Sample records for underwent computed tomographic

  1. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hammeschlag, S.B.; Hughes, S.; O'Reilly, G.V.

    Orbital blow-out fractures were experimentally created in eight human cadavers. Each orbit underwent conventional radiographic studies, complex motion tomography, and computed tomographic examinations. A comparison of the three modalities was made. Anatomical correlation was obtained by dissecting the orbits. The significance of medial-wall fractures and enophthalmos is discussed. Limitation of inferior rectus muscle mobility is thought to be a result of muscle kinking associated with orbital fat-pad prolapse at the fracture site, rather than muscle incarceration. Blow-out fractures should be evaluated by computed tomographic computer reformations in the oblique sagittal plane.

  2. Costs and clinical outcomes in individuals without known coronary artery disease undergoing coronary computed tomographic angiography from an analysis of Medicare category III transaction codes.

    PubMed

    Min, James K; Shaw, Leslee J; Berman, Daniel S; Gilmore, Amanda; Kang, Ning

    2008-09-15

    Multidetector coronary computed tomographic angiography (CCTA) demonstrates high accuracy for the detection and exclusion of coronary artery disease (CAD) and predicts adverse prognosis. To date, opportunity costs relating the clinical and economic outcomes of CCTA compared with other methods of diagnosing CAD, such as myocardial perfusion single-photon emission computed tomography (SPECT), remain unknown. An observational, multicenter, patient-level analysis of patients without known CAD who underwent CCTA or SPECT was performed. Patients who underwent CCTA (n = 1,938) were matched to those who underwent SPECT (n = 7,752) on 8 demographic and clinical characteristics and 2 summary measures of cardiac medications and co-morbidities and were evaluated for 9-month expenditures and clinical outcomes. Adjusted total health care and CAD expenditures were 27% (p <0.001) and 33% (p <0.001) lower, respectively, for patients who underwent CCTA compared with those who underwent SPECT, by an average of $467 (95% confidence interval $99 to $984) for CAD expenditures per patient. Despite lower total health care expenditures for CCTA, no differences were observed for rates of adverse cardiovascular events, including CAD hospitalizations (4.2% vs 4.1%, p = NS), CAD outpatient visits (17.4% vs 13.3%, p = NS), myocardial infarction (0.4% vs 0.6%, p = NS), and new-onset angina (3.0% vs 3.5%, p = NS). Patients without known CAD who underwent CCTA, compared with matched patients who underwent SPECT, incurred lower overall health care and CAD expenditures while experiencing similarly low rates of CAD hospitalization, outpatient visits, myocardial infarction, and angina. In conclusion, these data suggest that CCTA may be a cost-efficient alternative to SPECT for the initial coronary evaluation of patients without known CAD.

  3. Computed tomographic contrast tenography of the digital flexor tendon sheath of the equine hindlimb.

    PubMed

    Agass, Rachel; Dixon, Jonathon; Fraser, Barny

    2018-05-01

    Pre-surgical investigation of digital flexor tendon sheath pathology remains challenging with current standard imaging techniques. The aim of this prospective, anatomical, pilot study was to describe the anatomy of the equine hind limb digital flexor tendon sheath using a combination of computed tomography (CT) and computed tomographic contrast tenography in clinically normal cadaver limbs. Ten pairs of hind limbs with no external abnormalities were examined from the level of the tarsometatarsal joint distally. Limbs initially underwent non-contrast CT examination using 120 kVp, 300 mAs, and 1.5 mm slice thickness. Sixty millilitres of ioversol iodinated contrast media and saline (final concentration 100 mg/ml) were injected using a basilar sesamoidean approach. The computed tomographic contrast tenography examination was then repeated, before dissection of the specimens to compare gross and imaging findings. The combined CT and computed tomographic contrast tenography examinations provided excellent anatomical detail of intra-thecal structures. The borders of the superficial and deep digital flexor tendons, and the manica flexoria were consistently identifiable in all limbs. Detailed anatomy including that of the mesotenons, two of which are previously undescribed, and the plantar annular ligament were also consistently identifiable. Dissection of all 10 pairs of limbs revealed there to be no pathology, in accordance with the imaging findings. In conclusion, the combination of CT and computed tomographic contrast tenography may be useful adjunctive diagnostic techniques to define digital flexor tendon sheath pathology prior to surgical exploration in horses. © 2017 American College of Veterinary Radiology.

  4. Permeability Surface of Deep Middle Cerebral Artery Territory on Computed Tomographic Perfusion Predicts Hemorrhagic Transformation After Stroke.

    PubMed

    Li, Qiao; Gao, Xinyi; Yao, Zhenwei; Feng, Xiaoyuan; He, Huijin; Xue, Jing; Gao, Peiyi; Yang, Lumeng; Cheng, Xin; Chen, Weijian; Yang, Yunjun

    2017-09-01

    Permeability surface (PS) on computed tomographic perfusion reflects blood-brain barrier permeability and is related to hemorrhagic transformation (HT). HT of deep middle cerebral artery (MCA) territory can occur after recanalization of proximal large-vessel occlusion. We aimed to determine the relationship between HT and PS of deep MCA territory. We retrospectively reviewed 70 consecutive acute ischemic stroke patients presenting with occlusion of the distal internal carotid artery or M1 segment of the MCA. All patients underwent computed tomographic perfusion within 6 hours after symptom onset. Computed tomographic perfusion data were postprocessed to generate maps of different perfusion parameters. Risk factors were identified for increased deep MCA territory PS. Receiver operating characteristic curve analysis was performed to calculate the optimal PS threshold to predict HT of deep MCA territory. Increased PS was associated with HT of deep MCA territory. After adjustments for age, sex, onset time to computed tomographic perfusion, and baseline National Institutes of Health Stroke Scale, poor collateral status (odds ratio, 7.8; 95% confidence interval, 1.67-37.14; P =0.009) and proximal MCA-M1 occlusion (odds ratio, 4.12; 95% confidence interval, 1.03-16.52; P =0.045) were independently associated with increased deep MCA territory PS. Relative PS most accurately predicted HT of deep MCA territory (area under curve, 0.94; optimal threshold, 2.89). Increased PS can predict HT of deep MCA territory after recanalization therapy for cerebral proximal large-vessel occlusion. Proximal MCA-M1 complete occlusion and distal internal carotid artery occlusion in conjunction with poor collaterals elevate deep MCA territory PS. © 2017 American Heart Association, Inc.

  5. Long-term efficacy of biomodeled polymethyl methacrylate implants for orbitofacial defects.

    PubMed

    Groth, Michael J; Bhatnagar, Aparna; Clearihue, William J; Goldberg, Robert A; Douglas, Raymond S

    2006-01-01

    To report the long-term efficacy of custom polymethyl methacrylate implants using high-resolution computed tomographic modeling in the reconstruction of complex orbitofacial defects secondary to trauma. Nine patients with complex orbitofacial bone defects after trauma were evaluated for this retrospective, nonrandomized, noncomparative study. All the patients underwent reconstruction using custom, heat-cured polymethyl methacrylate implants. Patients were followed up postoperatively and evaluated for complications. Nine consecutive patients (5 men and 4 women) aged 28 to 63 years who underwent surgical reconstruction using prefabricated, heat-cured polymethyl methacrylate implants were included in the study. The interval between injury and presentation ranged from 1 month to 40 years. There were no significant complications, including infection, extrusion, or displacement of the implant. In all of the patients, wound healing was uneventful, with antibiotic drugs administered perioperatively. Mean follow-up was 4.3 years from the first visit (range, 6 months to 10 years). Computed tomographic biomodeled, prefabricated, heat-cured polymethyl methacrylate implants are well tolerated in the long term. Their advantages include customized design, long-term biocompatibility, and excellent aesthetic results.

  6. Corkscrew basilar artery as an incidental finding on neuroimaging.

    PubMed

    Moser, Franklin G; Sarnat, Harvey B; Maya, Marcel M; Menkes, John H

    2007-11-01

    We report on an incidental finding of a markedly tortuous basilar artery in a 6-year-old child. The child underwent a computed tomography scan for minor head trauma, and a basilar artery abnormality was discovered, i.e., a markedly tortuous basilar artery without any other congenital anomalies or syndromes. After an exhaustive workup including computed tomography, magnetic resonance imaging, magnetic resonance angiography, computed tomographic angiography, and genetic tests for associated genetic syndromes, no intervention was deemed necessary. The embryonic etiology and clinical implications are discussed.

  7. Variety of audiologic manifestations in patients with superior semicircular canal dehiscence.

    PubMed

    Chi, Fang-Lu; Ren, Dong-Dong; Dai, Chun-Fu

    2010-01-01

    To present diverse symptoms, signs, and findings on diagnostic tests of 11 patients with superior semicircular canal dehiscence (SSCD) syndrome and surgical treatments for dehiscence of 3 patients. Retrospective case review. Tertiary neurotologic and audiologic center. Patients with SSCD documented by history, physical examination, vestibular function testing, and high-resolution computed tomographic scans. Two patients underwent surgical procedures through middle fossa approach, and 1 patient underwent transmastoid repair. The rest underwent conservative treatments. Eleven patients were identified as SSCD. The variety of clinical manifestations, including 1) hearing presentations: mix hearing loss (4 of 11), conductive hearing loss (3 of 11), profound sensorineural hearing loss (2 of 11), and normal hearing (2 of 11); 2) vestibular manifestations: chronic disequilibrium (8 of 11), Tullio phenomenon (7 of 11), Hennebert sign (8 of 11), tinnitus (3 of 11), and autophony (3 of 11); and 3) accompanying disorders: encephalomeningocele (1 of 11). Abnormal nystagmus was identified in 3 patients. Dehiscence of bone overlying superior semicircular canal was confirmed by high-resolution computed tomographic scan in all cases. Three patients underwent operative management. (2 through the middle fossa approach and 1 through a transmastoid repair). Superior semicircular canal dehiscence demonstrates diverse and complex clinical features. Tegmental or petrosal bone rarefaction or mild dehiscences can be a harbinger or an aggressive cause of developing SSCD. No correlation was observed between the size of dehiscence and the severity of vestibular symptoms or the degree of hearing loss. Surgical repair of dehiscence can relieve symptoms with low morbidity.

  8. Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: a 6-year follow-up from the prospective multicentre international CONFIRM study.

    PubMed

    Cho, Iksung; Al'Aref, Subhi J; Berger, Adam; Ó Hartaigh, Bríain; Gransar, Heidi; Valenti, Valentina; Lin, Fay Y; Achenbach, Stephan; Berman, Daniel S; Budoff, Matthew J; Callister, Tracy Q; Al-Mallah, Mouaz H; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J W; DeLago, Augustin; Villines, Todd C; Hadamitzky, Martin; Hausleiter, Joerg; Leipsic, Jonathon; Shaw, Leslee J; Kaufmann, Philipp A; Feuchtner, Gudrun; Kim, Yong-Jin; Maffei, Erica; Raff, Gilbert; Pontone, Gianluca; Andreini, Daniele; Marques, Hugo; Rubinshtein, Ronen; Chang, Hyuk-Jae; Min, James K

    2018-03-14

    The long-term prognostic benefit of coronary computed tomographic angiography (CCTA) findings of coronary artery disease (CAD) in asymptomatic populations is unknown. From the prospective multicentre international CONFIRM long-term study, we evaluated asymptomatic subjects without known CAD who underwent both coronary artery calcium scoring (CACS) and CCTA (n = 1226). Coronary computed tomographic angiography findings included the severity of coronary artery stenosis, plaque composition, and coronary segment location. Using the C-statistic and likelihood ratio tests, we evaluated the incremental prognostic utility of CCTA findings over a base model that included a panel of traditional risk factors (RFs) as well as CACS to predict long-term all-cause mortality. During a mean follow-up of 5.9 ± 1.2 years, 78 deaths occurred. Compared with the traditional RF alone (C-statistic 0.64), CCTA findings including coronary stenosis severity, plaque composition, and coronary segment location demonstrated improved incremental prognostic utility beyond traditional RF alone (C-statistics range 0.71-0.73, all P < 0.05; incremental χ2 range 20.7-25.5, all P < 0.001). However, no added prognostic benefit was offered by CCTA findings when added to a base model containing both traditional RF and CACS (C-statistics P > 0.05, for all). Coronary computed tomographic angiography improved prognostication of 6-year all-cause mortality beyond a set of conventional RF alone, although, no further incremental value was offered by CCTA when CCTA findings were added to a model incorporating RF and CACS.

  9. Pseudo tumors of the lung after lung volume reduction surgery.

    PubMed

    Oey, Inger F; Jeyapalan, Kanagaratnam; Entwisle, James J; Waller, David A

    2004-03-01

    We describe 2 patients who underwent lung volume reduction surgery, who postoperatively had computed tomographic scans that showed symptomatic mass lesions suggestive of malignancy and an inhaled foreign body. Investigations excluded these conditions with the remaining likely diagnosis of pseudotumor secondary to buttressing material. These potential sequelae of lung volume reduction surgery should be recognized in follow-up investigations.

  10. Three-dimensional reconstruction of the peripancreatic vascular system based on computed tomographic angiography images and its clinical application in the surgical management of pancreatic tumors.

    PubMed

    Fang, Chi-hua; Kong, Deshuai; Wang, Xiaojun; Wang, Huaizhi; Xiang, Nan; Fan, Yingfang; Yang, Jian; Zhong, Shi Zheng

    2014-04-01

    This study aimed to investigate the clinical significance of 3-dimensional (3D) reconstruction of peripancreatic vessels for patients with suspected pancreatic cancer (PC). A total of 89 patients with PC were included; 60 patients randomly underwent computed tomographic angiography. Based on the findings of 3D reconstruction of peripancreatic vessels, the appropriate method for individualized tumor resection was determined. These patients were compared with 29 conventionally treated patients with PC. The rate of visualization was 100% for great vessels around the pancreas. The detection rates for anterior superior pancreaticoduodenal artery, posterior superior pancreaticoduodenal artery, anterior inferior pancreaticoduodenal artery, posterior inferior pancreaticoduodenal artery, dorsal pancreatic artery, superior marginal arterial branch of the pancreatic head, anterior superior pancreaticoduodenal vein, posterior superior pancreaticoduodenal vein, anterior inferior pancreaticoduodenal vein, and posterior inferior pancreaticoduodenal vein were 86.6%, 85.0%, 76.6%, 71.6%, 91.6%, 53.3%, 61.6%, 55.0%, 43.3%, and 51.6%, respectively. Forty-three patients who had undergone 3D reconstruction underwent surgery. Of the 29 conventionally treated patients, 19 underwent surgery. The operative time, blood loss, length of hospital stay, and complication incidence of the 43 patients were superior to that of the 19 patients. A peripancreatic vascular reconstruction can reveal the vascular anatomy, variations of peripancreatic vascular, and tumor-induced vascular changes; the application of the simulation surgery platform could reduce surgical trauma and decrease operative time.

  11. Aging of the midface bony elements: a three-dimensional computed tomographic study.

    PubMed

    Shaw, Robert B; Kahn, David M

    2007-02-01

    The face loses volume as the soft-tissue structures age. In this study, the authors demonstrate how specific bony aspects of the face change with age in both men and women and what impact this may have on the techniques used in facial cosmetic surgery. Facial bone computed tomographic scans were obtained from 60 Caucasian patients (30 women and 30 men). The authors' study population consisted of 10 male and 10 female subjects in each of three age categories. Each computed tomographic scan underwent three-dimensional reconstruction with volume rendering, and the following measurements were obtained: glabellar angle (maximal prominence of glabella to nasofrontal suture), pyriform angle (nasal bone to lateral inferior pyriform aperture), and maxillary angle (superior to inferior maxilla at the articulation of the inferior maxillary wing and alveolar arch). The pyriform aperture area was also obtained. The t test was used to identify any trends between age groups. The glabellar and maxillary angle in both the male and female subjects showed a significant decrease with increasing age. The pyriform angle did not show a significant change between age groups for either sex. There was a significant increase in pyriform aperture area from the young to the middle age group for both sexes. These results suggest that the bony elements of the midface change dramatically with age and, coupled with soft-tissue changes, lead to the appearance of the aged face.

  12. Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study.

    PubMed

    Singh, Parmanand; Emami, Hamed; Subramanian, Sharath; Maurovich-Horvat, Pal; Marincheva-Savcheva, Gergana; Medina, Hector M; Abdelbaky, Amr; Alon, Achilles; Shankar, Sudha S; Rudd, James H F; Fayad, Zahi A; Hoffmann, Udo; Tawakol, Ahmed

    2016-12-01

    Nonobstructive coronary plaques manifesting high-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM. In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent 18 F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and after 12 weeks of treatment with atorvastatin. Coronary arterial inflammation ( 18 F-fluorodeoxyglucose uptake, expressed as target-to-background ratio) was assessed in the left main coronary artery (LMCA). While blinded to the PET findings, contrast-enhanced computed tomographic angiography was performed to characterize the presence of HRM (defined as noncalcified or partially calcified plaques) in the LMCA. Arterial inflammation (target-to-background ratio) was higher in LMCA segments with HRM than those without HRM (mean±SEM: 1.95±0.43 versus 1.67±0.32 for LMCA with versus without HRM, respectively; P=0.04). Moreover, atorvastatin treatment for 12 weeks reduced target-to-background ratio more in LMCA segments with HRM than those without HRM (12 week-baseline Δtarget-to-background ratio [95% confidence interval]: -0.18 [-0.35 to -0.004] versus 0.09 [-0.06 to 0.26]; P=0.02). Furthermore, this relationship between coronary plaque morphology and change in LMCA inflammatory activity remained significant after adjusting for baseline low-density lipoprotein and statin dose (β=-0.27; P=0.038). In this first study to evaluate the impact of statins on coronary inflammation, we observed that the anti-inflammatory impact of statins is substantially greater within coronary plaques that contain HRM features. These findings suggest an additional mechanism by which statins disproportionately benefit individuals with more advanced atherosclerotic disease. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00703261. © 2016 The Authors.

  13. Assessment of Severity of Ovine Smoke Inhalation Injury by Analysis of Computed Tomographic Scans

    DTIC Science & Technology

    2003-09-01

    Computerized analysis of three- dimensional reconstructed scans was also performed, based on Hounsfield unit ranges: hyperinflated, 1,000 to 900; normal...the interactive segmentation function of the software. The pulmonary parenchyma was separated into four regions based on the Hounsfield unit (HU...SII) severity. Methods: Twenty anesthetized sheep underwent graded SII: group I, no smoke; group II, 5 smoke units ; group III, 10 units ; and group IV

  14. Comparison of computed tomography and complex motion tomography in the evaluation of cholesteatoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shaffer, K.A.

    1984-08-01

    High-resolution axial and coronal computed tomographic (CT) scans were compared with coronal and sagittal complex motion tomograms in patients with suspected middle ear cholesteatomas. Information on CT scans equaled or exceeded that on conventional complex motion tomograms in 16 of 17 patients, and in 11 it provided additional information. Soft-tissue resolution was superior with CT. In 14 patients who underwent surgery, CT provided information that was valuable to the surgeon. On the basis of this study, high-resolution CT is recommended as the preferred method for evaluating most patients with cholesteatomas of the temporal bone.

  15. Stiffness after total knee arthroplasty: does component alignment differ in knees requiring manipulation? A retrospective cohort study of 281 patients.

    PubMed

    Harvie, Paul; Larkin, James; Scaddan, Matt; Longstaff, Lee M; Sloan, Karen; Beaver, Richard J

    2013-01-01

    This study aims to evaluate component alignment in a large cohort of total knee arthroplasties (TKAs) and ascertain whether alignment in TKAs undergoing postoperative manipulation under anesthetic is significantly different from those achieving good function. A retrospective review of 281 consecutive primary TKAs was performed. All TKAs underwent computed tomographic scanning (Perth computed tomography knee protocol). Of 281 TKAs, 21 (7.4%) underwent manipulation, performed at a mean of 8.1 weeks (range, 3-14 weeks) after surgery. No statistically significant difference was seen between groups for any of 12 parameters of alignment. Postoperative stiffness with the need for manipulation under anesthetic is multifactorial in origin. This study found insufficient evidence to support the theory that component alignment contributes significantly to the etiology of this difficult problem. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  16. Relationship between pseudoaneurysm formation and biloma after successful transarterial embolization for severe hepatic injury: permanent embolization using stainless steel coils prevents pseudoaneurysm formation.

    PubMed

    Hagiwara, Akiyoshi; Tarui, Takehiko; Murata, Atsuo; Matsuda, Takeaki; Yamaguti, Yoshihiro; Shimazaki, Shuji

    2005-07-01

    The purpose of this study was to determine the association between bilomas and pseudoaneurysm complications after severe hepatic injury. Angiography was performed in patients with American Association for the Surgery of Trauma grade > or = III hepatic injury on contrast-enhanced computed tomographic scanning. When contrast extravasation was observed, transarterial embolization (TAE) was performed. After TAE, technetium-99m pyridoxyl-5-methyl-tryptophan cholescintigraphy was performed to detect the coexistence of bilomas. Follow-up angiography was performed when a biloma was detected. Eighty consecutive patients underwent angiography; after angiography, five patients died. The remaining 75 patients who underwent cholescintigraphy were included in this study. All 11 patients who had bilomas had angiographic evidence of contrast extravasation. The biloma frequency was higher in patients with grades IV and V injuries than in those with grade III injury (p = 0.024). Follow-up angiography revealed pseudoaneurysms in 7 of these 11 patients. All six patients in whom only gelatin sponge pledget injection was used to embolize had pseudoaneurysms. Among them, two patients had computed tomographic evidence of massive intra-abdominal fluid collection. In contrast, only one of five patients who received the combination of gelatin sponge pledget injection and stainless steel coils to permanently embolize injured arteries had a pseudoaneurysm. In this patient, the pseudoaneurysm was found in the peripheral part of the collateral vessels. All patients with pseudoaneurysms underwent repeat TAE and were discharged from the hospital uneventfully. In patients with high-grade hepatic injury and arterial bleeding who developed biloma, use of a gelatin sponge, an absorbable embolic material, is associated with a risk of pseudoaneurysm formation. Permanent arterial embolization using stainless steel coils is indicated to decrease this risk.

  17. A cost-utility analysis of the use of preoperative computed tomographic angiography in abdomen-based perforator flap breast reconstruction.

    PubMed

    Offodile, Anaeze C; Chatterjee, Abhishek; Vallejo, Sergio; Fisher, Carla S; Tchou, Julia C; Guo, Lifei

    2015-04-01

    Computed tomographic angiography is a diagnostic tool increasingly used for preoperative vascular mapping in abdomen-based perforator flap breast reconstruction. This study compared the use of computed tomographic angiography and the conventional practice of Doppler ultrasonography only in postmastectomy reconstruction using a cost-utility model. Following a comprehensive literature review, a decision analytic model was created using the three most clinically relevant health outcomes in free autologous breast reconstruction with computed tomographic angiography versus Doppler ultrasonography only. Cost and utility estimates for each health outcome were used to derive the quality-adjusted life-years and incremental cost-utility ratio. One-way sensitivity analysis was performed to scrutinize the robustness of the authors' results. Six studies and 782 patients were identified. Cost-utility analysis revealed a baseline cost savings of $3179, a gain in quality-adjusted life-years of 0.25. This yielded an incremental cost-utility ratio of -$12,716, implying a dominant choice favoring preoperative computed tomographic angiography. Sensitivity analysis revealed that computed tomographic angiography was costlier when the operative time difference between the two techniques was less than 21.3 minutes. However, the clinical advantage of computed tomographic angiography over Doppler ultrasonography only showed that computed tomographic angiography would still remain the cost-effective option even if it offered no additional operating time advantage. The authors' results show that computed tomographic angiography is a cost-effective technology for identifying lower abdominal perforators for autologous breast reconstruction. Although the perfect study would be a randomized controlled trial of the two approaches with true cost accrual, the authors' results represent the best available evidence.

  18. Feasibility of simultaneous computed tomographic colonography and fully automated bone mineral densitometry in a single examination.

    PubMed

    Summers, Ronald M; Baecher, Nicolai; Yao, Jianhua; Liu, Jiamin; Pickhardt, Perry J; Choi, J Richard; Hill, Suvimol

    2011-01-01

    To show the feasibility of calculating the bone mineral density (BMD) from computed tomographic colonography (CTC) scans using fully automated software. Automated BMD measurement software was developed that measures the BMD of the first and second lumbar vertebrae on computed tomography and calculates the mean of the 2 values to provide a per patient BMD estimate. The software was validated in a reference population of 17 consecutive women who underwent quantitative computed tomography and in a population of 475 women from a consecutive series of asymptomatic patients enrolled in a CTC screening trial conducted at 3 medical centers. The mean (SD) BMD was 133.6 (34.6) mg/mL (95% confidence interval, 130.5-136.7; n = 475). In women aged 42 to 60 years (n = 316) and 61 to 79 years (n = 159), the mean (SD) BMDs were 143.1 (33.5) and 114.7 (28.3) mg/mL, respectively (P < 0.0001). Fully automated BMD measurements were reproducible for a given patient with 95% limits of agreement of -9.79 to 8.46 mg/mL for the mean difference between paired assessments on supine and prone CTC. Osteoporosis screening can be performed simultaneously with screening for colorectal polyps.

  19. Tomographic phase analysis to detect the site of accessory conduction pathway in Wolff-Parkinson-White syndrome

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nakajima, K.; Bunko, H.; Tada, A.

    1984-01-01

    Phase analysis has been applied to Wolff-Parkinson-White syndrome (WPW) to detect the site of accessory conduction pathway (ACP); however, there was a limitation to estimate the precise location of ACP by planar phase analysis. In this study, the authors applied phase analysis to gated blood pool tomography. Twelve patients with WPW who underwent epicardial mapping and surgical division of ACP were studied by both of gated emission computed tomography (GECT) and routine gated blood pool study (GBPS). The GBPS was performed with Tc-99m red blood cells in multiple projections; modified left anterior oblique, right anterior oblique and/or left lateral views.more » In GECT, short axial, horizontal and vertical long axial blood pool images were reconstructed. Phase analysis was performed using fundamental frequency of the Fourier transform in both GECT and GBPS images, and abnormal initial contractions on both the planar and tomographic phase analysis were compared with the location of surgically confirmed ACPs. In planar phase analysis, abnormal initial phase was identified in 7 out of 12 (58%) patients, while in tomographic phase analysis, the localization of ACP was predicted in 11 out of 12 (92%) patients. Tomographic phase analysis is superior to planar phase images in 8 out of 12 patients to estimate the location of ACP. Phase analysis by GECT can avoid overlap of blood pool in cardiac chambers and has advantage to identify the propagation of phase three-dimensionally. Tomographic phase analysis is a good adjunctive method for patients with WPW to estimate the site of ACP.« less

  20. Clinical, radiographic, ultrasonographic and computed tomographic features of nonseptic osteitis of the axial border of the proximal sesamoid bones.

    PubMed

    Vanderperren, K; Bergman, H J; Spoormakers, T J P; Pille, F; Duchateau, L; Puchalski, S M; Saunders, J H

    2014-07-01

    Lysis of the axial aspect of equine proximal sesamoid bones (PSBs) is a rare condition reported to have septic or traumatic origins. Limited information exists regarding imaging of nonseptic axial osteitis of a PSB. To report the clinical, radiographic, ultrasonographic, computed tomographic and intra-arterial contrast-enhanced computed tomographic abnormalities in horses with axial nonseptic osteitis of a PSB. Retrospective clinical study. Eighteen horses diagnosed with nonseptic osteitis of the axial border of a PSB between 2007 and 2012 were reviewed retrospectively. Case details, clinical examination, radiographic, ultrasonographic, computed tomographic and intra-arterial/intra-articular contrast-enhanced computed tomographic features were recorded, when available. Radiographic, ultrasonographic and computed tomographic evaluations of the fetlock region had been performed on 18, 15 and 9 horses, respectively. The effect of the degree of lysis on the grade and duration of lameness was determined. All horses had chronic unilateral lameness, 4 with forelimb and 14 with hindlimb signs. On radiographs, lysis was identified in both PSBs in 14 horses, one PSB in 3 horses and in one horse no lysis was identified. The degree of osteolysis was variable. Ultrasonography identified variably sized irregularities of the bone surface and alteration in echogenicity of the palmar/plantar ligament (PL). All horses undergoing computed tomographic examination (n = 9) had biaxial lysis. The lesions were significantly longer and deeper on computed tomographic images compared with radiographic images. Intra-arterial contrast-enhanced computed tomography may reveal moderate to marked contrast enhancement of the PL. There was no significant effect of the degree of lysis on the grade and duration of lameness. Lesions of nonseptic axial osteitis of a PSB can be identified using a combination of radiography and ultrasonography. Computed tomography provides additional information regarding the extent of the pathology. © 2013 EVJ Ltd.

  1. Differentiation of nonneoplastic and neoplastic gallbladder polyps 1 cm or bigger with multi-detector row computed tomography.

    PubMed

    Park, Ko Woon; Kim, Seong Hyun; Choi, Seong Ho; Lee, Won Jae

    2010-01-01

    To evaluate useful computed tomographic features to differentiate nonneoplastic and neoplastic gallbladder polyps 1 cm or bigger. Thirty-one patients with 32 nonneoplastic polyps and 67 patients with 73 neoplastic polyps 1 cm or bigger underwent unenhanced and dual-phase (arterial and portal venous phases) multi-detector row computed tomography. Gallbladder polyps were diagnosed by cholecystectomy. Computed tomographic features including size (1.5 cm), surface (smooth or irregular), shape (pedunculated or sessile), accompanying wall thickening, basal indentation, perception on unenhanced images, and enhancement pattern between 2 groups were compared using univariate and multivariate analyses. On univariate analysis, age 55 years or older (P = 0.0019), size bigger than 1.5 cm (P < 0.0001), irregular surface (P = 0.0033), sessile shape (P = 0.0016), accompanying wall thickening (P = 0.0056), basal indentation (P = 0.0236), and perception on unenhanced images (P < 0.0001) were significantly more frequent in neoplastic polyps as compared with nonneoplastic polyps. On multivariate analysis, size bigger than 1.5 cm (P = 0.0260), sessile shape (P = 0.0397), and perception on unenhanced images (P < 0.0001) were statistically significant. Size bigger than 1.5 cm, sessile shape, and perception on unenhanced images are the main factors that differentiate neoplastic from nonneoplastic gallbladder polyps 1 cm or bigger.

  2. Chamber dimensions and functional assessment with coronary computed tomographic angiography as compared to echocardiography using American Society of Echocardiography guidelines

    PubMed Central

    Rose, Michael; Rubal, Bernard; Hulten, Edward; Slim, Jennifer N; Steel, Kevin; Furgerson, James L; Villines, Todd C

    2014-01-01

    Background: The correlation between normal cardiac chamber linear dimensions measured during retrospective coronary computed tomographic angiography as compared to transthoracic echocardiography using the American Society of Echocardiography guidelines is not well established. Methods: We performed a review from January 2005 to July 2011 to identify subjects with retrospective electrocardiogram-gated coronary computed tomographic angiography scans for chest pain and transthoracic echocardiography with normal cardiac structures performed within 90 days. Dimensions were manually calculated in both imaging modalities in accordance with the American Society of Echocardiography published guidelines. Left ventricular ejection fraction was calculated on echocardiography manually using the Simpson’s formula and by coronary computed tomographic angiography using the end-systolic and end-diastolic volumes. Results: We reviewed 532 studies, rejected 412 and had 120 cases for review with a median time between studies of 7 days (interquartile range (IQR25,75) = 0–22 days) with no correlation between the measurements made by coronary computed tomographic angiography and transthoracic echocardiography using Bland–Altman analysis. We generated coronary computed tomographic angiography cardiac dimension reference ranges for both genders for our population. Conclusion: Our findings represent a step towards generating cardiac chamber dimensions’ reference ranges for coronary computed tomographic angiography as compared to transthoracic echocardiography in patients with normal cardiac morphology and function using the American Society of Echocardiography guideline measurements that are commonly used by cardiologists. PMID:26770706

  3. 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.

  4. High-Resolution CT and Angiographic Evaluation of NexStent Wall Adaptation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nemes, Balazs, E-mail: nembal@freemail.hu; Lukacs, Levente; Balazs, Gyoergy

    2009-05-15

    Carotid stenting is a minimally invasive treatment for extracranial carotid artery stenosis. Stent design may affect technical success and complications in a certain subgroup of patients. We examined the wall adaptability of a new closed-cell carotid stent (NexStent), which has a unique rolled sheet design. Forty-one patients had 42 carotid arteries treated with angioplasty and stenting for internal carotid artery stenosis. The mean patient age was 65 {+-} 10 years. All patients underwent high-resolution computed tomographic angiography after the stent implantation. Data analysis included pre- and postprocedural stenosis, procedure complications, plaque calcification, and stent apposition. We reviewed the angiographic andmore » computed tomographic images for plaque coverage and stent expansion. All procedures were technically successful. Mean stenosis was reduced from 84 {+-} 8% before the procedure to 15.7 {+-} 7% after stenting. Two patients experienced transient ischemic attack; one patient had bradycardia and hypotension. Stent induced kinking was observed in one case. Good plaque coverage and proper overlapping of the rolled sheet was achieved in all cases. There was weak correlation between the residual stenosis and the amount of calcification. The stent provides adequate expansion and adaptation to the tapering anatomy of the bifurcation.« less

  5. Business aspects of cardiovascular computed tomography: tackling the challenges.

    PubMed

    Bateman, Timothy M

    2008-01-01

    The purpose of this article is to provide a comprehensive understanding of the business issues surrounding provision of dedicated cardiovascular computed tomographic imaging. Some of the challenges include high up-front costs, current low utilization relative to scanner capability, and inadequate payments. Cardiovascular computed tomographic imaging is a valuable clinical modality that should be offered by cardiovascular centers-of-excellence. With careful consideration of the business aspects, moderate-to-large size cardiology programs should be able to implement an economically viable cardiovascular computed tomographic service.

  6. Endovascular repair of abdominal aortic aneurysms in patients with congenital renal vascular anomalies.

    PubMed

    Kaplan, D B; Kwon, C C; Marin, M L; Hollier, L H

    1999-09-01

    The endovascular repair of abdominal aortic aneurysms (AAAs) has been suggested as an alternative to conventional aortic reconstruction. The presence of anomalous renal vascular anatomy frequently necessitates special planning during conventional aortic replacement and may also create unique challenges for endovascular repair. We analyzed our experience with 24 patients with variant renal vascular anatomies who underwent treatment with aortic endografts to determine the safety and efficacy of this technique in this population. During a 6-year period, 204 patients underwent aortic endograft procedures, 24 (11.8%) of whom had variations in renal vascular anatomy. There were 19 men and five women. Each of the 24 patients had variant renal vascular anatomy, which was defined by the presence of multiple renal arteries (n = 32), with or without a renal parenchymal anomaly (horseshoe or solitary pelvic kidney). Twenty patients underwent aneurysm repair with balloon expandable polytetrafluoroethylene grafts, and the remaining patients underwent endograft placement with self-expanding attachment systems. Eighteen patients underwent exclusion and presumed thrombosis of anomalous renal branches to effectively attach the aortic endograft. The decision to sacrifice a supernumerary artery was made on the basis of the vessel size (<3 mm), the absence of coexisting renal insufficiency, and the expectation for successful aneurysm exclusion. The successful exclusion of the AAAs was achieved in all the patients, with the loss of a total of 17 renal artery branches in 12 patients. Small segmental renal infarcts (<20%) were detected in only six of the 12 patients with follow-up computed tomographic scan results, despite angiographic evidence of vessel occlusion at the time of endografting. No evidence of new onset hypertension or changes in antihypertensive medication was seen in this group. No retrograde endoleaks were detected through the excluded renal branches on late follow-up computed tomographic scans. Serum creatinine levels before and after endografting were unchanged after the exclusion of the AAA in all but one patient with multiple renal branches. One patient had a transient rise in serum creatinine level presumed to be caused by contrast nephropathy. On the basis of this experience, we recommend the consideration of endovascular grafting for patients with AAAs and anomalous renal vessels when the main renal vascular anatomy can be preserved and when the loss of only small branches (<3 mm) is necessitated in patients with otherwise normal renal functions.

  7. Computed tomographic colonography for colorectal cancer screening: risk factors for the detection of advanced neoplasia.

    PubMed

    Hassan, Cesare; Pooler, B Dustin; Kim, David H; Rinaldi, Antonio; Repici, Alessandro; Pickhardt, Perry J

    2013-07-15

    The objective of this study was to determine whether age, sex, a positive family history of colorectal cancer, and body mass index (BMI) are important predictors of advanced neoplasia in the setting of screening computed tomographic colonography (CTC). Consecutive patients who were referred for first-time screening CTC from 2004 to 2011 at a single medical center were enrolled. Results at pathology were recorded for all patients who underwent polypectomy. Logistic regression was used to identify significant predictor variables for advanced neoplasia (any adenoma ≥ 10 mm or with villous component, high-grade dysplasia, or adenocarcinoma). Odds ratios (ORs) were used to express associations between the study variables (age, sex, BMI, and a positive family history of colorectal cancer) and advanced neoplasia. In total, 7620 patients underwent CTC screening. Of these, 276 patients (3.6%; 95% confidence interval [CI], 3.2%-4.1%) ultimately were diagnosed with advanced neoplasia. At multivariate analysis, age (mean OR per 10-year increase, 1.8; 95% CI, 1.6-2.0) and being a man (OR, 1.7; 95% CI, 1.3-2.2) were independent predictors of advanced neoplasia, whereas BMI and a positive family history of colorectal cancer were not. The number needed to screen to detect 1 case of advanced neoplasia varied from 51 among women aged ≤ 55 years to 10 among men aged >65 years. The number of post-CTC colonoscopies needed to detect 1 case of advanced neoplasia varied from 2 to 4. Age and sex were identified as important independent predictors of advanced neoplasia risk in individuals undergoing screening CTC, whereas BMI and a positive family history of colorectal cancer were not. These results have implications for appropriate patient selection. © 2013 American Cancer Society.

  8. Extracorporeal shock wave therapy is not useful after arthroscopic rotator cuff repair.

    PubMed

    Kim, Jae Yoon; Lee, Jae Sung; Park, Chi Woo

    2012-12-01

    Extracorporeal shock wave therapy (ESWT) is known to accelerate the healing of musculoskeletal tissue. The purpose of this study was to test the hypothesis that ESWT stimulates rotator cuff healing after arthroscopic repair. Seventy-one consecutive patients with a small- to large-sized rotator cuff tear underwent arthroscopic rotator cuff repair. The patients were randomized into two groups: 35 patients underwent ESWT at 6 weeks after surgery (ESWT group) and 36 patients did not (control group). Cuff integrity was evaluated with computed tomographic arthrography at 6 months after surgery. Constant and UCLA scores were measurable outcomes. All patients were available for a minimum one-year follow-up. The mean age of the ESWT and control groups was 59.4 (SD: 7.7) and 58.6 years (SD: 7.8) (n.s.). There were no significant differences in tear size and repair method between the two groups (n.s.). The mean Constant and UCLA scores, respectively, increased from 54.6 to 90.6 (P < 0.001) and from 18.5 to 27.4 (P < 0.001) in the ESWT group, and from 58.9 to 89.3 (P < 0.001) and 18.5 to 27.4 in the control group. Computed tomographic arthrography was performed in 26 patients from the ESWT group and 24 from the control group, and cuff integrity was maintained in 46 out of 50 patients. Definite re-tear was observed in two patients of the ESWT group and four of the controls. There were no complications associated with ESWT. This study failed to prove that ESWT stimulates rotator cuff healing after arthroscopic rotator cuff repair. Additional ESWT after rotator cuff repair could theoretically be advantageous, and it was proven to be safe in this study. II.

  9. Is triple contrast computed tomographic scanning useful in the selective management of stab wounds to the back?

    PubMed

    McAllister, E; Perez, M; Albrink, M H; Olsen, S M; Rosemurgy, A S

    1994-09-01

    We devised a protocol to prospectively manage stab wounds to the back with the hypothesis that the triple contrast computed tomographic (CT) scan is an effective means of detecting occult injury in these patients. All wounds to the back in hemodynamically stable adults were locally explored. All patients with muscular fascial penetration underwent triple contrast CT scanning utilizing oral, rectal, and IV contrast. Patients did not undergo surgical exploration if their CT scan was interpreted as negative or if the CT scan demonstrated injuries not requiring surgical intervention. Fifty-three patients were entered into the protocol. The time to complete the triple contrast CT scan ranged from 3 to 6 hours at a cost of $1050 for each scan. In 51 patients (96%), the CT scan either had negative findings (n = 31) or showed injuries not requiring exploration (n = 20). These patients did well with nonsurgical management. Two CT scans documented significant injury and led to surgical exploration and therapeutic celiotomies. Although triple contrast CT scanning was able to detect occult injury in patients with stab wounds to the back it did so at considerable cost and the results rarely altered clinical care. Therefore, its routine use in these patients is not recommended.

  10. Microendoscopic excision of C2 osteoid osteoma: a technical report.

    PubMed

    Kulkarni, Arvind G; Dhruv, Abhilash N; Bassi, Anupreet J

    2013-09-01

    Case report and description of technique. To describe a microendoscopic posterior approach for excision of an osteoid osteoma of C2. Microendoscopic techniques are widely used in the management of degenerative disorders of the spine. This is the first report of their use in the management of an osteoid osteoma via the posterior approach. A 12-year-old-boy presented with left-sided neck pain of 3-month duration. Investigations revealed an osteoid osteoma of C2 lamina-lateral mass complex. The patient underwent a posterior microendoscopic excision using 18-mm diameter METRx system (Medtronic Sofamor Danek, Memphis, TN) of tubular retractors. A postoperative computed tomographic scan was done and preoperative and postoperative visual analogue scale and Neck Disability Index were evaluated. The patient was periodically followed up for 1 year. The postoperative computed tomographic scan revealed complete excision of the tumor. The visual analogue scale score for neck pain improved from 3/5 (preoperative) to 0/5 (postoperative) and Neck Disability Index from 33.33 (preoperative) to 0 (postoperative) at 1-year follow-up. Microendoscopic techniques can be extended to excise lesions of the spine. It is a safe procedure in experienced hands. The advantages are minimal morbidity, minimal postoperative pain and discomfort, less analgesic dependence, and better cosmesis. The authors recommend this technique for accessible lesions involving the spine.

  11. Verification of computed tomographic estimates of cochlear implant array position: a micro-CT and histologic analysis.

    PubMed

    Teymouri, Jessica; Hullar, Timothy E; Holden, Timothy A; Chole, Richard A

    2011-08-01

    To determine the efficacy of clinical computed tomographic (CT) imaging to verify postoperative electrode array placement in cochlear implant (CI) patients. Nine fresh cadaver heads underwent clinical CT scanning, followed by bilateral CI insertion and postoperative clinical CT scanning. Temporal bones were removed, trimmed, and scanned using micro-CT. Specimens were then dehydrated, embedded in either methyl methacrylate or LR White resin, and sectioned with a diamond wafering saw. Histology sections were examined by 3 blinded observers to determine the position of individual electrodes relative to soft tissue structures within the cochlea. Electrodes were judged to be within the scala tympani, scala vestibuli, or in an intermediate position between scalae. The position of the array could be estimated accurately from clinical CT scans in all specimens using micro-CT and histology as a criterion standard. Verification using micro-CT yielded 97% agreement, and histologic analysis revealed 95% agreement with clinical CT results. A composite, 3-dimensional image derived from a patient's preoperative and postoperative CT images using a clinical scanner accurately estimates the position of the electrode array as determined by micro-CT imaging and histologic analyses. Information obtained using the CT method provides valuable insight into numerous variables of interest to patient performance such as surgical technique, array design, and processor programming and troubleshooting.

  12. Awake craniotomy for microsurgical obliteration of mycotic aneurysms: technical report of three cases.

    PubMed

    Lüders, Jürgen C; Steinmetz, Michael P; Mayberg, Marc R

    2005-01-01

    Infectious (mycotic) aneurysms that do not resolve with medical treatment require surgical obliteration, usually requiring sacrifice of the parent artery. In addition, patients with mycotic aneurysms frequently need subsequent cardiac valve repair, which often necessitates anticoagulation. Three cases of awake craniotomy for microsurgical clipping of mycotic aneurysms are presented. Awake minimally invasive craniotomy using frameless stereotactic guidance on the basis of computed tomographic angiography enables temporary occlusion of the parent artery with neurological assessment before obliteration of the aneurysm. A 56-year-old woman presented with progressively worsening mitral valve disease and a history of subacute bacterial endocarditis and subarachnoid hemorrhage 30 years previously. A cerebral angiogram revealed a 4-mm left middle cerebral artery (MCA) angular branch aneurysm, which required obliteration before mitral valve replacement. The second patient, a 64-year-old woman with a history of rheumatic fever, had an 8-mm right distal MCA aneurysm diagnosed in the setting of pulmonary abscess and worsening cardiac function as a result of mitral valve disease. The third patient, a 57-year-old man with a history of fevers, night sweats, and progressive mitral valve disease, had an enlarging left MCA angular branch aneurysm despite the administration of antibiotics. Because of their location on distal MCA branches, none of the aneurysms were amenable to preoperative test balloon occlusion. After undergoing stereotactic computed tomographic angiography with fiducial markers, the patients underwent a minimally invasive awake craniotomy with frameless stereotactic navigation. In all cases, the results of the neurological examination were unchanged during temporary parent artery occlusion and the aneurysms were successfully obliterated. Awake minimally invasive craniotomy for an infectious aneurysm located in eloquent brain enables awake testing before permanent clipping or vessel sacrifice. Combining frameless stereotactic navigation with computed tomographic angiography allowed us to perform the operation quickly through a small craniotomy with minimal exploration.

  13. Prospective radiographic followup after en bloc ligation of the renal hilum.

    PubMed

    White, Wesley M; Klein, Frederick A; Gash, Judson; Waters, W Bedford

    2007-11-01

    We determined the risk of arteriovenous fistula after en bloc ligation of the renal hilum. A prospective evaluation of all patients who underwent en bloc ligation of the renal hilum during nephrectomy for malignant disease was performed. Pertinent operative data were recorded and patients were followed for clinical evidence of arteriovenous fistula formation, including hypertension, abdominal bruit and new onset congestive heart failure. Patients with at least 12 months of followup underwent computerized tomographic arteriography to assess arteriovenous fistula formation. A total of 94 patients underwent en bloc renal hilar ligation during open (43) and laparoscopic (51) nephrectomy using a 45 mm titanium endovascular stapler. Of this cohort 11 patients were lost to followup and 3 died of disease. The remaining 80 patients were followed an average of 35.2 months with no clinical evidence of arteriovenous fistula formation. Specifically there was no statistically significant difference in preoperative and postoperative blood pressure (p = 0.18 and 0.62, respectively), no evidence of abdominal bruit on examination and no new onset congestive heart failure. A total of 32 had increased serum creatinine and, therefore, they were excluded from followup computerized tomographic arteriography. Eight patients had a followup of less than 1 year and they were not yet eligible for evaluation. In the 40 patients who underwent computerized tomographic arteriography no fistulas were noted. Based on clinical followup and prospective radiographic evaluation there appears to be a low risk of arteriovenous fistula formation after en bloc ligation of the renal hilum using a titanium endovascular stapler.

  14. Computed Tomographic Blend Sign Is Associated With Computed Tomographic Angiography Spot Sign and Predicts Secondary Neurological Deterioration After Intracerebral Hemorrhage.

    PubMed

    Sporns, Peter B; Schwake, Michael; Schmidt, Rene; Kemmling, André; Minnerup, Jens; Schwindt, Wolfram; Cnyrim, Christian; Zoubi, Tarek; Heindel, Walter; Niederstadt, Thomas; Hanning, Uta

    2017-01-01

    Significant early hematoma growth in patients with intracerebral hemorrhage is an independent predictor of poor functional outcome. Recently, the novel blend sign (BS) has been introduced as a new imaging sign for predicting hematoma growth in noncontrast computed tomography. Another parameter predicting increasing hematoma size is the well-established spot sign (SS) visible in computed tomographic angiography. We, therefore, aimed to clarify the association between established SS and novel BS and their values predicting a secondary neurological deterioration. Retrospective study inclusion criteria were (1) spontaneous intracerebral hemorrhage confirmed on noncontrast computed tomography and (2) noncontrast computed tomography and computed tomographic angiography performed on admission within 6 hours after onset of symptoms. We defined a binary outcome (secondary neurological deterioration versus no secondary deterioration). As secondary neurological deterioration, we defined (1) early hemicraniectomy under standardized criteria or (2) secondary decrease of Glasgow Coma Scale of >3 points, both within the first 48 hours after symptom onset. Of 182 patients with spontaneous intracerebral hemorrhage, 37 (20.3%) presented with BS and 39 (21.4%) with SS. Of the 81 patients with secondary deterioration, 31 (38.3%) had BS and SS on admission. Multivariable logistic regression analysis identified hematoma volume (odds ratio, 1.07 per mL; P≤0.001), intraventricular hemorrhage (odds ratio, 3.08; P=0.008), and the presence of BS (odds ratio, 11.47; P≤0.001) as independent predictors of neurological deterioration. The BS, which is obtainable in noncontrast computed tomography, shows a high correlation with the computed tomographic angiography SS and is a reliable predictor of secondary neurological deterioration after spontaneous intracerebral hemorrhage. © 2016 American Heart Association, Inc.

  15. Solitary kidney with renal artery aneurysm repaired by ex vivo reconstruction.

    PubMed

    Palcau, Laura; Gouicem, Djelloul; Joguet, Etienne; Cameliere, Lucie; Berger, Ludovic

    2014-01-01

    A 22-year-old pregnant female with pyelonephritis was found to have a 26-mm left renal artery aneurysm with unknown right kidney agenesis diagnosed by magnetic resonance imaging. Computed tomographic angiography with 3-dimensional reconstructions confirmed a saccular aneurysm localized at the bifurcation of the left posterior segmental artery. The patient ultimately underwent successful ex vivo left renal artery aneurysm repair with autotransplantation. Pathologic evaluation of the resected aneurysm confirmed the diagnosis of fibromuscular dysplasia. Fibromuscular dysplasia is the most common cause of renal artery stenosis and renovascular hypertension and can, in rare cases, be associated with the development of renal artery aneurysms. © The Author(s) 2014.

  16. Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region.

    PubMed

    Wei, Wei; Yu, Yongqiang; Lv, Weifu; Deng, Kexue; Yuan, Lei; Zhao, Yingming

    2014-08-01

    To investigate the value of dual-energy spectral computed tomographic imaging (DESCT) to predict the origin of carcinomas in the ampullary region. Fifty-seven patients with suspected ampullary region carcinomas underwent DESCT prior to biopsy or surgery. Among those patients, 30 were pancreatic adenocarcinomas, 11 were biliary adenocarcinomas, 16 were adenocarcinomas of the ampulla diagnosed by biopsy and/or pathological examination before or after surgical operation. We compared the CT spectral imaging features among the adenocarcinomas with the above-mentioned three different origins. Iodine concentration thresholds of 16.36, 21.86, and 21.86 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between common bile duct adenocarcinomas and pancreatic adenocarcinomas in the arterial phase (AP), portal venous phase (PP), and delayed phase (DP), respectively. Thresholds of 16.70, 24.33, and 26.43 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between common bile duct adenocarcinomas and ampullary adenocarcinomas in the AP, PP, and DP, respectively. Iodine concentration thresholds of 16.66 and 17.78 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between ampullary adenocarcinomas and pancreatic adenocarcinomas in the PP and DP, respectively. DESCT with multiple parameters can provide useful diagnostic information and may be used to predict the histological origin of carcinomas in the ampullary region.

  17. The Influence of the Size, Age and Sex on the Computed Tomographic Measured Size of the Pituitary Gland in Normal Horses.

    PubMed

    Crijns, C P; Van Bree, H J; Broeckx, B J G; Schauvliege, S; Van Loon, G; Martens, A; Vanderperren, K; Dingemanse, W B; Gielen, I M

    2017-06-01

    The objective of this study was to examine the influence of the size, age and sex of the horse on the size of the pituitary gland and determine the possibility of using the pituitary gland height-to-brain area ratio (P:B ratio) to allow comparison of different sized and aged horses. Thirty-two horses without pituitary pars inter-media dysfunction that underwent a contrast-enhanced computed tomographic (CT) examination were included in a cross-sectional study. On the CT images, the pituitary gland height was measured and the P:B ratio was calculated. These measurements were correlated to the size, age and sex of the horses. The pituitary gland height was significantly associated with the size (P < 0.001) and the age (P < 0.001), but not with the sex (P = 0.40), of the horses. No significant association was found between the P:B ratio and the size (P = 0.25), the age (P = 0.06) or the sex (P = 0.25) of the horses. In conclusion, the pituitary gland size varies between different sized and aged horses. The use of the P:B ratio is a valuable metric for making comparisons between the pituitary glands of these horses. © 2017 Blackwell Verlag GmbH.

  18. Presence and severity of noncalcified coronary plaque on 64-slice computed tomographic coronary angiography in patients with zero and low coronary artery calcium.

    PubMed

    Cheng, Victor Y; Lepor, Norman E; Madyoon, Hooman; Eshaghian, Shervin; Naraghi, Ashkan L; Shah, Prediman K

    2007-05-01

    How well absence of coronary artery calcium (CAC) predicts the absence of noncalcified coronary artery plaque (NCAP) has not been elucidated. We conducted a cross-sectional study of 554 outpatients to quantify NCAP prevalence as a function of CAC score. All patients underwent CAC scoring followed by 64-slice computed tomographic coronary angiography. Patients were categorized as having 0 CAC (416 patients) or low CAC (138 patients; men with CAC scores from 1 to 50 and women with scores from 1 to 10). Prevalence of detectable NCAP was 6.5% in patients with 0 CAC and 65.2% in those with low CAC. Compared with patients with 0 CAC, those with low CAC had markedly increased rates of NCAP occluding <50% of the arterial lumen (56.5% vs 6.0%, p <0.001) and > or =50% of the arterial lumen (8.7% vs 0.5%, p <0.001). In conclusion, in outpatients with a low to intermediate risk presentation and no known coronary artery disease, absence of CAC predicts low prevalence of any NCAP and very low prevalence of significantly occlusive NCAP. Low but detectable CAC scores are significantly less reliable in predicting plaque burden due to their association with high overall NCAP prevalence and nearly a 10% rate of significantly occlusive NCAP.

  19. Survival of a pedicled latissimus dorsi flap in breast reconstruction without a thoracodorsal pedicle.

    PubMed

    Hartmann, C E A; Branford, O A; Malhotra, A; Chana, J S

    2013-07-01

    The latissimus dorsi flap, first performed by Tansini in 1892, was popularised for use by Olivari in 1976. The successful transfer of a latissimus dorsi flap during breast reconstruction has previously been thought to be dependent on having an intact thoracodorsal pedicle to ensure flap survival. It is well documented that the flap may also survive on the serratus branch in thoracodorsal pedicle division. We report a case of a 52-year-old female patient who underwent successful delayed breast reconstruction with a latissimus dorsi flap following previous mastectomy and axillary node clearance. Intraoperatively, the thoracodorsal pedicle and serratus branch were found to have been previously divided. On postoperative computer tomographic angiography the thoracodorsal pedicle was shown to be divided together with the serratus branch. The flap was seen to be supplied by the lateral thoracic artery. To our knowledge survival of a pedicled latissimus dorsi flap in breast reconstruction with a vascular supply from this vessel following thoracodorsal pedicle division has not previously been described. Previous thoracodorsal pedicle and serratus branch division may not be an absolute contraindication for the use of the latissimus dorsi flap in breast reconstruction, depending on the results of preoperative Doppler or computer tomographic angiography studies. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. 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.

  1. Application of a 3-dimensional printed navigation template in Bernese periacetabular osteotomies: A cadaveric study.

    PubMed

    Zhou, You; Kang, Xiaopeng; Li, Chuan; Xu, Xiaoshan; Li, Rong; Wang, Jun; Li, Wei; Luo, Haotian; Lu, Sheng

    2016-12-01

    The aim of the present study was to describe the application of 3D printed templates for intraoperative navigation and simulation of periacetabular osteotomies (PAOs) in a cadaveric model.Five cadaveric specimens (10 sides) underwent thin-slice computed tomographic scans of the ala of ilium downwards to the proximal end of femoral shaft. Bernese PAO was performed. Using Mimics v10.1 software (Materialise, Leuven, Belgium), 3D computed tomographic reconstructions were created and the 4 standard PAO bone cuts-ischial, pubic, anterior, and posterior aspects of the ilium-as well as rotation of the dislocated acetabular bone blocks were simulated for each specimen. Using these data, custom 3D printed bone-drilling templates of the pelvis were manufactured, to guide surgical placement of the PAO bone cuts. An angle fix wedge was designed and printed, to help accurately achieve the predetermined rotation angle of the acetabular bone block. Each specimen underwent a conventional PAO. Preoperative, postsimulation, and postoperative lateral center-edge angles, acetabular indices, extrusion indices, and femoral head coverage were measured and compared; P and t values were calculated for above-mentioned measurements while comparing preoperative and postoperative data, and also in postsimulation and postoperative data comparison.All 10 PAO osteotomies were successfully completed using the 3D printed bone-drilling template and angle fix wedge. No osteotomy entered the hip joint and a single posterior column fracture was observed. Comparison of preoperative and postoperative measurements of the 10 sides showed statistically significant changes, whereas no statistically significant differences between postsimulation and postoperative values were noted, demonstrating the accuracy and utility of the 3D printed templates.The application of patient-specific 3D printed bone-drilling and rotation templates in PAO is feasible and may facilitate improved clinical outcomes, through the use of precise presurgical planning and reduced surgical complications with the precisely guided bone drilling.

  2. Computed Tomographic Airway Morphology in Chronic Obstructive Pulmonary Disease. Remodeling or Innate Anatomy?

    PubMed

    Diaz, Alejandro A; Estépar, Raul San José; Washko, George R

    2016-01-01

    Computed tomographic measures of central airway morphology have been used in clinical, epidemiologic, and genetic investigation as an inference of the presence and severity of small-airway disease in smokers. Although several association studies have brought us to believe that these computed tomographic measures reflect airway remodeling, a careful review of such data and more recent evidence may reveal underappreciated complexity to these measures and limitations that prompt us to question that belief. This Perspective offers a review of seminal papers and alternative explanations of their data in the light of more recent evidence. The relationships between airway morphology and lung function are observed in subjects who never smoked, implying that native airway structure indeed contributes to lung function; computed tomographic measures of central airways such as wall area, lumen area, and total bronchial area are smaller in smokers with chronic obstructive pulmonary disease versus those without chronic obstructive pulmonary disease; and the airways are smaller as disease severity increases. The observations suggest that (1) native airway morphology likely contributes to the relationships between computed tomographic measures of airways and lung function; and (2) the presence of smaller airways in those with chronic obstructive pulmonary disease versus those without chronic obstructive pulmonary disease as well as their decrease with disease severity suggests that smokers with chronic obstructive pulmonary disease may simply have smaller airways to begin with, which put them at greater risk for the development of smoking-related disease.

  3. Optimization of tomographic reconstruction workflows on geographically distributed resources

    DOE PAGES

    Bicer, Tekin; Gursoy, Doga; Kettimuthu, Rajkumar; ...

    2016-01-01

    New technological advancements in synchrotron light sources enable data acquisitions at unprecedented levels. This emergent trend affects not only the size of the generated data but also the need for larger computational resources. Although beamline scientists and users have access to local computational resources, these are typically limited and can result in extended execution times. Applications that are based on iterative processing as in tomographic reconstruction methods require high-performance compute clusters for timely analysis of data. Here, time-sensitive analysis and processing of Advanced Photon Source data on geographically distributed resources are focused on. Two main challenges are considered: (i) modelingmore » of the performance of tomographic reconstruction workflows and (ii) transparent execution of these workflows on distributed resources. For the former, three main stages are considered: (i) data transfer between storage and computational resources, (i) wait/queue time of reconstruction jobs at compute resources, and (iii) computation of reconstruction tasks. These performance models allow evaluation and estimation of the execution time of any given iterative tomographic reconstruction workflow that runs on geographically distributed resources. For the latter challenge, a workflow management system is built, which can automate the execution of workflows and minimize the user interaction with the underlying infrastructure. The system utilizes Globus to perform secure and efficient data transfer operations. The proposed models and the workflow management system are evaluated by using three high-performance computing and two storage resources, all of which are geographically distributed. Workflows were created with different computational requirements using two compute-intensive tomographic reconstruction algorithms. Experimental evaluation shows that the proposed models and system can be used for selecting the optimum resources, which in turn can provide up to 3.13× speedup (on experimented resources). Furthermore, the error rates of the models range between 2.1 and 23.3% (considering workflow execution times), where the accuracy of the model estimations increases with higher computational demands in reconstruction tasks.« less

  4. Optimization of tomographic reconstruction workflows on geographically distributed resources

    PubMed Central

    Bicer, Tekin; Gürsoy, Doǧa; Kettimuthu, Rajkumar; De Carlo, Francesco; Foster, Ian T.

    2016-01-01

    New technological advancements in synchrotron light sources enable data acquisitions at unprecedented levels. This emergent trend affects not only the size of the generated data but also the need for larger computational resources. Although beamline scientists and users have access to local computational resources, these are typically limited and can result in extended execution times. Applications that are based on iterative processing as in tomographic reconstruction methods require high-performance compute clusters for timely analysis of data. Here, time-sensitive analysis and processing of Advanced Photon Source data on geographically distributed resources are focused on. Two main challenges are considered: (i) modeling of the performance of tomographic reconstruction workflows and (ii) transparent execution of these workflows on distributed resources. For the former, three main stages are considered: (i) data transfer between storage and computational resources, (i) wait/queue time of reconstruction jobs at compute resources, and (iii) computation of reconstruction tasks. These performance models allow evaluation and estimation of the execution time of any given iterative tomographic reconstruction workflow that runs on geographically distributed resources. For the latter challenge, a workflow management system is built, which can automate the execution of workflows and minimize the user interaction with the underlying infrastructure. The system utilizes Globus to perform secure and efficient data transfer operations. The proposed models and the workflow management system are evaluated by using three high-performance computing and two storage resources, all of which are geographically distributed. Workflows were created with different computational requirements using two compute-intensive tomographic reconstruction algorithms. Experimental evaluation shows that the proposed models and system can be used for selecting the optimum resources, which in turn can provide up to 3.13× speedup (on experimented resources). Moreover, the error rates of the models range between 2.1 and 23.3% (considering workflow execution times), where the accuracy of the model estimations increases with higher computational demands in reconstruction tasks. PMID:27359149

  5. Optimization of tomographic reconstruction workflows on geographically distributed resources

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bicer, Tekin; Gursoy, Doga; Kettimuthu, Rajkumar

    New technological advancements in synchrotron light sources enable data acquisitions at unprecedented levels. This emergent trend affects not only the size of the generated data but also the need for larger computational resources. Although beamline scientists and users have access to local computational resources, these are typically limited and can result in extended execution times. Applications that are based on iterative processing as in tomographic reconstruction methods require high-performance compute clusters for timely analysis of data. Here, time-sensitive analysis and processing of Advanced Photon Source data on geographically distributed resources are focused on. Two main challenges are considered: (i) modelingmore » of the performance of tomographic reconstruction workflows and (ii) transparent execution of these workflows on distributed resources. For the former, three main stages are considered: (i) data transfer between storage and computational resources, (i) wait/queue time of reconstruction jobs at compute resources, and (iii) computation of reconstruction tasks. These performance models allow evaluation and estimation of the execution time of any given iterative tomographic reconstruction workflow that runs on geographically distributed resources. For the latter challenge, a workflow management system is built, which can automate the execution of workflows and minimize the user interaction with the underlying infrastructure. The system utilizes Globus to perform secure and efficient data transfer operations. The proposed models and the workflow management system are evaluated by using three high-performance computing and two storage resources, all of which are geographically distributed. Workflows were created with different computational requirements using two compute-intensive tomographic reconstruction algorithms. Experimental evaluation shows that the proposed models and system can be used for selecting the optimum resources, which in turn can provide up to 3.13× speedup (on experimented resources). Furthermore, the error rates of the models range between 2.1 and 23.3% (considering workflow execution times), where the accuracy of the model estimations increases with higher computational demands in reconstruction tasks.« less

  6. TomoBank: a tomographic data repository for computational x-ray science

    DOE PAGES

    De Carlo, Francesco; Gürsoy, Doğa; Ching, Daniel J.; ...

    2018-02-08

    There is a widening gap between the fast advancement of computational methods for tomographic reconstruction and their successful implementation in production software at various synchrotron facilities. This is due in part to the lack of readily available instrument datasets and phantoms representative of real materials for validation and comparison of new numerical methods. Recent advancements in detector technology made sub-second and multi-energy tomographic data collection possible [1], but also increased the demand to develop new reconstruction methods able to handle in-situ [2] and dynamic systems [3] that can be quickly incorporated in beamline production software [4]. The X-ray Tomography Datamore » Bank, tomoBank, provides a repository of experimental and simulated datasets with the aim to foster collaboration among computational scientists, beamline scientists, and experimentalists and to accelerate the development and implementation of tomographic reconstruction methods for synchrotron facility production software by providing easy access to challenging dataset and their descriptors.« less

  7. Intracerebral hemorrhage: a life-threatening complication of hypertension during pregnancy.

    PubMed

    Dai, Xuming; Diamond, Joseph A

    2007-11-01

    Intracerebral hemorrhage (ICH) is an infrequent but severe complication in pregnant women with hypertension. The authors describe a patient with chronic hypertension who developed superimposed preeclampsia and spontaneous ICH during the thirty-fifth week of pregnancy. ICH was diagnosed by computed tomographic scan. She underwent successful emergent cesarean section and neurosurgical decompression of the ICH. Both intraoperative surveillance and postoperative magnetic resonance angiographic examination of the cerebral vessels failed to identify an aneurysm or arteriovenous malformation. The authors discuss the diagnosis and management in this case and review the literature regarding this challenging complication of pregnancy and preeclampsia. Controversies regarding treatment of hypertension during pregnancy are discussed in light of the impact on the management of this patient.

  8. An Analysis for Capital Expenditure Decisions at a Naval Regional Medical Center.

    DTIC Science & Technology

    1981-12-01

    Service Equipment Review Committee 1. Portable defibrilator Computed tomographic scanner and cardioscope 2. ECG cart Automated blood cell counter 3. Gas...system sterilizer Gas system sterilizer 4. Automated blood cell Portable defibrilator and counter cardioscope 5. Computed tomographic ECG cart scanner...dictating and automated typing) systems. e. Filing equipment f. Automatic data processing equipment including data communications equipment. g

  9. Scalp marking for a craniotomy using a laser pointer during preoperative computed tomographic imaging: technical note.

    PubMed

    Kubo, S; Nakata, H; Sugauchi, Y; Yokota, N; Yoshimine, T

    2000-05-01

    The preoperative localization of superficial intracranial lesions is often necessary for accurate burr hole placement or craniotomy siting. It is not always easy, however, to localize the lesions over the scalp working only from computed tomographic images. We developed a simple method for such localization using a laser pointer during the preoperative computed tomographic examination. The angle of incidence, extending from a point on the scalp to the center of the computed tomographic image, is measured by the software included with the scanner. In the gantry, at the same angle as on the image, a laser is beamed from a handmade projector onto the patient's scalp toward the center of the gantry. The point illuminated on the patient's head corresponds to that on the image. The device and the method are described in detail herein. We applied this technique to mark the area for the craniotomy before surgery in five patients with superficial brain tumors. At the time of surgery, it was confirmed that the tumors were circumscribed precisely. The technique is easy to perform and useful in the preoperative planning for a craniotomy. In addition, the device is easily constructed and inexpensive.

  10. TomoBank: a tomographic data repository for computational x-ray science

    NASA Astrophysics Data System (ADS)

    De Carlo, Francesco; Gürsoy, Doğa; Ching, Daniel J.; Joost Batenburg, K.; Ludwig, Wolfgang; Mancini, Lucia; Marone, Federica; Mokso, Rajmund; Pelt, Daniël M.; Sijbers, Jan; Rivers, Mark

    2018-03-01

    There is a widening gap between the fast advancement of computational methods for tomographic reconstruction and their successful implementation in production software at various synchrotron facilities. This is due in part to the lack of readily available instrument datasets and phantoms representative of real materials for validation and comparison of new numerical methods. Recent advancements in detector technology have made sub-second and multi-energy tomographic data collection possible (Gibbs et al 2015 Sci. Rep. 5 11824), but have also increased the demand to develop new reconstruction methods able to handle in situ (Pelt and Batenburg 2013 IEEE Trans. Image Process. 22 5238-51) and dynamic systems (Mohan et al 2015 IEEE Trans. Comput. Imaging 1 96-111) that can be quickly incorporated in beamline production software (Gürsoy et al 2014 J. Synchrotron Radiat. 21 1188-93). The x-ray tomography data bank, tomoBank, provides a repository of experimental and simulated datasets with the aim to foster collaboration among computational scientists, beamline scientists, and experimentalists and to accelerate the development and implementation of tomographic reconstruction methods for synchrotron facility production software by providing easy access to challenging datasets and their descriptors.

  11. Remote cerebellar hemorrhage following supratentorial craniotomy.

    PubMed

    Huang, Chih-Yuan; Lee, Po-Hsuan; Lin, Sheng-Hsiang; Chuang, Ming-Tsung; Sun, Yuan-Ting; Hung, Yu-Chang; Lee, E-Jian

    2012-06-01

    Cerebellar hemorrhage remote from the site of surgery may complicate neurosurgical procedure. The exact pathophysiology of this type of hemorrhage is poorly understood. We retrospectively compared 16 patients who had remote cerebellar hemorrhage (RCH) with a case-matched control cohort, to determine the significance of perisurgical and surgical factors that may predispose patients to such bleeding events. From 1 June 2005 to 31 December 2008, postoperative routine head computed tomographic (CT) scan was performed in our institution and 16 patients with RCH after supratentorial neurosurgical procedure were identified. The medical charts of these 16 cases and a control cohort of 64 patients were recorded. All parameters were analyzed with regards to various variables. The incidence RCH after supratentorial craniotomy increased after postoperative computed tomographic scan. The mechanism of cerebellar hemorrhage in this series of patients is most likely multifactorial. Several variables showed a significant association with the occurrence of RCH. Multivariate analysis indicated that the following two factors independently correlated with occurrence of RCH: (1) postoperative epidural drainage amount; and (2) history of previous cerebrovascular accident (CVA) with cerebral atrophy. All cases with RCH underwent medical treatment and no neurological sequelae associated with RCH. Postoperative epidural drainage amount and history of previous CVA with cerebral atrophy can reliably predict the occurrence of cerebellar hemorrhage after supratentorial craniotomy. One of the most important strategies to minimize hazardous complications is to be aware of these potential risk factors and to take action to prevent them.

  12. Comparison of the Multidetector-row Computed Tomographic Angiography Axial and Coronal Planes' Usefulness for Detecting Thoracodorsal Artery Perforators

    PubMed Central

    Kim, Jong Gyu

    2012-01-01

    Background During the planning of a thoracodorsal artery perforator (TDAP) free flap, preoperative multidetector-row computed tomographic (MDCT) angiography is valuable for predicting the locations of perforators. However, CT-based perforator mapping of the thoracodorsal artery is not easy because of its small diameter. Thus, we evaluated 1-mm-thick MDCT images in multiple planes to search for reliable perforators accurately. Methods Between July 2010 and October 2011, 19 consecutive patients (13 males, 6 females) who underwent MDCT prior to TDAP free flap operations were enrolled in this study. Patients ranged in age from 10 to 75 years (mean, 39.3 years). MDCT images were acquired at a thickness of 1 mm in the axial, coronal, and sagittal planes. Results The thoracodorsal artery perforators were detected in all 19 cases. The reliable perforators originating from the descending branch were found in 14 cases, of which 6 had transverse branches. The former were well identified in the coronal view, and the latter in the axial view. The location of the most reliable perforators on MDCT images corresponded well with the surgical findings. Conclusions Though MDCT has been widely used in performing the abdominal perforator free flap for detecting reliable perforating vessels, it is not popular in the TDAP free flap. The results of this study suggest that multiple planes of MDCT may increase the probability of detecting the most reliable perforators, along with decreasing the probability of missing available vessels. PMID:22872839

  13. Trace: a high-throughput tomographic reconstruction engine for large-scale datasets.

    PubMed

    Bicer, Tekin; Gürsoy, Doğa; Andrade, Vincent De; Kettimuthu, Rajkumar; Scullin, William; Carlo, Francesco De; Foster, Ian T

    2017-01-01

    Modern synchrotron light sources and detectors produce data at such scale and complexity that large-scale computation is required to unleash their full power. One of the widely used imaging techniques that generates data at tens of gigabytes per second is computed tomography (CT). Although CT experiments result in rapid data generation, the analysis and reconstruction of the collected data may require hours or even days of computation time with a medium-sized workstation, which hinders the scientific progress that relies on the results of analysis. We present Trace, a data-intensive computing engine that we have developed to enable high-performance implementation of iterative tomographic reconstruction algorithms for parallel computers. Trace provides fine-grained reconstruction of tomography datasets using both (thread-level) shared memory and (process-level) distributed memory parallelization. Trace utilizes a special data structure called replicated reconstruction object to maximize application performance. We also present the optimizations that we apply to the replicated reconstruction objects and evaluate them using tomography datasets collected at the Advanced Photon Source. Our experimental evaluations show that our optimizations and parallelization techniques can provide 158× speedup using 32 compute nodes (384 cores) over a single-core configuration and decrease the end-to-end processing time of a large sinogram (with 4501 × 1 × 22,400 dimensions) from 12.5 h to <5 min per iteration. The proposed tomographic reconstruction engine can efficiently process large-scale tomographic data using many compute nodes and minimize reconstruction times.

  14. Evaluation of a Multicore-Optimized Implementation for Tomographic Reconstruction

    PubMed Central

    Agulleiro, Jose-Ignacio; Fernández, José Jesús

    2012-01-01

    Tomography allows elucidation of the three-dimensional structure of an object from a set of projection images. In life sciences, electron microscope tomography is providing invaluable information about the cell structure at a resolution of a few nanometres. Here, large images are required to combine wide fields of view with high resolution requirements. The computational complexity of the algorithms along with the large image size then turns tomographic reconstruction into a computationally demanding problem. Traditionally, high-performance computing techniques have been applied to cope with such demands on supercomputers, distributed systems and computer clusters. In the last few years, the trend has turned towards graphics processing units (GPUs). Here we present a detailed description and a thorough evaluation of an alternative approach that relies on exploitation of the power available in modern multicore computers. The combination of single-core code optimization, vector processing, multithreading and efficient disk I/O operations succeeds in providing fast tomographic reconstructions on standard computers. The approach turns out to be competitive with the fastest GPU-based solutions thus far. PMID:23139768

  15. Computed tomographic findings of trichuriasis

    PubMed Central

    Tokmak, Naime; Koc, Zafer; Ulusan, Serife; Koltas, Ismail Soner; Bal, Nebil

    2006-01-01

    In this report, we present computed tomographic findings of colonic trichuriasis. The patient was a 75-year-old man who complained of abdominal pain, and weight loss. Diagnosis was achieved by colonoscopic biopsy. Abdominal computed tomography showed irregular and nodular thickening of the wall of the cecum and ascending colon. Although these findings are nonspecific, they may be one of the findings of trichuriasis. These findings, confirmed by pathologic analysis of the biopsied tissue and Kato-Katz parasitological stool flotation technique, revealed adult Trichuris. To our knowledge, this is the first report of colonic trichuriasis indicated by computed tomography. PMID:16830393

  16. CT venography: use in selecting a surgical approach for the treatment of petrous apex cholesterol granulomas.

    PubMed

    Isaacson, Brandon; Kutz, Joe Walter; Mendelsohn, Dianne; Roland, Peter S

    2009-04-01

    To demonstrate the use of computed tomographic (CT) venography in selecting a surgical approach for cholesterol granulomas. Retrospective case review. Tertiary referral center. Three patients presented with symptomatic petrous apex cholesterol granulomas with extensive bone erosion involving the jugular fossa. Computed tomographic venography was performed on each patient before selecting a surgical approach for drainage. Localization of the jugular bulb in relation to the petrous carotid artery and basal turn of the cochlea was ascertained in each subject. Three patients with large symptomatic cholesterol granulomas were identified. Conventional CT demonstrated extensive bone erosion involving the jugular fossa in each patient. The location of the jugular bulb and its proximity to the petrous carotid artery and basal turn of the cochlea could not be determined with conventional temporal bone CT and magnetic resonance imaging. Computed tomographic venography provided the exact location of the jugular bulb in all 3 patients. The favorable position of the jugular bulb in all 3 cases permitted drainage of these lesions using an infracochlear approach. Computed tomographic venography provided invaluable information in 3 patients with large symptomatic cholesterol granulomas. All 3 patients were previously thought to be unsuitable candidates for an infracochlear or infralabyrinthine approach because of the unknown location of the jugular bulb.

  17. Tomographic and analog 3-D simulations using NORA. [Non-Overlapping Redundant Image Array formed by multiple pinholes

    NASA Technical Reports Server (NTRS)

    Yin, L. I.; Trombka, J. I.; Bielefeld, M. J.; Seltzer, S. M.

    1984-01-01

    The results of two computer simulations demonstrate the feasibility of using the nonoverlapping redundant array (NORA) to form three-dimensional images of objects with X-rays. Pinholes admit the X-rays to nonoverlapping points on a detector. The object is reconstructed in the analog mode by optical correlation and in the digital mode by tomographic computations. Trials were run with a stick-figure pyramid and extended objects with out-of-focus backgrounds. Substitution of spherical optical lenses for the pinholes increased the light transmission sufficiently that objects could be easily viewed in a dark room. Out-of-focus aberrations in tomographic reconstruction could be eliminated using Chang's (1976) algorithm.

  18. Three-dimensional computed tomographic airway analysis of patients with obstructive sleep apnea treated by maxillomandibular advancement.

