Trauma is the leading cause of death in age group less than 45 years. In trauma, time is one of the most crucial factors in predicting prognosis. Outcomes are greatly improved when critical interventions are provided ...Trauma is the leading cause of death in age group less than 45 years. In trauma, time is one of the most crucial factors in predicting prognosis. Outcomes are greatly improved when critical interventions are provided within the golden hour following injury. Whole body multidetector computerised tomography (WBMDCT) can decrease this critical time and increase survival. Emergency CT plays a major role in diagnostic workflow in the evaluation of patients with polytrauma. MDCT scanners are widely used because they rapidly produce high-resolution scans of large areas, offering short examination times for multiple body regions under emergency conditions. Such examinations most often include the head, cervical spine, and thorax to pelvis. Role of MDCT in head trauma remains unparalleled for reasons like its widespread availability and capability to reveal skull fractures, primarily because it is a fast and efficient method to triage the patients with treatable conditions mandating urgent surgical intervention such as extra axial hematomas, mass effect, herniations of brain, hydrocephalus, and midline shift and hence preventing secondary brain injury. MDCT angiography is an important tool to screen patients with suspected vascular injury.展开更多
Background: Radiology plays an essential role in the diagnosis, staging and surveillance of oncology patients. CT is the most sensitive imaging modality in the workup of these patients. Aim of the Study: The aim of th...Background: Radiology plays an essential role in the diagnosis, staging and surveillance of oncology patients. CT is the most sensitive imaging modality in the workup of these patients. Aim of the Study: The aim of this work is to detect the role of MDCT (multidetector computed tomography) in the preoperative investigation of gastric adenocarcinoma patients according to TNM staging. Patients and Methods: This is a prospective study enrolling 20 patients who had histologically proven adenocarcinoma based upon an upper gastrointestinal endoscopic biopsy for MDCT staging of gastric carcinoma during the period from June 2016 to June 2017. The MSCT data were correlated and compared with the histopathological results. The study was conducted in the Radiology Department of Assiut University Hospital using 64-MDCT (Toshiba Aquilion). Results: According to our study results, the sensitivity of determining T1 stage on CT scan can’t be detected as there was only 1 case pathologically proved T1 and overstaged as T2 by MSCT;however, accuracy and specificity are quite high, which was 95% and 100% respectively. For T2 stage tumors (25.0% of cases), accuracy is 95%, sensitivity—100%, and specificity—93.7%. According to our results the accuracy and sensitivity of T3 staging are 75% and 100%, while those of T4 stage were 75% and 44.4% respectively. Tumor was correctly staged in 14 of 20 patients (the valid T staging rate was 70.0%). Tumor was under-staged in 5 of 20 patients (25.0%) (staged as T3, but pathologically proven to be T4a). As regards N staging accuracy found results for N0 (62.5%), N2 (87.5%) and N3 (75%), while N1 accuracy recorded 37.5%. As regards the nodal staging sensitivity which had a range from (0% for N4) to (66% for N2) this wide range of sensitivity demonstrates the problem of CT in nodal staging. As regards sensitivity of M0, accuracy was 100% and 85% respectively. While that of M1 was (62.5%) and (85%) respectively. Conclusion: MSCT can be the first choice for the preoperative evaluation of patients with gastric carcinoma. It presents excellent accuracy in the staging of tumor invasion depth (T) and in the staging of metastatic neoplastic disease (M). Despite the good accuracy in the staging of patients without lymph node disease (N0), the method presents limitations in the staging of lymph node involvement.展开更多
We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the l...We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the left pulmonary artery, the relationship between pulmonary artery and airway, the diameter of the patent ductus artery and atrial septal defect. The information is helpful in diagnosis, pre-operative evaluation and post-operative follow-up of LPS.展开更多
