm3 of 3 percent diluted diatrizoate meglumine, an extraluminal leakage of the water-soluble iodinated contrast media could then be appreciated as a result of a perforated duodenal ulcer. During surgery, the abscess was drained and extensive adhesiolysis had to be performed to expose the duodenal bulb where the ulcer was first identified by methylene blue administration and then sutured. Conclusions While subphrenic abscesses are well known complications of perforated gastric or duodenal ulcers, they have nowadays become rare thanks to advances in both diagnostic and therapeutic strategies for peptic ulcer disease. However, when peptic ulcer disease is not clinically suspected, the contribution of imaging may be substantial. PMID:24215711

  14. Multidetector-Row Computed Tomography in the Evaluation of Transjugular Intrahepatic Portosystemic Shunt Performed with Expanded-Polytetrafluoroethylene-Covered Stent-Graft

    SciTech Connect

    Fanelli, Fabrizio Bezzi, Mario; Bruni, Antonio; Corona, Mario; Boatta, Emanuele; Lucatelli, Pierleone; Passariello, Roberto

    2011-02-15

    We assessed, in a prospective study, the efficacy of multidetector spiral computed tomography (MDCT) in the evaluation of transjugular intrahepatic portosystemic shunt (TIPS) patency in patients treated with the Viatorr (Gore, Flagstaff, AZ) expanded-polytetrafluoroethylene (e-PTFE)-covered stent-graft. Eighty patients who underwent TIPS procedure using the Viatorr self-expanding e-PTFE stent-graft were evaluated at follow-up of 1, 3, 6, and 12 months with clinical and laboratory tests as well as ultrasound-color Doppler (USCD) imaging. In case of varices, upper gastrointestinal endoscopy was also performed. In addition, the shunt was evaluated using MDCT at 6 and 12 months. In all cases of abnormal findings and discrepancy between MDCT and USCD, invasive control venography was performed. MDCT images were acquired before and after injection of intravenous contrast media on the axial plane and after three-dimensional reconstruction using different algorithms. MDCT was successfully performed in all patients. No artefacts correlated to the Viatorr stent-graft were observed. A missing correlation between UCSD and MDCT was noticed in 20 of 80 (25%) patients. Invasive control venography confirmed shunt patency in 16 (80%) cases and shunt malfunction in 4 (20%) cases. According to these data, MDCT sensitivity was 95.2%; specificity was 96.6%; and positive (PPV) and negative predictive values (NPV) were 90.9 and 98.2%, respectively. USCD sensitivity was 90%; specificity was 75%; and PPV and NPV were 54.5 and 95.7%, respectively. A high correlation (K value = 0.85) between MDCT and invasive control venography was observed. On the basis of these results, MDCT shows superior sensitivity and specificity compared with USCD in those patients in whom TIPS was performed with the Viatorr stent-graft. MDCT can be considered a valid tool in the follow-up of these patients.

  15. Iterative reconstruction and individualized automatic tube current selection reduce radiation dose while maintaining image quality in 320-multidetector computed tomography coronary angiography.

    PubMed

    Williams, M C; Weir, N W; Mirsadraee, S; Millar, F; Baird, A; Minns, F; Uren, N G; McKillop, G; Bull, R K; van Beek, E J R; Reid, J H; Newby, D E