    PubMed

    Abramson, Zachary; Susarla, Srinivas M; Lawler, Matthew; Bouchard, Carl; Troulis, Maria; Kaban, Leonard B

    2011-03-01

    To evaluate changes in airway size and shape in patients with obstructive sleep apnea (OSA) after maxillomandibular advancement (MMA) and genial tubercle advancement (GTA). This was a retrospective cohort study, enrolling a sample of adults with polysomnography-confirmed OSA who underwent MMA + GTA. All subjects who had preoperative and postoperative 3-dimensional computed tomography (CT) scans to evaluate changes in airway size and shape after MMA + GTA were included. Preoperative and postoperative sleep- and breathing-related symptoms were recorded. Descriptive and bivariate statistics were computed. For all analyses, P < .05 was considered statistically significant. During the study period, 13 patients underwent MMA + GTA, of whom 11 (84.6%) met the inclusion criteria. There were 9 men and 2 women with a mean age of 39 years. The mean body mass index was 26.3; mean respiratory disturbance index (RDI), 48.8; and mean lowest oxygen saturation, 80.5%. After MMA + GTA, there were significant increases in lateral and anteroposterior airway diameters (P < .01), volume (P = .02), surface area (P < .01), and cross-sectional areas at multiple sites (P < .04). Airway length decreased (P < .01) and airway shape (P = .04) became more uniform. The mean change in RDI was -60%. Results of this preliminary study indicate that MMA + GTA appears to produce significant changes in airway size and shape that correlate with a decrease in RDI. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Totally Endoscopic Coronary Artery Bypass for Anomalous Origin of Right Coronary Artery.

    PubMed

    Kuo, Chia-Cheng; Hsing, Chung-Hsi; Cheng, Bor-Chih

    2017-01-01

    Anomalous origin of the right coronary artery (ARCA) from the left Valsalva sinus is a rare but known cause of sudden cardiac death. Surgical revascularization techniques include coronary artery bypass grafting, unroofing, and reimplantation. We report 4 patients who underwent robot-assisted totally endoscopic coronary artery bypass (TECAB) for ARCA as an alternative surgical option. In 3 patients, a single aortocoronary saphenous vein bypass was performed, and in 1 patient the right internal mammary artery was used. All grafts are patent as shown by computed tomographic angiography or cardiac catheterization. We claim that totally endoscopic coronary artery bypass is feasible and safe for anomalous origin of the right coronary artery. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Esophageal stenosis: a differential diagnosis between esophageal cancer and metastasis from other neoplasia.

    PubMed

    Paris, Ida; Prelaj, Arsela; Onesti, Concetta Elisa; Baldoni, Alessandra; Giovagnoli, Maria Rosaria; Bassanelli, Maria; Lauro, Salvatore; Marchetti, Paolo

    2014-01-01

    The occurrence of radiological mediastinal lymphadenopathy as the only evidence of tumor recurrence of cervical carcinoma is very rare. We report on such a case with stenosis of the esophagus. A 36-year-old Caucasian woman, without any relevant history of gynecological cancer, underwent a trans-vaginal ultrasound with evidence of any cervical lesion locally extended. After histologically-proven diagnosis of squamous cell carcinoma of the cervix uterine, the patient was treated by neoadjuvant chemoradiation, followed by total abdominal hysterectomy with bilateral salpingoophorectomy. A subsequent close follow-up was negative for recurrence of disease until December 2008, two years after diagnosis. At that period, the patient experienced cough and severe dysphagia and for this reason she underwent several examinations including esophagogastroduodenoscopy, whole-body computed tomographic scan and bronchoscopy with transbronchial needle aspiration. Histology led to diagnosis of recurrence of cervical cancer, HPV31-positive, in multiple mediastinal lymphnodes, with infiltration of the esophageal mucosa. Mediastinal lymphade-nopathy in patients with a history of cervical carcinoma should be suspicious of metastatic disease, even if there is no radiological evidence of distant metastases.

  1. SIRT-FILTER v1.0.0

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    PELT, DANIEL

    2017-04-21

    Small Python package to compute tomographic reconstructions using a reconstruction method published in: Pelt, D.M., & De Andrade, V. (2017). Improved tomographic reconstruction of large-scale real-world data by filter optimization. Advanced Structural and Chemical Imaging 2: 17; and Pelt, D. M., & Batenburg, K. J. (2015). Accurately approximating algebraic tomographic reconstruction by filtered backprojection. In Proceedings of The 13th International Meeting on Fully Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine (pp. 158-161).

  2. Single-shot ultrafast tomographic imaging by spectral multiplexing

    NASA Astrophysics Data System (ADS)

    Matlis, N. H.; Axley, A.; Leemans, W. P.

    2012-10-01

    Computed tomography has profoundly impacted science, medicine and technology by using projection measurements scanned over multiple angles to permit cross-sectional imaging of an object. The application of computed tomography to moving or dynamically varying objects, however, has been limited by the temporal resolution of the technique, which is set by the time required to complete the scan. For objects that vary on ultrafast timescales, traditional scanning methods are not an option. Here we present a non-scanning method capable of resolving structure on femtosecond timescales by using spectral multiplexing of a single laser beam to perform tomographic imaging over a continuous range of angles simultaneously. We use this technique to demonstrate the first single-shot ultrafast computed tomography reconstructions and obtain previously inaccessible structure and position information for laser-induced plasma filaments. This development enables real-time tomographic imaging for ultrafast science, and offers a potential solution to the challenging problem of imaging through scattering surfaces.

  3. Computed tomographic atlas for the new international lymph node map for lung cancer: A radiation oncologist perspective.

    PubMed

    Lynch, Rod; Pitson, Graham; Ball, David; Claude, Line; Sarrut, David

    2013-01-01

    To develop a reproducible definition for each mediastinal lymph node station based on the new TNM classification for lung cancer. This paper proposes an atlas using the new international lymph node map used in the seventh edition of the TNM classification for lung cancer. Four radiation oncologists and 1 diagnostic radiologist were involved in the project to put forward a reproducible radiologic description for the lung lymph node stations. The International Association for the Study of Lung Cancer lymph node definitions for stations 1 to 11 have been described and illustrated on axial computed tomographic scan images using a certified radiotherapy planning system. This atlas will assist both diagnostic radiologists and radiation oncologists in accurately defining the lymph node stations on computed tomographic scan in patients diagnosed with lung cancer. Copyright © 2013 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  4. Fast projection/backprojection and incremental methods applied to synchrotron light tomographic reconstruction.

    PubMed

    de Lima, Camila; Salomão Helou, Elias

    2018-01-01

    Iterative methods for tomographic image reconstruction have the computational cost of each iteration dominated by the computation of the (back)projection operator, which take roughly O(N 3 ) floating point operations (flops) for N × N pixels images. Furthermore, classical iterative algorithms may take too many iterations in order to achieve acceptable images, thereby making the use of these techniques unpractical for high-resolution images. Techniques have been developed in the literature in order to reduce the computational cost of the (back)projection operator to O(N 2 logN) flops. Also, incremental algorithms have been devised that reduce by an order of magnitude the number of iterations required to achieve acceptable images. The present paper introduces an incremental algorithm with a cost of O(N 2 logN) flops per iteration and applies it to the reconstruction of very large tomographic images obtained from synchrotron light illuminated data.

  5. Detection of common carotid artery stenosis using duplex ultrasonography: a validation study with computed tomographic angiography.

    PubMed

    Slovut, David P; Romero, Javier M; Hannon, Kathleen M; Dick, James; Jaff, Michael R

    2010-01-01

    Severe stenosis of the common carotid artery (CCA), while uncommon, is associated with increased risk of transient ischemic attack and stroke. To date, no validated duplex ultrasound criteria have been established for grading the severity of CCA stenosis. The goal of this study was to use receiver-operating curve (ROC) analysis with computed tomographic angiography as the reference standard to establish duplex ultrasound criteria for diagnosing >or=50% CCA stenosis. The study cohort included 64 patients (42 men, 22 women) with a mean age of 65 +/- 12 years (range, 16-89 years) who had CCA peak systolic velocity (PSV) >or=150 cm/sec and underwent computed tomographic angiography (CTA) of the cervical and intracerebral vessels within 1 month of the duplex examination. One study was excluded because the CTA was technically inadequate, whereas another was excluded because the patient underwent bilateral CCA stenting. The CCA ipsilateral to any of the following was excluded from the analysis: innominate artery occlusion (n = 1), previous stenting of the ICA or CCA (n = 7), carotid endarterectomy (n = 1), or carotid-to-carotid bypass (n = 1). Thus, the data set included 62 patients and 115 vessels. Bland-Altman analysis was used to examine the agreement between two measures of luminal reduction measured by CTA: percent diameter stenosis and percent area stenosis. Receiver operating characteristic (ROC) analysis was used to determine optimal PSV and EDV thresholds for diagnosing >or=50% CCA stenosis. Severity of CCA stenosis was <50% in 76 vessels, 50%-59% in eight, 60%-69% in eight, 70%-79% in nine, 80%-89% in three, 90%-99% in five, and occluded in six. Duplex ultrasonography identified six of six (100%) patients with 100% CCA occlusion by CTA. Bland-Altman analysis showed poor agreement between percent stenosis determined by vessel diameter compared with percent stenosis determined by reduction in lumen area. Therefore, subsequent analysis was performed using percent stenosis by area. ROC analysis of different PSV thresholds for detecting stenosis >or=50% showed that >182 cm/sec was the most accurate with a sensitivity of 64% and specificity of 88% (P < .0001). Sensitivity, specificity, and accuracy of carotid duplex were higher when the stenosis was located in the mid or distal aspects of the CCA (sensitivity 76%, specificity 89%, area under curve 0.84, P < .001) than in the intrathoracic and proximal segment of the artery (P = NS). ROC analysis of different EDV thresholds for detecting CCA stenosis >or=50% showed that >30 cm/sec was the most accurate with a sensitivity of 54% and a specificity of 74% (P < .0239). Duplex ultrasonography is highly sensitive, specific, and accurate for detecting CCA lesions in the mid and distal CCA. Use of peak systolic velocity may lead to improved detection of CCA disease and initiation of appropriate therapy to reduce the risk of stroke. Copyright 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  6. Efficient control schemes with limited computation complexity for Tomographic AO systems on VLTs and ELTs

    NASA Astrophysics Data System (ADS)

    Petit, C.; Le Louarn, M.; Fusco, T.; Madec, P.-Y.

    2011-09-01

    Various tomographic control solutions have been proposed during the last decades to ensure efficient or even optimal closed-loop correction to tomographic Adaptive Optics (AO) concepts such as Laser Tomographic AO (LTAO), Multi-Conjugate AO (MCAO). The optimal solution, based on Linear Quadratic Gaussian (LQG) approach, as well as suboptimal but efficient solutions such as Pseudo-Open Loop Control (POLC) require multiple Matrix Vector Multiplications (MVM). Disregarding their respective performance, these efficient control solutions thus exhibit strong increase of on-line complexity and their implementation may become difficult in demanding cases. Among them, two cases are of particular interest. First, the system Real-Time Computer architecture and implementation is derived from past or present solutions and does not support multiple MVM. This is the case of the AO Facility which RTC architecture is derived from the SPARTA platform and inherits its simple MVM architecture, which does not fit with LTAO control solutions for instance. Second, considering future systems such as Extremely Large Telescopes, the number of degrees of freedom is twenty to one hundred times bigger than present systems. In these conditions, tomographic control solutions can hardly be used in their standard form and optimized implementation shall be considered. Single MVM tomographic control solutions represent a potential solution, and straightforward solutions such as Virtual Deformable Mirrors have been already proposed for LTAO but with tuning issues. We investigate in this paper the possibility to derive from tomographic control solutions, such as POLC or LQG, simplified control solutions ensuring simple MVM architecture and that could be thus implemented on nowadays systems or future complex systems. We theoretically derive various solutions and analyze their respective performance on various systems thanks to numerical simulation. We discuss the optimization of their performance and stability issues with respect to classic control solutions. We finally discuss off-line computation and implementation constraints.

  7. Subphrenic and Pleural Abscess Due to Spilled Gallstones

    PubMed Central

    Varker, Kimberly A.; Zaydfudim, Victor; McKee, Jason

    2006-01-01

    Background: A 70-year-old male approximately 3 years after laparoscopic cholecystectomy presented to his primary care physician with a 4-month history of generalized malaise. Methods: A workup included magnetic resonance imaging that revealed a perihepatic abscess. The patient underwent ultrasound-guided drainage, with the removal of 1400 mL of purulent fluid and placement of 2 drains. Computed tomographic scanning showed resolution, and he was discharged home on oral antibiotics. At 2-month follow-up, the patient was asymptomatic, denying any constitutional symptoms. However, abdominal computed tomographic scanning revealed recurrence of the abscess, which measured approximately 18x9x7.5 cm, with mass effect on the liver. The patient was placed on intravenous antibiotics and scheduled for operative drainage. The abdomen was entered with a right subcostal incision, and 900 mL of purulent fluid was drained. We also noted abscess erosion through the inferolateral aspect of the right diaphragm into the pleural space. The pleural abscess was loculated and isolated from the lung parenchyma. Palpation within the abscess cavity revealed 9 large gallstones. Following copious irrigation and debridement of necrotic tissue, 3 drains were placed and the incision was closed. Results: The patient had an uneventful recovery and was discharged home on postoperative day number 6. Follow-up imaging at 3 months demonstrated resolution of the collection. Conclusion: Spillage of gallstones is a complication of laparoscopic cholecystectomy, occurring in 6% to 16% of all cases. Retained stones rarely result in a problem, but when complications arise, aggressive surgical intervention is usually necessary. PMID:16709371

  8. Robust statistical reconstruction for charged particle tomography

    DOEpatents

    Schultz, Larry Joe; Klimenko, Alexei Vasilievich; Fraser, Andrew Mcleod; Morris, Christopher; Orum, John Christopher; Borozdin, Konstantin N; Sossong, Michael James; Hengartner, Nicolas W

    2013-10-08

    Systems and methods for charged particle detection including statistical reconstruction of object volume scattering density profiles from charged particle tomographic data to determine the probability distribution of charged particle scattering using a statistical multiple scattering model and determine a substantially maximum likelihood estimate of object volume scattering density using expectation maximization (ML/EM) algorithm to reconstruct the object volume scattering density. The presence of and/or type of object occupying the volume of interest can be identified from the reconstructed volume scattering density profile. The charged particle tomographic data can be cosmic ray muon tomographic data from a muon tracker for scanning packages, containers, vehicles or cargo. The method can be implemented using a computer program which is executable on a computer.

  9. Early In-Theater Management of Combat-Related Traumatic Brain Injury: A Prospective, Observational Study to Identify Opportunities for Performance Improvement

    DTIC Science & Technology

    2015-05-18

    Head computed tomographic scan most commonly found skull fracture (68.9%), subdural hematoma (54.1%), and cerebral contusion (51.4%). Hypertonic saline...were common on presentation. Head computed tomographic scan most commonly found skull fracture (68.9%), subdural hematoma (54.1%), and cerebral con...reported was skull fracture, occurring in 68.9% of patients. The most common type of intracranial hemorrhage was subdural hematoma (54.1%). Multiple

  10. Computer tomographic evaluation of digestive tract non-Hodgkin lymphomas.

    PubMed

    Lupescu, Ioana G; Grasu, Mugur; Goldis, Gheorghe; Popa, Gelu; Gheorghe, Cristian; Vasilescu, Catalin; Moicean, Andreea; Herlea, Vlad; Georgescu, Serban A

    2007-09-01

    Computer Tomographic (CT) study is crucial for defining distribution, characteristics and staging of primary gastrointestinal lymphomas. The presence of multifocal sites, the wall thickening with diffuse infiltration of the affected gastrointestinal (GI) segment in association with regional adenopathies, permit the orientation of the CT diagnosis for primary GI lymphomas. The gold standard for diagnosis remains, in all cases of digestive tract non-Hodgkin lymphomas (NHL), the histological examination, which allows a tissue diagnosis, performed preferably by transmural biopsy.

  11. Use of radiography, computed tomography and magnetic resonance imaging for evaluation of navicular syndrome in the horse.

    PubMed

    Widmer, W R; Buckwalter, K A; Fessler, J F; Hill, M A; VanSickle, D C; Ivancevich, S

    2000-01-01

    Radiographic evaluation of navicular syndrome is problematic because of its inconsistent correlation with clinical signs. Scintigraphy often yields false positive and false negative results and diagnostic ultrasound is of limited value. Therefore, we assessed the use of computed tomography and magnetic resonance imaging in a horse with clinical and radiographic signs of navicular syndrome. Cadaver specimens were examined with spiral computed tomographic and high-field magnetic resonance scanners and images were correlated with pathologic findings. Radiographic changes consisted of bony remodeling, which included altered synovial fossae, increased medullary opacity, cyst formation and shape change. These osseous changes were more striking and more numerous on computed tomographic and magnetic resonance images. They were most clearly defined with computed tomography. Many osseous changes seen with computed tomography and magnetic resonance imaging were not radiographically evident. Histologically confirmed soft tissue alterations of the deep digital flexor tendon, impar ligament and marrow were identified with magnetic resonance imaging, but not with conventional radiography. Because of their multiplanar capability and tomographic nature, computed tomography and magnetic resonance imaging surpass conventional radiography for navicular imaging, facilitating earlier, more accurate diagnosis. Current advances in imaging technology should make these imaging modalities available to equine practitioners in the future.

  12. 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 resonance angiography evidence of arterial obstruction, but the sample was underpowered to demonstrate significant treatment benefit or harm among patients with apparently patent arteries. Clinical Trial Registration— URL: http://www.isrctn.com. Unique identifier: ISRCTN25765518. PMID:28008093

  13. 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 underpowered to demonstrate significant treatment benefit or harm among patients with apparently patent arteries. URL: http://www.isrctn.com. Unique identifier: ISRCTN25765518. © 2016 The Authors.

  14. Electrocardiographically gated 16-section CT of the thorax: cardiac motion suppression.

    PubMed

    Hofmann, Lars K; Zou, Kelly H; Costello, Philip; Schoepf, U Joseph

    2004-12-01

    Thirty patients underwent 16-section multi-detector row computed tomographic (CT) angiography of the thorax with retrospective electrocardiographic gating. Institutional review board approval was obtained for retrospective analysis of CT scan data and records; patient informed consent was not required. Images reconstructed at six different time points (0%, 20%, 40%, 50%, 60%, 80%) within the R-R interval on the electrocardiogram were analyzed by two radiologists for diagnostic quality, to identify suitable reconstruction intervals for optimal suppression of cardiac motion. Five regions of interest (left coronary artery, aortic root, ascending and descending aorta, pulmonary arteries) were evaluated. Best image quality was achieved by referencing image reconstruction to middiastole (50%-60%) for the left coronary artery, aortic root, and ascending aorta. The pulmonary arteries are best displayed during mid- to late diastole (80%). (c) RSNA, 2004

  15. Mica dust and pneumoconiosis: example of a pure occupational exposure in a muscovite milling unit.

    PubMed

    Hulo, Sébastien; Cherot-kornobis, Nathalie; Edme, Jean-Louis; de Broucker, Virginie; Falgayrac, Guillaume; Penel, Guillaume; Legrand-Cattan, Karinne; Remy, Jacques; Sobaszek, Annie

    2013-12-01

    We present pulmonary disorders of four employees who were exposed to high concentration of pure mica dust in a muscovite milling unit. All cases underwent traditional examinations with a dual-energy chest computed tomographic scan. An analysis of exhaled breath condensate by Raman microspectrometry and of mineralogical content of a lung biopsy was performed for one case. All cases showed bilateral micronodular ground glass opacities and mediastinal and hilar hyperdense lymph nodes consistent with the nodal sequestration of mineral particles. Histological analysis showed giant cell granulomas without typical silicotic nodule with high concentration of birefringent particles consistent with mica. Mica particles found in the exhaled breath condensate were identical to particles in ambient air at the company. Occupational exposure to mica dust is responsible for diffuse infiltrative lung disease by overload processes.

  16. Comparative evaluation of the cadaveric and computed tomographic features of the coelomic cavity in the green iguana (Iguana iguana), black and white tegu (Tupinambis merianae) and bearded dragon (Pogona vitticeps).

    PubMed

    Banzato, T; Selleri, P; Veladiano, I A; Zotti, A

    2013-12-01

    Contrast-enhanced computed tomographic studies of the coelomic cavity in four green iguanas, four black and white tegus and four bearded dragons were performed using a conventional CT scanner. Anatomical reference cross sections were obtained from four green iguana, four black and white tegu and six bearded dragon cadavers; the specimens were stored in a -20°C freezer for 24 h then sliced into 5-mm intervals. The frozen sections were cleaned with water and photographed on both sides. The individual anatomical structures were identified by means of the available literature; these were labelled first on the anatomical images and then matched to the corresponding computed tomography images. The results provide an atlas of the normal cross-sectional and computed tomographic anatomy of the coelomic cavity in the green iguana, the black and white tegu and the bearded dragon, which is useful in the interpretation of any imaging modality. © 2013 Blackwell Verlag GmbH.

  17. Three-dimensional reconstructions from computed tomographic scans on smartphones and tablets: a simple tutorial for the ward and operating room using public domain software.

    PubMed

    Ketoff, Serge; Khonsari, Roman Hossein; Schouman, Thomas; Bertolus, Chloé

    2014-11-01

    Handling 3-dimensional reconstructions of computed tomographic scans on portable devices is problematic because of the size of the Digital Imaging and Communications in Medicine (DICOM) stacks. The authors provide a user-friendly method allowing the production, transfer, and sharing of good-quality 3-dimensional reconstructions on smartphones and tablets. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Utility of cervical spinal and abdominal computed tomography in diagnosing occult pneumothorax in patients with blunt trauma: Computed tomographic imaging protocol matters.

    PubMed

    Akoglu, Haldun; Akoglu, Ebru Unal; Evman, Serdar; Akoglu, Tayfun; Denizbasi, Arzu; Guneysel, Ozlem; Onur, Ozge; Onur, Ender

    2012-10-01

    Small pneumothoraces (PXs), which are not initially recognized with a chest x-ray film and diagnosed by a thoracic computed tomography (CT), are described as occult PX (OCPX). The objective of this study was to evaluate cervival spine (C-spine) and abdominal CT (ACT) for diagnosing OCPX and overt PX (OVPX). All patients with blunt trauma who presented consecutively to the emergency department during a 26-months period were included. Among all the chest CTs (CCTs) (6,155 patients) conducted during that period, 254 scans were confirmed to have a true PX. The findings in their C-spine CT and ACT were compared with the findings in CCTs. Among these patients, 254 had a diagnosis of PX confirmed with CCT. OCPXs were identified on the chest computed tomographic scan of 128 patients (70.3%), whereas OVPXs were evident in 54 patients (29.7%). Computed tomographic imaging of the C-spine was performed in 74% of patients with OCPX and 66.7% of patients with OVPX trauma. Only 45 (35.2%) cases of OCPX and 42 (77.8%) cases of OVPX were detected by C-spine CT. ACT was performed in almost all patients, and 121 (95.3%) of 127 of these correctly identified an existing OCPX. Sensitivity of C-spine CT and ACT was 35.1% and 96.5%, respectively; specificity was 100% and 100%, respectively. Almost all OCPXs, regardless of intrathoracic location, could be detected by ACT or by combining C-spine and abdominal computed tomographic screening for patients. If the junction of the first and second vertebra is used as the caudad extent, C-spine CT does not have sufficient power to diagnose more than a third of the cases. Diagnostic study, level III.

  19. Computed tomographic imaging interpretation improves fetal outcomes after maternal trauma.

    PubMed

    Kopelman, Tammy R; Bogert, James N; Walters, Jarvis W; Gridley, Daniel; Guzman, Oscar; Davis, Karole M; Pieri, Paola G; Vail, Sydney J; Pressman, Melissa

    2016-12-01

    Computed tomography (CT) has been validated to identify and classify placental abruption following blunt trauma. The purpose of this study was to demonstrate improvement in fetal survival when delivery occurs by protocol at the first sign of class III fetal heart rate tracing in pregnant trauma patients with a viable fetus on arrival and CT evidence of placental perfusion 50% or less secondary to placental abruption. This is a retrospective review of pregnant trauma patients at 26 weeks' gestation or greater who underwent abdominopelvic CT as part of their initial evaluation. Charts were reviewed for CT interpretation of placental pathology with classification of placental abruption based upon enhancement (Grade 1, >50% perfusion; Grade 2, 25%-50% perfusion; Grade 3, <25% perfusion), as well as need for delivery and fetal outcomes. Forty-one patients met inclusion criteria. Computed tomography revealed evidence of placental abruption in six patients (15%): Grade 1, one patient, Grade 2, one patient, and Grade 3, four patients. Gestational ages ranged from 26 to 39 weeks. All patients with placental abruption of Grade 2 or greater developed concerning fetal heart tracings and underwent delivery emergently at first sign. Abruption was confirmed intraoperatively in all cases. Each birth was viable, and Apgar scores at 10 minutes were greater than 7 in 80% of infants, all of whom were ultimately discharged home. The remaining infant was transferred to an outside facility. Delivery at first sign of nonreassuring fetal heart rate tracings in pregnant trauma patients (third trimester) with placental abruption of Grade 2 or greater can lead to improved fetal outcome. Therapeutic/care management study, level III.

  20. Tuning the cache memory usage in tomographic reconstruction on standard computers with Advanced Vector eXtensions (AVX)

    PubMed Central

    Agulleiro, Jose-Ignacio; Fernandez, Jose-Jesus

    2015-01-01

    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. PMID:26217710

  1. 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.

  2. Enteral Contrast in the Computed Tomography Diagnosis of Appendicitis

    PubMed Central

    Drake, Frederick Thurston; Alfonso, Rafael; Bhargava, Puneet; Cuevas, Carlos; Dighe, Manjiri K.; Florence, Michael G.; Johnson, Morris G.; Jurkovich, Gregory J.; Steele, Scott R.; Symons, Rebecca Gaston; Thirlby, Richard C.; Flum, David R.

    2014-01-01

    Objective Our goal was to perform a comparative effectiveness study of intravenous (IV)-only versus IV + enteral contrast in computed tomographic (CT) scans performed for patients undergoing appendectomy across a diverse group of hospitals. Background Small randomized trials from tertiary centers suggest that enteral contrast does not improve diagnostic performance of CT for suspected appendicitis, but generalizability has not been demonstrated. Eliminating enteral contrast may improve efficiency, patient comfort, and safety. Methods We analyzed data for adult patients who underwent nonelective appendectomy at 56 hospitals over a 2-year period. Data were obtained directly from patient charts by trained abstractors. Multivariate logistic regression was utilized to adjust for potential confounding. The main outcome measure was concordance between final radiology interpretation and final pathology report. Results A total of 9047 adults underwent appendectomy and 8089 (89.4%) underwent CT, 54.1% of these with IV contrast only and 28.5% with IV + enteral contrast. Pathology findings correlated with radiographic findings in 90.0% of patients who received IV + enteral contrast and 90.4% of patients scanned with IV contrast alone. Hospitals were categorized as rural or urban and by their teaching status. Regardless of hospital type, there was no difference in concordance between IV-only and IV + enteral contrast. After adjusting for age, sex, comorbid conditions, weight, hospital type, and perforation, odds ratio of concordance for IV + enteral contrast versus IV contrast alone was 0.95 (95% CI: 0.72–1.25). Conclusions Enteral contrast does not improve CT evaluation of appendicitis in patients undergoing appendectomy. These broadly generalizable results from a diverse group of hospitals suggest that enteral contrast can be eliminated in CT scans for suspected appendicitis. PMID:24598250

  3. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-file Systems.

    PubMed

    Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Dixit, Kratika; Naik, Saraswathi V

    2016-01-01

    Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. This is an experimental, in vitro study comparing the two groups. A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49.

  4. Computed tomographic-based quantification of emphysema and correlation to pulmonary function and mechanics.

    PubMed

    Washko, George R; Criner, Gerald J; Mohsenifar, Zab; Sciurba, Frank C; Sharafkhaneh, Amir; Make, Barry J; Hoffman, Eric A; Reilly, John J

    2008-06-01

    Computed tomographic based indices of emphysematous lung destruction may highlight differences in disease pathogenesis and further enable the classification of subjects with Chronic Obstructive Pulmonary Disease. While there are multiple techniques that can be utilized for such radiographic analysis, there is very little published information comparing the performance of these methods in a clinical case series. Our objective was to examine several quantitative and semi-quantitative methods for the assessment of the burden of emphysema apparent on computed tomographic scans and compare their ability to predict lung mechanics and function. Automated densitometric analysis was performed on 1094 computed tomographic scans collected upon enrollment into the National Emphysema Treatment Trial. Trained radiologists performed an additional visual grading of emphysema on high resolution CT scans. Full pulmonary function test results were available for correlation, with a subset of subjects having additional measurements of lung static recoil. There was a wide range of emphysematous lung destruction apparent on the CT scans and univariate correlations to measures of lung function were of modest strength. No single method of CT scan analysis clearly outperformed the rest of the group. Quantification of the burden of emphysematous lung destruction apparent on CT scan is a weak predictor of lung function and mechanics in severe COPD with no uniformly superior method found to perform this analysis. The CT based quantification of emphysema may augment pulmonary function testing in the characterization of COPD by providing complementary phenotypic information.

  5. Parallel Computing for the Computed-Tomography Imaging Spectrometer

    NASA Technical Reports Server (NTRS)

    Lee, Seungwon

    2008-01-01

    This software computes the tomographic reconstruction of spatial-spectral data from raw detector images of the Computed-Tomography Imaging Spectrometer (CTIS), which enables transient-level, multi-spectral imaging by capturing spatial and spectral information in a single snapshot.

  6. Hollow organ perforation in blunt abdominal trauma: the role of diagnostic peritoneal lavage.

    PubMed

    Wang, Yu-Chun; Hsieh, Chi-Hsun; Fu, Chih-Yuan; Yeh, Chun-Chieh; Wu, Shih-Chi; Chen, Ray-Jade

    2012-05-01

    With recent advances in radiologic diagnostic procedures, the use of diagnostic peritoneal lavage (DPL) has markedly declined. In this study, we reviewed data to reevaluate the role of DPL in the diagnosis of hollow organ perforation in patients with blunt abdominal trauma. Adult patients who had sustained blunt abdominal trauma and who were hemodynamically stable after initial resuscitation underwent an abdominal computed tomographic (CT) scan. Diagnostic peritoneal lavage was performed for patients who were indicated to receive nonoperative management and where hollow organ perforation could not be ruled out. During a 60-month period, 64 patients who had received abdominal CT scanning underwent DPL. Nineteen patients were diagnosed as having a positive DPL based on cell count ratio of 1 or higher. There were 4 patients who sustained small bowel perforation. The sensitivity and specificity of the cell count ratio for a hollow organ perforation in this study were 100% and 75%, respectively. No missed hollow organ perforations were detected. For patients with blunt abdominal trauma and hemoperitoneum who plan to receive nonoperative management, DPL is still a useful tool to exclude hollow organ perforation that is undetected by CT. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Computer tomographic assessment of postoperative peripancreatic collections after distal pancreatectomy.

    PubMed

    Uchida, Yuichiro; Masui, Toshihiko; Sato, Asahi; Nagai, Kazuyuki; Anazawa, Takayuki; Takaori, Kyoichi; Uemoto, Shinji

    2018-03-27

    Peripancreatic collections occur frequently after distal pancreatectomy. However, the sequelae of peripancreatic collections vary from case to case, and their clinical impact is uncertain. In this study, the correlations between CT findings of peripancreatic collections and complications after distal pancreatectomy were investigated. Ninety-six consecutive patients who had undergone distal pancreatectomy between 2010 and 2015 were retrospectively investigated. The extent and heterogeneity of peripancreatic collections and background clinicopathological characteristics were analyzed. The extent of peripancreatic collections was calculated based on three-dimensional computed tomography images, and the degree of heterogeneity of peripancreatic collections was assessed based on the standard deviation of their density on computed tomography. Of 85 patients who underwent postoperative computed tomography imaging, a peripancreatic collection was detected in 77 (91%). Patients with either a large extent or a high degree of heterogeneity of peripancreatic collection had a significantly higher rate of clinically relevant pancreatic fistula than those without (odds ratio 5.95, 95% confidence interval 2.12-19.72, p = 0.001; odds ratio 8.0, 95% confidence interval 2.87-24.19, p = 0.0001, respectively). A large and heterogeneous peripancreatic collection was significantly associated with postoperative complications, especially clinically relevant postoperative pancreatic fistula. A small and homogenous peripancreatic collection could be safely observed.

  8. Utility of minimal preparation ct colonography in detecting colorectal cancer in elderly and frail patients.

    PubMed

    Meiklejohn, D J; Ridley, L J; Ngu, M C; Cowlishaw, J L; Duller, A; Ridley, W

    2018-06-11

    Colorectal cancers result in substantial morbidity and mortality to Australian society each year. The usual investigation for bowel malignancyis optical colonoscopy (OC), withcomputed tomographic colonography (CTC) used as an alternative investigation. The catharsis and colon insufflation associated with these investigations pose a higher risk in the elderly and frail. Risks include perforation, serum electrolyte disturbance, and anaesthesia/sedation risks.Minimal preparation computed tomographic colonography (MPCTC) eliminates these risks. This paper audits a 6-year period ofMPCTC in an Australian tertiary referral hospital. 145 patients underwent MPCTC during the study period. There were 7 true positives, 2 false positives and 2 false negatives. Analysis of this population indicates a sensitivity of 0.78 (95% CI 0.51 - 1.05), specificity of 0.99 (95% CI 0.97 - 1.01), positive predictive value (PPV) of 0.78 (95% CI 0.51 - 1.05) and negative predictive value (NPV) of 0.99 (95% CI 0.97 - 1.01). These findings are concordant with other published studies. The auditconfirmsthatminimal preparation CT colonography is a reasonable alternative to OC and CTC in detecting colorectal cancer in symptomatic elderly and frail patients, without the procedural risks inherent inmore invasive investigations. For most patients MPCTC ruled out significant colorectal carcinoma with a high negative predictive value. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Clinical outcomes after magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) for pulmonary embolism evaluation.

    PubMed

    Repplinger, Michael D; Nagle, Scott K; Harringa, John B; Broman, Aimee T; Lindholm, Christopher R; François, Christopher J; Grist, Thomas M; Reeder, Scott B; Schiebler, Mark L

    2018-05-10

    To compare patient outcomes following magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) ordered for suspected pulmonary embolism (PE). In this IRB-approved, single-center, retrospective, case-control study, we reviewed the medical records of all patients evaluated for PE with MRA during a 5-year period along with age- and sex-matched controls evaluated with CTA. Only the first instance of PE evaluation during the study period was included. After application of our exclusion criteria to both study arms, the analysis included 1173 subjects. The primary endpoint was major adverse PE-related event (MAPE), which we defined as major bleeding, venous thromboembolism, or death during the 6 months following the index imaging test (MRA or CTA), obtained through medical record review. Logistic regression, chi-square test for independence, and Fisher's exact test were used with a p < 0.05 threshold. The overall 6-month MAPE rate following MRA (5.4%) was lower than following CTA (13.6%, p < 0.01). Amongst outpatients, the MAPE rate was lower for MRA (3.7%) than for CTA (8.0%, p = 0.01). Accounting for age, sex, referral source, BMI, and Wells' score, patients were less likely to suffer MAPE than those who underwent CTA, with an odds ratio of 0.44 [0.24, 0.80]. Technical success rate did not differ significantly between MRA (92.6%) and CTA (90.5%) groups (p = 0.41). Within the inherent limitations of a retrospective case-controlled analysis, we observed that the rate of MAPE was lower (more favorable) for patients following pulmonary MRA for the primary evaluation of suspected PE than following CTA.

  10. Extended supraclavicular fasciocutaneous island flap based on the transverse cervical artery for head and neck reconstruction after cancer ablation.

    PubMed

    Chen, Wei-Liang; Zhang, Da-ming; Yang, Zhao-hui; Huang, Zhi-quan; Wang, Jian-guang; Zhang, Bin; Li, Jing-song

    2010-10-01

    This clinical study assessed a pedicled supraclavicular fasciocutaneous island flap (SFIF) based on the transverse cervical artery that was extended to include shoulder skin for reconstructing the head and neck. Pedicled SFIFs extended to include the shoulder skin based on the cutaneous feeder vessels and perforator vessels in the deep fascia of the transverse cervical artery were designed for 24 patients with defects of the head and neck after cancer ablation. Preoperative 3-dimensional computed tomographic angiography was performed in all patients. The patients consisted of 15 men and 9 women ranging in age from 24 to 73 years. The primary lesions included squamous cell carcinoma of the tongue, buccal mucosa, floor of the mouth, oropharynx, palate, and lower gingiva. Three-dimensional computed tomographic angiography showed that the transverse cervical artery arose from the thyrocervical trunk in 13 cases and from the subclavian artery in 11 cases. The diameter of the artery ranged from 0.15 to 0.24 cm. The size of flaps ranged from 4 × 8 cm to 6 × 12 cm, and the mean length of the vascular pedicle was approximately 18.5 cm. Of the flaps, 23 survived completely, for a success rate of 95.8%. Three patients underwent radiotherapy, and the follow-up period ranged from 3 to 12 months. One patient died of local tumor recurrence, and cervical recurrences developed in 3 patients. An SFIF extended to include the shoulder skin based on the cutaneous feeder vessels and perforator vessels in the deep fascia of the transverse cervical artery is a useful, viable option for defects of the head and neck after cancer ablation. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Value of Computed Tomographic Perfusion-Based Patient Selection for Intra-Arterial Acute Ischemic Stroke Treatment.

    PubMed

    Borst, Jordi; Berkhemer, Olvert A; Roos, Yvo B W E M; van Bavel, Ed; van Zwam, Wim H; van Oostenbrugge, Robert J; van Walderveen, Marianne A A; Lingsma, Hester F; van der Lugt, Aad; Dippel, Diederik W J; Yoo, Albert J; Marquering, Henk A; Majoie, Charles B L M

    2015-12-01

    The utility of computed tomographic perfusion (CTP)-based patient selection for intra-arterial treatment of acute ischemic stroke has not been proven in randomized trials and requires further study in a cohort that was not selected based on CTP. Our objective was to study the relationship between CTP-derived parameters and outcome and treatment effect in patients with acute ischemic stroke because of a proximal intracranial arterial occlusion. We included 175 patients who underwent CTP in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN). Association of CTP-derived parameters (ischemic-core volume, penumbra volume, and percentage ischemic core) with outcome was estimated with multivariable ordinal logistic regression as an adjusted odds ratio for a shift in the direction of a better outcome on the modified Rankin Scale. Interaction between CTP-derived parameters and treatment effect was determined using multivariable ordinal logistic regression. Interaction with treatment effect was also tested for mismatch (core <70 mL; penumbra core >1.2; penumbra core >10 mL). The adjusted odds ratio for improved functional outcome for ischemic core, percentage ischemic core, and penumbra were 0.79 per 10 mL (95% confidence interval: 0.71-0.89; P<0.001), 0.82 per 10% (95% confidence interval: 0.66-0.90; P=0.002), and 0.97 per 10 mL (96% confidence interval: 0.92-1.01; P=0.15), respectively. No significant interaction between any of the CTP-derived parameters and treatment effect was observed. We observed no significant interaction between mismatch and treatment effect. CTP seems useful for predicting functional outcome, but cannot reliably identify patients who will not benefit from intra-arterial therapy. © 2015 American Heart Association, Inc.

  12. Ontario multidetector computed tomographic coronary angiography study: field evaluation of diagnostic accuracy.

    PubMed

    Chow, Benjamin J W; Freeman, Michael R; Bowen, James M; Levin, Leslie; Hopkins, Robert B; Provost, Yves; Tarride, Jean-Eric; Dennie, Carole; Cohen, Eric A; Marcuzzi, Dan; Iwanochko, Robert; Moody, Alan R; Paul, Narinder; Parker, John D; O'Reilly, Daria J; Xie, Feng; Goeree, Ron

    2011-06-13

    Computed tomographic coronary angiography (CTCA) has gained clinical acceptance for the detection of obstructive coronary artery disease. Although single-center studies have demonstrated excellent accuracy, multicenter studies have yielded variable results. The true diagnostic accuracy of CTCA in the "real world" remains uncertain. We conducted a field evaluation comparing multidetector CTCA with invasive CA (ICA) to understand CTCA's diagnostic accuracy in a real-world setting. A multicenter cohort study of patients awaiting ICA was conducted between September 2006 and June 2009. All patients had either a low or an intermediate pretest probability for coronary artery disease and underwent CTCA and ICA within 10 days. The results of CTCA and ICA were interpreted visually by local expert observers who were blinded to all clinical data and imaging results. Using a patient-based analysis (diameter stenosis ≥50%) of 169 patients, the sensitivity, specificity, positive predictive value, and negative predictive value were 81.3% (95% confidence interval [CI], 71.0%-89.1%), 93.3% (95% CI, 85.9%-97.5%), 91.6% (95% CI, 82.5%-96.8%), and 84.7% (95% CI, 76.0%-91.2%), respectively; the area under receiver operating characteristic curve was 0.873. The diagnostic accuracy varied across centers (P < .001), with a sensitivity, specificity, positive predictive value, and negative predictive value ranging from 50.0% to 93.2%, 92.0% to 100%, 84.6% to 100%, and 42.9% to 94.7%, respectively. Compared with ICA, CTCA appears to have good accuracy; however, there was variability in diagnostic accuracy across centers. Factors affecting institutional variability need to be better understood before CTCA is universally adopted. Additional real-world evaluations are needed to fully understand the impact of CTCA on clinical care. clinicaltrials.gov Identifier: NCT00371891.

  13. Endoscopic and computed tomographic evaluation of influence of nasal septal deviation on lateral wall of nose and its relation to sinus diseases.

    PubMed

    Poorey, V K; Gupta, Neha

    2014-09-01

    To correlate symptoms of deviated nasal septum (DNS) and chronic rhinosinusitis with the findings of nasal endoscopy and computed tomographic (CT) imaging. To evaluate the influence of degree of septal angle deviation on the severity of lateral nasal wall abnormalities. A prospective study was conducted on 67 patients with clinical evidence of DNS and chronic sinusitis attending ENT OPD between January 2012 and September 2013. All these patients underwent nasal endoscopy and CT scan PNS coronal sections. Direction and degree of DNS was recorded. Range of sinus mucosal thickening on CT scan films was also recorded. Chronic sinusitis is common in the age group between 21 and 40 years (50.74 %) with male preponderance (55.22 %), chief symptoms being nasal obstruction (86.56 %), headache (73.13 %) and nasal discharge (52.23 %). Left sided DNS is more common (64.17 %). Most of the patients have moderate DNS, i.e. 6°-10° (56.7 %), followed by severe (22.4 %) and then mild (20.9 %). DNS results in compensatory structural changes in the turbinates and/or lateral nasal wall which causes ostiomeatal complex (OMC) obstruction resulting in sinusitis. Contralateral concha bullosa and ethmoid bulla prominence was noted. Maxillary sinus is most commonly affected sinus (73.13 %). Patients with increasing septal angles were associated with a higher incidence of maxillary sinus mucosal changes (p < 0.05). Present study reemphasized the concept that septal deviation causes obstruction at OMC which results in an increased incidence and severity of bilateral chronic sinus disease.

  14. Lower gastrointestinal bleeding: Role of 64-row computed tomographic angiography in diagnosis and therapeutic planning

    PubMed Central

    Ren, Jian-Zhuang; Zhang, Meng-Fan; Rong, Ai-Mei; Fang, Xiang-Jie; Zhang, Kai; Huang, Guo-Hao; Chen, Peng-Fei; Wang, Zhao-Yang; Duan, Xu-Hua; Han, Xin-Wei; Liu, Yan-Jie

    2015-01-01

    AIM: To determine the value of computed tomographic angiography (CTA) for diagnosis and therapeutic planning in lower gastrointestinal (GI) bleeding. METHODS: Sixty-three consecutive patients with acute lower GI bleeding underwent CTA before endovascular or surgical treatment. CTA was used to determine whether the lower GI bleeding was suitable for endovascular treatment, surgical resection, or conservative treatment in each patient. Treatment planning with CTA was compared with actual treatment decisions or endovascular or surgical treatment that had been carried out in each patient based on CTA findings. RESULTS: 64-row CTA detected active extravasation of contrast material in 57 patients and six patients had no demonstrable active bleeding, resulting in an accuracy of 90.5% in the detection of acute GI bleeding (57 of 63). In three of the six patients with no demonstrable active bleeding, active lower GI bleeding recurred within one week after CTA, and angiography revealed acute bleeding. The overall location-based accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection of GI bleeding by 64-row CTA were 98.8% (249 of 252), 95.0% (57 of 60), 100% (192 of 192), 100% (57 of 57), and 98.5% (192 of 195), respectively. Treatment planning was correctly established on the basis of 64-row CTA with an accuracy, sensitivity, specificity, PPV and NPV of 98.4% (248 of 252), 93.3% (56 of 60), 100% (192 of 192), 100% (56 of 56), and 97.5% (192 of 196), respectively, in a location-based evaluation. CONCLUSION: 64-row CTA is safe and effective in making decisions regarding treatment, without performing digital subtraction angiography or surgery, in the majority of patients with lower GI bleeding. PMID:25852291

  15. Tomographic diagnostics of nonthermal plasmas

    NASA Astrophysics Data System (ADS)

    Denisova, Natalia

    2009-10-01

    In the previous work [1], we discussed a ``technology'' of tomographic method and relations between the tomographic diagnostics in thermal (equilibrium) and nonthermal (nonequilibrium) plasma sources. The conclusion has been made that tomographic reconstruction in thermal plasma sources is the standard procedure at present, which can provide much useful information on the plasma structure and its evolution in time, while the tomographic reconstruction of nonthermal plasma has a great potential at making a contribution to understanding the fundamental problem of substance behavior in strongly nonequilibrium conditions. Using medical terminology, one could say, that tomographic diagnostics of the equilibrium plasma sources studies their ``anatomic'' structure, while reconstruction of the nonequilibrium plasma is similar to the ``physiological'' examination: it is directed to study the physical mechanisms and processes. The present work is focused on nonthermal plasma research. The tomographic diagnostics is directed to study spatial structures formed in the gas discharge plasmas under the influence of electrical and gravitational fields. The ways of plasma ``self-organization'' in changing and extreme conditions are analyzed. The analysis has been made using some examples from our practical tomographic diagnostics of nonthermal plasma sources, such as low-pressure capacitive and inductive discharges. [0pt] [1] Denisova N. Plasma diagnostics using computed tomography method // IEEE Trans. Plasma Sci. 2009 37 4 502.

  16. Analysis of computer images in the presence of metals

    NASA Astrophysics Data System (ADS)

    Buzmakov, Alexey; Ingacheva, Anastasia; Prun, Victor; Nikolaev, Dmitry; Chukalina, Marina; Ferrero, Claudio; Asadchikov, Victor

    2018-04-01

    Artifacts caused by intensely absorbing inclusions are encountered in computed tomography via polychromatic scanning and may obscure or simulate pathologies in medical applications. To improve the quality of reconstruction if high-Z inclusions in presence, previously we proposed and tested with synthetic data an iterative technique with soft penalty mimicking linear inequalities on the photon-starved rays. This note reports a test at the tomographic laboratory set-up at the Institute of Crystallography FSRC "Crystallography and Photonics" RAS in which tomographic scans were successfully made of temporary tooth without inclusion and with Pb inclusion.

  17. Nose and Nasal Planum Neoplasia, Reconstruction.

    PubMed

    Worley, Deanna R

    2016-07-01

    Most intranasal lesions are best treated with radiation therapy. Computed tomographic imaging with intravenous contrast is critical for treatment planning. Computed tomographic images of the nose will best assess the integrity of the cribriform plate for central nervous system invasion by a nasal tumor. Because of an owner's emotional response to an altered appearance of their dog's face, discussions need to include the entire family before proceeding with nasal planectomy or radical planectomy. With careful case selection, nasal planectomy and radical planectomy surgeries can be locally curative. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Trace: a high-throughput tomographic reconstruction engine for large-scale datasets

    DOE PAGES

    Bicer, Tekin; Gursoy, Doga; Andrade, Vincent De; ...

    2017-01-28

    Here, synchrotron light source and detector technologies enable scientists to perform advanced experiments. These scientific instruments and experiments produce data at such scale and complexity that large-scale computation is required to unleash their full power. One of the widely used data acquisition technique at light sources is Computed Tomography, which can generate tens of GB/s depending on x-ray range. A large-scale tomographic dataset, such as mouse brain, may require hours of computation time with a medium size workstation. In this paper, we present Trace, a data-intensive computing middleware we developed for implementation and parallelization of iterative tomographic reconstruction algorithms. Tracemore » provides fine-grained reconstruction of tomography datasets using both (thread level) shared memory and (process level) distributed memory parallelization. Trace utilizes a special data structure called replicated reconstruction object to maximize application performance. We also present the optimizations we have done on the replicated reconstruction objects and evaluate them using a shale and a mouse brain sinogram. Our experimental evaluations show that the applied optimizations and parallelization techniques can provide 158x speedup (using 32 compute nodes) over single core configuration, which decreases the reconstruction time of a sinogram (with 4501 projections and 22400 detector resolution) from 12.5 hours to less than 5 minutes per iteration.« less

  19. Trace: a high-throughput tomographic reconstruction engine for large-scale datasets

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bicer, Tekin; Gursoy, Doga; Andrade, Vincent De

    Here, synchrotron light source and detector technologies enable scientists to perform advanced experiments. These scientific instruments and experiments produce data at such scale and complexity that large-scale computation is required to unleash their full power. One of the widely used data acquisition technique at light sources is Computed Tomography, which can generate tens of GB/s depending on x-ray range. A large-scale tomographic dataset, such as mouse brain, may require hours of computation time with a medium size workstation. In this paper, we present Trace, a data-intensive computing middleware we developed for implementation and parallelization of iterative tomographic reconstruction algorithms. Tracemore » provides fine-grained reconstruction of tomography datasets using both (thread level) shared memory and (process level) distributed memory parallelization. Trace utilizes a special data structure called replicated reconstruction object to maximize application performance. We also present the optimizations we have done on the replicated reconstruction objects and evaluate them using a shale and a mouse brain sinogram. Our experimental evaluations show that the applied optimizations and parallelization techniques can provide 158x speedup (using 32 compute nodes) over single core configuration, which decreases the reconstruction time of a sinogram (with 4501 projections and 22400 detector resolution) from 12.5 hours to less than 5 minutes per iteration.« less

  20. An efficient and accurate approach to MTE-MART for time-resolved tomographic PIV

    NASA Astrophysics Data System (ADS)

    Lynch, K. P.; Scarano, F.

    2015-03-01

    The motion-tracking-enhanced MART (MTE-MART; Novara et al. in Meas Sci Technol 21:035401, 2010) has demonstrated the potential to increase the accuracy of tomographic PIV by the combined use of a short sequence of non-simultaneous recordings. A clear bottleneck of the MTE-MART technique has been its computational cost. For large datasets comprising time-resolved sequences, MTE-MART becomes unaffordable and has been barely applied even for the analysis of densely seeded tomographic PIV datasets. A novel implementation is proposed for tomographic PIV image sequences, which strongly reduces the computational burden of MTE-MART, possibly below that of regular MART. The method is a sequential algorithm that produces a time-marching estimation of the object intensity field based on an enhanced guess, which is built upon the object reconstructed at the previous time instant. As the method becomes effective after a number of snapshots (typically 5-10), the sequential MTE-MART (SMTE) is most suited for time-resolved sequences. The computational cost reduction due to SMTE simply stems from the fewer MART iterations required for each time instant. Moreover, the method yields superior reconstruction quality and higher velocity field measurement precision when compared with both MART and MTE-MART. The working principle is assessed in terms of computational effort, reconstruction quality and velocity field accuracy with both synthetic time-resolved tomographic images of a turbulent boundary layer and two experimental databases documented in the literature. The first is the time-resolved data of flow past an airfoil trailing edge used in the study of Novara and Scarano (Exp Fluids 52:1027-1041, 2012); the second is a swirling jet in a water flow. In both cases, the effective elimination of ghost particles is demonstrated in number and intensity within a short temporal transient of 5-10 frames, depending on the seeding density. The increased value of the velocity space-time correlation coefficient demonstrates the increased velocity field accuracy of SMTE compared with MART.

  1. Case 223: Arytenoid Dislocation.

    PubMed

    Oppenheimer, Avi G; Gulati, Vishal; Kirsch, Jacobo; Alemar, Gilberto O

    2015-11-01

    A 71-year-old man with a history of atrial fibrillation refractory to medical therapy and lung cancer status after left upper lobectomy presented to our hospital for elective cardioversion and rate control with tikosyn. Overnight, the patient became unresponsive and was found to be in a state of cardiogenic shock. A code was called, and he was stabilized after cardioversion and bedside intubation. His stay in the intensive care unit was complicated by ventilator-associated pneumonia. The patient subsequently underwent multiple failed extubation attempts, requiring two additional reintubations. He was finally extubated 18 days after his initial admission to the intensive care unit. After he was discharged, he reported a hoarse voice and was only able to whisper. His voice varied in timbre and volume, and it became hoarser with use. Otolaryngology evaluation, including laryngoscopy and video stroboscopy, showed immobility of the right vocal cord. He was referred for speech therapy, and a computed tomographic (CT) examination of the neck was ordered.

  2. Assessment of gunshot bullet injuries with the use of magnetic resonance imaging.

    PubMed

    Hess, U; Harms, J; Schneider, A; Schleef, M; Ganter, C; Hannig, C

    2000-10-01

    Magnetic resonance imaging (MRI) is rarely used for preoperative assessment of shotgun injuries because of concerns of displacing the possibly ferromagnetic foreign body within the surrounding tissue. A total of 56 different projectiles underwent MRI testing for ferromagnetism and imaging quality in vitro and in pig carcasses with a commercially available 1.5-MRI scan. Image quality was compared with that of computed tomographic scans. Projectiles with ferromagnetic properties can be distinguished easily from nonferromagnetic ones by pretesting the motion of an identical projectile within the MRI coil. When ferromagnetic projectiles were excluded, MRI yielded the more precise images compared with other imaging techniques. Projectile localization and associated soft tissue injuries were visualized without artifacts in all cases. When ferromagnetic foreign bodies are excluded by pretesting their properties within the MRI with a comparative projectile, MRI portends an excellent imaging procedure for assessing the extent of injury and planning the removal by surgery.

  3. Rapid tomographic reconstruction based on machine learning for time-resolved combustion diagnostics

    NASA Astrophysics Data System (ADS)

    Yu, Tao; Cai, Weiwei; Liu, Yingzheng

    2018-04-01

    Optical tomography has attracted surged research efforts recently due to the progress in both the imaging concepts and the sensor and laser technologies. The high spatial and temporal resolutions achievable by these methods provide unprecedented opportunity for diagnosis of complicated turbulent combustion. However, due to the high data throughput and the inefficiency of the prevailing iterative methods, the tomographic reconstructions which are typically conducted off-line are computationally formidable. In this work, we propose an efficient inversion method based on a machine learning algorithm, which can extract useful information from the previous reconstructions and build efficient neural networks to serve as a surrogate model to rapidly predict the reconstructions. Extreme learning machine is cited here as an example for demonstrative purpose simply due to its ease of implementation, fast learning speed, and good generalization performance. Extensive numerical studies were performed, and the results show that the new method can dramatically reduce the computational time compared with the classical iterative methods. This technique is expected to be an alternative to existing methods when sufficient training data are available. Although this work is discussed under the context of tomographic absorption spectroscopy, we expect it to be useful also to other high speed tomographic modalities such as volumetric laser-induced fluorescence and tomographic laser-induced incandescence which have been demonstrated for combustion diagnostics.

  4. Rapid tomographic reconstruction based on machine learning for time-resolved combustion diagnostics.

    PubMed

    Yu, Tao; Cai, Weiwei; Liu, Yingzheng

    2018-04-01

    Optical tomography has attracted surged research efforts recently due to the progress in both the imaging concepts and the sensor and laser technologies. The high spatial and temporal resolutions achievable by these methods provide unprecedented opportunity for diagnosis of complicated turbulent combustion. However, due to the high data throughput and the inefficiency of the prevailing iterative methods, the tomographic reconstructions which are typically conducted off-line are computationally formidable. In this work, we propose an efficient inversion method based on a machine learning algorithm, which can extract useful information from the previous reconstructions and build efficient neural networks to serve as a surrogate model to rapidly predict the reconstructions. Extreme learning machine is cited here as an example for demonstrative purpose simply due to its ease of implementation, fast learning speed, and good generalization performance. Extensive numerical studies were performed, and the results show that the new method can dramatically reduce the computational time compared with the classical iterative methods. This technique is expected to be an alternative to existing methods when sufficient training data are available. Although this work is discussed under the context of tomographic absorption spectroscopy, we expect it to be useful also to other high speed tomographic modalities such as volumetric laser-induced fluorescence and tomographic laser-induced incandescence which have been demonstrated for combustion diagnostics.

  5. Estimating crustal heterogeneity from double-difference tomography

    USGS Publications Warehouse

    Got, J.-L.; Monteiller, V.; Virieux, J.; Okubo, P.

    2006-01-01

    Seismic velocity parameters in limited, but heterogeneous volumes can be inferred using a double-difference tomographic algorithm, but to obtain meaningful results accuracy must be maintained at every step of the computation. MONTEILLER et al. (2005) have devised a double-difference tomographic algorithm that takes full advantage of the accuracy of cross-spectral time-delays of large correlated event sets. This algorithm performs an accurate computation of theoretical travel-time delays in heterogeneous media and applies a suitable inversion scheme based on optimization theory. When applied to Kilauea Volcano, in Hawaii, the double-difference tomography approach shows significant and coherent changes to the velocity model in the well-resolved volumes beneath the Kilauea caldera and the upper east rift. In this paper, we first compare the results obtained using MONTEILLER et al.'s algorithm with those obtained using the classic travel-time tomographic approach. Then, we evaluated the effect of using data series of different accuracies, such as handpicked arrival-time differences ("picking differences"), on the results produced by double-difference tomographic algorithms. We show that picking differences have a non-Gaussian probability density function (pdf). Using a hyperbolic secant pdf instead of a Gaussian pdf allows improvement of the double-difference tomographic result when using picking difference data. We completed our study by investigating the use of spatially discontinuous time-delay data. ?? Birkha??user Verlag, Basel, 2006.

  6. Interlaced X-ray diffraction computed tomography

    PubMed Central

    Vamvakeros, Antonios; Jacques, Simon D. M.; Di Michiel, Marco; Senecal, Pierre; Middelkoop, Vesna; Cernik, Robert J.; Beale, Andrew M.

    2016-01-01

    An X-ray diffraction computed tomography data-collection strategy that allows, post experiment, a choice between temporal and spatial resolution is reported. This strategy enables time-resolved studies on comparatively short timescales, or alternatively allows for improved spatial resolution if the system under study, or components within it, appear to be unchanging. The application of the method for studying an Mn–Na–W/SiO2 fixed-bed reactor in situ is demonstrated. Additionally, the opportunities to improve the data-collection strategy further, enabling post-collection tuning between statistical, temporal and spatial resolutions, are discussed. In principle, the interlaced scanning approach can also be applied to other pencil-beam tomographic techniques, like X-ray fluorescence computed tomography, X-ray absorption fine structure computed tomography, pair distribution function computed tomography and tomographic scanning transmission X-ray microscopy. PMID:27047305

  7. TomoEED: Fast Edge-Enhancing Denoising of Tomographic Volumes.

    PubMed

    Moreno, J J; Martínez-Sánchez, A; Martínez, J A; Garzón, E M; Fernández, J J

    2018-05-29

    TomoEED is an optimized software tool for fast feature-preserving noise filtering of large 3D tomographic volumes on CPUs and GPUs. The tool is based on the anisotropic nonlinear diffusion method. It has been developed with special emphasis in the reduction of the computational demands by using different strategies, from the algorithmic to the high performance computing perspectives. TomoEED manages to filter large volumes in a matter of minutes in standard computers. TomoEED has been developed in C. It is available for Linux platforms at http://www.cnb.csic.es/%7ejjfernandez/tomoeed. gmartin@ual.es, JJ.Fernandez@csic.es. Supplementary data are available at Bioinformatics online.

  8. Maxillary sinusitis and periapical abscess following periodontal therapy: a case report using three-dimensional evaluation.

    PubMed

    Huang, Chih-Hao; Brunsvold, Michael A

    2006-01-01

    Maxillary sinusitis may develop from the extension of periodontal disease. In this case, reconstructed three-dimensional images from multidetector spiral computed tomographs were helpful in evaluating periodontal bony defects and their relationship with the maxillary sinus. A 42-year-old woman in good general health presented with a chronic deep periodontal pocket on the palatal and interproximal aspects of tooth #14. Probing depths of the tooth ranged from 2 to 9 mm, and it exhibited a Class 1 mobility. Radiographs revealed a close relationship between the root apex and the maxillary sinus. The patient's periodontal diagnosis was localized severe chronic periodontitis. Treatment of the tooth consisted of cause-related therapy, surgical exploration, and bone grafting. A very deep circumferential bony defect at the palatal root of tooth #14 was noted during surgery. After the operation, the wound healed without incidence, but 10 days later, a maxillary sinusitis and periapical abscess developed. To control the infection, an evaluation of sinus and alveolus using computed tomographs was performed, systemic antibiotics were prescribed, and endodontic treatment was initiated. Two weeks after surgical treatment, the infection was relieved with the help of antibiotics and endodontic treatment. Bilateral bony communications between the maxillary sinus and periodontal bony defect of maxillary first molars were shown on three-dimensional computed tomographs. The digitally reconstructed images added valuable information for evaluating the periodontal defects. Three-dimensional images from spiral computed tomographs (CT) aided in evaluating and treating the close relationship between maxillary sinus disease and adjacent periodontal defects.

  9. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-file Systems

    PubMed Central

    Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Naik, Saraswathi V

    2016-01-01

    ABSTRACT Background: Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. Study design: This is an experimental, in vitro study comparing the two groups. Materials and methods: A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. Results: A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Conclusion: Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49. PMID:27274155

  10. DOE Office of Scientific and Technical Information (OSTI.GOV)

    De Carlo, Francesco; Gürsoy, Doğa; Ching, Daniel J.

    There is a widening gap between the fast advancement of computational methods for tomographic reconstruction and their successful implementation in production software at various synchrotron facilities. This is due in part to the lack of readily available instrument datasets and phantoms representative of real materials for validation and comparison of new numerical methods. Recent advancements in detector technology made sub-second and multi-energy tomographic data collection possible [1], but also increased the demand to develop new reconstruction methods able to handle in-situ [2] and dynamic systems [3] that can be quickly incorporated in beamline production software [4]. The X-ray Tomography Datamore » Bank, tomoBank, provides a repository of experimental and simulated datasets with the aim to foster collaboration among computational scientists, beamline scientists, and experimentalists and to accelerate the development and implementation of tomographic reconstruction methods for synchrotron facility production software by providing easy access to challenging dataset and their descriptors.« less

  11. Glaucoma management in patients with osteo-odonto-keratoprosthesis (OOKP): the Singapore OOKP Study.

    PubMed

    Kumar, Rajesh S; Tan, Donald T H; Por, Yong-Ming; Oen, Francis T; Hoh, Sek-Tien; Parthasarathy, Anand; Aung, Tin

    2009-01-01

    To report diagnostic modalities and treatment options for glaucoma in eyes with osteo-odonto keratoprosthesis (OOKP). Eyes that underwent OOKP were evaluated for glaucoma at the time of the first postoperative visit, then at 1 and 3 months after the procedure, and thereafter every 6 months. All eyes underwent stereo-biomicroscopic optic nerve head (ONH) assessment, kinetic (Goldmann perimetry) and automated static visual field testing, ONH photography, Heidelberg retina tomograph, scanning laser polarimetery (GDx), and optical coherence tomography. Treatment of glaucoma was also reviewed. Average follow-up period was 19.1 (range: 5 to 31) months. Of the 15 eyes that underwent OOKP, 5 eyes had preexisting glaucoma. None of the other 10 eyes developed glaucoma after OOKP. ONH photography and visual field testing were the most reliable methods to assess status of the disease, whereas Heidelberg retina tomograph and optical coherence tomography could be performed with reasonable reproducibility and quality; GDx imaging was poor. All patients with glaucoma were treated with oral acetazolamide 500 mg twice a day. Transscleral cyclophotocoagulation was performed in 3 eyes at stage 2 of OOKP surgery. Progression of glaucoma was noted in 2 eyes on the basis of optic disc photographs and automated perimetry. Visual field testing and optic disc assessment with optic disc photographs seem to be effective methods to monitor eyes with OOKP for glaucoma. Treatment strategies include oral medications to lower intraocular pressure and cyclophotocoagulation.

  12. A maximum entropy reconstruction technique for tomographic particle image velocimetry

    NASA Astrophysics Data System (ADS)

    Bilsky, A. V.; Lozhkin, V. A.; Markovich, D. M.; Tokarev, M. P.

    2013-04-01

    This paper studies a novel approach for reducing tomographic PIV computational complexity. The proposed approach is an algebraic reconstruction technique, termed MENT (maximum entropy). This technique computes the three-dimensional light intensity distribution several times faster than SMART, using at least ten times less memory. Additionally, the reconstruction quality remains nearly the same as with SMART. This paper presents the theoretical computation performance comparison for MENT, SMART and MART, followed by validation using synthetic particle images. Both the theoretical assessment and validation of synthetic images demonstrate significant computational time reduction. The data processing accuracy of MENT was compared to that of SMART in a slot jet experiment. A comparison of the average velocity profiles shows a high level of agreement between the results obtained with MENT and those obtained with SMART.

  13. Virtual endoscopic imaging of the spine.

    PubMed

    Kotani, Toshiaki; Nagaya, Shigeyuki; Sonoda, Masaru; Akazawa, Tsutomu; Lumawig, Jose Miguel T; Nemoto, Tetsuharu; Koshi, Takana; Kamiya, Koshiro; Hirosawa, Naoya; Minami, Shohei

    2012-05-20

    Prospective trial of virtual endoscopy in spinal surgery. To investigate the utility of virtual endoscopy of the spine in conjunction with spinal surgery. Several studies have described clinical applications of virtual endoscopy to visualize the inside of the bronchi, paranasal sinus, stomach, small intestine, pancreatic duct, and bile duct, but, to date, no study has described the use of virtual endoscopy in the spine. Virtual endoscopy is a realistic 3-dimensional intraluminal simulation of tubular structures that is generated by postprocessing of computed tomographic data sets. Five patients with spinal disease were selected: 2 patients with degenerative disease, 2 patients with spinal deformity, and 1 patient with spinal injury. Virtual endoscopy software allows an observer to explore the spinal canal with a mouse, using multislice computed tomographic data. Our study found that virtual endoscopy of the spine has advantages compared with standard imaging methods because surgeons can noninvasively explore the spinal canal in all directions. Virtual endoscopy of the spine may be useful to surgeons for diagnosis, preoperative planning, and postoperative assessment by obviating the need to mentally construct a 3-dimensional picture of the spinal canal from 2-dimensional computed tomographic scans.

  14. Lamb wave tomographic imaging system for aircraft structural health assessment

    NASA Astrophysics Data System (ADS)

    Schwarz, Willi G.; Read, Michael E.; Kremer, Matthew J.; Hinders, Mark K.; Smith, Barry T.

    1999-01-01

    A tomographic imaging system using ultrasonic Lamb waves for the nondestructive inspection of aircraft components such as wings and fuselage is being developed. The computer-based system provides large-area inspection capability by electronically scanning an array of transducers that can be easily attached to flat and curved surface without moving parts. Images of the inspected area are produced in near real time employing a tomographic reconstruction method adapted from seismological applications. Changes in material properties caused by structural flaws such as disbonds, corrosion, and fatigue cracks can be effectively detected and characterized utilizing this fast NDE technique.

  15. Research in Image Understanding as Applied to 3-D Microwave Tomographic Imaging with Near Optical Resolution.

    DTIC Science & Technology

    1986-03-10

    and P. Frangos , "Inverse Scattering for Dielectric Media", Annual OSA Meeting, Wash. D.C., Oct. 1985. Invited Presentations 1. N. Farhat, "Tomographic...Optical Computing", DARPA Briefing, ~~April 1985. ... -7--.. , 1% If .% P . .% .% *-. 7777~14e 7-7. K-7 77 Theses 0 P.V. Frangos , "The Electromagnetic

  16. Exercise-associated Excessive Dynamic Airway Collapse in Military Personnel.

    PubMed

    Weinstein, Daniel J; Hull, James E; Ritchie, Brittany L; Hayes, Jackie A; Morris, Michael J

    2016-09-01

    Evaluation of military personnel for exertional dyspnea can present a diagnostic challenge, given multiple unique factors that include wide variation in military deployment. Initial consideration is given to common disorders such as asthma, exercise-induced bronchospasm, and inducible laryngeal obstruction. Excessive dynamic airway collapse has not been reported previously as a cause of dyspnea in these individuals. To describe the clinical and imaging characteristics of military personnel with exertional dyspnea who were found to have excessive dynamic collapse of large airways during exercise. After deployment to Afghanistan or Iraq, 240 active U.S. military personnel underwent a standardized evaluation to determine the etiology of persistent dyspnea on exertion. Study procedures included full pulmonary function testing, impulse oscillometry, exhaled nitric oxide measurement, methacholine challenge testing, exercise laryngoscopy, cardiopulmonary exercise testing, and fiberoptic bronchoscopy. Imaging included high-resolution computed tomography with inspiratory and expiratory views. Selected individuals underwent further imaging with dynamic computed tomography. A total of five men and one woman were identified as having exercise-associated excessive dynamic airway collapse on the basis of the following criteria: (1) exertional dyspnea without resting symptoms, (2) focal expiratory wheezing during exercise, (3) functional collapse of the large airways during bronchoscopy, (4) expiratory computed tomographic imaging showing narrowing of a large airway, and (5) absence of underlying apparent pathology in small airways or pulmonary parenchyma. Identification of focal expiratory wheezing correlated with bronchoscopic and imaging findings. Among 240 military personnel evaluated after presenting with postdeployment exertional dyspnea, a combination of symptoms, auscultatory findings, imaging, and visualization of the airways by bronchoscopy identified six individuals with excessive dynamic central airway collapse as the sole apparent cause of dyspnea. Exercise-associated excessive dynamic airway collapse should be considered in the differential diagnosis of exertional dyspnea.

  17. 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

    Current trauma guidelines dictate that the cervical spine should not be cleared in intoxicated patients, resulting in prolonged immobilization or additional imaging. Modern computed tomography (CT) technology may obviate this and allow for immediate clearance. To analyze cervical spine clearance practices and the utility of CT scans of the cervical spine in intoxicated patients with blunt trauma. We performed a prospective observational study of 1668 patients with blunt trauma aged 18 years and older who underwent cervical spine CT scans from March 2014 to March 2015 at an American College of Surgeons-verified Level I trauma center. Intoxication was determined by serum alcohol levels and urine drug screens. Physical examination and CT scan findings were evaluated for cervical spine injuries (CSI) and the incidence of missed injuries. Clinically relevant CSIs requiring cervical stabilization. The hypotheses formed prior to data collection were that cervical CT scans are sensitive and specific enough to diagnose CSIs that require stabilization and that normal CT scans are sufficient to clear CSIs in intoxicated patients. Of 1668 patients, 1103 (66.1%) were male, with a mean (SD) age of 49 (20) years and a mean (SD) Injury Severity Score of 10 (9). Vehicular (734 [44.0%]) and falls (579 [34.7%]) were the most common mechanisms for hospitalization. Intoxication was identified in 632 of 1429 of patients tested (44.2%; 425 [29.7%] by serum alcohol levels and 350 [24.5%] by urine drug screens). Half (316 [50.0%]) were admitted with cervical spine immobilization, and 38 (12%) of these were solely owing to the presence of intoxication. There were 65 abnormal CT scans (10.3%) in the intoxicated group. Among 567 normal CT scans, 4 (0.7%) had central cord syndrome found on initial physical examination, and 1 (0.2%) had a symptomatic unstable ligament injury that was misread as normal on CT scan but was abnormal on magnetic resonance imaging. The 316 patients kept in a 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.

  18. A Novel Quantitative Computed Tomographic Analysis Suggests How Sirolimus Stabilizes Progressive Air Trapping in Lymphangioleiomyomatosis

    PubMed Central

    Kokosi, Maria; Lo, Pechin; Kim, Hyun J.; Ravenel, James G.; Meyer, Cristopher; Goldin, Jonathan; Lee, Hye-Seung; Strange, Charlie; McCormack, Francis X.

    2016-01-01

    Rationale: The Multicenter International Lymphangioleiomyomatosis Efficacy and Safety of Sirolimus (MILES) trial demonstrated that sirolimus stabilized lung function and improved measures of functional performance and quality of life in patients with lymphangioleiomyomatosis. The physiologic mechanisms of these beneficial actions of sirolimus are incompletely understood. Objectives: To prospectively determine the longitudinal computed tomographic lung imaging correlates of lung function change in MILES patients treated with placebo or sirolimus. Methods: We determined the baseline to 12-month change in computed tomographic image–derived lung volumes and the volume of the lung occupied by cysts in the 31 MILES participants (17 in sirolimus group, 14 in placebo group) with baseline and 12-month scans. Measurements and Main Results: There was a trend toward an increase in median expiratory cyst volume percentage in the placebo group and a reduction in the sirolimus group (+2.68% vs. +0.97%, respectively; P = 0.10). The computed tomographic image–derived residual volume and the ratio of residual volume to total lung capacity increased more in the placebo group than in the sirolimus group (+214.4 ml vs. +2.9 ml [P = 0.054] and +0.05 ml vs. −0.01 ml [P = 0.0498], respectively). A Markov transition chain analysis of respiratory cycle cyst volume changes revealed greater dynamic variation in the sirolimus group than in the placebo group at the 12-month time point. Conclusions: Collectively, these data suggest that sirolimus attenuates progressive gas trapping in lymphangioleiomyomatosis, consistent with a beneficial effect of the drug on airflow obstruction. We speculate that a reduction in lymphangioleiomyomatosis cell burden around small airways and cyst walls alleviates progressive airflow limitation and facilitates cyst emptying. PMID:26799509

  19. A Novel Quantitative Computed Tomographic Analysis Suggests How Sirolimus Stabilizes Progressive Air Trapping in Lymphangioleiomyomatosis.

    PubMed

    Argula, Rahul G; Kokosi, Maria; Lo, Pechin; Kim, Hyun J; Ravenel, James G; Meyer, Cristopher; Goldin, Jonathan; Lee, Hye-Seung; Strange, Charlie; McCormack, Francis X

    2016-03-01

    The Multicenter International Lymphangioleiomyomatosis Efficacy and Safety of Sirolimus (MILES) trial demonstrated that sirolimus stabilized lung function and improved measures of functional performance and quality of life in patients with lymphangioleiomyomatosis. The physiologic mechanisms of these beneficial actions of sirolimus are incompletely understood. To prospectively determine the longitudinal computed tomographic lung imaging correlates of lung function change in MILES patients treated with placebo or sirolimus. We determined the baseline to 12-month change in computed tomographic image-derived lung volumes and the volume of the lung occupied by cysts in the 31 MILES participants (17 in sirolimus group, 14 in placebo group) with baseline and 12-month scans. There was a trend toward an increase in median expiratory cyst volume percentage in the placebo group and a reduction in the sirolimus group (+2.68% vs. +0.97%, respectively; P = 0.10). The computed tomographic image-derived residual volume and the ratio of residual volume to total lung capacity increased more in the placebo group than in the sirolimus group (+214.4 ml vs. +2.9 ml [P = 0.054] and +0.05 ml vs. -0.01 ml [P = 0.0498], respectively). A Markov transition chain analysis of respiratory cycle cyst volume changes revealed greater dynamic variation in the sirolimus group than in the placebo group at the 12-month time point. Collectively, these data suggest that sirolimus attenuates progressive gas trapping in lymphangioleiomyomatosis, consistent with a beneficial effect of the drug on airflow obstruction. We speculate that a reduction in lymphangioleiomyomatosis cell burden around small airways and cyst walls alleviates progressive airflow limitation and facilitates cyst emptying.

  20. The Use of Chest Computed Tomographic Angiography in Blunt Trauma Pediatric Population.

    PubMed

    Hasadia, Rabea; DuBose, Joseph; Peleg, Kobi; Stephenson, Jacob; Givon, Adi; Kessel, Boris

    2018-02-05

    Blunt chest trauma in children is common. Although rare, associated major thoracic vascular injuries (TVIs) are lethal potential sequelae of these mechanisms. The preferred study for definitive diagnosis of TVI in stable patients is computed tomographic angiography imaging of the chest. This imaging modality is, however, associated with high doses of ionizing radiation that represent significant carcinogenic risk for pediatric patients. The aim of the present investigation was to define the incidence of TVI among blunt pediatric trauma patients in an effort to better elucidate the usefulness of computed tomographic angiography use in this population. A retrospective cohort study was conducted including all blunt pediatric (age < 14 y) trauma victims registered in Israeli National Trauma Registry maintained by Gertner Institute for Epidemiology and Health Policy Research between the years 1997 and 2015. Data collected included age, sex, mechanism of injury, Glasgow Coma Scale, Injury Severity Score, and incidence of chest named vessel injuries. Statistical analysis was performed using SAS statistical software version 9.2 (SAS Institute Inc, Cary, NC). Among 433,325 blunt trauma victims, 119,821patients were younger than 14 years. Twelve (0.0001%, 12/119821) of these children were diagnosed with TVI. The most common mechanism in this group was pedestrian hit by a car. Mortality was 41.7% (5/12). Thoracic vascular injury is exceptionally rare among pediatric blunt trauma victims but does contribute to the high morbidity and mortality seen with blunt chest trauma. Computed tomographic angiography, with its associated radiation exposure risk, should not be used as a standard tool after trauma in injured children. Clinical protocols are needed in this population to minimize radiation risk while allowing prompt identification of life-threatening injuries.

  1. Influence of using a single facial vein as outflow in full-face transplantation: A three-dimensional computed tomographic study.

