Evaluation effect of multi-detector CT on pulmonary changes in post-operative adult receptor of liver transplantation complicated with acute respiratory distress syndrome / 中国中西医结合急救杂志

Objective To evaluate the multi-detector CT (MDCT) on pulmonary changes in post-operative adult receptor of liver transplantation complicated with acute respiratory distress syndrome (ARDS).Methods Nineteen adult patients admitted into Tianjin First Center Hospital from January to December 2016 to perform the first time liver transplantation were enrolled in this study. Before operation, the CT showed no significant abnormality in the patients' lungs, after operation MDCT was applied to observe the pulmonary changes of ARDS post-operative complication in the adult receiver of liver transplantation, and the pulmonary changes in different gender of patients were analyzed and compared.Results MDCT showed that after liver transplantation all the 19 patients (100%) had lung pathological changes, of whom 18 cases (94.7%) manifested 2 or more than 2 kinds of pulmonary changes, including consolidation shadows (12 cases, 63.2%), patchy shadows (2 cases, 10.5%), ground glass opacity (6 cases, 31.5%) and pleural effusion (18 cases, 94.7%). In the comparisons between male and female patients with post-operative ARDS after liver transplantation, there were no significant differences in the lung pathological changes shown in MDCT (allP > 0.05) statistically.Conclusion The application of MDCT has great potential value in the evaluation of the disease situation after liver transplantation, that might providehelp to the postoperative treatment.

Multi detector computerized tomography scans aid in the staging of Head and Neck cancers

Introduction/Objectives: To assess the efficacy and correlation of MDCT scans in the clinical staging of patients with HNCs prior to therapeutic intervention. Methodology: Thirty-four HNCs were studied according to the 2005 WHO. Clinical AJCC 6th edition & radiological staging. Results: 14 Squamous Cell Carcinoma (SCC 41.2%) mean age 49.4 + 14.7 years, 13 Nasopharyngeal Carcinoma (NPC 38.2%) mean age 37.1 + 20.5 years, 3 Odontogenic Carcinoma (ODC 8.8% made up of 2 cases ameloblastic carcinoma 5.9% and 1 case of ameloblastic carcinosarcoma 2.9%). Others cases were 3 Adenocarcinoma (8.8%) and 1 Sinonasal Carcinoma NC (2.9%). Mean age insignificant according to gender (p = 0.342). Sensitivity, specificity, positive & negative predictive values and accuracy of clinical and radiological nodal involvements were: (47.4%; 80%; 61.8%; 75%; 54.5%) & (78.9%; 93.3%; 85.3%; 93.8%; 77.8%) respectively. Difference between clinical and radiological stages was statistically significant (X2= 260.8; p=0.01). There was a low but positive correlation between the clinical and radiologic stages (Pearson's correlation r = 0.6). Conclusion: MDCT was significantly more accurate than clinical examination in the TNM of HNCs using AJCC/UICC TNM guidelines. Authors recommend MDCT as first line imaging technique in resource limited settings (AU)

An approach to estimate the characterizations of mmulti-detector CT / 中国医学装备

Objective: The purpose of the current study was to investigate the correction coefficient of the characterizations of multi-detector CT (MDCT). Methods: The dose profile of Siemens SOMATOM Definition Flash CT scanner was measured with CT-SD 16 detector under the conditions of different collimations, pitches and tube voltages in phantoms of different diameters, and the ratio between weighted CTDI∞and weighted CTDI100 was calculated. Results:The ratio between weighted CTDI∞and weighted CTDI100, which is growing for increasing beam collimation, was found to range from 1.123 to 1.162 in head phantom and range from 1.118 to 1.173 in body phantom. Conclusion: For MDCT, the use of CTDI100, which is one of the most commonly used characterizations of CT, has always underestimated the levels of radiation dose. Therefore, CTDI100 should be corrected.

MDCT Findings of Right Circumaortic Renal Vein with Ectopic Kidney

Anomalies of renal vasculature combined with ectopic kidneys were found on a multi-detector CT scan. Knowledge of renal vascular variation is very important for surgical exploration, radiologic intervention and staging for urologic cancer. We present an extremely rare case of a right circumaortic renal vein combined with a right ectopic kidney. The right kidney was located at the level between the third and fifth lumbar vertebra. The right circumaortic renal vein crossed the aorta and returned to the inferior vena cava behind the aorta.

Accuracy of multi-detector CT scan in pre-operative staging of renal cell carcinoma: Comparison of radiological and histopathological findings.