    2013-11-01

    To assess the effect of two iterative reconstruction algorithms (AIDR and AIDR3D) and individualized automatic tube current selection on radiation dose and image quality in computed tomography coronary angiography (CTCA). In a single-centre cohort study, 942 patients underwent electrocardiogram-gated CTCA using a 320-multidetector CT system. Images from group 1 (n = 228) were reconstructed with a filtered back projection algorithm (Quantum Denoising Software, QDS+). Iterative reconstruction was used for group 2 (AIDR, n = 379) and group 3 (AIDR3D, n = 335). Tube current was selected based on body mass index (BMI) for groups 1 and 2, and selected automatically based on scout image attenuation for group 3. Subjective image quality was graded on a four-point scale (1 = excellent, 4 = non-diagnostic). There were no differences in age (p = 0.975), body mass index (p = 0.435), or heart rate (p = 0.746) between the groups. Image quality improved with iterative reconstruction and automatic tube current selection [1.3 (95% confidence intervals (CI): 1.2-1.4), 1.2 (1.1-1.2) and 1.1 (1-1.2) respectively; p < 0.001] and radiation dose decreased [274 (260-290), 242 (230-253) and 168 (156-180) mGy cm, respectively; p < 0.001]. The application of the latest iterative reconstruction algorithm and individualized automatic tube current selection can substantially reduce radiation dose whilst improving image quality in CTCA. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. A novel contribution towards coherent and reproducible intravalvular measurement of the aortic annulus by multidetector computed tomography ahead of transcatheter aortic valve implantation.

    PubMed

    Dementhon, Julie; Rioufol, Gilles; Obadia, Jean-François; Vergnat, Mathieu; Green, Lisa; Croisille, Pierre; Boussel, Loïc; Peron, Julien; Revel, Didier; Finet, Gérard

    2015-05-01

    As current multidetector computed tomography (MDCT) measurements underestimate the size of the aortic annulus ahead of transcatheter aortic valve implantation (TAVI), a strategy of approximate annulus area oversizing has been adopted recently. To measure the aortic annulus using a novel complementary intravalvular MDCT slice. Fifty-five patients with severe aortic stenosis were selected for MDCT ahead of and 1 month after CoreValve(®) TAVI. Two MDCT slices were analysed and compared: the current standard virtual basal ring (VBR) at the nadir of the aortic cusps; and a novel slice, defined as the basal (lowest) complete commissural coaptation (BCCC) plane. BCCC is an intravalvular plane lying 5.2±0.8 mm above the VBR. The BCCC annulus is almost circular, unlike the VBR (mean eccentricity index 0.09±0.04 vs 0.3±0.1, respectively). The mean BCCC annulus diameter was 26.6±2.3 mm, 16% larger than that of the VBR (23.9±2.2 mm; P<0.001). The BCCC annulus area proved coherent with the orifice area measured after TAVI on the projection of the same slice (i.e. systematically equal to or greater than the latter [mean difference, +2.3±1.4 mm]), in contrast to the wider scatter found for the VBR (-1.3±2.0 mm). Once the sclerotic calcified valves have been pushed back by the implant, the aortic orifice after TAVI will inevitably be equal to or less than the diameter of the virtually unvalved annulus before TAVI. Based on the present results, we recommend including a BCCC slice to complete aortic annulus sizing, in order to optimize implant calibration. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Correlation between preoperative tomographic staging and definitive histopathologic results in gastric cancer at the Hospital Central Militar.

    PubMed

    López-Ramírez, M A; Lever-Rosas, C D; Motta-Ramírez, G A; Rebollo-Hurtado, V; Guzmán-Bárcenas, J; Fonseca-Morales, J V; Carreño-Lomeli, M A

    In relation to the number of new cases diagnosed, gastric cancer is the fourth most common cancer worldwide, and the second cause of cancer death. The development of multidetector tomography has improved the preoperative staging of gastric cancer. To correlate preoperative tomographic studies with the definitive pathologic results according to the TNM staging system. A retrospective, cross-sectional study within the time frame of January 2009 to December 2013 was conducted that included the case records of 67 patients. They all had upper endoscopy and preoperative multidetector tomography examinations, underwent surgical resection, and had the corresponding histopathology study. Statistical analysis was carried out with the SPSS version 15.0 software and the sensitivity and specificity calculations were made using the Excel 2011 program for Mac. The majority of the patients included in the case series had clinical stage iii and iv disease. When compared with the histopathologic result, the overall accuracy of multidetector CT was 83% (T0 96%, T1 94%, T2 93%, T3 67%, and T4 67%) for tumor size (T) and was 70% (N0 72%, N1 73%, N2 70%, and N3 66%) for lymph node involvement (N). Overall sensitivity was 48% (T0 100%, T1 0%, T2 33%, T3 44%, and T4 65%) for T and was 41% (N0 58%, N1 56%, N2 15%, and N3 35%) for N. A strong association between the multidetector CT results and the pathology results was demonstrated through the Spearman's correlation, especially in T4 and N3. Multidetector computed tomography showed greater congruency in detecting stages T4, N0, and N3 in gastric cancer, when compared with the definitive histopathologic results. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  18. Validation of Multi-Detector Computed Tomography as a Non-Invasive Method for Measuring Ovarian Volume in Macaques (Macaca fascicularis)