    PubMed

    Rodriguez-Lorenzo, Andres; Audolfsson, Thorir; Wong, Corrine; Cheng, Angela; Arbique, Gary; Nowinski, Daniel; Rozen, Shai

    2015-10-01

    The aim of this study was to evaluate the contribution of a single unilateral facial vein in the venous outflow of total-face allograft using three-dimensional computed tomographic imaging techniques to further elucidate the mechanisms of venous complications following total-face transplant. Full-face soft-tissue flaps were harvested from fresh adult human cadavers. A single facial vein was identified and injected distally to the submandibular gland with a radiopaque contrast (barium sulfate/gelatin mixture) in every specimen. Following vascular injections, three-dimensional computed tomographic venographies of the faces were performed. Images were viewed using TeraRecon Software (Teracon, Inc., San Mateo, CA, USA) allowing analysis of the venous anatomy and perfusion in different facial subunits by observing radiopaque filling venous patterns. Three-dimensional computed tomographic venographies demonstrated a venous network with different degrees of perfusion in subunits of the face in relation to the facial vein injection side: 100% of ipsilateral and contralateral forehead units, 100% of ipsilateral and 75% of contralateral periorbital units, 100% of ipsilateral and 25% of contralateral cheek units, 100% of ipsilateral and 75% of contralateral nose units, 100% of ipsilateral and 75% of contralateral upper lip units, 100% of ipsilateral and 25% of contralateral lower lip units, and 50% of ipsilateral and 25% of contralateral chin units. Venographies of the full-face grafts revealed better perfusion in the ipsilateral hemifaces from the facial vein in comparison with the contralateral hemifaces. Reduced perfusion was observed mostly in the contralateral cheek unit and contralateral lower face including the lower lip and chin units. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Computed tomographic analysis of temporal maxillary stability and pterygomaxillary generate formation following pediatric Le Fort III distraction advancement.

    PubMed

    Hopper, Richard A; Sandercoe, Gavin; Woo, Albert; Watts, Robyn; Kelley, Patrick; Ettinger, Russell E; Saltzman, Babette

    2010-11-01

    Le Fort III distraction requires generation of bone in the pterygomaxillary region. The authors performed retrospective digital analysis on temporal fine-cut computed tomographic images to quantify both radiographic evidence of pterygomaxillary region bone formation and relative maxillary stability. Fifteen patients with syndromic midface hypoplasia were included in the study. The average age of the patients was 8.7 years; 11 had either Crouzon or Apert syndrome. The average displacement of the maxilla during distraction was 16.2 mm (range, 7 to 31 mm). Digital analysis was performed on fine-cut computed tomographic scans before surgery, at device removal, and at annual follow-up. Seven patients also had mid-consolidation computed tomographic scans. Relative maxillary stability and density of radiographic bone in the pterygomaxillary region were calculated between each scan. There was no evidence of clinically significant maxillary relapse, rotation, or growth between the end of consolidation and 1-year follow-up, other than a relatively small 2-mm subnasal maxillary vertical growth. There was an average radiographic ossification of 0.5 mm/mm advancement at the time of device removal, with a 25th percentile value of 0.3 mm/mm. The time during consolidation that each patient reached the 25th percentile of pterygomaxillary region bone density observed in this series of clinically stable advancements ranged from 1.3 to 9.8 weeks (average, 3.7 weeks). There was high variability in the amount of bone formed in the pterygomaxillary region associated with clinical stability of the advanced Le Fort III segment. These data suggest that a subsection of patients generate the minimal amount of pterygomaxillary region bone formation associated with advancement stability as early as 4 weeks into consolidation.

  3. Recurrent Merkel cell carcinoma of the testis with unknown primary site: a case report.

    PubMed

    Mweempwa, Angela; Tan, Alvin; Dray, Michael

    2016-11-05

    Merkel cell carcinoma is a rare and aggressive neuroendocrine tumor that commonly arises in the skin. It is rare for it to occur in the testes. There are only seven cases of testicular Merkel cell carcinoma reported in the literature. A 66-year-old Maori man presented to our hospital with left testicular swelling. His alpha-fetoprotein and beta-human chorionic gonadotrophin levels were within normal limits. His lactate dehydrogenase concentration was elevated to 267 U/L. Ultrasound imaging confirmed a large testicular mass, and he underwent left orchiectomy. His histological examination revealed a neuroendocrine tumor with an immunostaining pattern suggesting Merkel cell carcinoma. He presented to our hospital again 3 months later with right testicular swelling that was confirmed on ultrasound sonography to be a tumor. He underwent a right orchiectomy, and his histological examination revealed metastatic Merkel cell carcinoma. A primary lesion was not identified, and computed tomographic imaging did not reveal spread to other organs. He received six cycles of adjuvant carboplatin and etoposide chemotherapy and remained disease-free 18 months after completion of chemotherapy. Given the paucity of studies, standard adjuvant treatment for testicular Merkel cell carcinoma remains uncertain, although platinum-based chemotherapy seems to be an appropriate option.

  4. 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 Association, Inc.

  5. Pineal region tumors: computed tomographic-pathologic spectrum

    DOE Office of Scientific and Technical Information (OSTI.GOV)

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

    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 andmore » is recommended for treatment planning.« less

  6. Normal cord in infants and children examined with computed tomographic metrizamide myelography.

    PubMed

    Resjö, I M; Harwood-Nash, D C; Fitz, C R; Chuang, S

    1979-03-01

    Computed tomographic metrizamide myelography (CTMM) was performed on 25 infants and children and 2 adults with normal spinal cords. Both the cord and the cauda equina were precisely outlined. The most detailed information was obtained with a small window setting, with the image subsequently magnified and color-reversed. Hounsfield-unit measurements alone were inaccurate. Advantages of CTMM include: high accuracy in demonstrating the intrathecal contents of the spine; less need for general anesthesia; and the need for a smaller amount of water-soluble contrast material than in conventional myelography. In selected cases of intraspinal abnormality in children, CTMM is recommended.

  7. Continuous Regional Arterial Infusion Therapy for Acute Necrotizing Pancreatitis Due to Mycoplasma pneumoniae Infection in a Child

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nakagawa, Motoo, E-mail: lmloltlolol@gmail.com; Ogino, Hiroyuki; Shimohira, Masashi

    2009-05-15

    A case of acute necrotizing pancreatitis due to Mycoplasma pneumoniae infection was treated in an 8-year-old girl. She experienced acute pancreatitis during treatment for M. pneumoniae. Contrast-enhanced computed tomographic scan revealed necrotizing pancreatitis. The computed tomographic severity index was 8 points (grade E). A protease inhibitor, ulinastatin, was provided via intravenous infusion but was ineffective. Continuous regional arterial infusion therapy was provided with gabexate mesilate (FOY-007, a protease inhibitor) and meropenem trihydrate, and the pancreatitis improved. This case suggests that infusion therapy is safe and useful in treating necrotizing pancreatitis in children.

  8. Contralateral decubitus positioning enhances computed tomographic angiographic evaluation of pulmonary vasculature in a patient with a pulmonary arteriovenous malformation.

    PubMed

    Tafti, Bashir Akhavan; Berenji, Gholam R; Santiago, Silverio; Barack, Bruce M

    2012-11-01

    Computed tomographic pulmonary angiography has become the diagnostic procedure of choice in patients suspected of having a pulmonary embolus. However, intrapulmonary shunting of blood in a variety of pathologic conditions can cause suboptimal opacification of the pulmonary arterial circulation and result in a suboptimal or even nondiagnostic study. Radiologists should be aware of these conditions and be familiar with positioning techniques to minimize such shunting. We report a patient suspected of having pulmonary embolism, in whom a preexisting unilateral arteriovenous malformation prevented adequate evaluation of the pulmonary circulation. Positioning the patient in the contralateral decubitus position significantly enhanced image quality.

  9. Lumbar artery perforators: an anatomical study based on computed tomographic angiography imaging.

    PubMed

    Sommeling, Casper Emile; Colebunders, Britt; Pardon, Heleen E; Stillaert, Filip B; Blondeel, Phillip N; van Landuyt, Koenraad

    2017-08-01

    The free lumbar artery perforator flap has recently been introduced as a potentially valuable option for autologous breast reconstruction in a subset of patients. Up to date, few anatomical studies, exploring the lumbar region as a donor site for perforator- based flaps, have been conducted. An anatomical study of the position of the dominant lumbar artery perforator was performed, using the preoperative computed tomographic angiography images of 24 autologous breast reconstruction patients. In total, 61 dominant perforators were determined, 28 on the left and 33 on the right side. A radiologist defined the position of the perforator as coordinates in an xy-grid. Dominant perforators were shown to originate from the lumbar arteries at the level of lumbar vertebrae three or four. Remarkably, approximately 85% of these lumbar artery perforators enter the skin at 7-10 cm lateral from the midline (mean left 8.6 cm, right 8.2 cm). This study concludes a rather constant position of the dominant perforator. Therefore, preoperative-computed tomographic angiography is not always essential to find this perforator and Doppler ultrasound could be considered as an alternative, thereby carefully assessing all advantages and disadvantages inherent to either of these imaging methods.

  10. Muscle tension line concept in nasolabial muscle complex--based on 3-dimensional reconstruction of nasolabial muscle fibers.

    PubMed

    Yin, Ningbei; Wu, Jiajun; Chen, Bo; Song, Tao; Ma, Hengyuan; Zhao, Zhenmin; Wang, Yongqian; Li, Haidong; Wu, Di

    2015-03-01

    Plastic surgeons have attempted various ways to rebuild the aesthetic subunits of the upper lip in patients with cleft lip with less than perfect results in most cases. We propose that repairing the 3 muscle tension line groups in the nasolabial complex will have improved aesthetic results. Micro-computed tomographic scans were performed on the nasolabial tissues of 5 normal aborted fetuses and used to construct a 3-dimensional model to study the nasolabial muscle complex structure. The micro-computed tomographic (CT) scans showed the close relationship and interaction between the muscle fibers of nasalis, pars peripheralis, levator labii superioris, and pars marginalis. Based on the 2-dimensional images obtained from the micro-computed tomographic scans, we suggest the concept of nasolabial muscle complex and muscle tension line group theory: there is a close relationship among the alar part of the nasalis, depressor septi muscle, orbicularis oris muscle, and levator labii superioris alaeque nasi. The tension line groups are 3 tension line structures in the nasolabial muscle complex that interlock with each other at the intersections and maintain the specific shape and aesthetics of the lip and nose.

  11. Osteochondroma of the mandibular condyle: a classification system based on computed tomographic appearances.

    PubMed

    Chen, Min-jie; Yang, Chi; Qiu, Ya-ting; Zhou, Qin; Huang, Dong; Shi, Hui-min

    2014-09-01

    The objectives of this study were to introduce the classification of osteochondroma of the mandibular condyle based on computed tomographic images and to present our treatment experiences. From January 2002 and December 2012, a total of 61 patients with condylar osteochondroma were treated in our division. Both clinical and radiologic aspects were reviewed. The average follow-up period was 24.3 months with a range of 6 to 120 months. Two types of condylar osteochondroma were presented: type 1 (protruding expansion) in 50 patients (82.0%) and type 2 (globular expansion) in 11 patients (18.0%). Type 1 condylar osteochondroma presented 5 forms: anterior/anteromedial (58%), posterior/posteromedial (6%), medial (16%), lateral (6%), and gigantic (14%). Local resection was performed on patients with type 1 condylar osteochondroma. Subtotal condylectomy/total condylectomy using costochondral graft reconstruction with/without orthognathic surgeries was performed on patients with type 2 condylar osteochondroma. During the follow-up period, tumor reformation, condyle absorption, and new deformity were not detected. The patients almost reattained facial symmetry. Preoperative classification based on computed tomographic images will help surgeons to choose the suitable surgical procedure to treat the condylar osteochondroma.

  12. 3D Printing of Plant Golgi Stacks from Their Electron Tomographic Models.

    PubMed

    Mai, Keith Ka Ki; Kang, Madison J; Kang, Byung-Ho

    2017-01-01

    Three-dimensional (3D) printing is an effective tool for preparing tangible 3D models from computer visualizations to assist in scientific research and education. With the recent popularization of 3D printing processes, it is now possible for individual laboratories to convert their scientific data into a physical form suitable for presentation or teaching purposes. Electron tomography is an electron microscopy method by which 3D structures of subcellular organelles or macromolecular complexes are determined at nanometer-level resolutions. Electron tomography analyses have revealed the convoluted membrane architectures of Golgi stacks, chloroplasts, and mitochondria. But the intricacy of their 3D organizations is difficult to grasp from tomographic models illustrated on computer screens. Despite the rapid development of 3D printing technologies, production of organelle models based on experimental data with 3D printing has rarely been documented. In this chapter, we present a simple guide to creating 3D prints of electron tomographic models of plant Golgi stacks using the two most accessible 3D printing technologies.

  13. Split-mouth comparison of the accuracy of computer-generated and conventional surgical guides.

    PubMed

    Farley, Nathaniel E; Kennedy, Kelly; McGlumphy, Edwin A; Clelland, Nancy L

    2013-01-01

    Recent clinical studies have shown that implant placement is highly predictable with computer-generated surgical guides; however, the reliability of these guides has not been compared to that of conventional guides clinically. This study aimed to compare the accuracy of reproducing planned implant positions with computer-generated and conventional surgical guides using a split-mouth design. Ten patients received two implants each in symmetric locations. All implants were planned virtually using a software program and information from cone beam computed tomographic scans taken with scan appliances in place. Patients were randomly selected for computer-aided design/computer-assisted manufacture (CAD/CAM)-guided implant placement on their right or left side. Conventional guides were used on the contralateral side. Patients underwent operative cone beam computed tomography postoperatively. Planned and actual implant positions were compared using three-dimensional analyses capable of measuring volume overlap as well as differences in angles and coronal and apical positions. Results were compared using a mixed-model repeated-measures analysis of variance and were further analyzed using a Bartlett test for unequal variance (α = .05). Implants placed with CAD/CAM guides were closer to the planned positions in all eight categories examined. However, statistically significant differences were shown only for coronal horizontal distances. It was also shown that CAD/CAM guides had less variability than conventional guides, which was statistically significant for apical distance. Implants placed using CAD/CAM surgical guides provided greater accuracy in a lateral direction than conventional guides. In addition, CAD/CAM guides were more consistent in their deviation from the planned locations than conventional guides.

  14. Quantification of pericardial effusions by echocardiography and computed tomography.

    PubMed

    Leibowitz, David; Perlman, Gidon; Planer, David; Gilon, Dan; Berman, Philip; Bogot, Naama

    2011-01-15

    Echocardiography is a well-accepted tool for the diagnosis and quantification of pericardial effusion (PEff). Given the increasing use of computed tomographic (CT) scanning, more PEffs are being initially diagnosed by computed tomography. No study has compared quantification of PEff by computed tomography and echocardiography. The objective of this study was to assess the accuracy of quantification of PEff by 2-dimensional echocardiography and computed tomography compared to the amount of pericardial fluid drained at pericardiocentesis. We retrospectively reviewed an institutional database to identify patients who underwent chest computed tomography and echocardiography before percutaneous pericardiocentesis with documentation of the amount of fluid withdrawn. Digital 2-dimensional echocardiographic and CT images were retrieved and quantification of PEff volume was performed by applying the formula for the volume of a prolate ellipse, π × 4/3 × maximal long-axis dimension/2 × maximal transverse dimension/2 × maximal anteroposterior dimension/2, to the pericardial sac and to the heart. Nineteen patients meeting study qualifications were entered into the study. The amount of PEff drained was 200 to 1,700 ml (mean 674 ± 340). Echocardiographically calculated pericardial effusion volume correlated relatively well with PEff volume (r = 0.73, p <0.001, mean difference -41 ± 225 ml). There was only moderate correlation between CT volume quantification and actual volume drained (r = 0.4, p = 0.004, mean difference 158 ± 379 ml). In conclusion, echocardiography appears a more accurate imaging technique than computed tomography in quantitative assessment of nonloculated PEffs and should continue to be the primary imaging in these patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Computed Tomographic Evaluation of Posttreatment Soft-Tissue Changes by Using a Lymphedema Scoring System in Patients with Oral Cancer.

    PubMed

    Akashi, Masaya; Teraoka, Shun; Kakei, Yasumasa; Kusumoto, Junya; Hasegawa, Takumi; Minamikawa, Tsutomu; Hashikawa, Kazunobu; Komori, Takahide

    2018-04-01

    This study aimed to evaluate posttreatment soft-tissue changes in patients with oral cancer with computed tomography (CT). To accomplish that purpose, a scoring system was established, referring to the criteria of lower leg lymphedema (LE). One hundred and six necks in 95 patients who underwent oral oncologic surgery with neck dissection (ND) were analyzed retrospectively using routine follow-up CT images. A two-point scoring system to evaluate soft-tissue changes (so-called "LE score") was established as follows: Necks with a "honeycombing" appearance were assigned 1 point. Necks with "taller than wide" fat lobules were assigned 1 point. Necks with neither appearance were assigned 0 points. Comparisons between patients with LE score ≥1 and LE score = 0 at 6 months postoperatively were performed using the Fisher exact test for discrete variables and the Mann-Whitney U test for continuous variables. Univariate predictors associated with posttreatment changes (i.e., LE score ≥1 at 6 months postoperatively) were entered into a multivariate logistic regression analysis. Values of p < 0.05 were considered to indicate statistical significance. The occurrence of the posttreatment soft-tissue changes was 32%. Multivariate logistic regression analysis showed that postoperative radiation therapy (RT) and bilateral ND were potential risk factors of posttreatment soft-tissue changes on CT images. Sequential evaluation of "honeycombing" and the "taller than wide" appearances on routine follow-up CT revealed the persistence of posttreatment soft-tissue changes in patients who underwent oral cancer treatment, and those potential risk factors were postoperative RT and bilateral ND.

  16. Does the pancreatic volume reduction rate using serial computed tomographic volumetry predict new onset diabetes after pancreaticoduodenectomy?

    PubMed Central

    Yun, Sung Pil; Seo, Hyung-Il; Kim, Suk; Kim, Dong Uk; Baek, Dong Hoon

    2017-01-01

    Abstract Volume reduction of the pancreatic tissues following a pancreatectomy can lead to the deterioration of glucose homeostasis. This is defined as pancreatogenic diabetes mellitus (DM). The objective of this study was to investigate the occurrence of new-onset DM (NODM) and evaluate the risk factors, including the pancreas volume reduction rate in patients undergoing pancreaticoduodenectomy (PD). Sixty-six patients without preoperative DM underwent PD for periampullary tumors between August 2007 and December 2012 and were included in this analysis. These patients underwent follow-up tests and abdominal computed tomography (CT) scan 7 days, 6 months, 12 months, 24 months, and 36 months after the operation. The pancreas volume reduction rate was calculated by CT volumetry. The patients were divided into 2 groups according to the postoperative development of DM. After PD, newly diagnosed DM occurred in 16 patients (24.2%). The incidence of DM was highest among patients with carcinomas with an advanced T stage. The pancreatic volume reduction rate after 6 and 12 months in the NODM group was significantly higher than the normal glucose group in the univariate analysis. In the multivariate analysis, the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM (P = 0.002). This study suggests that the pancreatic volume reduction rate 6 months after PD was the only significant predictive factor for the development of NODM. CT volumetry of the pancreas may be useful as a predictor of NODM after PD. PMID:28353594

  17. Prehistological evaluation of benign and malignant pigmented skin lesions with optical computed tomography

    NASA Astrophysics Data System (ADS)

    Kokolakis, Athanasios; Zacharakis, Giannis; Krasagakis, Konstantin; Lasithiotakis, Konstantinos; Favicchio, Rosy; Spiliopoulos, George; Giannikaki, Elpida; Ripoll, Jorge; Tosca, Androniki

    2012-06-01

    Discrimination of benign and malignant melanocytic lesions is a major issue in clinical dermatology. Assessment of the thickness of melanoma is critical for prognosis and treatment selection. We aimed to evaluate a novel optical computed tomography (optical-CT) system as a tool for three-dimensional (3-D) imaging of melanocytic lesions and its ability to discriminate benign from malignant melanocytic lesions while simultaneously determining the thickness of invasive melanoma. Seventeen melanocytic lesions, one hemangioma, and normal skin were assessed immediately after their excision by optical-CT and subsequently underwent histopathological examination. Tomographic reconstructions were performed with a back-propagation algorithm calculating a 3-D map of the total attenuation coefficient (AC). There was a statistically significant difference between melanomas, dysplastic nevi, and non-dysplastic nevi, as indicated by Kruskal-Wallis test. Median AC values were higher for melanomas compared with dysplastic and non-dysplastic nevi. No statistically significant difference was observed when thickness values obtained by optical-CT were compared with histological thickness using a Wilcoxon sighed rank test. Our results suggest that optical-CT can be important for the immediate prehistological evaluation of biopsies, assisting the physician for a rapid assessment of malignancy and of the thickness of a melanocytic lesion.

  18. Computer image-guided surgery for total maxillectomy.

    PubMed

    Homma, Akihiro; Saheki, Masahiko; Suzuki, Fumiyuki; Fukuda, Satoshi

    2008-12-01

    In total maxillectomy, the entire upper jaw including the tumor is removed en bloc from the facial skeleton. An intraoperative computed tomographic guidance system (ICTGS) can improve orientation during surgical procedures. However, its efficacy in head and neck surgery remains controversial. This study evaluated the use of an ICTGS in total maxillectomy. Five patients with maxillary sinus neoplasms underwent surgery using a StealthStation ICTGS. The headset was used for anatomic registration during the preoperative CT scan and surgical procedure. The average accuracy was 0.95 mm. The ICTGS provided satisfactory accuracy until the end of resection in all cases, and helped the surgeon to confirm the anatomical location and decide upon the extent of removal in real time. It was particularly useful when the zygoma, maxillary frontal process, orbital floor, and pterygoid process were divided. All patients remained alive and disease free during short-term follow-up. The ICTGS played a supplementary role in total maxillectomy, helping the surgeon to recognize target points accurately in real time, to determine the minimum accurate bone-resection line, and to use the most direct route to reach the lesion. It could also reduce the extent of the skin incision and removal, thus maintaining oncological safety.

  19. Image processing pipeline for synchrotron-radiation-based tomographic microscopy.

    PubMed

    Hintermüller, C; Marone, F; Isenegger, A; Stampanoni, M

    2010-07-01

    With synchrotron-radiation-based tomographic microscopy, three-dimensional structures down to the micrometer level can be visualized. Tomographic data sets typically consist of 1000 to 1500 projections of 1024 x 1024 to 2048 x 2048 pixels and are acquired in 5-15 min. A processing pipeline has been developed to handle this large amount of data efficiently and to reconstruct the tomographic volume within a few minutes after the end of a scan. Just a few seconds after the raw data have been acquired, a selection of reconstructed slices is accessible through a web interface for preview and to fine tune the reconstruction parameters. The same interface allows initiation and control of the reconstruction process on the computer cluster. By integrating all programs and tools, required for tomographic reconstruction into the pipeline, the necessary user interaction is reduced to a minimum. The modularity of the pipeline allows functionality for new scan protocols to be added, such as an extended field of view, or new physical signals such as phase-contrast or dark-field imaging etc.

  20. Browsing Software of the Visible Korean Data Used for Teaching Sectional Anatomy

    ERIC Educational Resources Information Center

    Shin, Dong Sun; Chung, Min Suk; Park, Hyo Seok; Park, Jin Seo; Hwang, Sung Bae

    2011-01-01

    The interpretation of computed tomographs (CTs) and magnetic resonance images (MRIs) to diagnose clinical conditions requires basic knowledge of sectional anatomy. Sectional anatomy has traditionally been taught using sectioned cadavers, atlases, and/or computer software. The computer software commonly used for this subject is practical and…

  1. Single-photon tomographic determination of regional cerebral blood flow in epilepsy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bonte, F.J.; Devous, M.D. Sr.; Stokely, E.M.

    Using a single-photon emission computed tomographic scanner (SPECT) the authors determined regional cerebral blood flow (rCBF) with inhaled xenon-133, a noninvasive procedure. Studies were performed in 40 normal individuals, and these were compared with rCBF determinations in 51 patients with seizure disorders. Although positive results were obtained in 15 of 16 patients with mass lesions, the group of principal interest comprised 25 patients suffering from ''temporal lobe'' epilepsy. Only one of these had a positive x-ray computed tomogram, but 16 had positive findings on rCBF study. These findings included increased local blood flow in the ictal state and reduced flowmore » interictally.« less

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pettersson, H.; Harwood-Nash, D.C.; Fitz, C.R.

    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 themore » entire spine is essential, preferably with MM.« less

  3. 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

  4. Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: case report and review of literature.

    PubMed

    Syrimpeis, Vasileios; Vitsas, Vasileios; Korovessis, Panagiotis

    2014-03-01

    Context Hemangiomas are the commonest benign tumors of the spine. Most occur in the thoracolumbar spine and the majority are asymptomatic. Rarely, hemangiomas cause symptoms through epidural expansion of the involved vertebra, resulting in spinal canal stenosis, spontaneous epidural hemorrhage, and pathological burst fracture. Findings We report a rare case of a 73-year-old woman, who had been treated for two months for degenerative neurogenic claudication. On admission, magnetic resonance imaging and computed tomographic scans revealed a hemangioma of the third lumbar vertebra protruding to the epidural space producing lateral spinal stenosis and ipsilateral nerve root compression. The patient underwent successful right hemilaminectomy for decompression of the nerve root, balloon kyphoplasty with poly-methyl methacrylate (PMMA) and pedicle screw segmental stabilization. Postoperative course was uneventful. Conclusion In the elderly, this rare presentation of spinal stenosis due to hemangiomas may be encountered. Decompression and vertebral augmentation by means balloon kyphoplasty with PMMA plus segmental pedicle screw fixation is recommended.

  5. Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: Case report and review of literature

    PubMed Central

    Syrimpeis, Vasileios; Vitsas, Vasileios; Korovessis, Panagiotis

    2014-01-01

    Context Hemangiomas are the commonest benign tumors of the spine. Most occur in the thoracolumbar spine and the majority are asymptomatic. Rarely, hemangiomas cause symptoms through epidural expansion of the involved vertebra, resulting in spinal canal stenosis, spontaneous epidural hemorrhage, and pathological burst fracture. Findings We report a rare case of a 73-year-old woman, who had been treated for two months for degenerative neurogenic claudication. On admission, magnetic resonance imaging and computed tomographic scans revealed a hemangioma of the third lumbar vertebra protruding to the epidural space producing lateral spinal stenosis and ipsilateral nerve root compression. The patient underwent successful right hemilaminectomy for decompression of the nerve root, balloon kyphoplasty with poly-methyl methacrylate (PMMA) and pedicle screw segmental stabilization. Postoperative course was uneventful. Conclusion In the elderly, this rare presentation of spinal stenosis due to hemangiomas may be encountered. Decompression and vertebral augmentation by means balloon kyphoplasty with PMMA plus segmental pedicle screw fixation is recommended. PMID:24090267

  6. Obesogenic diets have deleterious effects on fat deposits irrespective of the nature of dietary carbohydrates in a Yucatan minipig model.

    PubMed

    Ochoa, Melissa; Val-Laillet, David; Lallès, Jean-Paul; Meurice, Paul; Malbert, Charles-Henri

    2016-09-01

    The effects of digestible carbohydrates, fructose in particular, on the development of metabolic disturbances remain controversial. We explored the effects of prolonged consumption of high-fat diets differing in their carbohydrate source on fat deposits in the adult Yucatan minipig. Eighteen minipigs underwent computed tomographic imaging and blood sampling before and after 8 weeks of three isocaloric high-fat diets with different carbohydrate sources (20% by weight for starch in the control diet, glucose or fructose, n=6 per diet). Body adiposity, liver volume, and fat content were estimated from computed tomographic images (n=18). Liver volume and lipid content were also measured post mortem (n=12). We hypothesized that the quantity and the spatial distribution of fat deposits in the adipose tissue or in the liver would be altered by the nature of the carbohydrate present in the obesogenic diet. After 8 weeks of dietary exposure, body weight (from 26±4 to 58±3 kg), total body adiposity (from 38±1 to 47±1%; P<.0001), liver volume (from 1156±31 to 1486±66 mL; P<.0001), plasma insulin (from 10±1 to 14±2 mIU/L; P=.001), triacylglycerol (from 318±37 to 466±33 mg/L; P=.005), and free-fatty acids (from 196±60 to 396±59 μmol/L; P=.0001) increased irrespective of the carbohydrate type. Similarly, the carbohydrate type did not induce changes in the spatial repartition of the adipose tissue. Divergent results were obtained for fat deposits in the liver depending on the investigation method. In conclusion, obesogenic diets alter adipose tissue fat deposits and the metabolic profile independently of the nature of dietary carbohydrates. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Intravertebral deformation in idiopathic scoliosis: a transverse plane computer tomographic study.

    PubMed

    Kotwicki, Tomasz; Napiontek, Marek

    2008-03-01

    The scoliotic vertebrae are submitted to (1) the displacement in the 3-dimensional space and (2) the bone remodeling, which results in a 3-dimensional intrinsic vertebral deformation. Both phenomena are most expressed inside the apical zone of the curve and can be measured in a computer tomographic (CT) scan. A comparative study of CT thoracic scans in scoliotic and normal children was performed to provide a better description of the altered anatomy with respect to patomechanism of scoliosis. Twenty-three scoliotic girls, aged 14.3 +/- 2.1 years, a case of a right thoracic curve with a Cobb angle of 60.6 +/- 19.3 degrees, and 24 controls, free of spinal deformity, sex- and age-matched, underwent CT examination of the thorax at the level of Th8 to Th9 vertebra. The rotation angle of the apical vertebra and the sagittal to coronal rib cage diameters ratio were measured. The intravertebral deformation was assessed by measuring the angles between the axis of the whole vertebra and the axes of the spinous or transverse processes. The ratio of sagittal to coronal chest diameter was reduced in scoliosis patients (P < 0.001) and correlated with the Cobb angle. The angle between the axis of vertebra and the spinous process increased (P = 0.008), and its value was positively correlated with the rotation angle of the vertebra (r = 0.78, P < 0.05); however, the rotation was oriented clockwise, whereas the spinous process deviation was counterclockwise. The angle between the spinous and the transverse process revealed greater values on the concave side (P < 0.001), whereas the transverse processes were not deviated from the axis of vertebra (P = 0.469). A constant pattern, previously not described, of the alteration of morphology of the apical vertebra due to the intravertebral bone remodeling was identified. The intravertebral deformation accompanied the displacement of the vertebra with a linear correlation; however, the 2 phenomena were developing in the opposite directions. Level III, cross-sectional study.

  8. Heavily T2-weighted MR myelography vs CT myelography in spontaneous intracranial hypotension.

    PubMed

    Wang, Y-F; Lirng, J-F; Fuh, J-L; Hseu, S-S; Wang, S-J

    2009-12-01

    To assess the diagnostic accuracy of heavily T2-weighted magnetic resonance myelography (MRM) in patients with spontaneous intracranial hypotension (SIH). Patients with SIH were recruited prospectively, and first underwent MRM and then computed tomographic myelography (CTM). The results of MRM were validated with the gold standard, CTM, focusing on 1) CSF leaks along the nerve roots, 2) epidural CSF collections, and 3) high-cervical (C1-3) retrospinal CSF collections. Comparisons of these 3 findings between the 2 studies were made by kappa statistics and agreement rates. Targeted epidural blood patches (EBPs) were placed at the levels of CSF leaks if supportive treatment failed. Nineteen patients (6 men and 13 women, mean age 37.9 +/- 8.6 years) with SIH completed the study. MRM did not differ from CTM in the detection rates of CSF leaks along the nerve roots (84% vs 74%, p = 0.23), high-cervical retrospinal CSF collections (32% vs 16%, p = 0.13), and epidural CSF collections (89% vs 79%, p = 0.20). MRM demonstrated more spinal levels of CSF leaks (2.2 +/- 1.7 vs 1.5 +/- 1.5, p = 0.011) and epidural collections (12.2 +/- 5.9 vs 7.1 +/- 5.8, p < 0.001) than CTM. The overall level-by-level concordance was substantial for CSF leaks along the nerve roots (C1-L3) (kappa = 0.71, p < 0.001, agreement = 95%) and high-cervical retrospinal CSF collections (C1-3) (kappa = 0.73, p < 0.001, agreement = 92%), and moderate for epidural CSF collections (C1-L3) (kappa = 0.47, p < 0.001, agreement = 72%). Ten of the 14 patients (71%) receiving targeted EBPs experienced sustained symptomatic relief after a single attempt. Heavily T2-weighted magnetic resonance myelography was accurate in localizing CSF leaks for patients with spontaneous intracranial hypotension. This noninvasive technique may be an alternative to computed tomographic myelography before targeted epidural blood patches.

  9. 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 predictors of outcome after LVRS.

  10. 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.

  11. Computed Tomographic Analysis of Ventral Atlantoaxial Optimal Safe Implantation Corridors in 27 Dogs.

    PubMed

    Leblond, Guillaume; Gaitero, Luis; Moens, Noel M M; Zur Linden, Alex; James, Fiona M K; Monteith, Gabrielle J; Runciman, John

    2017-11-01

    Objectives  Ventral atlantoaxial stabilization techniques are challenging surgical procedures in dogs. Available surgical guidelines are based upon subjective anatomical landmarks, and limited radiographic and computed tomographic data. The aims of this study were (1) to provide detailed anatomical descriptions of atlantoaxial optimal safe implantation corridors to generate objective recommendations for optimal implant placements and (2) to compare anatomical data obtained in non-affected Toy breed dogs, affected Toy breed dogs suffering from atlantoaxial instability and non-affected Beagle dogs. Methods  Anatomical data were collected from a prospectively recruited population of 27 dogs using a previously validated method of optimal safe implantation corridor analysis using computed tomographic images. Results  Optimal implant positions and three-dimensional numerical data were generated successfully in all cases. Anatomical landmarks could be used to generate objective definitions of optimal insertion points which were applicable across all three groups. Overall the geometrical distribution of all implant sites was similar in all three groups with a few exceptions. Clinical Significance  This study provides extensive anatomical data available to facilitate surgical planning of implant placement for atlantoaxial stabilization. Our data suggest that non-affected Toy breed dogs and non-affected Beagle dogs constitute reasonable research models to study atlantoaxial stabilization constructs. Schattauer GmbH Stuttgart.

  12. Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke.

    PubMed

    Joux, Julien; Chausson, Nicolas; Jeannin, Séverine; Saint-Vil, Martine; Mejdoubi, Mehdi; Hennequin, Jean-Luc; Deschamps, Lydia; Smadja, Didier; Olindo, Stéphane

    2014-12-01

    An atypical form of fibromuscular dysplasia located in the internal carotid-bulb (CaFMD) is thought to be uncommon and is poorly described as a cause of ischemic stroke in the young. This study aimed to obtain a better description of CaFMD in Afro-Caribbean population, who could be particularly affected by it. This study included consecutive patients <55 years consulting at Fort-de-France University Hospital Stroke Center (Martinique, FWI) found to have CaFMD as the only cause after a comprehensive work-up. CaFMD was diagnosed when computed tomographic angiography showed a bulbar spur without calcification. Twenty-five patients with stroke and CaFMD were identified. Computed tomographic angiography showed 2 CaFMD patterns: a thin (n=15) or thick (n=10) spur. Three patients initial computed tomographic angiography images showed a mural thrombus overlying the CaFMD. CaFMD was surgically removed from 7 of 25 and 20 of 25 patients who received antiplatelet therapy; after mean follow-up of 25.3±19.5 months, their respective recurrence rates were 0% and 30%. CaFMD could be a common condition in young Afro-Caribbeans with carotid-territory ischemic stroke. Recurrences were frequent under antiplatelet treatment, while surgical CaFMD removal seemed more effective. © 2014 American Heart Association, Inc.

  13. Interdisciplinary Study of Egyptian Mummies from the Pushkin State Museum of Fine Arts Collection at the National Research Centre ``Kurchatov Institute''

    NASA Astrophysics Data System (ADS)

    Yatsishina, E. B.; Kovalchuk, M. V.; Loshak, M. D.; Vasilyev, S. V.; Vasilieva, O. A.; Dyuzheva, O. P.; Pojidaev, V. M.; Ushakov, V. L.

    2018-05-01

    Nine ancient Egyptian mummies (dated preliminarily to the period from the 1st mill. BCE to the first centuries CE) from the collection of the State Pushkin Museum of Fine Arts have been studied at the National Research Centre "Kurchatov Institute" (NRC KI) on the base of the complex of NBICS technologies. Tomographic scanning is performed using a magneto-resonance tomograph (3 T) and a hybrid positron emission tomography/computed tomography (PET-CT) scanner. Three-dimensional reconstructions of mummies and their anthropological measurements are carried out. Some medical conclusions are drawn based on the tomographic data. In addition, the embalming composition and tissue of one of the mummies are preliminarily analyzed.

  14. Singular value decomposition: a diagnostic tool for ill-posed inverse problems in optical computed tomography

    NASA Astrophysics Data System (ADS)

    Lanen, Theo A.; Watt, David W.

    1995-10-01

    Singular value decomposition has served as a diagnostic tool in optical computed tomography by using its capability to provide insight into the condition of ill-posed inverse problems. Various tomographic geometries are compared to one another through the singular value spectrum of their weight matrices. The number of significant singular values in the singular value spectrum of a weight matrix is a quantitative measure of the condition of the system of linear equations defined by a tomographic geometery. The analysis involves variation of the following five parameters, characterizing a tomographic geometry: 1) the spatial resolution of the reconstruction domain, 2) the number of views, 3) the number of projection rays per view, 4) the total observation angle spanned by the views, and 5) the selected basis function. Five local basis functions are considered: the square pulse, the triangle, the cubic B-spline, the Hanning window, and the Gaussian distribution. Also items like the presence of noise in the views, the coding accuracy of the weight matrix, as well as the accuracy of the accuracy of the singular value decomposition procedure itself are assessed.

  15. Fusion of Three-Dimensional Echocardiographic Regional Myocardial Strain with Cardiac Computed Tomography for Noninvasive Evaluation of the Hemodynamic Impact of Coronary Stenosis in Patients with Chest Pain.

    PubMed

    Mor-Avi, Victor; Patel, Mita B; Maffessanti, Francesco; Singh, Amita; Medvedofsky, Diego; Zaidi, S Javed; Mediratta, Anuj; Narang, Akhil; Nazir, Noreen; Kachenoura, Nadjia; Lang, Roberto M; Patel, Amit R

    2018-06-01

    Combined evaluation of coronary stenosis and the extent of ischemia is essential in patients with chest pain. Intermediate-grade stenosis on computed tomographic coronary angiography (CTCA) frequently triggers downstream nuclear stress testing. Alternative approaches without stress and/or radiation may have important implications. Myocardial strain measured from echocardiographic images can be used to detect subclinical dysfunction. The authors recently tested the feasibility of fusion of three-dimensional (3D) echocardiography-derived regional resting longitudinal strain with coronary arteries from CTCA to determine the hemodynamic significance of stenosis. The aim of the present study was to validate this approach against accepted reference techniques. Seventy-eight patients with chest pain referred for CTCA who also underwent 3D echocardiography and regadenoson stress computed tomography were prospectively studied. Left ventricular longitudinal strain data (TomTec) were used to generate fused 3D displays and detect resting strain abnormalities (RSAs) in each coronary territory. Computed tomographic coronary angiographic images were interpreted for the presence and severity of stenosis. Fused 3D displays of subendocardial x-ray attenuation were created to detect stress perfusion defects (SPDs). In patients with stenosis >25% in at least one artery, fractional flow reserve was quantified (HeartFlow). RSA as a marker of significant stenosis was validated against two different combined references: stenosis >50% on CTCA and SPDs seen in the same territory (reference standard A) and fractional flow reserve < 0.80 and SPDs in the same territory (reference standard B). Of the 99 arteries with no stenosis >50% and no SPDs, considered as normal, 19 (19%) had RSAs. Conversely, with stenosis >50% and SPDs, RSAs were considerably more frequent (17 of 24 [71%]). The sensitivity, specificity, and accuracy of RSA were 0.71, 0.81, and 0.79, respectively, against reference standard A and 0.83, 0.81, and 0.82 against reference standard B. Fusion of CTCA and 3D echocardiography-derived resting myocardial strain provides combined displays, which may be useful in determination of the hemodynamic or functional impact of coronary abnormalities, without additional ionizing radiation or stress testing. Copyright © 2018 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  16. Arteriovenous malformation of the external ear: a clinical assessment with a scoping review of the literature.

    PubMed

    Kim, Shin Hye; Han, Seung Hoon; Song, Yoonjae; Park, Chang Sik; Song, Jae-Jin

    Auricular Arteriovenous Malformation of the external ear is a rarely encountered disease; in particular, arteriovenous malformation arising from the auricle, with spontaneous bleeding, has seldom been reported. In the current study, we report an unusual case of late-onset auricular arteriovenous malformation originating from the posterior auricular artery that was confirmed by computed tomographic angiography. The case was successfully managed by pre-surgical intravascular embolization followed by total lesion excision. Prompted by this case, we also present a scoping review of the literature. A case of a 60 year-old man with right auricular arteriovenous malformation treated in our tertiary care center, and 52 patients with auricular arteriovenous malformation described in 10 case reports and a retrospective review are presented. Auricular arteriovenous malformation can manifest as swelling of the ear, pulsatile tinnitus, pain, and/or bleeding. On physical examination, a pulsatile swelling and/or a tender mass is evident. When arteriovenous malformation is suspected, the lesions should be visualized using imaging modalities that optimally detect vascular lesions, and managed via embolization, mass excision, or auricular resection. Effectiveness of the various diagnostic methods used and the treatment outcomes were analyzed. Various imaging modalities including Doppler sonography, computed tomographic angiography, magnetic resonance angiography, and/or transfemoral cerebral angiography were used to diagnose 38 cases reported in the literature. In another 15 cases, no imaging was performed; treatment was determined solely by physical examination and auscultation. Of the total of 53 cases, 12 were not treated (their symptoms were merely observed) whereas 20 underwent therapeutic embolization. In total, 32 patients, including 1 patient who was not treated and 10 with persistent or aggravated arteriovenous malformation after previous embolization, underwent mass excision or auricular resection depending on the extent of the lesion. No major postoperative complication was recorded. The postoperative follow-up duration varied from 1 month to 19 years, and only one case of unresectable, residual cervicofacial arteriovenous malformation was recorded. Auricular arteriovenous malformation is a rarely encountered disease, but should be suspected if a patient presents with a swollen ear and pulsatile tinnitus. Appropriate imaging is essential for diagnosis and evaluation of the extent of disease. As embolization affords only relatively poor control, total surgical removal of the vascular mass is recommended. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  17. Comparative evaluation of the cadaveric, radiographic and computed tomographic anatomy of the heads of green iguana (Iguana iguana), common tegu (Tupinambis merianae) and bearded dragon (Pogona vitticeps).

    PubMed

    Banzato, Tommaso; Selleri, Paolo; Veladiano, Irene A; Martin, Andrea; Zanetti, Emanuele; Zotti, Alessandro

    2012-05-11

    Radiology and computed tomography are the most commonly available diagnostic tools for the diagnosis of pathologies affecting the head and skull in veterinary practice. Nevertheless, accurate interpretation of radiographic and CT studies requires a thorough knowledge of the gross and the cross-sectional anatomy. Despite the increasing success of reptiles as pets, only a few reports over their normal imaging features are currently available. The aim of this study is to describe the normal cadaveric, radiographic and computed tomographic features of the heads of the green iguana, tegu and bearded dragon. 6 adult green iguanas, 4 tegus, 3 bearded dragons, and, the adult cadavers of: 4 green iguana, 4 tegu, 4 bearded dragon were included in the study. 2 cadavers were dissected following a stratigraphic approach and 2 cadavers were cross-sectioned for each species. These latter specimens were stored in a freezer (-20°C) until completely frozen. Transversal sections at 5 mm intervals were obtained by means of an electric band-saw. Each section was cleaned and photographed on both sides. Radiographs of the head of each subject were obtained. Pre- and post- contrast computed tomographic studies of the head were performed on all the live animals. CT images were displayed in both bone and soft tissue windows. Individual anatomic structures were first recognised and labelled on the anatomic images and then matched on radiographs and CT images. Radiographic and CT images of the skull provided good detail of the bony structures in all species. In CT contrast medium injection enabled good detail of the soft tissues to be obtained in the iguana whereas only the eye was clearly distinguishable from the remaining soft tissues in both the tegu and the bearded dragon. The results provide an atlas of the normal anatomical and in vivo radiographic and computed tomographic features of the heads of lizards, and this may be useful in interpreting any imaging modality involving these species.

  18. Comparative evaluation of the cadaveric, radiographic and computed tomographic anatomy of the heads of green iguana (Iguana iguana) , common tegu ( Tupinambis merianae) and bearded dragon ( Pogona vitticeps)

    PubMed Central

    2012-01-01

    Background Radiology and computed tomography are the most commonly available diagnostic tools for the diagnosis of pathologies affecting the head and skull in veterinary practice. Nevertheless, accurate interpretation of radiographic and CT studies requires a thorough knowledge of the gross and the cross-sectional anatomy. Despite the increasing success of reptiles as pets, only a few reports over their normal imaging features are currently available. The aim of this study is to describe the normal cadaveric, radiographic and computed tomographic features of the heads of the green iguana, tegu and bearded dragon. Results 6 adult green iguanas, 4 tegus, 3 bearded dragons, and, the adult cadavers of : 4 green iguana, 4 tegu, 4 bearded dragon were included in the study. 2 cadavers were dissected following a stratigraphic approach and 2 cadavers were cross-sectioned for each species. These latter specimens were stored in a freezer (−20°C) until completely frozen. Transversal sections at 5 mm intervals were obtained by means of an electric band-saw. Each section was cleaned and photographed on both sides. Radiographs of the head of each subject were obtained. Pre- and post- contrast computed tomographic studies of the head were performed on all the live animals. CT images were displayed in both bone and soft tissue windows. Individual anatomic structures were first recognised and labelled on the anatomic images and then matched on radiographs and CT images. Radiographic and CT images of the skull provided good detail of the bony structures in all species. In CT contrast medium injection enabled good detail of the soft tissues to be obtained in the iguana whereas only the eye was clearly distinguishable from the remaining soft tissues in both the tegu and the bearded dragon. Conclusions The results provide an atlas of the normal anatomical and in vivo radiographic and computed tomographic features of the heads of lizards, and this may be useful in interpreting any imaging modality involving these species. PMID:22578088

  19. Diagnostic Accuracy of Periapical Radiography and Cone-beam Computed Tomography in Identifying Root Canal Configuration of Human Premolars.

    PubMed

    Sousa, Thiago Oliveira; Haiter-Neto, Francisco; Nascimento, Eduarda Helena Leandro; Peroni, Leonardo Vieira; Freitas, Deborah Queiroz; Hassan, Bassam

    2017-07-01

    The aim of this study was to assess the diagnostic accuracy of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in the detection of the root canal configuration (RCC) of human premolars. PR and CBCT imaging of 114 extracted human premolars were evaluated by 2 oral radiologists. RCC was recorded according to Vertucci's classification. Micro-computed tomographic imaging served as the gold standard to determine RCC. Accuracy, sensitivity, specificity, and predictive values were calculated. The Friedman test compared both PR and CBCT imaging with the gold standard. CBCT imaging showed higher values for all diagnostic tests compared with PR. Accuracy was 0.55 and 0.89 for PR and CBCT imaging, respectively. There was no difference between CBCT imaging and the gold standard, whereas PR differed from both CBCT and micro-computed tomographic imaging (P < .0001). CBCT imaging was more accurate than PR for evaluating different types of RCC individually. Canal configuration types III, VII, and "other" were poorly identified on CBCT imaging with a detection accuracy of 50%, 0%, and 43%, respectively. With PR, all canal configurations except type I were poorly visible. PR presented low performance in the detection of RCC in premolars, whereas CBCT imaging showed no difference compared with the gold standard. Canals with complex configurations were less identifiable using both imaging methods, especially PR. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. Computed Tomography Angiography in Microsurgery: Indications, Clinical Utility, and Pitfalls

    PubMed Central

    Lee, Gordon K.; Fox, Paige M.; Riboh, Jonathan; Hsu, Charles; Saber, Sepideh; Rubin, Geoffrey D.; Chang, James

    2013-01-01

    Objective: Computed tomographic angiography (CTA) can be used to obtain 3-dimensional vascular images and soft-tissue definition. The goal of this study was to evaluate the reliability, usefulness, and pitfalls of CTA in preoperative planning of microvascular reconstructive surgery. Methods: A retrospective review of patients who obtained preoperative CTA in preparation for planned microvascular reconstruction was performed over a 5-year period (2001–2005). The influence of CTA on the original operative plan was assessed for each patient, and CTA results were correlated to the operative findings. Results: Computed tomographic angiography was performed on 94 patients in preparation for microvascular reconstruction. In 48 patients (51%), vascular abnormalities were noted on CTA. Intraoperative findings correlated with CTA results in 97% of cases. In 42 patients (45%), abnormal CTA findings influenced the original operative plan, such as the choice of vessels, side of harvest, or nature of the reconstruction (local flap instead of free tissue transfer). Technical difficulties in performing CTA were encountered in 5 patients (5%) in whom interference from external fixation devices was the main cause. Conclusions: This large study of CTA obtained for preoperative planning of reconstructive microsurgery at both donor and recipient sites study demonstrates that CTA is safe and highly accurate. Computed tomographic angiography can alter the surgeon's reconstructive plan when abnormalities are noted preoperatively and consequently improve results by decreasing vascular complication rates. The use of CTA should be considered for cases of microsurgical reconstruction where the vascular anatomy may be questionable. PMID:24023972

  1. A PC-controlled microwave tomographic scanner for breast imaging

    NASA Astrophysics Data System (ADS)

    Padhi, Shantanu; Howard, John; Fhager, A.; Bengtsson, Sebastian

    2011-01-01

    This article presents the design and development of a personal computer based controller for a microwave tomographic system for breast cancer detection. The system uses motorized, dual-polarized antennas and a custom-made GUI interface to control stepper motors, a wideband vector network analyzer (VNA) and to coordinate data acquisition and archival in a local MDSPlus database. Both copolar and cross-polar scattered field components can be measured directly. Experimental results are presented to validate the various functionalities of the scanner.

  2. 3D electron tomography of pretreated biomass informs atomic modeling of cellulose microfibrils.

    PubMed

    Ciesielski, Peter N; Matthews, James F; Tucker, Melvin P; Beckham, Gregg T; Crowley, Michael F; Himmel, Michael E; Donohoe, Bryon S

    2013-09-24

    Fundamental insights into the macromolecular architecture of plant cell walls will elucidate new structure-property relationships and facilitate optimization of catalytic processes that produce fuels and chemicals from biomass. Here we introduce computational methodology to extract nanoscale geometry of cellulose microfibrils within thermochemically treated biomass directly from electron tomographic data sets. We quantitatively compare the cell wall nanostructure in corn stover following two leading pretreatment strategies: dilute acid with iron sulfate co-catalyst and ammonia fiber expansion (AFEX). Computational analysis of the tomographic data is used to extract mathematical descriptions for longitudinal axes of cellulose microfibrils from which we calculate their nanoscale curvature. These nanostructural measurements are used to inform the construction of atomistic models that exhibit features of cellulose within real, process-relevant biomass. By computational evaluation of these atomic models, we propose relationships between the crystal structure of cellulose Iβ and the nanoscale geometry of cellulose microfibrils.

  3. False-Positive Cases of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomographic Scans in Metastasis of Esophageal Cancer

    PubMed Central

    Yamatsuji, Tomoki; Ishida, Naomasa; Takaoka, Munenori; Hayashi, Jiro; Yoshida, Kazuhiro; Shigemitsu, Kaori; Urakami, Atsushi; Haisa, Minoru; Naomoto, Yoshio

    2017-01-01

    Of 129 esophagectomies at our institute from June 2010 to March 2015, we experienced three preoperative positron emission tomography-computed tomographic (PET/CT) false positives. Bone metastasis was originally suspected in 2 cases, but they were later found to be bone metastasis negative after a preoperative bone biopsy and clinical course observation. The other cases suspected of mediastinal lymph node metastasis were diagnosed as inflammatory lymphadenopathy by a pathological examination of the removed lymph nodes. Conducting a PET/CT is useful when diagnosing esophageal cancer metastasis, but we need to be aware of the possibility of false positives. Therapeutic decisions should be made based on appropriate and accurate diagnoses, with pathological diagnosis actively introduced if necessary. PMID:28469502

  4. Using the technique of computed tomography for nondestructive analysis of pharmaceutical dosage forms

    NASA Astrophysics Data System (ADS)

    de Oliveira, José Martins, Jr.; Mangini, F. Salvador; Carvalho Vila, Marta Maria Duarte; ViníciusChaud, Marco

    2013-05-01

    This work presents an alternative and non-conventional technique for evaluatingof physic-chemical properties of pharmaceutical dosage forms, i.e. we used computed tomography (CT) technique as a nondestructive technique to visualize internal structures of pharmaceuticals dosage forms and to conduct static and dynamical studies. The studies were conducted involving static and dynamic situations through the use of tomographic images, generated by the scanner at University of Sorocaba - Uniso. We have shown that through the use of tomographic images it is possible to conduct studies of porosity, densities, analysis of morphological parameters and performing studies of dissolution. Our results are in agreement with the literature, showing that CT is a powerful tool for use in the pharmaceutical sciences.

  5. 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.

  6. Computed-tomographic and conventional linear-tomographic evaluation of tracheobronchial lesions for laser photoresection

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pearlberg, J.L.; Sandler, M.A.; Kvale, P.

    1985-03-01

    Laser therapy is a new modality for treatment of airway lesions. The authors examined 18 patients prior to laser photoresection of tracheobronchial lesions. Thirteen had cancers involving the distal trachea, carina, and/or proximal bronchi; five had benign lesions of the middle or proximal trachea. Each patient was examined by conventional linear tomography (CLT) and computed tomography (CT). CT was valuable in patients who had lesions of the distal trachea, carina, and/or proximal bronchi. Its particular usefulness, and its advantage relative to CLT, consisted in its ability to delineate vascular structures adjacent to the planned area of photoresection. Neither CLT normore » CT was helpful in evaluation of benign lesions of the proximal trachea.« less

  7. Reconstructive valve surgery within 10 days of stroke in endocarditis.

    PubMed

    Raman, Jai; Ballal, Apoorva; Hota, Bala; Mirza, Sara; Lai, David; Bleck, Thomas; Lateef, Omar

    2016-07-01

    The optimal timing of surgical treatment for infective endocarditis complicated by cerebrovascular events is controversial, largely due to the perceived risk of perioperative intracranial bleeding. Current guidelines suggest waiting 2 weeks between the diagnosis of stroke and surgery. The aim of this study was to investigate the clinical and neurological outcomes of early surgery following a stroke. This was a single-center retrospective analysis of 12 consecutive patients requiring surgery for infective endocarditis between 2011 and 2014 at Rush University Medical Center, with either ischemic (n = 6) and/or hemorrhagic (n = 6) cerebrovascular complications. All underwent computed tomographic angiography prior to early valve reconstructive surgery to identify potentially actionable neurological findings. Early valve surgery was performed for ongoing sepsis or persistent emboli. Neurologic risk and outcome were assessed pre- and postoperatively using the National Institutes of Health Stroke Scale and the Glasgow Outcome Scale, respectively. All 12 patients underwent surgical treatment within 10 days of the diagnosis of stroke. Mortality in the immediate postoperative period was 8%. Eleven of the 12 patients exhibited good neurological recovery in the immediate postoperative period, with a Glasgow Outcome Scale score ≥ 3. There was no correlation between duration of cardiopulmonary bypass and neurological outcomes. Early cardiac surgery in patients with infective endocarditis and stroke maybe lifesaving with a low neurological risk. Comprehensive neurovascular imaging may help in identifying patient-related risk factors. © The Author(s) 2016.

  8. Computed tomographic pelvimetry in English bulldogs.

    PubMed

    Dobak, Tetyda P; Voorhout, George; Vernooij, Johannes C M; Boroffka, Susanne A E B

    2018-05-31

    English bulldogs have been reported to have a high incidence of dystocia and caesarean section is often performed electively in this breed. A narrow pelvic canal is the major maternal factor contributing to obstructive dystocia. The objective of this cross-sectional study was to assess the pelvic dimensions of 40 clinically healthy English bulldogs using computed tomography pelvimetry. A control group consisting of 30 non-brachycephalic dogs that underwent pelvic computed tomography was retrospectively collected from the patient archive system. Univariate analysis of variance was used to compare computed tomography pelvimetry of both groups and the effects of weight and gender on the measurements. In addition, ratios were obtained to address pelvic shape differences. A significantly (P = 0.00) smaller pelvic size was found in English bulldogs compared to the control group for all computed tomography measurements: width and length of the pelvis, pelvic inlet and caudal pelvic aperture. The pelvic conformation was significantly different between the groups, English bulldogs had an overall shorter pelvis and pelvic canal and a narrower pelvic outlet. Weight had a significant effect on all measurements whereas gender that only had a significant effect on some (4/11) pelvic dimensions. Our findings prove that English bulldogs have a generally reduced pelvic size as well as a shorter pelvis and narrower pelvic outlet when compared to non-brachycephalic breeds. We suggest that some of our measurements may serve as a baseline for pelvic dimensions in English bulldogs and may be useful for future studies on dystocia in this breed. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Computed tomographic assessment of the causal factors of unsuccessful medialization thyroplasty.

    PubMed

    Iwahashi, Toshihiko; Ogawa, Makoto; Hosokawa, Kiyohito; Mochizuki, Ryuichi; Inohara, Hidenori

    2015-03-01

    The present results demonstrate that a small implant size, undercorrection of the vocal fold, antero-posterior implant malposition, and the use of expanded polytetrafluoroethylene (ePTFE) are the primary factors that cause a poor outcome of medialization thyroplasty (MT). To assess the postoperative laryngeal condition using computed tomography (CT) in patients with unilateral vocal fold paralysis who underwent MT alone, and to identify the primary causal factors in terms of the surgical procedures that affect the outcomes of MT. Twenty-two patients who underwent MT alone were divided into two groups based on either the maximal phonation time or the perceived vocal breathiness. Two laryngologists assessed the postoperative laryngeal CT images during sustained vowel phonation and judged whether there were abnormalities of the arytenoid cartilage position, window position, implant size, and implant position, as well as the degree of correction of the vocal fold. As implant material, a silicone block, ePTFE, and hydroxyapatite had been inserted in 2, 9, and 11 patients, respectively. Comparisons of the prevalence of abnormalities in the abovementioned factors between the different outcomes and between the types of material used for the implant were performed. Twelve patients with a poor outcome and 10 with a good outcome showed 36 and 18 abnormal findings identified by either of the two laryngologists, respectively. In the poor outcome group, a smaller implant size and undercorrection of the vocal fold showed both high kappa values and a significantly higher prevalence than those in the good outcome group (p < 0.001 and p < 0.05), respectively. The comparison between material types demonstrated that the sheet-like material (ePTFE) group exhibited a significantly higher prevalence of undercorrection than the block-like material group (p < 0.05).

  10. Gross, histologic, and computed tomographic characterization of nonpathological intrascleral cartilage and bone in the domestic goat (Capra aegagrus hircus).

    PubMed

    Tusler, Charlotte A; Good, Kathryn L; Maggs, David J; Zwingenberger, Allison L; Reilly, Christopher M

    2017-05-01

    To characterize grossly, histologically, and via computed tomography (CT) the appearance of intrascleral cartilage, bone, or both in domestic goats with otherwise normal eyes and to correlate this with age, sex, and breed. Sixty-eight domestic goats (89 eyes). Forty-nine formalin-fixed globes from 38 goats underwent high-resolution CT, and gross and light microscopic examination. An additional 40 eyes from 30 goats underwent light microscopy only. Age, breed, and sex of affected goats were retrieved from medical records. Considering all methods of evaluation collectively, cartilage was detected in 42% of eyes (44% of goats) and bone in 11% of eyes (12% of goats); bone was never seen without cartilage. Goats in which bone, cartilage, or both were detected ranged from 0.25 to 13 (median = 3.5) years of age, represented 11 of 12 breeds of the study population, and had a male:female ratio of 11:19. Bone was detected in the eyes of significantly more males (n = 8) than females (n = 2). No sex predilection was noted for cartilage alone. Histology revealed intrascleral chondrocyte-like cells, hyaline cartilage, and islands of lamellar bone. Some regions of bone had central, adipose-rich, marrow-like cavities. CT localized mineralized tissue as adjacent to or partially surrounding the optic nerve head. This is the first report of intrascleral bone or cartilage in a normal goat and of intrascleral bone in an otherwise normal mammal. The high prevalence of intrascleral cartilage and bone in this study suggests that this finding is normal and likely represents an adaptation in goats. © 2016 American College of Veterinary Ophthalmologists.

  11. Long-term survival of heart transplant recipients with lung cancer: the role of chest computed tomography screening.

    PubMed

    Mohammadi, S; Bonnet, N; Leprince, P; Charbonneau, E; Berberian, G; Aslani, M; Silvaggio, G; Dorent, R; Pavie, A; Gandjbakhch, I

    2007-10-01

    We sought to evaluate the screening modality and outcome of lung cancer occurring in heart transplant recipients (HTR) during a 21-year period. We conducted a retrospective review to investigate the incidence, risk factors, screening modality, treatment, and outcomes in HTR with lung cancer. We compared them with a case-matched HTR control group. Out of 829 recipients of heart transplants, 19 cases of bronchogenic carcinoma were found either by routine chest X-ray (n = 10), chest computed tomographic (CT) scanning (n = 4), or by assessment of clinical symptoms (n = 5). The mean time from transplantation to bronchogenic carcinoma diagnosis was 68.8 +/- 42.4 months. A history of smoking was the only risk factor in HTR with bronchogenic carcinoma compared to their case-matched HTR control group ( P < 0.05). Of 18 patients with non-small cell lung cancer (NSCLC), 13 underwent surgery and 5 with advanced cancer underwent chemotherapy and/or radiotherapy. NSCLC was diagnosed by chest X-ray (n = 10), and 6 of these patients died after an average of 43.7 +/- 62.2 months following cancer detection. NSCLC was also diagnosed on the basis of clinical symptoms (n = 4), and 2 of these patients died after a mean follow-up of 9 +/- 4.2 months after cancer diagnosis. All 4 patients in whom cancer was detected by CT scan were alive at an average of 53.5 +/- 36.7 months following cancer detection. The survival rates did not differ between the study and control groups ( P = 0.5). Optimal outcomes of treatment for primary lung cancer after heart transplantation seem to be related to early detection. A high proportion of deaths from NSCLC may be prevented by chest CT scan screening.

  12. A proposed-standard format to represent and distribute tomographic models and other earth spatial data

    NASA Astrophysics Data System (ADS)

    Postpischl, L.; Morelli, A.; Danecek, P.

    2009-04-01

    Formats used to represent (and distribute) tomographic earth models differ considerably and are rarely self-consistent. In fact, each earth scientist, or research group, uses specific conventions to encode the various parameterizations used to describe, e.g., seismic wave speed or density in three dimensions, and complete information is often found in related documents or publications (if available at all) only. As a consequence, use of various tomographic models from different authors requires considerable effort, is more cumbersome than it should be and prevents widespread exchange and circulation within the community. We propose a format, based on modern web standards, able to represent different (grid-based) model parameterizations within the same simple text-based environment, easy to write, to parse, and to visualise. The aim is the creation of self-describing data-structures, both human and machine readable, that are automatically recognised by general-purpose software agents, and easily imported in the scientific programming environment. We think that the adoption of such a representation as a standard for the exchange and distribution of earth models can greatly ease their usage and enhance their circulation, both among fellow seismologists and among a broader non-specialist community. The proposed solution uses semantic web technologies, fully fitting the current trends in data accessibility. It is based on Json (JavaScript Object Notation), a plain-text, human-readable lightweight computer data interchange format, which adopts a hierarchical name-value model for representing simple data structures and associative arrays (called objects). Our implementation allows integration of large datasets with metadata (authors, affiliations, bibliographic references, units of measure etc.) into a single resource. It is equally suited to represent other geo-referenced volumetric quantities — beyond tomographic models — as well as (structured and unstructured) computational meshes. This approach can exploit the capabilities of the web browser as a computing platform: a series of in-page quick tools for comparative analysis between models will be presented, as well as visualisation techniques for tomographic layers in Google Maps and Google Earth. We are working on tools for conversion into common scientific format like netCDF, to allow easy visualisation in GEON-IDV or gmt.

  13. Condylar repositioning using centric relation bite in bimaxillary surgery

    PubMed Central

    Lee, Chang-Youn; Jang, Chang-Su; Kim, Ju-Won; Kim, Jwa-Young

    2013-01-01

    Objective The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. Methods The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A survey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. Results No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). Conclusions Due to its simplicity, this method may be feasible and useful for repositioning condyles. PMID:23671832

  14. Downscaling Smooth Tomographic Models: Separating Intrinsic and Apparent Anisotropy

    NASA Astrophysics Data System (ADS)

    Bodin, Thomas; Capdeville, Yann; Romanowicz, Barbara

    2016-04-01

    In recent years, a number of tomographic models based on full waveform inversion have been published. Due to computational constraints, the fitted waveforms are low pass filtered, which results in an inability to map features smaller than half the shortest wavelength. However, these tomographic images are not a simple spatial average of the true model, but rather an effective, apparent, or equivalent model that provides a similar 'long-wave' data fit. For example, it can be shown that a series of horizontal isotropic layers will be seen by a 'long wave' as a smooth anisotropic medium. In this way, the observed anisotropy in tomographic models is a combination of intrinsic anisotropy produced by lattice-preferred orientation (LPO) of minerals, and apparent anisotropy resulting from the incapacity of mapping discontinuities. Interpretations of observed anisotropy (e.g. in terms of mantle flow) requires therefore the separation of its intrinsic and apparent components. The "up-scaling" relations that link elastic properties of a rapidly varying medium to elastic properties of the effective medium as seen by long waves are strongly non-linear and their inverse highly non-unique. That is, a smooth homogenized effective model is equivalent to a large number of models with discontinuities. In the 1D case, Capdeville et al (GJI, 2013) recently showed that a tomographic model which results from the inversion of low pass filtered waveforms is an homogenized model, i.e. the same as the model computed by upscaling the true model. Here we propose a stochastic method to sample the ensemble of layered models equivalent to a given tomographic profile. We use a transdimensional formulation where the number of layers is variable. Furthermore, each layer may be either isotropic (1 parameter) or intrinsically anisotropic (2 parameters). The parsimonious character of the Bayesian inversion gives preference to models with the least number of parameters (i.e. least number of layers, and maximum number of isotropic layers). The non-uniqueness of the problem can be addressed by adding high frequency data such as receiver functions, able to map first order discontinuities. We show with synthetic tests that this method enables us to distinguish between intrinsic and apparent anisotropy in tomographic models, as layers with intrinsic anisotropy are only present when required by the data. A real data example is presented based on the latest global model produced at Berkeley.

  15. A fast multi-resolution approach to tomographic PIV

    NASA Astrophysics Data System (ADS)

    Discetti, Stefano; Astarita, Tommaso

    2012-03-01

    Tomographic particle image velocimetry (Tomo-PIV) is a recently developed three-component, three-dimensional anemometric non-intrusive measurement technique, based on an optical tomographic reconstruction applied to simultaneously recorded images of the distribution of light intensity scattered by seeding particles immersed into the flow. Nowadays, the reconstruction process is carried out mainly by iterative algebraic reconstruction techniques, well suited to handle the problem of limited number of views, but computationally intensive and memory demanding. The adoption of the multiplicative algebraic reconstruction technique (MART) has become more and more accepted. In the present work, a novel multi-resolution approach is proposed, relying on the adoption of a coarser grid in the first step of the reconstruction to obtain a fast estimation of a reliable and accurate first guess. A performance assessment, carried out on three-dimensional computer-generated distributions of particles, shows a substantial acceleration of the reconstruction process for all the tested seeding densities with respect to the standard method based on 5 MART iterations; a relevant reduction in the memory storage is also achieved. Furthermore, a slight accuracy improvement is noticed. A modified version, improved by a multiplicative line of sight estimation of the first guess on the compressed configuration, is also tested, exhibiting a further remarkable decrease in both memory storage and computational effort, mostly at the lowest tested seeding densities, while retaining the same performances in terms of accuracy.

  16. Rapid prototyping in aortic surgery.

    PubMed

    Bangeas, Petros; Voulalas, Grigorios; Ktenidis, Kiriakos

    2016-04-01

    3D printing provides the sequential addition of material layers and, thus, the opportunity to print parts and components made of different materials with variable mechanical and physical properties. It helps us create 3D anatomical models for the better planning of surgical procedures when needed, since it can reveal any complex anatomical feature. Images of abdominal aortic aneurysms received by computed tomographic angiography were converted into 3D images using a Google SketchUp free software and saved in stereolithography format. Using a 3D printer (Makerbot), a model made of polylactic acid material (thermoplastic filament) was printed. A 3D model of an abdominal aorta aneurysm was created in 138 min, while the model was a precise copy of the aorta visualized in the computed tomographic images. The total cost (including the initial cost of the printer) reached 1303.00 euros. 3D imaging and modelling using different materials can be very useful in cases when anatomical difficulties are recognized through the computed tomographic images and a tactile approach is demanded preoperatively. In this way, major complications during abdominal aorta aneurysm management can be predicted and prevented. Furthermore, the model can be used as a mould; the development of new, more biocompatible, less antigenic and individualized can become a challenge in the future. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  17. Can macrocirculation changes predict nonhealing diabetic foot ulcers?

    PubMed

    Lee, Ye-Na; Kim, Hyon-Surk; Kang, Jeong-A; Han, Seung-Kyu

    2014-01-01

    Transcutaneous partial oxygen tension (TcpO2) is considered the gold standard for assessment of tissue oxygenation, which is an essential factor for wound healing. The purpose of this study was to evaluate the association between macrocirculation and TcpO2 in persons with diabetes mellitus. Ninety-eight patients with diabetic foot ulcers participated in the study (61 men and 37 women). The subjects had a mean age of 66.6 years (range, 30-83 years) and were treated at the Diabetic Wound Center of Korea University Guro Hospital, Seoul, Republic of Korea. Macrocirculation was evaluated using 2 techniques: computed tomographic angiography and Doppler ultrasound. Macrocirculation scores were based on the patency of the two tibial arteries in 98 patients. Computed tomographic angiography and Doppler ultrasound scores (0-4 points) were given according to intraluminal filling defects and arterial pulse waveform of each vessel, respectively. Tissue oxygenation was measured by TcpO2. Macrocirculation scores were statistically analyzed as a function of the TcpO2. Statistical analysis revealed no significant linear trend between the macrocirculation status and TcpO2. Biavariate analysis using the Fisher exact test, Mantel-Haenszel tests, and McNemar-Bowker tests also found no significant relationship between macrocirculation and TcpO2. Computed tomographic angiography and Doppler ultrasound are not sufficiently reliable substitutes for TcpO2 measurements in regard to determining the optimal treatment for diabetic patients.

  18. Computed tomography manifestation of a triple-barreled aortic dissection: the Mercedes-Benz mark sign.

    PubMed

    Shin, M S; Zorn, G L; Ho, K J

    1988-04-01

    Computed tomographic (CT) findings of a rare case of triple-barreled aortic dissection was described. CT demonstrated the extent of dissection, a communication between two channels, and three lumens separated by the intimal flap and a thin undetached tunica media, resembling a Mercedes-Benz mark.

  19. Influence of proton-pump inhibitors on stomach wall uptake of 99mTc-tetrofosmin in cadmium-zinc-telluride SPECT myocardial perfusion imaging.

    PubMed

    Mouden, Mohamed; Rijkee, Karlijn S; Schreuder, Nanno; Timmer, Jorik R; Jager, Pieter L

    2015-02-01

    Proton-pump inhibitors (PPIs) induce potentially interfering stomach wall activity in single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) with technetium-99m ((99m)Tc)-sestamibi. However, no data are available for (99m)Tc-tetrofosmin. We assessed the influence of prolonged (>2 weeks) PPI use on the stomach wall uptake of (99m)Tc-tetrofosmin in patients referred for stress MPI with a cadmium-zinc-telluride-based SPECT camera and its relation with dyspepsia symptoms. Consecutive patients (n=127) underwent a 1-day adenosine stress-first SPECT-MPI with (99m)Tc-tetrofosmin, of whom 54 (43%) patients had been on PPIs for more than 2 weeks. Stomach wall activity was identified on stress SPECT using computed tomographic attenuation maps and was scored using a four-point grading scale into clinically relevant (scores 2 or 3) or nonrelevant (scores 0 or 1).Patients on PPIs had stomach wall uptake more frequently as compared with patients not using PPIs (22 vs. 7%, P=0.017). Dyspepsia was similar in both groups. Prolonged use of PPIs is associated with stomach wall uptake of (99m)Tc-tetrofosmin in stress cadmium-zinc-telluride-SPECT images. Gastric symptoms were not associated with stomach wall uptake.

  20. The ability of computed tomography to diagnose placental abruption in the trauma patient.

    PubMed

    Kopelman, Tammy R; Berardoni, Nicole E; Manriquez, Maria; Gridley, Daniel; Vail, Sydney J; Pieri, Paola G; O'Neill; Pressman, Melissa A

    2013-01-01

    Fetal demise following trauma remains a devastating complication largely owing to placental injury and abruption. Our objective was to determine if abdominopelvic computed tomographic (CT) imaging can assess for placental abruption (PA) when obtained to exclude associated maternal injuries. Retrospective review of pregnant trauma patients of 20-week gestation or longer presenting to a trauma center during a 7-year period who underwent CT imaging as part of their initial evaluation. Radiographic images were reviewed by a radiologist for evidence of PA and classified based on percentage of visualized placental enhancement. Blinded to CT results, charts were reviewed by an obstetrician for clinical evidence of PA and classified as strongly positive, possibly positive, or no evidence. A total of 176 patients met inclusion criteria. CT imaging revealed evidence of PA in 61 patients (35%). As the percentage of placental enhancement decreased, patients were more likely to have strong clinical manifestations of PA, reaching statistical significance when enhancement was less than 50%. CT imaging evidence of PA was apparent in all patients who required delivery for nonassuring fetal heart tones. CT imaging evaluation of the placenta can accurately identify PA and therefore can help stratify patients at risk for fetal complications. The likelihood of requiring delivery increased as placental enhancement declined to less than 25%. Diagnostic study, level III.

  1. Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating the renal vascular anatomy in potential living renal donors.

    PubMed

    Bhatti, Aftab A; Chugtai, Aamir; Haslam, Philip; Talbot, David; Rix, David A; Soomro, Naeem A

    2005-11-01

    To prospectively compare the accuracy of multislice spiral computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) in evaluating the renal vascular anatomy in potential living renal donors. Thirty-one donors underwent multislice spiral CTA and gadolinium-enhanced MRA. In addition to axial images, multiplanar reconstruction and maximum intensity projections were used to display the renal vascular anatomy. Twenty-four donors had a left laparoscopic donor nephrectomy (LDN), whereas seven had right open donor nephrectomy (ODN); LDN was only considered if the renal vascular anatomy was favourable on the left. CTA and MRA images were analysed by two radiologists independently. The radiological and surgical findings were correlated after the surgery. CTA showed 33 arteries and 32 veins (100% sensitivity) whereas MRA showed 32 arteries and 31 veins (97% sensitivity). CTA detected all five accessory renal arteries whereas MRA only detected one. CTA also identified all three accessory renal veins whereas MRA identified two. CTA had a sensitivity of 97% and 47% for left lumbar and left gonadal veins, whereas MRA had a sensitivity of 74% and 46%, respectively. Multislice spiral CTA with three-dimensional reconstruction was more accurate than MRA for both renal arterial and venous anatomy.

  2. Coronary artery anomalies in Turner Syndrome.

    PubMed

    Viuff, Mette H; Trolle, Christian; Wen, Jan; Jensen, Jesper M; Nørgaard, Bjarne L; Gutmark, Ephraim J; Gutmark-Little, Iris; Mortensen, Kristian H; Gravholt, Claus Højbjerg; Andersen, Niels H

    Congenital heart disease, primarily involving the left-sided structures, is often seen in patients with Turner Syndrome. Moreover, a few case reports have indicated that coronary anomalies may be more prevalent in Turner Syndrome than in the normal population. We therefore set out to systematically investigate coronary arterial anatomy by computed tomographic coronary angiography (coronary CTA) in Turner Syndrome patients. Fifty consecutive women with Turner Syndrome (mean age 47 years [17-71]) underwent coronary CTA. Patients were compared with 25 gender-matched controls. Coronary anomaly was more frequent in patients with Turner Syndrome than in healthy controls [20% vs. 4% (p = 0.043)]. Nine out of ten abnormal cases had an anomalous left coronary artery anatomy (absent left main trunk, n = 7; circumflex artery originating from the right aortic sinus, n = 2). One case had a tubular origin of the right coronary artery above the aortic sinus. There was no correlation between the presence of coronary arterial anomalies and karyotype, bicuspid aortic valve, or other congenital heart defects. Coronary anomalies are highly prevalent in Turner Syndrome. The left coronary artery is predominantly affected, with an absent left main coronary artery being the most common anomaly. No hemodynamically relevant coronary anomalies were found. Copyright © 2016 Society of Cardiovascular Computed Tomography. All rights reserved.

  3. Prognostic significance of tumor histology and computed tomographic staging for radiation treatment response of canine nasal tumors.

