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Posts Tagged ‘Computed Tomography’

ACEI prompted angioedema of small intestine should be comprised in differential diagnosis (DDx) while patients are receiving ACEI therapy, showed with abdominal complaints, and CT findings of ascites, intestinal wall thickening and related.

Small bowel - angioneurotic edema_CT

The medical research was conducted by Christopher D. Scheirey, Francis J. Scholz, Michael J. Shortsleeve and Douglas S. Katz from Department of Radiology, Lahey Clinic, Burlington, MA; Department of Radiology, Mount Auburn Hospital, Cambridge, MA; Department of Radiology, Winthrop-University Hospital, Mineola, NY.

The research study objective was to retroactively examine clinical/radiologic discoveries in patients with angiotensin converting enzyme/catalyst inhibitor (ACEI) provoked small bowel-angioedema/quincke’s edema (intestine), with special importance on computed tomography findings.

Abdominal radiologists conscious of the nature of illness retroactively examined imaging discoveries (in significance with computed tomography) and clinical attributes of about 20 patients introduced to emergency departments of two varied institutions, from the time period of 1996-2010, with ACEI prompted angioedema of the small intestine; examinations were considered in agreement, to settle on common radiographic findings.

All the patients submitted for the study were in the age group of 23-83 years; most were obese women, with grave abdominal pain/stomach ache. All the patients were passed through abdominal/ventral computed tomography examinations; some had small bowel series procedures; others experienced surgery for surmised small bowel/intestinal ischemia/local anemia.

After few days of hospitalization, the symptoms were determined out for all the patients; computed tomography findings comprised subsequent, in patients: ascites/collection of serous fluid, intestinal wall thickening, mild dilatation/expansion, and straightening etc.! No small intestine/bowel hindrance could be established by.

Conclusion: ACEI prompted small bowel angioedema must be comprised in discriminatory diagnosis while patients are receiving ACEI therapy showed with abdominal ailments, with subsequent CT findings, on examination: ascites/collection of serous fluid, intestinal wall thickening, mild dilatation/expansion, and straightening etc.

No significant deviations were found amongst modified CT severity index and CT severity index in evaluation of severity of acute pancreatitis/ pancreatic necrosis.

In analogy with APACHE II, both the indexes more accurately identify the nature of clinically severe disorder and better connect with the need for intervention and pancreatic inflammation.

Acute Pancreatitis

The medical research study was conducted by Thomas L. Bollen, Vikesh K. Singh, Rie Maurer, Kathryn Repas, Hendrik W. van Es, Peter A. Banks and Koenraad J. Mortele from Department of Radiology, Division of Abdominal Imaging and Intervention, Division of Gastroenterology, Center for Pancreatic Disease (Brigham and Women’s Hospital, Harvard Medical School, Boston, MA); Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands; Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD.

The research objective was to equate CT severity index (CTSI) with modified CT severity index (MCTSI), for evaluation of severity parameters in acute pancreatitis/acute pancreatic necrosis – abrupt inflammation of the pancreas. Both the CT indexes were even equated with APACHE II index (Acute Physiology and Chronic Health Evaluation), to categorize severity of disease/illness in patients.

About 196 patients, of 397 successive medical cases of acute pancreatitis were passed through contrast-enhanced computed tomography, after a period of one week, with commencement of the disease symptoms. Single blind study by radiologists were executed for CT indexes; the severity parameters comprised subsequent – death rate, organ failure, pancreatic contamination, hospital admittance/intensive care unit stay, requirement for medical interference, clinical severity of pancreatic inflammation etc.! Kappa coefficient stats and discrimination analysis were executed, for the process.

About the results, no considerable deviation could be established amongst the CT indexes, though score and severity parameters showed some relationship, for both the indexes. Equated with the APACHE II index – both the CT indexes precisely correlated with the requirement for medical interference and pancreatic inflammation, and more precisely identified out clinically grave disorder; for both the CT severity indexes, the interobserver agreement demonstrated fine results.

Conclusion: No meaningful deviation could be established amongst modified CT severity index and CT severity index in assessment of severity of acute pancreatitis/pancreatic necrosis. In comparison with APACHE II, both the indexes more precisely identify out clinically grave disorder and better connect with the requirement for intervention and pancreatic inflammation.

Considerable dose variance were noticed amongst all CT-guided interventional procedures.

The peril of settled outcomes seems to be very low, since the perceived (maximum) skin dose did not go beyond the threshold for transient skin erythema.

CT guided Interventional Procedure

The medical research study was conducted by Shuai Leng, Jodie A. Christner, Stephanie K. Carlson, Megan Jacobsen, Thomas J. Vrieze, Thomas D. Atwell and Cynthia H. McCollough from Department of Radiology, Mayo Clinic, Rochester, MN.