    PubMed Central

    Jones, Jeryl C.; Appt, Susan E.; Werre, Stephen R.; Tan, Joshua C.; Kaplan, Jay R.

    2013-01-01

    The purpose of this study was to validate low radiation dose, contrast-enhanced, multi-detector computed tomography (MDCT) as a non-invasive method for measuring ovarian volume in macaques. Computed tomography scans of four known-volume phantoms and nine mature female cynomolgus macaques were acquired using a previously described, low radiation dose scanning protocol, intravenous contrast enhancement, and a 32-slice MDCT scanner. Immediately following MDCT, ovaries were surgically removed and the ovarian weights were measured. The ovarian volumes were determined using water displacement. A veterinary radiologist who was unaware of actual volumes measured ovarian CT volumes three times, using a laptop computer, pen display tablet, hand-traced regions of interest, and free image analysis software. A statistician selected and performed all tests comparing the actual and CT data. Ovaries were successfully located in all MDCT scans. The iliac arteries and veins, uterus, fallopian tubes, cervix, ureters, urinary bladder, rectum, and colon were also consistently visualized. Large antral follicles were detected in six ovaries. Phantom mean CT volume was 0.702±SD 0.504 cc and the mean actual volume was 0.743±SD 0.526 cc. Ovary mean CT volume was 0.258±SD 0.159 cc and mean water displacement volume was 0.257±SD 0.145 cc. For phantoms, the mean coefficient of variation for CT volumes was 2.5%. For ovaries, the least squares mean coefficient of variation for CT volumes was 5.4%. The ovarian CT volume was significantly associated with actual ovarian volume (ICC coefficient 0.79, regression coefficient 0.5, P = 0.0006) and the actual ovarian weight (ICC coefficient 0.62, regression coefficient 0.6, P = 0.015). There was no association between the CT volume accuracy and mean ovarian CT density (degree of intravenous contrast enhancement), and there was no proportional or fixed bias in the CT volume measurements. Findings from this study indicate that MDCT is a valid non

  19. Validation of multi-detector computed tomography as a non-invasive method for measuring ovarian volume in macaques (Macaca fascicularis).