    PubMed

    Adams, William M; Kleiter, Miriam M; Thrall, Donald E; Klauer, Julia M; Forrest, Lisa J; La Due, Tracy A; Havighurst, Thomas C

    2009-01-01

    Prognostic significance of tumor histology and four computed tomography (CT) staging methods was tested retrospectively in dogs from three treatment centers that underwent intent-to-cure-radiotherapy for intranasal neoplasia. Disease-free and overall survival times were available for 94 dogs. A grouping of anaplastic, squamous cell, and undifferentiated carcinomas had a significantly shorter median disease-free survival (4.4 mo) than a grouping of all sarcomas (10.6 months). Disease-free survivals were not significantly different, when all carcinomas were compared with all sarcomas. The published original and modified WHO staging methods did not significantly relate to either survival endpoint. A modified human maxillary tumor staging system previously applied to canine nasal tumors was prognostically significant for both survival endpoints; a further modified version of that CT-based staging system resulted in improved significance for both survival endpoints. Dogs with unilateral intranasal involvement without bone destruction beyond the turbinates on CT, had longest median survival (23.4 months); CT evidence of cribriform plate involvement was associated with shortest median survival (6.7 months). Combining CT and histology statistically improved prognostic significance for both survival endpoints over the proposed CT staging method alone. Significance was lost when CT stages were collapsed to < four categories or histopathology groupings were collapsed to < three categories.

  4. 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.

  5. Murder, insanity, and medical expert witnesses.

    PubMed

    Ciccone, J R

    1992-06-01

    Recent advances in the ability to study brain anatomy and function and attempts to link these findings with human behavior have captured the attention of the legal system. This had led to the increasing use of the "neurological defense" to support a plea of not guilty by reason of insanity. This article explores the history of the insanity defense and explores the role of the medical expert witnesses in integrating clinical and laboratory findings, eg, computed tomographic scans, magnetic resonance scans, and single-photon emission computed tomographic scans. Three cases involving murder and brain dysfunction are discussed: the first case involves a subarachnoid hemorrhage resulting in visual perceptual and memory impairment; the second case, a diagnosis of Alzheimer's disease; and the third case, the controverted diagnosis of complex partial seizures in a serial killer.

  6. Computed tomographic and cross-sectional anatomy of the normal pacu (Colossoma macroponum).

    PubMed

    Carr, Alaina; Weber, E P Scott; Murphy, Chris J; Zwingenberger, Alison

    2014-03-01

    The purpose of this study was to compare and define the normal cross-sectional gross and computed tomographic (CT) anatomy for a species of boney fish to better gain insight into the use of advanced diagnostic imaging for future clinical cases. The pacu (Colossoma macropomum) was used because of its widespread presence in the aquarium trade, its relatively large body size, and its importance in the research and aquaculture settings. Transverse 0.6-mm CT images of three cadaver fish were obtained and compared to corresponding frozen cross sections of the fish. Relevant anatomic structures were identified and labeled at each level; the Hounsfield unit density of major organs was established. The images presented good anatomic detail and provide a reference for future research and clinical investigation.

  7. How does electromagnetic navigation stack up against infrared navigation in minimally invasive total knee arthroplasties?

    PubMed

    Lionberger, David R; Weise, Jennifer; Ho, David M; Haddad, John L

    2008-06-01

    Forty-six primary total knee arthroplasties were performed using either an electromagnetic (EM) or infrared (IR) navigation system. In this IRB-approved study, patients were evaluated clinically and for accuracy using spiral computed tomographic imaging and 36-in standing radiographs. Although EM navigation was subject to metal interference, it was not as drastic as line-of-sight interference with IR navigation. Mechanical alignment was ideal in 92.9% of EM and 90.0% of IR cases based on spiral computed tomographic imaging and 100% of EM and 95% of IR cases based on x-ray. Individual measurements of component varus/valgus and sagittal measurements showed EM to be equivalent to IR, with both systems producing subdegree accuracy in 95% of the readings.

  8. Successful Removal of Malpositioned Chest Drain Within the Liver by Embolization of the Transhepatic Track

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tait, Paul; Waheed, Umeer; Bell, Suzanne, E-mail: drsuzy29@hotmail.co

    2009-07-15

    The insertion of a chest drain catheter for the management of a pneumothorax in an 82-year-old woman resulted in the unusual complication of liver penetration. The position of the drain was assessed by contrast-enhanced computed tomographic scan. Because the patient was hemodynamically stable and no damage to major vessels was seen on computed tomographic scan, the patient was treated in a nonoperative manner. A procedure was performed under controlled conditions using techniques used during transhepatic liver biopsies but with the addition of a balloon catheter. Embolization of the liver track was performed during chest drain removal. The drain was successfullymore » removed without the complication of bleeding in a patient unsuitable for a general anesthetic.« less

  9. 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. © 2015 American College of Veterinary Radiology.

  10. Metronidazole-induced central nervous system toxicity: a systematic review.

    PubMed

    Kuriyama, Akira; Jackson, Jeffrey L; Doi, Asako; Kamiya, Toru

    2011-01-01

    To assess patient and medication factors that contribute to metronidazole toxicity. We searched PUBMED from 1965 through April 7, 2011, and performed a hand search of bibliographies. Case reports or case series reporting metronidazole-induced central nervous toxicity. Two authors independently abstracted demographics, metronidazole indication, dose and duration, neurological manifestations, and outcomes as well as brain imaging findings. Among 64 patients, 48 (77%) had cerebellar dysfunction, 21 (33%) had altered mental status, and 8 (15%) had seizures. Patients' ages averaged 53.3 years (range, 12-87 years), and 64% were male. The median duration of metronidazole was 54 days, although 26% had taken it less than a week and 11% had taken it less than 72 hours. Among cases with outcome data, most patients either improved (n = 18 [29%]) or had complete resolution of their symptoms with discontinuation of metronidazole (n = 41 [65%]). There was no difference in resolution of symptom by age (P = 0.71) or sex (P = 0.34). The patients with cerebellar dysfunction were less likely to experience complete resolution than those with mental status changes or seizures (relative risk, 0.67; 95% confidence interval (CI), 0.49-0.92). Nearly all patients (n = 55 [86%]) underwent imaging of the brain: 44 (69%) underwent magnetic resonance imaging (MRI) and 12 (19%) underwent computed tomographic studies. All patients with cerebellar dysfunction had abnormalities on imaging: 93% (n = 39) had a cerebellar lesion, although numerous areas in the brain were affected. On follow-up MRIs, 25 patients (83%) had complete resolution of abnormalities. Metronidazole can rarely cause central nervous system toxicity; it does not seem to be a dose- or duration-related phenomenon. Most patients will have MRI abnormalities. Prognosis is excellent with metronidazole cessation.

  11. Efficient volumetric estimation from plenoptic data

    NASA Astrophysics Data System (ADS)

    Anglin, Paul; Reeves, Stanley J.; Thurow, Brian S.

    2013-03-01

    The commercial release of the Lytro camera, and greater availability of plenoptic imaging systems in general, have given the image processing community cost-effective tools for light-field imaging. While this data is most commonly used to generate planar images at arbitrary focal depths, reconstruction of volumetric fields is also possible. Similarly, deconvolution is a technique that is conventionally used in planar image reconstruction, or deblurring, algorithms. However, when leveraged with the ability of a light-field camera to quickly reproduce multiple focal planes within an imaged volume, deconvolution offers a computationally efficient method of volumetric reconstruction. Related research has shown than light-field imaging systems in conjunction with tomographic reconstruction techniques are also capable of estimating the imaged volume and have been successfully applied to particle image velocimetry (PIV). However, while tomographic volumetric estimation through algorithms such as multiplicative algebraic reconstruction techniques (MART) have proven to be highly accurate, they are computationally intensive. In this paper, the reconstruction problem is shown to be solvable by deconvolution. Deconvolution offers significant improvement in computational efficiency through the use of fast Fourier transforms (FFTs) when compared to other tomographic methods. This work describes a deconvolution algorithm designed to reconstruct a 3-D particle field from simulated plenoptic data. A 3-D extension of existing 2-D FFT-based refocusing techniques is presented to further improve efficiency when computing object focal stacks and system point spread functions (PSF). Reconstruction artifacts are identified; their underlying source and methods of mitigation are explored where possible, and reconstructions of simulated particle fields are provided.

  12. SALSA3D: A Tomographic Model of Compressional Wave Slowness in the Earth’s Mantle for Improved Travel-Time Prediction and Travel-Time Prediction Uncertainty

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ballard, Sanford; Hipp, James R.; Begnaud, Michael L.

    The task of monitoring the Earth for nuclear explosions relies heavily on seismic data to detect, locate, and characterize suspected nuclear tests. In this study, motivated by the need to locate suspected explosions as accurately and precisely as possible, we developed a tomographic model of the compressional wave slowness in the Earth’s mantle with primary focus on the accuracy and precision of travel-time predictions for P and Pn ray paths through the model. Path-dependent travel-time prediction uncertainties are obtained by computing the full 3D model covariance matrix and then integrating slowness variance and covariance along ray paths from source tomore » receiver. Path-dependent travel-time prediction uncertainties reflect the amount of seismic data that was used in tomography with very low values for paths represented by abundant data in the tomographic data set and very high values for paths through portions of the model that were poorly sampled by the tomography data set. The pattern of travel-time prediction uncertainty is a direct result of the off-diagonal terms of the model covariance matrix and underscores the importance of incorporating the full model covariance matrix in the determination of travel-time prediction uncertainty. In addition, the computed pattern of uncertainty differs significantly from that of 1D distance-dependent travel-time uncertainties computed using traditional methods, which are only appropriate for use with travel times computed through 1D velocity models.« less

  13. SALSA3D: A Tomographic Model of Compressional Wave Slowness in the Earth’s Mantle for Improved Travel-Time Prediction and Travel-Time Prediction Uncertainty

    DOE PAGES

    Ballard, Sanford; Hipp, James R.; Begnaud, Michael L.; ...

    2016-10-11

    The task of monitoring the Earth for nuclear explosions relies heavily on seismic data to detect, locate, and characterize suspected nuclear tests. In this study, motivated by the need to locate suspected explosions as accurately and precisely as possible, we developed a tomographic model of the compressional wave slowness in the Earth’s mantle with primary focus on the accuracy and precision of travel-time predictions for P and Pn ray paths through the model. Path-dependent travel-time prediction uncertainties are obtained by computing the full 3D model covariance matrix and then integrating slowness variance and covariance along ray paths from source tomore » receiver. Path-dependent travel-time prediction uncertainties reflect the amount of seismic data that was used in tomography with very low values for paths represented by abundant data in the tomographic data set and very high values for paths through portions of the model that were poorly sampled by the tomography data set. The pattern of travel-time prediction uncertainty is a direct result of the off-diagonal terms of the model covariance matrix and underscores the importance of incorporating the full model covariance matrix in the determination of travel-time prediction uncertainty. In addition, the computed pattern of uncertainty differs significantly from that of 1D distance-dependent travel-time uncertainties computed using traditional methods, which are only appropriate for use with travel times computed through 1D velocity models.« less

  14. Toward regional-scale adjoint tomography in the deep earth

    NASA Astrophysics Data System (ADS)

    Masson, Y.; Romanowicz, B. A.

    2013-12-01

    Thanks to the development of efficient numerical computation methods, such as the Spectral Element Method (SEM) and to the increasing power of computer clusters, it is now possible to obtain regional-scale images of the Earth's interior using adjoint-tomography (e.g. Tape, C., et al., 2009). As for now, these tomographic models are limited to the upper layers of the earth, i.e., they provide us with high-resolution images of the crust and the upper part of the mantle. Given the gigantic amount of calculation it represents, obtaing similar models at the global scale (i.e. images of the entire Earth) seems out of reach at the moment. Furthermore, it's likely that the first generation of such global adjoint tomographic models will have a resolution significantly smaller than the current regional models. In order to image regions of interests in the deep Earth, such as plumes, slabs or large low shear velocity provinces (LLSVPs), while keeping the computation tractable, we are developing new tools that will allow us to perform regional-scale adjoint-tomography at arbitrary depths. In a recent study (Masson et al., 2013), we showed that a numerical equivalent of the time reversal mirrors used in experimental acoustics permits to confine the wave propagation computations (i.e. using SEM simulations) inside the region to be imaged. With this ability to limit wave propagation modeling inside a region of interest, obtaining the adjoint sensitivity kernels needed for tomographic imaging is only two steps further. First, the local wavefield modeling needs to be coupled with field extrapolation techniques in order to obtain synthetic seismograms at the surface of the earth. These seismograms will account for the 3D structure inside the region of interest in a quasi-exact manner. We will present preliminary results where the field-extrapolation is performed using Green's function computed in a 1D Earth model thanks to the Direct Solution Method (DSM). Once synthetic seismograms can be obtained, it is possible to evaluate the misfit between observed and computed seismograms. The second step will then be to extrapolate the misfit function back into the SEM region in order to compute local adjoint sensitivity kernels. When available, these kernels will allow us to perform regional-scale adjoint tomography at arbitrary locations inside the earth. Masson Y., Cupillard P., Capdeville Y., & Romanowicz B., 2013. On the numerical implementation of time-reversal mirrors for tomographic imaging, Journal of Geophysical Research (under review). Tape, C., et al. (2009). "Adjoint tomography of the southern California crust." Science 325(5943): 988-992.

  15. Tomographic assessment of the spine in children with spondylocostal dysotosis syndrome.

    PubMed

    Kaissi, Ali Al; Klaushofer, Klaus; Grill, Franz

    2010-01-01

    The aim of this study was to perform a detailed tomographic analysis of the skull base, craniocervical junction, and the entire spine in seven patients with spondylocostal dysostosis syndrome. Detailed scanning images have been organized in accordance with the most prominent clinical pathology. The reasons behind plagiocephaly, torticollis, short immobile neck, scoliosis and rigid back have been detected. Radiographic documentation was insufficient modality. Detailed computed tomography scans provided excellent delineation of the osseous abnormality pattern in our patients. This article throws light on the most serious osseous manifestations of spondylocostal dysostosissyndrome.

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

    PubMed Central

    2012-01-01

    Background 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. Results 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. Conclusions High-resolution, high-contrast CT examination with no overlapping of organs is superior to radiography in the assessment of pneumonic lung lesions after App challenge. The new CT scoring system allows for quantification of gross pathological lung alterations in living pigs. However, computed tomographic findings are not informative of the etiology of respiratory disease. PMID:22546414

  17. [Multispiral computed tomographic semiotics of laryngeal cancer].

    PubMed

    Vasil'ev, P V; Iudin, A L; Sdvizhkov, A M; Kozhanov, L G

    2007-01-01

    Multispiral computed tomography (MSCT) with intravenous bolus contrasting is a currently available method for radiodiagnosis of laryngeal cancer. MSCT is of much higher informative value in estimating the extent of a tumorous lesion than the traditional radiodiagnostic techniques: linear tomography, lateral X-ray study, roentgenoscopy and roentgenography of the laryngopharynx and esophagus with barium meal.

  18. 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...

  19. Natural pixel decomposition for computational tomographic reconstruction from interferometric projection: algorithms and comparison

    NASA Astrophysics Data System (ADS)

    Cha, Don J.; Cha, Soyoung S.

    1995-09-01

    A computational tomographic technique, termed the variable grid method (VGM), has been developed for improving interferometric reconstruction of flow fields under ill-posed data conditions of restricted scanning and incomplete projection. The technique is based on natural pixel decomposition, that is, division of a field into variable grid elements. The performances of two algorithms, that is, original and revised versions, are compared to investigate the effects of the data redundancy criteria and seed element forming schemes. Tests of the VGMs are conducted through computer simulation of experiments and reconstruction of fields with a limited view angel of 90 degree(s). The temperature fields at two horizontal sections of a thermal plume of two interacting isothermal cubes, produced by a finite numerical code, are analyzed as test fields. The computer simulation demonstrates the superiority of the revised VGM to either the conventional fixed grid method or the original VGM. Both the maximum and average reconstruction errors are reduced appreciably. The reconstruction shows substantial improvement in the regions with dense scanning by probing rays. These regions are usually of interest in engineering applications.

  20. Iliac screw fixation using computer-assisted computer tomographic image guidance: technical note.

    PubMed

    Shin, John H; Hoh, Daniel J; Kalfas, Iain H

    2012-03-01

    Iliac screw fixation is a powerful tool used by spine surgeons to achieve fusion across the lumbosacral junction for a number of indications, including deformity, tumor, and pseudarthrosis. Complications associated with screw placement are related to blind trajectory selection and excessive soft tissue dissection. To describe the technique of iliac screw fixation using computed tomographic (CT)-based image guidance. Intraoperative registration and verification of anatomic landmarks are performed with the use of a preoperatively acquired CT of the lumbosacral spine. With the navigation probe, the ideal starting point for screw placement is selected while visualizing the intended trajectory and target on a computer screen. Once the starting point is selected and marked with a burr, a drill guide is docked within this point and the navigation probe re-inserted, confirming the trajectory. The probe is then removed and the high-speed drill reinserted within the drill guide. Drilling is performed to a depth measured on the computer screen and a screw is placed. Confirmation of accurate placement of iliac screws can be performed with standard radiographs. CT-guided navigation allows for 3-dimensional visualization of the pelvis and minimizes complications associated with soft-tissue dissection and breach of the ilium during screw placement.

  1. Dental computed tomographic imaging as age estimation: morphological analysis of the third molar of a group of Turkish population.

    PubMed

    Cantekin, Kenan; Sekerci, Ahmet Ercan; Buyuk, Suleyman Kutalmis

    2013-12-01

    Computed tomography (CT) is capable of providing accurate and measurable 3-dimensional images of the third molar. The aims of this study were to analyze the development of the mandibular third molar and its relation to chronological age and to create new reference data for a group of Turkish participants aged 9 to 25 years on the basis of cone-beam CT images. All data were obtained from the patients' records including medical, social, and dental anamnesis and cone-beam CT images of 752 patients. Linear regression analysis was performed to obtain regression formulas for dental age calculation with chronological age and to determine the coefficient of determination (r) for each sex. Statistical analysis showed a strong correlation between age and third-molar development for the males (r2 = 0.80) and the females (r2 = 0.78). Computed tomographic images are clinically useful for accurate and reliable estimation of dental ages of children and youth.

  2. Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection.

    PubMed

    Casey, M B; Pearson, G R; Perkins, J D; Tremaine, W H

    2015-09-01

    The most prevalent type of equine dental pulpitis due to apical infection is not associated with coronal fractures or periodontal disease. The pathogenesis of this type of pulpitis is not fully understood. Computed tomography (CT) is increasingly used to investigate equine dental disorders. However, gross, tomographic and histopathological changes in equine dental pulpitis have not been compared previously. To compare gross, CT and histological appearances of sectioned mandibular cheek teeth extracted from horses with clinical signs of pulpitis without coronal fractures or periodontal disease. To contribute to understanding the pathogenesis of equine dental pulpitis. Descriptive study using diseased and healthy teeth. Mandibular cheek teeth extracted from horses with clinical signs of pulpitis (cases), and from cadavers with no history of dental disease (controls), were compared using CT in the transverse plane at 1 mm intervals. Teeth were then sectioned transversely, photographed and processed for histopathological examination. Tomographs were compared with corresponding gross and histological sections. Cement, dentine and bone had similar ranges of attenuation (550-2000 Hounsfield Units, HU) in tomographs but could be differentiated from pulp (-400 to 500 HU) and enamel (> 2500 HU). Twelve discrete dental lesions were identified grossly, 10 of which were characterised histologically. Reactive and reparative dentinogenesis and extensive pulpar mineralisation, previously undescribed, were identified. Pulpar oedema, neutrophilic inflammation, cement and enamel defects, and reactive cemental deposition were also observed. The CT and pathological findings corresponded well where there was mineralised tissue deposited, defects in mineralised tissue, or food material in the pulpar area. Pulpar and dentinal necrosis and cement destruction, evident grossly and histologically, did not correspond to CT changes. Computed tomography is useful for identifying deposition and defects of mineralised material but less useful for identifying inflammation and tissue destruction. The equine dentine-pulp complex responds to insult with reactive and reparative changes. © 2014 EVJ Ltd.

  3. Endovascular Treatment of Infrarenal Abdominal Aortic Lesions With or Without Common Iliac Artery Involvement

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Oender, Hakan, E-mail: drhakanonder@hotmail.com; Oguzkurt, Levent; Guer, Serkan

    To evaluate the results of stent placement for obstructive atherosclerotic aortic disease with or without involvement of the common iliac artery. Forty patients had self-expanding stents primarily or after balloon dilatation in the abdominal aorta between January 2005 and May 2011. All patients had trouble walking. Follow-up examinations were performed with clinical visits; these included color Doppler ultrasonography and computed tomographic angiography. Technical, clinical, and hemodynamic success was achieved in all patients. None of the patients underwent reintervention during the follow-up period, which ranged from 3 months to 6 years (median 24 months). Nine complications occurred in six patients. Ofmore » the nine complications, four were distal thromboembolisms, which were successfully treated with catheter-directed thrombolysis or anticoagulation therapy. Endovascular treatment of the obstructive aortic disease using self-expanding stents was safe and effective, with high technical success and long-term patency. Thromboembolic complications were high even though direct stenting was considered protective for thromboembolism formation. Particularly for infrarenal aortic stenosis, it can be recommended as the first-line treatment option for patients with obstructive atherosclerotic aortic disease.« less

  4. Initial clinical application of a robotically steerable catheter system in endovascular aneurysm repair.

    PubMed

    Riga, Celia; Bicknell, Colin; Cheshire, Nicholas; Hamady, Mohamad

    2009-04-01

    To report the initial clinical use of a robotically steerable catheter during endovascular aneurysm repair (EVAR) in order to assess this novel and innovative approach in a clinical setting. Following a series of in-vitro studies and procedure rehearsals using a pulsatile silicon aneurysm model, a 78-year-old man underwent robot-assisted EVAR of a 5.9-cm infrarenal abdominal aortic aneurysm. During the standard procedure, a 14-F remotely steerable robotic catheter was used to successfully navigate through the aneurysm sac, cannulate the contralateral limb of a bifurcated stent-graft under fluoroscopic guidance, and place stiff wires using fine and controlled movements. The procedure was completed successfully. There were no postoperative complications, and computed tomographic angiography prior to discharge and at 3 months confirmed that the stent-graft remained in good position, with no evidence of an endoleak. EVAR using robotically-steerable catheters is feasible. This technology may simplify more complex procedures by increasing the accuracy of vessel cannulation and perhaps reduce procedure times and radiation exposure to the patient and operator.

  5. Testosterone-secreting adrenal adenoma in a peripubertal girl

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kamilaris, T.C.; DeBold, C.R.; Manolas, K.J.

    1987-11-13

    A 15-year-old girl who presented with primary amenorrhea and virilization had an adrenocortical adenoma that secreted predominantly testosterone. To the authors' knowledge, she is the first peripubertal and second youngest patient with a testosterone-secreting adrenal tumor described. Serum dehydroepiandrosterone sulfate and urinary 17-ketosteroid an 17-hydroxycorticosteroid levels were normal. A tumor was located by a computed tomographic (CT) scan and by uptake of 6-..beta..-(/sup 75/Se) selenomethylnorcholesterol. Microscopic examination of the tumor showed typical features of an adrenocortical adenoma with no histologic features characteristic of Leydig cells. Postoperatively, her hirsutism regressed, she rapidly went through puberty, and regular monthly menstruation started fourmore » months later. Finding the source of testosterone in a virilized patient can be difficult. Eleven of the 14 previously described patients with testosterone-secreting adrenal tumors initially underwent misdirected surgery on the ovaries. Review of these cases revealed that results of hormone stimulation and suppression tests are unreliable and that these tumors are usually large. Therefore, CT scanning of the adrenal glands is recommended in all patients suspected of having a testosterone-secreting tumor.« less

  6. Fixation of mandibular fractures with biodegradable plates and screws.

    PubMed

    Yerit, Kaan C; Enislidis, Georg; Schopper, Christian; Turhani, Dritan; Wanschitz, Felix; Wagner, Arne; Watzinger, Franz; Ewers, Rolf

    2002-09-01

    Little data exist regarding the use of biodegradable plates and screws for the internal fixation of human mandibular fractures. The purpose of this study was to evaluate the stability of biodegradable, self-reinforced poly-L-lactide plates and screws for the internal fixation of fractures of the human mandible. Twenty-two individuals (14 male, 8 female; average age, 26.3 years) with a variety of fracture patterns of the mandible underwent management with a biodegradable fixation system. After surgery, maxillomandibular fixation was applied in 3 cases. Images (panoramic radiograph, computed tomographic scan) were taken immediately after surgery and at the 4-week, 8-week, 12-week, and 24-week intervals. The follow-up period averaged 49.1 weeks (range, 22 to 78 weeks). Mucosal dehiscences over the resorbable devices were present in 2 patients. In 1 of these 2 cases, the material had to be replaced with titanium plates. Mucosal healing and consolidation of the fracture were normal in all other patients. Self-reinforced biodegradable osteosynthesis materials provide a reliable and sufficient alternative to conventional titanium plate systems.

  7. Endovascular Treatment of Ruptured Abdominal Aneurysm into the Inferior Vena Cava in Patient After Stent Graft Placement

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Juszkat, Robert, E-mail: radiologiamim@wp.p; Pukacki, Fryderyk; Zarzecka, Anna

    We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, high-output cardiac failure, and renal failure. A computed tomographic scan and angiography revealed bending of the right iliac limb, a type I endoleak, and rupture of the aneurysm into the inferior vena cava with aortocaval fistula formation. An iliac extension was positioned in the right external iliac artery. The proceduremore » was finished successfully. Control angiography showed normal flow within the endoprosthesis, and both iliac arteries were without signs of endoleakage and aortocaval fistula. Ectatic common iliac artery may lead to a late distal attachment site endoleak. The application of a stent graft in cases of secondary aortocaval fistula after stent graft repair is a good option, particularly in emergency cases.« less

  8. Aneurysm of the intradural artery of Adamkiewicz treated with muslin wrapping: technical case report.

    PubMed

    Vishteh, A G; Brown, A P; Spetzler, R F

    1997-01-01

    An exceedingly rare, isolated spinal arterial aneurysm and its management are presented. A 30-year-old man who presented with severe lower back pain and headache underwent a computed tomographic study of his head that disclosed nothing abnormal and a lumbar puncture that revealed bloody, xanthochromic cerebrospinal fluid. The findings from cerebral angiography were normal, and the results from spinal angiography were consistent with a diagnosis of an aneurysm of the artery of Adamkiewicz. A transthoracic approach with a partial T11 vertebrectomy gained exposure to this anteriorly located lesion. A fusiform aneurysm of the intradural portion of the artery of Adamkiewicz was discovered. Excision of the aneurysm with a vascular bypass was deemed impossible. The lesion was treated with muslin wrapping. One year after surgery, the patient remains at his baseline neurological condition. A review of the literature revealed only one other reported case of a ruptured aneurysm of the artery of Adamkiewicz, which was discovered postmortem. Therefore, this case represents the first report of a diagnosed and treated artery of Adamkiewicz aneurysm.

  9. Giant intrascrotal embryonal rhabdomyosarcoma in an adult: a case report and review of the literature.

    PubMed

    Gong, Wentao; Gao, Qingqiang; Xu, Zhipeng; Dai, Yutian

    2018-05-28

    Intrascrotal embryonal rhabdomyosarcoma in adults is a rare tumor with high aggression and a poor prognosis. We report our patient's case and review the relevant literature to improve the understanding of this rare disease. A 21-year-old Han Chinese man presented to our hospital with a right intrascrotal mass of 1 year's duration. His physical examination revealed an enlarged right scrotum containing a huge tender mass measuring about 10 × 7 cm. Ordinary and contrast-enhanced ultrasonography showed a solid mass in the right scrotum, which was suspected to be a malignant tumor. An abdominopelvic computed tomographic scan revealed metastases in the retroperitoneal lymph nodes. The patient was diagnosed with malignant testicular tumor and underwent a right radical orchiectomy by an inguinal approach. Postoperative pathological examination suggested an intrascrotal embryonal rhabdomyosarcoma. Intrascrotal embryonal rhabdomyosarcoma is a rare but highly aggressive tumor. Clinical and imaging manifestations of this tumor are nonspecific, so the definitive diagnosis depends on postoperative pathology and immunohistochemistry. Early suspicion, radical orchiectomy, accurate pathologic diagnosis, and adjuvant chemotherapy and/or radiotherapy are the keys to optimal prognosis.

  10. An Unruptured Aneurysm Coexisting with an Infundibular Dilatation: A Case Report.

    PubMed

    Kitamura, Takao; Murai, Yasuo; Shirokane, Kazutaka; Matano, Fumihiro; Kitamura, Takayuki; Morita, Akio

    2016-01-01

    Infundibular dilatation (ID) is a funnel-shaped enlargement of the origin of cerebral arteries. The coexistence of an aneurysm and ID is relatively rare. Patients with IDs are rarely followed up. However, some IDs have been reported to develop into aneurysms with subsequent rupture. Here we report on a case of an aneurysm that coexisted with ID of the posterior communicating artery. A 51-year-old woman underwent magnetic resonance imaging (MRI) to check for aneurysms and other problems. MRI revealed an unruptured aneurysm of the right internal carotid artery, for which the patient was admitted to our hospital. Three-dimensional computed tomographic angiography revealed an aneurysm, which protruded outward, and ID of the posterior communicating artery, which protruded inward. A right pterional craniotomy was performed with aneurysm clipping. The postoperative course was uneventful. In this report, we demonstrate operative views of the aneurysm and ID with the use of neuroendoscopy. ID can develop into a true arterial aneurysm and potentially rupture. Therefore, we need to observe the patients with IDs carefully, particularly in young women.

  11. Computed tomographic features of canine nonparenchymal hemangiosarcoma.

    PubMed

    Fukuda, Shoko; Kobayashi, Tetsuya; Robertson, Ian D; Oshima, Fukiko; Fukazawa, Eri; Nakano, Yuko; Ono, Shin; Thrall, Donald E

    2014-01-01

    The purpose of this retrospective study was to describe pre- and postcontrast computed tomographic (CT) characteristics of confirmed nonparenchymal hemangiosarcoma in a group of dogs. Medical records were searched during the period of July 2003 and October 2011 and dogs with histologically confirmed nonparenchymal hemangiosarcoma and pre- and postcontrast CT images were recruited. Two observers recorded a consensus opinion for the following CT characteristics for each dog: largest transverse tumor diameter, number of masses, general tumor shape, character of the tumor margin, precontrast appearance, presence of dystrophic calcification, presence of postcontrast enhancement, pattern of postcontrast enhancement, presence of regional lymphadenopathy, and presence of associated cavitary fluid. A total of 17 dogs met inclusion criteria. Tumors were located in the nasal cavity, muscle, mandible, mesentery, subcutaneous tissue, and retroperitoneal space. Computed tomographic features of nonparenchymal hemangiosarcoma were similar to those of other soft tissue sarcomas, with most tumors being heterogeneous in precontrast images, invasive into adjacent tissue, and heterogeneously contrast enhancing. One unexpected finding was the presence of intense foci of contrast enhancement in 13 of the 17 tumors (76%). This appearance, which is not typical of other soft tissue sarcomas, was consistent with contrast medium residing in vascular channels. Findings indicated that there were no unique distinguishing CT characteristics for nonparenchymal hemangiosarcoma in dogs; however, the presence of highly attenuating foci of contrast enhancement may warrant further investigation in prospective diagnostic sensitivity and treatment outcome studies. © 2014 American College of Veterinary Radiology.

  12. Influence of Heat Treatment of Nickel-Titanium Rotary Endodontic Instruments on Apical Preparation: A Micro-Computed Tomographic Study.

    PubMed

    de Almeida, Bernardo Corrêa; Ormiga, Fabíola; de Araújo, Marcos César Pimenta; Lopes, Ricardo Tadeu; Lima, Inayá Corrêa Barbosa; dos Santos, Bernardo Camargo; Gusman, Heloisa

    2015-12-01

    The aim of this study was to make a 3-dimensional comparison of the canal transportation and changes in apical geometry using micro-computed tomographic imaging after canal preparation with K3 (SybronEndo, Orange, CA) and K3XF (SybronEndo) file systems. Twenty-eight mandibular molars were randomly divided into 2 groups according to the rotary system used in instrumentation: K3 or K3XF. The specimens were scanned by micro-computed tomographic imaging before and after instrumentation. Images before and after instrumentation from each group were compared with regard to canal volume, surface area, and structure model index (SMI) (paired t test, P < .05). After instrumentation, the canals from each group were compared regarding the changes in volume, surface area, SMI, and canal transportation in the last 4 apical mm (t test, P < .05). Instrumentation with the 2 rotary systems significantly changed the canal volume, surface area, and SMI (P < .05). There were no significant differences between instrument types concerning these parameters (P > .05). There were no significant differences between the 2 groups with regard to canal transportation in the last 4 apical mm (P > .05). Both rotary systems showed adequate canal preparations with reduced values of canal transportation. Heat treatment did not influence changes in root canal geometry in the apical region. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Computed tomographic features of idiopathic fibrosing interstitial pneumonia: comparison with pulmonary fibrosis related to collagen vascular disease.

    PubMed

    Hwang, Jeong-Hwa; Misumi, Shigeki; Sahin, Hakan; Brown, Kevin K; Newell, John D; Lynch, David A

    2009-01-01

    To compare the computed tomographic (CT) features of idiopathic fibrosing interstitial pneumonia with those of pulmonary fibrosis related to collagen vascular disease (CVD). We reviewed the CT scans of 177 patients with diffuse interstitial pulmonary fibrosis, of which 97 had idiopathic fibrosing interstitial pneumonia and 80 had CVD. The CT images were systematically scored for the presence and extent of pulmonary and extrapulmonary abnormalities. Computed tomographic diagnosis of usual interstitial pneumonia (UIP) or nonspecific interstitial pneumonia (NSIP) was assigned. A CT pattern of UIP was identified in 59 (60.8%) of patients with idiopathic fibrosing interstitial pneumonia compared with 15 (18.7%) of those patients with CVD; conversely, the CT diagnosis of NSIP was made in 51 (64%) of patients with CVD compared with 36 (37%) of patients with idiopathic disease (P < 0.01). In 113 patients who had lung biopsy, the CT diagnoses of UIP and NSIP were concordant with the histologic diagnoses in 36 of 50 patients and 34 of 41 patients, respectively. Pleural effusions, esophageal dilation, and pericardial abnormalities were more frequent in patients with CVD than in patients with idiopathic fibrosing interstitial pneumonia. Compared with patients with CVD, those patients with an idiopathic fibrosing interstitial pneumonia showed a higher prevalence of a UIP pattern and lower prevalence of an NSIP pattern as determined by CT. Identification of coexisting extrapulmonary abnormalities on CT can support a diagnosis of CVD.

  14. Orthodontic decompensation in skeletal Class III malocclusion: redefining the amount of movement assessed by Cone-Beam Computed Tomography

    PubMed Central

    Cappellozza, José Antonio Zuega; Guedes, Fabio Pinto; Nary, Hugo; Capelozza, Leopoldino; Cardoso, Mauricio de Almeida

    2015-01-01

    Introduction: Cone-Beam Computed Tomography (CBCT) is essential for tridimensional planning of orthognathic surgery, as it allows visualization and evaluation of bone structures and mineralized tissues. Tomographic slices allow evaluation of tooth inclination and individualization of movement performed during preoperative decompensation. The aim of this paper was to assess maxillary and mandibular incisors inclination pre and post orthodontic decompensation in skeletal Class III malocclusion. Methods: The study was conducted on six individuals with skeletal Class III malocclusion, surgically treated, who had Cone-Beam Computed Tomographic scans obtained before and after orthodontic decompensation. On multiplanar reconstruction view, tomographic slices (axial, coronal and sagittal) were obtained on the long axis of each incisor. The sagittal slice was used for measurement taking, whereas the references used to assess tooth inclination were the long axis of maxillary teeth in relation to the palatal plane and the long axis of mandibular teeth in relation to the mandibular plane. Results: There was significant variation in the inclination of incisors before and after orthodontic decompensation. This change was of greater magnitude in the mandibular arch, evidencing that natural compensation is more effective in this arch, thereby requiring more intensive decompensation. Conclusion: When routinely performed, the protocols of decompensation treatment in surgical individuals often result in intensive movements, which should be reevaluated, since the extent of movement predisposes to reduction in bone attachment levels and root length. PMID:26560818

  15. Visual computed tomographic scoring of emphysema and its correlation with its diagnostic electrocardiographic sign: the frontal P vector.

    PubMed

    Chhabra, Lovely; Sareen, Pooja; Gandagule, Amit; Spodick, David H

    2012-03-01

    Verticalization of the frontal P vector in patients older than 45 years is virtually diagnostic of pulmonary emphysema (sensitivity, 96%; specificity, 87%). We investigated the correlation of P vector and the computed tomographic visual score of emphysema (VSE) in patients with established diagnosis of chronic obstructive pulmonary disease/emphysema. High-resolution computed tomographic scans of 26 patients with emphysema (age, >45 years) were reviewed to assess the type and extent of emphysema using the subjective visual scoring. Electrocardiograms were independently reviewed to determine the frontal P vector. The P vector and VSE were compared for statistical correlation. Both P vector and VSE were also directly compared with the forced expiratory volume at 1 second. The VSE and the orientation of the P vector (ÂP) had an overall significant positive correlation (r = +0.68; P = .0001) in all patients, but the correlation was very strong in patients with predominant lower-lobe emphysema (r = +0.88; P = .0004). Forced expiratory volume at 1 second and ÂP had almost a linear inverse correlation in predominant lower-lobe emphysema (r = -0.92; P < .0001). Orientation of the P vector positively correlates with visually scored emphysema. Both ÂP and VSE are strong reflectors of qualitative lung function in patients with predominant lower-lobe emphysema. A combination of more vertical ÂP and predominant lower-lobe emphysema reflects severe obstructive lung dysfunction. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Comparison of computed tomography with radiography as a noninvasive diagnostic technique for chronic nasal disease in dogs.

    PubMed

    Codner, E C; Lurus, A G; Miller, J B; Gavin, P R; Gallina, A; Barbee, D D

    1993-04-01

    Computed tomography was evaluated as a noninvasive technique for the diagnosis of chronic nasal disease in dogs. Computed tomographic images, radiographs, and histopathologic findings were compared in 11 dogs with chronic nasal disease. Definitive diagnosis was made following traumatic nasal flush, exploratory surgery, or necropsy. The study included 8 dogs with intranasal tumors, 2 dogs with bacterial rhinitis (Pasteurella sp), and 1 dog with mycotic rhinitis (Aspergillus sp). Computed tomography was superior to radiography in defining the extent of the disease process and in differentiating infectious rhinitis from nasal neoplasms. It defined lesions in the palate, nasopharyngeal meatus, maxillary sinus, caudal ethmoturbinates, and periorbital tissues that were difficult to demonstrate by use of conventional radiography. Tumors appeared as space-occupying lesions that obliterated the turbinates, caused deviation of the nasal septum, and eroded bone. Rhinitis appeared as a cavitating lesion that spared the paranasal sinuses, thickened and distorted the turbinates, and widened the meatus. Although morphologically distinct on computed tomographic images, infectious rhinitis and nasal neoplasms could not be differentiated by attenuation measurements or degree of contrast enhancement. Computed tomography appeared to be a reliable, noninvasive technique for the diagnosis of chronic nasal disease in dogs, and a promising alternative to diagnostic techniques currently in use.

  17. Field-portable lensfree tomographic microscope†

    PubMed Central

    Isikman, Serhan O.; Bishara, Waheb; Sikora, Uzair; Yaglidere, Oguzhan; Yeah, John; Ozcan, Aydogan

    2011-01-01

    We present a field-portable lensfree tomographic microscope, which can achieve sectional imaging of a large volume (~20 mm3) on a chip with an axial resolution of <7 μm. In this compact tomographic imaging platform (weighing only ~110 grams), 24 light-emitting diodes (LEDs) that are each butt-coupled to a fibre-optic waveguide are controlled through a cost-effective micro-processor to sequentially illuminate the sample from different angles to record lensfree holograms of the sample that is placed on the top of a digital sensor array. In order to generate pixel super-resolved (SR) lensfree holograms and hence digitally improve the achievable lateral resolution, multiple sub-pixel shifted holograms are recorded at each illumination angle by electromagnetically actuating the fibre-optic waveguides using compact coils and magnets. These SR projection holograms obtained over an angular range of ~50° are rapidly reconstructed to yield projection images of the sample, which can then be back-projected to compute tomograms of the objects on the sensor-chip. The performance of this compact and light-weight lensfree tomographic microscope is validated by imaging micro-beads of different dimensions as well as a Hymenolepis nana egg, which is an infectious parasitic flatworm. Achieving a decent three-dimensional spatial resolution, this field-portable on-chip optical tomographic microscope might provide a useful toolset for telemedicine and high-throughput imaging applications in resource-poor settings. PMID:21573311

  18. Tomographic capabilities of the new GEM based SXR diagnostic of WEST

    NASA Astrophysics Data System (ADS)

    Jardin, A.; Mazon, D.; O'Mullane, M.; Mlynar, J.; Loffelmann, V.; Imrisek, M.; Chernyshova, M.; Czarski, T.; Kasprowicz, G.; Wojenski, A.; Bourdelle, C.; Malard, P.

    2016-07-01

    The tokamak WEST (Tungsten Environment in Steady-State Tokamak) will start operating by the end of 2016 as a test bed for the ITER divertor components in long pulse operation. In this context, radiative cooling of heavy impurities like tungsten (W) in the Soft X-ray (SXR) range [0.1 keV; 20 keV] is a critical issue for the plasma core performances. Thus reliable tools are required to monitor the local impurity density and avoid W accumulation. The WEST SXR diagnostic will be equipped with two new GEM (Gas Electron Multiplier) based poloidal cameras allowing to perform 2D tomographic reconstructions in tunable energy bands. In this paper tomographic capabilities of the Minimum Fisher Information (MFI) algorithm developed for Tore Supra and upgraded for WEST are investigated, in particular through a set of emissivity phantoms and the standard WEST scenario including reconstruction errors, influence of noise as well as computational time.

  19. Imaging open-path Fourier transform infrared spectrometer for 3D cloud profiling

    NASA Astrophysics Data System (ADS)

    Rentz Dupuis, Julia; Mansur, David J.; Vaillancourt, Robert; Carlson, David; Evans, Thomas; Schundler, Elizabeth; Todd, Lori; Mottus, Kathleen

    2010-04-01

    OPTRA has developed an imaging open-path Fourier transform infrared (I-OP-FTIR) spectrometer for 3D profiling of chemical and biological agent simulant plumes released into test ranges and chambers. An array of I-OP-FTIR instruments positioned around the perimeter of the test site, in concert with advanced spectroscopic algorithms, enables real time tomographic reconstruction of the plume. The approach is intended as a referee measurement for test ranges and chambers. This Small Business Technology Transfer (STTR) effort combines the instrumentation and spectroscopic capabilities of OPTRA, Inc. with the computed tomographic expertise of the University of North Carolina, Chapel Hill. In this paper, we summarize the design and build and detail system characterization and test of a prototype I-OP-FTIR instrument. System characterization includes radiometric performance and spectral resolution. Results from a series of tomographic reconstructions of sulfur hexafluoride plumes in a laboratory setting are also presented.

  20. Imaging open-path Fourier transform infrared spectrometer for 3D cloud profiling

    NASA Astrophysics Data System (ADS)

    Rentz Dupuis, Julia; Mansur, David J.; Engel, James R.; Vaillancourt, Robert; Todd, Lori; Mottus, Kathleen

    2008-04-01

    OPTRA and University of North Carolina are developing an imaging open-path Fourier transform infrared (I-OP-FTIR) spectrometer for 3D profiling of chemical and biological agent simulant plumes released into test ranges and chambers. An array of I-OP-FTIR instruments positioned around the perimeter of the test site, in concert with advanced spectroscopic algorithms, enables real time tomographic reconstruction of the plume. The approach will be considered as a candidate referee measurement for test ranges and chambers. This Small Business Technology Transfer (STTR) effort combines the instrumentation and spectroscopic capabilities of OPTRA, Inc. with the computed tomographic expertise of the University of North Carolina, Chapel Hill. In this paper, we summarize progress to date and overall system performance projections based on the instrument, spectroscopy, and tomographic reconstruction accuracy. We then present a preliminary optical design of the I-OP-FTIR.

  1. A prospective study for the detection of vascular injury in adult and pediatric patients with cervicothoracic seat belt signs.

    PubMed

    Rozycki, Grace S; Tremblay, Lorraine; Feliciano, David V; Tchorz, Kathryn; Hattaway, Aaron; Fountain, Jack; Pettitt, Barbara J

    2002-04-01

    A delayed diagnosis of injury to cervicothoracic vessels from blunt trauma may cause significant adverse sequelae. The association of a cervicothoracic seat belt sign with such an injury is unknown. Algorithms were prospectively studied for the detection of occult vascular injury in patients with cervicothoracic seat belt signs. Patients with neck seat belt signs underwent arteriography or computed tomographic angiography (CTA). Those with thoracic seat belt signs underwent aortography/arteriography if a ruptured thoracic aorta or injury to a great vessel was suspected or a neurovascular abnormality was present. During a 17-month period, 797 patients were admitted to the trauma service secondary to motor vehicle crashes. One hundred thirty-one (16.4%) had cervical or thoracic seat belt signs. Four (3%) of the patients had carotid artery injuries, the presence of which was strongly associated with a Glasgow Coma Scale score < 14, an Injury Severity Score > 16 (p < 0.0001), and the presence of a clavicle and/or first rib fracture (p < 0.0037). Of the remaining patients, 17 had thoracic trauma. There were no vascular injuries in the children and only one had thoracic trauma. The algorithms are safe and accurate for the detection of cervicothoracic vascular injury in adult and pediatric patients with seat belt signs. The cervicothoracic seat belt mark and an abnormal physical examination are an effective combination in screening for cervicothoracic vascular injury.

  2. Pseudoephedrine and guaifenesin urolithiasis: widening the differential diagnosis of radiolucent calculi on abdominal radiograph.

    PubMed

    Song, G Y; Lockhart, M E; Smith, J K; Burns, J R; Kenney, P J

    2005-01-01

    Unenhanced helical computed tomography has played an increasingly important role in the management of urinary tract stones, guiding diagnosis and control of calculus disease. We report computed tomographic and radiographic appearances of a renal calculus composed of pseudoephedrine and guaifenesin in a patient who abused over-the-counter allergy medication.

  3. Concurrent EEG And NIRS Tomographic Imaging Based on Wearable Electro-Optodes

    DTIC Science & Technology

    2014-04-13

    Interfaces   ( BCIs ),   and   other   systems   in   the   same   computational   framework.   Figure   11   below   shows...Improving  Brain-­‐Computer   Interfaces  Using   Independent  Component   Analysis,  In:  Towards  Future   BCIs ,  2012

  4. Application of gray level mapping in computed tomographic colonography: a pilot study to compare with traditional surface rendering method for identification and differentiation of endoluminal lesions

    PubMed Central

    Chen, Lih-Shyang; Hsu, Ta-Wen; Chang, Shu-Han; Lin, Chih-Wen; Chen, Yu-Ruei; Hsieh, Chin-Chiang; Han, Shu-Chen; Chang, Ku-Yaw; Hou, Chun-Ju

    2017-01-01

    Objective: In traditional surface rendering (SR) computed tomographic endoscopy, only the shape of endoluminal lesion is depicted without gray-level information unless the volume rendering technique is used. However, volume rendering technique is relatively slow and complex in terms of computation time and parameter setting. We use computed tomographic colonography (CTC) images as examples and report a new visualization technique by three-dimensional gray level mapping (GM) to better identify and differentiate endoluminal lesions. Methods: There are 33 various endoluminal cases from 30 patients evaluated in this clinical study. These cases were segmented using gray-level threshold. The marching cube algorithm was used to detect isosurfaces in volumetric data sets. GM is applied using the surface gray level of CTC. Radiologists conducted the clinical evaluation of the SR and GM images. The Wilcoxon signed-rank test was used for data analysis. Results: Clinical evaluation confirms GM is significantly superior to SR in terms of gray-level pattern and spatial shape presentation of endoluminal cases (p < 0.01) and improves the confidence of identification and clinical classification of endoluminal lesions significantly (p < 0.01). The specificity and diagnostic accuracy of GM is significantly better than those of SR in diagnostic performance evaluation (p < 0.01). Conclusion: GM can reduce confusion in three-dimensional CTC and well correlate CTC with sectional images by the location as well as gray-level value. Hence, GM increases identification and differentiation of endoluminal lesions, and facilitates diagnostic process. Advances in knowledge: GM significantly improves the traditional SR method by providing reliable gray-level information for the surface points and is helpful in identification and differentiation of endoluminal lesions according to their shape and density. PMID:27925483

  5. 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.

  6. Objective Assessment of the Interfrontal Angle for Severity Grading and Operative Decision-Making in Metopic Synostosis.

    PubMed

    Anolik, Rachel A; Allori, Alexander C; Pourtaheri, Navid; Rogers, Gary F; Marcus, Jeffrey R

    2016-05-01

    The purpose of this study was to evaluate the utility of a previously validated interfrontal angle for classification of severity of metopic synostosis and as an aid to operative decision-making. An expert panel was asked to study 30 cases ranging from minor to severe metopic synostosis. Based on computed tomographic images of the skull and clinical photographs, they classified the severity of trigonocephaly (1 = normal, 2 = mild, 3 = moderate, and 4 = severe) and management (0 = nonoperative and 1 = operative). The severity scores and management reported by experts were then pooled and matched with the interfrontal angle computed from each respective computed tomographic scan. A threshold was identified at which most experts agree on operative management. Expert severity scores were higher for more acute interfrontal angles. There was a high concordance at the extremes of classifications, severe (4) and normal (1) (p < 0.0001); however, between interfrontal angles of 114.3 and 136.1 degrees, there exists a "gray zone," with severe discordance in expert rankings. An operative threshold of 118.2 degrees was identified, with the interfrontal angle able to predict the expert panel's decision to proceed with surgery 87.6 percent of the time. The interfrontal angle has been previously validated as a simple, accurate, and reproducible means for diagnosing trigonocephaly, but must be obtained from computed tomographic data. In this article, the authors demonstrate that the interfrontal angle can be used to further characterize the severity of trigonocephaly. It also correlated with expert decision-making for operative versus nonoperative management. This tool may be used as an adjunct to clinical decision-making when the decision to proceed with surgery may not be straightforward. Diagnostic, V.

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

    PubMed Central

    Sharma, Pranjal; Swamy, Dinesh Francis; Shashidara, R; Swamy, Elaine Barretto

    2015-01-01

    ABSTRACT 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. Aims: 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. Materials and methods: 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. Results: 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. Conclusion: 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. PMID:26628855

  8. Tomographic assessment of the spine in children with spondylocostal dysotosis syndrome

    PubMed Central

    Kaissi, Ali Al; Klaushofer, Klaus; Grill, Franz

    2010-01-01

    OBJECTIVE: The aim of this study was to perform a detailed tomographic analysis of the skull base, craniocervical junction, and the entire spine in seven patients with spondylocostal dysostosis syndrome. METHOD: Detailed scanning images have been organized in accordance with the most prominent clinical pathology. The reasons behind plagiocephaly, torticollis, short immobile neck, scoliosis and rigid back have been detected. Radiographic documentation was insufficient modality. RESULTS: Detailed computed tomography scans provided excellent delineation of the osseous abnormality pattern in our patients. CONCLUSION: This article throws light on the most serious osseous manifestations of spondylocostal dysostosis syndrome. PMID:21120293

  9. 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 of emphysema and its distribution are weak but statistically significant predictors of outcome after LVRS. PMID:19965810

  10. Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: results from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry) registry.

    PubMed

    Chow, Benjamin J W; Small, Gary; Yam, Yeung; Chen, Li; McPherson, Ruth; Achenbach, Stephan; Al-Mallah, Mouaz; Berman, Daniel S; Budoff, Matthew J; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Cheng, Victor Y; Chinnaiyan, Kavitha; Cury, Ricardo; Delago, Augustin; Dunning, Allison; Feuchtner, Gundrun; Hadamitzky, Martin; Hausleiter, Jörg; Karlsberg, Ronald P; Kaufmann, Philipp A; Kim, Yong-Jin; Leipsic, Jonathon; LaBounty, Troy; Lin, Fay; Maffei, Erica; Raff, Gilbert L; Shaw, Leslee J; Villines, Todd C; Min, James K

    2015-04-01

    We sought to examine the risk of mortality associated with nonobstructive coronary artery disease (CAD) and to determine the impact of baseline statin and aspirin use on mortality. Coronary computed tomographic angiography permits direct visualization of nonobstructive CAD. To date, the prognostic implications of nonobstructive CAD and the potential benefit of directing therapy based on nonobstructive CAD have not been carefully examined. A total of 27 125 consecutive patients who underwent computed tomographic angiography (12 enrolling centers and 6 countries) were prospectively entered into the COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry. Patients, without history of previous CAD or obstructive CAD, for whom baseline statin and aspirin use was available were analyzed. Each coronary segment was classified as normal or nonobstructive CAD (1%-49% stenosis). Patients were followed up for a median of 27.2 months for all-cause mortality. The study comprised 10 418 patients (5712 normal and 4706 with nonobstructive CAD). In multivariable analyses, patients with nonobstructive CAD had a 6% (95% confidence interval, 1%-12%) higher risk of mortality for each additional segment with nonobstructive plaque (P=0.021). Baseline statin use was associated with a reduced risk of mortality (hazard ratio, 0.44; 95% confidence interval, 0.28-0.68; P=0.0003), a benefit that was present for individuals with nonobstructive CAD (hazard ratio, 0.32; 95% confidence interval, 0.19-0.55; P<0.001) but not for those without plaque (hazard ratio, 0.66; 95% confidence interval, 0.30-1.43; P=0.287). When stratified by National Cholesterol Education Program/Adult Treatment Program III, no mortality benefit was observed in individuals without plaque. Aspirin use was not associated with mortality benefit, irrespective of the status of plaque. The presence and extent of nonobstructive CAD predicted mortality. Baseline statin therapy was associated with a significant reduction in mortality for individuals with nonobstructive CAD but not for individuals without CAD. URL: http://clinicaltrials.gov/. Unique identifier NCT01443637. © 2015 American Heart Association, Inc.

  11. Pulmonary function recovery demonstrated by ventilation-perfusion scan after posterior vertebral column resection for severe adolescent idiopathic scoliosis: a case report.

    PubMed

    Fujii, Takeshi; Watanabe, Kota; Toyama, Yoshiaki; Matsumoto, Morio

    2014-09-01

    Case report. To describe a case in which a patient regained pulmonary function, assessed by ventilation-perfusion scans, after undergoing posterior vertebral column resection (VCR) to correct severe adolescent idiopathic scoliosis (AIS) with associated pulmonary dysfunction. Pulmonary improvement after corrective surgery for AIS has been reported. Ventilation-perfusion scans are useful for assessing pulmonary function. However, these scans have not been used to examine the recovery of pulmonary function after VCR for severe AIS with pulmonary dysfunction. A patient was described in whom ventilation-perfusion scans were used to examine improvements in impaired air ventilation and blood perfusion after VCR surgery for severe AIS. The relevant literature was reviewed. An 18-year-old male came to Keio University Hospital with exertional dyspnea associated with severe AIS. Radiographs showed severe scoliosis of 91° at T6-T12, and hypokyphosis of 6° at T5-T12. Computed tomographic scans showed narrowing of the thoracic cage on the convex side of the main thoracic curve, with the vertebral bodies at the apex of the curve obstructing the right main bronchus. Pulmonary function tests revealed a percent vital capacity of 44% and percent forced expiratory volume in 1 second of 76%. A ventilation-perfusion scan showed decreased air ventilation and blood perfusion in the right lung. The patient underwent posterior correction surgery, which used segmental pedicle screws with a VCR at T9. The scoliosis was corrected to 28°, and the kyphosis to 14°. Postoperative computed tomographic scans showed expansion of the right main bronchus. A ventilation-perfusion scan conducted 1 year after surgery showed clear improvement in both ventilation and blood perfusion in the right lung. The patient's forced expiratory volume in 1 second had increased to 91%. This is the first report in which ventilation-perfusion scans were used to examine improvements in impaired air ventilation and blood perfusion after VCR surgery in a patient with severe AIS. N/A.

  12. MIMO nonlinear ultrasonic tomography by propagation and backpropagation method.

    PubMed

    Dong, Chengdong; Jin, Yuanwei

    2013-03-01

    This paper develops a fast ultrasonic tomographic imaging method in a multiple-input multiple-output (MIMO) configuration using the propagation and backpropagation (PBP) method. By this method, ultrasonic excitation signals from multiple sources are transmitted simultaneously to probe the objects immersed in the medium. The scattering signals are recorded by multiple receivers. Utilizing the nonlinear ultrasonic wave propagation equation and the received time domain scattered signals, the objects are to be reconstructed iteratively in three steps. First, the propagation step calculates the predicted acoustic potential data at the receivers using an initial guess. Second, the difference signal between the predicted value and the measured data is calculated. Third, the backpropagation step computes updated acoustical potential data by backpropagating the difference signal to the same medium computationally. Unlike the conventional PBP method for tomographic imaging where each source takes turns to excite the acoustical field until all the sources are used, the developed MIMO-PBP method achieves faster image reconstruction by utilizing multiple source simultaneous excitation. Furthermore, we develop an orthogonal waveform signaling method using a waveform delay scheme to reduce the impact of speckle patterns in the reconstructed images. By numerical experiments we demonstrate that the proposed MIMO-PBP tomographic imaging method results in faster convergence and achieves superior imaging quality.

  13. 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.

  14. 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. Overall, utilization of the newborn tomographic phantom in MC simulations has shown the need for and usefulness of pediatric tomographic phantoms. The newborn tomographic model has shown more versatility and realistic anatomical modeling when compared to the existing stylized newborn phantom. This work has provided important organ dose data for infant patients in common examinations in pediatric radiology.

  15. Creating three-dimensional tooth models from tomographic images.

    PubMed

    Lima da Silva, Isaac Newton; Barbosa, Gustavo Frainer; Soares, Rodrigo Borowski Grecco; Beltrao, Maria Cecilia Gomes; Spohr, Ana Maria; Mota, Eduardo Golcalves; Oshima, Hugo Mitsuo Silva; Burnett, Luiz Henrique

    2008-01-01

    The use of Finite Element Analysis (FEA) is becoming very frequent in Dentistry. However, most of the three-dimensional models presented by the literature for teeth are limited in terms of geometry. Discrepancy in shape and dimensions can cause wrong results to occur. Sharp cusps and faceted contour can produce stress concentrations, which are incoherent with the reality. The aim of this study was the processing of tomographic images in order to develop an advanced three-dimensional reconstruction of the anatomy of a molar tooth and the integration of the resulting solid with commercially available CAD/CAE software. Computed tomographic images were obtained from 0.5 mm thick slices of mandibular molar and transferred to commercial cad software. Once the point cloud data have been generated, the work on these points started to get to the solid model of the tooth with Pro/Engineer software. The obtained tooth model showed very accurate shape and dimensions, as it was obtained from real tooth data with error of 0.0 to -0.8 mm. The methodology presented was efficient for creating a biomodel of a tooth from tomographic images that realistically represented its anatomy.

  16. Computerized tomography using video recorded fluoroscopic images

    NASA Technical Reports Server (NTRS)

    Kak, A. C.; Jakowatz, C. V., Jr.; Baily, N. A.; Keller, R. A.

    1975-01-01

    A computerized tomographic imaging system is examined which employs video-recorded fluoroscopic images as input data. By hooking the video recorder to a digital computer through a suitable interface, such a system permits very rapid construction of tomograms.

  17. Diffractive Optical Elements for Spectral Imaging

    NASA Technical Reports Server (NTRS)

    Wilson, D.; Maker, P.; Muller, R.; Mourolis, P.; Descour, M.; Volin, C.; Dereniak, E.

    2000-01-01

    Diffractive optical elements fabricated on flat and non-flat substrates frequently act as dispersive elements in imaging spectrometers. We describe the design and electron-beam fabrication of blazed and computer-generated-hologram gratings for slit and tomographic imaging spectrometer.

  18. Diffractive Optical Elements for Spectral Imaging

    NASA Technical Reports Server (NTRS)

    Wilson, D.; Maker, P.; Muller, R.; Maker, P.; Mouroulis, P.; Descour, M.; Volin, C.; Dereniak, E.

    2000-01-01

    Diffractive optical elements fabricated on flat and non-flat substrates frequently act as dispersive elements in imaging spectrometers. We describe the design and electron-beam fabrication of blazed and computer-generated-hologram gratings for slit and tomographic imaging spectrometers.

  19. Conservative orthodontic treatment of mandibular bilateral condyle fracture.

    PubMed

    Gašpar, Goran; Brakus, Ivan; Kovačić, Ivan

    2014-09-01

    Maxillofacial trauma is rare in children younger than the age of 5 years (range 0.6%-1.2%), and they can require different clinical treatment strategies compared with fractures in the adult population because of concerns regarding mandibular growth and development of dentition. A 5-year-old girl with a history of falling from a bicycle 7 hours earlier was referred to the department of oral and maxillofacial surgery. Multislice computed tomographic examination demonstrated a bilateral fracture of the mandibular condyle neck associated with minimal fracture of the alveolar ridge of the maxilla. The multislice computed tomographic scan also demonstrated dislocation on the right condyle neck and, on the left side, a medial inclination of approximately 45 degrees associated with greenstick fracture of the right parasymphysis region. In this particular case, orthodontic rubber elastics in combination with fixed orthodontic brackets provided good results in the treatment of bilateral condyle neck fractures associated with greenstick fracture of parasymphysis.

  20. A tomographic technique for aerodynamics at transonic speeds

    NASA Technical Reports Server (NTRS)

    Lee, G.

    1985-01-01

    Computer aided tomography (CAT) provides a means of noninvasively measuring the air density distribution around an aerodynamic model. This technique is global in that a large portion of the flow field can be measured. A test of the applicability of CAT to transonic velocities was studied. A hemispherical-nose cylinder afterbody model was tested at a Mach number of 0.8 with a new laser holographic interferometer at the 2- by 2-Foot Transonic Wind Tunnel. Holograms of the flow field were taken and were reconstructed into interferograms. The fringe distribution (a measure of the local densities) was digitized for subsequent data reduction. A computer program based on the Fourier-transform technique was developed to convert the fringe distribution into three-dimensional densities around the model. Theoretical aerodynamic densities were calculated for evaluating and assessing the accuracy of the data obtained from the tomographic method.

  1. Gadolinium-enhanced computed tomographic angiography: current status.

    PubMed

    Rosioreanu, Alex; Alberico, Ronald A; Litwin, Alan; Hon, Man; Grossman, Zachary D; Katz, Douglas S

    2005-01-01

    This article reviews the research to date, as well as our clinical experience from two institutions, on gadolinium-enhanced computed tomographic angiography (gCTA) for imaging the body. gCTA may be an appropriate examination for the small percentage of patients who would benefit from noninvasive vascular imaging, but who have contraindications to both iodinated contrast and magnetic resonance imaging. gCTA is more expensive than CTA with iodinated contrast, due to the dose of gadolinium administered, and gCTA has limitations compared with CTA with iodinated contrast, in that parenchymal organs are not optimally enhanced at doses of 0.5 mmol/kg or lower. However, in our experience, gCTA has been a very useful problem-solving examination in carefully selected patients. With the advent of 16-64 detector CT, in combination with bolus tracking, we believe that the overall dose of gadolinium needed for diagnostic CTA examinations, while relatively high, can be safely administered.

  2. 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. Copyright © 2014 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  3. 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.

  4. Associations Between Collateral Status and Thrombus Characteristics and Their Impact in Anterior Circulation Stroke.

    PubMed

    Alves, Heitor C; Treurniet, Kilian M; Dutra, Bruna G; Jansen, Ivo G H; Boers, Anna M M; Santos, Emilie M M; Berkhemer, Olvert A; Dippel, Diederik W J; van der Lugt, Aad; van Zwam, Wim H; van Oostenbrugge, Robert J; Lingsma, Hester F; Roos, Yvo B W E M; Yoo, Albert J; Marquering, Henk A; Majoie, Charles B L M

    2018-02-01

    Thrombus characteristics and collateral score are associated with functional outcome in patients with acute ischemic stroke. It has been suggested that they affect each other. The aim of this study is to evaluate the association between clot burden score, thrombus perviousness, and collateral score and to determine whether collateral score influences the association of thrombus characteristics with functional outcome. Patients with baseline thin-slice noncontrast computed tomography and computed tomographic angiography images from the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands) were included (n=195). Collateral score and clot burden scores were determined on baseline computed tomographic angiography. Thrombus attenuation increase was determined by comparing thrombus density on noncontrast computed tomography and computed tomographic angiography using a semiautomated method. The association of collateral score with clot burden score and thrombus attenuation increase was evaluated with linear regression. Mediation and effect modification analyses were used to assess the influence of collateral score on the association of clot burden score and thrombus attenuation increase with functional outcome. A higher clot burden score (B=0.063; 95% confidence interval, 0.008-0.118) and a higher thrombus attenuation increase (B=0.014; 95% confidence interval, 0.003-0.026) were associated with higher collateral score. Collateral score mediated the association of clot burden score with functional outcome. The association between thrombus attenuation increase and functional outcome was modified by the collateral score, and this association was stronger in patients with moderate and good collaterals. Patients with lower thrombus burden and higher thrombus perviousness scores had higher collateral score. The positive effect of thrombus perviousness on clinical outcome was only present in patients with moderate and high collateral scores. URL: http://www.trialregister.nl. Unique identifier: NTR1804 and URL: http://www.controlled-trials.com Unique identifier: ISRCTN10888758. © 2018 The Authors.

  5. Acceleration of image-based resolution modelling reconstruction using an expectation maximization nested algorithm.

    PubMed

    Angelis, G I; Reader, A J; Markiewicz, P J; Kotasidis, F A; Lionheart, W R; Matthews, J C

    2013-08-07

    Recent studies have demonstrated the benefits of a resolution model within iterative reconstruction algorithms in an attempt to account for effects that degrade the spatial resolution of the reconstructed images. However, these algorithms suffer from slower convergence rates, compared to algorithms where no resolution model is used, due to the additional need to solve an image deconvolution problem. In this paper, a recently proposed algorithm, which decouples the tomographic and image deconvolution problems within an image-based expectation maximization (EM) framework, was evaluated. This separation is convenient, because more computational effort can be placed on the image deconvolution problem and therefore accelerate convergence. Since the computational cost of solving the image deconvolution problem is relatively small, multiple image-based EM iterations do not significantly increase the overall reconstruction time. The proposed algorithm was evaluated using 2D simulations, as well as measured 3D data acquired on the high-resolution research tomograph. Results showed that bias reduction can be accelerated by interleaving multiple iterations of the image-based EM algorithm solving the resolution model problem, with a single EM iteration solving the tomographic problem. Significant improvements were observed particularly for voxels that were located on the boundaries between regions of high contrast within the object being imaged and for small regions of interest, where resolution recovery is usually more challenging. Minor differences were observed using the proposed nested algorithm, compared to the single iteration normally performed, when an optimal number of iterations are performed for each algorithm. However, using the proposed nested approach convergence is significantly accelerated enabling reconstruction using far fewer tomographic iterations (up to 70% fewer iterations for small regions). Nevertheless, the optimal number of nested image-based EM iterations is hard to be defined and it should be selected according to the given application.

  6. 3D galaxy clustering with future wide-field surveys: Advantages of a spherical Fourier-Bessel analysis

    NASA Astrophysics Data System (ADS)

    Lanusse, F.; Rassat, A.; Starck, J.-L.

    2015-06-01

    Context. Upcoming spectroscopic galaxy surveys are extremely promising to help in addressing the major challenges of cosmology, in particular in understanding the nature of the dark universe. The strength of these surveys, naturally described in spherical geometry, comes from their unprecedented depth and width, but an optimal extraction of their three-dimensional information is of utmost importance to best constrain the properties of the dark universe. Aims: Although there is theoretical motivation and novel tools to explore these surveys using the 3D spherical Fourier-Bessel (SFB) power spectrum of galaxy number counts Cℓ(k,k'), most survey optimisations and forecasts are based on the tomographic spherical harmonics power spectrum C(ij)_ℓ. The goal of this paper is to perform a new investigation of the information that can be extracted from these two analyses in the context of planned stage IV wide-field galaxy surveys. Methods: We compared tomographic and 3D SFB techniques by comparing the forecast cosmological parameter constraints obtained from a Fisher analysis. The comparison was made possible by careful and coherent treatment of non-linear scales in the two analyses, which makes this study the first to compare 3D SFB and tomographic constraints on an equal footing. Nuisance parameters related to a scale- and redshift-dependent galaxy bias were also included in the computation of the 3D SFB and tomographic power spectra for the first time. Results: Tomographic and 3D SFB methods can recover similar constraints in the absence of systematics. This requires choosing an optimal number of redshift bins for the tomographic analysis, which we computed to be N = 26 for zmed ≃ 0.4, N = 30 for zmed ≃ 1.0, and N = 42 for zmed ≃ 1.7. When marginalising over nuisance parameters related to the galaxy bias, the forecast 3D SFB constraints are less affected by this source of systematics than the tomographic constraints. In addition, the rate of increase of the figure of merit as a function of median redshift is higher for the 3D SFB method than for the 2D tomographic method. Conclusions: Constraints from the 3D SFB analysis are less sensitive to unavoidable systematics stemming from a redshift- and scale-dependent galaxy bias. Even for surveys that are optimised with tomography in mind, a 3D SFB analysis is more powerful. In addition, for survey optimisation, the figure of merit for the 3D SFB method increases more rapidly with redshift, especially at higher redshifts, suggesting that the 3D SFB method should be preferred for designing and analysing future wide-field spectroscopic surveys. CosmicPy, the Python package developed for this paper, is freely available at https://cosmicpy.github.io. Appendices are available in electronic form at http://www.aanda.org

  7. Magnetic resonance and computed tomographic features of 4 cases of canine congenital thoracic vertebral anomalies

    PubMed Central

    Berlanda, Michele; Zotti, Alessandro; Brandazza, Giada; Poser, Helen; Calò, Pietro; Bernardini, Marco

    2011-01-01

    Magnetic resonance and computed tomography features of 4 cases of canine congenital vertebral anomalies (CVAs) are discussed. Two of the cases represent unusual presentations for such anomalies that commonly affect screw-tail or toy breeds. Moreover, the combination of CVAs and a congenital peritoneo-pericardial diaphragmatic hernia has never before been imaged. PMID:22654139

  8. [Prostatic abscess. Contribution of the x-ray computed tomography. Apropos of a case].

    PubMed

    Husain, A; Touzard, D

    1988-01-01

    We reported a case of prostatic abscess due to staphylococeus aureus developed in a chronic alcoholic patient. The clinical symptoms and signs were largely masked by prior antibiotic therapy. Computed axial tomographic scanning of the pelvis made the diagnosis and demonstrated the resolution of the prostatic abscess following antibiotic therapy and spontaneous rupture to the urethra.

  9. Complex facial deformity reconstruction with a surgical guide incorporating a built-in occlusal stent as the positioning reference.

    PubMed

    Fang, Jing-Jing; Liu, Jia-Kuang; Wu, Tzu-Chieh; Lee, Jing-Wei; Kuo, Tai-Hong

    2013-05-01

    Computer-aided design has gained increasing popularity in clinical practice, and the advent of rapid prototyping technology has further enhanced the quality and predictability of surgical outcomes. It provides target guides for complex bony reconstruction during surgery. Therefore, surgeons can efficiently and precisely target fracture restorations. Based on three-dimensional models generated from a computed tomographic scan, precise preoperative planning simulation on a computer is possible. Combining the interdisciplinary knowledge of surgeons and engineers, this study proposes a novel surgical guidance method that incorporates a built-in occlusal wafer that serves as the positioning reference.Two patients with complex facial deformity suffering from severe facial asymmetry problems were recruited. In vitro facial reconstruction was first rehearsed on physical models, where a customized surgical guide incorporating a built-in occlusal stent as the positioning reference was designed to implement the surgery plan. This study is intended to present the authors' preliminary experience in a complex facial reconstruction procedure. It suggests that in regions with less information, where intraoperative computed tomographic scans or navigation systems are not available, our approach could be an effective, expedient, straightforward aid to enhance surgical outcome in a complex facial repair.

  10. New Severity Indices for Quantifying Single-suture Metopic Craniosynostosis

    PubMed Central

    Ruiz-Correa, Salvador; Starr, Jacqueline R.; Lin, H. Jill; Kapp-Simon, Kathleen A.; Sze, Raymond W.; Ellenbogen, Richard G.; Speltz, Matthew L.; Cunningham, Michael L.

    2012-01-01

    OBJECTIVE To describe novel severity indices with which to quantify severity of trigonocephaly malformation in children diagnosed with isolated metopic synostosis. METHODS Computed tomographic scans of the cranium were obtained from 38 infants diagnosed with isolated metopic synostosis and 53 age-matched control patients. Volumetric reformations of the cranium were used to trace two-dimensional planes defined by the cranium-base plane and well-defined brain landmarks. For each patient, novel trigonocephaly severity indices (TSI) were computed from outline cranium shapes on each of these planes. The metopic severity index based on measurements of interlandmark distances was also computed and a receiver operating characteristic analysis used to compare the accuracy of classification based on TSIs versus that based on the metopic severity index. RESULTS The proposed TSIs are a sensitive measure of trigonocephaly malformation that can provide a classification accuracy of 96% with a specificity of 95%, in contrast with 82% of the metopic severity index at the same specificity level. CONCLUSIONS We completed exploratory analysis of outline-based severity measurements computed from computed tomographic image planes of the cranium. These TSIs enable quantitative analysis of cranium features in isolated metopic synostosis that may not be accurately detected by analytic tools derived from a sparse set of traditional interlandmark and semilandmark distances. PMID:18797362

  11. Anisakiasis presenting to the ED: clinical manifestations, time course, hematologic tests, computed tomographic findings, and treatment.

    PubMed

    Takabayashi, Takeshi; Mochizuki, Toshiaki; Otani, Norio; Nishiyama, Kei; Ishimatsu, Shinichi

    2014-12-01

    The prevalence of anisakiasis is rare in the United States and Europe compared with that in Japan, with few reports of its presentation in the emergency department (ED). This study describes the clinical, hematologic, computed tomographic (CT) characteristics, and treatment in gastric and small intestinal anisakiasis patients in the ED. We retrospectively reviewed the data of 83 consecutive anisakiasis presentations in our ED between 2003 and 2012. Gastric anisakiasis was endoscopically diagnosed with the Anisakis polypide. Small intestinal anisakiasis was diagnosed based on both hematologic (Anisakis antibody) and CT findings. Of the 83 cases, 39 had gastric anisakiasis and 44 had small intestinal anisakiasis based on our diagnostic criteria. Although all patients had abdominal pain, the gastric anisakiasis group developed symptoms significantly earlier (peaking within 6 hours) than the small intestinal anisakiasis group (peaking within 48 hours), and fewer patients with gastric anisakiasis needed admission therapy (5% vs 57%, P<.01). All patients in the gastric and 40 (91%) in the small intestinal anisakiasis group had a history of raw seafood ingestion. Computed tomographic findings revealed edematous wall thickening in all patients, and ascites and phlegmon of the mesenteric fat were more frequently observed in the small intestinal anisakiasis group. In the ED, early and accurate diagnosis of anisakiasis is important to treat and explain to the patient, and diagnosis can be facilitated by a history of raw seafood ingestion, evaluation of the time-to-symptom development, and classic CT findings. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Field-portable lensfree tomographic microscope.

    PubMed

    Isikman, Serhan O; Bishara, Waheb; Sikora, Uzair; Yaglidere, Oguzhan; Yeah, John; Ozcan, Aydogan

    2011-07-07

    We present a field-portable lensfree tomographic microscope, which can achieve sectional imaging of a large volume (∼20 mm(3)) on a chip with an axial resolution of <7 μm. In this compact tomographic imaging platform (weighing only ∼110 grams), 24 light-emitting diodes (LEDs) that are each butt-coupled to a fibre-optic waveguide are controlled through a cost-effective micro-processor to sequentially illuminate the sample from different angles to record lensfree holograms of the sample that is placed on the top of a digital sensor array. In order to generate pixel super-resolved (SR) lensfree holograms and hence digitally improve the achievable lateral resolution, multiple sub-pixel shifted holograms are recorded at each illumination angle by electromagnetically actuating the fibre-optic waveguides using compact coils and magnets. These SR projection holograms obtained over an angular range of ±50° are rapidly reconstructed to yield projection images of the sample, which can then be back-projected to compute tomograms of the objects on the sensor-chip. The performance of this compact and light-weight lensfree tomographic microscope is validated by imaging micro-beads of different dimensions as well as a Hymenolepis nana egg, which is an infectious parasitic flatworm. Achieving a decent three-dimensional spatial resolution, this field-portable on-chip optical tomographic microscope might provide a useful toolset for telemedicine and high-throughput imaging applications in resource-poor settings. This journal is © The Royal Society of Chemistry 2011

  13. The role of simulated small-scale ocean variability in inverse computations for ocean acoustic tomography.

    PubMed

    Dushaw, Brian D; Sagen, Hanne

    2017-12-01

    Ocean acoustic tomography depends on a suitable reference ocean environment with which to set the basic parameters of the inverse problem. Some inverse problems may require a reference ocean that includes the small-scale variations from internal waves, small mesoscale, or spice. Tomographic inversions that employ data of stable shadow zone arrivals, such as those that have been observed in the North Pacific and Canary Basin, are an example. Estimating temperature from the unique acoustic data that have been obtained in Fram Strait is another example. The addition of small-scale variability to augment a smooth reference ocean is essential to understanding the acoustic forward problem in these cases. Rather than a hindrance, the stochastic influences of the small scale can be exploited to obtain accurate inverse estimates. Inverse solutions are readily obtained, and they give computed arrival patterns that matched the observations. The approach is not ad hoc, but universal, and it has allowed inverse estimates for ocean temperature variations in Fram Strait to be readily computed on several acoustic paths for which tomographic data were obtained.