The study is available in American Journal of Roentgenology, and the research objective was to establish characteristic radiation dose levels to the patients going through CT-guided interventional procedures.

The retroactive study was comprised of about 571 patients that were undergoing CT interventional procedures, and all the registered patients passed through one of subsequent procedures: biopsy, aspiration, cryoablation, drain and injection. With each of the process, either of two helical or intermittent scan mode were utilized, and skin dosage was evaluated through phantom measurements and the volumetric CT dose index.

Effectual dose was computed by multiplying conversion (k) factor and dose length product (DLP) for helical mode; Monte Carlo simulation (organ dose coefficient) was utilized for the intermittent mode. The mean effective and skin doses for all the five-procedures were reviewed; maximum skin dose was gauged, and mean effective dose over all the procedural types were recorded, from helical and intermittent scans.

Conclusion: Considerable dose variance were noticed amongst all the procedures. Since the perceived (maximum) skin dose did not go beyond the threshold for transient skin erythema, the peril of settled outcomes seems to be very low. The mean risk factor for stochastic effects was equivalent to that of pelvis and CT examinations. However, the intermittent mode (scan) can put up considerably to skin dose, it does minimum to the effective dose, for the sole reason of utilization of shorter scan range.

There is no increased childhood cancer risk, with very low dose radiation through diagnostic imaging, which is consistent with model calculations.

Childhood Cancer Risk_Radiography

The medical research study was conducted by Gaël P. Hammer, Michael C. Seidenbusch, Dieter F. Regulla, Claudia Spix, Hajo Zeeb, Karl Schneider and Maria Blettner from Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz; Department of Pediatric Radiology, Dr. von Hauner’s Children’s Hospital, Ludwig-Maximilians–University of Munich; Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg; German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz; Department of Prevention and Evaluation, Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany.

The study is available in American Journal of Roentgenology. The long-term consequences of diagnostic ionizing radiation exposure in childhood is slightly less known. Current evaluations are made with models obtained chiefly through research of survivors of atom bombs, people that vary from present-day patients in many aspects, and the preliminary research objective was to quantify risk amongst young patients through radiography exam.

In a German university hospital, cancer occurrence in children that underwent diagnostic x ray exposures during year 1976-2003 were assessed by the researchers. They reorganized case-by-case radiation dosage for each, and classified results by referral criteria groups for all cancers.

Through 78,527-patient cohort, in the duration of 1980-2006, about 68 cancer incidence cases were recognized, in the German childhood cancer registry: except for 25 other, 9 lymphoma, 28 leukemia, and 6 tumors of the central nervous system were found. For all the cancers, the standardized incidence ratio was 0.97; through multivariate poisson regression – dose response relationships were evaluated.

Even though cancer incidence risk varied by primary referral criterion for radiographic examination, for 5 patients with metabolic/endocrine disease, a positive dose response relationship was noted.

Conclusion: There was no heightened cancer risk amongst children/youth, with very low dose radiation through diagnostic imaging, which is consistent with model calculations. The increased usage of computed tomography justifies further studies to evaluate related cancer risk.

Observed features on imaging, attributed to the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in patients that underwent cervical fusion include: increased fusion rate, and incidence of swelling of prevertebral soft tissues.

Transforaminal lumbar interbody fusion_with rhBMP-2

The medical research study was conducted by Anil Sethi, Joseph Craig, Stephen Bartol, Wei Chen, Mark Jacobsen, Chad Coe and Rahul Vaidya from the Department of Orthopedics, Detroit Receiving Hospital; Department of Radiology and Department of Orthopedics (Henry Ford Hospital); Biostatistics Core, Karmanos Cancer Institute and Wayne State University School of Medicine, Detroit, MI.

The study is available in American Journal of Roentgenology. Bone morphogenetic proteins (BMP) when utilized in spinal fusion/spondylodesis – accelerate healing, and commence distinct imaging attributes. Through the study, researchers tried to register and assess the CT and radiographic alterations, after utilization of recombinant human bone morphogenetic protein 2 (rhBMP-2) in spine fusion surgery.

The study was comprised of about 95 patients that were made to pass through interbody spine fusion making use of recombinant human bone morphogenetic protein 2 (rhBMP-2) . Cohort study of lumbar spine fusion had 23 patients that passed through anterior lumbar interbody fusion (ALIF); 35 underwent transforaminal lumbar interbody fusion (TLIF), while 2 made to go through posterior lumbar interbody fusion. The residual, 34 patients were subjected to anterior cervical decompression and fusion (ACDF).