    PubMed

    Jones, Jeryl C; Appt, Susan E; Werre, Stephen R; Tan, Joshua C; Kaplan, Jay R

    2010-06-01

    The purpose of this study was to validate low radiation dose, contrast-enhanced, multi-detector computed tomography (MDCT) as a non-invasive method for measuring ovarian volume in macaques. Computed tomography scans of four known-volume phantoms and nine mature female cynomolgus macaques were acquired using a previously described, low radiation dose scanning protocol, intravenous contrast enhancement, and a 32-slice MDCT scanner. Immediately following MDCT, ovaries were surgically removed and the ovarian weights were measured. The ovarian volumes were determined using water displacement. A veterinary radiologist who was unaware of actual volumes measured ovarian CT volumes three times, using a laptop computer, pen display tablet, hand-traced regions of interest, and free image analysis software. A statistician selected and performed all tests comparing the actual and CT data. Ovaries were successfully located in all MDCT scans. The iliac arteries and veins, uterus, fallopian tubes, cervix, ureters, urinary bladder, rectum, and colon were also consistently visualized. Large antral follicles were detected in six ovaries. Phantom mean CT volume was 0.702+/-SD 0.504 cc and the mean actual volume was 0.743+/-SD 0.526 cc. Ovary mean CT volume was 0.258+/-SD 0.159 cc and mean water displacement volume was 0.257+/-SD 0.145 cc. For phantoms, the mean coefficient of variation for CT volumes was 2.5%. For ovaries, the least squares mean coefficient of variation for CT volumes was 5.4%. The ovarian CT volume was significantly associated with actual ovarian volume (ICC coefficient 0.79, regression coefficient 0.5, P=0.0006) and the actual ovarian weight (ICC coefficient 0.62, regression coefficient 0.6, P=0.015). There was no association between the CT volume accuracy and mean ovarian CT density (degree of intravenous contrast enhancement), and there was no proportional or fixed bias in the CT volume measurements. Findings from this study indicate that MDCT is a valid non

  20. Periprocedural safety of 64-detector row coronary computed tomographic angiography: results from the prospective multicenter ACCURACY trial.

    PubMed

    Bell, George W; Edwardes, Michael; Dunning, Allison M; Glasofer, Sidney; Lin, Fay Y; Labounty, Troy M; Delago, Augustin; Budoff, Matthew J; Min, James K

    2010-01-01

    Coronary computed tomographic angiography (CCTA) requires iodinated contrast and often atrioventricular nodal blocking agents and nitroglycerin for heart rate lowering and coronary vasodilation, respectively. To date, the periprocedural safety of CCTA is unknown. The purpose of this study was to evaluate the periprocedural safety of CCTA. We prospectively evaluated 232 patients with symptomatic chest pain without preexisting renal insufficiency at 16 sites who underwent CCTA as part of the Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography (ACCURACY) trial. Patients received iodinated contrast, β-blockers, and nitroglycerin as part of a predefined CCTA protocol. We assessed the rates of adverse events (AEs) related to these agents. As measured by serum creatinine and creatinine clearance, no significant change was observed in renal function from baseline (1.00 ± 0.19 mg/dL; modification of diet in renal disease [MDRD]: 76.91 ± 17.96 mL/min/1.73 m(2)) to 48 hours (1.0 ± 0.2 mg/dL; P = 1.00; MDRD change: 0.2 ± 12.4 mL/min/1.73 m(2); P = 0.83) or at 30 days (1.0 ± 0.2 mg/dL; P = 0.52; MDRD change: -0.9 ± 16.9 mL/min/1.73 m(2); P = 0.77). Mean systolic blood pressure decreased from baseline (133 ± 19 mm Hg) at 1 hour (125 ± 17 mm Hg; P < 0.001) and rebounded at 48 hours (133 ± 17 mm Hg). Mean heart rate decreased from baseline (65 ± 10 beats/min) at 1 hour (60 ± 7 beats/min) but rose at 48 hours (69 ± 11 beats/min; P < 0.001. All patients were asymptomatic from baseline to follow-up. The performance of CCTA is safe with low rates of AEs. © 2010 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  1. The right sided great vessels by cardiac multidetector computed tomography: normative reference values among healthy adults free of cardiopulmonary disease, hypertension, and obesity.

    PubMed

    Lin, Fay Y; Devereux, Richard B; Roman, Mary J; Meng, Joyce; Jow, Veronica M; Simprini, Lauren; Jacobs, Avrum; Weinsaft, Jonathan W; Shaw, Leslee J; Berman, Daniel S; Callister, Tracy Q; Min, James K