  14. Steady shape analysis of tomographic pumping tests for characterization of aquifer heterogeneities

    USGS Publications Warehouse

    Bohling, Geoffrey C.; Zhan, Xiaoyong; Butler, James J.; Zheng, Li

    2002-01-01

    Hydraulic tomography, a procedure involving the performance of a suite of pumping tests in a tomographic format, provides information about variations in hydraulic conductivity at a level of detail not obtainable with traditional well tests. However, analysis of transient data from such a suite of pumping tests represents a substantial computational burden. Although steady state responses can be analyzed to reduce this computational burden significantly, the time required to reach steady state will often be too long for practical applications of the tomography concept. In addition, uncertainty regarding the mechanisms driving the system to steady state can propagate to adversely impact the resulting hydraulic conductivity estimates. These disadvantages of a steady state analysis can be overcome by exploiting the simplifications possible under the steady shape flow regime. At steady shape conditions, drawdown varies with time but the hydraulic gradient does not. Thus transient data can be analyzed with the computational efficiency of a steady state model. In this study, we demonstrate the value of the steady shape concept for inversion of hydraulic tomography data and investigate its robustness with respect to improperly specified boundary conditions.

  15. Role of high-resolution image integration to visualize left phrenic nerve and coronary arteries during epicardial ventricular tachycardia ablation.

    PubMed

    Yamashita, Seigo; Sacher, Frédéric; Mahida, Saagar; Berte, Benjamin; Lim, Han S; Komatsu, Yuki; Amraoui, Sana; Denis, Arnaud; Derval, Nicolas; Laurent, François; Montaudon, Michel; Hocini, Mélèze; Haïssaguerre, Michel; Jaïs, Pierre; Cochet, Hubert

    2015-04-01

    Epicardial ventricular tachycardia (VT) ablation is associated with risks of coronary artery (CA) and phrenic nerve (PN) injury. We investigated the role of multidetector computed tomography in visualizing CA and PN during VT ablation. Ninety-five consecutive patients (86 men; age, 57 ± 15) with VT underwent cardiac multidetector computed tomography. The PN detection rate and anatomic variability were analyzed. In 49 patients undergoing epicardial mapping, real-time multidetector computed tomographic integration was used to display CAs/PN locations in 3-dimensional mapping systems. Elimination of local abnormal ventricular activities (LAVAs) was used as ablation end point. The distribution of CAs/PN with respect to LAVA was analyzed and compared between VT etiologies. Multidetector computed tomography detected PN in 81 patients (85%). Epicardial LAVAs were observed in 44 of 49 patients (15 ischemic cardiomyopathy, 15 nonischemic cardiomyopathy, and 14 arrhythmogenic right ventricular cardiomyopathy) with a mean of 35 ± 37 LAVA points/patient. LAVAs were located within 1 cm from CAs and PN in 35 (80%) and 18 (37%) patients, respectively. The prevalence of LAVA adjacent to CAs was higher in nonischemic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy than in ischemic cardiomyopathy (100% versus 86% versus 53%; P < 0.01). The prevalence of LAVAs adjacent to PN was higher in nonischemic cardiomyopathy than in ischemic cardiomyopathy (93% versus 27%; P < 0.001). Epicardial ablation was performed in 37 patients (76%). Epicardial LAVAs could not be eliminated because of the proximity to CAs or PN in 8 patients (18%). The epicardial electrophysiological VT substrate is often close to CAs and PN in patients with nonischemic cardiomyopathy. High-resolution image integration is potentially useful to minimize risks of PN and CA injury during epicardial VT ablation. © 2015 American Heart Association, Inc.

  16. Impact of wall thickness and saccular geometry on the computational wall stress of descending thoracic aortic aneurysms.

    PubMed

    Shang, Eric K; Nathan, Derek P; Sprinkle, Shanna R; Fairman, Ronald M; Bavaria, Joseph E; Gorman, Robert C; Gorman, Joseph H; Jackson, Benjamin M

    2013-09-10

    Wall stress calculated using finite element analysis has been used to predict rupture risk of aortic aneurysms. Prior models often assume uniform aortic wall thickness and fusiform geometry. We examined the effects of including local wall thickness, intraluminal thrombus, calcifications, and saccular geometry on peak wall stress (PWS) in finite element analysis of descending thoracic aortic aneurysms. Computed tomographic angiography of descending thoracic aortic aneurysms (n=10 total, 5 fusiform and 5 saccular) underwent 3-dimensional reconstruction with custom algorithms. For each aneurysm, an initial model was constructed with uniform wall thickness. Experimental models explored the addition of variable wall thickness, calcifications, and intraluminal thrombus. Each model was loaded with 120 mm Hg pressure, and von Mises PWS was computed. The mean PWS of uniform wall thickness models was 410 ± 111 kPa. The imposition of variable wall thickness increased PWS (481 ± 126 kPa, P<0.001). Although the addition of calcifications was not statistically significant (506 ± 126 kPa, P=0.07), the addition of intraluminal thrombus to variable wall thickness (359 ± 86 kPa, P ≤ 0.001) reduced PWS. A final model incorporating all features also reduced PWS (368 ± 88 kPa, P<0.001). Saccular geometry did not increase diameter-normalized stress in the final model (77 ± 7 versus 67 ± 12 kPa/cm, P=0.22). Incorporation of local wall thickness can significantly increase PWS in finite element analysis models of thoracic aortic aneurysms. Incorporating variable wall thickness, intraluminal thrombus, and calcifications significantly impacts computed PWS of thoracic aneurysms; sophisticated models may, therefore, be more accurate in assessing rupture risk. Saccular aneurysms did not demonstrate a significantly higher normalized PWS than fusiform aneurysms.

  17. Imaging open-path Fourier transform infrared spectrometer for 3D cloud profiling

    NASA Astrophysics Data System (ADS)

    Rentz Dupuis, Julia; Mansur, David J.; Vaillancourt, Robert; Carlson, David; Evans, Thomas; Schundler, Elizabeth; Todd, Lori; Mottus, Kathleen

    2009-05-01

    OPTRA is developing an imaging open-path Fourier transform infrared (I-OP-FTIR) spectrometer for 3D profiling of chemical and biological agent simulant plumes released into test ranges and chambers. An array of I-OP-FTIR instruments positioned around the perimeter of the test site, in concert with advanced spectroscopic algorithms, enables real time tomographic reconstruction of the plume. The approach is intended as a referee measurement for test ranges and chambers. This Small Business Technology Transfer (STTR) effort combines the instrumentation and spectroscopic capabilities of OPTRA, Inc. with the computed tomographic expertise of the University of North Carolina, Chapel Hill.

  18. Role of spiral volumetric computed tomographic scanning in the assessment of patients with clinical suspicion of pulmonary embolism and an abnormal ventilation/perfusion lung scan.

    PubMed Central

    van Rossum, A. B.; Treurniet, F. E.; Kieft, G. J.; Smith, S. J.; Schepers-Bok, R.

    1996-01-01

    BACKGROUND: A study was carried out to evaluate the potential place of spiral volumetric computed tomography (SVCT) in the diagnostic strategy for pulmonary embolism. METHODS: In a prospective study 249 patients with clinical suspicion of pulmonary embolism were evaluated with various imaging techniques. In all patients a ventilation/perfusion (V/Q) scan was performed. Seventy seven patients with an abnormal V/Q scan underwent SVCT. Pulmonary angiography was then performed in all 42 patients with a non-diagnostic V/Q scan and in three patients with a high probability V/Q scan without emboli on the SVCT scan. Patients with an abnormal perfusion scan also underwent ultrasonography of the legs for the detection of deep vein thrombosis. RESULTS: One hundred and seventy two patients (69%) had a normal V/Q scan. Forty two patients (17%) had a non-diagnostic V/Q scan, and in five of these patients pulmonary emboli were found both by SVCT and pulmonary angiography. In one patient, although SVCT showed no emboli, the angiogram was positive for pulmonary embolism. In one of the 42 patients the SVCT scan showed an embolus which was not confirmed by pulmonary angiography. The other 35 patients showed no sign of emboli. Thirty five patients (14%) had a high probability V/Q scan, and in 32 patients emboli were seen on SVCT images. Two patients had both a negative SVCT scan and a negative pulmonary angiogram. In one who had an inconclusive SVCT scan pulmonary angiography was positive. The sensitivity for pulmonary embolism was 95% and the specificity 97%; the positive and negative predicted values of SVCT were 97% and 97%, respectively. CONCLUSIONS: SVCT is a relatively noninvasive test for pulmonary embolism which is both sensitive and specific and which may serve as an alternative to ventilation scintigraphy and possibly to pulmonary angiography in the diagnostic strategy for pulmonary embolism. Images PMID:8658363

  19. Computed Tomography Status

    DOE R&D Accomplishments Database

    Hansche, B. D.

    1983-01-01

    Computed tomography (CT) is a relatively new radiographic technique which has become widely used in the medical field, where it is better known as computerized axial tomographic (CAT) scanning. This technique is also being adopted by the industrial radiographic community, although the greater range of densities, variation in samples sizes, plus possible requirement for finer resolution make it difficult to duplicate the excellent results that the medical scanners have achieved.

  20. Including Short Period Constraints In the Construction of Full Waveform Tomographic Models

    NASA Astrophysics Data System (ADS)

    Roy, C.; Calo, M.; Bodin, T.; Romanowicz, B. A.

    2015-12-01

    Thanks to the introduction of the Spectral Element Method (SEM) in seismology, which allows accurate computation of the seismic wavefield in complex media, the resolution of regional and global tomographic models has improved in recent years. However, due to computational costs, only long period waveforms are considered, and only long wavelength structure can be constrained. Thus, the resulting 3D models are smooth, and only represent a small volumetric perturbation around a smooth reference model that does not include upper-mantle discontinuities (e.g. MLD, LAB). Extending the computations to shorter periods, necessary for the resolution of smaller scale features, is computationally challenging. In order to overcome these limitations and to account for layered structure in the upper mantle in our full waveform tomography, we include information provided by short period seismic observables (receiver functions and surface wave dispersion), sensitive to sharp boundaries and anisotropic structure respectively. In a first step, receiver functions and dispersion curves are used to generate a number of 1D radially anisotropic shear velocity profiles using a trans-dimensional Markov-chain Monte Carlo (MCMC) algorithm. These 1D profiles include both isotropic and anisotropic discontinuities in the upper mantle (above 300 km depth) beneath selected stationsand are then used to build a 3D starting model for the full waveform tomographic inversion. This model is built after 1) interpolation between the available 1D profiles, and 2) homogeneization of the layered 1D models to obtain an equivalent smooth 3D starting model in the period range of interest for waveform inversion. The waveforms used in the inversion are collected for paths contained in the region of study and filtered at periods longer than 40s. We use the spectral element code "RegSEM" (Cupillard et al., 2012) for forward computations and a quasi-Newton inversion approach in which kernels are computed using normal mode perturbation theory. We present here the first reults of such an approach after successive iterations of a full waveform tomography of the North American continent.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

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

    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, andmore » 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 stylized ORNL phantom. The armless KTMAN-1 can be applied to dosimetry for computed tomography or lateral x-ray examination, while the whole body KTMAN-2 can be used for radiation protection dosimetry.« less

  2. Bilateral mandibular pyogranulomatous lymphadenitis and pulmonary nodules in a dog with Bartonella henselae bacteremia

    PubMed Central

    Tucker, Melissa D.; Sellon, Rance K.; Tucker, Russell L.; Wills, Tamara B.; Simonsen, Andrea; Maggi, Ricardo G.; Breitschwerdt, Edward B.

    2014-01-01

    This report describes a 2-year-old collie dog with pulmonary nodules, visualized by computed tomographic (CT) scan, with evidence of Bartonella henselae bacteremia and pyogranulomatous lymphadenitis. Clinical signs resolved with antimicrobial therapy. PMID:25320386

  3. Procedures for Geometric Data Reduction in Solid Log Modelling

    Treesearch

    Luis G. Occeña; Wenzhen Chen; Daniel L. Schmoldt

    1995-01-01

    One of the difficulties in solid log modelling is working with huge data sets, such as those that come from computed axial tomographic imaging. Algorithmic procedures are described in this paper that have successfully reduced data without sacrificing modelling integrity.

  4. Computed tomographic angiography in stroke imaging: fundamental principles, pathologic findings, and common pitfalls.

    PubMed

    Gupta, Rajiv; Jones, Stephen E; Mooyaart, Eline A Q; Pomerantz, Stuart R

    2006-06-01

    The development of multidetector row computed tomography (MDCT) now permits visualization of the entire vascular tree that is relevant for the management of stroke within 15 seconds. Advances in MDCT have brought computed tomography angiography (CTA) to the frontline in evaluation of stroke. CTA is a rapid and noninvasive modality for evaluating the neurovasculature. This article describes the role of CTA in the management of stroke. Fundamentals of contrast delivery, common pathologic findings, artifacts, and pitfalls in CTA interpretation are discussed.

  5. Laparoscopic resection for diverticular disease.

    PubMed

    Bruce, C J; Coller, J A; Murray, J J; Schoetz, D J; Roberts, P L; Rusin, L C

    1996-10-01

    The role of laparoscopic surgery in treatment of patients with diverticulitis is unclear. A retrospective comparison of laparoscopic with conventional surgery for patients with chronic diverticulitis was performed to assess morbidity, recovery from surgery, and cost. Records of patients undergoing elective resection for uncomplicated diverticulitis from 1992 to 1994 at a single institution were reviewed. Laparoscopic resection involved complete intracorporeal dissection, bowel division, and anastomosis with extracorporeal placement of an anvil. Sigmoid and left colon resections were performed laparoscopically in 25 patients and by open technique in 17 patients by two independent operating teams. No significant differences existed in age, gender, weight, comorbidities, or operations performed. In the laparoscopic group, three operations were converted to open laparotomy (12 percent) because of unclear anatomy. Major complications occurred in two patients who underwent laparoscopic resection, both requiring laparotomy, and in one patient in the conventional surgery group who underwent computed tomographic-guided drainage of an abscess. Patients who underwent laparoscopic resection tolerated a regular diet sooner than patients who underwent conventional surgery (3.2 +/- 0.9 vs. 5.7 +/- 1.1 days; P < 0.001) and were discharged from the hospital earlier (4.2 +/- 1.1 vs. 6.8 +/- 1.1 days; P < 0.001). Overall costs were higher in the laparoscopic group than the open surgery group ($10,230 +/- 49.1 vs. $7,068 +/- 37.1; P < 0.001) because of a significantly longer total operating room time (397 +/- 9.1 vs. 115 +/- 5.1 min; P < 0.001). Follow-up studies with a mean of one year revealed two port site infections in the laparoscopic group and one wound infection in the open group. Of patients undergoing conventional resection, one patient experienced a postoperative bowel obstruction that was managed nonoperatively, and, in one patient, an incarcerated incisional hernia developed that required urgent laparotomy. Laparoscopic resection in patients with chronic diverticulitis is safe, with faster recovery and shorter hospital stay compared with conventional open surgery. Higher cost of operating room usage time makes the laparoscopic technique difficult to justify economically. Simplification of operating room use and better case selection may improve cost-effectiveness of the laparoscopic approach.

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

    PubMed

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

    2016-08-01

    We set out to determine the diagnostic value of computed tomographic (CT) scans in relation to the radiation dose, tumor incidence, and tumor mortality by radiation for hemodynamically stable pediatric patients with blunt abdominal injury. We focused on the changes in management because of new information obtained by CT. CT scans for suspected pediatric abdominal injury performed in our accident and emergency department were retrieved from the radiology registry and analyzed for: injury and hemodynamic parameters, changes in therapy, and radiological interventions. The dose length product (DLP) was used to calculate the effective dose (ED) and with the BEIR VII report we calculated the estimated induced lifetime tumor and mortality risk. Seventy-two patients underwent abdominal CT scanning for suspicion of abdominal injury and eight patients were excluded for hemodynamic instability, leaving 64 hemodynamically stable patients. Four patients died (6%). On the remaining 60 patients, only one laparotomy was performed for suspicion of duodenal perforation. Only in three out of the 64 hemodynamically stable cases (5%), a CT scan brought forward an indication for intervention or change in management. One patient was suspected of a duodenal perforation and underwent a laparotomy. A grade II hepatic laceration, but no duodenal, injury was found. Two patients underwent embolization of the splenic artery. One for an arterial blush caused by splenic laceration as was observed on the contrast enhanced-CT. Patient remained stable and during the angiogram the blush had disappeared. The second patient underwent (prophylactic) selective arterial embolization for having sustained a grade V splenic injury. The median radiation dosage was 11.43 mSv (range 1.19-23.76 mSv) in our patients. The use of the BEIR VII methodology results in an estimated increase in the lifetime tumor incidence of 0.17% (range, 0.05-0.67%) and an estimated increase in lifetime tumor incidence of 0.08% (0.02-0.28%). The results of our data suggest that the use of CT scans can largely be avoided in hemodynamically stable children with blunt abdominal injury. Georg Thieme Verlag KG Stuttgart · New York.

  7. Minimally Invasive Surgery in Pediatric Trauma: One Institution's 20-Year Experience

    PubMed Central

    Xu, Min Li; Lopez, Joseph

    2016-01-01

    Background: Minimally invasive surgery (MIS) for trauma in pediatric cases remains controversial. Recent studies have shown the validity of using minimally invasive techniques to decrease the rate of negative and nontherapeutic laparotomy and thoracotomy. The purpose of this study was to evaluate the diagnostic accuracy and therapeutic options of MIS in pediatric trauma at a level I pediatric trauma center. Methods: We reviewed cases of patients aged 15 years and younger who had undergone laparoscopy or thoracoscopy for trauma in our institution over the past 20 years. Each case was evaluated for mechanism of injury, computed tomographic (CT) scan findings, operative management, and patient outcomes. Results: There were 23 patients in the study (16 boys and 7 girls). Twenty-one had undergone diagnostic laparoscopy and 2 had had diagnostic thoracoscopy. In 16, there were positive findings in diagnostic laparoscopy. Laparoscopic therapeutic interventions were performed in 6 patients; the remaining 10 required conversion to laparotomy. Both patients who underwent diagnostic thoracoscopy had positive findings. One had a thoracoscopic repair, and the other underwent conversion to thoracotomy. There were 5 negative diagnostic laparoscopies. There was no mortality among the 23 patients. Conclusions: The use of laparoscopy and thoracoscopy in pediatric trauma helps to reduce unnecessary laparotomy and thoracotomy. Some injuries can be repaired by a minimally invasive approach. When conversion is necessary, the use of these techniques can guide the placement and size of surgical incisions. The goal is to shift the paradigm in favor of using MIS in the treatment of pediatric trauma as the first-choice modality in stable patients. PMID:26877626

  8. Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy.

    PubMed

    Kim, Sun Woo; Ahn, Ji Hoon; Yim, Sang Un; Cho, Yang Hyun; Shin, Bo Sung; Chung, Ho Seok; Hwang, Eu Chang; Yu, Ho Song; Oh, Kyung Jin; Kim, Sun-Ouck; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung

    2016-09-01

    This study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi. From January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis. A total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p<0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15-7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis. Large preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis.

  9. Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy

    PubMed Central

    Kim, Sun Woo; Ahn, Ji Hoon; Yim, Sang Un; Cho, Yang Hyun; Shin, Bo Sung; Chung, Ho Seok; Yu, Ho Song; Oh, Kyung Jin; Kim, Sun-Ouck; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung

    2016-01-01

    Purpose This study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi. Materials and Methods From January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis. Results A total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p<0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12–1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15–7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis. Conclusions Large preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis. PMID:27617316

  10. Use of gadoxetic acid for computed tomographic cholangiography in healthy dogs.

    PubMed

    Chau, Jennifer; Podadera, Juan M; Young, Alex C; Makara, Mariano A

    2017-07-01

    OBJECTIVE To evaluate the effect of gadoxetic acid (contrast) dose on biliary tract enhancement, determine the optimal time after contrast injection for CT image acquisition, and assess the feasibility of CT cholangiography in sedated dogs. ANIMALS 8 healthy dogs. PROCEDURES The study had 2 parts. In part 1, 4 dogs were anesthetized and underwent CT cholangiography twice. Gadoxetic acid was administered IV at a low dose (0.025 mmol/kg) for the first procedure and high dose (0.3 mmol/kg) for the second procedure. Serial CT scans were obtained at predetermined times after contrast injection. In part 2, 4 dogs were sedated and underwent CT angiography 85 minutes after IV administration of the high contrast dose. Contrast enhancement of the biliary tract on all scans was objectively assessed by measurement of CT attenuation and qualitatively assessed by use of a subjective 4-point scoring system by 3 independent reviewers. All measurements were compared over time and between contrast doses for the dogs of part 1. Subjective measurements were compared between the sedated dogs of part 2 and anesthetized dogs of part 1. RESULTS Enhancement of the biliary tract was positively associated with contrast dose and time after contrast injection. Optimal enhancement was achieved 65 minutes after contrast injection. Subjective visualization of most biliary structures did not differ significantly between sedated and anesthetized dogs. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated CT cholangiography with gadoxetic acid was feasible in sedated dogs. The high contrast dose provided better visualization of biliary structures than the low dose; CT scans should be obtained 65 minutes after contrast injection.

  11. A Novel Procedure for the Immediate Reconstruction of Severely Resorbed Alveolar Sockets for Advanced Periodontal Disease.

    PubMed

    Aimetti, Mario; Manavella, Valeria; Cricenti, Luca; Romano, Federica

    2017-01-01

    Background. Several clinical techniques and a variety of biomaterials have been introduced over the years in an effort to overcome bone remodeling and resorption after tooth extraction. However, the predictability of these procedures in sockets with severely resorbed buccal/lingual plate due to periodontal disease is still unknown. Case Description. A patient with advanced periodontitis underwent extraction of upper right lateral and central incisors. The central incisor exhibited complete buccal bone plate loss and a 9 mm vertical bone deficiency on its palatal side. The alveolar sockets were filled with collagen sponge and covered with a nonresorbable high-density PTFE membrane. Primary closure was not attained and any rigid scaffold material was not used. Histologic analysis provided evidence of new bone formation. At 12 months a cone-beam computed tomographic scan revealed enough bone volume to insert two conventional dental implants in conjunction with minor horizontal bone augmentation procedures. Clinical Implications. This case report would seem to support the potential of the proposed reconstructive approach in changing the morphology of severely resorbed alveolar sockets, minimizing the need for advanced bone regeneration procedures during implant placement.

  12. A Novel Procedure for the Immediate Reconstruction of Severely Resorbed Alveolar Sockets for Advanced Periodontal Disease

    PubMed Central

    2017-01-01

    Background. Several clinical techniques and a variety of biomaterials have been introduced over the years in an effort to overcome bone remodeling and resorption after tooth extraction. However, the predictability of these procedures in sockets with severely resorbed buccal/lingual plate due to periodontal disease is still unknown. Case Description. A patient with advanced periodontitis underwent extraction of upper right lateral and central incisors. The central incisor exhibited complete buccal bone plate loss and a 9 mm vertical bone deficiency on its palatal side. The alveolar sockets were filled with collagen sponge and covered with a nonresorbable high-density PTFE membrane. Primary closure was not attained and any rigid scaffold material was not used. Histologic analysis provided evidence of new bone formation. At 12 months a cone-beam computed tomographic scan revealed enough bone volume to insert two conventional dental implants in conjunction with minor horizontal bone augmentation procedures. Clinical Implications. This case report would seem to support the potential of the proposed reconstructive approach in changing the morphology of severely resorbed alveolar sockets, minimizing the need for advanced bone regeneration procedures during implant placement. PMID:28250998

  13. Recurrent pulmonary embolism due to echinococcosis secondary to hepatic surgery for hydatid cysts.

    PubMed

    Damiani, Mario Francesco; Carratù, Pierluigi; Tatò, Ilaria; Vizzino, Heleanna; Florio, Carlo; Resta, Onofrio

    2012-01-01

    We describe the case of a 53-year-old man with recurrent pulmonary embolism due to intra-arterial cysts from Echinococcus. Both the patient's medical history and the computed tomographic (CT) scan abnormalities led to the diagnosis. The CT scan, performed during hospitalization in our ward, showed cystic masses in the left main pulmonary artery and in the descending branch of the right pulmonary artery. Within cystic masses, thin septa were visible, giving a chambered appearance, which was suggestive of a group of daughter cysts. In the past, our patient underwent multiple operations for recurring echinococcal cysts of the liver. After the last intervention, 4 years earlier, his postoperative course was complicated by pulmonary embolism: a CT scan showed a filling defect in the descending branch of the right pulmonary artery, which was caused by the same cystic mass as 4 years later, although smaller. This mass, not properly treated, increased in diameter. Moreover, after 4 years, there has been a new episode of embolism, which involved the left main pulmonary artery. This is the first case in which there are repeated episodes of pulmonary embolism echinococcosis after hepatic surgery for removal of hydatid cysts.

  14. Laparoscopy to evaluate scrotal edema during peritoneal dialysis.

    PubMed

    Haggerty, Stephen P; Jorge, Juaquito M

    2013-01-01

    Acute scrotal edema is an infrequent complication in patients who undergo continuous ambulatory peritoneal dialysis (CAPD), occurring in 2% to 4% of patients. Inguinal hernia is usually the cause, but the diagnosis is sometimes confusing. Imaging modalities such as computed tomographic peritoneography are helpful but can be equivocal. We have used diagnostic laparoscopy in conjunction with open unilateral or bilateral hernia repair for diagnosis and treatment of peritoneal dialysis (PD) patients with acute scrotal edema. TECHNIQUE AND CASES: Three patients with acute scrotal edema while receiving CAPD over the span of 7 years had inconclusive results at clinical examination and on diagnostic imaging. All patients underwent diagnostic laparoscopy that revealed indirect inguinal hernia, which was concomitantly repaired using an open-mesh technique. Diagnostic laparoscopy revealed the etiology of the scrotal edema 100% of the time, with no complications, and allowed concomitant repair of the hernia. One patient had postoperative catheter outflow obstruction, which was deemed to be unrelated to the hernia repair. Diagnostic laparoscopy is helpful in confirming the source of acute scrotal edema in CAPD patients and can be performed in conjunction with an open-mesh repair with minimal added time or risk.

  15. Recurrent hemorrhage in hemangioblastoma involving the posterior fossa: Case report

    PubMed Central

    Marvin, Eric; Akhter, Asad S.; Coppens, Jeroen R.

    2017-01-01

    Background: Hemangioblastomas (HGBs) are the most common primary intra-axial posterior fossa tumor in adults. Although spontaneous hemorrhage of these tumors is exceedingly rare, despite their vascular nature, we describe a case of recurrent hemorrhage with associated tonsillar herniation, and demonstrate that a surgical approach can provide a suitable outcome. Case Description: A 54-year-old female with von Hippel-Lindau (VHL) syndrome presented with acute loss of consciousness and Glasgow Coma Scale (GCS) was 4. Computed tomographic (CT) images demonstrated large volume subarachnoid hemorrhage of the posterior fossa with intraventricular extension and intraparenchymal hemorrhage involving the right cerebellar tonsil. Magnetic resonance imaging (MRI) displayed three lesions in the posterior fossa, two near the hemorrhage site. Patient underwent suboccipital craniectomy with a decent recovery followed by radiosurgery as she refused resection. A second hemorrhage occurred ultimately prompting surgical resection of the three posterior fossa lesions, with a reasonable postoperative course. Conclusion: Hemorrhage of HGBs of the posterior fossa can present in conjunction of tonsillar herniation. Re-hemorrhage appears to be likely if prior acute hemorrhage has occurred. A stepwise approach of surgical decompression and resection may provide the best outcome. PMID:28713626

  16. Inferior vena cava tumor thrombus after partial nephrectomy for renal cell carcinoma.

    PubMed

    Akatsuka, Jun; Suzuki, Yasutomo; Hamasaki, Tsutomu; Shindo, Takao; Yanagi, Masato; Kimura, Go; Yamamoto, Yoichiro; Kondo, Yukihiro

    2014-03-29

    Partial nephrectomy is now the gold standard treatment for small renal tumors. Local recurrence is a major problem after partial nephrectomy, and local recurrence in the remnant kidney after partial nephrectomy is common. A 77-year-old man underwent right partial nephrectomy for a T1 right renal cell carcinoma. Microscopic examination revealed a clear cell renal carcinoma, grade 2, stage pT3a. Although the surgical margin was negative, the carcinoma invaded the perirenal fat, and vascular involvement was strongly positive. Thirty months after partial nephrectomy, an enhanced computed tomographic scan showed local recurrence of the renal cell carcinoma extending into the inferior vena cava without renal mass. Hence, we performed right radical nephrectomy and intracaval thrombectomy. Microscopic examination revealed a clear cell carcinoma grade 2, stage pT3a + b. The patient is still alive with no evidence of recurrence 10 months post-procedure. To our knowledge, local recurrence of renal cell carcinoma extending into the inferior vena cava after partial nephrectomy has not been reported in the literature. Our case report emphasizes the importance of strict surveillance of patients after partial nephrectomy, especially for those with renal cell carcinoma positive for microvessel involvement.

  17. Toxic Myocarditis Caused by Acetaminophen in a Multidrug Overdose.

    PubMed

    Gosselin, Maxime; Dazé, Yann; Mireault, Pascal; Crahes, Marie

    2017-12-01

    We report the case of an 18-year-old woman with personality disorders who was hospitalized a few hours after suicidal ingestion of acetaminophen, quetiapine, acetylsalicylic acid, and ethanol. Twelve hours after admission, severe liver damage was evident, but the patient was stable and awaiting hepatic transplantation. Electrolytes were successfully controlled. The condition of the liver stabilized. Cardiac biomarkers then deteriorated unexpectedly. Localized ST-segment elevations were noted on electrocardiogram, but angiography ruled out myocardial infarction. A computed tomographic scan ruled out cerebral edema. The patient died of irreversible cardiac arrest 40 hours after admission. Heart failure remained unexplained, and the body underwent forensic autopsy.At autopsy, histologic findings were indicative of acute toxic myocarditis and were concluded to be caused by acetaminophen intoxication. Acetaminophen overdose is common and typically leads to liver failure requiring supportive treatment and emergency liver transplantation. Toxic myocarditis is an extremely rare complication of acetaminophen overdose. It has only been reported 4 times in the literature despite the widespread use and misuse of acetaminophen. Toxic myocarditis remains a possibility in many cases of overdose but can be overlooked in a clinical picture dominated by hepatorenal failure and encephalopathy. Clinicians and forensic pathologists should be aware of this rare potential complication.

  18. Redistribution of pulmonary blood flow impacts thermodilution-based extravascular lung water measurements in a model of acute lung injury

    PubMed Central

    Easley, R. Blaine; Mulreany, Daniel G.; Lancaster, Christopher T.; Custer, Jason W.; Fernandez-Bustamante, Ana; Colantuoni, Elizabeth; Simon, Brett A.

    2009-01-01

    Background Studies using transthoracic thermodilution have demonstrated increased extravascular lung water (EVLW) measurements attributed to progression of edema and flooding during sepsis and acute lung injury. We hypothesize that redistribution of pulmonary blood flow can cause increased apparent EVLW secondary to increased perfusion of thermally silent tissue, not increased lung edema. Methods Anesthetized, mechanically ventilated canines were instrumented with PiCCO® (Pulsion Medical, Munich, Germany) catheters and underwent lung injury by repetitive saline lavage. Hemodynamic and respiratory physiologic data were recorded. After stabilized lung injury, endotoxin was administered to inactivate hypoxic pulmonary vasoconstriction. Computerized tomographic imaging was performed to quantify in vivo lung volume, total tissue (fluid) and air content, and regional distribution of blood flow. Results Lavage injury caused an increase in airway pressures and decreased arterial oxygen content with minimal hemodynamic effects. EVLW and shunt fraction increased after injury and then markedly following endotoxin administration. Computerized tomographic measurements quantified an endotoxin-induced increase in pulmonary blood flow to poorly aerated regions with no change in total lung tissue volume. Conclusions The abrupt increase in EVLW and shunt fraction after endotoxin administration is consistent with inactivation of hypoxic pulmonary vasoconstriction and increased perfusion to already flooded lung regions that were previously thermally silent. Computerized tomographic studies further demonstrate in vivo alterations in regional blood flow (but not lung water) and account for these alterations in shunt fraction and EVLW. PMID:19809280

  19. 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.

  20. 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.

  1. Micro-computed Tomographic Analysis of Apical Microcracks before and after Root Canal Preparation by Hand, Rotary, and Reciprocating Instruments at Different Working Lengths.

    PubMed

    de Oliveira, Bruna Paloma; Câmara, Andréa Cruz; Duarte, Daniel Amancio; Heck, Richard John; Antonino, Antonio Celso Dantas; Aguiar, Carlos Menezes

    2017-07-01

    This study aimed to compare apical microcrack formation after root canal shaping by hand, rotary, and reciprocating files at different working lengths using micro-computed tomographic analysis. Sixty mandibular incisors were randomly divided into 6 experimental groups (n = 10) according to the systems and working lengths used for the root canal preparation: ProTaper Universal for Hand Use (Dentsply Maillefer, Ballaigues, Switzerland), HyFlex CM (Coltene-Whaledent, Allstetten, Switzerland), and Reciproc (VDW, Munich, Germany) files working at the apical foramen (AF) and 1 mm short of the AF (AF - 1 mm). The teeth were imaged with micro-computed tomographic scanning at an isotropic resolution of 14 μm before and after root canal preparation, and the cross-sectional images generated were assessed to detect microcracks in the apical portion of the roots. Overall, 17 (28.3%) specimens presented microcracks before instrumentation. Apical microcracks were present in 1 (ProTaper Universal for Hand Use), 3 (Hyflex CM), and 2 (Reciproc) specimens when the instrumentation terminated at the AF. When instrumentation was terminated at AF - 1 mm, apical microcracks were detected in 3 (ProTaper Universal for Hand Use) and 4 (Hyflex CM and Reciproc) specimens. All these microcracks detected after root canal preparation were already present before instrumentation, and no new apical microcrack was visualized. For all groups, the number of slices presenting microcracks after root canal preparation was the same as before canal preparation. Root canal shaping with ProTaper Universal for Hand Use, HyFlex CM, and Reciproc systems, regardless of the working length, did not produce apical microcracks. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. 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.

  3. Effect of ProTaper Gold, Self-Adjusting File, and XP-endo Shaper Instruments on Dentinal Microcrack Formation: A Micro-computed Tomographic Study.

    PubMed

    Bayram, H Melike; Bayram, Emre; Ocak, Mert; Uygun, Ahmet Demirhan; Celik, Hakan Hamdi

    2017-07-01

    The aim of the present study was to evaluate the frequency of dentinal microcracks observed after root canal preparation with ProTaper Universal (PTU; Dentsply Tulsa Dental Specialties, Tulsa, OK), ProTaper Gold (PTG; Dentsply Tulsa Dental Specialties), Self-Adjusting File (SAF; ReDent Nova, Ra'anana, Israel), and XP-endo Shaper (XP; FKG Dentaire, La Chaux-de-Fonds, Switzerland) instruments using micro-computed tomographic (CT) analysis. Forty extracted human mandibular premolars having single-canal and straight root were randomly assigned to 4 experimental groups (n = 10) according to the different nickel-titanium systems used for root canal preparation: PTU, PTG, SAF, and XP. In the SAF and XP groups, the canals were first prepared with a K-file until #25 at the working length, and then the SAF or XP files were used. The specimens were scanned using high-resolution micro-computed tomographic imaging before and after root canal preparation. Afterward, preoperative and postoperative cross-sectional images of the teeth were screened to identify the presence of dentinal defects. For each group, the number of microcracks was determined as a percentage rate. The McNemar test was used to determine significant differences before and after instrumentation. The level of significance was set at P ≤ .05. The PTU system significantly increased the percentage rate of microcracks compared with preoperative specimens (P < .05). No new dentinal microcracks were observed in the PTG, SAF, or XP groups. Root canal preparations with the PTG, SAF, and XP systems did not induce the formation of new dentinal microcracks on straight root canals of mandibular premolars. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. The Collaborative Seismic Earth Model Project

    NASA Astrophysics Data System (ADS)

    Fichtner, A.; van Herwaarden, D. P.; Afanasiev, M.

    2017-12-01

    We present the first generation of the Collaborative Seismic Earth Model (CSEM). This effort is intended to address grand challenges in tomography that currently inhibit imaging the Earth's interior across the seismically accessible scales: [1] For decades to come, computational resources will remain insufficient for the exploitation of the full observable seismic bandwidth. [2] With the man power of individual research groups, only small fractions of available waveform data can be incorporated into seismic tomographies. [3] The limited incorporation of prior knowledge on 3D structure leads to slow progress and inefficient use of resources. The CSEM is a multi-scale model of global 3D Earth structure that evolves continuously through successive regional refinements. Taking the current state of the CSEM as initial model, these refinements are contributed by external collaborators, and used to advance the CSEM to the next state. This mode of operation allows the CSEM to [1] harness the distributed man and computing power of the community, [2] to make consistent use of prior knowledge, and [3] to combine different tomographic techniques, needed to cover the seismic data bandwidth. Furthermore, the CSEM has the potential to serve as a unified and accessible representation of tomographic Earth models. Generation 1 comprises around 15 regional tomographic refinements, computed with full-waveform inversion. These include continental-scale mantle models of North America, Australasia, Europe and the South Atlantic, as well as detailed regional models of the crust beneath the Iberian Peninsula and western Turkey. A global-scale full-waveform inversion ensures that regional refinements are consistent with whole-Earth structure. This first generation will serve as the basis for further automation and methodological improvements concerning validation and uncertainty quantification.

  5. Solving large tomographic linear systems: size reduction and error estimation

    NASA Astrophysics Data System (ADS)

    Voronin, Sergey; Mikesell, Dylan; Slezak, Inna; Nolet, Guust

    2014-10-01

    We present a new approach to reduce a sparse, linear system of equations associated with tomographic inverse problems. We begin by making a modification to the commonly used compressed sparse-row format, whereby our format is tailored to the sparse structure of finite-frequency (volume) sensitivity kernels in seismic tomography. Next, we cluster the sparse matrix rows to divide a large matrix into smaller subsets representing ray paths that are geographically close. Singular value decomposition of each subset allows us to project the data onto a subspace associated with the largest eigenvalues of the subset. After projection we reject those data that have a signal-to-noise ratio (SNR) below a chosen threshold. Clustering in this way assures that the sparse nature of the system is minimally affected by the projection. Moreover, our approach allows for a precise estimation of the noise affecting the data while also giving us the ability to identify outliers. We illustrate the method by reducing large matrices computed for global tomographic systems with cross-correlation body wave delays, as well as with surface wave phase velocity anomalies. For a massive matrix computed for 3.7 million Rayleigh wave phase velocity measurements, imposing a threshold of 1 for the SNR, we condensed the matrix size from 1103 to 63 Gbyte. For a global data set of multiple-frequency P wave delays from 60 well-distributed deep earthquakes we obtain a reduction to 5.9 per cent. This type of reduction allows one to avoid loss of information due to underparametrizing models. Alternatively, if data have to be rejected to fit the system into computer memory, it assures that the most important data are preserved.

  6. Whole-body biodistribution and brain PET imaging with [18F]AV-45, a novel amyloid imaging agent--a pilot study.

    PubMed

    Lin, Kun-Ju; Hsu, Wen-Chuin; Hsiao, Ing-Tsung; Wey, Shiaw-Pyng; Jin, Lee-Way; Skovronsky, Daniel; Wai, Yau-Yau; Chang, Hsiu-Ping; Lo, Chuan-Wei; Yao, Cheng Hsiang; Yen, Tzu-Chen; Kung, Mei-Ping

    2010-05-01

    The compound (E)-4-(2-(6-(2-(2-(2-(18)F-fluoroethoxy)ethoxy)ethoxy) pyridin-3-yl)vinyl)-N-methylbenzenamine ([(18)F]AV-45) is a novel radiopharmaceutical capable of selectively binding to beta-amyloid (A beta) plaques. This pilot study reports the safety, biodistribution, and radiation dosimetry of [(18)F]AV-45 in human subjects. In vitro autoradiography and fluorescent staining of postmortem brain tissue from patients with Alzheimer's disease (AD) and cognitively healthy subjects were performed to assess the specificity of the tracer. Biodistribution was assessed in three healthy elderly subjects (mean age: 60.0+/-5.2 years) who underwent 3-h whole-body positron emission tomography (PET)/computed tomographic (CT) scans after a bolus injection of 381.9+/-13.9 MBq of [(18)F]AV-45. Another six subjects (three AD patients and three healthy controls, mean age: 67.7+/-13.6 years) underwent brain PET studies. Source organs were delineated on PET/CT. All subjects underwent magnetic resonance imaging (MRI) for obtaining structural information. In vitro autoradiography revealed exquisitely high specific binding of [(18)F]AV-45 to postmortem AD brain sections, but not to the control sections. There were no serious adverse events throughout the study period. The peak uptake of the tracer in the brain was 5.12+/-0.41% of the injected dose. The highest absorbed organ dose was to the gallbladder wall (184.7+/-78.6 microGy/MBq, 4.8 h voiding interval). The effective dose equivalent and effective dose values for [(18)F]AV-45 were 33.8+/-3.4 microSv/MBq and 19.3+/-1.3 microSv/MBq, respectively. [(18)F]AV-45 binds specifically to A beta in vitro, and is a safe PET tracer for studying A beta distribution in human brain. The dosimetry is suitable for clinical and research application. (c) 2010 Elsevier Inc. All rights reserved.

  7. Linear Optimization and Image Reconstruction

    DTIC Science & Technology

    1994-06-01

    final example is again a novel one. We formulate the problem of computer assisted tomographic ( CAT ) image reconstruction as a linear optimization...possibility that a patient, Fred, suffers from a brain tumor. Further, the physician opts to make use of the CAT (Computer Aided Tomography) scan device...and examine the inside of Fred’s head without exploratory surgery. The CAT scan machine works by projecting a finite number of X-rays of known

  8. A Detailed Study of Sonar Tomographic Imaging

    DTIC Science & Technology

    2013-08-01

    BPA ) to form an object image. As the data is collected radially about the axis of rotation, one computation method computes an inverse Fourier...images are not quite as sharp. It is concluded UNCLASSIFIED iii DSTO–RR–0394 UNCLASSIFIED that polar BPA processing requires an appropriate choice of...attenuation factor to reduce the effect of the specular reflections, while for the 2DIFT BPA approach the degrading effect from these reflections is

  9. Cardiac metastases of Ewing sarcoma detected by 18F-FDG PET/CT.

    PubMed

    Coccia, Paola; Ruggiero, Antonio; Rufini, Vittoria; Maurizi, Palma; Attinà, Giorgio; Marano, Riccardo; Natale, Luigi; Leccisotti, Lucia; Calcagni, Maria L; Riccardi, Riccardo

    2012-04-01

    Positron emission tomography (PET) is widely used in the diagnostic evaluation and staging of different malignant tumors. The role of PET/computed tomographic scan in detecting distant metastases in the workup of Ewing sarcoma in children or young adults is less well defined. We report a case of a boy affected by a metastatic Ewing sarcoma with cardiac asymptomatic metastasis detected by F-FDG PET/computed tomography.

  10. Computed tomographic identification of calcified optic nerve drusen

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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.

  11. 3D multimodal cardiac data reconstruction using angiography and computerized tomographic angiography registration.

    PubMed

    Moosavi Tayebi, Rohollah; Wirza, Rahmita; Sulaiman, Puteri S B; Dimon, Mohd Zamrin; Khalid, Fatimah; Al-Surmi, Aqeel; Mazaheri, Samaneh

    2015-04-22

    Computerized tomographic angiography (3D data representing the coronary arteries) and X-ray angiography (2D X-ray image sequences providing information about coronary arteries and their stenosis) are standard and popular assessment tools utilized for medical diagnosis of coronary artery diseases. At present, the results of both modalities are individually analyzed by specialists and it is difficult for them to mentally connect the details of these two techniques. The aim of this work is to assist medical diagnosis by providing specialists with the relationship between computerized tomographic angiography and X-ray angiography. In this study, coronary arteries from two modalities are registered in order to create a 3D reconstruction of the stenosis position. The proposed method starts with coronary artery segmentation and labeling for both modalities. Then, stenosis and relevant labeled artery in X-ray angiography image are marked by a specialist. Proper control points for the marked artery in both modalities are automatically detected and normalized. Then, a geometrical transformation function is computed using these control points. Finally, this function is utilized to register the marked artery from the X-ray angiography image on the computerized tomographic angiography and get the 3D position of the stenosis lesion. The result is a 3D informative model consisting of stenosis and coronary arteries' information from the X-ray angiography and computerized tomographic angiography modalities. The results of the proposed method for coronary artery segmentation, labeling and 3D reconstruction are evaluated and validated on the dataset containing both modalities. The advantage of this method is to aid specialists to determine a visual relationship between the correspondent coronary arteries from two modalities and also set up a connection between stenosis points from an X-ray angiography along with their 3D positions on the coronary arteries from computerized tomographic angiography. Moreover, another benefit of this work is that the medical acquisition standards remain unchanged, which means that no calibration in the acquisition devices is required. It can be applied on most computerized tomographic angiography and angiography devices.

  12. High resolution x-ray CMT: Reconstruction methods

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brown, J.K.

    This paper qualitatively discusses the primary characteristics of methods for reconstructing tomographic images from a set of projections. These reconstruction methods can be categorized as either {open_quotes}analytic{close_quotes} or {open_quotes}iterative{close_quotes} techniques. Analytic algorithms are derived from the formal inversion of equations describing the imaging process, while iterative algorithms incorporate a model of the imaging process and provide a mechanism to iteratively improve image estimates. Analytic reconstruction algorithms are typically computationally more efficient than iterative methods; however, analytic algorithms are available for a relatively limited set of imaging geometries and situations. Thus, the framework of iterative reconstruction methods is better suited formore » high accuracy, tomographic reconstruction codes.« less

  13. Normal-pressure hydrocephalus and the saga of the treatable dementias

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Friedland, R.P.

    1989-11-10

    A case study of a 74-year-old woman is presented which illustrates the difficulty of understanding dementing illnesses. A diagnosis of normal-pressure hydrocephalus (NPH) was made because of the development of abnormal gait, with urinary incontinence and severe, diffuse, white matter lesions on the MRI scan. Computed tomographic, MRI scans and positron emission tomographic images of glucose use are presented. The treatable dementias are a large, multifaceted group of illnesses, of which NPH is one. The author proposes a new term for this disorder commonly known as NPH because the problem with the term normal-pressure hydrocephalus is that the cerebrospinal fluidmore » pressure is not always normal in the disease.« less

  14. X-ray tomographic image magnification process, system and apparatus therefor

    DOEpatents

    Kinney, J.H.; Bonse, U.K.; Johnson, Q.C.; Nichols, M.C.; Saroyan, R.A.; Massey, W.N.; Nusshardt, R.

    1993-09-14

    A computerized three-dimensional x-ray tomographic microscopy system is disclosed, comprising: (a) source means for providing a source of parallel x-ray beams, (b) staging means for staging and sequentially rotating a sample to be positioned in the path of the (c) x-ray image magnifier means positioned in the path of the beams downstream from the sample, (d) detecting means for detecting the beams after being passed through and magnified by the image magnifier means, and (e) computing means for analyzing values received from the detecting means, and converting the values into three-dimensional representations. Also disclosed is a process for magnifying an x-ray image, and apparatus therefor. 25 figures.

  15. X-ray tomographic image magnification process, system and apparatus therefor

    DOEpatents

    Kinney, John H.; Bonse, Ulrich K.; Johnson, Quintin C.; Nichols, Monte C.; Saroyan, Ralph A.; Massey, Warren N.; Nusshardt, Rudolph

    1993-01-01

    A computerized three-dimensional x-ray tomographic microscopy system is disclosed, comprising: a) source means for providing a source of parallel x-ray beams, b) staging means for staging and sequentially rotating a sample to be positioned in the path of the c) x-ray image magnifier means positioned in the path of the beams downstream from the sample, d) detecting means for detecting the beams after being passed through and magnified by the image magnifier means, and e) computing means for analyzing values received from the detecting means, and converting the values into three-dimensional representations. Also disclosed is a process for magnifying an x-ray image, and apparatus therefor.

  16. Childhood Psychosis and Computed Tomographic Brain Scan Findings.

    ERIC Educational Resources Information Center

    Gillberg, Christopher; Svendsen, Pal

    1983-01-01

    Computerized tomography (CT) of the brain was used to examine 27 infantile autistic children, 9 children with other kinds of childhood psychoses, 23 children with mental retardation, and 16 normal children. Gross abnormalities were seen in 26 percent of the autism cases. (Author/SEW)

  17. Fulminant cerebral infarction of anterior and posterior cerebral circulation after ascending type of facial necrotizing fasciitis.

    PubMed

    Lee, Jun Ho; Choi, Hui-Chul; Kim, Chulho; Sohn, Jong Hee; Kim, Heung Cheol

    2014-01-01

    Necrotizing fasciitis is a soft tissue infection that is characterized by extensive necrosis of the subcutaneous fat, neurovascular structures, and fascia. Cerebral infarction after facial necrotizing fasciitis has been rarely reported. A 61-year-old woman with diabetes was admitted with painful swelling of her right cheek. One day later, she was stuporous and quadriplegic. A computed tomographic scan of her face revealed right facial infection in the periorbital soft tissue, parotid, buccal muscle, and maxillary sinusitis. A computed tomographic scan of the brain revealed cerebral infarction in the right hemisphere, left frontal area, and both cerebellum. Four days later, she died from cerebral edema and septic shock. Involvement of the cerebral vasculature, such as the carotid or vertebral artery by necrotizing fasciitis, can cause cerebral infarction. Facial necrotizing fasciitis should be treated early with surgical treatment and the appropriate antibiotic therapy. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. Multislice coronary computed tomographic angiography in emergency department presentations of unsuspected acute myocardial infarction.

    PubMed

    Hecht, Harvey S; Bhatti, Tandeep

    2009-01-01

    Coronary computed tomographic angiography (CCTA) is not indicated in the setting of acute myocardial infarction in the emergency department (ED). Nonetheless, acute coronary syndromes may have atypical presentations, and CCTA may be inadvertently performed in this setting. This study was designed to determine the frequency and characteristics of CCTA imaging of unsuspected acute myocardial infarction in the ED. All CCTAs performed in the ED at Lenox Hill Hospital were reviewed for clinical indications and subsequent course; patients with documented acute myocardial infarction were identified. Of the 500 CCTAs performed on ED patients in the Lenox Hill laboratory, 5 patients (1%) were imaged during the initial phase of an unsuspected acute myocardial infarction; in all cases the CCTAs were key to the diagnosis. The imaging characteristics were (1) total or subtotal occlusion and (2) transmural hypodensity in the infarct area. Although acute myocardial infarction on CCTA in ED patients is an infrequent event, proper and prompt recognition is critical for appropriate patient care, particularly as applications to the ED increase.

  19. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices.

    PubMed

    Barngkgei, Imad; Halboub, Esam; Almashraqi, Abeer Abdulkareem; Khattab, Razan; Al Haffar, Iyad

    2016-09-01

    The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.

  20. 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.

  1. Launch of the I13-2 data beamline at the Diamond Light Source synchrotron

    NASA Astrophysics Data System (ADS)

    Bodey, A. J.; Rau, C.

    2017-06-01

    Users of the Diamond-Manchester Imaging Branchline I13-2 commonly spend many months analysing the large volumes of tomographic data generated in a single beamtime. This is due to the difficulties inherent in performing complicated, computationally-expensive analyses on large datasets with workstations of limited computing power. To improve productivity, a ‘data beamline’ was launched in January 2016. Users are scheduled for visits to the data beamline in the same way as for regular beamlines, with bookings made via the User Administration System and provision of financial support for travel and subsistence. Two high-performance graphics workstations were acquired, with sufficient RAM to enable simultaneous analysis of several tomographic volumes. Users are given high priority on Diamond’s central computing cluster for the duration of their visit, and if necessary, archived data are restored to a high-performance disk array. Within the first six months of operation, thirteen user visits were made, lasting an average of 4.5 days each. The I13-2 data beamline was the first to be launched at Diamond Light Source and, to the authors’ knowledge, the first to be formalised in this way at any synchrotron.

  2. 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

  3. Assessment of Normal Eyeball Protrusion Using Computed Tomographic Imaging and Three-Dimensional Reconstruction in Korean Adults.

    PubMed

    Shin, Kang-Jae; Gil, Young-Chun; Lee, Shin-Hyo; Kim, Jeong-Nam; Yoo, Ja-Young; Kim, Soon-Heum; Choi, Hyun-Gon; Shin, Hyun Jin; Koh, Ki-Seok; Song, Wu-Chul

    2017-01-01

    The aim of the present study was to assess normal eyeball protrusion from the orbital rim using two- and three-dimensional images and demonstrate the better suitability of CT images for assessment of exophthalmos. The facial computed tomographic (CT) images of Korean adults were acquired in sagittal and transverse views. The CT images were used in reconstructing three-dimensional volume of faces using computer software. The protrusion distances from orbital rims and the diameters of eyeballs were measured in the two views of the CT image and three-dimensional volume of the face. Relative exophthalmometry was calculated by the difference in protrusion distance between the right and left sides. The eyeball protrusion was 4.9 and 12.5 mm in sagittal and transverse views, respectively. The protrusion distances were 2.9 mm in the three-dimensional volume of face. There were no significant differences between right and left sides in the degree of protrusion, and the difference was within 2 mm in more than 90% of the subjects. The results of the present study will provide reliable criteria for precise diagnosis and postoperative monitoring using CT imaging of diseases such as thyroid-associated ophthalmopathy and orbital tumors.

  4. Temporal sparsity exploiting nonlocal regularization for 4D computed tomography reconstruction

    PubMed Central

    Kazantsev, Daniil; Guo, Enyu; Kaestner, Anders; Lionheart, William R. B.; Bent, Julian; Withers, Philip J.; Lee, Peter D.

    2016-01-01

    X-ray imaging applications in medical and material sciences are frequently limited by the number of tomographic projections collected. The inversion of the limited projection data is an ill-posed problem and needs regularization. Traditional spatial regularization is not well adapted to the dynamic nature of time-lapse tomography since it discards the redundancy of the temporal information. In this paper, we propose a novel iterative reconstruction algorithm with a nonlocal regularization term to account for time-evolving datasets. The aim of the proposed nonlocal penalty is to collect the maximum relevant information in the spatial and temporal domains. With the proposed sparsity seeking approach in the temporal space, the computational complexity of the classical nonlocal regularizer is substantially reduced (at least by one order of magnitude). The presented reconstruction method can be directly applied to various big data 4D (x, y, z+time) tomographic experiments in many fields. We apply the proposed technique to modelled data and to real dynamic X-ray microtomography (XMT) data of high resolution. Compared to the classical spatio-temporal nonlocal regularization approach, the proposed method delivers reconstructed images of improved resolution and higher contrast while remaining significantly less computationally demanding. PMID:27002902

  5. Roles of Transesophageal Echocardiography and Cardiac Computed Tomography for Evaluation of Left Atrial Thrombus and Associated Pathology: A Review and Critical Analysis.

    PubMed

    Pathan, Faraz; Hecht, Harvey; Narula, Jagat; Marwick, Thomas H

    2018-04-01

    Evaluation of the left atrium and left atrial appendage for the presence of thrombus prior to cardioversion and pulmonary vein isolation, and of the entire heart for embolic sources in the setting of cryptogenic stroke, has long been standard medical care. Guidelines have uniformly recommended transesophageal echocardiography (TEE) to accomplish these goals. In recent years, computed tomographic angiography has demonstrated diagnostic accuracy similar to that of TEE for the detection of thrombus. Analysis of the pertinent data and relative merits of the 2 technologies leads to the conclusions that: 1) both modalities have some unique, nonoverlapping capabilities that may dictate their use in specific situations; 2) computed tomographic angiography is a reasonable alternative to TEE when the primary aim is to exclude left atrial and left atrial appendage thrombus and in patients in whom the risks associated with TEE outweigh the benefits; and 3) both options should be discussed with the patient in the setting of shared decision making. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. Fluorine 18 fluorodeoxyglucose PET/CT volume-based indices in locally advanced non-small cell lung cancer: prediction of residual viable tumor after induction chemotherapy.

    PubMed

    Soussan, Michael; Cyrta, Joanna; Pouliquen, Christelle; Chouahnia, Kader; Orlhac, Fanny; Martinod, Emmanuel; Eder, Véronique; Morère, Jean-François; Buvat, Irène

    2014-09-01

    To study whether volume-based indices of fluorine 18 fluorodeoxyglucose positron emission tomographic (PET)/computed tomographic (CT) imaging is an accurate tool to predict the amount of residual viable tumor after induction chemotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). This study was approved by institutional review board with waivers of informed consent. Twenty-two patients with locally advanced NSCLC underwent surgery after induction chemotherapy. All had pre- and posttreatment FDG PET/CT scans. CT largest diameter, CT volume, maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (TV), and total lesion glycolysis of primary tumor were calculated. Changes in tumor measurements were determined by dividing follow-up by baseline measurement (ratio index). Amounts of residual viable tumor, necrosis, fibrous tissue, inflammatory infiltrate, and Ki-67 proliferative index were estimated on resected tumor. Correlations between imaging indices and histologic parameters were estimated by using Spearman correlation coefficients or Mann-Whitney tests. No baseline or posttreatment indices correlated with percentage of residual viable tumor. TV ratio was the only index that correlated with percentage of residual viable tumor (r = 0.61 [95% confidence interval: 0.24, 0.81]; P = .003). Conversely, SUVmax and SUVmean ratios were only indices correlated with Ki-67 (r = 0.62 [95% confidence interval: 0.24, 0.82]; P = .003; and r = 0.60 [95% confidence interval: 0.21, 0.81]; P = .004, respectively). Total lesion glycolysis ratio was moderately correlated with residual viable tumor (r = 0.53 [95% confidence interval: 0.13, 0.78]; P = .01) and with Ki-67 (r = 0.57 [95% confidence interval: 0.18, 0.80]; P = .006). No ratios were correlated with presence of inflammatory infiltrate or foamy macrophages. TV and total lesion glycolysis ratios were the only indices correlated with residual viable tumor after induction chemotherapy in locally advanced NSCLC.

  8. Diagnosis and surgical approach of popliteal artery entrapment syndrome: a retrospective study.

    PubMed

    Gourgiotis, Stavros; Aggelakas, John; Salemis, Nikolaos; Elias, Charalabos; Georgiou, Charalabos

    2008-01-01

    Popliteal artery entrapment syndrome (PAES) is a rare but potentially limb threatening peripheral vascular disease occurring predominantly in young adults. This study is a retrospective review of 49 limbs in 38 patients with PAES treated surgically over an 8-year period. From 1995 to 2002, 38 patients with a mean age of 21 years (range, 18-29 years) underwent surgery for PAES at a single institution. The patients' demographic data and clinical features are recorded. The preoperative diagnosis of PAES was made based on various combinations of investigations including positional stress test, duplex ultrasonography, computed tomography, computed tomographic angiography, and angiography. Nine, 33, and 7 patients had Delaney's type I, II, and III PAES respectively. The surgical procedures consisted of simple release of the popliteal artery in 33 limbs (67.3%), autogenous saphenous vein (ASV) patch angioplasty with or without thromboendarterectomy (TEA) in 5 limbs (10.2%) and ASV graft interposition or bypass in 11 limbs (22.5%). At a median follow up of 34 months (range, 8-42 months), there were no postoperative complications and all the patients were cured of their symptoms. PAES is an unusual but important cause of peripheral vascular insufficiency especially in young patients. Early diagnosis through a combined approach is necessary for exact diagnosis. Popliteal artery release alone or with vein bypass is the treatment of choice when intervention is indicated for good operative outcome and to prevent limb loss.

  9. Adult sail sign: radiographic and computed tomographic features.

    PubMed

    Lee, Yu-Jin; Han, Daehee; Koh, Young Hwan; Zo, Joo Hee; Kim, Sang-Hyun; Kim, Deog Kyeom; Lee, Jeong Sang; Moon, Hyeon Jong; Kim, Jong Seung; Chun, Eun Ju; Youn, Byung Jae; Lee, Chang Hyun; Kim, Sam Soo

    2008-02-01

    The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. To investigate the sail sign appearing in adult chest radiography. Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging.

  10. Comparison of serologic evaluation via agar gel immunodiffusion and fungal culture of tissue for diagnosis of nasal aspergillosis in dogs.

    PubMed

    Pomrantz, Jill S; Johnson, Lynelle R; Nelson, Richard W; Wisner, Erik R

    2007-05-01

    To compare the sensitivity and specificity of serologic evaluation and fungal culture of tissue for diagnosis of nasal aspergillosis in dogs. Prospective study. 58 dogs with nasal discharge and 26 healthy dogs. Dogs with nasal discharge were anesthetized and underwent computed tomography and rhinoscopy; nasal tissues were collected for histologic examination and fungal culture. Sera were assessed for antibodies against Aspergillus spp (healthy dog sera were used as negative control specimens). Nasal aspergillosis was diagnosed in dogs that had at least 2 of the following findings: computed tomographic characteristics consistent with aspergillosis, fungal plaques detected during rhinoscopy, and histologically detectable fungal hyphae in nasal tissue. Histologic characteristics of malignancy were diagnostic for neoplasia. Without evidence of neoplasia or fungal disease, nonfungal rhinitis was diagnosed. Among the 58 dogs, 21 had nasal aspergillosis, 25 had nonfungal rhinitis, and 12 had nasal neoplasia. Fourteen aspergillosis-affected dogs and 1 dog with nonfungal rhinitis had serum antibodies against Aspergillus spp. Fungal culture results were positive for Aspergillus spp only for 17 dogs with aspergillosis. With regard to aspergillosis diagnosis, sensitivity, specificity, and positive and negative predictive values were 67%, 98%, 93%, and 84%, respectively, for serum anti-Aspergillus antibody determination and 81%, 100%, 100%, and 90%, respectively, for fungal culture. Results suggest that seropositivity for Aspergillus spp and identification of Aspergillus spp in cultures of nasal tissue are highly suggestive of nasal aspergillosis in dogs; however, negative test results do not rule out nasal aspergillosis.

  11. Clinical and Procedural Predictors of Outcomes From the Endovascular Treatment of Posterior Circulation Strokes.

    PubMed

    Mokin, Maxim; Sonig, Ashish; Sivakanthan, Sananthan; Ren, Zeguang; Elijovich, Lucas; Arthur, Adam; Goyal, Nitin; Kan, Peter; Duckworth, Edward; Veznedaroglu, Erol; Binning, Mandy J; Liebman, Kenneth M; Rao, Vikas; Turner, Raymond D; Turk, Aquilla S; Baxter, Blaise W; Dabus, Guilherme; Linfante, Italo; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H

    2016-03-01

    Patients with posterior circulation strokes have been excluded from recent randomized endovascular stroke trials. We reviewed the recent multicenter experience with endovascular treatment of posterior circulation strokes to identify the clinical, radiographic, and procedural predictors of successful recanalization and good neurological outcomes. We performed a multicenter retrospective analysis of consecutive patients with posterior circulation strokes, who underwent thrombectomy with stent retrievers or primary aspiration thrombectomy (including A Direct Aspiration First Pass Technique [ADAPT] approach). We correlated clinical and radiographic outcomes with demographic, clinical, and technical characteristics. A total of 100 patients were included in the final analysis (mean age, 63.5±14.2 years; mean admission National Institutes of Health Stroke Scale score, 19.2±8.2). Favorable clinical outcome at 3 months (modified Rankin Scale score ≤2) was achieved in 35% of patients. Successful recanalization and shorter time from stroke onset to the start of the procedure were significant predictors of favorable clinical outcome at 90 days. Stent retriever and aspiration thrombectomy as primary treatment approaches showed comparable procedural and clinical outcomes. None of the baseline advanced imaging modalities (magnetic resonance imaging, computed tomographic perfusion, or computed tomography angiography assessment of collaterals) showed superiority in selecting patients for thrombectomy. Time to the start of the procedure is an important predictor of clinical success after thrombectomy in patients with posterior circulation strokes. Both stent retriever and aspiration thrombectomy as primary treatment approaches are effective in achieving successful recanalization. © 2016 American Heart Association, Inc.

  12. Computed tomography, radiology and echocardiography in cats naturally infected with Aelurostrongylus abstrusus.

    PubMed

    Lacava, Giuseppe; Zini, Eric; Marchesotti, Federica; Domenech, Oriol; Romano, Francesca; Manzocchi, Simone; Venco, Luigi; Auriemma, Edoardo

    2017-04-01

    Objectives The aims of the study were to describe the radiographic and computed tomographic features in cats naturally infected with Aelurostrongylus abstrusus, and to identify signs of pulmonary hypertension with echocardiography. Methods Fourteen cats positive on Baermann test for A abstrusus were included in the study. All cats underwent thoracic radiography, CT and echocardiography. Results The most common clinical signs were coughing (10/14) and dyspnoea (5/14). Radiographic findings included a generalised unstructured interstitial pulmonary pattern (8/14), mixed bronchointerstitioalveolar pattern (3/14) and bronchointerstitial pattern with bronchial wall thickening (3/14). Sternal lymphadenopathy was detected on thoracic radiographs in six cats. On CT, features were mixed bronchointerstitioalveolar pattern with ground-glass appearance in six cats, interstitioalveolar with multiple pulmonary nodules in five, interstitial ground-glass infiltrates in three, regional lymph node enlargement in 11 (10 sternal, three cranial mediastinal and three tracheobronchial lymph nodes) and subpleural thickening in four. None of the thoracic radiographs revealed subpleural thickening. In all cases, pulmonary vessels were normal in terms of size, shape and attenuation on both radiography and CT. Pulmonary hypertension and cardiac abnormalities were not observed in any cat during echocardiography. Conclusions and relevance CT provided a more thorough characterisation of pulmonary and mediastinal lesions compared with thoracic radiographs in cats naturally infected with A abstrusus. Although feline aelurostrongylosis has been previously associated with histopathological lesions in lung arteries, in this cohort clinical evidence of pulmonary hypertension was not documented.

  13. Limited-angle tomography for analyzer-based phase-contrast X-ray imaging

    PubMed Central

    Majidi, Keivan; Wernick, Miles N; Li, Jun; Muehleman, Carol; Brankov, Jovan G

    2014-01-01

    Multiple-Image Radiography (MIR) is an analyzer-based phase-contrast X-ray imaging method (ABI), which is emerging as a potential alternative to conventional radiography. MIR simultaneously generates three planar parametric images containing information about scattering, refraction and attenuation properties of the object. The MIR planar images are linear tomographic projections of the corresponding object properties, which allows reconstruction of volumetric images using computed tomography (CT) methods. However, when acquiring a full range of linear projections around the tissue of interest is not feasible or the scanning time is limited, limited-angle tomography techniques can be used to reconstruct these volumetric images near the central plane, which is the plane that contains the pivot point of the tomographic movement. In this work, we use computer simulations to explore the applicability of limited-angle tomography to MIR. We also investigate the accuracy of reconstructions as a function of number of tomographic angles for a fixed total radiation exposure. We use this function to find an optimal range of angles over which data should be acquired for limited-angle tomography MIR (LAT-MIR). Next, we apply the LAT-MIR technique to experimentally acquired MIR projections obtained in a cadaveric human thumb study. We compare the reconstructed slices near the central plane to the same slices reconstructed by CT-MIR using the full angular view around the object. Finally, we perform a task-based evaluation of LAT-MIR performance for different numbers of angular views, and use template matching to detect cartilage in the refraction image near the central plane. We use the signal-to-noise ratio of this test as the detectability metric to investigate an optimum range of tomographic angles for detecting soft tissues in LAT-MIR. Both results show that there is an optimum range of angular view for data acquisition where LAT-MIR yields the best performance, comparable to CT-MIR only if one considers volumetric images near the central plane and not the whole volume. PMID:24898008

  14. Limited-angle tomography for analyzer-based phase-contrast x-ray imaging

    NASA Astrophysics Data System (ADS)

    Majidi, Keivan; Wernick, Miles N.; Li, Jun; Muehleman, Carol; Brankov, Jovan G.

    2014-07-01

    Multiple-image radiography (MIR) is an analyzer-based phase-contrast x-ray imaging method, which is emerging as a potential alternative to conventional radiography. MIR simultaneously generates three planar parametric images containing information about scattering, refraction and attenuation properties of the object. The MIR planar images are linear tomographic projections of the corresponding object properties, which allows reconstruction of volumetric images using computed tomography (CT) methods. However, when acquiring a full range of linear projections around the tissue of interest is not feasible or the scanning time is limited, limited-angle tomography techniques can be used to reconstruct these volumetric images near the central plane, which is the plane that contains the pivot point of the tomographic movement. In this work, we use computer simulations to explore the applicability of limited-angle tomography to MIR. We also investigate the accuracy of reconstructions as a function of number of tomographic angles for a fixed total radiation exposure. We use this function to find an optimal range of angles over which data should be acquired for limited-angle tomography MIR (LAT-MIR). Next, we apply the LAT-MIR technique to experimentally acquired MIR projections obtained in a cadaveric human thumb study. We compare the reconstructed slices near the central plane to the same slices reconstructed by CT-MIR using the full angular view around the object. Finally, we perform a task-based evaluation of LAT-MIR performance for different numbers of angular views, and use template matching to detect cartilage in the refraction image near the central plane. We use the signal-to-noise ratio of this test as the detectability metric to investigate an optimum range of tomographic angles for detecting soft tissues in LAT-MIR. Both results show that there is an optimum range of angular view for data acquisition where LAT-MIR yields the best performance, comparable to CT-MIR only if one considers volumetric images near the central plane and not the whole volume.

  15. Monte Carlo simulations of adult and pediatric computed tomography exams: Validation studies of organ doses with physical phantoms

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Long, Daniel J.; Lee, Choonsik; Tien, Christopher

    2013-01-15

    Purpose: To validate the accuracy of a Monte Carlo source model of the Siemens SOMATOM Sensation 16 CT scanner using organ doses measured in physical anthropomorphic phantoms. Methods: The x-ray output of the Siemens SOMATOM Sensation 16 multidetector CT scanner was simulated within the Monte Carlo radiation transport code, MCNPX version 2.6. The resulting source model was able to perform various simulated axial and helical computed tomographic (CT) scans of varying scan parameters, including beam energy, filtration, pitch, and beam collimation. Two custom-built anthropomorphic phantoms were used to take dose measurements on the CT scanner: an adult male and amore » 9-month-old. The adult male is a physical replica of University of Florida reference adult male hybrid computational phantom, while the 9-month-old is a replica of University of Florida Series B 9-month-old voxel computational phantom. Each phantom underwent a series of axial and helical CT scans, during which organ doses were measured using fiber-optic coupled plastic scintillator dosimeters developed at University of Florida. The physical setup was reproduced and simulated in MCNPX using the CT source model and the computational phantoms upon which the anthropomorphic phantoms were constructed. Average organ doses were then calculated based upon these MCNPX results. Results: For all CT scans, good agreement was seen between measured and simulated organ doses. For the adult male, the percent differences were within 16% for axial scans, and within 18% for helical scans. For the 9-month-old, the percent differences were all within 15% for both the axial and helical scans. These results are comparable to previously published validation studies using GE scanners and commercially available anthropomorphic phantoms. Conclusions: Overall results of this study show that the Monte Carlo source model can be used to accurately and reliably calculate organ doses for patients undergoing a variety of axial or helical CT examinations on the Siemens SOMATOM Sensation 16 scanner.« less

  16. East Pacific Rise axial structure from a joint tomographic inversion of traveltimes picked on downward continued and standard shot gathers collected by 3D MCS surveying

    NASA Astrophysics Data System (ADS)

    Newman, Kori; Nedimović, Mladen; Delescluse, Matthias; Menke, William; Canales, J. Pablo; Carbotte, Suzanne; Carton, Helene; Mutter, John

    2010-05-01

    We present traveltime tomographic models along closely spaced (~250 m), strike-parallel profiles that flank the axis of the East Pacific Rise at 9°41' - 9°57' N. The data were collected during a 3D (multi-streamer) multichannel seismic (MCS) survey of the ridge. Four 6-km long hydrophone streamers were towed by the ship along three along-axis sail lines, yielding twelve possible profiles over which to compute tomographic models. Based on the relative location between source-receiver midpoints and targeted subsurface structures, we have chosen to compute models for four of those lines. MCS data provide for a high density of seismic ray paths with which to constrain the model. Potentially, travel times for ~250,000 source-receiver pairs can be picked over the 30 km length of each model. However, such data density does not enhance the model resolution, so, for computational efficiency, the data are decimated so that ~15,000 picks per profile are used. Downward continuation of the shot gathers simulates an experimental geometry in which the sources and receivers are positioned just above the sea floor. This allows the shallowest sampling refracted arrivals to be picked and incorporated into the inversion whereas they would otherwise not be usable with traditional first-arrival travel-time tomographic techniques. Some of the far-offset deep-penetrating 2B refractions cannot be picked on the downward continued gathers due to signal processing artifacts. For this reason, we run a joint inversion by also including 2B traveltime picks from standard shot gathers. Uppermost velocity structure (seismic layer 2A thickness and velocity) is primarily constrained from 1D inversion of the nearest offset (<500 m) source-receiver travel-time picks for each downward continued shot gather. Deeper velocities are then computed in a joint 2D inversion that uses all picks from standard and downward continued shot gathers and incorporates the 1D results into the starting model. The resulting velocity models extend ~1 km into the crust. Preliminary results show thicker layer 2A and faster layer 2A velocities at fourth order ridge segment boundaries. Additionally, layer 2A thickens north of 9° 52' N, which is consistent with earlier investigations of this ridge segment. Slower layer 2B velocities are resolved in the vicinity of documented hydrothermal vent fields. We anticipate that additional analyses of the results will yield further insight into fine scale variations in near-axis mid-ocean ridge structure.

  17. Computed tomography in cases of coccidioidal meningitis, with clinical correlation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shetter, A.G.; Fischer, D.W.; Flom, R.A.

    1985-06-01

    Cranial computed tomographic (CT) scans of 22 patients with coccidioidal meningitis were reviewed and their clinical course was analyzed. Abnormalities of the ventricular system or the basilar cisterns or both were present in 16 instances. Although it is not a definitive diagnostic tool, the CT scan is helpful in suggesting a diagnosis of coccidioidal meningitis and in predicting the prognosis of patients affected by the disease. 19 references, 4 figures, 2 tables.

  18. Microfocus computed tomography in medicine

    NASA Astrophysics Data System (ADS)

    Obodovskiy, A. V.

    2018-02-01

    Recent advances in the field of high-frequency power schemes for X-ray devices allow the creation of high-resolution instruments. At the department of electronic devices and Equipment of the St. Petersburg State Electrotechnical University, a model of a microfocus computer tomograph was developed. Used equipment allows to receive projection data with an increase up to 100 times. A distinctive feature of the device is the possibility of implementing various schemes for obtaining projection data.

  19. Site and Severity of the Increased Humeral Retroversion in Symptomatic Baseball Players: A 3-dimensional Computed Tomographic Analysis.

    PubMed

    Itami, Yasuo; Mihata, Teruhisa; Shibano, Koji; Sugamoto, Kazuomi; Neo, Masashi

    2016-07-01

    Humeral retroversion in baseball players is greater in the dominant shoulder than in the nondominant shoulder. However, the site and severity of the humeral rotational deformity remain unclear. To evaluate the site of side-to-side differences in humeral retroversion in baseball players and the severity of these changes through 3-dimensional computed tomographic (3D CT) bone models. Cross-sectional study; Level of evidence, 3. From 2008 to 2014, we studied 25 baseball players (12 pitchers, 13 fielders) who underwent surgery for throwing-related injuries (shoulder injury, 15 players; elbow injury, 10 players). The mean age (±SD) at the time of surgery was 20.0 ± 5.9 years. A reconstructed 3D CT model of the entire humerus was divided into 15 segments of equal height (overall mean, 21.4 ± 1.0 mm). The side-to-side difference in humeral retroversion in each segment was calculated by superimposing the model of the dominant side over the mirror-image model of the nondominant side. The overall mean increase in humeral retroversion was 13.0° ± 6.2° on the dominant side. Significant side-to-side differences in retroversion were present throughout the humerus. The largest side-to-side difference in humeral retroversion was seen at the insertions of the internal rotator muscles (2.5° ± 4.3°) and around the proximal physis (2.5° ± 1.4°). At the insertions of shoulder capsule and rotator cuff tendons, the superior half of the humeral head was more retroverted than the inferior half (P < .0001). The side-to-side difference in humeral retroversion was significantly greater in the pitchers (16.2° ± 5.1°) than in the fielders (10.0° ± 5.7°) (P = .009), particularly at the proximal physis. Baseball players exhibited significant side-to-side differences in humeral retroversion at multiple sites throughout the humerus, including the proximal humerus near the epiphyseal plate and at the insertions of the internal rotator muscles, the middle of the humeral shaft, and the distal third of the humerus. Therefore, the increased humeral retroversion at multiple sites throughout the humerus needs to be considered when we perform physical examinations, provide treatment, or undertake biomechanical studies for any throwing-related injuries. © 2016 The Author(s).

  20. Computed Tomographic Findings and Mortality in Patients With Pneumomediastinum From Blunt Trauma.

    PubMed

    Lee, Wayne S; Chong, Vincent E; Victorino, Gregory P

    2015-08-01

    The care of most patients with pneumomediastinum (PNM) due to trauma can be managed conservatively; however, owing to aerodigestive tract injury and other associated injuries, there is a subset of patients with PNM who are at higher risk of mortality but can be difficult to identify. To characterize computed tomographic (CT) findings associated with mortality in patients with PNM due to blunt trauma. A retrospective review of medical records from January 1, 2002, to December 31, 2011, was conducted at a university-based urban trauma center. The patients evaluated were those injured by blunt trauma and found to have PNM on initial chest CT scanning. Data analysis was performed July 2, 2013, to June 18, 2014. In-hospital mortality. During the study period, 3327 patients with blunt trauma underwent chest CT. Of these, 72 patients (2.2%) had PNM. Patients with PNM had higher Injury Severity Scores (P < .001) and chest Abbreviated Injury Scale scores (P < .001) compared with those without PNM. Pneumomediastinum was associated with higher mortality (9 [12.5%] vs 118 [3.6%] patients; P < .001) and longer mean (SD) hospital stays (11.3 [14.6] vs 5.1 [8.8] days; P < .001), intensive care unit stays (5.4 [10.2] vs 1.8 [5.7] days; P < .001), and ventilator days (1.7 [4.2] vs 0.6 [4.0] days; P < .03). We evaluated several chest CT findings that may have predictive value. Pneumomediastinum size was not associated with in-hospital mortality (P = .22). However, location of air in the posterior mediastinum was associated with increased mortality of 25% (7 of 28 patients; P = .007). Air in all mediastinal compartments was also associated with increased mortality of 40.0% (4 of 10 patients; P = .01). Presence of hemothorax along with PNM was associated with mortality of 22.2% (8 of 36 patients; P = .01). Pneumomediastinum is uncommon in patients with injury from blunt trauma; however, CT findings of posterior PNM, air in all mediastinal compartments, and concurrent hemothorax are associated with increased mortality. These CT findings could be used as a triage tool to alert the trauma surgeon to a potentially lethal injury.