About the results, in 59 patients – polyetheretherketone (peek) cage was utilized as an interbody spacer, while for 36 patients – allograft bone worked as the spacer. The patients were assessed at various durations, after a slot of procedures, started initially with a gap of 2 and 6 weeks, and followed up to 3, 6, 12, 24 months, in respective order. All the patients were made to go through radiography follow-up examination, and computed tomography assessment was executed in 32 patients.

Conclusions: Attributed to the use of rhBMP-2, the imaging features observed included: increased fusion rate, and incidence of swelling of prevertebral soft tissues in patients that underwent cervical fusion. Endplate resorption was perceived in 100% of these patients that underwent cervical fusion, and in 82% of the lumbar levels. The gradual caving of the cage ensuing in disk space narrowing was observed in half of the cases. Heterotopic bone formation and cage migration in the neural foramen and spinal canal come out the maximum in the lumbar spine of patients that  had polyetheretherketone (peek) cage positioned through a transforaminal approach.

There is no significant effect of arterial input selection on CT perfusion parameters, of head and neck cancer.

Internal carotid artery (ICA) as the arterial input is feasible for simplification and standardization of postprocessing.

CT Brain Perfusion

The medical research study was conducted by Ahmed M. Tawfik, Ahmed A. Abdel Razek, Lamiaa G. Elsorogy, Nermin Y. Soliman, J. Matthias Kerl, Martin G. Mack and Thomas J. Vogl from Department of Diagnostic and Interventional Radiology, Johan Wolfgang Goethe University Hospital, Hessen, Germany, and Diagnostic Radiology Department, Mansoura Faculty of Medicine, Mansoura, Egypt.

The study is available in online journal of American Roentgen Ray Society, and the research objective was to assess arterial input selection effects on CT perfusion parameter values, of neck and head tumors.

Through deconvolution method perfusion index were calculated for 50 cases, along with the records of peak enhancement values of ipsilateral internal carotid artery (IICA) and external carotid artery (ECA). Through with IICA, ECA and contralateral internal carotid artery – blood flow/volume, average transit time and permeability surface area were calculated by. The values were equated through with Pearson’s coefficient of correlation and Wilcoxon’s matched pairs test.

High statistical significance were found amidst peak enhancement values of external carotid artery and internal carotid artery, perfusion calculations through IICA and ECA, contralateral and ipsilateral ICA. No vital deviations were found amid perfusion calculation through IICA against ECA, and in the same way for ipsilateral against contralateral ICA etc.

Conclusion: There is no significant effect of arterial input selection on CT perfusion parameters, of head and neck cancer. Internal carotid artery (ICA) is advocated as the arterial input by researchers for simplification/standardization of postprocessing, so as to decrease partial volume effects.

Computed tomography has higher detection risk for hypovascular liver tumors in obese patients – noise filter improves image quality.

CT_Liver Tumor

The medical research study was conducted by Sebastian T. Schindera, Jaled Charimo Torrente, Thomas D. Ruder, Hanno Hoppe, Daniele Marin, Rendon C. Nelson and Zsolt Szucs-Farkas from Institute of Diagnostic, Interventional, and Pediatric Radiology, University Hospital Berne, University of Berne, Freiburgstrasse, Berne, Switzerland and Department of Radiology, Duke University Medical Center, Durham, NC.

The study is available in online journal of American Roentgen Ray Society, and the research objective was to assess impact of Multidetector computed tomography on obese patients for hypovascular liver tumors, and noise-filter effects in detection of lesion and on the image quality.

Two water containers were utilized by, for to imitate intermediate and obese patients, and liver phantom with 45 hypovascular tumors – of varied diameters was submerged in both. With 64-MDCT scanner both the containers were scanned by; the data gathered of CT from large phantom was postprocessed through noise filter.

Contrast-to-noise-ratio of tumors and image noise was gauged, and three independent radiology readers followed-up on with tumor detection methods.

There was image noise reduction by 42% in the large phantom, due to noise filter application. For filtered and non-filtered large phantom, the contrast-to-noise ratio of tumors were lower, in comparison to that of intermediate phantom. Fewer tumors were identified out on an average in filtered (19%) and non-filtered large phantom (25%), in comparison with the intermediate phantom.

Conclusion: Noise filter improves image quality in obese patients, but hypovascular liver tumors with computed tomography has higher detection risk in them.

Dual source dual energy MDCT demonstrated well in phantom for concentration and presence of iodine in a renal lesion

Iodine Quantification_ Dual-Energy CT

The medical research was conducted by Hersh Chandarana, Alec J. Megibow, Benjamin A. Cohen, Ramya Srinivasan, Danny Kim, Christianne Leidecker and Michael Macari from Department of Radiology, New York University Langone Medical Center, New York, and Siemens Healthcare, Malvern, PA.