    2009-08-01

    We sought to derive normative reference values for the thoracic great vessels using multidetector computed tomography (MDCT) in a healthy normotensive non-obese population free of cardiovascular disease. Non-gated axial computed tomography (CT) of the chest has traditionally been used to evaluate normal great vessel anatomy for prognosis and management. However, non-gated axial chest CT cannot account for the obliquity, systolic expansion, and non-axial motion of the great vessels during the cardiac cycle and may misclassify patients as normal or abnormal for prognostic and management purposes. To date, normative reference values for double-oblique, short-axis great vessel diameters have not been established using current generation electrocardiogram (ECG)-gated 64-detector row MDCT. A total of 103 (43% women, age 51 +/- 14 years) consecutive normotensive, non-obese adults free of cardiopulmonary or great vessel structural disease, arrhythmias, or significant coronary artery disease were studied by MDCT. Individuals underwent examination for determination of end-diastolic (ED) pulmonary artery (PA) and superior vena cava (SVC) dimensions in double-oblique short axes for comparison with the ascending aorta and the right-sided cardiac chambers. For right sided great vessels, the 5th to 95th interval was 1.89-3.03 cm for ED PA diameter and 1.08-4.42 cm(2) for SVC cross-sectional area. The pulmonary artery to ascending aortic (PA-to-Ao) ratio was 0.66-1.13. In multivariate analysis, the PA was significantly associated with weight, whereas the PA-to-Ao ratio was inversely associated with age. Axial PA measurements were significantly higher and PA-to-Ao measurements significantly lower than corresponding short axis measurements (P = .04 and P < .001, respectively). This study establishes ECG-gated MDCT reference values for right-sided great vessel dimensions derived from a healthy population of individuals free of cardiovascular disease, hypertension, and obesity. The

  2. Effect of beta blockade on single photon emission computed tomographic (SPECT) thallium-201 images in patients with coronary disease

    SciTech Connect

    Narahara, K.A.; Thompson, C.J.; Hazen, J.F.; Brizendine, M.; Mena, I.

    1989-05-01

    We evaluated the effect of beta blockers on thallium-201 (Tl-201) single photon emission computed tomographic (SPECT) imaging in 12 patients with coronary disease using an automated computer algorithm. Maximal exercise heart rate and blood pressure were reduced and exercise time was increased with beta blockers. Estimated stress defect size decreased from 47 +/- 36.3 gm during placebo treatment to 32 +/- 27.1 gm during beta blocker therapy (-32%; p less than 0.01). The placebo treatment redistribution defect was estimated to be 28 +/- 29.8 gm. It fell to 15 +/- 23.3 gm with beta blockade (-46%; p less than 0.005). All patients had a stress Tl-201 defect during placebo treatment and eight had redistribution defects consistent with residual scar. During beta blocker therapy, 2 of 12 patients had normal stress-redistribution studies and only five patients had redistribution defects. Beta blockade can reduce exercise and redistribution Tl-201 SPECT defect size significantly while simultaneously increasing exercise time and reducing angina. Beta blockers may unmask or may eliminate evidence of redistribution. Tl-201 SPECT imaging may be useful in defining the reduction in ischemia produced by cardiac drugs.

  3. Evaluation of computerized detection of pulmonary embolism in independent data sets of computed tomographic pulmonary angiographic (CTPA) scans

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

    Computed tomographic pulmonary angiography (CTPA) has been reported to be an effective means for clinical diagnosis of pulmonary embolism (PE). We are developing a computer-aided diagnosis (CAD) system for assisting radiologists in detection of pulmonary embolism in CTPA images. The pulmonary vessel tree is extracted based on the analysis of eigenvalues of Hessian matrices at multiple scales followed by 3D hierarchical EM segmentation. A multiprescreening method is designed to identify suspicious PEs along the extracted vessels. A linear discriminant analysis (LDA) classifier with feature selection is then used to reduce false positives (FPs). Two data sets of 59 and 69 CTPA PE cases were randomly selected from patient files at the University of Michigan (UM) and the PIOPED II study, respectively, and used as independent training and test sets. The PEs that were identified by three experienced thoracic radiologists were used as the gold standard. The detection performance of the CAD system was assessed by free response receiver operating characteristic analysis. The results indicated that our PE detection system can achieve a sensitivity of 80% at 18.9 FPs/case on the PIOPED cases when the LDA classifier was trained with the UM cases. The test sensitivity with the UM cases is 80% at 22.6 FPs/cases when the LDA classifier was trained with the PIOPED cases.