  1. Relationship between lung function and quantitative computed tomographic parameters of airway remodeling, air trapping, and emphysema in patients with asthma and chronic obstructive pulmonary disease: A single-center study.

    PubMed

    Hartley, Ruth A; Barker, Bethan L; Newby, Chris; Pakkal, Mini; Baldi, Simonetta; Kajekar, Radhika; Kay, Richard; Laurencin, Marie; Marshall, Richard P; Sousa, Ana R; Parmar, Harsukh; Siddiqui, Salman; Gupta, Sumit; Brightling, Chris E

    2016-05-01

    There is a paucity of studies comparing asthma and chronic obstructive pulmonary disease (COPD) based on thoracic quantitative computed tomographic (QCT) parameters. We sought to compare QCT parameters of airway remodeling, air trapping, and emphysema between asthmatic patients and patients with COPD and explore their relationship with airflow limitation. Asthmatic patients (n = 171), patients with COPD (n = 81), and healthy subjects (n = 49) recruited from a single center underwent QCT and clinical characterization. Proximal airway percentage wall area (%WA) was significantly increased in asthmatic patients (62.5% [SD, 2.2]) and patients with COPD (62.7% [SD, 2.3]) compared with that in healthy control subjects (60.3% [SD, 2.2], P < .001). Air trapping measured based on mean lung density expiratory/inspiratory ratio was significantly increased in patients with COPD (mean, 0.922 [SD, 0.037]) and asthmatic patients (mean, 0.852 [SD, 0.061]) compared with that in healthy subjects (mean, 0.816 [SD, 0.066], P < .001). Emphysema assessed based on lung density measured by using Hounsfield units below which 15% of the voxels lie (Perc15) was a feature of COPD only (patients with COPD: mean, -964 [SD, 19.62] vs asthmatic patients: mean, -937 [SD, 22.7] and healthy subjects: mean, -937 [SD, 17.1], P < .001). Multiple regression analyses showed that the strongest predictor of lung function impairment in asthmatic patients was %WA, whereas in the COPD and asthma subgrouped with postbronchodilator FEV1 percent predicted value of less than 80%, it was air trapping. Factor analysis of QCT parameters in asthmatic patients and patients with COPD combined determined 3 components, with %WA, air trapping, and Perc15 values being the highest loading factors. Cluster analysis identified 3 clusters with mild, moderate, or severe lung function impairment with corresponding decreased lung density (Perc15 values) and increased air trapping. In asthmatic patients and patients with COPD, lung function impairment is strongly associated with air trapping, with a contribution from proximal airway narrowing in asthmatic patients. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Use of a hybrid iterative reconstruction technique to reduce image noise and improve image quality in obese patients undergoing computed tomographic pulmonary angiography.

    PubMed

    Kligerman, Seth; Mehta, Dhruv; Farnadesh, Mahmmoudreza; Jeudy, Jean; Olsen, Kathryn; White, Charles

    2013-01-01

    To determine whether an iterative reconstruction (IR) technique (iDose, Philips Healthcare) can reduce image noise and improve image quality in obese patients undergoing computed tomographic pulmonary angiography (CTPA). The study was Health Insurance Portability and Accountability Act compliant and approved by our institutional review board. A total of 33 obese patients (average body mass index: 42.7) underwent CTPA studies following standard departmental protocols. The data were reconstructed with filtered back projection (FBP) and 3 iDose strengths (iDoseL1, iDoseL3, and iDoseL5) for a total of 132 studies. FBP data were collected from 33 controls (average body mass index: 22) undergoing CTPA. Regions of interest were drawn at 6 identical levels in the pulmonary artery (PA), from the main PA to a subsegmental branch, in both the control group and study groups using each algorithm. Noise and attenuation were measured at all PA levels. Three thoracic radiologists graded each study on a scale of 1 (very poor) to 5 (ideal) by 4 categories: image quality, noise, PA enhancement, and "plastic" appearance. Statistical analysis was performed using an unpaired t test, 1-way analysis of variance, and linear weighted κ. Compared with the control group, there was significantly higher noise with FBP, iDoseL1, and iDoseL3 algorithms (P<0.001) in the study group. There was no significant difference between the noise in the control group and iDoseL5 algorithm in the study group. Analysis within the study group showed a significant and progressive decrease in noise and increase in the contrast-to-noise ratio as the level of IR was increased (P<0.001). Compared with FBP, readers graded overall image quality as being higher using iDoseL1 (P=0.0018), iDoseL3 (P<0.001), and iDoseL5 (P<0.001). Compared with FBP, there was subjective improvement in image noise and PA enhancement with increasing levels of iDose. The use of an IR technique leads to qualitative and quantitative improvements in image noise and image quality in obese patients undergoing CTPA.

  3. Towards Omni-Tomography—Grand Fusion of Multiple Modalities for Simultaneous Interior Tomography

    PubMed Central

    Wang, Ge; Zhang, Jie; Gao, Hao; Weir, Victor; Yu, Hengyong; Cong, Wenxiang; Xu, Xiaochen; Shen, Haiou; Bennett, James; Furth, Mark; Wang, Yue; Vannier, Michael

    2012-01-01

    We recently elevated interior tomography from its origin in computed tomography (CT) to a general tomographic principle, and proved its validity for other tomographic modalities including SPECT, MRI, and others. Here we propose “omni-tomography”, a novel concept for the grand fusion of multiple tomographic modalities for simultaneous data acquisition in a region of interest (ROI). Omni-tomography can be instrumental when physiological processes under investigation are multi-dimensional, multi-scale, multi-temporal and multi-parametric. Both preclinical and clinical studies now depend on in vivo tomography, often requiring separate evaluations by different imaging modalities. Over the past decade, two approaches have been used for multimodality fusion: Software based image registration and hybrid scanners such as PET-CT, PET-MRI, and SPECT-CT among others. While there are intrinsic limitations with both approaches, the main obstacle to the seamless fusion of multiple imaging modalities has been the bulkiness of each individual imager and the conflict of their physical (especially spatial) requirements. To address this challenge, omni-tomography is now unveiled as an emerging direction for biomedical imaging and systems biomedicine. PMID:22768108

  4. Drive-by large-region acoustic noise-source mapping via sparse beamforming tomography.

    PubMed

    Tuna, Cagdas; Zhao, Shengkui; Nguyen, Thi Ngoc Tho; Jones, Douglas L

    2016-10-01

    Environmental noise is a risk factor for human physical and mental health, demanding an efficient large-scale noise-monitoring scheme. The current technology, however, involves extensive sound pressure level (SPL) measurements at a dense grid of locations, making it impractical on a city-wide scale. This paper presents an alternative approach using a microphone array mounted on a moving vehicle to generate two-dimensional acoustic tomographic maps that yield the locations and SPLs of the noise-sources sparsely distributed in the neighborhood traveled by the vehicle. The far-field frequency-domain delay-and-sum beamforming output power values computed at multiple locations as the vehicle drives by are used as tomographic measurements. The proposed method is tested with acoustic data collected by driving an electric vehicle with a rooftop-mounted microphone array along a straight road next to a large open field, on which various pre-recorded noise-sources were produced by a loudspeaker at different locations. The accuracy of the tomographic imaging results demonstrates the promise of this approach for rapid, low-cost environmental noise-monitoring.

  5. Pneumorachis caused by metastatic gas gangrene.

    PubMed

    Thompson, George R; Crawford, George E

    2009-01-01

    Pneumorachis has previously been described only after spread from a contiguous site or after a traumatic event. Our patient experienced sepsis due to multiple enteric organisms, and gas was identified within the spinal canal on computed tomographic imaging. We present the 1st case of pneumorachis caused by disseminated infection.

  6. Various origins of the duplicated middle cerebral artery.

    PubMed

    Tutar, Nihal Uslu; Töre, Hüseyin Gürkan; Kirbaş, Ismail; Tarhan, Nefise Cağla; Coşkun, Mehmet

    2008-10-01

    We describe the features of a duplicated middle cerebral artery identified by computed tomographic angiography that originates from a previously undefined origin, ie, from the petrous portion of the internal carotid artery. Recognition of this anomaly is important in patients with a possible aneurysm, which was not present in our patient.

  7. 3D spectral imaging with synchrotron Fourier transform infrared spectro-microtomography

    Treesearch

    Michael C. Martin; Charlotte Dabat-Blondeau; Miriam Unger; Julia Sedlmair; Dilworth Y. Parkinson; Hans A. Bechtel; Barbara Illman; Jonathan M. Castro; Marco Keiluweit; David Buschke; Brenda Ogle; Michael J. Nasse; Carol J. Hirschmugl

    2013-01-01

    We report Fourier transform infrared spectro-microtomography, a nondestructive three-dimensional imaging approach that reveals the distribution of distinctive chemical compositions throughout an intact biological or materials sample. The method combines mid-infrared absorption contrast with computed tomographic data acquisition and reconstruction to enhance chemical...

  8. Focal fibrocartilaginous dysplasia and tibia vara: a case report.

    PubMed

    Cockshott, W P; Martin, R; Friedman, L; Yuen, M

    1994-07-01

    A 2-year-old black boy with focal fibrocartilaginous dysplasia is described with illustrations of the typical radiographic appearances supplemented by computed tomographic and magnetic resonance images. Since this rare condition is self-correcting, diagnosis is important so that surgical intervention and biopsy can be avoided and conservative management instituted.

  9. Reversible suprasellar pituitary mass secondary to hypothyroidism

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Atchison, J.A.; Lee, P.A.; Albright, A.L.

    1989-12-08

    Sellar enlargement and suprasellar extension of a pituitary mass, demonstrated by magnetic resonance imaging or computed tomographic scanning in three children with primary hypothyroidism, resolved after treatment with levothyroxine sodium. This condition, a logical consequence of the pathogenesis of primary hypothyroidism, must be considered in patients with pituitary and suprasellar masses.

  10. Soil physical and X-ray computed tomographic measurements to investigate small-scale structural differences under strip tillage compared to mulch till and no-till

    NASA Astrophysics Data System (ADS)

    Pöhlitz, Julia; Rücknagel, Jan; Schlüter, Steffen; Vogel, Hans-Jörg

    2017-04-01

    In recent years there has been an increasing application of conservation tillage techniques where the soil is no longer turned, but only loosened or left completely untilled. Dead plant material remains on the soil surface, which provides environmental and economic benefits such as the conservation of water, preventing soil erosion and saving time during seedbed preparation. There is a variety of conservation tillage systems, e.g. mulch till, no-till and strip tillage, which is a special feature. In strip tillage, the seed bed is divided into a seed zone (strip-till within the seed row: STWS) and a soil management zone (strip-till between the seed row: STBS). However, each tillage application affects physical soil properties and processes. Here, the combined application of classical soil mechanical and computed tomographic methods is used on a Chernozem (texture 0-30 cm: silt loam) to show small-scale structural differences under strip tillage (STWS, STBS) compared to no-till (NT) and mulch till (MT). In addition to the classical soil physical parameters dry bulk density and saturated conductivity (years: 2012, 2014, 2015) at soil depths 2-8 and 12-18 cm, stress-strain tests were carried out to map mechanical behavior. The stress-strain tests were performed for a load range from 5-550 kPa at 12-18 cm depth (year 2015). Mechanical precompression stress was determined on the stress-dry bulk density curves. Further, CT image cross sections and computed tomographic examinations (average pore size, porosity, connectivity, and anisotropy) were used from the same soil samples. For STBS and NT, a significant increase in dry bulk density was observed over the course of time compared to STWS and MT, which was more pronounced at 2-8 cm than at 12-18 cm depth. Despite higher dry bulk density, STBS displayed higher saturated conductivity in contrast to STWS, which can be attributed to higher earthworm abundance. In strip tillage, structural differences were identified. Mechanical precompression stress was significantly higher for STBS (141 kPa) than STWS (38 kPa). In addition, the CT image cross sections and the computed tomographic parameters confirmed the mechanically more stable soil structure observed under STBS with a higher initial average pore size but lower porosity and connectivity values compared to STWS. The reason for this is the lack of tillage. On the other hand, tillage at STWS created a loosened, porous and connective substrate. For all variants, the increasing load application led to progressive homogenization processes of the soil structure. At the same time, as stress application increased in all variants, the increase in dry bulk density led to a decrease in average pore size, porosity, and connectivity, while anisotropy increased. It was possible to confirm that strip tillage combines the advantages of no-till and a deeper conservation primary tillage, since on the one hand MT and STWS and on the other hand STBS and NT showed very similar soil structures. The computed tomographic parameters therefore provide valuable information about the impact of tillage on microscopic pore space attributes that improve our understanding about soil functional behavior at much larger scales.

  11. Advanced Ultrasonic Tomograph of Children's Bones

    NASA Astrophysics Data System (ADS)

    Lasaygues, Philippe; Lefebvre, Jean-Pierre; Guillermin, Régine; Kaftandjian, Valérie; Berteau, Jean-Philippe; Pithioux, Martine; Petit, Philippe

    This study deals with the development of an experimental device for performing ultrasonic computed tomography (UCT) on bone in pediatric degrees. The children's bone tomographs obtained in this study, were based on the use of a multiplexed 2-D ring antenna (1 MHz and 3 MHz) designed for performing electronic and mechanical scanning. Although this approach is known to be a potentially valuable means of imaging objects with similar acoustical impedances, problems arise when quantitative images of more highly contrasted media such as bones are required. Various strategies and various mathematical procedures for modeling the wave propagation based on Born approximations have been developed at our laboratory, which are suitable for use with pediatric cases. Inversions of the experimental data obtained are presented.

  12. Tomographic determination of the power distribution in electron beams

    DOEpatents

    Teruya, Alan T.; Elmer, John W.

    1996-01-01

    A tomographic technique for determining the power distribution of an electron beam using electron beam profile data acquired from a modified Faraday cup to create an image of the current density in high and low power beams. A refractory metal disk with a number of radially extending slits is placed above a Faraday cup. The beam is swept in a circular pattern so that its path crosses each slit in a perpendicular manner, thus acquiring all the data needed for a reconstruction in one circular sweep. Also, a single computer is used to generate the signals actuating the sweep, to acquire that data, and to do the reconstruction, thus reducing the time and equipment necessary to complete the process.

  13. Tomographic determination of the power distribution in electron beams

    DOEpatents

    Teruya, A.T.; Elmer, J.W.

    1996-12-10

    A tomographic technique for determining the power distribution of an electron beam using electron beam profile data acquired from a modified Faraday cup to create an image of the current density in high and low power beams is disclosed. A refractory metal disk with a number of radially extending slits is placed above a Faraday cup. The beam is swept in a circular pattern so that its path crosses each slit in a perpendicular manner, thus acquiring all the data needed for a reconstruction in one circular sweep. Also, a single computer is used to generate the signals actuating the sweep, to acquire that data, and to do the reconstruction, thus reducing the time and equipment necessary to complete the process. 4 figs.

  14. Computation in generalised probabilisitic theories

    NASA Astrophysics Data System (ADS)

    Lee, Ciarán M.; Barrett, Jonathan

    2015-08-01

    From the general difficulty of simulating quantum systems using classical systems, and in particular the existence of an efficient quantum algorithm for factoring, it is likely that quantum computation is intrinsically more powerful than classical computation. At present, the best upper bound known for the power of quantum computation is that {{BQP}}\\subseteq {{AWPP}}, where {{AWPP}} is a classical complexity class (known to be included in {{PP}}, hence {{PSPACE}}). This work investigates limits on computational power that are imposed by simple physical, or information theoretic, principles. To this end, we define a circuit-based model of computation in a class of operationally-defined theories more general than quantum theory, and ask: what is the minimal set of physical assumptions under which the above inclusions still hold? We show that given only an assumption of tomographic locality (roughly, that multipartite states and transformations can be characterized by local measurements), efficient computations are contained in {{AWPP}}. This inclusion still holds even without assuming a basic notion of causality (where the notion is, roughly, that probabilities for outcomes cannot depend on future measurement choices). Following Aaronson, we extend the computational model by allowing post-selection on measurement outcomes. Aaronson showed that the corresponding quantum complexity class, {{PostBQP}}, is equal to {{PP}}. Given only the assumption of tomographic locality, the inclusion in {{PP}} still holds for post-selected computation in general theories. Hence in a world with post-selection, quantum theory is optimal for computation in the space of all operational theories. We then consider whether one can obtain relativized complexity results for general theories. It is not obvious how to define a sensible notion of a computational oracle in the general framework that reduces to the standard notion in the quantum case. Nevertheless, it is possible to define computation relative to a ‘classical oracle’. Then, we show there exists a classical oracle relative to which efficient computation in any theory satisfying the causality assumption does not include {{NP}}.

  15. Direct integration of the inverse Radon equation for X-ray computed tomography.

    PubMed

    Libin, E E; Chakhlov, S V; Trinca, D

    2016-11-22

    A new mathematical appoach using the inverse Radon equation for restoration of images in problems of linear two-dimensional x-ray tomography is formulated. In this approach, Fourier transformation is not used, and it gives the chance to create the practical computing algorithms having more reliable mathematical substantiation. Results of software implementation show that for especially for low number of projections, the described approach performs better than standard X-ray tomographic reconstruction algorithms.

  16. Comparative Analysis of the Mini-pterional and Supraorbital Keyhole Craniotomies for Unruptured Aneurysms with Numeric Measurements of Their Geometric Configurations.

    PubMed

    Kang, Ho-Jun; Lee, Yoon-Soo; Suh, Sang-Jun; Lee, Jeong-Ho; Ryu, Kee-Young; Kang, Dong-Gee

    2013-03-01

    Keyhole craniotomy is a modification of pterional craniotomy that allows for use of a minimally invasive approach toward cerebral aneurysms. Currently, mini-pterional (MPKC) and supraorbital keyhole craniotomies (SOKC) are commonly used. In this study, we measured and compared the geometric configurations of surgical exposure provided by MPKC and SOKC. Nine patients underwent MPKC and four underwent SOKC. Their postoperative contrast-enhanced brain computed tomographic scans were evaluated. The transverse and longitudinal diameters and areas of exposure were measured. The locations of the anterior communicating artery, bifurcation of the middle cerebral artery (MCAB), and the internal carotid artery (ICA) terminal were identified, and the working angles and depths for these targets were measured. No significant differences in the transverse diameters of exposure were observed between MPKC and SOKC. However, the longitudinal diameters and the areas were significantly larger, by 1.5 times in MPKC. MPKC provided larger operable working angles for the targets. The angles by MPKC, particularly for the MCAB, reached up to 1.9-fold of those by SOKC. Greater working depths were required in order to reach the targets by SOKC, and the differences were the greatest in the MCAB by 1.6-fold. MPKC provides larger exposure than SOKC with a similar length of skin incision. MPKC allows for use of a direct transsylvian approach, and exposes the target in a wide working angle within a short distance. Despite some limitations in exposure, SOKC is suitable for a direct subfrontal approach, and provides a more anteromedial and basal view. MCAB and posteriorly directing ICA terminal aneurysms can be good candidates for MPKC.

  17. The influence of kyphosis correction surgery on pulmonary function and thoracic volume.

    PubMed

    Zeng, Yan; Chen, Zhongqiang; Ma, Desi; Guo, Zhaoqing; Qi, Qiang; Li, Weishi; Sun, Chuiguo; Liu, Ning; White, Andrew P

    2014-10-01

    A clinical study. To measure the changes in pulmonary function and thoracic volume associated with surgical correction of kyphotic deformities. No prior study has focused on the pulmonary function and thoracic cavity volume before and after corrective surgery for kyphosis. Thirty-four patients with kyphosis underwent posterior deformity correction with instrumented fusion. Preoperative and postoperative pulmonary function was measured, and pulmonary function grade was evaluated as mild, significant, or severe. The change in preoperative to postoperative pulmonary function was analyzed, using 6 comparative subgroupings of patients on the basis of age, severity of kyphosis, location of kyphosis apex, length of follow-up time after surgery, degree of kyphosis correction, and number of segments fused. A second group of 19 patients also underwent posterior surgical correction of kyphosis, which had thoracic volume measured preoperatively and postoperatively with computed tomographic scanning. All of the pulmonary impairments were found to be restrictive. After surgery, most of the patients had improvement of the pulmonary function. Before surgery, the pulmonary function differences were found to be significant based on both severity of preoperative kyphosis (<60° vs. >60°) and location of the kyphosis apex (above T10 vs. below T10). Younger patients (younger than 35 yr) were more likely to exhibit statistically significant improvements in pulmonary function after surgery. However, thoracic volume was not significantly related to pulmonary function parameters. After surgery, average thoracic volume had no significant change. The major pulmonary impairment caused by kyphosis was found to be restrictive. Patients with kyphosis angle of 60° or greater or with kyphosis apex above T10 had more severe pulmonary dysfunction. Patients' age was significantly related to change in pulmonary function after surgery. However, the average thoracic volume had no significant change after surgery. 3.

  18. Two-year follow-up evaluation of surgical treatment for thoracolumbar fracture-dislocation.

    PubMed

    Hao, Dingjun; Wang, Wentao; Duan, Kun; Ma, Minjie; Jiang, Yong; Liu, Tuanjiang; He, Baorong

    2014-10-01

    A randomized, controlled clinical trial. This randomized controlled clinical trial was aimed at comparing the clinical outcomes of combined posteroanterior (P-A) fusion and transforaminal thoracic interbody fusion (TTIF) in cases of thoracolumbar fracture-dislocation. The optimal treatment strategy for thoracolumbar fracture-dislocation remains controversial. Sixty-one patients presenting with acute fracture-dislocation of the thoracolumbar joint between March 2010 and December 2011 were enrolled and randomly assigned to the P-A or TTIF group. The radiological outcome was assessed by acquiring radiographs in the standing position and computed tomographic scans. The clinical outcome was measured in terms of the American Spinal Injury Association score, visual analogue scale score, and Oswestry Disability Index. Moreover, we assessed the severity of overall morbidity and morbidity at the donor site in the 2 patient groups. The Student t and χ tests were used for the analysis of independent variables and categorical data, respectively. Only 57 of the enrolled patients were available for the required 24-month follow-up period, 27 underwent TTIF and 30 underwent P-A fusion. Both treatments were similar with respect to the fusion rate, extent of decompression, loss of correction, rate of instrumentation failure, American Spinal Injury Association score, visual analogue scale score, and Oswestry Disability Index (P > 0.05). However, the blood loss, operating time, and rate of perioperative complications were greater in the P-A group than in the TTIF group (P < 0.05). The clinical and radiological outcomes were similar for both the treatment procedures. However, our findings suggest that TTIF allows for safe interbody fusion and circumferential decompression, requires only a posterior approach, and is associated with a lower incidence of surgery-related complications. 2.

  19. Longitudinal Analysis of Superficial Midfacial Fat Volumes Over a 10-Year Period.

    PubMed

    Tower, Jacob; Seifert, Kimberly; Paskhover, Boris

    2018-04-11

    Volumetric changes to facial fat that occur with aging remain poorly understood. The aim of this study was to evaluate for longitudinal changes to midfacial fat volumes in a group of individuals. We conducted a retrospective longitudinal study of adult subjects who underwent multiple facial computed tomographic (CT) scans timed at least 8 years apart. Subjects who underwent facial surgery or suffered facial trauma were excluded. Facial CT scans were analyzed, and superficial cheek fat volumes were measured and compared to track changes that occurred with aging. Fourteen subjects were included in our analysis of facial aging (5 male, 9 female; mean initial age 50.9 years; mean final age 60.4 years). In the right superficial cheek there was an increase in mean (SD) superficial fat volume from 10.33 (2.01) to 10.50 (1.80) cc, which was not statistically significant (P = 0.75). Similar results were observed in the left cheek. There were no statistically significant longitudinal changes to caudal, middle, or cephalad subdivisions of bilateral superficial cheek fat. A simple linear regression was performed to predict superficial cheek fat pad volume based on age which did not reach statistical significance (P = 0.31), with an R 2 of 0.039. This study is the first to quantitatively assess for longitudinal changes to midfacial fat in a group of individuals. Superficial cheek fat remained stable as subjects aged from approximately 50 to 60 years old, with no change in total volume or redistribution within a radiographically defined compartment. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  20. Clinical, computed tomographic, magnetic resonance imaging, and histologic findings associated with myxomatous neoplasia of the temporomandibular joint in two dogs.

    PubMed

    Parslow, Arana; Taylor, David P; Simpson, David J

    2016-12-01

    CASE DESCRIPTION A 15-year-old neutered female mixed-breed dog (dog 1) and an 11-year-old neutered female Labrador Retriever (dog 2) were examined because of unilateral exophthalmus, third eyelid protrusion, and periorbital swelling that failed to respond to antimicrobial treatment. CLINICAL FINDINGS Both dogs underwent ultrasonographic, CT, and MRI examination of the head. In both dogs, advanced imaging revealed a poorly defined, peripherally contrast-enhancing, mucous-filled cystic mass that radiated from the temporomandibular joint and infiltrated the periorbital tissues and retrobulbar space. Both dogs underwent surgical biopsy of the periorbital mass. A viscous, straw-colored fluid was aspirated from the retrobulbar region in both dogs. The initial histologic diagnosis for dog 1 was zygomatic sialadenitis and sialocele. However, the clinical signs recurred, and histologic examination of specimens obtained during a second surgical biopsy resulted in a diagnosis of myxoma. The histologic diagnosis was myxosarcoma for dog 2. TREATMENT AND OUTCOME In both dogs, clinical signs recurred within 2 weeks after surgery and persisted for the duration of their lives. Dog 1 received no further treatment after the second surgery and was euthanized 34 months after initial examination because of multicentric lymphoma. Dog 2 was treated with various chemotherapy agents and was euthanized 11 months after initial examination because of a dramatic increase in periocular swelling and respiratory stertor. CLINICAL RELEVANCE Temporomandibular myxomatous neoplasia can be confused with zygomatic sialocele on the basis of clinical signs but has characteristic MRI features. Representative biopsy specimens should be obtained from areas close to the temporomandibular joint to avoid misdiagnosis.

  1. CT Imaging of Hardwood Logs for Lumber Production

    Treesearch

    Daniel L. Schmoldt; Pei Li; A. Lynn Abbott

    1996-01-01

    Hardwood sawmill operators need to improve the conversion of raw material (logs) into lumber. Internal log scanning provides detailed information that can aid log processors in improving lumber recovery. However, scanner data (i.e. tomographic images) need to be analyzed prior to presentation to saw operators. Automatic labeling of computer tomography (CT) images is...

  2. Diagnostic cardiology: Noninvasive imaging techniques

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Come, P.C.

    1985-01-01

    This book contains 23 chapters. Some of the chapter titles are: The chest x-ray and cardiac series; Computed tomographic scanning of the heart, coronary arteries, and great vessels; Digital subtraction angiography in the assessment of cardiovascular disease; Magnetic resonance: technique and cardiac applications; Basics of radiation physics and instrumentation; and Nuclear imaging: the assessment of cardiac performance.

  3. Histological and computed tomographic evaluation of a parasitic conjoined twin in hybrid catfish (Ictalurus punctatus [rafinesque] X Ictalurus furcatus [lesueur])

    USDA-ARS?s Scientific Manuscript database

    There is growing use of hybrid catfish (Ictalurus punctatus ' X Ictalurus furcatus ') in commercial aquaculture to utilize hybrid vigour to improve production A conjoined twin specimen found during the course of production studies by the United States Department of Agriculture Catfish Genetic Resear...

  4. Bridging the Gap between Basic and Clinical Sciences: A Description of a Radiological Anatomy Course

    ERIC Educational Resources Information Center

    Torres, Anna; Staskiewicz, Grzegorz J.; Lisiecka, Justyna; Pietrzyk, Lukasz; Czekajlo, Michael; Arancibia, Carlos U.; Maciejewski, Ryszard; Torres, Kamil

    2016-01-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images…

  5. Frequency and Relevance of Acute Peritraumatic Pulmonary Thrombus Diagnosed by Computed Tomographic Imaging in Combat Casualties

    DTIC Science & Technology

    2013-08-01

    variable. Tourniquet and tranexamic acid (TXA) use before CT imaging were also recorded. Admission temperature and systolic blood pressure (SBP) were...Trauma Data Bank. Ann Surg. 2004;240:490Y498. 11. Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ. Military appli- cation of tranexamic acid in

  6. [A Case of Pancreatic Neuroendocrine Tumor with Necrolytic Migratory Erythema].

    PubMed

    Hijikawa, Takeshi; Kitade, Hiroaki; Yanagida, Hidesuke; Yamada, Masanori; Yoshioka, Kazuhiko; Shijimaya, Takako; Kiyohara, Takahiro; Uemura, Yoshiko; Kon, Masanori

    2017-10-01

    A 45-year-old man was admitted because of necrolytic migratory erythema. A computed tomographic scan of the abdomen revealed a 4.5cm mass in the tail of the pancreas. We performed distal pancreatectomy and splenectomy, and a definitive diagnosis of pancreatic neuroendocrine tumor(WHO class grade 2)was made histopathologically.

  7. Misdiagnosis of acute peripheral vestibulopathy in central nervous ischemic infarction.

    PubMed

    Braun, Eva Maria; Tomazic, Peter Valentin; Ropposch, Thorsten; Nemetz, Ulrike; Lackner, Andreas; Walch, Christian

    2011-12-01

    Vertigo is a very common symptom at otorhinolaryngology (ENT), neurological, and emergency units, but often, it is difficult to distinguish between vertigo of peripheral and central origin. We conducted a retrospective analysis of a hospital database, including all patients admitted to the ENT University Hospital Graz after neurological examination, with a diagnosis of peripheral vestibular vertigo and subsequent diagnosis of central nervous infarction as the actual cause for the vertigo. Twelve patients were included in this study. All patients with acute spinning vertigo after a thorough neurological examination and with uneventful computed tomographic scans were referred to our ENT department. Nine of them presented with horizontal nystagmus. Only 1 woman experienced additional hearing loss. The mean diagnostic delay to the definite diagnosis of a central infarction through magnetic resonance imaging was 4 days (SD, 2.3 d). A careful otologic and neurological examination, including the head impulse test and caloric testing, is mandatory. Because ischemic events cannot be diagnosed in computed tomographic scans at an early stage, we strongly recommend to perform cranial magnetic resonance imaging within 48 hours from admission if vertigo has not improved under conservative treatment.

  8. The use of laparoscopy in the diagnosis and treatment of blunt and penetrating abdominal injuries: 10-year experience at a level 1 trauma center.

    PubMed

    Johnson, Jeremy J; Garwe, Tabitha; Raines, Alexander R; Thurman, Joseph B; Carter, Sandra; Bender, Jeffrey S; Albrecht, Roxie M

    2013-03-01

    Diagnostic laparoscopy (DL) has decreased the rate of nontherapeutic laparotomy for patients suffering from penetrating injuries. We evaluated whether DL similarly lowers the rate of nontherapeutic laparotomy for patients with blunt injuries. All patients undergoing DL over a 10-year period (ie, 2001-2010) in a single level 1 trauma center were classified by the mechanism of injury. Demographic and perioperative data were compared using the Student t and Fisher exact tests. There were 131 patients included, 22 of whom sustained blunt injuries. Patients suffering from blunt injuries were more severely injured (Injury Severity Score 18.0 vs 7.3, P = .0001). The most common indication for DL after blunt injury was a computed tomographic scan concerning for bowel injury (59.1%). The rate of nontherapeutic laparotomy for patients sustaining penetrating vs blunt injury was 1.8% and nil, respectively. DL, when coupled with computed tomographic findings, is an effective tool for the initial management of patients with blunt injuries. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Is magnetic resonance imaging in addition to a computed tomographic scan necessary to identify clinically significant cervical spine injuries in obtunded blunt trauma patients?

    PubMed

    Fisher, Brian M; Cowles, Steven; Matulich, Jennifer R; Evanson, Bradley G; Vega, Diana; Dissanaike, Sharmila

    2013-12-01

    Guidelines are in place directing the clearance of the cervical spine in patients who are awake, alert, and oriented, but a gold standard has not been recognized for patients who are obtunded. Our study is designed to determine if magnetic resonance imaging (MRI) detects clinically significant injuries not seen on computed tomographic (CT) scans. The trauma registry was used to identify and retrospectively review medical records of blunt trauma patients from January 1, 2005, to March 30, 2012. Only obtunded patients with a CT scan and MRI of the cervical spine were included. The study cohort consisted of 277 patients. In 13 (5%) patients, MRI detected clinically significant cervical spine injuries that were missed by CT scans, and in 7 (3%) these injuries required intervention. The number needed to screen with MRI to prevent 1 missed injury was 21. The findings suggest that the routine use of MRI in clearing the cervical spine in the obtunded blunt trauma patient. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Evaluation of hepatic arterial anatomy by multidetector computed tomographic angiography in living donor liver transplantation.

    PubMed

    Keles, Papatya; Yuce, Ihsan; Keles, Sait; Kantarci, Mecit

    2016-06-01

    The aim of this study was to define the different courses and percentages of hepatic artery that were detected during preoperative evaluation of living liver donors by multidetector computed tomographic angiography (MDCTA). We evaluated 150 donors before hepatic transplantation. All of the donors were evaluated by multislice CT scan with 256 detectors. For each patient, arterial, portal and venous phase images were obtained. The hepatic arterial variations were evaluated by the same radiologist according to Michels' classification. Common hepatic arterial anatomy (type I) was observed in 95 donors (63.3%). Other arterial variations were determined in the remaining 55 donors (36.6%). The second common variation was type XI which did not match with the description of Michels' classification variation in 15 donors (10%). The remaining variations described in Michels' classification were seen at lower rates. Type VII or X variation was not seen. MDCTA is a useful method to identify the blood supply of the liver before the liver transplantations, and surgeons can make their plan on the basis of CT data.

  11. Inflammatory Myofibroblastic Tumor Mimicking Apical Periodontitis.

    PubMed

    Adachi, Makoto; Kiho, Kazuki; Sekine, Genta; Ohta, Takahisa; Matsubara, Makoto; Yoshida, Takakazu; Katsumata, Akitoshi; Tanuma, Jun-ichi; Sumitomo, Shinichiro

    2015-12-01

    Inflammatory myofibroblastic tumors (IMTs) are rare. IMTs of the head and neck occur in all age groups, from neonates to old age, with the highest incidence occurring in childhood and early adulthood. An IMT has been defined as a histologically distinctive lesion of uncertain behavior. This article describes an unusual case of IMT mimicking apical periodontitis in the mandible of a 42-year-old man. At first presentation, the patient showed spontaneous pain and percussion pain at teeth #28 to 30, which continued after initial endodontic treatment. Panoramic radiography revealed a radiolucent lesion at the site. Cone-beam computed tomographic imaging showed osteolytic lesions, suggesting an aggressive neoplasm requiring incisional biopsy. Histopathological examination indicated an IMT. The lesion was removed en bloc under general anesthesia, and the patient manifested no clinical evidence of recurrence for 24 months. Lesions of nonendodontic origin should be included in the differential diagnosis of apical periodontitis. Every available diagnostic tool should be used to confirm the diagnosis. Cone-beam computed tomographic imaging is very helpful for differential diagnosis in IMTs mimicking apical periodontitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  12. Perforating internal root resorption repaired with mineral trioxide aggregate caused complete resolution of odontogenic sinus mucositis: a case report.

    PubMed

    Bendyk-Szeffer, Maja; Łagocka, Ryta; Trusewicz, Matylda; Lipski, Mariusz; Buczkowska-Radlińska, Jadwiga

    2015-02-01

    An extensive perforating internal root resorption accompanied by apical periodontitis and odontogenic sinus mucositis was detected on preoperative cone-beam computed tomographic scans in a first maxillary molar. After the chemomechanical debridement of the root canals, calcium hydroxide was placed as a temporary dressing for 7 days. Mineral trioxide aggregate was used to fill the perforation site with the aid of a surgical microscope. At the next visit, the root with the resorption defect was filled with warm vertical compaction of gutta-percha. A control cone-beam computed tomographic scan acquired 6 months after the endodontic treatment revealed complete resolution of the sinus retention cyst. Moreover, the patient's frequent otolaryngologic disturbances ceased. The tooth was functional with satisfactory clinical and radiographic results after 12 months. Based on the results of this case, successful repair of an extensive, perforating internal resorption with mineral trioxide aggregate may lead to complete resolution of apical periodontitis and maxillary sinus retention cyst. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices

    PubMed Central

    Halboub, Esam; Almashraqi, Abeer Abdulkareem; Khattab, Razan; Al Haffar, Iyad

    2016-01-01

    Purpose The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. Materials and Methods A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. Results The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). Conclusion IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices. PMID:27672615

  14. Inspiratory and expiratory computed tomographic volumetry for lung volume reduction surgery.

    PubMed

    Morimura, Yuki; Chen, Fengshi; Sonobe, Makoto; Date, Hiroshi

    2013-06-01

    Three-dimensional (3D) computed tomographic (CT) volumetry has been introduced into the field of thoracic surgery, and a combination of inspiratory and expiratory 3D-CT volumetry provides useful data on regional pulmonary function as well as the volume of individual lung lobes. We report herein a case of a 62-year-old man with severe emphysema who had undergone lung volume reduction surgery (LVRS) to assess this technique as a tool for the evaluation of regional lung function and volume before and after LVRS. His postoperative pulmonary function was maintained in good condition despite a gradual slight decrease 2 years after LVRS. This trend was also confirmed by a combination of inspiratory and expiratory 3D-CT volumetry. We confirm that a combination of inspiratory and expiratory 3D-CT volumetry might be effective for the preoperative assessment of LVRS in order to determine the amount of lung tissue to be resected as well as for postoperative evaluation. This novel technique could, therefore, be used more widely to assess local lung function.

  15. Inspiratory and expiratory computed tomographic volumetry for lung volume reduction surgery

    PubMed Central

    Morimura, Yuki; Chen, Fengshi; Sonobe, Makoto; Date, Hiroshi

    2013-01-01

    Three-dimensional (3D) computed tomographic (CT) volumetry has been introduced into the field of thoracic surgery, and a combination of inspiratory and expiratory 3D-CT volumetry provides useful data on regional pulmonary function as well as the volume of individual lung lobes. We report herein a case of a 62-year-old man with severe emphysema who had undergone lung volume reduction surgery (LVRS) to assess this technique as a tool for the evaluation of regional lung function and volume before and after LVRS. His postoperative pulmonary function was maintained in good condition despite a gradual slight decrease 2 years after LVRS. This trend was also confirmed by a combination of inspiratory and expiratory 3D-CT volumetry. We confirm that a combination of inspiratory and expiratory 3D-CT volumetry might be effective for the preoperative assessment of LVRS in order to determine the amount of lung tissue to be resected as well as for postoperative evaluation. This novel technique could, therefore, be used more widely to assess local lung function. PMID:23460599

  16. Left main coronary artery stenosis: severity evaluation and implications for management.

    PubMed

    Habibi, Susan E; Shah, Rahman; Berzingi, Chalak O; Melchior, Ryan; Sumption, Kevin F; Jovin, Ion S

    2017-03-01

    The significant stenosis of the left main coronary artery is associated with poor outcomes and is considered a strong indication for revascularization. However, deciding whether the stenosis is significant can sometimes be challenging, especially when the degree of stenosis is intermediate, and can necessitate additional tests and imaging modalities. Areas covered: We did a literature search using keywords like 'left main', 'imaging', 'intravascular ultrasound', 'fractional flow reserve', 'computed tomographic angiography' and 'magnetic resonance imaging'. The most commonly used methods for better characterizing intermediate left main coronary stenoses are intravascular ultrasound and fractional flow reserve, while optical coherence tomography is the newer technique that provides better images, but for which not as much data is available. The noninvasive techniques are coronary computed tomographic angiography and, to a lesser degree, coronary magnetic resonance imaging. Expert commentary: Accurately determining the severity of left main coronary stenosis can mean the difference between a major intervention and conservative therapy. The reviewed newer imaging modalities give us greater confidence that patients with left main stenosis are assigned to the right treatment modality.

  17. First-in-Man Computed Tomography-Guided Percutaneous Revascularization of Coronary Chronic Total Occlusion Using a Wearable Computer: Proof of Concept.

    PubMed

    Opolski, Maksymilian P; Debski, Artur; Borucki, Bartosz A; Szpak, Marcin; Staruch, Adam D; Kepka, Cezary; Witkowski, Adam

    2016-06-01

    We report a case of successful computed tomography-guided percutaneous revascularization of a chronically occluded right coronary artery using a wearable, hands-free computer with a head-mounted display worn by interventional cardiologists in the catheterization laboratory. The projection of 3-dimensional computed tomographic reconstructions onto the screen of virtual reality glass allowed the operators to clearly visualize the distal coronary vessel, and verify the direction of the guide wire advancement relative to the course of the occluded vessel segment. This case provides proof of concept that wearable computers can improve operator comfort and procedure efficiency in interventional cardiology. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  18. 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.

  19. Dynamic Computed Tomographic Features of Adult Renal Cell Carcinoma Associated With Xp11.2 Translocation/TFE3 Gene Fusions: Comparison With Clear Cell Renal Cell Carcinoma.

    PubMed

    He, Jian; Gan, Weidong; Liu, Song; Zhou, Kefeng; Zhang, Gutian; Guo, Hongqian; Zhu, Bin

    2015-01-01

    To investigate the dynamic contrast-enhanced computed tomography (CT) characteristics of renal cell carcinoma associated with Xp11.2 translocation and TFE gene fusion (Xp11.2 RCC) by comparison with clear cell renal cell carcinoma (CCRCC). Dynamic contrast-enhanced CT images and clinical and pathological records of 20 adult patients with Xp11.2 RCC confirmed by TFE3 immunohistochemical and fluorescence in situ hybridization assay were retrospectively analyzed and compared with the findings of 21 contemporary CCRCCs. Renal cell carcinoma associated with Xp11.2 translocation and TFE gene fusions often occurred in young (30.6 ± 8.6 years) patients with hematuria (9/20). They presented as well-defined (17/20) cystic-solid (17/20) mass with hemorrhage (8/20) and circular/rim calcifications (6/20). Dynamic contrast-enhanced CT showed heterogeneous moderate prolonged enhancement. A tumor-to-cortex attenuation ratio in corticomedullary phase less than 0.62 gave a sensitivity of 90.0% and a specificity of 92.9% in differentiating Xp11.2 RCC from CCRCC (area under the receiver operating characteristic curve = 0.957, P < 0.001). Computed tomographic characteristics and dynamic contrast-enhanced patterns and index can differentiate Xp11.2 RCC from CCRCC.

  20. Seismic tomography of the southern California crust based on spectral-element and adjoint methods

    NASA Astrophysics Data System (ADS)

    Tape, Carl; Liu, Qinya; Maggi, Alessia; Tromp, Jeroen

    2010-01-01

    We iteratively improve a 3-D tomographic model of the southern California crust using numerical simulations of seismic wave propagation based on a spectral-element method (SEM) in combination with an adjoint method. The initial 3-D model is provided by the Southern California Earthquake Center. The data set comprises three-component seismic waveforms (i.e. both body and surface waves), filtered over the period range 2-30 s, from 143 local earthquakes recorded by a network of 203 stations. Time windows for measurements are automatically selected by the FLEXWIN algorithm. The misfit function in the tomographic inversion is based on frequency-dependent multitaper traveltime differences. The gradient of the misfit function and related finite-frequency sensitivity kernels for each earthquake are computed using an adjoint technique. The kernels are combined using a source subspace projection method to compute a model update at each iteration of a gradient-based minimization algorithm. The inversion involved 16 iterations, which required 6800 wavefield simulations. The new crustal model, m16, is described in terms of independent shear (VS) and bulk-sound (VB) wave speed variations. It exhibits strong heterogeneity, including local changes of +/-30 per cent with respect to the initial 3-D model. The model reveals several features that relate to geological observations, such as sedimentary basins, exhumed batholiths, and contrasting lithologies across faults. The quality of the new model is validated by quantifying waveform misfits of full-length seismograms from 91 earthquakes that were not used in the tomographic inversion. The new model provides more accurate synthetic seismograms that will benefit seismic hazard assessment.

  1. Adjoint Tomography of the Southern California Crust (Invited) (Invited)

    NASA Astrophysics Data System (ADS)

    Tape, C.; Liu, Q.; Maggi, A.; Tromp, J.

    2009-12-01

    We iteratively improve a three-dimensional tomographic model of the southern California crust using numerical simulations of seismic wave propagation based on a spectral-element method (SEM) in combination with an adjoint method. The initial 3D model is provided by the Southern California Earthquake Center. The dataset comprises three-component seismic waveforms (i.e. both body and surface waves), filtered over the period range 2-30 s, from 143 local earthquakes recorded by a network of 203 stations. Time windows for measurements are automatically selected by the FLEXWIN algorithm. The misfit function in the tomographic inversion is based on frequency-dependent multitaper traveltime differences. The gradient of the misfit function and related finite-frequency sensitivity kernels for each earthquake are computed using an adjoint technique. The kernels are combined using a source subspace projection method to compute a model update at each iteration of a gradient-based minimization algorithm. The inversion involved 16 iterations, which required 6800 wavefield simulations and a total of 0.8 million CPU hours. The new crustal model, m16, is described in terms of independent shear (Vs) and bulk-sound (Vb) wavespeed variations. It exhibits strong heterogeneity, including local changes of ±30% with respect to the initial 3D model. The model reveals several features that relate to geologic observations, such as sedimentary basins, exhumed batholiths, and contrasting lithologies across faults. The quality of the new model is validated by quantifying waveform misfits of full-length seismograms from 91 earthquakes that were not used in the tomographic inversion. The new model provides more accurate synthetic seismograms that will benefit seismic hazard assessment.

  2. Segmentation and Estimation of the Histological Composition of the Tumor Mass in Computed Tomographic Images of Neuroblastoma

    DTIC Science & Technology

    2001-10-25

    a CT image, each voxel contains an integer number which is the CT value, in Hounsfield units (HU), of the voxel. Therefore, the standard method of...Task Number Work Unit Number Performing Organization Name(s) and Address(es) Department of Electrical and Computer Engineering, University of...34, Journal of Pediatric Surgery, vol 24(7), pp. 708-711, 1989. [4] I. N. Bankman, editor, Handbook of Medical Image Analysis, Academic Press, London, UK

  3. Computed tomographic analysis of deformity and dimensional changes in the eyeball

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Osborne, D.R.; Foulks, G.N.

    1984-12-01

    Computed tomography (CT) was performed in 40 patients with a confirmed ophthalmic diagnosis and a change in the dimensions or configuration of the eyeball. Abnormalities studied included coloboma, microphthalmus, buphthalmos, axial myopia, macrophthalmus, phthisis bulbi, trauma, neoplasm, posterior staphyloma, granuloma, pseudotumor, and surgicalscleral banding for retinal detachment. CT findings could be grouped into three categories depending upon whether the eye was small, large, or normal in size, with the findings in each group allowing distinction of most disease processes.

  4. Computer tomography of flows external to test models

    NASA Technical Reports Server (NTRS)

    Prikryl, I.; Vest, C. M.

    1982-01-01

    Computer tomographic techniques for reconstruction of three-dimensional aerodynamic density fields, from interferograms recorded from several different viewing directions were studied. Emphasis is on the case in which an opaque object such as a test model in a wind tunnel obscures significant regions of the interferograms (projection data). A method called the Iterative Convolution Method (ICM), existing methods in which the field is represented by a series expansions, and analysis of real experimental data in the form of aerodynamic interferograms are discussed.

  5. Model studies of laser absorption computed tomography for remote air pollution measurement

    NASA Technical Reports Server (NTRS)

    Wolfe, D. C., Jr.; Byer, R. L.

    1982-01-01

    Model studies of the potential of laser absorption-computed tomography are presented which demonstrate the possibility of sensitive remote atmospheric pollutant measurements, over kilometer-sized areas, with two-dimensional resolution, at modest laser source powers. An analysis of this tomographic reconstruction process as a function of measurement SNR, laser power, range, and system geometry, shows that the system is able to yield two-dimensional maps of pollutant concentrations at ranges and resolutions superior to those attainable with existing, direct-detection laser radars.

  6. Advances in target imaging of deep Earth structure

    NASA Astrophysics Data System (ADS)

    Masson, Y.; Romanowicz, B. A.; Clouzet, P.

    2015-12-01

    A new generation of global tomographic models (Lekić and Romanowicz, 2011; French et al, 2013, 2014) has emerged with the development of accurate numerical wavefield computations in a 3D earth combined with access to enhanced HPC capabilities. These models have sharpened up mantle images and unveiled relatively small scale structures that were blurred out in previous generation models. Fingerlike structures have been found at the base of the oceanic asthenosphere, and vertically oriented broad low velocity plume conduits extend throughout the lower mantle beneath those major hotspots that are located within the perimeter of the deep mantle large low shear velocity provinces (LLSVPs). While providing new insights into our understanding of mantle dynamics, the detailed morphology of these features, requires further efforts to obtain higher resolution images. The focus of our ongoing effort is to develop advanced tomographic methods to image remote regions of the Earth at fine scales. We have developed an approach in which distant sources (located outside of the target region) are replaced by an equivalent set of local sources located at the border of the computational domain (Masson et al., 2014). A limited number of global simulations in a reference 3D earth model is then required. These simulations are computed prior to the regional inversion, while iterations of the model need to be performed only within the region of interest, potentially allowing us to include shorter periods at limited additional computational cost. Until now, the application was limited to a distribution of receivers inside the target region. This is particularly suitable for studies of upper mantle structure in regions with dense arrays (e.g. see our companion presentation Clouzet et al., this Fall AGU). Here we present our latest development that now can include teleseismic data recorded outside the imaged region. This allows us to perform regional waveform tomography in the situation where neither earthquakes nor seismological stations are present within the region of interest, such as would be desireable for the study of a region in the deep mantle. We present benchmark tests showing how the uncertainties in the reference 3D model employed outside of the target region affects the quality of the regional tomographic images obtained.

  7. Prevalence of Pancreatic Steatosis at a Pediatric Tertiary Care Center.

    PubMed

    Pham, Yen H; Bingham, Brigid A; Bell, Cynthia S; Greenfield, Susan A; John, Susan D; Robinson, Lawrence H; Eissa, Mona A

    2016-03-01

    Pancreatic steatosis in adults has been proposed to be associated with obesity; however, data on pancreatic steatosis in children are lacking. Our study aimed to measure the prevalence of pancreatic steatosis in children and to examine its association with obesity and nonalcoholic fatty liver disease. This is a retrospective chart review study of 232 patients 2 to 18 years old who underwent abdominal computed tomographic imaging in the emergency department or inpatient ward within a 1-year time span and from whom demographics, anthropometrics, and medical history were obtained. Our radiologist determined mean Hounsfield unit (HU) measurements for the pancreas, liver, and spleen. A difference of -20 between the pancreas and spleen (psHU) and between the liver and spleen was used to determine fatty infiltration. Of the 232 patients, 11.5% had a psHU less than -20. The prevalence of pancreatic steatosis was more than double among obese children (19%) than that in nonobese groups (8%). There is a significant correlation between the psHU and liver-spleen HU (r = 0.50, P < 0.001). Pancreatic steatosis was identified in 10% of the study population and is associated with obesity. Also, pancreatic steatosis is significantly associated with nonalcoholic fatty liver disease. This is the first study assessing the prevalence of pancreatic steatosis in children.

  8. Advanced cardiovascular imaging in Williams syndrome: Abnormalities, usefulness, and strategy for use.

    PubMed

    Hills, Jordan A; Zarate, Yuri A; Danylchuk, Noelle R; Lepard, Tiffany; Chen, Jean Chi-Jen; Collins, Ronnie Thomas

    2017-05-01

    Extracardiac arterial stenoses are not uncommon in Williams syndrome (WS); however, data on the utility of advanced cardiovascular imaging (CVI) to assess these stenoses are lacking. We retrospectively reviewed the frequency, indication, and diagnostic outcomes of CVI modalities performed in patients with WS evaluated at a single institution between 2001 and 2014. Data were collected and analyzed from 34 patients (56% female) who underwent CVI during the study period. The median age was 10 years (range 1.8-33 years). Excluding echocardiograms, 78 CVI studies "advanced" were performed in the 34 patients (mean 2.3 studies/patient). The most common advanced CVI was renal ultrasound with Doppler (29/34, 85%), followed by computed tomographic angiography (13/34, 38%) and magnetic resonance angiography in (9/34, 26%). Abnormalities were detected in 62% of patients (21/34). For the 20 patients in whom advanced CVI were performed for defined clinical indications, the rate of abnormalities were 73, 70, 57, and 100% when performed for anatomic delineation (15 patients), hypertension (10 patients), bruits (7 patients), and/or decreased peripheral pulses (2 patients), respectively. Advanced CVI in patients with WS reveals abnormalities in the majority of cases, and physical exam findings frequently indicate abnormalities on advanced CVI. © 2017 Wiley Periodicals, Inc.

  9. Radiological and archaeological investigation of a mummy from Roman Egypt curated in the National Museum of Lithuania.

    PubMed

    Piombino-Mascali, Dario; Jankauskas, Rimantas; Snitkuvienė, Aldona; Rutkauskas, Tadas; Sutherland, M Linda

    2016-01-01

    Among the collections belonging to the National Museum of Lithuania at Vilnius, resides an ancient Egyptian coffin containing a mummified human body. The coffin and its occupant are believed to have belonged to the King of Poland and to have been located in his palace at Warsaw. At the turn of the last century, Egyptologists dated the coffin to the end of the 21st dynasty (1070 BC-945 BC), and described the item as coming from Thebes, belonging to Hori, priest of Amun-Ra. However, no investigation was ever carried out on the human body associated with the coffin. Within the framework of the Lithuanian Mummy Project, the preserved human remains underwent computed tomographic investigation in order to reconstruct the biological profile of the subject and to determine the embalming method employed. This led to the identification of a young adult male. Additionally, the mummy shroud was stylistically assessed in order to determine the mummy's chronology in Egyptian history. Interestingly, the body could be ascribed to the Roman period of Egypt (30 BC-395 AD) due to analogies with the burial shrouds of the Soter group. This indicates a reuse of the coffin at some point in history.

  10. Computed tomographic imaging in the pediatric patient with a seatbelt sign: still not good enough.

    PubMed

    Kopelman, Tammy R; Jamshidi, Ramin; Pieri, Paola G; Davis, Karole; Bogert, James; Vail, Sydney J; Gridley, Daniel; Singer Pressman, Melissa A

    2018-02-01

    Considering the improvements in CT over the past decade, this study aimed to determine whether CT can diagnose HVI in pediatric trauma patients with seatbelt signs (SBS). We retrospectively identified pediatric patients with SBS who had abdominopelvic CT performed on initial evaluation over 5 1/2years. Abnormal CT was defined by identification of any intra-abdominal abnormality possibly related to trauma. One hundred twenty patients met inclusion criteria. CT was abnormal in 38/120 (32%) patients: 34 scans had evidence of HVI and 6 showed solid organ injury (SOI). Of the 34 with suspicion for HVI, 15 (44%) had small amounts of isolated pelvic free fluid as the only abnormal CT finding; none required intervention. Ultimately, 16/120 (13%) patients suffered HVI and underwent celiotomy. Three patients initially had a normal CT but required celiotomy for clinical deterioration within 20h of presentation. False negative CT rate was 3.6%. The sensitivity, specificity and accuracy of CT to diagnose significant HVI in the presence of SBS were 81%, 80%, and 80%, respectively. Despite improvements in CT, pediatric patients with SBS may have HVI not evident on initial CT confirming the need to observation for delayed manifestation of HVI. Level II Study of a Diagnostic Test. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Hyperbaric therapy for a postpartum patient with prolonged epidural blockade and tomographic evidence of epidural air.

    PubMed

    Panni, Moeen K; Camann, William; Bhavani Shankar, Kodali

    2003-12-01

    We used the epidural technique "loss of resistance to air" to provide labor analgesia in a healthy parturient. Inadequate analgesia required epidural catheter replacement using the same technique. Delayed recovery of sensory and motor blockade postpartum necessitated computed tomography and magnetic resonance imaging studies. These revealed 4-6 mL of air in the epidural space with no evidence of thecal compression. On the advice of the neurologist, this patient underwent hyperbaric therapy 14 h after the discontinuation of the epidural infusion. The patient made a complete recovery and was discharged without neurologic sequelae. It is possible that epidural air delayed the absorption of local anesthetics as a result of a reduction in the vascular surface area. Although a cause and effect relationship between epidural air and prolonged neurological block cannot be categorically established, the use of "loss of resistance to air" technique complicated the differential diagnosis. We report a case of prolonged motor and sensory block after labor analgesia using "loss of resistance to air" technique. The presence of epidural air on tomography resulted in the patient undergoing hyperbaric therapy. The use of loss of resistance to air technique complicated the differential diagnosis of prolonged sensory and motor block.

  12. Portable imaging system method and apparatus

    DOEpatents

    Freifeld, Barry M.; Kneafsley, Timothy J.; Pruess, Jacob; Tomutsa, Liviu; Reiter, Paul A.; deCastro, Ted M.

    2006-07-25

    An operator shielded X-ray imaging system has sufficiently low mass (less than 300 kg) and is compact enough to enable portability by reducing operator shielding requirements to a minimum shielded volume. The resultant shielded volume may require a relatively small mass of shielding in addition to the already integrally shielded X-ray source, intensifier, and detector. The system is suitable for portable imaging of well cores at remotely located well drilling sites. The system accommodates either small samples, or small cross-sectioned objects of unlimited length. By rotating samples relative to the imaging device, the information required for computer aided tomographic reconstruction may be obtained. By further translating the samples relative to the imaging system, fully three dimensional (3D) tomographic reconstructions may be obtained of samples having arbitrary length.

  13. Unipolar Endocardial Voltage Mapping in the Right Ventricle: Optimal Cutoff Values Correcting for Computed Tomography-Derived Epicardial Fat Thickness and Their Clinical Value for Substrate Delineation.

    PubMed

    Venlet, Jeroen; Piers, Sebastiaan R D; Kapel, Gijsbert F L; de Riva, Marta; Pauli, Philippe F G; van der Geest, Rob J; Zeppenfeld, Katja

    2017-08-01

    Low endocardial unipolar voltage (UV) at sites with normal bipolar voltage (BV) may indicate epicardial scar. Currently applied UV cutoff values are based on studies that lacked epicardial fat information. This study aimed to define endocardial UV cutoff values using computed tomography-derived fat information and to analyze their clinical value for right ventricular substrate delineation. Thirty-three patients (50±14 years; 79% men) underwent combined endocardial-epicardial right ventricular electroanatomical mapping and ablation of right ventricular scar-related ventricular tachycardia with computed tomographic image integration, including computed tomography-derived fat thickness. Of 6889 endocardial-epicardial mapping point pairs, 547 (8%) pairs with distance <10 mm and fat thickness <1.0 mm were analyzed for voltage and abnormal (fragmented/late potential) electrogram characteristics. At sites with endocardial BV >1.50 mV, the optimal endocardial UV cutoff for identification of epicardial BV <1.50 mV was 3.9 mV (area under the curve, 0.75; sensitivity, 60%; specificity, 79%) and cutoff for identification of abnormal epicardial electrogram was 3.7 mV (area under the curve, 0.88; sensitivity, 100%; specificity, 67%). The majority of abnormal electrograms (130 of 151) were associated with transmural scar. Eighty-six percent of abnormal epicardial electrograms had corresponding endocardial sites with BV <1.50 mV, and the remaining could be identified by corresponding low endocardial UV <3.7 mV. For identification of epicardial right ventricular scar, an endocardial UV cutoff value of 3.9 mV is more accurate than previously reported cutoff values. Although the majority of epicardial abnormal electrograms are associated with transmural scar with low endocardial BV, the additional use of endocardial UV at normal BV sites improves the diagnostic accuracy resulting in identification of all epicardial abnormal electrograms at sites with <1.0 mm fat. © 2017 American Heart Association, Inc.

  14. Accuracy of Computed Tomographic Perfusion in Diagnosis of Brain Death: A Prospective Cohort Study.

    PubMed

    Sawicki, Marcin; Sołek-Pastuszka, Joanna; Chamier-Ciemińska, Katarzyna; Walecka, Anna; Bohatyrewicz, Romuald

    2018-05-04

    BACKGROUND This study was designed to determine diagnostic accuracy of computed tomographic perfusion (CTP) compared to computed tomographic angiography (CTA) for the diagnosis of brain death (BD). MATERIAL AND METHODS Whole-brain CTP was performed in patients diagnosed with BD and in patients with devastating brain injury with preserved brainstem reflexes. CTA was derived from CTP datasets. Cerebral blood flow (CBF) and volume (CBV) were calculated in all brain regions. CTP findings were interpreted as confirming diagnosis of BD (positive) when CBF and CBV in all ROIs were below 10 mL/100 g/min and 1.0 mL/100 g, respectively. CTA findings were interpreted using a 4-point system. RESULTS Fifty brain-dead patients and 5 controls were included. In brain-dead patients, CTP results revealed CBF 0.00-9.98 mL/100 g/min and CBV 0.00-0.99 mL/100 g, and were thus interpreted as positive in all patients. CTA results suggested 7 negative cases, providing 86% sensitivity. In the non-brain-dead group, CTP results revealed CBF 2.37-37.59 mL/100 g/min and CBV 0.73-2.34 mL/100 g. The difference between values of CBF and CBV in the brain-dead and non-brain-dead groups was statistically significant (p=0.002 for CBF and p=0.001 for CBV). CTP findings in all non-brain-dead patients were interpreted as negative. This resulted in a specificity of 100% (95% CI, 0.31-1.00) for CTP in the diagnosis of BD. In all non-brain-dead patients, CTA revealed preserved intracranial filling and was interpreted as negative. This resulted in a specificity of 100% (95% CI, 0.31-1.00) for CTA in diagnosis of BD. CONCLUSIONS Whole-brain CTP seems to be a highly sensitive and specific method in diagnosis of BD.

  15. Change of aortic length after closing-opening wedge osteotomy for patients with ankylosing spondylitis with thoracolumbar kyphosis: a computed tomographic study.

    PubMed

    Ji, Ming-Liang; Qian, Bang-ping; Qiu, Yong; Wang, Bin; Zhu, Ze-zhang; Yu, Yang; Jiang, Jun

    2013-10-15

    A computed tomographic study. To investigate the change in aortic length in patients with ankylosing spondylitis (AS) with thoracolumbar kyphosis after closing-opening wedge osteotomy (COWO). Several previous studies reported that COWO can effectively correct severe thoracolumbar kyphosis caused by AS. However, one disadvantage of COWO is elongation of the aorta, which increases the risk of aortic injury. To date, no studies have analyzed the alteration in aortic length in patients with AS undergoing COWO for thoracolumbar kyphosis. A total of 21 consecutive patients with AS with a mean age of 38.9 years undergoing COWO for the correction of thoracolumbar kyphosis were retrospectively studied. Radiographical measurements included global kyphosis, thoracic kyphosis, lumbar lordosis, angle of fusion levels, local kyphosis, and anterior height of the osteotomized vertebra. The computed tomographic scans of the spine were used to measure the aortic diameter (at the site of the osteotomy) and length (the length between the superior endplate of the upper instrumented vertebra and the inferior endplate of L4). The aortic length increased by an average of 2.2 cm postoperatively. Significant changes in global kyphosis, local kyphosis, angle of fusion levels, lumbar lordosis, anterior height of the osteotomized vertebra, and aortic diameter at the site of the osteotomy were observed (P < 0.01). Significant correlation was noted between aortic length and changes in global kyphosis (r = 0.525, P = 0.015), local kyphosis (r = 0.654, P = 0.001), angle of fusion levels (r = 0.634, P = 0.002), and lumbar lordosis (r = 0.538, P = 0.012). Aortic lengthening after COWO for correction of kyphosis was quantitatively confirmed by this study. Spine surgeons should be aware of the potential risk for the development of aortic injury in patients with AS undergoing COWO for the correction of thoracolumbar kyphosis. 4.

  16. 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 the development of abdominal complications caused by the lengthening of longitudinal diameter of the abdominal cavity. 3.

  17. Wave Propagation in Non-Stationary Statistical Mantle Models at the Global Scale

    NASA Astrophysics Data System (ADS)

    Meschede, M.; Romanowicz, B. A.

    2014-12-01

    We study the effect of statistically distributed heterogeneities that are smaller than the resolution of current tomographic models on seismic waves that propagate through the Earth's mantle at teleseismic distances. Current global tomographic models are missing small-scale structure as evidenced by the failure of even accurate numerical synthetics to explain enhanced coda in observed body and surface waveforms. One way to characterize small scale heterogeneity is to construct random models and confront observed coda waveforms with predictions from these models. Statistical studies of the coda typically rely on models with simplified isotropic and stationary correlation functions in Cartesian geometries. We show how to construct more complex random models for the mantle that can account for arbitrary non-stationary and anisotropic correlation functions as well as for complex geometries. Although this method is computationally heavy, model characteristics such as translational, cylindrical or spherical symmetries can be used to greatly reduce the complexity such that this method becomes practical. With this approach, we can create 3D models of the full spherical Earth that can be radially anisotropic, i.e. with different horizontal and radial correlation functions, and radially non-stationary, i.e. with radially varying model power and correlation functions. Both of these features are crucial for a statistical description of the mantle in which structure depends to first order on the spherical geometry of the Earth. We combine different random model realizations of S velocity with current global tomographic models that are robust at long wavelengths (e.g. Meschede and Romanowicz, 2014, GJI submitted), and compute the effects of these hybrid models on the wavefield with a spectral element code (SPECFEM3D_GLOBE). We finally analyze the resulting coda waves for our model selection and compare our computations with observations. Based on these observations, we make predictions about the strength of unresolved small-scale structure and extrinsic attenuation.

  18. Velocity Gradient Across the San Andreas Fault and Changes in Slip Behavior as Outlined by Full non Linear Tomography

    NASA Astrophysics Data System (ADS)

    Chiarabba, C.; Giacomuzzi, G.; Piana Agostinetti, N.

    2017-12-01

    The San Andreas Fault (SAF) near Parkfield is the best known fault section which exhibit a clear transition in slip behavior from stable to unstable. Intensive monitoring and decades of studies permit to identify details of these processes with a good definition of fault structure and subsurface models. Tomographic models computed so far revealed the existence of large velocity contrasts, yielding physical insight on fault rheology. In this study, we applied a recently developed full non-linear tomography method to compute Vp and Vs models which focus on the section of the fault that exhibit fault slip transition. The new tomographic code allows not to impose a vertical seismic discontinuity at the fault position, as routinely done in linearized codes. Any lateral velocity contrast found is directly dictated by the data themselves and not imposed by subjective choices. The use of the same dataset of previous tomographic studies allows a proper comparison of results. We use a total of 861 earthquakes, 72 blasts and 82 shots and the overall arrival time dataset consists of 43948 P- and 29158 S-wave arrival times, accurately selected to take care of seismic anisotropy. Computed Vp and Vp/Vs models, which by-pass the main problems related to linarized LET algorithms, excellently match independent available constraints and show crustal heterogeneities with a high resolution. The high resolution obtained in the fault surroundings permits to infer lateral changes of Vp and Vp/Vs across the fault (velocity gradient). We observe that stable and unstable sliding sections of the SAF have different velocity gradients, small and negligible in the stable slip segment, but larger than 15 % in the unstable slip segment. Our results suggest that Vp and Vp/Vs gradients across the fault control fault rheology and the attitude of fault slip behavior.

  19. Comparative Validity and Reproducibility Study of Various Landmark-Oriented Reference Planes in 3-Dimensional Computed Tomographic Analysis for Patients Receiving Orthognathic Surgery

    PubMed Central

    Lin, Hsiu-Hsia; Chuang, Ya-Fang; Weng, Jing-Ling; Lo, Lun-Jou

    2015-01-01

    Background Three-dimensional computed tomographic imaging has become popular in clinical evaluation, treatment planning, surgical simulation, and outcome assessment for maxillofacial intervention. The purposes of this study were to investigate whether there is any correlation among landmark-based horizontal reference planes and to validate the reproducibility and reliability of landmark identification. Materials and Methods Preoperative and postoperative cone-beam computed tomographic images of patients who had undergone orthognathic surgery were collected. Landmark-oriented reference planes including the Frankfort horizontal plane (FHP) and the lateral semicircular canal plane (LSP) were established. Four FHPs were defined by selecting 3 points from the orbitale, porion, or midpoint of paired points. The LSP passed through both the lateral semicircular canal points and nasion. The distances between the maxillary or mandibular teeth and the reference planes were measured, and the differences between the 2 sides were calculated and compared. The precision in locating the landmarks was evaluated by performing repeated tests, and the intraobserver reproducibility and interobserver reliability were assessed. Results A total of 30 patients with facial deformity and malocclusion—10 patients with facial symmetry, 10 patients with facial asymmetry, and 10 patients with cleft lip and palate—were recruited. Comparing the differences among the 5 reference planes showed no statistically significant difference among all patient groups. Regarding intraobserver reproducibility, the mean differences in the 3 coordinates varied from 0 to 0.35 mm, with correlation coefficients between 0.96 and 1.0, showing high correlation between repeated tests. Regarding interobserver reliability, the mean differences among the 3 coordinates varied from 0 to 0.47 mm, with correlation coefficients between 0.88 and 1.0, exhibiting high correlation between the different examiners. Conclusions The 5 horizontal reference planes were reliable and comparable for 3D craniomaxillofacial analysis. These reference planes were useful in standardizing the orientation of 3D skull models. PMID:25668209

  20. Comparative validity and reproducibility study of various landmark-oriented reference planes in 3-dimensional computed tomographic analysis for patients receiving orthognathic surgery.

    PubMed

    Lin, Hsiu-Hsia; Chuang, Ya-Fang; Weng, Jing-Ling; Lo, Lun-Jou

    2015-01-01

    Three-dimensional computed tomographic imaging has become popular in clinical evaluation, treatment planning, surgical simulation, and outcome assessment for maxillofacial intervention. The purposes of this study were to investigate whether there is any correlation among landmark-based horizontal reference planes and to validate the reproducibility and reliability of landmark identification. Preoperative and postoperative cone-beam computed tomographic images of patients who had undergone orthognathic surgery were collected. Landmark-oriented reference planes including the Frankfort horizontal plane (FHP) and the lateral semicircular canal plane (LSP) were established. Four FHPs were defined by selecting 3 points from the orbitale, porion, or midpoint of paired points. The LSP passed through both the lateral semicircular canal points and nasion. The distances between the maxillary or mandibular teeth and the reference planes were measured, and the differences between the 2 sides were calculated and compared. The precision in locating the landmarks was evaluated by performing repeated tests, and the intraobserver reproducibility and interobserver reliability were assessed. A total of 30 patients with facial deformity and malocclusion--10 patients with facial symmetry, 10 patients with facial asymmetry, and 10 patients with cleft lip and palate--were recruited. Comparing the differences among the 5 reference planes showed no statistically significant difference among all patient groups. Regarding intraobserver reproducibility, the mean differences in the 3 coordinates varied from 0 to 0.35 mm, with correlation coefficients between 0.96 and 1.0, showing high correlation between repeated tests. Regarding interobserver reliability, the mean differences among the 3 coordinates varied from 0 to 0.47 mm, with correlation coefficients between 0.88 and 1.0, exhibiting high correlation between the different examiners. The 5 horizontal reference planes were reliable and comparable for 3D craniomaxillofacial analysis. These reference planes were useful in standardizing the orientation of 3D skull models.

  1. Volumetric changes in the upper airway after bimaxillary surgery for skeletal class III malocclusions: a case series study using 3-dimensional cone-beam computed tomography.

    PubMed

    Lee, Yoonjung; Chun, Youn-Sic; Kang, Nara; Kim, Minji

    2012-12-01

    Postsurgical changes of the airway have become a great point of interest and often have been reported to be a predisposing factor for obstructive sleep apnea after mandibular setback surgery. The purpose of this study was to evaluate the 3-dimensional volumetric changes in the upper airway space of patients who underwent bimaxillary surgery to correct Class III malocclusions. This study was performed retrospectively in a group of patients who underwent bimaxillary surgery for Class III malocclusion and had full cone-beam computed tomographic (CBCT) images taken before surgery and 1 day, 3 months, and 6 months after surgery. The upper and lower parts of the airway volume and the diameters of the airway were measured from 2 different levels. Presurgical measurements and the amount of surgical correction were evaluated for their effect on airway volume. Data analyses were performed by analysis of variance and multiple stepwise regression analysis. The subjects included 21 patients (6 men and 15 women; mean age, 22.7 yrs). The surgeries were Le Fort I impaction (5.27 ± 2.58 mm impaction from the posterior nasal spine) and mandibular setback surgery (9.20 ± 4.60 mm set back from the pogonion). No statistically significant differences were found in the total airway volume for all time points. In contrast, the volume of the upper part showed an increase (12.35%) and the lower part showed a decrease (14.07%), with a statistically significant difference 6 months after surgery (P < .05). Predictor variables affecting the upper and lower parts of the airway volume were presurgical A point to Nasion-perpendicular (A to N-perp) and vertical surgical correction of the pogonion and the posterior nasal spine (P < .05). Bimaxillary surgery for the correction of Class III malocclusion affected the morphology by increasing the upper part and decreasing the lower part of the airway, but not the total volume. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Implementation of Lung Cancer Screening in the Veterans Health Administration.

    PubMed

    Kinsinger, Linda S; Anderson, Charles; Kim, Jane; Larson, Martha; Chan, Stephanie H; King, Heather A; Rice, Kathryn L; Slatore, Christopher G; Tanner, Nichole T; Pittman, Kathleen; Monte, Robert J; McNeil, Rebecca B; Grubber, Janet M; Kelley, Michael J; Provenzale, Dawn; Datta, Santanu K; Sperber, Nina S; Barnes, Lottie K; Abbott, David H; Sims, Kellie J; Whitley, Richard L; Wu, R Ryanne; Jackson, George L

    2017-03-01

    The US Preventive Services Task Force recommends annual lung cancer screening (LCS) with low-dose computed tomography for current and former heavy smokers aged 55 to 80 years. There is little published experience regarding implementing this recommendation in clinical practice. To describe organizational- and patient-level experiences with implementing an LCS program in selected Veterans Health Administration (VHA) hospitals and to estimate the number of VHA patients who may be candidates for LCS. This clinical demonstration project was conducted at 8 academic VHA hospitals among 93 033 primary care patients who were assessed on screening criteria; 2106 patients underwent LCS between July 1, 2013, and June 30, 2015. Implementation Guide and support, full-time LCS coordinators, electronic tools, tracking database, patient education materials, and radiologic and nodule follow-up guidelines. Description of implementation processes; percentages of patients who agreed to undergo LCS, had positive findings on results of low-dose computed tomographic scans (nodules to be tracked or suspicious findings), were found to have lung cancer, or had incidental findings; and estimated number of VHA patients who met the criteria for LCS. Of the 4246 patients who met the criteria for LCS, 2452 (57.7%) agreed to undergo screening and 2106 (2028 men and 78 women; mean [SD] age, 64.9 [5.1] years) underwent LCS. Wide variation in processes and patient experiences occurred among the 8 sites. Of the 2106 patients screened, 1257 (59.7%) had nodules; 1184 of these patients (56.2%) required tracking, 42 (2.0%) required further evaluation but the findings were not cancer, and 31 (1.5%) had lung cancer. A variety of incidental findings, such as emphysema, other pulmonary abnormalities, and coronary artery calcification, were noted on the scans of 857 patients (40.7%). It is estimated that nearly 900 000 of a population of 6.7 million VHA patients met the criteria for LCS. Implementation of LCS in the VHA will likely lead to large numbers of patients eligible for LCS and will require substantial clinical effort for both patients and staff.

  3. Scaled Anatomical Model Creation of Biomedical Tomographic Imaging Data and Associated Labels for Subsequent Sub-surface Laser Engraving (SSLE) of Glass Crystals.

    PubMed

    Betts, Aislinn M; McGoldrick, Matthew T; Dethlefs, Christopher R; Piotrowicz, Justin; Van Avermaete, Tony; Maki, Jeff; Gerstler, Steve; Leevy, W M

    2017-04-25

    Biomedical imaging modalities like computed tomography (CT) and magnetic resonance (MR) provide excellent platforms for collecting three-dimensional data sets of patient or specimen anatomy in clinical or preclinical settings. However, the use of a virtual, on-screen display limits the ability of these tomographic images to fully convey the anatomical information embedded within. One solution is to interface a biomedical imaging data set with 3D printing technology to generate a physical replica. Here we detail a complementary method to visualize tomographic imaging data with a hand-held model: Sub Surface Laser Engraving (SSLE) of crystal glass. SSLE offers several unique benefits including: the facile ability to include anatomical labels, as well as a scale bar; streamlined multipart assembly of complex structures in one medium; high resolution in the X, Y, and Z planes; and semi-transparent shells for visualization of internal anatomical substructures. Here we demonstrate the process of SSLE with CT data sets derived from pre-clinical and clinical sources. This protocol will serve as a powerful and inexpensive new tool with which to visualize complex anatomical structures for scientists and students in a number of educational and research settings.

  4. DRAGON score predicts functional outcomes in acute ischemic stroke patients receiving both intravenous tissue plasminogen activator and endovascular therapy.