Background Studies on intrathoracic tuberculous lymphadenitis in adults are confined to the preliminary CT findings with ordinary CT and ordinary spiral CT. There has been no deepgoing study of multidetector CT to dat...Background Studies on intrathoracic tuberculous lymphadenitis in adults are confined to the preliminary CT findings with ordinary CT and ordinary spiral CT. There has been no deepgoing study of multidetector CT to date. Multidetector CT could contribute to better imaging of intrathoracic tuberculous lymphadenitis in adults. The purpose of this study was to explore the multidetector CT features of intrathoracic tuberculous lymphadenitis in adults, and the correlation with clinical symptoms and pathologic changes. Methods Multidetector CT findings from 42 consecutive adult patients with intrathoracic tuberculous lymphadenitis were analyzed retrospectively with regard to locations, sizes, numbers, shapes, margins, and densities reviewing precontrast and enhanced images. CT results were correlated with clinical symptoms and pathologic results （n=37）. Results One hundred and eighty-five intrathoracic lymph nodes that had tuberculous lymphadenitis in 42 patients were distributed mainly in regions 4R （n=37）, 2R （n=33）, 7 （n=31） and 10R （n=21）, more than 2 regions were implicated in 34 patients. One hundred and twenty-two （72.2%） of the tuberculous lymphadenitis without confluence were oval or round with clear margins. On precontrast scanning, 78.4% of tuberculous lymphadenitis had a homogeneous density. Seven enhancement patterns were demonstrated in 169 tuberculous lymphadenitis from 37 patients with pathologic results： homogeneous enhancement with no clinical symptom （n=12）, corresponded pathologically to tuberculous hyperplasia without caseous necrosis; heterogeneous enhancement with a small central no enhancement area, slight clinical symptoms （n=22）, tuberculous granulomas with a little caseous necroses; peripheral irregular thick wall enhancement with a central area with no enhancement, slight clinical symptoms （n=52）, tuberculous granulomas with some caseous necroses in the center; peripheral thin rim enhancement with a central area having no enhancement, moderate clinical symptoms （n=36）, a few tuberculous granulomas with a great quantity of caseous necroses in the center; peripheral irregular enhancement without central enhancement, extending outside the capsule, severe clinical symptoms （n=4）, caseous necroses ruptured from capsule; peripheral irregular rim enhancement with central separate enhancement, severe clinical symptoms （n=40）, multiple lymph nodes with liquefaction of caseous necroses were adherent and confluent, rim and separation were tuberculous granulomas; no obvious enhancement, severe clinical symptoms （n=3）. Caseous necrosis was usually associated with little tuberculous granulomas. Conclusions The main multidetector CT features of intrathoracic tuberculous lymphadenitis in adults are involvement of multiregional lymph nodes with oval or round shape and clear margins, a basically homogeneous density on precontrast scanning, multiple enhancement patterns, and they correlate closely with clinical symptoms. Multidetector CT could reveal pathological changes of intrathoracic tuberculous lymphadenitis in adults.展开更多
BACKGROUND No qualitative or quantitative analysis of contrast-enhanced computed tomography(CT)images has been reported for the differentiation between ameloblastomas and central giant cell granulomas(CGCGs).AIM To de...BACKGROUND No qualitative or quantitative analysis of contrast-enhanced computed tomography(CT)images has been reported for the differentiation between ameloblastomas and central giant cell granulomas(CGCGs).AIM To describe differentiating multidetector CT(MDCT)features in CGCGs and ameloblastomas and to compare differences in enhancement of these lesions qualitatively and using histogram analysis.METHODS MDCT of CGCGs and ameloblastomas was retrospectively reviewed to evaluate qualitative imaging descriptors.Histogram analysis was used to compare the extent of enhancement of the soft tissue.Fisher’s exact tests and Mann–Whitney U test were used for statistical analysis(P<0.05).RESULTS Twelve CGCGs and 33 ameloblastomas were reviewed.Ameloblastomas had a predilection for the posterior mandible with none of the CGCGs involving the angle.CGCGs were multilocular(58.3%),with a mixed lytic sclerotic appearance(75%).Soft tissue component was present in 91%of CGCGs,which showed hyperenhancement(compared to surrounding muscles)in 50%of cases,while the remaining showed isoenhancement.Matrix mineralization was present in 83.3%of cases.Ameloblastomas presented as a unilocular(66.7%),lytic(60.6%)masses with solid components present in 81.8%of cases.However,the solid component showed isoenhancement in 63%.No matrix mineralization was present in 69.7%of cases.Quantitatively,the enhancement of soft tissue in CGCG was significantly higher than in ameloblastoma on histogram analysis(P<0.05),with a minimum enhancement of>49.05 HU in the tumour providing 100%sensitivity and 85%specificity in identifying a CGCG.CONCLUSION A multilocular,lytic sclerotic lesion with significant hyperenhancement in soft tissue,which spares the angle of the mandible and has matrix mineralization,should indicate prospective diagnosis of CGCG.展开更多