  4. A Method for Identifying Contours in Processing Digital Images from Computer Tomograph

    NASA Astrophysics Data System (ADS)

    Roşu, Şerban; Pater, Flavius; Costea, Dan; Munteanu, Mihnea; Roşu, Doina; Fratila, Mihaela

    2011-09-01

    The first step in digital processing of two-dimensional computed tomography images is to identify the contour of component elements. This paper deals with the collective work of specialists in medicine and applied mathematics in computer science on elaborating new algorithms and methods in medical 2D and 3D imagery.

  5. Change in Abdominal Morphology After Surgical Correction of Thoracolumbar Kyphosis Secondary to Ankylosing Spondylitis: A Computed Tomographic Study.

    PubMed

    Ji, Ming-Liang; Qian, Bang-Ping; Qiu, Yong; Wang, Bin; Mao, Sai-Hu; Zhu, Ze-Zhang; Yu, Yang

    2015-12-01

    A computed tomographic study. To investigate the change in abdominal morphology in surgically treated patients with ankylosing spondylitis (AS) and thoracolumbar kyphosis. Severe thoracolumbar kyphosis in patients with AS exerts pressure on the abdominal cavity and subsequently causes intra-abdominal complications. Several spinal osteotomy techniques have been widely used to correct AS-related thoracolumbar kyphosis. To date, the changed abdominal morphology in patients with AS undergoing surgical correction of thoracolumbar kyphosis has not been addressed. A total of 29 patients with AS undergoing lumbar pedicle subtraction osteotomy for correction of thoracolumbar kyphosis were retrospectively reviewed. Computed tomographic scans of the spine were used to measure the longitudinal, transverse, and anterior-posterior diameters of the abdominal cavity. Furthermore, the abdominal cavity was considered as an ellipsoid structure, thereby allowing calculation of its volume. Radiographical evaluations included global kyphosis (GK), thoracic kyphosis, lumbar lordosis (LL), and angle of fusion levels (AFL). The longitudinal diameter of abdominal cavity significantly increased (P < 0.01), whereas the transverse and anterior-posterior diameters of the abdominal cavity did not change, postoperatively (P > 0.05). Significant changes in GK, LL, and AFL were observed (P < 0.01). The abdominal cavity volume (ACV) increased by an average of 652  mL. The change in ACV was significantly correlated with the changes in GK (r = 0.453, P = 0.014), LL (r = 0.42, P = 0.023), and AFL (r = 0.388, P = 0.037). The increased ACV after correction of thoracolumbar kyphosis was quantitatively confirmed by this study. Thus, the improvement in digestive function after correction of thoracolumbar kyphosis secondary to AS, which has been previously documented, may be because of an increase in ACV. Moreover, spine surgeons should be aware of the potential risk for

  6. The role of bone subtraction computed tomographic angiography in determining intracranial aneurysms in non-traumatic subarachnoid hemorrhage.