    PubMed

    Wang, Arthur; Pednekar, Noorie; Lehrer, Rachel; Todo, Akira; Sahni, Ramandeep; Marks, Stephen; Stiefel, Michael F

    2017-01-01

    The DRAGON score, which includes clinical and computed tomographic (CT) scan parameters, predicts functional outcomes in ischemic stroke patients treated with intravenous tissue plasminogen activator (IV tPA). We assessed the utility of the DRAGON score in predicting functional outcome in stroke patients receiving both IV tPA and endovascular therapy. A retrospective chart review of patients treated at our institution from February 2009 to October 2015 was conducted. All patients with computed tomography angiography (CTA) proven large vessel occlusions (LVO) who underwent intravenous thrombolysis and endovascular therapy were included. Baseline DRAGON scores and modified Rankin Score (mRS) at the time of hospital discharge was calculated. Good outcome was defined as mRS ≤3. Fifty-eight patients with LVO of the anterior circulation were studied. The mean DRAGON score of patients on admission was 5.3 (range, 3-8). All patients received IV tPA and endovascular therapy. Multivariate analysis demonstrated that DRAGON scores ≥7 was associated with higher mRS ( P < 0.006) and higher mortality ( P < 0.0001) compared with DRAGON scores ≤6. Patients with DRAGON scores of 7 and 8 on admission had a mortality rate of 3.8% and 40%, respectively. The DRAGON score can help predict better functional outcomes in ischemic stroke patients receiving both IV tPA and endovascular therapy. This data supports the use of the DRAGON score in selecting patients who could potentially benefit from more invasive therapies such as endovascular treatment. Larger prospective studies are warranted to further validate these results.

  5. Utilization of Cone-Beam Computed Tomographic Angiography in Planning for Gamma Knife Radiosurgery of Arteriovenous Malformations: A Case Series and Early Report

    PubMed Central

    Safain, Mina G.; Rahal, Jason P.; Raval, Ami; Rivard, Mark J.; Mignano, John; Wu, Julian; Malek, Adel M.

    2014-01-01

    Background The effectiveness of Gamma Knife radiosurgery (GKR) for cerebral arteriovenous malformations (AVM) is predicated on inclusion of the entire nidus while excluding normal tissue. As such, GKR may be limited by the resolution and accuracy of the imaging modality used in targeting. Objective We present the first case series to demonstrate the feasibility of utilizing ultra-high-resolution C-arm cone beam computed tomography angiography (CBCT-A) in AVM targeting. Methods From June 2009 to June 2013, CBCT-A was utilized for targeting of all patients with AVMs treated with GKR at our institution. Patients underwent Leksell stereotactic head frame placement followed by catheter-based biplane 2-D digital subtraction angiography (DSA), 3-D rotational angiography (3DRA), as well as CBCT-A. The CBCT-A dataset was used for stereotactic planning for GKR. Patients were followed up at 1, 3, 6, and 12 months, and then annually thereafter. Results CBCT-A-based targeting was used in twenty-two consecutive patients. CBCT-A provided detailed spatial resolution and sensitivity of nidal angioarchitecture enabling treatment. The average radiation dose to the margin of the AVM nidus corresponding to the 50% percent isodose line was 15.6 Gy. No patient had treatment-associated hemorrhage. At early follow-up (mean=16 months), 84% of patients had a decreasing or obliterated AVM nidus. Conclusion CBCT-A-guided radiosurgery is feasible and useful because it provides sufficient detailed resolution and sensitivity for imaging brain AVMs. PMID:24584136

  6. Binary Decision Trees for Preoperative Periapical Cyst Screening Using Cone-beam Computed Tomography.

    PubMed

    Pitcher, Brandon; Alaqla, Ali; Noujeim, Marcel; Wealleans, James A; Kotsakis, Georgios; Chrepa, Vanessa

    2017-03-01

    Cone-beam computed tomographic (CBCT) analysis allows for 3-dimensional assessment of periradicular lesions and may facilitate preoperative periapical cyst screening. The purpose of this study was to develop and assess the predictive validity of a cyst screening method based on CBCT volumetric analysis alone or combined with designated radiologic criteria. Three independent examiners evaluated 118 presurgical CBCT scans from cases that underwent apicoectomies and had an accompanying gold standard histopathological diagnosis of either a cyst or granuloma. Lesion volume, density, and specific radiologic characteristics were assessed using specialized software. Logistic regression models with histopathological diagnosis as the dependent variable were constructed for cyst prediction, and receiver operating characteristic curves were used to assess the predictive validity of the models. A conditional inference binary decision tree based on a recursive partitioning algorithm was constructed to facilitate preoperative screening. Interobserver agreement was excellent for volume and density, but it varied from poor to good for the radiologic criteria. Volume and root displacement were strong predictors for cyst screening in all analyses. The binary decision tree classifier determined that if the volume of the lesion was >247 mm 3 , there was 80% probability of a cyst. If volume was <247 mm 3 and root displacement was present, cyst probability was 60% (78% accuracy). The good accuracy and high specificity of the decision tree classifier renders it a useful preoperative cyst screening tool that can aid in clinical decision making but not a substitute for definitive histopathological diagnosis after biopsy. Confirmatory studies are required to validate the present findings. Published by Elsevier Inc.

  7. Studies in fat grafting: Part III. Fat grafting irradiated tissue--improved skin quality and decreased fat graft retention.

    PubMed

    Garza, Rebecca M; Paik, Kevin J; Chung, Michael T; Duscher, Dominik; Gurtner, Geoffrey C; Longaker, Michael T; Wan, Derrick C

    2014-08-01

    Following radiation therapy, skin becomes fibrotic and can present a difficult problem for reconstructive surgeons. There is an increasing belief that fat grafting under irradiated skin can reverse the damage caused by radiation. The present study evaluated the effect of fat grafting on irradiated skin, along with fat graft quality and retention rates in irradiated tissue. Nine adult Crl:NU-Foxn1 CD-1 mice underwent 30-Gy external beam irradiation of the scalp. Four weeks after irradiation, scalp skin from irradiated and nonirradiated mice was harvested and compared histologically for dermal thickness, collagen content, and vascular density. Human fat grafts were then injected in the subcutaneous plane of the scalp. Skin assessment was performed in the irradiated group at 2 and 8 weeks after grafting, and fat graft retention was measured at baseline and every 2 weeks up to 8 weeks after grafting using micro-computed tomography. Finally, fat graft samples were explanted at 8 weeks, and quality scoring was performed. Fat grafting resulted in decreased dermal thickness, decreased collagen content, and increased vascular density in irradiated skin. Computed tomographic analysis revealed significantly decreased fat graft survival in the irradiated group compared with the nonirradiated group. Histologic scoring of explanted fat grafts demonstrated no difference in quality between the irradiated and nonirradiated groups. Fat grafting attenuates dermal collagen deposition and vessel depletion characteristic of radiation fibrosis. Although fat graft retention rates are significantly lower in irradiated than in nonirradiated tissue, the quality of retained fat between the groups is similar.

  8. Sixteen-slice multidetector computed tomographic virtual cystoscopy in the evaluation of a patient with suspected bladder tumor and history of bladder carcinoma operation.

    PubMed

    Basak, Muzaffer; Ozkurt, Huseyin; Tanriverdi, Orhan; Cay, Esra; Aydin, Mustafa; Miroglu, Cengiz

    2009-01-01

    The purpose of this study was to evaluate the use of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with suspected bladder tumors and histories of bladder carcinoma operation. Thirty-six patients (29 men and 7 women) with a mean age of 66 years (range, 24-88 years) with suspected bladder tumors and histories of bladder carcinoma operation were included in this prospective study. Virtual cystoscopy was performed by 16-slice multidetector CT scanner. The bladder was filled with diluted contrast material solution through a Foley catheter. Then, all patients underwent conventional cystoscopy examination. Two reviewers found 18 lesions detected by virtual cystoscopy by consensus, whereas 19 lesions were depicted by conventional cystoscopy. At virtual and conventional cystoscopies, the conditions of 3 patients, 2 with chronic inflammations and 1 with foreign body reaction, were wrongly diagnosed as tumors. At conventional cystoscopy, one patient's result was wrongly interpreted as normal. In pathologic evaluation, all tumors were diagnosed as transitional cell carcinoma. Bladder tumor can be noninvasively diagnosed using virtual cystoscopy. Use of virtual cystoscopy should be considered inpatients who present with hematuria or have histories of bladder carcinoma operation and are for follow-up because of its lesser complication risk and its being a less invasive, easily applied procedure without need of anesthesia. In the future, owing to the development of the CT technology and image processing technique, virtual cystoscopy may have a part in the detection of bladder cancer.

  9. Computational adaptive optics for broadband optical interferometric tomography of biological tissue.

    PubMed

    Adie, Steven G; Graf, Benedikt W; Ahmad, Adeel; Carney, P Scott; Boppart, Stephen A

    2012-05-08

    Aberrations in optical microscopy reduce image resolution and contrast, and can limit imaging depth when focusing into biological samples. Static correction of aberrations may be achieved through appropriate lens design, but this approach does not offer the flexibility of simultaneously correcting aberrations for all imaging depths, nor the adaptability to correct for sample-specific aberrations for high-quality tomographic optical imaging. Incorporation of adaptive optics (AO) methods have demonstrated considerable improvement in optical image contrast and resolution in noninterferometric microscopy techniques, as well as in optical coherence tomography. Here we present a method to correct aberrations in a tomogram rather than the beam of a broadband optical interferometry system. Based on Fourier optics principles, we correct aberrations of a virtual pupil using Zernike polynomials. When used in conjunction with the computed imaging method interferometric synthetic aperture microscopy, this computational AO enables object reconstruction (within the single scattering limit) with ideal focal-plane resolution at all depths. Tomographic reconstructions of tissue phantoms containing subresolution titanium-dioxide particles and of ex vivo rat lung tissue demonstrate aberration correction in datasets acquired with a highly astigmatic illumination beam. These results also demonstrate that imaging with an aberrated astigmatic beam provides the advantage of a more uniform depth-dependent signal compared to imaging with a standard gaussian beam. With further work, computational AO could enable the replacement of complicated and expensive optical hardware components with algorithms implemented on a standard desktop computer, making high-resolution 3D interferometric tomography accessible to a wider group of users and nonspecialists.

  10. 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.

  11. The visible ear simulator: a public PC application for GPU-accelerated haptic 3D simulation of ear surgery based on the visible ear data.

    PubMed

    Sorensen, Mads Solvsten; Mosegaard, Jesper; Trier, Peter

    2009-06-01

    Existing virtual simulators for middle ear surgery are based on 3-dimensional (3D) models from computed tomographic or magnetic resonance imaging data in which image quality is limited by the lack of detail (maximum, approximately 50 voxels/mm3), natural color, and texture of the source material.Virtual training often requires the purchase of a program, a customized computer, and expensive peripherals dedicated exclusively to this purpose. The Visible Ear freeware library of digital images from a fresh-frozen human temporal bone was segmented, and real-time volume rendered as a 3D model of high-fidelity, true color, and great anatomic detail and realism of the surgically relevant structures. A haptic drilling model was developed for surgical interaction with the 3D model. Realistic visualization in high-fidelity (approximately 125 voxels/mm3) and true color, 2D, or optional anaglyph stereoscopic 3D was achieved on a standard Core 2 Duo personal computer with a GeForce 8,800 GTX graphics card, and surgical interaction was provided through a relatively inexpensive (approximately $2,500) Phantom Omni haptic 3D pointing device. This prototype is published for download (approximately 120 MB) as freeware at http://www.alexandra.dk/ves/index.htm.With increasing personal computer performance, future versions may include enhanced resolution (up to 8,000 voxels/mm3) and realistic interaction with deformable soft tissue components such as skin, tympanic membrane, dura, and cholesteatomas-features some of which are not possible with computed tomographic-/magnetic resonance imaging-based systems.

  12. The Dynamo package for tomography and subtomogram averaging: components for MATLAB, GPU computing and EC2 Amazon Web Services

    PubMed Central

    Castaño-Díez, Daniel

    2017-01-01

    Dynamo is a package for the processing of tomographic data. As a tool for subtomogram averaging, it includes different alignment and classification strategies. Furthermore, its data-management module allows experiments to be organized in groups of tomograms, while offering specialized three-dimensional tomographic browsers that facilitate visualization, location of regions of interest, modelling and particle extraction in complex geometries. Here, a technical description of the package is presented, focusing on its diverse strategies for optimizing computing performance. Dynamo is built upon mbtools (middle layer toolbox), a general-purpose MATLAB library for object-oriented scientific programming specifically developed to underpin Dynamo but usable as an independent tool. Its structure intertwines a flexible MATLAB codebase with precompiled C++ functions that carry the burden of numerically intensive operations. The package can be delivered as a precompiled standalone ready for execution without a MATLAB license. Multicore parallelization on a single node is directly inherited from the high-level parallelization engine provided for MATLAB, automatically imparting a balanced workload among the threads in computationally intense tasks such as alignment and classification, but also in logistic-oriented tasks such as tomogram binning and particle extraction. Dynamo supports the use of graphical processing units (GPUs), yielding considerable speedup factors both for native Dynamo procedures (such as the numerically intensive subtomogram alignment) and procedures defined by the user through its MATLAB-based GPU library for three-dimensional operations. Cloud-based virtual computing environments supplied with a pre-installed version of Dynamo can be publicly accessed through the Amazon Elastic Compute Cloud (EC2), enabling users to rent GPU computing time on a pay-as-you-go basis, thus avoiding upfront investments in hardware and longterm software maintenance. PMID:28580909

  13. The Dynamo package for tomography and subtomogram averaging: components for MATLAB, GPU computing and EC2 Amazon Web Services.

    PubMed

    Castaño-Díez, Daniel

    2017-06-01

    Dynamo is a package for the processing of tomographic data. As a tool for subtomogram averaging, it includes different alignment and classification strategies. Furthermore, its data-management module allows experiments to be organized in groups of tomograms, while offering specialized three-dimensional tomographic browsers that facilitate visualization, location of regions of interest, modelling and particle extraction in complex geometries. Here, a technical description of the package is presented, focusing on its diverse strategies for optimizing computing performance. Dynamo is built upon mbtools (middle layer toolbox), a general-purpose MATLAB library for object-oriented scientific programming specifically developed to underpin Dynamo but usable as an independent tool. Its structure intertwines a flexible MATLAB codebase with precompiled C++ functions that carry the burden of numerically intensive operations. The package can be delivered as a precompiled standalone ready for execution without a MATLAB license. Multicore parallelization on a single node is directly inherited from the high-level parallelization engine provided for MATLAB, automatically imparting a balanced workload among the threads in computationally intense tasks such as alignment and classification, but also in logistic-oriented tasks such as tomogram binning and particle extraction. Dynamo supports the use of graphical processing units (GPUs), yielding considerable speedup factors both for native Dynamo procedures (such as the numerically intensive subtomogram alignment) and procedures defined by the user through its MATLAB-based GPU library for three-dimensional operations. Cloud-based virtual computing environments supplied with a pre-installed version of Dynamo can be publicly accessed through the Amazon Elastic Compute Cloud (EC2), enabling users to rent GPU computing time on a pay-as-you-go basis, thus avoiding upfront investments in hardware and longterm software maintenance.

  14. Colonic polyps: application value of computer-aided detection in computed tomographic colonography.

    PubMed

    Zhang, Hui-Mao; Guo, Wei; Liu, Gui-Feng; An, Dong-Hong; Gao, Shuo-Hui; Sun, Li-Bo; Yang, Hai-Shan

    2011-02-01

    Colonic polyps are frequently encountered in clinics. Computed tomographic colonography (CTC), as a painless and quick detection, has high values in clinics. In this study, we evaluated the application value of computer-aided detection (CAD) in CTC detection of colonic polyps in the Chinese population. CTC was performed with a GE 64-row multidetector computed tomography (MDCT) scanner. Data of 50 CTC patients (39 patients positive for at least one polyp of ≥ 0.5 cm in size and the other 11 patients negative by endoscopic detection) were retrospectively reviewed first without computer-aided detection (CAD) and then with CAD by four radiologists (two were experienced and another two inexperienced) blinded to colonoscopy findings. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of detected colonic polyps, as well as the areas under the ROC curves (Az value) with and without CAD were calculated. CAD increased the overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the colonic polyps detected by experienced and inexperienced readers. The sensitivity in detecting small polyps (5 - 9 mm) with CAD in experienced and inexperienced readers increased from 82% and 44% to 93% and 82%, respectively (P > 0.05 and P < 0.001). With the use of CAD, the overall false positive rate and false negative rate for the detection of polyps by experienced and inexperienced readers decreased in different degrees. Among 13 sessile polyps not detected by CAD, two were ≥ 1.0 cm, eleven were 5 - 9 mm in diameter, and nine were flat-shaped lesions. The application of CAD in combination with CTC can increase the ability to detect colonic polyps, particularly for inexperienced readers. However, CAD is of limited value for the detection of flat polyps.

  15. Which test for CAD should be used in patients with left bundle branch block?

    PubMed

    Xu, Bo; Cremer, Paul; Jaber, Wael; Moir, Stuart; Harb, Serge C; Rodriguez, L Leonardo

    2018-03-01

    Exercise stress electrocardiography is unreliable as a test for obstructive coronary artery disease (CAD) if the patient has left bundle branch block. The authors provide an algorithm for using alternative tests: exercise stress echocardiography, dobutamine echocardiography, computed tomographic (CT) angiography, and nuclear myocardial perfusion imaging. Copyright © 2018 Cleveland Clinic.

  16. High resolution microtomography for density and spatial infomation about wood structures

    Treesearch

    Barbara Illman; Betsy Dowd

    1999-01-01

    Microtomography has successfully been used to characterize loss of structural integrity of wood. Tomographic images were generated with the newly developed third generation x-ray computed microtomography (XCMT) instrument at the X27A beamline at the national Synchrotron Light source (NSLS). The beamline is equipped with high-flux x-ray monochromator based on multilayer...

  17. [Computed tomographic and clinical validation of the use of endosseous titanium nickelide dental implants].

    PubMed

    Temerkhanov, F T; Garafutdinov, D M; Arkharov, S L

    1997-01-01

    The authors analyze the efficacy of repair of atrophied [correction of arthrophic] alveolar processes of the jaws in the projections of the maxillary sinus and inferior alveolar canal with endosseous implants with porous cone-dilating mesostructure made of TN-1P alloy. Prospects for using the new implant design are outlined.

  18. Tomographic Imaging of Water Injection and Withdrawal in PEMFC Gas Diffusion Layers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McGill U; Gostick, J. T.; Gunterman, H. P.

    2010-06-25

    X-ray computed tomography was used to visualize the water configurations inside gas diffusion layers for various applied capillary pressures, corresponding to both water invasion and withdrawal. A specialized sample holder was developed to allow capillary pressure control on the small-scale samples required. Tests were performed on GDL specimens with and without hydrophobic treatments.

  19. Delayed cerebral development in twins with congenital hyperthyroidism.

    PubMed

    Kopelman, A E

    1983-09-01

    Twins had congenital hyperthyroidism and delayed cerebral development manifested as ventriculomegaly, increased space in the interhemispheric fissure, and an exaggerated gyral pattern on cranial computed tomographic scans. At 3 1/2 years of age, both children had delayed development. Fetal and neonatal hyperthyroidism may interfere with normal brain growth and maturation with both neuranatomic and developmental sequelae.

  20. Adaptive optics fundus images of cone photoreceptors in the macula of patients with retinitis pigmentosa.

    PubMed

    Tojo, Naoki; Nakamura, Tomoko; Fuchizawa, Chiharu; Oiwake, Toshihiko; Hayashi, Atsushi

    2013-01-01

    The purpose of this study was to examine cone photoreceptors in the macula of patients with retinitis pigmentosa using an adaptive optics fundus camera and to investigate any correlations between cone photoreceptor density and findings on optical coherence tomography and fundus autofluorescence. We examined two patients with typical retinitis pigmentosa who underwent ophthalmological examination, including measurement of visual acuity, and gathering of electroretinographic, optical coherence tomographic, fundus autofluorescent, and adaptive optics fundus images. The cone photoreceptors in the adaptive optics images of the two patients with retinitis pigmentosa and five healthy subjects were analyzed. An abnormal parafoveal ring of high-density fundus autofluorescence was observed in the macula in both patients. The border of the ring corresponded to the border of the external limiting membrane and the inner segment and outer segment line in the optical coherence tomographic images. Cone photoreceptors at the abnormal parafoveal ring were blurred and decreased in the adaptive optics images. The blurred area corresponded to the abnormal parafoveal ring in the fundus autofluorescence images. Cone densities were low at the blurred areas and at the nasal and temporal retina along a line from the fovea compared with those of healthy controls. The results for cone spacing and Voronoi domains in the macula corresponded with those for the cone densities. Cone densities were heavily decreased in the macula, especially at the parafoveal ring on high-density fundus autofluorescence in both patients with retinitis pigmentosa. Adaptive optics images enabled us to observe in vivo changes in the cone photoreceptors of patients with retinitis pigmentosa, which corresponded to changes in the optical coherence tomographic and fundus autofluorescence images.

  1. Box Tomography: An efficient tomographic method for imaging localized structures in the deep Earth

    NASA Astrophysics Data System (ADS)

    Masson, Yder; Romanowicz, Barbara

    2017-04-01

    The accurate imaging of localized geological structures inside the deep Earth is key to understand our planet and its history. Since the introduction of the Preliminary Reference Earth Model, many generations of global tomographic models have been developed and give us access to the 3D structure of the Earth's interior. The latest generation of global tomographic models has emerged with the development of accurate numerical wavefield computations in a 3D earth combined with access to enhanced HPC capabilities. These models have sharpened up mantle images and unveiled relatively small scale structures that were blurred out in previous generation models. Fingerlike structures have been found at the base of the oceanic asthenosphere, and vertically oriented broad low velocity plume conduits [1] extend throughout the lower mantle beneath those major hotspots that are located within the perimeter of the deep mantle large low shear velocity provinces (LLSVPs). While providing new insights into our understanding of mantle dynamics, the detailed morphology of these features requires further efforts to obtain higher resolution images. In recent years, we developed a theoretical framework [2][3] for the tomographic imaging of localised geological structures buried inside the Earth, where no seismic sources nor receivers are necessarily present. We call this "box tomography" [4]. The essential difference between box-tomography and standard tomographic methods is that the numerical modeling (i.e. the raytracing in travel time tomography and the wave propagation in waveform tomography or full waveform inversion) is completely confined within the small box-region imaged. Thus, box tomography is a lot more efficient than global tomography (i.e. where we invert for the velocity in the larger volume that encompasses all the sources and receivers), for imaging localised objects. We present 2D and 3D examples showing that box tomography can be employed for imaging structures present within the D'' region at the base of the mantle. Further, we show that box-tomography performs well even in the difficult situation where the velocity distribution in the mantle above the target structure is not known a-priori. REFERENCES [1] French, S. W. and B. Romanowicz (2015) Broad Plumes at the base of the mantle beneath major hotspots, Nature, 525, 95-99 [2] Masson, Y., Cupillard, P., Capdeville, Y., & Romanowicz, B. (2013). On the numerical implementation of time-reversal mirrors for tomographic imaging. Geophysical Journal International, ggt459. [3] Masson, Y., & Romanowicz, B. (2017). Fast computation of synthetic seismograms within a medium containing remote localized perturbations: a numerical solution to the scattering problem. Geophysical Journal International, 208(2), 674-692. [4] Masson, Y., & Romanowicz, B. (2017). Box Tomography: Localised imaging of remote targets buried in an unknown medium, a step forward for understanding key structures in the deep Earth. Geophysical Journal International, (under review).

  2. X-ray fluorescence tomographic system design and image reconstruction.

    PubMed

    Cong, Wenxiang; Shen, Haiou; Cao, Guohua; Liu, Hong; Wang, Ge

    2013-01-01

    In this paper, we presented a new design of x-ray fluorescence CT imaging system. For detecting fuorescence signals of gold nanoparticles in-vivo, multiple spectroscopic detectors are arranged and rotated orthogonal to an excited region of interest so that a localized scan can be acquired with a maximized efficiency. Excitation filtration was employed to minimize the effects of low-energy x-rays and background scattering for lowering radiation dose to the object. Numerical simulations showed that the radiation dose is less than 300 mGy/second for a complete 30 views tomographic scan; and the sensitivity of 3D fluorescence signal detection is up to 0.2% contrast concentrations of nanoparticles. The x-ray fluorescence computed tomography is an important molecular imaging tool. It can be used directly in samall animal research. It has great translational potential for future clinical applications.

  3. Partially coherent lensfree tomographic microscopy⋄

    PubMed Central

    Isikman, Serhan O.; Bishara, Waheb; Ozcan, Aydogan

    2012-01-01

    Optical sectioning of biological specimens provides detailed volumetric information regarding their internal structure. To provide a complementary approach to existing three-dimensional (3D) microscopy modalities, we have recently demonstrated lensfree optical tomography that offers high-throughput imaging within a compact and simple platform. In this approach, in-line holograms of objects at different angles of partially coherent illumination are recorded using a digital sensor-array, which enables computing pixel super-resolved tomographic images of the specimen. This imaging modality, which forms the focus of this review, offers micrometer-scale 3D resolution over large imaging volumes of, for example, 10–15 mm3, and can be assembled in light weight and compact architectures. Therefore, lensfree optical tomography might be particularly useful for lab-on-a-chip applications as well as for microscopy needs in resource-limited settings. PMID:22193016

  4. System for tomographic determination of the power distribution in electron beams

    DOEpatents

    Elmer, John W.; Teruya, Alan T.; O'Brien, Dennis W.

    1995-01-01

    A tomographic technique for measuring the current density distribution in electron beams using electron beam profile data acquired from a modified Faraday cup to create an image of the current density in high and low power beams. The modified Faraday cup includes a narrow slit and is rotated by a stepper motor and can be moved in the x, y and z directions. The beam is swept across the slit perpendicular thereto and controlled by deflection coils, and the slit rotated such that waveforms are taken every few degrees form 0.degree. to 360.degree. and the waveforms are recorded by a digitizing storage oscilloscope. Two-dimensional and three-dimensional images of the current density distribution in the beam can be reconstructed by computer tomography from this information, providing quantitative information about the beam focus and alignment.

  5. System for tomographic determination of the power distribution in electron beams

    DOEpatents

    Elmer, J.W.; Teruya, A.T.; O`Brien, D.W.

    1995-11-21

    A tomographic technique for measuring the current density distribution in electron beams using electron beam profile data acquired from a modified Faraday cup to create an image of the current density in high and low power beams. The modified Faraday cup includes a narrow slit and is rotated by a stepper motor and can be moved in the x, y and z directions. The beam is swept across the slit perpendicular thereto and controlled by deflection coils, and the slit rotated such that waveforms are taken every few degrees form 0{degree} to 360{degree} and the waveforms are recorded by a digitizing storage oscilloscope. Two-dimensional and three-dimensional images of the current density distribution in the beam can be reconstructed by computer tomography from this information, providing quantitative information about the beam focus and alignment. 12 figs.

  6. Active and Passive Hydrologic Tomographic Surveys:A Revolution in Hydrology (Invited)

    NASA Astrophysics Data System (ADS)

    Yeh, T. J.

    2013-12-01

    Mathematical forward or inverse problems of flow through geological media always have unique solutions if necessary conditions are givens. Unique mathematical solutions to forward or inverse modeling of field problems are however always uncertain (an infinite number of possibilities) due to many reasons. They include non-representativeness of the governing equations, inaccurate necessary conditions, multi-scale heterogeneity, scale discrepancies between observation and model, noise and others. Conditional stochastic approaches, which derives the unbiased solution and quantifies the solution uncertainty, are therefore most appropriate for forward and inverse modeling of hydrological processes. Conditioning using non-redundant data sets reduces uncertainty. In this presentation, we explain non-redundant data sets in cross-hole aquifer tests, and demonstrate that active hydraulic tomographic survey (using man-made excitations) is a cost-effective approach to collect the same type but non-redundant data sets for reducing uncertainty in the inverse modeling. We subsequently show that including flux measurements (a piece of non-redundant data set) collected in the same well setup as in hydraulic tomography improves the estimated hydraulic conductivity field. We finally conclude with examples and propositions regarding how to collect and analyze data intelligently by exploiting natural recurrent events (river stage fluctuations, earthquakes, lightning, etc.) as energy sources for basin-scale passive tomographic surveys. The development of information fusion technologies that integrate traditional point measurements and active/passive hydrogeophysical tomographic surveys, as well as advances in sensor, computing, and information technologies may ultimately advance our capability of characterizing groundwater basins to achieve resolution far beyond the feat of current science and technology.

  7. Wavefield simulations of earthquakes in Alaska for tomographic inversion

    NASA Astrophysics Data System (ADS)

    Silwal, V.; Tape, C.; Casarotti, E.

    2017-12-01

    We assemble a catalog of moment tensors and a three-dimensional seismic velocity model for mainland Alaska, in preparation for an iterative tomographic inversion using spectral-element and adjoint methods. The catalog contains approximately 200 earthquakes with Mw ≥ 4.0 that generate good long-period (≥6 s) signals for stations at distances up to approximately 500 km. To maximize the fraction of usable stations per earthquake, we divide our model into three subregions for simulations: south-central Alaska, central Alaska, and eastern Alaska. The primary geometrical interfaces in the model are the Moho surface, the basement surface of major sedimentary basins, and the topographic surface. The crustal and upper mantle tomographic model is from Eberhart-Phillips et al. (2006), but modified by removing the uppermost slow layer, then embedding sedimentary basin models for Cook Inlet basin, Susitna basin, and Nenana basin. We compute 3D synthetic seismograms using the spectral-element method. We demonstrate the accuracy of the initial three-dimensional reference model in each subregion by comparing 3D synthetics with observed data for several earthquakes originating in the crust and underlying subducting slab. Full waveform similarity between data and synthetics over the period range 6 s to 30 s provides a basis for an iterative inversion. The target resolution of the crustal structure is 4 km vertically and 20 km laterally. We use surface wave and body wave measurements from local earthquakes to obtain moment tensors that will be used within our tomographic inversion. Local slab events down to 180 km depth, in additional to pervasive crustal seismicity, should enhance resolution.

  8. Tunable diode laser absorption spectroscopy-based tomography system for on-line monitoring of two-dimensional distributions of temperature and H2O mole fraction.

    PubMed

    Xu, Lijun; Liu, Chang; Jing, Wenyang; Cao, Zhang; Xue, Xin; Lin, Yuzhen

    2016-01-01

    To monitor two-dimensional (2D) distributions of temperature and H2O mole fraction, an on-line tomography system based on tunable diode laser absorption spectroscopy (TDLAS) was developed. To the best of the authors' knowledge, this is the first report on a multi-view TDLAS-based system for simultaneous tomographic visualization of temperature and H2O mole fraction in real time. The system consists of two distributed feedback (DFB) laser diodes, a tomographic sensor, electronic circuits, and a computer. The central frequencies of the two DFB laser diodes are at 7444.36 cm(-1) (1343.3 nm) and 7185.6 cm(-1) (1391.67 nm), respectively. The tomographic sensor is used to generate fan-beam illumination from five views and to produce 60 ray measurements. The electronic circuits not only provide stable temperature and precise current controlling signals for the laser diodes but also can accurately sample the transmitted laser intensities and extract integrated absorbances in real time. Finally, the integrated absorbances are transferred to the computer, in which the 2D distributions of temperature and H2O mole fraction are reconstructed by using a modified Landweber algorithm. In the experiments, the TDLAS-based tomography system was validated by using asymmetric premixed flames with fixed and time-varying equivalent ratios, respectively. The results demonstrate that the system is able to reconstruct the profiles of the 2D distributions of temperature and H2O mole fraction of the flame and effectively capture the dynamics of the combustion process, which exhibits good potential for flame monitoring and on-line combustion diagnosis.

  9. Tunable diode laser absorption spectroscopy-based tomography system for on-line monitoring of two-dimensional distributions of temperature and H2O mole fraction

    NASA Astrophysics Data System (ADS)

    Xu, Lijun; Liu, Chang; Jing, Wenyang; Cao, Zhang; Xue, Xin; Lin, Yuzhen

    2016-01-01

    To monitor two-dimensional (2D) distributions of temperature and H2O mole fraction, an on-line tomography system based on tunable diode laser absorption spectroscopy (TDLAS) was developed. To the best of the authors' knowledge, this is the first report on a multi-view TDLAS-based system for simultaneous tomographic visualization of temperature and H2O mole fraction in real time. The system consists of two distributed feedback (DFB) laser diodes, a tomographic sensor, electronic circuits, and a computer. The central frequencies of the two DFB laser diodes are at 7444.36 cm-1 (1343.3 nm) and 7185.6 cm-1 (1391.67 nm), respectively. The tomographic sensor is used to generate fan-beam illumination from five views and to produce 60 ray measurements. The electronic circuits not only provide stable temperature and precise current controlling signals for the laser diodes but also can accurately sample the transmitted laser intensities and extract integrated absorbances in real time. Finally, the integrated absorbances are transferred to the computer, in which the 2D distributions of temperature and H2O mole fraction are reconstructed by using a modified Landweber algorithm. In the experiments, the TDLAS-based tomography system was validated by using asymmetric premixed flames with fixed and time-varying equivalent ratios, respectively. The results demonstrate that the system is able to reconstruct the profiles of the 2D distributions of temperature and H2O mole fraction of the flame and effectively capture the dynamics of the combustion process, which exhibits good potential for flame monitoring and on-line combustion diagnosis.

  10. On the estimation of wall pressure coherence using time-resolved tomographic PIV

    NASA Astrophysics Data System (ADS)

    Pröbsting, Stefan; Scarano, Fulvio; Bernardini, Matteo; Pirozzoli, Sergio

    2013-07-01

    Three-dimensional time-resolved velocity field measurements are obtained using a high-speed tomographic Particle Image Velocimetry (PIV) system on a fully developed flat plate turbulent boundary layer for the estimation of wall pressure fluctuations. The work focuses on the applicability of tomographic PIV to compute the coherence of pressure fluctuations, with attention to the estimation of the stream and spanwise coherence length. The latter is required for estimations of aeroacoustic noise radiation by boundary layers and trailing edge flows, but is also of interest for vibro-structural problems. The pressure field is obtained by solving the Poisson equation for incompressible flows, where the source terms are provided by time-resolved velocity field measurements. Measured 3D velocity data is compared to results obtained from planar PIV, and a Direct Numerical Simulation (DNS) at similar Reynolds number. An improved method for the estimation of the material based on a least squares estimator of the velocity derivative along a particle trajectory is proposed and applied. Computed surface pressure fluctuations are further verified by means of simultaneous measurements by a pinhole microphone and compared to the DNS results and a semi-empirical model available from literature. The correlation coefficient for the reconstructed pressure time series with respect to pinhole microphone measurements attains approximately 0.5 for the band-pass filtered signal over the range of frequencies resolved by the velocity field measurements. Scaled power spectra of the pressure at a single point compare favorably to the DNS results and those available from literature. Finally, the coherence of surface pressure fluctuations and the resulting span- and streamwise coherence lengths are estimated and compared to semi-empirical models and DNS results.

  11. Finite frequency shear wave splitting tomography: a model space search approach

    NASA Astrophysics Data System (ADS)

    Mondal, P.; Long, M. D.

    2017-12-01

    Observations of seismic anisotropy provide key constraints on past and present mantle deformation. A common method for upper mantle anisotropy is to measure shear wave splitting parameters (delay time and fast direction). However, the interpretation is not straightforward, because splitting measurements represent an integration of structure along the ray path. A tomographic approach that allows for localization of anisotropy is desirable; however, tomographic inversion for anisotropic structure is a daunting task, since 21 parameters are needed to describe general anisotropy. Such a large parameter space does not allow a straightforward application of tomographic inversion. Building on previous work on finite frequency shear wave splitting tomography, this study aims to develop a framework for SKS splitting tomography with a new parameterization of anisotropy and a model space search approach. We reparameterize the full elastic tensor, reducing the number of parameters to three (a measure of strength based on symmetry considerations for olivine, plus the dip and azimuth of the fast symmetry axis). We compute Born-approximation finite frequency sensitivity kernels relating model perturbations to splitting intensity observations. The strong dependence of the sensitivity kernels on the starting anisotropic model, and thus the strong non-linearity of the inverse problem, makes a linearized inversion infeasible. Therefore, we implement a Markov Chain Monte Carlo technique in the inversion procedure. We have performed tests with synthetic data sets to evaluate computational costs and infer the resolving power of our algorithm for synthetic models with multiple anisotropic layers. Our technique can resolve anisotropic parameters on length scales of ˜50 km for realistic station and event configurations for dense broadband experiments. We are proceeding towards applications to real data sets, with an initial focus on the High Lava Plains of Oregon.

  12. Bilateral choroidal osteomas associated with fatal systemic illness.

    PubMed

    Kline, L B; Skalka, H W; Davidson, J D; Wilmes, F J

    1982-02-01

    An 11-year-old black boy complained of intermittent occipital headaches with nausea and projectile vomiting. Previous skin and lung biopsy specimens were interpreted as histiocytosis X. Cranial computed tomographic scanning disclosed a mass lesion in the region of the choroid plexus of the left lateral ventricle. This was surgically removed but proved nondiagnostic despite extensive histologic examination. An ophthalmologic evaluation showed discrete, elevated, yellow-white choroidal tumors in both maculas. The ophthalmoscopic appearance, as well as ultrasonography and computed tomography, led to the diagnosis of choroidal osteomas.

  13. Diagnostic Imaging and Newer Modalities for Thoracic Diseases: PET/Computed Tomographic Imaging and Endobronchial Ultrasound for Staging and Its Implication for Lung Cancer.

    PubMed

    Counts, Sarah J; Kim, Anthony W

    2017-08-01

    Modalities to detect and characterize lung cancer are generally divided into those that are invasive [endobronchial ultrasound (EBUS), esophageal ultrasound (EUS), and electromagnetic navigational bronchoscopy (ENMB)] versus noninvasive [chest radiography (CXR), computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI)]. This chapter describes these modalities, the literature supporting their use, and delineates what tests to use to best evaluate the patient with lung cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Three-dimensional computed tomographic volumetry precisely predicts the postoperative pulmonary function.

    PubMed

    Kobayashi, Keisuke; Saeki, Yusuke; Kitazawa, Shinsuke; Kobayashi, Naohiro; Kikuchi, Shinji; Goto, Yukinobu; Sakai, Mitsuaki; Sato, Yukio

    2017-11-01

    It is important to accurately predict the patient's postoperative pulmonary function. The aim of this study was to compare the accuracy of predictions of the postoperative residual pulmonary function obtained with three-dimensional computed tomographic (3D-CT) volumetry with that of predictions obtained with the conventional segment-counting method. Fifty-three patients scheduled to undergo lung cancer resection, pulmonary function tests, and computed tomography were enrolled in this study. The postoperative residual pulmonary function was predicted based on the segment-counting and 3D-CT volumetry methods. The predicted postoperative values were compared with the results of postoperative pulmonary function tests. Regarding the linear correlation coefficients between the predicted postoperative values and the measured values, those obtained using the 3D-CT volumetry method tended to be higher than those acquired using the segment-counting method. In addition, the variations between the predicted and measured values were smaller with the 3D-CT volumetry method than with the segment-counting method. These results were more obvious in COPD patients than in non-COPD patients. Our findings suggested that the 3D-CT volumetry was able to predict the residual pulmonary function more accurately than the segment-counting method, especially in patients with COPD. This method might lead to the selection of appropriate candidates for surgery among patients with a marginal pulmonary function.

  15. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zilkha, A.

    Computed tomographic (CT) findings in four patients with isolated blow-out fracture of the medial orbital wall are reported. CT delineated the fracture site and its extent in each case, and clearly demonstrated medial rectus muscle entrapment in two. This was confirmed by surgery. CT was found superior to polytomography and proved to be the best radiologic means for the diagnosis of medial orbital wall fracture and muscle entrapment.

  16. High Energy Computed Tomographic Inspection of Munitions

    DTIC Science & Technology

    2016-11-01

    this collection of information is estimated to av erage 1 hour per response, including the time for rev iewing instructions, searching existing data... estimate or any other aspect of this collection of information, including suggestions for reducing the burden to Department of Defense, Washington...UNCLASSIFIED i CONTENTS Page System Background 1 Unique Features 3 Scattering Estimating Device 3 Distortion and Geometric Calibration

  17. Primitive neuroectodermal tumour of the kidney: radiologic-pathological correlations.

    PubMed

    Chea, Y W; Agrawal, Rashi; Poh, Angeline C C

    2008-06-01

    A primitive neuroectodermal tumour of the kidney is a rare malignancy. We report the computed tomographic features and the histopathological correlation of such a tumour occurring in a middle-aged man. Although the radiological appearance has significant overlap with other renal tumours, this tumour should be included in the differential diagnosis of a large renal mass in younger patients.

  18. Volume reconstruction optimization for tomo-PIV algorithms applied to experimental data

    NASA Astrophysics Data System (ADS)

    Martins, Fabio J. W. A.; Foucaut, Jean-Marc; Thomas, Lionel; Azevedo, Luis F. A.; Stanislas, Michel

    2015-08-01

    Tomographic PIV is a three-component volumetric velocity measurement technique based on the tomographic reconstruction of a particle distribution imaged by multiple camera views. In essence, the performance and accuracy of this technique is highly dependent on the parametric adjustment and the reconstruction algorithm used. Although synthetic data have been widely employed to optimize experiments, the resulting reconstructed volumes might not have optimal quality. The purpose of the present study is to offer quality indicators that can be applied to data samples in order to improve the quality of velocity results obtained by the tomo-PIV technique. The methodology proposed can potentially lead to significantly reduction in the time required to optimize a tomo-PIV reconstruction, also leading to better quality velocity results. Tomo-PIV data provided by a six-camera turbulent boundary-layer experiment were used to optimize the reconstruction algorithms according to this methodology. Velocity statistics measurements obtained by optimized BIMART, SMART and MART algorithms were compared with hot-wire anemometer data and velocity measurement uncertainties were computed. Results indicated that BIMART and SMART algorithms produced reconstructed volumes with equivalent quality as the standard MART with the benefit of reduced computational time.

  19. Pulp Revascularization on Permanent Teeth with Open Apices in a Middle-aged Patient.

    PubMed

    Wang, Yu; Zhu, Xiaofei; Zhang, Chengfei

    2015-09-01

    Pulp revascularization is a promising procedure for the treatment of adolescents' immature permanent teeth with necrotic pulp and/or apical periodontitis. However, the ability to successfully perform pulp revascularization in a middle-aged patient remains unclear. A 39-year-old woman was referred for treatment of teeth #20 and #29 with necrotic pulp, extensive periapical radiolucencies, and incomplete apices. Pulp revascularization procedures were attempted, including root canal debridement, triple antibiotic paste medication, and platelet-rich plasma transplantation to act as a scaffold. Periapical radiographic and cone-beam computed tomographic examinations were used to review the changes in the apical lesions and root apex configuration. The patient remained asymptomatic throughout the 30-month follow-up. Periapical radiographic examination revealed no change in the apical lesions of either tooth at 8 months. The periapical radiolucency disappeared on tooth #20 and significantly decreased on tooth #29 by the 30-month follow-up, findings that were also confirmed by cone-beam computed tomographic imaging. No evidence of root lengthening or thickening was observed. Successful revascularization was achieved in a middle-aged patient's teeth. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. The use of stable xenon-enhanced computed tomographic studies of cerebral blood flow to define changes in cerebral carbon dioxide vasoresponsivity caused by a severe head injury.

    PubMed

    Marion, D W; Bouma, G J

    1991-12-01

    Previous studies using the xenon-133 cerebral blood flow (CBF) method have documented the impairment of CO2 vasoresponsivity after a severe head injury, but only global values can be obtained reliably with this technique. We studied CO2 vasoresponsivity using the stable xenon-enhanced computed tomographic CBF method, which provided information about well-defined cortical regions and deep brain structures not available with the xenon-133 method. In 17 patients with admission Glasgow Coma Scale scores of 8 or less, hemispheric CO2 vasoresponsivity ranged from 1.3 to 8.5% per mm Hg change in partial CO2 pressure. Lobar, cerebellar, basal ganglia, and brain stem CO2 vasoresponsivity frequently varied from the mean global value by more than 25%. In all but one patient, local CO2 vasoresponsivity in one or more of these areas differed from the mean global value by more than 50%. The greatest variability occurred in patients with acute subdural hematomas and diffuse (bihemispheric) injuries. This variability in CO2 vasoresponsivity has important implications for the effective and safe management of intracranial hypertension that frequently accompanies severe head injury.

  1. Regional brain hematocrit in stroke by single photon emission computed tomography imaging

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Loutfi, I.; Frackowiak, R.S.; Myers, M.J.

    1987-01-01

    Nineteen studies on 18 subjects were performed by single photon emission computed tomography (SPECT) of the head after the successive intravenous administration of a plasma label (/sup 99m/Tc-human serum albumin (HSA)) and /sup 99m/Tc-labeled autologous red blood cells (RBC). Two sets of cerebral tomographic sections were generated: for cerebral /sup 99m/Tc-HSA alone and for combined /sup 99m/Tc-HSA and /sup 99m/Tc-RBC. By relating counts in regions of interest from the cerebral tomograms to counts from blood samples obtained during each tomographic acquisition, regional cerebral haematocrit (Hct) was calculated by the application of a simple formula. Results show 1) lower cerebral Hctmore » than venous Hct (ratio of HCT brain/Hct venous 0.65-0.90) in all subjects, and 2) comparison between right and left hemisphere Hct in 3/3 normal subjects, 6/6 patients with transient ischaemic attacks and 3/8 patients with stroke showed no significant difference. However, in 3/8 patients with stroke (most recent strokes) significant differences were found, the higher Hct value corresponding to the affected side.« less

  2. Computational modeling of optical projection tomographic microscopy using the finite difference time domain method.

    PubMed

    Coe, Ryan L; Seibel, Eric J

    2012-12-01

    We present a method for modeling image formation in optical projection tomographic microscopy (OPTM) using high numerical aperture (NA) condensers and objectives. Similar to techniques used in computed tomography, OPTM produces three-dimensional, reconstructed images of single cells from two-dimensional projections. The model is capable of simulating axial scanning of a microscope objective to produce projections, which are reconstructed using filtered backprojection. Simulation of optical scattering in transmission optical microscopy is designed to analyze all aspects of OPTM image formation, such as degree of specimen staining, refractive-index matching, and objective scanning. In this preliminary work, a set of simulations is performed to examine the effect of changing the condenser NA, objective scan range, and complex refractive index on the final reconstruction of a microshell with an outer radius of 1.5 μm and an inner radius of 0.9 μm. The model lays the groundwork for optimizing OPTM imaging parameters and triaging efforts to further improve the overall system design. As the model is expanded in the future, it will be used to simulate a more realistic cell, which could lead to even greater impact.

  3. Mapping the vascular anatomy of free transplanted soft tissue flaps with computed tomographic angiography.

    PubMed

    Rozen, Warren M; Chubb, Daniel; Ashton, Mark W; Webster, Howard R

    2012-05-01

    The use of advanced imaging technologies such as computed tomographic angiography (CTA) has opened the door to the analysis of microvascular anatomy not previously demonstrable with prior imaging techniques. While CTA has been used to evaluate the vascular anatomy of donor body regions in the planning of harvest of tissue for free flap transfer, the use of CTA to evaluate tissues after tissue transplantation has not been demonstrated. The current study aimed to explore whether vascular anatomy was able to highlight CTA within transferred flaps. The arterial and venous anatomy of a transferred deep inferior epigastric artery (DIEA) perforator (DIEP) flap was explored postoperatively with the use of CTA. Intra-flap vasculature was mapped and recorded qualitatively. Postoperative CTA is able to highlight the vascular pedicle of a transferred free flap, highlight the course of individual perforators supplying the flap, and map the zones of lesser perfusion by the source pedicle. The current study has demonstrated that CTA may be of value in identifying vascular anatomy within transferred tissue, as a guide to evaluate flap perfusion and planning further surgery involving the flap. © Springer-Verlag 2011

  4. Navigation-supported diagnosis of the substantia nigra by matching midbrain sonography and MRI

    NASA Astrophysics Data System (ADS)

    Salah, Zein; Weise, David; Preim, Bernhard; Classen, Joseph; Rose, Georg

    2012-03-01

    Transcranial sonography (TCS) is a well-established neuroimaging technique that allows for visualizing several brainstem structures, including the substantia nigra, and helps for the diagnosis and differential diagnosis of various movement disorders, especially in Parkinsonian syndromes. However, proximate brainstem anatomy can hardly be recognized due to the limited image quality of B-scans. In this paper, a visualization system for the diagnosis of the substantia nigra is presented, which utilizes neuronavigated TCS to reconstruct tomographical slices from registered MRI datasets and visualizes them simultaneously with corresponding TCS planes in realtime. To generate MRI tomographical slices, the tracking data of the calibrated ultrasound probe are passed to an optimized slicing algorithm, which computes cross sections at arbitrary positions and orientations from the registered MRI dataset. The extracted MRI cross sections are finally fused with the region of interest from the ultrasound image. The system allows for the computation and visualization of slices at a near real-time rate. Primary tests of the system show an added value to the pure sonographic imaging. The system also allows for reconstructing volumetric (3D) ultrasonic data of the region of interest, and thus contributes to enhancing the diagnostic yield of midbrain sonography.

  5. Brainstem auditory-evoked potentials as an objective tool for evaluating hearing dysfunction in traumatic brain injury.

    PubMed

    Lew, Henry L; Lee, Eun Ha; Miyoshi, Yasushi; Chang, Douglas G; Date, Elaine S; Jerger, James F

    2004-03-01

    Because of the violent nature of traumatic brain injury, traumatic brain injury patients are susceptible to various types of trauma involving the auditory system. We report a case of a 55-yr-old man who presented with communication problems after traumatic brain injury. Initial results from behavioral audiometry and Weber/Rinne tests were not reliable because of poor cooperation. He was transferred to our service for inpatient rehabilitation, where review of the initial head computed tomographic scan showed only left temporal bone fracture. Brainstem auditory-evoked potential was then performed to evaluate his hearing function. The results showed bilateral absence of auditory-evoked responses, which strongly suggested bilateral deafness. This finding led to a follow-up computed tomographic scan, with focus on bilateral temporal bones. A subtle transverse fracture of the right temporal bone was then detected, in addition to the left temporal bone fracture previously identified. Like children with hearing impairment, traumatic brain injury patients may not be able to verbalize their auditory deficits in a timely manner. If hearing loss is suspected in a patient who is unable to participate in traditional behavioral audiometric testing, brainstem auditory-evoked potential may be an option for evaluating hearing dysfunction.

  6. Computed tomography in the evaluation of Crohn disease

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goldberg, H.I.; Gore, R.M.; Margulis, A.R.

    1983-02-01

    The abdominal and pelvic computed tomographic examinations in 28 patients with Crohn disease were analyzed and correlated with conventional barium studies, sinograms, and surgical findings. Mucosal abnormalities such as aphthous lesions, pseudopolyps, and ulcerations were only imaged by conventional techniques. Computed tomography proved superior in demonstrating the mural, serosal, and mesenteric abnormalities such as bowel wall thickening (82%), fibrofatty proliferation of mesenteric fat (39%), mesenteric abscess (25%), inflammatory reaction of the mesentery (14%), and mesenteric lymphadenopathy (18%). Computed tomography was most useful clinically in defining the nature of mass effects, separation, or displacement of small bowel segments seen on smallmore » bowel series. Although conventional barium studies remain the initial diagnostic procedure in evaluating Crohn disease, computed tomography can be a useful adjunct in resolving difficult clinical and radiologic diagnostic problems.« less

  7. Impact of Data-driven Respiratory Gating in Clinical PET.

    PubMed

    Büther, Florian; Vehren, Thomas; Schäfers, Klaus P; Schäfers, Michael

    2016-10-01

    Purpose To study the feasibility and impact of respiratory gating in positron emission tomographic (PET) imaging in a clinical trial comparing conventional hardware-based gating with a data-driven approach and to describe the distribution of determined parameters. Materials and Methods This prospective study was approved by the ethics committee of the University Hospital of Münster (AZ 2014-217-f-N). Seventy-four patients suspected of having abdominal or thoracic fluorine 18 fluorodeoxyglucose (FDG)-positive lesions underwent clinical whole-body FDG PET/computed tomographic (CT) examinations. Respiratory gating was performed by using a pressure-sensitive belt system (belt gating [BG]) and an automatic data-driven approach (data-driven gating [DDG]). PET images were analyzed for lesion uptake, metabolic volumes, respiratory shifts of lesions, and diagnostic image quality. Results Forty-eight patients had at least one lesion in the field of view, resulting in a total of 164 lesions analyzed (range of number of lesions per patient, one to 13). Both gating methods revealed respiratory shifts of lesions (4.4 mm ± 3.1 for BG vs 4.8 mm ± 3.6 for DDG, P = .76). Increase in uptake of the lesions compared with nongated values did not differ significantly between both methods (maximum standardized uptake value [SUVmax], +7% ± 13 for BG vs +8% ± 16 for DDG, P = .76). Similarly, gating significantly decreased metabolic lesion volumes with both methods (-6% ± 26 for BG vs -7% ± 21 for DDG, P = .44) compared with nongated reconstructions. Blinded reading revealed significant improvements in diagnostic image quality when using gating, without significant differences between the methods (DDG was judged to be inferior to BG in 22 cases, equal in 12 cases, and superior in 15 cases; P = .32). Conclusion Respiratory gating increases diagnostic image quality and uptake values and decreases metabolic volumes compared with nongated acquisitions. Data-driven approaches are clinically applicable alternatives to belt-based methods and might help establishing routine respiratory gating in clinical PET/CT. (©) RSNA, 2016 Online supplemental material is available for this article.

  8. Lesion site patterns in severe, nonverbal aphasia to predict outcome with a computer-assisted treatment program.

    PubMed

    Naeser, M A; Baker, E H; Palumbo, C L; Nicholas, M; Alexander, M P; Samaraweera, R; Prete, M N; Hodge, S M; Weissman, T

    1998-11-01

    To test whether lesion site patterns in patients with chronic, severe aphasia who have no meaningful spontaneous speech are predictive of outcome following treatment with a nonverbal, icon-based computer-assisted visual communication (C-ViC) program. Retrospective study in which computed tomographic scans performed 3 months after onset of stroke and aphasia test scores obtained before C-ViC therapy were reviewed for patients after receiving C-ViC treatment. A neurology department and speech pathology service of a Department of Veterans Affairs medical center and a university aphasia research center. Seventeen patients with stroke and severe aphasia who began treatment with C-ViC from 3 months to 10 years after onset of stroke. Level of ability to use C-ViC on a personal computer to communicate. All patients with bilateral lesions failed to learn C-ViC. For patients with unilateral left hemisphere lesion sites, statistical analyses accurately discriminated between those who could initiate communication with C-ViC from those who were only able to answer directed questions. The critical lesion areas involved temporal lobe structures (Wernicke cortical area and the subcortical temporal isthmus), supraventricular frontal lobe structures (supplementary motor area or cingulate gyrus 24), and the subcortical medial subcallosal fasciculus, deep to the Broca area. Specific lesion sites were also identified for appropriate candidacy for C-ViC. Lesion site patterns on computed tomographic scans are helpful to define candidacy for C-ViC training, and to predict outcome level. A practical method is presented for clinical application of these lesion site results in combination with aphasia test scores.

  9. Fast tomosynthesis for lung cancer detection using the SBDX geometry

    NASA Astrophysics Data System (ADS)

    Fahrig, Rebecca; Pineda, Angel R.; Solomon, Edward G.; Leung, Ann N.; Pelc, Norbert J.

    2003-06-01

    Radiology-based lung-cancer detection is a high-contrast imaging task, consisting of the detection of a small mass of tissue within much lower density lung parenchyma. This imaging task requires removal of confounding image details, fast image acquisition (< 0.1 s for pericardial region), low dose (comparable to a chest x-ray), high resolution (< 0.25 mm in-plane) and patient positioning flexibility. We present an investigation of tomosynthesis, implemented using the Scanning-Beam Digital X-ray System (SBDX), to achieve these goals. We designed an image-based computer model of tomosynthesis using a high-resolution (0.15-mm isotropic voxels), low-noise CT volume image of a lung phantom, numerically added spherical lesions and convolution-based tomographic blurring. Lesion visibility was examined as a function of half-tomographic angle for 2.5 and 4.0 mm diameter lesions. Gaussian distributed noise was added to the projected images. For lesions 2.5 mm and 4.0 mm in diameter, half-tomographic angles of at least 6° and 9° respectively were necessary before visualization of the lesions improved. The addition of noise for a dose equivalent to 1/10 that used for a standard chest radiograph did not significantly impair lesion detection. The results are promising, indicating that lung-cancer detection using a modified SBDX system is possible.

  10. TomoPhantom, a software package to generate 2D-4D analytical phantoms for CT image reconstruction algorithm benchmarks

    NASA Astrophysics Data System (ADS)

    Kazantsev, Daniil; Pickalov, Valery; Nagella, Srikanth; Pasca, Edoardo; Withers, Philip J.

    2018-01-01

    In the field of computerized tomographic imaging, many novel reconstruction techniques are routinely tested using simplistic numerical phantoms, e.g. the well-known Shepp-Logan phantom. These phantoms cannot sufficiently cover the broad spectrum of applications in CT imaging where, for instance, smooth or piecewise-smooth 3D objects are common. TomoPhantom provides quick access to an external library of modular analytical 2D/3D phantoms with temporal extensions. In TomoPhantom, quite complex phantoms can be built using additive combinations of geometrical objects, such as, Gaussians, parabolas, cones, ellipses, rectangles and volumetric extensions of them. Newly designed phantoms are better suited for benchmarking and testing of different image processing techniques. Specifically, tomographic reconstruction algorithms which employ 2D and 3D scanning geometries, can be rigorously analyzed using the software. TomoPhantom also provides a capability of obtaining analytical tomographic projections which further extends the applicability of software towards more realistic, free from the "inverse crime" testing. All core modules of the package are written in the C-OpenMP language and wrappers for Python and MATLAB are provided to enable easy access. Due to C-based multi-threaded implementation, volumetric phantoms of high spatial resolution can be obtained with computational efficiency.

  11. Scaled Anatomical Model Creation of Biomedical Tomographic Imaging Data and Associated Labels for Subsequent Sub-surface Laser Engraving (SSLE) of Glass Crystals

    PubMed Central

    Dethlefs, Christopher R.; Piotrowicz, Justin; Van Avermaete, Tony; Maki, Jeff; Gerstler, Steve; Leevy, W. M.

    2017-01-01

    Biomedical imaging modalities like computed tomography (CT) and magnetic resonance (MR) provide excellent platforms for collecting three-dimensional data sets of patient or specimen anatomy in clinical or preclinical settings. However, the use of a virtual, on-screen display limits the ability of these tomographic images to fully convey the anatomical information embedded within. One solution is to interface a biomedical imaging data set with 3D printing technology to generate a physical replica. Here we detail a complementary method to visualize tomographic imaging data with a hand-held model: Sub Surface Laser Engraving (SSLE) of crystal glass. SSLE offers several unique benefits including: the facile ability to include anatomical labels, as well as a scale bar; streamlined multipart assembly of complex structures in one medium; high resolution in the X, Y, and Z planes; and semi-transparent shells for visualization of internal anatomical substructures. Here we demonstrate the process of SSLE with CT data sets derived from pre-clinical and clinical sources. This protocol will serve as a powerful and inexpensive new tool with which to visualize complex anatomical structures for scientists and students in a number of educational and research settings. PMID:28518066

  12. Colorectal cancer screening with virtual colonoscopy

    NASA Astrophysics Data System (ADS)

    Ge, Yaorong; Vining, David J.; Ahn, David K.; Stelts, David R.

    1999-05-01

    Early detection and removal of colorectal polyps have been proven to reduce mortality from colorectal carcinoma (CRC), the second leading cause of cancer deaths in the United States. Unfortunately, traditional techniques for CRC examination (i.e., barium enema, sigmoidoscopy, and colonoscopy) are unsuitable for mass screening because of either low accuracy or poor public acceptance, costs, and risks. Virtual colonoscopy (VC) is a minimally invasive alternative that is based on tomographic scanning of the colon. After a patient's bowel is optimally cleansed and distended with gas, a fast tomographic scan, typically helical computed tomography (CT), of the abdomen is performed during a single breath-hold acquisition. Two-dimensional (2D) slices and three-dimensional (3D) rendered views of the colon lumen generated from the tomographic data are then examined for colorectal polyps. Recent clinical studies conducted at several institutions including ours have shown great potential for this technology to be an effective CRC screening tool. In this paper, we describe new methods to improve bowel preparation, colon lumen visualization, colon segmentation, and polyp detection. Our initial results show that VC with the new bowel preparation and imaging protocol is capable of achieving accuracy comparable to conventional colonoscopy and our new algorithms for image analysis contribute to increased accuracy and efficiency in VC examinations.

  13. Contribution of computed tomography to the investigation of La Tene culture iron artefacts

    NASA Astrophysics Data System (ADS)

    Vopálenský, M.; Sankot, P.; Fořt, M.; Kumpová, I.; Vavřík, D.

    2017-07-01

    The X-ray tomographic study was realized in addition to the standard X-ray radiography for the purpose of the new conservation work upon the La Tene culture iron artifacts from the collections of the National Museum in Prague. These artifacts are heavily damaged by the corrosion, avoiding thus an effective visual exploration. The work shows that even details, which are shallow compared to the artifact thickness and therefore not detectable in standard radiographic images, can be made visible in 3D models obtained tomografically. The tomographic data acquisition was performed utilizing the unique TORATOM device, equipped with a large area X-ray detector with Gadox scintillator. The tomographic reconstruction revealed insufficiencies in the earlier conservation processes of the La Tene culture swords, as well as so-far unknown details, such as the exact sword shapes and their decoration. These new findings allowed better classifying of the artifacts. Tomography also helped in visualizing details of iron clips that are completely hidden under the rust, making thus the technology of the clip formation clearly observable. With this work, it has been proven that tomography can bear valuable new information compared to the standard X-ray radiography commonly used in the investigation of iron archeological artifacts.

  14. Scalar localization of the electrode array after cochlear implantation: clinical experience using 64-slice multidetector computed tomography.

    PubMed

    Lane, John I; Witte, Robert J; Driscoll, Colin L W; Shallop, Jon K; Beatty, Charles W; Primak, Andrew N

    2007-08-01

    To use the improved resolution available with 64-slice multidetector computed tomography (MDCT) in vivo to localize the cochlear implant electrode array within the basal turn. Sixty-four-slice MDCT examinations of the temporal bones were retrospectively reviewed in 17 patients. Twenty-three implants were evaluated. Tertiary referral facility. All patients with previous cochlear implantation evaluated at our center between January 2004 and March 2006 were offered a computed tomographic examination as part of the study. In addition, preoperative computed tomographic examinations in patients being evaluated for a second bilateral device were included. Sixty-four-slice MDCT examination of the temporal bones. Localization of the electrode array within the basal turn from multiplanar reconstructions of the cochlea. Twenty-three implants were imaged in 17 patients. We were able to localize the electrode array within the scala tympani within the basal turn in 10 implants. In 3 implants, the electrode array was localized to the scala vestibuli. Migration of the electrode array from scala tympani to scala vestibuli was observed in three implants. Of the 7 implants in which localization of the electrode array was indeterminate, all had disease entities that obscured the definition of the normal cochlear anatomy. Sixty-four-slice MDCT with multiplanar reconstructions of the postoperative cochlea after cochlear implantation allows for accurate localization of the electrode array within the basal turn where normal cochlear anatomy is not obscured by the underlying disease process. Correlating the position of the electrode in the basal turn with surgical technique and implant design could be helpful in improving outcomes.

  15. 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. © 2013 Blackwell Verlag GmbH.

  16. 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.

  17. 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.

  18. Computed Tomography-Derived Fractional Flow Reserve in the Detection of Lesion-Specific Ischemia: An Integrated Analysis of 3 Pivotal Trials.

    PubMed

    Xu, Rende; Li, Chenguang; Qian, Juying; Ge, Junbo

    2015-11-01

    Invasive fractional flow reserve (FFR) is the gold standard for the determination of physiologic stenosis severity and the need for revascularization. FFR computed from standard acquired coronary computed tomographic angiography datasets (FFRCT) is an emerging technology which allows calculation of FFR using resting image data from coronary computed tomographic angiography (CCTA). However, the diagnostic accuracy of FFRCT in the evaluation of lesion-specific myocardial ischemia remains to be confirmed, especially in patients with intermediate coronary stenosis. We performed an integrated analysis of data from 3 prospective, international, and multicenter trials, which assessed the diagnostic performance of FFRCT using invasive FFR as a reference standard. Three studies evaluating 609 patients and 1050 vessels were included. The total calculated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FFRCT were 82.8%, 77.7%, 60.8%, 91.6%, and 79.2%, respectively, for the per-vessel analysis, and 89.4%, 70.5%, 69.7%, 89.7%, and 78.7%, respectively, for the per-patient analysis. Compared with CCTA alone, FFRCT demonstrated significantly improved accuracy (P < 0.001) in detecting lesion-specific ischemia. In patients with intermediate coronary stenosis, FFRCT remained both highly sensitive and specific with respect to the diagnosis of ischemia. In conclusion, FFRCT appears to be a reliable noninvasive alternative to invasive FFR, as it demonstrates high accuracy in the determination of anatomy and lesion-specific ischemia, which justifies the performance of additional randomized controlled trials to evaluate both the clinical benefits and the cost-effectiveness of FFRCT-guided coronary revascularization.

  19. Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

    PubMed

    Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C

    2018-05-01

    The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. A mega Ultra Low Velocity Zone at the Base of the Iceland Plume: a Target for Tomographic Telescope Implementation

    NASA Astrophysics Data System (ADS)

    Romanowicz, Barbara; Yuan, Kaiqing; Masson, Yder; Adourian, Sevan

    2017-04-01

    We have recently constructed the first global whole mantle radially anisotropic shear wave velocity model based on time domain full waveform inversion and numerical wavefield computations using the Spectral Element Method (French et al., 2013; French and Romanowicz, 2014). This model's most salient features are broad chimney-like low velocity conduits, rooted within the large-low-shear-velocity provinces (LLSVPs) at the base of the mantle, and extending from the core-mantle boundary up through most of the lower mantle, projecting to the earth's surface in the vicinity of major hotspots. The robustness of these features is confirmed through several non-linear synthetic tests, which we present here, including several iterations of inversion using a different starting model than that which served for the published model. The roots of these not-so-classical "plumes" are regions of more pronounced low shear velocity. While the detailed structure is not yet resolvable tomographically, at least two of them contain large (>800 km diameter) ultra-low-velocity zones (ULVZs), one under Hawaii (Cottaar and Romanowicz, 2012) and the other one under Samoa (Thorne et al., 2013). Through 3D numerical forward modelling of Sdiff phases down to 10s period, using data from broadband arrays illuminating the base of the Iceland plume from different directions, we show that such a large ULVZ also exists at the root of this plume, embedded within a taller region of moderately reduced low shear velocity, such as proposed by He et al. (2015). We also show that such a wide, but localized ULVZ is unique in a broad region around the base of the Iceland Plume. Because of the intense computational effort required for forward modelling of trial structures, to first order this ULVZ is represented by a cylindrical structure of diameter 900 km, height 20 km and velocity reduction 20%. To further refine the model, we have developed a technique which we call "tomographic telescope", in which we are able to compute the teleseismic wavefield down to periods of 10s only once, while subsequent iterations require numerical wavefield computations only within the target region, in this case, around the base of the Iceland plume. We describe the method and preliminary results of its implementation.

  1. Tomography of the Red Supergiant Star MU Cep

    NASA Astrophysics Data System (ADS)

    Kravchenko, Kateryna

    2018-04-01

    We present a tomographic method allowing to recover the velocity field at different optical depths in a stellar atmosphere. It is based on the computation of the contribution function to identify the depth of formation of spectral lines in order to construct numerical masks probing different optical depths. These masks are cross-correlated with observed spectra to extract information about the average shape of lines forming at a given optical depth and to derive the velocity field projected on the line of sight. We applied this method to series of spectra of the red supergiant star mu Cep and derived velocities in different atmospheric layers. The resulting velocity variations reveal complex atmospheric dynamics and indicate that convective cells are present in the atmosphere of the mu Cep. The mu Cep velocities were compared with those obtained by applying the tomographic masks to series of snapshot spectra from 3D radiative-hydrodynamics CO5BOLD simulations.

  2. System for tomographic determination of the power distribution in electron beams

    DOEpatents

    Elmer, J.W.; Teruya, A.T.; O'Brien, D.W.

    1995-01-17

    A tomographic technique is disclosed for measuring the current density distribution in electron beams using electron beam profile data acquired from a modified Faraday cup to create an image of the current density in high and low power beams. The modified Faraday cup includes a narrow slit and is rotated by a stepper motor and can be moved in the x, y and z directions. The beam is swept across the slit perpendicular thereto and controlled by deflection coils, and the slit rotated such that waveforms are taken every few degrees form 0[degree] to 360[degree] and the waveforms are recorded by a digitizing storage oscilloscope. Two-dimensional and three-dimensional images of the current density distribution in the beam can be reconstructed by computer tomography from this information, providing quantitative information about the beam focus and alignment. 12 figures.

  3. Image-guided therapies for myocardial repair: concepts and practical implementation

    PubMed Central

    Bengel, Frank M.; George, Richard T.; Schuleri, Karl H.; Lardo, Albert C.; Wollert, Kai C.

    2013-01-01

    Cell- and molecule-based therapeutic strategies to support wound healing and regeneration after myocardial infarction (MI) are under development. These emerging therapies aim at sustained preservation of ventricular function by enhancing tissue repair after myocardial ischaemia and reperfusion. Such therapies will benefit from guidance with regard to timing, regional targeting, suitable candidate selection, and effectiveness monitoring. Such guidance is effectively obtained by non-invasive tomographic imaging. Infarct size, tissue characteristics, muscle mass, and chamber geometry can be determined by magnetic resonance imaging and computed tomography. Radionuclide imaging can be used for the tracking of therapeutic agents and for the interrogation of molecular mechanisms such as inflammation, angiogenesis, and extracellular matrix activation. This review article portrays the hypothesis that an integrated approach with an early implementation of structural and molecular tomographic imaging in the development of novel therapies will provide a framework for achieving the goal of improved tissue repair after MI. PMID:23720377

  4. Tomographic techniques for the study of exceptionally preserved fossils

    PubMed Central

    Sutton, Mark D

    2008-01-01

    Three-dimensional fossils, especially those preserving soft-part anatomy, are a rich source of palaeontological information; they can, however, be difficult to work with. Imaging of serial planes through an object (tomography) allows study of both the inside and outside of three-dimensional fossils. Tomography may be performed using physical grinding or sawing coupled with photography, through optical techniques of serial focusing, or using a variety of scanning technologies such as neutron tomography, magnetic resonance imaging and most usefully X-ray computed tomography. This latter technique is applicable at a variety of scales, and when combined with a synchrotron X-ray source can produce very high-quality data that may be augmented by phase-contrast information to enhance contrast. Tomographic data can be visualized in several ways, the most effective of which is the production of isosurface-based ‘virtual fossils’ that can be manipulated and dissected interactively. PMID:18426749

  5. TOMOGRAPHIC MORPHOLOGICAL STUDY OF THE CRANIUM AND ITS CORRELATION WITH CRANIAL HALO USE IN ADULTS

    PubMed Central

    ALMEIDA, TIAGO FERREIRA DE; CHARAFEDDINE, HOMAR TOLEDO; ARAÚJO, FERNANDO FLORES DE; CRISTANTE, ALEXANDRE FOGAÇA; MARCON, RAPHAEL MARTUS; LETAIF, OLAVO BIRAGHI

    2017-01-01

    ABSTRACT Objective: To evaluate using tomographic study the thickness of the cranial board at the insertions points of the cranial halo pins in adults Methods: This is a retrospective, cross-sectional, descriptive analysis of Computed Tomography (CT) scans of adult patients' crania. The study included adults between 20 and 50 years without cranial abnormalities. We excluded any exam with cranial abnormalities Results: We analyzed 50 CT scans, including 27 men and 23 women, at the original insertion points and alternative points (1 and 2 cm above the frontal and parietal bones). The average values were 7.4333 mm in the frontal bone and 6.0290 mm in the parietal bone Conclusion: There was no statistically significant difference between the classical and alternative points, making room for alternative fixings and safer introduction of the pins, if necessary.Level of Evidence II, Retrospective Study. PMID:28642643

  6. Tomographic reconstruction of an aerosol plume using passive multiangle observations from the MISR satellite instrument

    NASA Astrophysics Data System (ADS)

    Garay, Michael J.; Davis, Anthony B.; Diner, David J.

    2016-12-01

    We present initial results using computed tomography to reconstruct the three-dimensional structure of an aerosol plume from passive observations made by the Multi-angle Imaging SpectroRadiometer (MISR) instrument on NASA's Terra satellite. MISR views the Earth from nine different angles at four visible and near-infrared wavelengths. Adopting the 672 nm channel, we treat each view as an independent measure of aerosol optical thickness along the line of sight at 1.1 km resolution. A smoke plume over dark water is selected as it provides a more tractable lower boundary condition for the retrieval. A tomographic algorithm is used to reconstruct the horizontal and vertical aerosol extinction field for one along-track slice from the path of all camera rays passing through a regular grid. The results compare well with ground-based lidar observations from a nearby Micropulse Lidar Network site.

  7. Laser-wakefield accelerators as hard x-ray sources for 3D medical imaging of human bone

    PubMed Central

    Cole, J. M.; Wood, J. C.; Lopes, N. C.; Poder, K.; Abel, R. L.; Alatabi, S.; Bryant, J. S. J.; Jin, A.; Kneip, S.; Mecseki, K.; Symes, D. R.; Mangles, S. P. D.; Najmudin, Z.

    2015-01-01

    A bright μm-sized source of hard synchrotron x-rays (critical energy Ecrit > 30 keV) based on the betatron oscillations of laser wakefield accelerated electrons has been developed. The potential of this source for medical imaging was demonstrated by performing micro-computed tomography of a human femoral trabecular bone sample, allowing full 3D reconstruction to a resolution below 50 μm. The use of a 1 cm long wakefield accelerator means that the length of the beamline (excluding the laser) is dominated by the x-ray imaging distances rather than the electron acceleration distances. The source possesses high peak brightness, which allows each image to be recorded with a single exposure and reduces the time required for a full tomographic scan. These properties make this an interesting laboratory source for many tomographic imaging applications. PMID:26283308

  8. Hybrid-dual-fourier tomographic algorithm for a fast three-dimensionial optical image reconstruction in turbid media

    NASA Technical Reports Server (NTRS)

    Alfano, Robert R. (Inventor); Cai, Wei (Inventor)

    2007-01-01

    A reconstruction technique for reducing computation burden in the 3D image processes, wherein the reconstruction procedure comprises an inverse and a forward model. The inverse model uses a hybrid dual Fourier algorithm that combines a 2D Fourier inversion with a 1D matrix inversion to thereby provide high-speed inverse computations. The inverse algorithm uses a hybrid transfer to provide fast Fourier inversion for data of multiple sources and multiple detectors. The forward model is based on an analytical cumulant solution of a radiative transfer equation. The accurate analytical form of the solution to the radiative transfer equation provides an efficient formalism for fast computation of the forward model.

  9. Dual-energy computed tomographic virtual noncalcium algorithm for detection of bone marrow edema in acute fractures: early experiences.

    PubMed

    Reagan, Adrian C; Mallinson, Paul I; O'Connell, Timothy; McLaughlin, Patrick D; Krauss, Bernhard; Munk, Peter L; Nicolaou, Savvas; Ouellette, Hugue A

    2014-01-01

    Computed tomography (CT) is often used to assess the presence of occult fractures when plain radiographs are equivocal in the acute traumatic setting. While providing increased spatial resolution, conventional computed tomography is limited in the assessment of bone marrow edema, a finding that is readily detectable on magnetic resonance imaging (MRI).Dual-energy CT has recently been shown to demonstrate patterns of bone marrow edema similar to corresponding MRI studies. Dual-energy CT may therefore provide a convenient modality for further characterizing acute bony injury when MRI is not readily available. We report our initial experiences of 4 cases with imaging and clinical correlation.

  10. Spectroscopic micro-tomography of metallic-organic composites by means of photon-counting detectors

    NASA Astrophysics Data System (ADS)

    Pichotka, M.; Jakubek, J.; Vavrik, D.

    2015-12-01

    The presumed capabilities of photon counting detectors have aroused major expectations in several fields of research. In the field of nuclear imaging ample benefits over standard detectors are to be expected from photon counting devices. First of all a very high contrast, as has by now been verified in numerous experiments. The spectroscopic capabilities of photon counting detectors further allow material decomposition in computed tomography and therefore inherently adequate beam hardening correction. For these reasons measurement setups featuring standard X-ray tubes combined with photon counting detectors constitute a possible replacement of the much more cost intensive tomographic setups at synchrotron light-sources. The actual application of photon counting detectors in radiographic setups in recent years has been impeded by a number of practical issues, above all by restrictions in the detectors size. Currently two tomographic setups in Czech Republic feature photon counting large-area detectors (LAD) fabricated in Prague. The employed large area hybrid pixel-detector assemblies [1] consisting of 10×10/10×5 Timepix devices have a surface area of 143×143 mm2 / 143×71,5 mm2 respectively, suitable for micro-tomographic applications. In the near future LAD devices featuring the Medipix3 readout chip as well as heavy sensors (CdTe, GaAs) will become available. Data analysis is obtained by a number of in house software tools including iterative multi-energy volume reconstruction.In this paper tomographic analysis of of metallic-organic composites is employed to illustrate the capabilities of our technology. Other than successful material decomposition by spectroscopic tomography we present a method to suppress metal artefacts under certain conditions.

  11. Regional lipiodolized chemotherapy for cholangiocarcinoma associated with oral contraceptives.

    PubMed Central

    McAleer, J. J.; Dickey, W.; Clarke, R.; Johnston, G. W.; Callender, M. E.