The study is available online in American Journal of Roentgenology. The research objective was to substantiate significance of dual source dual energy multidetector computed tomography in determination of iodine concentration in renal masses, as well in a phantom.

A series of tubes containing solutions of varying iodine concentration were imaged with dual-source dual-energy MDCT. The iodine concentration was equated and calculated through known concentration levels. The data accumulated through contrast enhanced dual source dual energy MDCT on about 15 patients with renal lesions were evaluated by independent readers, where dual energy CT imaging post-processing was utilized for generation of contrast enhanced images. The iodine concentration in aorta and lesions were evaluated by.

Mixed model analysis of variance was utilized for comparability of lesion types, with respect to lesion-aorta iodine ratio, and lesion iodine concentration.

Of the phantom study, it demonstrated excellent correlation amongst true and calculated iodine concentration, while the study with patients, about 21 renal masses (enhancing and nonenhancing) were assessed by, in 15 patients.

The lesion-aorta iodine ratio and lesion iodine concentration in enhancing renal masses were comparatively higher, in comparison to simple and hyperdense renal cysts.

Conclusion: iodine determination through dual source dual energy MDCT was found precise in phantom, for determination of concentration and presence of iodine in a renal lesion. Renal mass characterization is possible with single dual-source dual-energy MDCT acquisition without change in relative attenuation measurements or unenhanced images.

With extra tin filtration, dual energy dual source CT scan demonstrates well for differentiation of non-uric acid kidney stones.

Dual-energy CT _renal stone

The medical research was conducted by Mingliang Qu, Juan C. Ramirez-Giraldo, Shuai Leng, James C. Williams, Terri J. Vrtiska, John C. Lieske and Cynthia H. McCollough from Department of Radiology, Mayo Clinic, Rochester, MN, and Department of Anatomy and Cell Biology, Indiana University, Indianapolis.

The study is available online in American Journal of Roentgenology. The research objective was to decide on – out of the living capability of dual energy dual source CT (DSCT) with spectral filtration for differentiation of non-uric acid kidney stones.

About 10 different types of 43 renal stones were classified into 5 preliminary  groups, on grounds of effective atomic numbers, as per weighted mean of atomic numbers of component atoms. The engrafted stones in porcine kidneys were placed in water phantom.

Dual energy dual source CT scans were executed with and otherwise with spectral filtration of 140 kV beam, where the CT number ratio for each stone was calculated through voxel by voxel method. Through receiver operating characteristic (ROC) analysis the deviation in CT number ratio, with and without spectral filtration were equated by.

On the consequence part, the CT number ratio was found to be increased by 0.17 with spectral filtration, but the number ratios were not different in any of the groups without spectral filtration. The application of spectral filtration on high energy X-ray tube in a significant way enhanced the separation of non–uric acid renal stone types by CT number ratio. Of region under the ROC curve, it showed an upswing from 0.89 to 0.95 with tin filtration, and 0.78 to 0.84 without fin filtration.

Conclusion: additional spectral filtration on dual energy dual source CT scan demonstrated better separation amongst varied stone types, for stone classification scheme of 5 preliminary groups. Some imbrication amongst certain stone types concurrently exist, inclusive of calcium oxalate and brushite.

CT scan demonstrates well for pulmonary arterial hypertension, for evaluation of patients with bronchiectasis.

CT Scan_Pulmonary Arterial Hypertension

The medical research was conducted by Anand Devaraj, Athol U. Wells, Mark G. Meister, Michael R. Loebinger, Robert Wilson and David M. Hansell from Departments of Radiology, Royal Brompton Hospital and St. George’s Hospital, along with Interstitial Lung Disease Department and Host Defence Unit, Royal Brompton Hospital, London, United Kingdom.

The study is available online in American Journal of Roentgenology. The research objective was to assess the link amongst pulmonary hypertension figured out with computed tomography and consequences among bronchiectasis patients.

About 91 bronchiectasis patients evaluated for the study. CT findings in pulmonary hypertension were registered for presence of bronchial dilatation, mucus plugging, bronchial wall thickening, chronic obstructive pulmonary disease/emphysema, mosaicism, and magnitude of bronchiectasis. Cox proportional hazards model with random variables were utilized to examine casual factor of CT signs on fatality rate.

Of the results, mean left and right pulmonary artery diameter predicted best for fatality rate, and was related with the consequence – free of CT signs of bronchiectasis.

Conclusion: CT scans is vital prognostic indicator on pulmonary hypertension imaging, for assessment of patients with bronchiectasis.