    PubMed

    Kayhan, Aysegul; Koc, Osman; Keskin, Suat; Keskin, Fatih

    2014-05-01

    The presence of blood in the subarachnoid space is an acute pathology with a serious risk of death and complications. The most common etiology (approximately 80%) is intracranial aneurysm. The aim of this study was to assess the role of bone subtracted computed tomographic angiography (BSCTA), a novel and noninvasive method for determining and characterizing intracranial aneurysms. Sixty consecutive patients with clinically suspected non-traumatic subarachnoid hemorrhage (SAH) were considered to enter the study. The subtraction quality was inadequate in ten patients; thus, they were excluded, leaving 50 patients (84.4%) in the study. Bone subtracted and non-subtracted 3D images were obtained from the BSCTA raw data sets. All images obtained by digital subtraction angiography (DSA), BSCTA, and computed tomographic angiography (CTA) were evaluated for the presence or absence of an aneurysm and the location, minimal sac diameter, and neck size ratio of the aneurysm. DSA was considered as the gold standard during the evaluation of the data. Of the 50 patients who participated in this study, 11 had no aneurysms as determined by both CTA and DSA. Examination of the remaining 39 patients revealed the presence of 51 aneurysms. While 3D-CTA could not detect six aneurysms that were located in the base of the skull, 3D-BSCTA easily detected them. Moreover, five aneurysms were only partially detected by 3D-CTA. According to this data, the sensitivity of 3D-BSCTA and 3D-CTA was calculated as 98% and 86.3%, respectively; the specificity was calculated as 100% and 90.9%, respectively, per aneurysm; and the sensitivity of 100% for 3D-BSCTA and 98% for 3D-CTA was achieved by using combined images with multi-planar reconstruction (MPR) and maximum intensity projection (MIP). BSCTA detected and characterized the aneurysms as well as DSA, and BSCTA and DSA gave concordant results in detecting aneurysms. BSCTA is easily accessible, less time consuming, and most importantly, a non

  7. Hypothenar hammer syndrome in a computer programmer: CTA diagnosis and surgical and endovascular treatment.

    PubMed

    Abdel-Gawad, Ehab A; Bonatti, Hugo; Housseini, Ahmed M; Maged, Ismaeel M; Morgan, Raymond F; Hagspiel, Klaus D

    2009-01-01

    Finger ischemia due to embolic occlusion of digital arteries resulting from trauma to the palmar ulnar artery has been termed hypothenar hammer syndrome (HHS). In HHS, arterial thrombosis and/or aneurysm formation with embolization to the digital arteries causes symptoms of ischemia. We describe a patient in whom the initial diagnosis was made on multidetector computed tomographic angiography (CTA), as well as his endovascular and surgical management.

  8. Multidetector Computed Tomography Versus Staging Laparoscopy for the Detection of Peritoneal Metastases in Esophagogastric Junctional and Gastric Cancer.

    PubMed

    Leeman, Matthew F; Patel, Dilip; Anderson, Judith; OʼNeill, J Robert; Paterson-Brown, Simon

    2017-08-04

    Staging laparoscopy (SL) is the gold standard investigation for detecting peritoneal metastases (PM) in patients with esophagogastric cancer but computed tomography (CT) has undergone significant improvements in recent years. The aim of this study was to investigate whether CT can replace SL in the detection of PM. Patients undergoing SL between January 2008 and December 2009 were identified from a prospectively collected database, operation notes were reviewed for the detection of PM. Corresponding CTs were reassessed by 2 experienced gastrointestinal radiologists, blinded to the SL results. In total, 74 patients undergoing SL were included. Sensitivity and specificity of SL for PM were 94.1% (95% confidence interval, 69.2-99.7) and 100% (90.7-100). Sensitivity and specificity of CT were 58.8% (33.5-80.6) and 89.6% (76.6-96.1), respectively. Area under the curve of receiver operating characteristic curves for SL and CT were 0.971 (SE, 0.033) and 0.742 (SE, 0.78), respectively. CT cannot replace SL for the detection of PM in lower esophageal and gastric cancer.

  9. Role of multidetector computed tomography in the anatomical definition of the left atrium-pulmonary vein complex in patients with atrial fibrillation. Personal experience and pictorial assay.