    1987-01-01

    We describe a case of cholangiocarcinoma in a young woman, who presented with cholestatic jaundice following oral contraceptive ingestion. Following diagnostic laparotomy she received intra-arterial 'lipiodolized' chemotherapy. Intravenous mitozantrone was given for 2 years and she is asymptomatic, with computed tomographic evidence of tumour response, 27 months after diagnosis. We suggest that this form of treatment is of value for cholangiocarcinoma. PMID:2821526

  12. Feasibility of RACT for 3D dose measurement and range verification in a water phantom.

    PubMed

    Alsanea, Fahed; Moskvin, Vadim; Stantz, Keith M

    2015-02-01

    The objective of this study is to establish the feasibility of using radiation-induced acoustics to measure the range and Bragg peak dose from a pulsed proton beam. Simulation studies implementing a prototype scanner design based on computed tomographic methods were performed to investigate the sensitivity to proton range and integral dose. Derived from thermodynamic wave equation, the pressure signals generated from the dose deposited from a pulsed proton beam with a 1 cm lateral beam width and a range of 16, 20, and 27 cm in water using Monte Carlo methods were simulated. The resulting dosimetric images were reconstructed implementing a 3D filtered backprojection algorithm and the pressure signals acquired from a 71-transducer array with a cylindrical geometry (30 × 40 cm) rotated over 2π about its central axis. Dependencies on the detector bandwidth and proton beam pulse width were performed, after which, different noise levels were added to the detector signals (using 1 μs pulse width and a 0.5 MHz cutoff frequency/hydrophone) to investigate the statistical and systematic errors in the proton range (at 20 cm) and Bragg peak dose (of 1 cGy). The reconstructed radioacoustic computed tomographic image intensity was shown to be linearly correlated to the dose within the Bragg peak. And, based on noise dependent studies, a detector sensitivity of 38 mPa was necessary to determine the proton range to within 1.0 mm (full-width at half-maximum) (systematic error < 150 μm) for a 1 cGy Bragg peak dose, where the integral dose within the Bragg peak was measured to within 2%. For existing hydrophone detector sensitivities, a Bragg peak dose of 1.6 cGy is possible. This study demonstrates that computed tomographic scanner based on ionizing radiation-induced acoustics can be used to verify dose distribution and proton range with centi-Gray sensitivity. Realizing this technology into the clinic has the potential to significantly impact beam commissioning, treatment verification during particle beam therapy and image guided techniques.

  13. Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFR(CT): outcome and resource impacts study.

    PubMed

    Douglas, Pamela S; Pontone, Gianluca; Hlatky, Mark A; Patel, Manesh R; Norgaard, Bjarne L; Byrne, Robert A; Curzen, Nick; Purcell, Ian; Gutberlet, Matthias; Rioufol, Gilles; Hink, Ulrich; Schuchlenz, Herwig Walter; Feuchtner, Gudrun; Gilard, Martine; Andreini, Daniele; Jensen, Jesper M; Hadamitzky, Martin; Chiswell, Karen; Cyr, Derek; Wilk, Alan; Wang, Furong; Rogers, Campbell; De Bruyne, Bernard

    2015-12-14

    In symptomatic patients with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) improves patient selection for invasive coronary angiography (ICA) compared with functional testing. The impact of measuring fractional flow reserve by CTA (FFRCT) is unknown. At 11 sites, 584 patients with new onset chest pain were prospectively assigned to receive either usual testing (n = 287) or CTA/FFR(CT) (n = 297). Test interpretation and care decisions were made by the clinical care team. The primary endpoint was the percentage of those with planned ICA in whom no significant obstructive CAD (no stenosis ≥50% by core laboratory quantitative analysis or invasive FFR < 0.80) was found at ICA within 90 days. Secondary endpoints including death, myocardial infarction, and unplanned revascularization were independently and blindly adjudicated. Subjects averaged 61 ± 11 years of age, 40% were female, and the mean pre-test probability of obstructive CAD was 49 ± 17%. Among those with intended ICA (FFR(CT)-guided = 193; usual care = 187), no obstructive CAD was found at ICA in 24 (12%) in the CTA/FFR(CT) arm and 137 (73%) in the usual care arm (risk difference 61%, 95% confidence interval 53-69, P< 0.0001), with similar mean cumulative radiation exposure (9.9 vs. 9.4 mSv, P = 0.20). Invasive coronary angiography was cancelled in 61% after receiving CTA/FFR(CT) results. Among those with intended non-invasive testing, the rates of finding no obstructive CAD at ICA were 13% (CTA/FFR(CT)) and 6% (usual care; P = 0.95). Clinical event rates within 90 days were low in usual care and CTA/FFR(CT) arms. Computed tomographic angiography/fractional flow reserve by CTA was a feasible and safe alternative to ICA and was associated with a significantly lower rate of invasive angiography showing no obstructive CAD. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  14. Comparison of patient-specific instruments with standard surgical instruments in determining glenoid component position: a randomized prospective clinical trial.

    PubMed

    Hendel, Michael D; Bryan, Jason A; Barsoum, Wael K; Rodriguez, Eric J; Brems, John J; Evans, Peter J; Iannotti, Joseph P

    2012-12-05

    Glenoid component malposition for anatomic shoulder replacement may result in complications. The purpose of this study was to define the efficacy of a new surgical method to place the glenoid component. Thirty-one patients were randomized for glenoid component placement with use of either novel three-dimensional computed tomographic scan planning software combined with patient-specific instrumentation (the glenoid positioning system group), or conventional computed tomographic scan, preoperative planning, and surgical technique, utilizing instruments provided by the implant manufacturer (the standard surgical group). The desired position of the component was determined preoperatively. Postoperatively, a computed tomographic scan was used to define and compare the actual implant location with the preoperative plan. In the standard surgical group, the average preoperative glenoid retroversion was -11.3° (range, -39° to 17°). In the glenoid positioning system group, the average glenoid retroversion was -14.8° (range, -27° to 7°). When the standard surgical group was compared with the glenoid positioning system group, patient-specific instrumentation technology significantly decreased (p < 0.05) the average deviation of implant position for inclination and medial-lateral offset. Overall, the average deviation in version was 6.9° in the standard surgical group and 4.3° in the glenoid positioning system group. The average deviation in inclination was 11.6° in the standard surgical group and 2.9° in the glenoid positioning system group. The greatest benefit of patient-specific instrumentation was observed in patients with retroversion in excess of 16°; the average deviation was 10° in the standard surgical group and 1.2° in the glenoid positioning system group (p < 0.001). Preoperative planning and patient-specific instrumentation use resulted in a significant improvement in the selection and use of the optimal type of implant and a significant reduction in the frequency of malpositioned glenoid implants. Novel three-dimensional preoperative planning, coupled with patient and implant-specific instrumentation, allows the surgeon to better define the preoperative pathology, select the optimal implant design and location, and then accurately execute the plan at the time of surgery.

  15. Changes in the syndesmotic reduction after syndesmotic screw fixation for ankle malleolar fractures: One-year longitudinal evaluations using computer tomography.

    PubMed

    Endo, Jun; Yamaguchi, Satoshi; Saito, Masahiko; Morikawa, Tsuguo; Akagi, Ryuichiro; Sasho, Takahisa

    2016-10-01

    To evaluate time-dependent changes in the syndesmotic reduction after syndesmotic screw fixation and one year after screw removal for ankle malleolar fractures, and to assess whether the incidence of syndesmotic malreduction changes depending on the measurement method. We assessed twenty patients who underwent syndesmotic screw fixation for ankle fractures. The syndesmotic screws were removed after six weeks of the fracture surgery. Syndesmotic reduction was assessed within two weeks of the fracture surgery and one year after the screw removal using the axial computer tomographic images. Side-to-side differences in the anterior and posterior tibiofibular distances, anteroposterior fibular translation, and fibular rotation were measured. The mean anterior tibiofibular distance was 0.7mm after syndesmotic fixation. It increased to 1.9mm at one year after screw removal (p=0.002). After syndesmotic fixation, four ankles had malreduction of the anterior tibiofibular distance, including three ankles with widening and one with overtightening. At one year, eight ankles had malreduction, all of whom had widening. The other measurement values did not change over time (0.1mm vs. 0.6mm for the posterior tibiofibular distance, 0.2mm vs. 0.3mm for the anteroposterior fibular translation, and 0.7° vs. 0° for the fibular rotation). The incidences of malreduction were significantly different depending on the definition of malreduction, ranging from 10% to 50% after syndesmotic fixation (p=0.01) and from 20% to 60% at one year after screw removal (p=0.02). The anterior tibiofibular distance widened after one year of syndesmotic screw removal. The incidence of malreduction varied depending on the measurement method. Copyright © 2016. Published by Elsevier Ltd.

  16. Facet Joint Osteoarthritis Affects Spinal Segmental Motion in Degenerative Spondylolisthesis.

    PubMed

    Kitanaka, Shigeyuki; Takatori, Ryota; Arai, Yuji; Nagae, Masateru; Tonomura, Hitoshi; Mikami, Yasuo; Inoue, Nozomu; Ogura, Taku; Fujiwara, Hiroyoshi; Kubo, Toshikazu

    2018-06-15

    This is a retrospective clinical case series (case-control study). To clarify the influence of facet joint osteoarthritis (FJOA) on the pathology of degenerative spondylolisthesis (DS) using in vivo 3-dimensional image analysis. There are no radical treatments to prevent progression of DS in patients with lumbar spinal canal stenosis associated with DS. Therefore, an effective treatment method based on the pathology of DS should be developed. In total, 50 patients with lumbar spinal canal stenosis involving L4/5 who underwent dynamic computed tomography were divided into 2 groups: with DS [spondylolisthesis (Sp) group; 12 male, 14 female; mean age, 74 y]; and without DS (non-Sp group; 15 male, 9 female; mean age, 70 y). Degeneration of the intervertebral disk and FJOA at L4/5 were evaluated using magnetic resonance imaging. Disk and intervertebral foramen heights, the distance between the craniocaudal edges of the facet joint, and the interspinous distance were measured on dynamic computed tomographic images. Also, in vivo 3-dimensional segmental motion was evaluated using the volume merge method. There were no significant differences in degenerative findings for the intervertebral disk; however, progressive FJOA was detected in the Sp group. Dynamic changes in the distance between the craniocaudal edges of the facet joints were significantly larger in the Sp group. In this study, progressive FJOA and larger segmental motion in the distance between the craniocaudal edges of the facet joints were found in the Sp group. We clarified for the first time that DS involves ligament laxity due to FJOA that affects spinal segmental motion in vivo. We consider that a treatment method based on FJOA would be useful for treating patients with DS. Level IV.

  17. Optimal scan timing and intravenous route for contrast-enhanced computed tomography in patients after Fontan operation.

    PubMed

    Park, Eun-Ah; Lee, Whal; Chung, Se-Young; Yin, Yong Hu; Chung, Jin Wook; Park, Jae Hyung

    2010-01-01

    To determine the optimal scan timing and adequate intravenous route for patients having undergone the Fontan operation. A total of 88 computed tomographic images in 49 consecutive patients who underwent the Fontan operation were retrospectively evaluated and divided into 7 groups: group 1, bolus-tracking method with either intravenous route (n = 20); group 2, 1-minute-delay scan with single antecubital route (n = 36); group 3, 1-minute-delay scan with both antecubital routes (n = 2); group 4, 1-minute-delay scan with foot vein route (n = 3); group 5, 1-minute-delay scan with simultaneous infusion via both antecubital and foot vein routes (n = 2); group 6, 3-minute-delay scan with single antecubital route (n = 22); and group 7, 3-minute-delay scan with foot vein route (n = 3). The presence of beam-hardening artifact, uniform enhancement, and optimal enhancement was evaluated at the right pulmonary artery (RPA), left pulmonary artery (LPA), and Fontan tract. Optimal enhancement was determined when evaluation of thrombus was possible. Standard deviation was measured at the RPA, LPA, and Fontan tract. Beam-hardening artifacts of the RPA, LPA, and Fontan tract were frequently present in groups 1, 4, and 5. The success rate of uniform and optimal enhancement was highest (100%) in groups 6 and 7, followed by group 2 (75%). An SD of less than 30 Hounsfield unit for the pulmonary artery and Fontan tract was found in groups 3, 6, and 7. The optimal enhancement of the pulmonary arteries and Fontan tract can be achieved by a 3-minute-delay scan irrespective of the intravenous route location.

  18. Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors.

    PubMed

    Türkvatan, Aysel; Akinci, Serkan; Yildiz, Sener; Olçer, Tülay; Cumhur, Turhan

    2009-04-01

    Currently, multidetector computed tomographic (MDCT) angiography has become a noninvasive alternative imaging modality to catheter renal angiography for the evaluation of renal vascular anatomy in living renal donors. In this study, we investigated the diagnostic accuracy of 16-slice MDCT in the preoperative assessment of living renal donors. Fifty-nine consecutive living renal donors (32 men, 27 women) underwent MDCT angiography followed by open donor nephrectomy. All MDCT studies were performed by using a 16-slice MDCT scanner with the same protocol consisting of arterial and nephrographic phases followed by conventional abdominal radiography. The MDCT images were assessed retrospectively for the number and branching pattern of the renal arteries and for the number and presence of major or minor variants of the renal veins. The results were compared with open surgical results. The sensitivity and specificity of MDCT for the detection of anatomic variants of renal arteries including the accessory arteries (n = 9), early arterial branching (n = 7) and major renal venous anomalies including the accessory renal veins (n = 3), late venous confluence (n = 4), circumaortic (n = 2) or retroaortic (n = 3) left renal veins were 100%. However, the sensitivity for identification of minor venous variants was 79%. All of three ureteral duplications were correctly identified at excretory phase conventional abdominal radiography. Sixteen-slice MDCT is highly accurate for the identification of anatomic variants of renal arteries and veins. Dual-phase MDCT angiography including arterial and nephrographic phases followed by conventional abdominal radiography enables complete assessment of renal donors without significant increase of radiation dose. However, the evaluation of minor venous variants may be problematic because of their small diameters and poor opacification.

  19. Computed tomographic findings in dogs with head trauma and development of a novel prognostic computed tomography-based scoring system.

    PubMed

    Chai, Orit; Peery, Dana; Bdolah-Abram, Tali; Moscovich, Efrat; Kelmer, Efrat; Klainbart, Sigal; Milgram, Joshua; Shamir, Merav H

    2017-09-01

    OBJECTIVE To characterize CT findings and outcomes in dogs with head trauma and design a prognostic scale. ANIMALS 27 dogs admitted to the Koret School Veterinary Teaching Hospital within 72 hours after traumatic head injury that underwent CT imaging of the head. PROCEDURES Data were extracted from medical records regarding dog signalment, history, physical and neurologic examination findings, and modified Glasgow coma scale scores. All CT images were retrospectively evaluated by a radiologist unaware of dog status. Short-term (10 days after trauma) and long-term (≥ 6 months after trauma) outcomes were determined, and CT findings and other variables were analyzed for associations with outcome. A prognostic CT-based scale was developed on the basis of the results. RESULTS Cranial vault fractures, parenchymal abnormalities, or both were identified via CT in 24 of 27 (89%) dogs. Three (11%) dogs had only facial bone fractures. Intracranial hemorrhage was identified in 16 (59%) dogs, cranial vault fractures in 15 (56%), midline shift in 14 (52%), lateral ventricle asymmetry in 12 (44%), and hydrocephalus in 7 (26%). Hemorrhage and ventricular asymmetry were significantly and negatively associated with short- and long-term survival, respectively. The developed 7-point prognostic scale included points for hemorrhage, midline shift or lateral ventricle asymmetry, cranial vault fracture, and depressed fracture (1 point each) and infratentorial lesion (3 points). CONCLUSIONS AND CLINICAL RELEVANCE The findings reported here may assist in determining prognoses for other dogs with head trauma. The developed scale may be useful for outcome assessment of dogs with head trauma; however, it must be validated before clinical application.

  20. Melioidosis presenting as an infected intrathoracic subclavian artery pseudoaneurysm treated with femoral vein interposition graft.

    PubMed

    Schindler, Nancy; Calligaro, Keith D; Dougherty, Matthew J; Diehl, James; Modi, Ketang H; Braffman, Michael N

    2002-03-01

    We present the first case of in situ replacement of an infected subclavian artery using superficial femoral vein and the fourth reported case of an infected arterial pseudoaneurysm caused by pseudomonas pseudomallei. Sepsis and hoarseness developed in a 58-year-old man after recent travel to Borneo, Indonesia. Indirect laryngoscopy revealed a paralyzed right vocal cord. Computed tomography and arteriography revealed a 6.5-cm pseudoaneurysm of the proximal right subclavian artery. Blood cultures grew pseudomonas pseudomallei. An abnormal cardiac stress test prompted a coronary angiography, which revealed severe coronary artery disease.The patient underwent coronary artery bypass and in situ replacement of the infected subclavian artery pseudoaneurysm with a superficial femoral vein, along with placement of a pectoralis major muscle flap to cover the vein graft. Operative cultures of the pseudoaneurysm grew pseudomonas pseudomallei. The patient was treated with a 6-week course of intravenous ceftazidime and oral doxycycline and then continued on oral amoxicillin-clavulanate. One week after discontinuing intravenous antibiotics, the patient presented to the emergency department with a rapidly expanding, pulsatile mass in the right supraclavicular space. He was taken emergently to the operating room. After hypothermic circulatory arrest was accomplished, the disrupted vein graft and aneurysm cavity were resected and the subclavian artery was oversewn proximally and distally. Parenteral ceftazidime was continued for 3 months and oral amoxicillin-clavulanate (augmentin) was continued indefinitely. There was no evidence of infection clinically or by computed tomographic scan 2 years later. Although autogenous vein replacement of infected arteries and grafts may be successful in the majority of cases, this strategy should probably be avoided when particularly virulent bacteria such as the organism in this case are present.

  1. Application of the Mandible Injury Severity Score to Pediatric Mandibular Fractures.

    PubMed

    Swanson, Edward W; Susarla, Srinivas M; Ghasemzadeh, Ali; Mundinger, Gerhard S; Redett, Richard J; Tufaro, Anthony P; Manson, Paul N; Dorafshar, Amir H

    2015-07-01

    The Mandible Injury Severity Score (MISS) has been used to evaluate adult mandibular fractures. The purpose of this study was to evaluate the MISS in a cohort of pediatric patients. This was a retrospective study of pediatric patients treated for mandibular fractures over a 20-year period. Patients were included if they had computed tomographic imaging available for review and had at least 1 post-treatment visit. The primary predictor variable was the MISS. Secondary predictors were demographic and injury-associated factors. The outcome was treatment-associated complications. Descriptive, bivariate, and multiple logistic regression statistics were computed. One hundred sixteen patients with mandibular fractures were identified; 73 (62.9%) met the inclusion criteria. The sample's mean age was 8.5 ± 4.1 years; 44% were girls. Motor vehicle collisions (60%) and falls (15.1%) were the most common mechanisms. More than 50% of patients had an extra-mandibular injury. The mean MISS was 13.5 ± 7.8. Forty-five percent of the sample underwent open reduction and internal fixation. Complications were noted in 20.5% of patients, of which malocclusion was the most common (8.2%). Increasing MISS was associated with complications (P < .001). After controlling for the effects of age, mechanism, cervical spine and skull base injuries, and treatment, patients with an MISS of at least 14 were significantly more likely to have a complication (odds ratio = 4.0; 95% confidence interval, 1.05-15.0; P = .04). In pediatric patients with mandibular fractures, increased severity of injury is associated with complications, even after controlling for the effects of multiple confounders, including open treatment. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography.

    PubMed

    Kadziela, Jacek; Michalowska, Ilona; Pregowski, Jerzy; Janaszek-Sitkowska, Hanna; Lech, Katarzyna; Kabat, Marek; Staruch, Adam; Januszewicz, Andrzej; Witkowski, Adam

    2016-01-01

    Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA) versus conventional angiography. Forty patients (41 renal arteries), aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D) and lesion length (CTA_LL) were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D) and lesion length (ANGIO_LL) as well as proposed stent dimensions were obtained by visual estimation. The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001). Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001). The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS), with significant correlation of these variables (r = 0.66, p < 0.0001). The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005) and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001). Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure.

  3. Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography

    PubMed Central

    Michalowska, Ilona; Pregowski, Jerzy; Janaszek-Sitkowska, Hanna; Lech, Katarzyna; Kabat, Marek; Staruch, Adam; Januszewicz, Andrzej; Witkowski, Adam

    2016-01-01

    Introduction Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. Aim To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA) versus conventional angiography. Material and methods Forty patients (41 renal arteries), aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D) and lesion length (CTA_LL) were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D) and lesion length (ANGIO_LL) as well as proposed stent dimensions were obtained by visual estimation. Results The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001). Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001). The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS), with significant correlation of these variables (r = 0.66, p < 0.0001). The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005) and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001). Conclusions Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure. PMID:27279870

  4. Intraoperative Secondary Insults During Orthopedic Surgery in Traumatic Brain Injury.

    PubMed

    Algarra, Nelson N; Lele, Abhijit V; Prathep, Sumidtra; Souter, Michael J; Vavilala, Monica S; Qiu, Qian; Sharma, Deepak

    2017-07-01

    Secondary insults worsen outcomes after traumatic brain injury (TBI). However, data on intraoperative secondary insults are sparse. The primary aim of this study was to examine the prevalence of intraoperative secondary insults during orthopedic surgery after moderate-severe TBI. We also examined the impact of intraoperative secondary insults on postoperative head computed tomographic scan, intracranial pressure (ICP), and escalation of care within 24 hours of surgery. We reviewed medical records of TBI patients 18 years and above with Glasgow Coma Scale score <13 who underwent single orthopedic surgery within 2 weeks of TBI. Secondary insults examined were: systemic hypotension (systolic blood pressure<90 mm Hg), intracranial hypertension (ICP>20 mm Hg), cerebral hypotension (cerebral perfusion pressure<50 mm Hg), hypercarbia (end-tidal CO2>40 mm Hg), hypocarbia (end-tidal CO2<30 mm Hg in absence of intracranial hypertension), hyperglycemia (glucose>200 mg/dL), hypoglycemia (glucose<60 mg/dL), and hyperthermia (temperature >38°C). A total of 78 patients (41 [18 to 81] y, 68% male) met the inclusion criteria. The most common intraoperative secondary insults were systemic hypotension (60%), intracranial hypertension and cerebral hypotension (50% and 45%, respectively, in patients with ICP monitoring), hypercarbia (32%), and hypocarbia (29%). Intraoperative secondary insults were associated with worsening of head computed tomography, postoperative decrease of Glasgow Coma Scale score by ≥2, and escalation of care. After Bonferroni correction, association between cerebral hypotension and postoperative escalation of care remained significant (P<0.001). Intraoperative secondary insults were common during orthopedic surgery in patients with TBI and were associated with postoperative escalation of care. Strategies to minimize intraoperative secondary insults are needed.

  5. Do Women With Anxiety or Depression Have Higher Rates of Myocardial Ischemia During Exercise Testing Than Men?

    PubMed

    Paine, Nicola J; Bacon, Simon L; Pelletier, Roxanne; Arsenault, André; Diodati, Jean G; Lavoie, Kim L

    2016-02-01

    Women diagnosed with coronary artery disease (CAD) typically experience worse outcomes relative to men, possibly through diagnosis and treatment delays. Reasons for these delays may be influenced by mood and anxiety disorders, which are more prevalent in women and have symptoms (eg, palpitations and fatigue) that may be confounded with CAD. Our study examined sex differences in the association between mood and anxiety disorders and myocardial ischemia in patients with and without a CAD history presenting for exercise stress tests. A total of 2342 patients (women n=760) completed a single photon emission computed tomographic exercise stress test (standard Bruce Protocol) and underwent a psychiatric interview (The Primary Care Evaluation of Mental Disorders) to assess mood and anxiety disorders. Ischemia was assessed using single photon emission computed tomography, with odds ratio used to calculate the effect of sex and mood/anxiety on the presence of ischemia during stress testing by CAD history in a stratified analyses, adjusted for relevant covariates. There was a sex by anxiety interaction with ischemia in those without a CAD history (P=0.015): women with anxiety were more likely to exhibit ischemia during exercise than women without anxiety (odds ratio, 1.75; 95% confidence interval, 1.05-2.89). No significant effects were observed for men nor mood. Women with anxiety and no CAD history had higher rates of ischemia than women without anxiety. Results suggest that anxiety symptoms, many of which overlap with those of CAD, might mask CAD symptoms among women (but not men) and contribute to referral and diagnostic delays. Further research is needed to confirm this hypothesis. © 2016 American Heart Association, Inc.

  6. What Is the Standard Volume to Increase a Cup Size for Breast Augmentation Surgery? A Novel Three-Dimensional Computed Tomographic Approach.

    PubMed

    King, Nina-Marie; Lovric, Vedran; Parr, William C H; Walsh, W R; Moradi, Pouria

    2017-05-01

    Breast augmentation surgery poses many challenges, and meeting the patient's expectations is one of the most important. Previous reports equate 100 cc to a one-cup-size increase; however, no studies have confirmed this between commercially available bras. The aim of this study was to identify the volume increase between cup sizes across different brands and the relationship with implant selection. Five bra cup sizes from three different companies were analyzed for their volume capacity. Three methods were used to calculate the volume of the bras: (1) linear measurements; (2) volume measurement by means of water displacement; and (3) volume calculation after three-dimensional reconstruction of serial radiographic data (computed tomography). The clinical arm consisted of 79 patients who underwent breast augmentation surgery from February 1, 2014, to June 30, 2016. Answers from a short questionnaire in combination with the implant volume were analyzed. Across all three brands, the interval volume increase varied between sizes, but not all were above 100 cc. There was some variation in the volume capacity of the same cup size among the different brands. The average incremental increase in bra cup size across all three brands in the laboratory arm was 135 cc. The mean volume increase per cup size was 138.23 cc in the clinical arm. This article confirms that there is no standardization within the bra manufacturing industry. On the basis of this study, patients should be advised that 130 to 150 cc equates to a one-cup-size increase. Bras with narrower band widths need 130 cc and wider band widths require 150 cc to increase one cup size.

  7. Virtual surgery for patients with nasal obstruction: Use of computational fluid dynamics (MeComLand®, Digbody® & Noseland®) to document objective flow parameters and optimise surgical results.

    PubMed

    Burgos, Manuel A; Sevilla García, Maria Agustina; Sanmiguel Rojas, Enrique; Del Pino, Carlos; Fernández Velez, Carlos; Piqueras, Francisco; Esteban Ortega, Francisco

    Computational fluid dynamics (CFD) is a mathematical tool to analyse airflow. We present a novel CFD software package to improve results following nasal surgery for obstruction. A group of engineers in collaboration with otolaryngologists have developed a very intuitive CFD software package called MeComLand®, which uses the patient's cross-sectional (tomographic) images, thus showing in detail results originated by CFD such as airflow distributions, velocity profiles, pressure, or wall shear stress. NOSELAND® helps medical evaluation with dynamic reports by using a 3D endoscopic view. Using this CFD-based software a patient underwent virtual surgery (septoplasty, turbinoplasty, spreader grafts, lateral crural J-flap and combinations) to choose the best improvement in nasal flow. To present a novel software package to improve nasal surgery results. To apply the software on CT slices from a patient affected by septal deviation. To evaluate several surgical procedures (septoplasty, turbinectomy, spreader-grafts, J-flap and combination among them) to find the best alternative with less morbidity. The combination of all the procedures does not provide the best nasal flow improvement. Septoplasty plus turbinoplasty obtained the best results. Turbinoplasty alone rendered almost similar results to septoplasty in our simulation. CFD provides useful complementary information to cover diagnosis, prognosis, and follow-up of nasal pathologies based on quantitative magnitudes linked to fluid flow. MeComLand®, DigBody® and NoseLand® represent a non-invasive, low-cost alternative for the functional study of patients with nasal obstruction. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  8. Timing of Occurrence Is the Most Important Characteristic of Spot Sign.

    PubMed

    Wang, Binli; Yan, Shenqiang; Xu, Mengjun; Zhang, Sheng; Liu, Keqin; Hu, Haitao; Selim, Magdy; Lou, Min

    2016-05-01

    Most previous studies have used single-phase computed tomographic angiography to detect the spot sign, a marker for hematoma expansion (HE) in spontaneous intracerebral hemorrhage. We investigated whether defining the spot sign based on timing on perfusion computed tomography (CTP) would improve its specificity for predicting HE. We prospectively enrolled supratentorial spontaneous intracerebral hemorrhage patients who underwent CTP within 6 hours of onset. Logistic regression was performed to assess the risk factors for HE and poor outcome. Predictive performance of individual CTP spot sign characteristics were examined with receiver operating characteristic analysis. Sixty-two men and 21 women with spontaneous intracerebral hemorrhage were included in this analysis. Spot sign was detected in 46% (38/83) of patients. Receiver operating characteristic analysis indicated that the timing of spot sign occurrence on CTP had the greatest area under receiver operating characteristic curve for HE (0.794; 95% confidence interval, 0.630-0.958; P=0.007); the cutoff time was 23.13 seconds. On multivariable analysis, the presence of early-occurring spot sign (ie, spot sign before 23.13 seconds) was an independent predictor not only of HE (odds ratio=28.835; 95% confidence interval, 6.960-119.458; P<0.001), but also of mortality at 3 months (odds ratio =22.377; 95% confidence interval, 1.773-282.334; P=0.016). Moreover, the predictive performance showed that the redefined early-occurring spot sign maintained a higher specificity for HE compared with spot sign (91% versus 74%). Redefining the spot sign based on timing of contrast leakage on CTP to determine early-occurring spot sign improves the specificity for predicting HE and 3-month mortality. The use of early-occurring spot sign could improve the selection of ICH patients for potential hemostatic therapy. © 2016 American Heart Association, Inc.

  9. COMPARISON BETWEEN COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE MIDDLE EAR IN NONBRACHYCEPHALIC AND BRACHYCEPHALIC DOGS WITH OBSTRUCTIVE AIRWAY SYNDROME.

    PubMed

    Salgüero, Raquel; Herrtage, Michael; Holmes, Mark; Mannion, Paddy; Ladlow, Jane

    2016-01-01

    Prevalence of subclinical middle ear lesions in dogs that undergo computed tomography (CT) and magnetic resonance imaging of the head has been reported up to 41%. A predisposition in brachycephalics has been suggested, however evidence-based studies are lacking. Aims of this retrospective cross-sectional study were to compare CT characteristics of the middle ear in groups of nonbrachycephalic and brachycephalic dogs that underwent CT of the head for conditions unrelated to ear disease, and test associations between thickness of the soft palate and presence of subclinical middle ear lesions. One observer recorded CT findings for each dog without knowledge of group status. A total of 65 dogs met inclusion criteria (25 brachycephalic, 40 nonbrachycephalic). Brachycephalic dogs had a significantly thicker bulla wall (P = 2.38 × 10(-26)) and smaller luminal volume (P = 5.74 × 10(-20)), when compared to nonbrachycephalic dogs. Soft palate thickness was significantly greater in the brachycephalic group (P = 2.76 × 10(-9)). Nine of 25 brachycephalic dogs had material in the lumen of the tympanic cavity, compared to zero of 45 of nonbrachycephalics. Within the brachycephalic group, a significant difference in mean soft palate thickness was identified for dogs with material in the middle ear (12.2 mm) vs. air-filled bullae (9 mm; P = 0.016). Findings from the current study supported previous theories that brachycephalic dogs have a greater prevalence of subclinical middle ear effusion and smaller bulla luminal size than nonbrachycephalic dogs. Authors recommend that the bulla lumen volume formula previously developed for mesaticephalic dogs, (-0.612 + 0.757 [lnBW]) be adjusted to 1/3(-0.612 + 0.757 [lnBW]) for brachycephalic breeds. © 2016 American College of Veterinary Radiology.

  10. Prognostic value of computed tomographic coronary angiography and exercise electrocardiography for cardiovascular events

    PubMed Central

    Kim, Kye-Hwan; Jeon, Kyung Nyeo; Kang, Min Gyu; Ahn, Jong Hwa; Koh, Jin-Sin; Park, Yongwhi; Hwang, Seok-Jae; Jeong, Young-Hoon; Kwak, Choong Hwan; Hwang, Jin-Yong; Park, Jeong Rang

    2016-01-01

    Background/Aims: This study is a head-to-head comparison of predictive values for long-term cardiovascular outcomes between exercise electrocardiography (ex-ECG) and computed tomography coronary angiography (CTCA) in patients with chest pain. Methods: Four hundred and forty-two patients (mean age, 56.1 years; men, 61.3%) who underwent both ex-ECG and CTCA for evaluation of chest pain were included. For ex-ECG parameters, the patients were classified according to negative or positive results, and Duke treadmill score (DTS). Coronary artery calcium score (CACS), presence of plaque, and coronary artery stenosis were evaluated as CTCA parameters. Cardiovascular events for prognostic evaluation were defined as unstable angina, acute myocardial infarction, revascularization, heart failure, and cardiac death. Results: The mean follow-up duration was 2.8 ± 1.1 years. Fifteen patients experienced cardiovascular events. Based on pretest probability, the low- and intermediate-risks of coronary artery disease were 94.6%. Odds ratio of CACS > 40, presence of plaque, coronary stenosis ≥ 50% and DTS ≤ 4 were significant (3.79, p = 0.012; 9.54, p = 0.030; 6.99, p < 0.001; and 4.58, p = 0.008, respectively). In the Cox regression model, coronary stenosis ≥ 50% (hazard ratio, 7.426; 95% confidence interval, 2.685 to 20.525) was only significant. After adding DTS ≤ 4 to coronary stenosis ≥ 50%, the integrated discrimination improvement and net reclassification improvement analyses did not show significant. Conclusions: CTCA was better than ex-ECG in terms of predicting long-term outcomes in low- to intermediate-risk populations. The predictive value of the combination of CTCA and ex-ECG was not superior to that of CTCA alone. PMID:27017387

  11. Subcutaneous Tissue Thickness is an Independent Predictor of Image Noise in Cardiac CT

    PubMed Central

    Staniak, Henrique Lane; Sharovsky, Rodolfo; Pereira, Alexandre Costa; de Castro, Cláudio Campi; Benseñor, Isabela M.; Lotufo, Paulo A.; Bittencourt, Márcio Sommer

    2014-01-01

    Background Few data on the definition of simple robust parameters to predict image noise in cardiac computed tomography (CT) exist. Objectives To evaluate the value of a simple measure of subcutaneous tissue as a predictor of image noise in cardiac CT. Methods 86 patients underwent prospective ECG-gated coronary computed tomographic angiography (CTA) and coronary calcium scoring (CAC) with 120 kV and 150 mA. The image quality was objectively measured by the image noise in the aorta in the cardiac CTA, and low noise was defined as noise < 30HU. The chest anteroposterior diameter and lateral width, the image noise in the aorta and the skin-sternum (SS) thickness were measured as predictors of cardiac CTA noise. The association of the predictors and image noise was performed by using Pearson correlation. Results The mean radiation dose was 3.5 ± 1.5 mSv. The mean image noise in CT was 36.3 ± 8.5 HU, and the mean image noise in non-contrast scan was 17.7 ± 4.4 HU. All predictors were independently associated with cardiac CTA noise. The best predictors were SS thickness, with a correlation of 0.70 (p < 0.001), and noise in the non-contrast images, with a correlation of 0.73 (p < 0.001). When evaluating the ability to predict low image noise, the areas under the ROC curve for the non-contrast noise and for the SS thickness were 0.837 and 0.864, respectively. Conclusion Both SS thickness and CAC noise are simple accurate predictors of cardiac CTA image noise. Those parameters can be incorporated in standard CT protocols to adequately adjust radiation exposure. PMID:24173136

  12. Evaluation of the portal vein after duodenoduodenostomy for congenital duodenal stenosis associated with the preduodenal superior mesenteric vein, situs inversus, polysplenia, and malrotation.

    PubMed

    Ohno, Koichi; Nakamura, Tetsuro; Azuma, Takashi; Yoshida, Tatusyuki; Hayashi, Hiroaki; Nakahira, Masashi; Nishigaki, Kyoichi; Kawahira, Yoichi; Ueno, Takayoshi

    2007-02-01

    A male infant weighting 2970 g with total situs inversus, polysplenia, malrotation, duodenal stenosis, and complex cardiac anomalies, was admitted to our hospital. At 4 days of age, he underwent surgery that revealed a blood vessel passing over the duodenum from the mesenterium to the porta hepatis. A loose overbridging duodenoduodenostomy was performed to prevent compression of the vessel. The cardiac anomalies were corrected, and he could eat unrestricted diets. At the age of 1 year and 3 months, a 3-dimensional computed tomographic scan demonstrated that the vessel on the duodenum was the superior mesenteric vein (SMV), and it formed the portal vein with the splenic vein at the porta hepatis. Further, the scan revealed no compression of the SMV at the anastomosis. Doppler ultrasonography revealed a normal portal blood flow of 118.6 mL/min. This report describes the junction between the SMV and the splenic vein in a patient who had the SMV passing over the duodenum from the mesenterium. Correctly, patients previously diagnosed with a preduodenal portal vein could have a preduodenal SMV. The loose overbridging duodenoduodenostomy had advantages not only in passage of the anastomosis but also in maintenance of the portal blood flow for the congenital duodenal obstruction with the preduodenal SMV.

  13. Carotid plaque characterization using CT and MRI scans for synergistic image analysis

    NASA Astrophysics Data System (ADS)

    Getzin, Matthew; Xu, Yiqin; Rao, Arhant; Madi, Saaussan; Bahadur, Ali; Lennartz, Michelle R.; Wang, Ge

    2014-09-01

    Noninvasive determination of plaque vulnerability has been a holy grail of medical imaging. Despite advances in tomographic technologies , there is currently no effective way to identify vulnerable atherosclerotic plaques with high sensitivity and specificity. Computed tomography (CT) and magnetic resonance imaging (MRI) are widely used, but neither provides sufficient information of plaque properties. Thus, we are motivated to combine CT and MRI imaging to determine if the composite information can better reflect the histological determination of plaque vulnerability. Two human endarterectomy specimens (1 symptomatic carotid and 1 stable femoral) were imaged using Scanco Medical Viva CT40 and Bruker Pharmascan 16cm 7T Horizontal MRI / MRS systems. μCT scans were done at 55 kVp and tube current of 70 mA. Samples underwent RARE-VTR and MSME pulse sequences to measure T1, T2 values, and proton density. The specimens were processed for histology and scored for vulnerability using the American Heart Association criteria. Single modality-based analyses were performed through segmentation of key imaging biomarkers (i.e. calcification and lumen), image registration, measurement of fibrous capsule, and multi-component T1 and T2 decay modeling. Feature differences were analyzed between the unstable and stable controls, symptomatic carotid and femoral plaque, respectively. By building on the techniques used in this study, synergistic CT+MRI analysis may provide a promising solution for plaque characterization in vivo.

  14. Small bowel entrapment and ureteropelvic junction disruption associated with L3 Chance fracture-dislocation.

    PubMed

    Pesenti, Sebastien; Blondel, Benjamin; Faure, Alice; Peltier, Emilie; Launay, Franck; Jouve, Jean-Luc

    2016-09-16

    Paediatric Chance fracture are rare lesions but often associated with abdominal injuries. We herein present the case of a seven years old patient who sustained an entrapment of small bowel and an ureteropelvic disruption associated with a Chance fracture and spine dislocation following a traffic accident. Initial X-rays and computed tomographic (CT) scan showed a Chance fracture with dislocation of L3 vertebra, with an incarceration of a small bowel loop in the spinal canal and a complete section of the left lumbar ureter. Paraplegia was noticed on the initial neurological examination. A posterior L2-L4 osteosynthesis was performed firstly. In a second time she underwent a sus umbilical laparotomy to release the incarcerated jejunum loop in the spinal canal. An end-to-end anastomosis was performed on a JJ probe to suture the left injured ureter. One month after the traumatism, she started to complain of severe headaches related to a leakage of cerebrospinalis fluid. Three months after the traumatism there was a clear regression of the leakage. One year after the trauma, an anterior intervertebral fusion was done. At final follow-up, no neurologic recovery was noticed. In case of Chance fracture, all physicians should think about abdominal injuries even if the patient is asymptomatic. Initial abdominal CT scan and magnetic resonance imaging provide in such case crucial info for management of the spine and the associated lesions.

  15. Curvularia fungi presenting as a large cranial base meningioma: case report.

    PubMed

    Singh, Harminder; Irwin, Sibyl; Falowski, Steven; Rosen, Mark; Kenyon, Lawrence; Jungkind, Donald; Evans, James

    2008-07-01

    Fungal infections are emerging as a growing threat to human health, especially in immunocompromised patients. Candida, Cryptococcus, and Aspergillus are a few of the commonly encountered organisms leading to brain abscesses. In this report, we describe Curvularia geniculata as the causative agent in central nervous system infection. Our review of the literature did not reveal a similar published case of central nervous system infection with this organism. A 35-year-old African-American man presented with obstructive hydrocephalus from a large cranial base lesion. Imaging characteristics on computed tomographic and magnetic resonance imaging scans were consistent with those of a cranial base meningioma. The patient underwent an endoscopic transnasal/transclival approach to the anterior middle cranial base for biopsy and decompression of this lesion. A spindle cell proliferation was observed on frozen section, which favored a diagnosis of meningioma. However, on permanent sections, we identified fungal hyphae with budding. Subsequent biopsies grew Curvularia in fungal cultures. Deoxyribonucleic acid sequencing was used to confirm the identification of the isolate as Curvularia geniculata. Limited data are available for in vitro susceptibility testing of Curvularia, and treatment modalities have not yet been standardized. The prognosis is usually poor. Despite being treated with voriconazole and intravenous amphotericin, this patient progressed to multiorgan failure and ultimately died. This is the first reported case of central nervous system infection by Curvularia geniculata.

  16. Variation in diagnostic performance among radiologists at screening CT colonography.

    PubMed

    Pooler, B Dustin; Kim, David H; Hassan, Cesare; Rinaldi, Antonio; Burnside, Elizabeth S; Pickhardt, Perry J

    2013-07-01

    To assess the variation in diagnostic performance among radiologists at screening computed tomographic (CT) colonography. In this HIPAA-compliant, institutional review board-approved study, 6866 asymptomatic adults underwent first-time CT colonographic screening at a single center between January 2005 and November 2011. Results of examinations were interpreted by one of eight board-certified abdominal radiologists (mean number of CT colonographic studies per reader, 858; range, 131-2202). Findings at CT colonography and subsequent colonoscopy were recorded, and key measures of diagnostic performance, including adenoma and advanced neoplasia detection rate, were compared among the radiologists. The overall prevalence of histopathologically confirmed advanced neoplasia was 3.6% and did not differ significantly among radiologists (range, 2.4%-4.4%; P = .067; P = .395 when one outlier was excluded). Overall, 19.5% of polyps detected at CT colonography proved to be advanced neoplasia and did not differ significantly among radiologists (range, 14.4%-23.2%; P = .223). The overall per-polyp endoscopic confirmation rate was 93.5%, ranging from 80.0% to 97.6% among radiologists (P = .585). The overall percentage of nondiagnostic CT colonographic examinations was 0.7% and was consistent among radiologists (range, 0.3%-1.1%; P = .509). Consistent performance for adenoma and advanced neoplasia detection, as well as other clinically relevant end points, were observed among radiologists at CT colonographic screening.

  17. Model-based iterative reconstruction in low-dose CT colonography-feasibility study in 65 patients for symptomatic investigation.

    PubMed

    Vardhanabhuti, Varut; James, Julia; Nensey, Rehaan; Hyde, Christopher; Roobottom, Carl

    2015-05-01

    To compare image quality on computed tomographic colonography (CTC) acquired at standard dose (STD) and low dose (LD) using filtered-back projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction (MBIR) techniques. A total of 65 symptomatic patients were prospectively enrolled for the study and underwent STD and LD CTC with filtered-back projection, adaptive statistical iterative reconstruction, and MBIR to allow direct per-patient comparison. Objective image noise, subjective image analyses, and polyp detection were assessed. Objective image noise analysis demonstrates significant noise reduction using MBIR technique (P < .05) despite being acquired at lower doses. Subjective image analyses were superior for LD MBIR in all parameters except visibility of extracolonic lesions (two-dimensional) and visibility of colonic wall (three-dimensional) where there were no significant differences. There was no significant difference in polyp detection rates (P > .05). Doses: LD (dose-length product, 257.7), STD (dose-length product, 483.6). LD MBIR CTC objectively shows improved image noise using parameters in our study. Subjectively, image quality is maintained. Polyp detection shows no significant difference but because of small numbers needs further validation. Average dose reduction of 47% can be achieved. This study confirms feasibility of using MBIR in this context of CTC in symptomatic population. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  18. Liver Hypertrophy After Percutaneous Portal Vein Embolization: Comparison of N-Butyl-2-Cyanocrylate Versus Sodium Acrylate-Vinyl Alcohol Copolymer Particles in a Swine Model

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Theocharis, Stamatis, E-mail: theocharis@ath.forthnet.gr; Ptohis, Nikolaos, E-mail: nikptohis@yahoo.gr

    2011-10-15

    Purpose: Percutaneous portal vein embolization (PPVE) induces hypertrophy of the future liver remnant before hepatic resection. The ideal embolic material has not yet been determined. We compared N-butyl-2-cyanocrylate (NBCA) with sodium acrylate-vinyl alcohol copolymer particles using a swine model. Materials and Methods: Twelve pigs underwent PPVE. Six pigs (group A) were embolized with NBCA, and 6 pigs (group B) were embolized with sodium acrylate-vinyl alcohol copolymer particles. Computed tomographic volumetry of the embolized lobe (EL) and the nonembolized lobe (NEL), along with liver function tests, was performed before and at 14 and 28 days after embolization. Tissue samples from bothmore » lobes were taken 14 and 28 days after PPVE. Results: NEL-volume and NEL-ratio increases were significantly higher in group A at 14 and 28 days after PPVE (78 and 52% and 91 and 66%, respectively) than in group B (32 and 12% and 28 and 10%, respectively) (p < 0.05). Percent change of the EL-volume was significantly higher for group A at 28 days after PPVE. No statistically significant difference was found between the groups regarding hepatocyte proliferation on the NEL and apoptosis on the EL at both time intervals. Conclusion: PPVE using NBCA is more efficient and causes more NEL hypertrophy than microspheres.« less

  19. Evaluating of small intracranial aneurysms by 64-detector CT Angiography: a comparison with 3-dimensional rotation DSA or surgical findings.

    PubMed

    Zhang, He; Hou, Chang; Zhou, Zhi; Zhang, Hao; Zhou, Gen; Zhang, Gui

    2014-01-01

    The diagnostic performance of 64-detector computed tomographic angiography (CTA) for detection of small intracranial aneurysms (SIAs) was evaluated. In this prospective study, 112 consecutive patients underwent 64-detector CTA before volume-rendering rotation digital subtraction angiography (VR-RDSA) or surgery. VR-RDSA or intraoperative findings or both were used as the gold standards. The accuracy, sensitivity, specificity, and positive predictive values (PPV) and negative predictive values (NPV), as measures to detect or rule out SIAs, were determined by patient-based and aneurysm size-based evaluations. The reference standard methods revealed 84 small aneurysms in 71 patients. The results of patient-based 64-detector CTA evaluation for SIAs were: accuracy, 98.2%; sensitivity, 98.6%; specificity, 97.6%; PPV, 98.6%; and NPV, 97.6%. The aneurysm-based evaluation results were: accuracy, 96.8%; sensitivity, 97.6%; specificity, 95.1%; PPV, 97.6%; and NPV, 95.1%. Two false-positive and two false-negative findings for aneurysms <3 mm in size occurred in the 64-detector CTA analysis. The diagnostic performance of 64-detector CTA did not improve much compared with 16-detector CTA for detecting SIAs, especially for very small aneurysms. VR-RDSA is still necessary for patients with a history of subarachnoid hemorrhage if the CTA findings are negative. Copyright © 2012 by the American Society of Neuroimaging.

  20. Effect of Esophagus Position on Surgical Difficulty and Postoperative Morbidities After Thoracoscopic Esophagectomy.

    PubMed

    Yoshida, Naoya; Baba, Yoshifumi; Shigaki, Hironobu; Shiraishi, Shinya; Harada, Kazuto; Watanabe, Masayuki; Iwatsuki, Masaaki; Kurashige, Junji; Sakamoto, Yasuo; Miyamoto, Yuji; Ishimoto, Takatsugu; Kosumi, Keisuke; Tokunaga, Ryuma; Yamashita, Yasuyuki; Baba, Hideo

    2016-01-01

    The objective include thoracoscopic esophagectomy for the deep-seated (left-sided) esophagus has several technical difficulties, which may affects the intraoperative or postoperative outcomes. However, no previous studies have focused on the correlation between the position of the esophagus and short-term outcome after thoracoscopic esophagectomy. Of 470 esophagectomies between April 2005 and April 2015 in Kumamoto University Hospital, 112 patients who underwent thoracoscopic esophagectomy for esophageal cancer were examined. The position of the esophagus was divided into 2 types: deep-seated esophagus or another type based on computed tomographic images in the supine position. In results, the deep-seated esophagus was associated with a longer operation time in the thorax and high incidence of severe morbidity of Clavien-Dindo classification ≥IIIb, pneumonia, and any pulmonary morbidity. The deep-seated esophagus was also an independent risk factor for severe morbidity (hazard ratio [HR] = 5.37, 95% CI: 1.307-22.03; P = 0.020), pneumonia (HR = 9.23, 95% CI: 2.150-39.60; P = 0.003), and any pulmonary morbidity (HR = 10.3, 95% CI: 2.714-38.78; P < 0.001). In conclusion, the position of the esophagus had a strong influence on the difficulty of thoracoscopic esophagectomy and the incidence of postoperative morbidities. Surgeons would be well advised to keep a careful watch perioperatively for patients with a deep-seated esophagus. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Utility of three-dimensional and multiplanar reformatted computed tomography for evaluation of pediatric congenital spine abnormalities.

    PubMed

    Newton, Peter O; Hahn, Gregory W; Fricka, Kevin B; Wenger, Dennis R

    2002-04-15

    A retrospective radiographic review of 31 patients with congenital spine abnormalities who underwent conventional radiography and advanced imaging studies was conducted. To analyze the utility of three-dimensional computed tomography with multiplanar reformatted images for congenital spine anomalies, as compared with plain radiographs and axial two-dimensional computed tomography imaging. Conventional radiographic imaging for congenital spine disorders often are difficult to interpret because of the patient's small size, the complexity of the disorder, a deformity not in the plane of the radiographs, superimposed structures, and difficulty in forming a mental three-dimensional image. Multiplanar reformatted and three-dimensional computed tomographic imaging offers many potential advantages for defining congenital spine anomalies including visualization of the deformity in any plane, from any angle, with the overlying structures subtracted. The imaging studies of patients who had undergone a three-dimensional computed tomography for congenital deformities of the spine between 1992 and 1998 were reviewed (31 cases). All plain radiographs and axial two-dimensional computed tomography images performed before the three-dimensional computed tomography were reviewed and the findings documented. This was repeated for the three-dimensional reconstructions and, when available, the multiplanar reformatted images (15 cases). In each case, the utility of the advanced imaging was graded as one of the following: Grade A (substantial new information obtained), Grade B (confirmatory with improved visualization and understanding of the deformity), and Grade C (no added useful information obtained). In 17 of 31 cases, the multiplanar reformatted and three-dimensional images allowed identification of unrecognized malformations. In nine additional cases, the advanced imaging was helpful in better visualizing and understanding previously identified deformities. In five cases, no new information was gained. The standard and curved multiplanar reformatted images were best for defining the occiput-C1-C2 anatomy and the extent of segmentation defects. The curved multiplanar reformatted images were especially helpful in keeping the spine from "coming in" and "going out" of the plane of the image when there was significant spine deformity in the sagittal or coronal plane. The three-dimensional reconstructions proved valuable in defining failures of formation. Advanced computed tomography imaging (three-dimensional computed tomography and curved/standard multiplanar reformatted images) allows better definition of congenital spine anomalies. More than 50% of the cases showed additional abnormalities not appreciated on plain radiographs or axial two-dimensional computed tomography images. Curved multiplanar reformatted images allowed imaging in the coronal and sagittal planes of the entire deformity.

  2. Replacing Heavily Damaged Teeth by Third Molar Autotransplantation With the Use of Cone-Beam Computed Tomography and Rapid Prototyping.

    PubMed

    Verweij, Jop P; Anssari Moin, David; Wismeijer, Daniel; van Merkesteyn, J P Richard

    2017-09-01

    This article describes the autotransplantation of third molars to replace heavily damaged premolars and molars. Specifically, this article reports on the use of preoperative cone-beam computed tomographic planning and 3-dimensional (3D) printed replicas of donor teeth to prepare artificial tooth sockets. In the present case, an 18-year-old patient underwent autotransplantation of 3 third molars to replace 1 premolar and 2 molars that were heavily damaged after trauma. Approximately 1 year after the traumatic incident, autotransplantation with the help of 3D planning and rapid prototyping was performed. The right maxillary third molar replaced the right maxillary first premolar. The 2 mandibular wisdom teeth replaced the left mandibular first and second molars. During the surgical procedure, artificial tooth sockets were prepared with the help of 3D printed donor tooth copies to prevent iatrogenic damage to the actual donor teeth. These replicas of the donor teeth were designed based on the preoperative cone-beam computed tomogram and manufactured with the help of 3D printing techniques. The use of a replica of the donor tooth resulted in a predictable and straightforward procedure, with extra-alveolar times shorter than 2 minutes for all transplantations. The transplanted teeth were placed in infraocclusion and fixed with a suture splint. Postoperative follow-up showed physiologic integration of the transplanted teeth and a successful outcome for all transplants. In conclusion, this technique facilitates a straightforward and predictable procedure for autotransplantation of third molars. The use of printed analogues of the donor teeth decreases the risk of iatrogenic damage and the extra-alveolar time of the transplanted tooth is minimized. This facilitates a successful outcome. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Building a symbolic computer algebra toolbox to compute 2D Fourier transforms in polar coordinates.

    PubMed

    Dovlo, Edem; Baddour, Natalie

    2015-01-01

    The development of a symbolic computer algebra toolbox for the computation of two dimensional (2D) Fourier transforms in polar coordinates is presented. Multidimensional Fourier transforms are widely used in image processing, tomographic reconstructions and in fact any application that requires a multidimensional convolution. By examining a function in the frequency domain, additional information and insights may be obtained. The advantages of our method include: •The implementation of the 2D Fourier transform in polar coordinates within the toolbox via the combination of two significantly simpler transforms.•The modular approach along with the idea of lookup tables implemented help avoid the issue of indeterminate results which may occur when attempting to directly evaluate the transform.•The concept also helps prevent unnecessary computation of already known transforms thereby saving memory and processing time.

  4. Tomographic methods in flow diagnostics

    NASA Technical Reports Server (NTRS)

    Decker, Arthur J.

    1993-01-01

    This report presents a viewpoint of tomography that should be well adapted to currently available optical measurement technology as well as the needs of computational and experimental fluid dynamists. The goals in mind are to record data with the fastest optical array sensors; process the data with the fastest parallel processing technology available for small computers; and generate results for both experimental and theoretical data. An in-depth example treats interferometric data as it might be recorded in an aeronautics test facility, but the results are applicable whenever fluid properties are to be measured or applied from projections of those properties. The paper discusses both computed and neural net calibration tomography. The report also contains an overview of key definitions and computational methods, key references, computational problems such as ill-posedness, artifacts, missing data, and some possible and current research topics.

  5. Advanced imaging in acute stroke management-Part I: Computed tomographic.

    PubMed

    Saini, Monica; Butcher, Ken

    2009-01-01

    Neuroimaging is fundamental to stroke diagnosis and management. Non-contrast computed tomography (NCCT) has been the primary imaging modality utilized for this purpose for almost four decades. Although NCCT does permit identification of intracranial hemorrhage and parenchymal ischemic changes, insights into blood vessel patency and cerebral perfusion are limited. Advances in reperfusion strategies have made identification of potentially salvageable brain tissue a more practical concern. Advances in CT technology now permit identification of acute and chronic arterial lesions, as well as cerebral blood flow deficits. This review outlines principles of advanced CT image acquisition and its utility in acute stroke management.

  6. Meaning of Interior Tomography

    PubMed Central

    Wang, Ge; Yu, Hengyong

    2013-01-01

    The classic imaging geometry for computed tomography is for collection of un-truncated projections and reconstruction of a global image, with the Fourier transform as the theoretical foundation that is intrinsically non-local. Recently, interior tomography research has led to theoretically exact relationships between localities in the projection and image spaces and practically promising reconstruction algorithms. Initially, interior tomography was developed for x-ray computed tomography. Then, it has been elevated as a general imaging principle. Finally, a novel framework known as “omni-tomography” is being developed for grand fusion of multiple imaging modalities, allowing tomographic synchrony of diversified features. PMID:23912256

  7. Why did ancient people have atherosclerosis?: from autopsies to computed tomography to potential causes.

    PubMed

    Thomas, Gregory S; Wann, L Samuel; Allam, Adel H; Thompson, Randall C; Michalik, David E; Sutherland, M Linda; Sutherland, James D; Lombardi, Guido P; Watson, Lucia; Cox, Samantha L; Valladolid, Clide M; Abd El-Maksoud, Gomaa; Al-Tohamy Soliman, Muhammad; Badr, Ibrahem; el-Halim Nur el-Din, Abd; Clarke, Emily M; Thomas, Ian G; Miyamoto, Michael I; Kaplan, Hillard S; Frohlich, Bruno; Narula, Jagat; Stewart, Alexandre F R; Zink, Albert; Finch, Caleb E

    2014-06-01

    Computed tomographic findings of atherosclerosis in the ancient cultures of Egypt, Peru, the American Southwest and the Aleutian Islands challenge our understanding of the fundamental causes of atherosclerosis. Could these findings be true? Is so, what traditional risk factors might be present in these cultures that could explain this apparent paradox? The recent computed tomographic findings are consistent with multiple autopsy studies dating as far back as 1852 that demonstrate calcific atherosclerosis in ancient Egyptians and Peruvians. A nontraditional cause of atherosclerosis that could explain this burden of atherosclerosis is the microbial and parasitic inflammatory burden likely to be present in ancient cultures inherently lacking modern hygiene and antimicrobials. Patients with chronic systemic inflammatory diseases of today, including systemic lupus erythematosus, rheumatoid arthritis, and human immunodeficiency virus infection, experience premature atherosclerosis and coronary events. Might the chronic inflammatory load of ancient times secondary to infection have resulted in atherosclerosis? Smoke inhalation from the use of open fires for daily cooking and illumination represents another potential cause. Undiscovered risk factors could also have been present, potential causes that technologically cannot currently be measured in our serum or other tissue. A synthesis of these findings suggests that a gene-environmental interplay is causal for atherosclerosis. That is, humans have an inherent genetic susceptibility to atherosclerosis, whereas the speed and severity of its development are secondary to known and potentially unknown environmental factors. Copyright © 2014 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  8. Lung Mass in Smokers.

    PubMed

    Washko, George R; Kinney, Gregory L; Ross, James C; San José Estépar, Raúl; Han, MeiLan K; Dransfield, Mark T; Kim, Victor; Hatabu, Hiroto; Come, Carolyn E; Bowler, Russell P; Silverman, Edwin K; Crapo, James; Lynch, David A; Hokanson, John; Diaz, Alejandro A

    2017-04-01

    Emphysema is characterized by airspace dilation, inflammation, and irregular deposition of elastin and collagen in the interstitium. Computed tomographic studies have reported that lung mass (LM) may be increased in smokers, a finding attributed to inflammatory and parenchymal remodeling processes observed on histopathology. We sought to examine the epidemiologic and clinical associations of LM in smokers. Baseline epidemiologic, clinical, and computed tomography (CT) data (n = 8156) from smokers enrolled into the COPDGene Study were analyzed. LM was calculated from the CT scan. Changes in lung function at 5 years' follow-up were available from 1623 subjects. Regression analysis was performed to assess for associations of LM with forced expiratory volume in 1 second (FEV 1 ) and FEV 1 decline. Subjects with Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 chronic obstructive pulmonary disease had greater LM than either smokers with normal lung function or those with GOLD 2-4 chronic obstructive pulmonary disease (P < 0.001 for both comparisons). LM was predictive of the rate of the decline in FEV 1 (decline per 100 g, -4.7 ± 1.7 mL/y, P = 0.006). Our cross-sectional data suggest the presence of a biphasic radiological remodeling process in smokers: the presence of such nonlinearity must be accounted for in longitudinal computed tomographic studies. Baseline LM predicts the decline in lung function. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  9. Epicardial adipose tissue as a predictor of coronary artery disease in asymptomatic subjects.

    PubMed

    Bachar, Gil N; Dicker, Dror; Kornowski, Ran; Atar, Eli

    2012-08-15

    This study sought to elucidate the relation between epicardial adipose tissue (EAT) thickness measured by multidetector computed tomography and presence of coronary artery atherosclerosis. Recent studies have suggested that fat disposition in visceral organs and epicardial tissue could serve as a predictor of coronary artery disease (CAD). The sample included 190 asymptomatic subjects with ≥ 1 cardiovascular risk factor who were referred for cardiac computed tomographic angiography. Body mass index, blood pressure, fasting glucose level, and lipid profile were measured. Multidetector computed tomographic results were analyzed for atherosclerosis burden, calcium Agatston score, and EAT thickness: mean EAT values were 3.54 ± 1.59 mm in patients with atherosclerosis and 1.85 ± 1.28 mm in patients without atherosclerosis (p <0.001). On receiver operating characteristic analysis, an EAT value ≥ 2.4 mm predicted the presence of significant (>50% diameter) coronary artery stenosis. There was a significant difference in EAT values between patients with and without metabolic syndrome (2.58 ± 1.63 vs 2.04 ± 1.46 mm, p <0.05) and between patients with a calcium score >400 and <400 (3.38 ± 1.58 vs 2.02 ± 1.42 mm, p <0.0001). In conclusion, asymptomatic patients with CAD have significantly more EAT than patients without CAD. An EAT thickness of 2.4 mm is the optimal cutoff for prediction of presence of significant CAD. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. CT Imaging Findings and Their Relevance to the Clinical Outcomes After Stent Graft Repair of Penetrating Aortic Ulcers: Six-year, Single-center Experience

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shin, Ji Hoon; Angle, John F.; Park, Auh Whan

    Purpose: To present the computed tomographic (CT) imaging findings and their relevance to clinical outcomes related to stent graft placement in patients with penetrating aortic ulcers (PAUs). Methods: Medical and imaging records and imaging studies were reviewed for consecutive patients who underwent stent graft repair of a PAU. The distribution and characteristics of the PAU, technical success of stent graft repair, procedure-related complications, associated aortic wall abnormalities, and outcomes of the PAUs at follow-up CT scans were evaluated. Results: Fifteen patients underwent endovascular treatment for PAU. A total of 87% of the PAUs were in the proximal (n = 8)more » or distal (n = 5) descending thoracic aorta. There was a broad spectrum of PAU depth (mean, 7.9 {+-} 5.6 mm; range 1.5-25.0 mm) and diameter (mean, 13.5 {+-} 9.7 mm; range 2.2-41.0 mm). Atherosclerosis of the thoracic aorta and intramural hematoma were associated in 53 and 93% of the patients, respectively. Technical success was achieved in 100%. Two or more stent grafts were used in five patients. Endoleaks were observed in two patients within 2 weeks of the procedure, both of which resolved spontaneously. At follow-up CT scanning, regression and thrombosis of the PAUs were observed in all patients. The average patient survival was 61.8 months, with an overall mortality of 13% (2 of 15) at follow-up. Neither death was related to the endograft device or the PAU. Conclusion: Endovascular stent graft placement was safe and effective in causing regression and thrombosis of PAUs in this small series of patients. Two or more stent grafts were used in five patients (33%) with associated long-segmental atherosclerotic changes of the thoracic aorta or intramural hematoma.« less

  11. Transcatheter aortic valve implantation: durability of clinical and hemodynamic outcomes beyond 3 years in a large patient cohort.

    PubMed

    Gurvitch, R; Wood, D A; Tay, E L; Leipsic, J; Ye, J; Lichtenstein, S V; Thompson, C R; Carere, R G; Wijesinghe, N; Nietlispach, F; Boone, R H; Lauck, S; Cheung, A; Webb, J G

    2010-09-28

    Although short- and medium-term outcomes after transcatheter aortic valve implantation are encouraging, long-term data on valve function and clinical outcomes are limited. Consecutive high-risk patients who had been declined as surgical candidates because of comorbidities but who underwent successful transcatheter aortic valve implantation with a balloon-expandable valve between January 2005 and December 2006 and survived past 30 days were assessed. Clinical, echocardiographic, and computed tomographic follow-up examinations were performed. Seventy patients who underwent successful procedures and survived longer than 30 days were evaluated at a minimum follow-up of 3 years. At a median follow-up of 3.7 years (interquartile range 3.4 to 4.3 years), survival was 57%. Survival at 1, 2, and 3 years was 81%, 74%, and 61%, respectively. Freedom from reoperation was 98.5% (1 patient with endocarditis). During this early procedural experience, 11 patients died within 30 days, and 8 procedures were unsuccessful. When these patients were included, overall survival was 51%. Transaortic pressure gradients increased from 10.0 mm Hg (interquartile range 8.0 to 12.0 mm Hg) immediately after the procedure to 12.1 mm Hg (interquartile range 8.6 to 16.0 mm Hg) after 3 years (P=0.03). Bioprosthetic valve area decreased from a mean of 1.7±0.4 cm(2) after the procedure to 1.4±0.3 cm(2) after 3 years (P<0.01). Aortic incompetence after implantation was trivial or mild in 84% of cases and remained unchanged or improved over time. There were no cases of structural valvular deterioration, stent fracture, deformation, or valve migration. Transcatheter aortic valve implantation demonstrates good medium- to long-term durability and preserved hemodynamic function, with no evidence of structural failure. The procedure appears to offer an adequate and lasting resolution of aortic stenosis in selected patients.

  12. Comparison of standard- and low-tube voltage 320-detector row volume CT angiography in detection of intracranial aneurysms with digital subtraction angiography as gold standard.

    PubMed

    Sun, Gang; Ding, Juan; Lu, Yang; Li, Min; Li, Li; Li, Guo-ying; Zhang, Xu-ping

    2012-03-01

    The aim of this study was to prospectively assess the effect of low-tube voltage (80 kVp) 320-detector row volume computed tomographic (CT) angiography (L-VCTA) in the detection of intracranial aneurysms, with three-dimensional (3D) spin digital subtraction angiography (DSA) as the gold standard. Forty-eight patients with clinically suspected subarachnoid hemorrhages were divided into two groups. One group underwent L-VCTA and DSA, while the other group underwent conventional-tube voltage (120 kVp) volume CT angiography (C-VCTA) and DSA. Vascular enhancement, image quality, detection accuracy of aneurysms, and radiation dose were compared between the two groups. For objective image quality, the L-VCTA group had higher mean vessel attenuation, correlated with higher image noise and lower signal-to-noise ratio, than the C-VCTA group. For subjective image quality, there were no significant differences between the two groups regarding scores for arterial enhancement, depiction of small arterial detail, interference of venous structures, and overall image quality scores. The mean effective dose for the L-VCTA group was significantly lower than for the C-VCTA group (0.56 ± 0.25 vs 1.84 ± 0.002 mSv), with a reduction of radiation dose of 69.73%. With 3D DSA as the reference standard, the sensitivity, specificity, and accuracy in the L-VCTA and C-VCTA groups were 94.12%, 100%, 94.4% and 100%, 100%, and 100%, respectively. In both groups, there were significant correlations for maximum aneurysm diameter measurements between volume CT angiography and 3D DSA; no statistical difference in the mean maximum diameter of each aneurysm was measured between volume CT angiography and 3D DSA. L-VCTA is helpful in detecting intracranial aneurysms, with results similar to those of 3D DSA, but at a lower radiation dose than C-VCTA. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

  13. Dissection and Aneurysm in Patients With Fibromuscular Dysplasia: Findings From the U.S. Registry for FMD.

    PubMed

    Kadian-Dodov, Daniella; Gornik, Heather L; Gu, Xiaokui; Froehlich, James; Bacharach, J Michael; Chi, Yung-Wei; Gray, Bruce H; Jaff, Michael R; Kim, Esther S H; Mace, Pamela; Sharma, Aditya; Kline-Rogers, Eva; White, Christopher; Olin, Jeffrey W

    2016-07-12

    Fibromuscular dysplasia (FMD) is a noninflammatory arterial disease that predominantly affects women. The arterial manifestations may include beading, stenosis, aneurysm, dissection, or tortuosity. This study compared the frequency, location, and outcomes of FMD patients with aneurysm and/or dissection to those of patients without. The U.S. Registry for FMD involves 12 clinical centers. This analysis included clinical history, diagnostic, and therapeutic procedure results for 921 FMD patients enrolled in the registry as of October 17, 2014. Aneurysm occurred in 200 patients (21.7%) and dissection in 237 patients (25.7%); in total, 384 patients (41.7%) had an aneurysm and/or a dissection by the time of FMD diagnosis. The extracranial carotid, renal, and intracranial arteries were the most common sites of aneurysm; dissection most often occurred in the extracranial carotid, vertebral, renal, and coronary arteries. FMD patients with dissection were younger at presentation (48.4 vs. 53.5 years of age, respectively; p < 0.0001) and experienced more neurological symptoms and other end-organ ischemic events than those without dissection. One-third of aneurysm patients (63 of 200) underwent therapeutic intervention for aneurysm repair. Patients with FMD have a high prevalence of aneurysm and/or dissection prior to or at the time of FMD diagnosis. Patients with dissection were more likely to experience ischemic events, and a significant number of patients with dissection or aneurysm underwent therapeutic procedures for these vascular events. Because of the high prevalence and associated morbidity in patients with FMD who have an aneurysm and/or dissection, it is recommended that every patient with FMD undergo one-time cross-sectional imaging from head to pelvis with computed tomographic angiography or magnetic resonance angiography. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. A safe and effective management strategy for blunt cerebrovascular injury: Avoiding unnecessary anticoagulation and eliminating stroke.

    PubMed

    Shahan, Charles P; Magnotti, Louis J; Stickley, Shaun M; Weinberg, Jordan A; Hendrick, Leah E; Uhlmann, Rebecca A; Schroeppel, Thomas J; Hoit, Daniel A; Croce, Martin A; Fabian, Timothy C

    2016-06-01

    Few injuries have produced as much debate with respect to management as have blunt cerebrovascular injuries (BCVIs). Recent work (American Association for the Surgery of Trauma 2013) from our institution suggested that 64-channel multidetector computed tomographic angiography (CTA) could be the primary screening tool for BCVI. Consequently, our screening algorithm changed from digital subtraction angiography (DSA) to CTA, with DSA reserved for definitive diagnosis of BCVI following CTA-positive study results or unexplained neurologic findings. The current study was performed to evaluate outcomes, including the potential for missed clinically significant BCVI, since this new management algorithm was adopted. Patients who underwent DSA (positive CTA finding or unexplained neurologic finding) over an 18-month period subsequent to the previous study were identified. Screening and confirmatory test results, complications, and BCVI-related strokes were reviewed and compared. A total of 228 patients underwent DSA: 64% were male, with mean age and Injury Severity Score (ISS) of 43 years and 22, respectively. A total of 189 patients (83%) had a positive screening CTA result. Of these, DSA confirmed injury in 104 patients (55%); the remaining 85 patients (45%) (false-positive results) were found to have no injury on DSA. Five patients (4.8%) experienced BCVI-related strokes, unchanged from the previous study (3.9%, p = 0.756); two were symptomatic at trauma center presentation, and three occurred while receiving appropriate therapy. No patient with a negative screening CTA result experienced a stroke. This management scheme using 64-channel CTA for screening coupled with DSA for definitive diagnosis was proven to be safe and effective in identifying clinically significant BCVIs and maintaining a low stroke rate. Definitive diagnosis by DSA led to avoidance of potentially harmful anticoagulation in 45% of CTA-positive patients (false-positive results). No strokes resulted from injuries missed by CTA. Diagnostic study, level III.

  15. Brucella pelvic tubo-ovarian abscess mimicking a pelvic malignancy.

    PubMed

    Seoud, Muhiedine A F; Kanj, Suha S; Habli, Munira; Araj, George F; Khalil, Ali M

    2003-01-01

    A 57-y-old woman presented with recurrent abdominal and pelvic pain of 6 months' duration with low-grade fever. A computed tomographic scan indicated an ovarian tumor. Laparotomy revealed a pelvic abscess. Her symptoms resolved following surgery and antibiotic therapy. Pathology revealed an extensive inflammatory process. Tissue culture grew Brucella sp. The diagnosis and management of this previously undescribed pelvic tubo-ovarian abscess present a particular challenge.

  16. Chest CT window settings with multiscale adaptive histogram equalization: pilot study.

    PubMed

    Fayad, Laura M; Jin, Yinpeng; Laine, Andrew F; Berkmen, Yahya M; Pearson, Gregory D; Freedman, Benjamin; Van Heertum, Ronald

    2002-06-01

    Multiscale adaptive histogram equalization (MAHE), a wavelet-based algorithm, was investigated as a method of automatic simultaneous display of the full dynamic contrast range of a computed tomographic image. Interpretation times were significantly lower for MAHE-enhanced images compared with those for conventionally displayed images. Diagnostic accuracy, however, was insufficient in this pilot study to allow recommendation of MAHE as a replacement for conventional window display.

  17. Introduction to Seismic Tomography

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rowe, Charlotte Anne

    2017-11-21

    Tomography is a method of obtaining an image of a 3d object by observing the behavior of energy transmissions through the object. The image is obtained by Interrogating the object with Energy sources at a variety of Locations and observing the Object’s effects on the energy at a Variety of sensors. Tomography was first Used to build 3-dimensional Scans through Human bodies. These Are called computed Tomographic (ct) scans.

  18. Computed tomographic findings in 44 dogs and 10 cats with grass seed foreign bodies.

    PubMed

    Vansteenkiste, D P; Lee, K C L; Lamb, C R

    2014-11-01

    To supplement recent reports of computed tomographic (CT) findings in dogs and cats with grass seed foreign bodies. Retrospective review of cases that had CT scan and subsequent retrieval of a grass seed during the same period of hospitalisation from a site included in the scan. Records of 44 dogs and 10 cats were reviewed. Most were presented in the months July to December. Median duration of clinical signs was 4 weeks (range 2 days to 2 years). The most frequent clinical signs were soft tissue swelling (30% cases), coughing (28%), sneezing (28%) and discharge (26%). Grass seeds were retrieved from the thorax (35% cases), nasal cavity (31%), ear (7%), other sites in the head and neck (22%), sublumbar muscles (2%) and pelvic limb (2%). The grass seed was visible in CT images in 10 (19%) cases. Secondary lesions were visible in CT images of 52 (96%) cases, including collection of exudate (37%), abscess (24%), enlarged lymph nodes (22%) and pulmonary consolidation (20%). CT images appeared normal in 4% animals. Grass seeds within the respiratory tract are frequently visible in CT images, but in general CT appears to be more useful for localisation of secondary lesions than as a method of definite diagnosis. © 2014 British Small Animal Veterinary Association.

  19. Congenital tri-cavernous hemangiomas of the right buccal region, right accessory parotid gland, and masseter muscle region.

    PubMed

    Yang, Tao; Gu, Yongchun; Zhang, Li; Hua, Zequan

    2014-03-01

    We report a rare case of congenital tri-cavernous hemangiomas of the right buccal region, right accessory parotid gland, and masseter muscle region in an adult. The patient, a 25-year-old woman, complained of 3 masses in her right midcheek. Ultrasonographic and computed tomographic findings showed an irregular-shaped mass (multiple calcifications) with a well-defined margin in the masseter muscle region, an ellipse-shaped mass (multiple calcifications) with a well-defined margin in the right buccal region, and a comma-shaped mass (no calcifications) with a well-defined margin separate from the parotid gland in the right accessory parotid gland region. These iconographic findings suggested that the masses were all hemangiomas separately originating from the parotid gland, accessory parotid gland, and masseter muscle. The masses were completely removed through a standard parotid incision without postoperative facial palsy, skin deformity, and difficulty in secreting saliva. Findings from histologic examination of the tumor revealed multiple, thin-walled, and dilated blood vessels, confirming the diagnosis of cavernous hemangiomas. Ultrasonographic and computed tomographic findings were extremely useful in diagnosing the mass/masses as hemangioma before surgery, clarifying relationships between the mass and adjacent structures, and determining the surgical approach to the mass/masses.

  20. Noninvasive coronary artery angiography using electron beam computed tomography

    NASA Astrophysics Data System (ADS)

    Rumberger, John A.; Rensing, Benno J.; Reed, Judd E.; Ritman, Erik L.; Sheedy, Patrick F., II

    1996-04-01

    Electron beam computed tomography (EBCT), also known as ultrafast-CT or cine-CT, uses a unique scanning architecture which allows for multiple high spatial resolution electrocardiographic triggered images of the beating heart. A recent study has demonstrated the feasibility of qualitative comparisons between EBCT derived 3D coronary angiograms and invasive angiography. Stenoses of the proximal portions of the left anterior descending and right coronary arteries were readily identified, but description of atherosclerotic narrowing in the left circumflex artery (and distal epicardial disease) was not possible with any degree of confidence. Although these preliminary studies support the notion that this approach has potential, the images overall were suboptimal for clinical application as an adjunct to invasive angiography. Furthermore, these studies did not examine different methods of EBCT scan acquisition, tomographic slice thicknesses, extent of scan overlap, or other segmentation, thresholding, and interpolation algorithms. Our laboratory has initiated investigation of these aspects and limitations of EBCT coronary angiography. Specific areas of research include defining effects of cardiac orientation; defining the effects of tomographic slice thickness and intensity (gradient) versus positional (shaped based) interpolation; and defining applicability of imaging each of the major epicardial coronary arteries for quantitative definition of vessel size, cross-sectional area, taper, and discrete vessel narrowing.

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