文摘Trauma is the leading cause of death in age group less than 45 years. In trauma, time is one of the most crucial factors in predicting prognosis. Outcomes are greatly improved when critical interventions are provided within the golden hour following injury. Whole body multidetector computerised tomography (WBMDCT) can decrease this critical time and increase survival. Emergency CT plays a major role in diagnostic workflow in the evaluation of patients with polytrauma. MDCT scanners are widely used because they rapidly produce high-resolution scans of large areas, offering short examination times for multiple body regions under emergency conditions. Such examinations most often include the head, cervical spine, and thorax to pelvis. Role of MDCT in head trauma remains unparalleled for reasons like its widespread availability and capability to reveal skull fractures, primarily because it is a fast and efficient method to triage the patients with treatable conditions mandating urgent surgical intervention such as extra axial hematomas, mass effect, herniations of brain, hydrocephalus, and midline shift and hence preventing secondary brain injury. MDCT angiography is an important tool to screen patients with suspected vascular injury.
文摘Background: Radiology plays an essential role in the diagnosis, staging and surveillance of oncology patients. CT is the most sensitive imaging modality in the workup of these patients. Aim of the Study: The aim of this work is to detect the role of MDCT (multidetector computed tomography) in the preoperative investigation of gastric adenocarcinoma patients according to TNM staging. Patients and Methods: This is a prospective study enrolling 20 patients who had histologically proven adenocarcinoma based upon an upper gastrointestinal endoscopic biopsy for MDCT staging of gastric carcinoma during the period from June 2016 to June 2017. The MSCT data were correlated and compared with the histopathological results. The study was conducted in the Radiology Department of Assiut University Hospital using 64-MDCT (Toshiba Aquilion). Results: According to our study results, the sensitivity of determining T1 stage on CT scan can’t be detected as there was only 1 case pathologically proved T1 and overstaged as T2 by MSCT;however, accuracy and specificity are quite high, which was 95% and 100% respectively. For T2 stage tumors (25.0% of cases), accuracy is 95%, sensitivity—100%, and specificity—93.7%. According to our results the accuracy and sensitivity of T3 staging are 75% and 100%, while those of T4 stage were 75% and 44.4% respectively. Tumor was correctly staged in 14 of 20 patients (the valid T staging rate was 70.0%). Tumor was under-staged in 5 of 20 patients (25.0%) (staged as T3, but pathologically proven to be T4a). As regards N staging accuracy found results for N0 (62.5%), N2 (87.5%) and N3 (75%), while N1 accuracy recorded 37.5%. As regards the nodal staging sensitivity which had a range from (0% for N4) to (66% for N2) this wide range of sensitivity demonstrates the problem of CT in nodal staging. As regards sensitivity of M0, accuracy was 100% and 85% respectively. While that of M1 was (62.5%) and (85%) respectively. Conclusion: MSCT can be the first choice for the preoperative evaluation of patients with gastric carcinoma. It presents excellent accuracy in the staging of tumor invasion depth (T) and in the staging of metastatic neoplastic disease (M). Despite the good accuracy in the staging of patients without lymph node disease (N0), the method presents limitations in the staging of lymph node involvement.
文摘We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the left pulmonary artery, the relationship between pulmonary artery and airway, the diameter of the patent ductus artery and atrial septal defect. The information is helpful in diagnosis, pre-operative evaluation and post-operative follow-up of LPS.