    PubMed

    Benini, K; Marini, M; Del Greco, M; Nollo, G; Manera, V; Centonze, M

    2008-09-01

    This study aimed to illustrate the typical anatomical pattern and anatomical variants of the left atrium-pulmonary vein (LA-PV) complex studied by 16-slice multidetector computed tomography (MDCT) in a population of patients with atrial fibrillation (AF) undergoing percutaneous transcatheter left atrial ablation. Accurate knowledge of this anatomical region is fundamental for increasing the efficiency, efficacy and accuracy of the procedure and for reducing the risk of complications. From January 2004 to March 2007, we studied 75 patients (57 men, 18 women) affected by paroxysmal and chronic AF by using MDCT. In 63 patients, the MDCT examination was performed using retrospective cardiac electrocardiographic (ECG) gating and dose modulation, with reconstructions performed at 75% of R-R interval. In the remaining 12 patients, ECG gating was not possible due to high-frequency AF. We identified 286 PV: 157 right and 129 left. On the right side, eight PV were supernumerary and one was a common trunk, whereas on the left side, we found 22 common trunks and one supernumerary vein. In 61.3% of patients, the anatomical pattern was typical (two right and two left PV). In the remaining 38.7%, it was atypical [two right PV-left common trunk (26.6%); three right PV-two left PV (6.7%); three right PV-left common trunk (2.6%); three right PV-three left PV (1.3%); right common trunk-two left PV (1.3%)]. MDCT identified branching of the right inferior PV in 94.5%, of the right superior PV in 75.6%, of the left superior PV in 7.5% and of the left inferior PV in 7.5%; 3/8 of the right supernumerary veins presented branching. With respect to the left PV ostia, the position of the orifice of the 74 recognised appendages was high in 85.1%, intermediate in 12.1% and low in 2.8%. There was no association between PV anatomical variants and clinical presentation of AF (paroxysmal or chronic). MDCT represents a fundamental diagnostic imaging tool in the anatomical definition of the LA

  10. Value and impact factors of multidetector computed tomography in diagnosis of preoperative lymph node metastasis in gastric cancer: A PRISMA-compliant systematic review and meta-analysis.

    PubMed

    Luo, Mingxu; Lv, You; Guo, Xiuyu; Song, Hongmei; Su, Guoqiang; Chen, Bo

    2017-08-01

    Multidetector computed tomography (MDCT) exhibited wide ranges of sensitivities and specificities for lymph node assessment of gastric cancer (GC) in several individual studies. This present meta-analysis was carried out to evaluate the value of MDCT in diagnosis of preoperative lymph node metastasis (LNM) and to explore the impact factors that might explain the heterogeneity of its diagnostic accuracy in GC. A comprehensive search was conducted to collect all the relevant studies about the value of MDCT in assessing LNM of GC within the PubMed, Cochrane library and Embase databases up to Feb 2, 2016. Two investigators independently screened the studies, extracted data, and evaluated the quality of included studies. The sensitivity, specificity, and area under ROC curve (AUC) were pooled to estimate the overall accuracy of MDCT. Meta-regression and subgroup analysis were carried out to identify the possible factors influencing the heterogeneity of the accuracy. A total of 27 studies with 6519 subjects were finally included. Overall, the pooled sensitivity, specificity, and AUC were 0.67 (95% CI: 0.56-0.77), 0.86 (95% CI: 0.81-0.90), and 0.86 (95% CI: 0.83-0.89), respectively. Meta-regression revealed that MDCT section thickness, proportion of serosal invasion, and publication year were the main significant impact factors in sensitivity, and MDCT section thickness, multiplanar reformation (MPR), and reference standard were the main significant impact factors in specificity. After the included studies were divided into 2 groups (Group A: studies with proportion of serosa-invasive GC subjects ≥50%; Group B: studies with proportion of serosa-invasive GC subjects <50%), the pooled sensitivity in Group A was significantly higher than in Group B (0.84 [95% CI: 0.75-0.90] vs 0.55 [95% CI: 0.41-0.68], P < .01). For early gastric cancer (EGC), the pooled sensitivity, specificity, and AUC were 0.34 (95% CI: 0.15-0.61), 0.91 (95% CI: 0.84-0.95), and 0.83 (95% CI: 0