Objective: To evaluate the accuracy of pre-operative multi-detector CT scan (MDCT) compared to histopathology findings in tumor staging of renal cell carcinoma. Methods: Retrospective review of 29 renal cell carcinomas at Siriraj Hospital from 2004-2007. Two blinded radiologists evaluated the pre-operative MDCT images independently. Imaging findings were compared with surgical specimens and pathological findings. Results: A total of 29 renal cell carcinomas were proven on histopathology. The respective accuracy for overall staging of reader 1 and 2 were 0.75 and 0.65. The reader 1 and 2 reached a sensitivity of 75% and 87%, a specificity of 70% and 50% for perinephric involvement, and a sensitivity of 100% and 100%, a specificity of 63% and 54% for renal pelvis involvement. The kappa interobserver agreements for perinephric involvement and renal pelvis involvement were 0.67 and 0.83, respectively. Conclusion: False positive finding of perinephric involvement causes overstaging of Robson stage I disease or in T1-T2 disease of TNM classification. Perinephric stranding may not be reliable or specific findings, and a result of perinephric involvement in CT scan is still limited. MDCT is accurate in the pre-operative evaluation of renal cell carcinoma in Robson stage II-IV disease.

Diagnostic accuracy of 64-slice multi-detector CT in assessment of coronary artery stenosis.

Objective: To investigate the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of noninvasive coronary artery assessment. Methods: A total of 559 patients with suspected coronary artery disease had undergone noninvasive coronary CT angiography. The 78 patients (55 men and 23 women) had consecutively received a 64-slice multi-detector row CT (MDCT) examination, as well as invasive coronary angiography, within the three months period of the study. The coronary CT angiography was retrospectively reviewed by two radiologists. The degree of coronary stenosis was compared with invasive conventional angiography. Results: The coronary CT angiography of 1,032 segments in 78 patients were evaluated. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of coronary CT angiography for the detection of coronary artery stenosis were 71.1%, 98.4%, 89.4%, 94.7%, and 94.0% respectively. Conclusion: Coronary CT angiography using a 64-slice MDCT implies the reliable detection of coronary artery stenoses with high diagnostic accuracy.

Small Bowel Volvulus Induced by Mesenteric Lymphangioma in an Adult: a Case Report

Mesenteric lymphangiomas are rare abdominal masses that are seldom associated with small bowel volvulus, and especially in adult patients. We report here on an unusual case of small bowel volvulus that was induced by a mesenteric lymphangioma in a 43-year-old man who suffered from repeated bouts of abdominal pain. At multidetector CT, we noticed whirling of the cystic mesenteric mass and the adjacent small bowel around the superior mesenteric artery. Small bowel volvulus induced by the rotation of the mesenteric lymphangioma was found on exploratory laparotomy. Lymphangioma should be considered as a rare cause of small bowel volvulus in adult patients.

Value of Coronal Reformatted Images Using Multi-detector Computed Tomography for Nodal Staging in Non Small Cell Lung Cancer Cases

PURPOSE: The aim of our study was to evaluate the value of coronal reformatted images using multi-detector computed tomography (MDCT) imaging in non small cell lung cancer (NSCLC) for the determination of lymph node (LN) metastasis. MATERIALS AND METHODS: Chest CT scans using MDCT were performed in 43 patients with pathologically proven NSCLC. The images were reconstructed with a 3 mm thickness in the axial and coronal planes. The axial images were examined for LN metastasis with and without the coronal reformatted images by the consensus of two radiologists on two separate occasions. RESULTS: In total, 214 nodal groups were dissected, of which, 33 (15.4%) were pathologically proven as LN metastasis. The sensitivity of diagnosis was higher when assessing both the axial and coronal reformatted images compared to the axial images alone (51.5% vs. 33.3%), whereas the specificity and accuracy was lower when examining both the axial and coronal reformatted images (65.7% vs. 87.8% and 63.6% vs. 79.4%). Despite this, the additional coronal reformatted images provided additional anatomical information which was helpful in the assessment of accurate nodal stations and the decline of the pitfalls. CONCLUSION: The value of coronal reformatted images for the diagnosis of nodal metastasis in NSCLC may still be unclear; however, the coronal reformatted images may lend support to the axial images in being able to provide additional anatomical information.

MDCT Application in Neuroimaging

Multidetector CT (MDCT) is widely used in the clinical field and becoming the new standard in radiological diagnosis. In contrast to cardiovascular, thoracic and abdominal imaging, the role of MDCT is not yet clearly documented in neuroradiology. However, the application of MDCT in stroke, head and neck trauma, spinal diseases and tumor staging of head and neck cancer is actively performed in many institutions, and the results are promising. The shorter scan time, higher resolution, and less radiation dose enable higher and safer CT diagnosis in various neurological diseases. Due to thin slicing and isotropic multiplanar reconstruction (MPR), scanning in one axis is enough to get multiplanar images allowing for a more accurate diagnosis. Further clinical applications and research will be mandatory to prove the clinical utility of MDCT in the field of neuroimaging.