文摘Background Studies on intrathoracic tuberculous lymphadenitis in adults are confined to the preliminary CT findings with ordinary CT and ordinary spiral CT. There has been no deepgoing study of multidetector CT to date. Multidetector CT could contribute to better imaging of intrathoracic tuberculous lymphadenitis in adults. The purpose of this study was to explore the multidetector CT features of intrathoracic tuberculous lymphadenitis in adults, and the correlation with clinical symptoms and pathologic changes. Methods Multidetector CT findings from 42 consecutive adult patients with intrathoracic tuberculous lymphadenitis were analyzed retrospectively with regard to locations, sizes, numbers, shapes, margins, and densities reviewing precontrast and enhanced images. CT results were correlated with clinical symptoms and pathologic results （n=37）. Results One hundred and eighty-five intrathoracic lymph nodes that had tuberculous lymphadenitis in 42 patients were distributed mainly in regions 4R （n=37）, 2R （n=33）, 7 （n=31） and 10R （n=21）, more than 2 regions were implicated in 34 patients. One hundred and twenty-two （72.2%） of the tuberculous lymphadenitis without confluence were oval or round with clear margins. On precontrast scanning, 78.4% of tuberculous lymphadenitis had a homogeneous density. Seven enhancement patterns were demonstrated in 169 tuberculous lymphadenitis from 37 patients with pathologic results： homogeneous enhancement with no clinical symptom （n=12）, corresponded pathologically to tuberculous hyperplasia without caseous necrosis; heterogeneous enhancement with a small central no enhancement area, slight clinical symptoms （n=22）, tuberculous granulomas with a little caseous necroses; peripheral irregular thick wall enhancement with a central area with no enhancement, slight clinical symptoms （n=52）, tuberculous granulomas with some caseous necroses in the center; peripheral thin rim enhancement with a central area having no enhancement, moderate clinical symptoms （n=36）, a few tuberculous granulomas with a great quantity of caseous necroses in the center; peripheral irregular enhancement without central enhancement, extending outside the capsule, severe clinical symptoms （n=4）, caseous necroses ruptured from capsule; peripheral irregular rim enhancement with central separate enhancement, severe clinical symptoms （n=40）, multiple lymph nodes with liquefaction of caseous necroses were adherent and confluent, rim and separation were tuberculous granulomas; no obvious enhancement, severe clinical symptoms （n=3）. Caseous necrosis was usually associated with little tuberculous granulomas. Conclusions The main multidetector CT features of intrathoracic tuberculous lymphadenitis in adults are involvement of multiregional lymph nodes with oval or round shape and clear margins, a basically homogeneous density on precontrast scanning, multiple enhancement patterns, and they correlate closely with clinical symptoms. Multidetector CT could reveal pathological changes of intrathoracic tuberculous lymphadenitis in adults.
文摘BACKGROUND No qualitative or quantitative analysis of contrast-enhanced computed tomography(CT)images has been reported for the differentiation between ameloblastomas and central giant cell granulomas(CGCGs).AIM To describe differentiating multidetector CT(MDCT)features in CGCGs and ameloblastomas and to compare differences in enhancement of these lesions qualitatively and using histogram analysis.METHODS MDCT of CGCGs and ameloblastomas was retrospectively reviewed to evaluate qualitative imaging descriptors.Histogram analysis was used to compare the extent of enhancement of the soft tissue.Fisher’s exact tests and Mann–Whitney U test were used for statistical analysis(P<0.05).RESULTS Twelve CGCGs and 33 ameloblastomas were reviewed.Ameloblastomas had a predilection for the posterior mandible with none of the CGCGs involving the angle.CGCGs were multilocular(58.3%),with a mixed lytic sclerotic appearance(75%).Soft tissue component was present in 91%of CGCGs,which showed hyperenhancement(compared to surrounding muscles)in 50%of cases,while the remaining showed isoenhancement.Matrix mineralization was present in 83.3%of cases.Ameloblastomas presented as a unilocular(66.7%),lytic(60.6%)masses with solid components present in 81.8%of cases.However,the solid component showed isoenhancement in 63%.No matrix mineralization was present in 69.7%of cases.Quantitatively,the enhancement of soft tissue in CGCG was significantly higher than in ameloblastoma on histogram analysis(P<0.05),with a minimum enhancement of>49.05 HU in the tumour providing 100%sensitivity and 85%specificity in identifying a CGCG.CONCLUSION A multilocular,lytic sclerotic lesion with significant hyperenhancement in soft tissue,which spares the angle of the mandible and has matrix mineralization,should indicate prospective diagnosis of CGCG.
