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1.
Chinese Journal of Medical Imaging ; (12): 250-254,262, 2024.
Article in Chinese | WPRIM | ID: wpr-1026383

ABSTRACT

Purpose To compare the CT imaging features of the novel coronavirus Omicron variant and influenza A-H1N1-associated viral pneumonia,and to investigate the factors associated with the uptake process of the two pneumonias.Materials and Methods A total of 43 patients with Omicron virus pneumonia(Omicron group)and 30 patients with influenza A(H1N1)virus pneumonia[influenza A(H1N1)group]in Civil Aviation General Hospital from December 2022 to March 2023 were retrospectively collected.The clinical data of the two groups were compared,including age,gender,symptoms(fever or not),duration of symptoms and incidence of complications.White blood cells,monocytes,lymphocytes,neutrophils,C-reactive protein,etc.]and initial and follow-up CT imaging features[lesion density,distribution,signs and qualitative CT severity score(CTSS)].Results The mean age of patients in Omicron group was higher versus that in H1N1 group[(68.61±15.94)years vs.(51.20±16.39)years,P<0.000 1],and the fever rate in Omicron group(58.1%vs.86.7%,P=0.009)and monocyte count[(0.40±0.16)vs.(0.58±0.19),P<0.000 1]were lower than those in the influenza A(H1N1)group.Chest CT showed that the lesions of patients in the Omicron group were mainly distributed under the pleura,and the lesions of patients in the influenza A(H1N1)group were mainly distributed under the pleura and along the bronchovascular bundle(χ2=8.592,P=0.035).Patients in the Omicron group were more likely to have interlobular septal thickening(χ2=11.753,P=0.001),paving pattern(χ2=16.216,P<0.000 1),air bronchogram(χ2=16.216,P<0.000 1),pleural effusion(P=0.039)and pleural thickening(χ2=4.067,P=0.044)than patients in the influenza A(H1N1)group,while patients in the influenza A(H1N1)group were more likely to have nodules than those in the omicron group(χ2=6.971,P=0.008).The CTSS scores of patients in the omicron group were higher than those in the influenza A(H1N1)group at the initial diagnosis(Z=413,P=0.009)and follow-up(Z=107,P=0.027).The correlation between the change of follow-up CTSS and the initial CTSS in the Omicron group was the strongest(r=0.689,P<0.000 1).There was the strongest correlation between the change of follow-up CTSS and the duration of symptoms in influenza A(H1N1)group(r=0.954,P<0.000 1).Conclusion Patients in the Omicron group have a higher range of initial and follow-up lesions than those in influenza A(H1N1)group,and the degree of pneumonia absorption in the omicron group may be related to the initial CTSS,whereas in the influenza A(H1N1)group it may be related to the duration of symptoms.

2.
Int. arch. otorhinolaryngol. (Impr.) ; 28(2): 203-210, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1558016

ABSTRACT

Abstract Introduction Jet aircraft pilots are exposed to huge pressure variation during flight, which affect physiological functions as systems, such as the respiratory system. Objectives The objective of the present investigation was to evaluate inflammatory changes of paranasal sinuses of jet aircraft pilots before and after a jet aircraft training program, using multislice computed tomography (CT), in comparison with a group of nonairborne individuals with the same age, sex, and physical health conditions. A second objective of the present study was to assess the association between the ostiomeatal complex obstruction and its anatomical variations. Methods The study group consisted of 15 jet aircraft pilots participating in the training program. The control group consisted of 41 nonairborne young adults. The 15 fighter pilots were evaluated before initiating the training program and after their final approval for the presence of inflammatory paranasal sinus disease. The ostiomeatal complex anatomical variations and obstructions were analyzed in pilots after the training program. Results Jet aircraft pilots presented higher incidence of mucosal thickening in maxillary sinus and anterior ethmoid cells than controls. Prominent ethmoidal bulla showed significant association with obstruction of the osteomeatal complex. Conclusions Jet aircraft pilots present increased inflammatory disease when compared with nonairborne individuals. The presence of a prominent ethmoidal bulla is associated with ostiomeatal complex obstruction.

3.
Radiol. bras ; Radiol. bras;57: e20230079en, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1558823

ABSTRACT

Abstract Objective: To evaluate the correlation between multidetector computed tomography (MDCT) findings and laboratory test results in patients with pulmonary tuberculosis (PTB). Materials and Methods: A total of 57 patients were evaluated. Patients with suspected PTB were divided into groups according to the final diagnosis (confirmed or excluded), and the groups were compared in terms of sociodemographic variables, clinical symptoms, tomography findings, and laboratory test results. Results: Among the patients with a confirmed diagnosis of PTB, small pulmonary nodules with a peribronchovascular distribution were significantly more common in the patients with a positive sputum smear microscopy result (47.4% vs. 8.3%; p = 0.046), as were a miliary pattern (36.8% vs. 0.0%; p = 0.026), septal thickening (84.2% vs. 41.7%; p = 0.021), and lymph node enlargement (52.6% vs. 8.3%; p = 0.020). Small pulmonary nodules with a centrilobular distribution were significantly more common among the culture-positive patients (75.0% vs. 35.7%; p = 0.045), as was a tree-in-bud pattern (91.7% vs. 42.9%; p = 0.014). A tree-in-bud pattern, one of the main tomography findings characteristic of PTB, had a sensitivity, specificity, positive predictive value, and negative predictive value of 71.0%, 73.1%, 75.9%, and 67.9%, respectively. Conclusion: MDCT presented reliable predictive values for the main tomography findings in the diagnosis of PTB, being a safe tool for the diagnosis of PTB in patients with clinical suspicion of the disease. It also appears to be a suitable tool for the selection of patients who are candidates for more complex, invasive examinations from among those with high clinical suspicion of PTB and a negative sputum smear microscopy result.


Resumo Objetivo: Avaliar a correlação entre os achados na tomografia computadorizada multidetectores (TCMD) comparativamente aos resultados laboratoriais em pacientes com tuberculose pulmonar (TBP). Materiais e Métodos: Amostra de 57 pacientes foi avaliada. Pacientes com suspeita clínica de TBP foram divididos de acordo com a positividade do diagnóstico, e as variáveis sociodemográficas, sintomas clínicos e achados tomográficos e laboratoriais foram comparados. Resultados: Nos pacientes com TBP e baciloscopia positiva, foram verificadas frequências significativas para pequenos nódulos pulmonares com distribuição peribroncovascular (47,4% vs. 8,3%; p = 0,046) e miliar (36,8% vs. 0,0%; p = 0,026), espessamento septal (84,2% vs. 41,7%; p = 0,021) e linfonodomegalias (52,6% vs. 8,3%; p = 0,020). Em relação à cultura, os pequenos nódulos pulmonares com distribuição centrolobular (75,0% vs. 35,7%; p = 0,045) e opacidades em árvore em brotamento (91,7% vs. 42,9%; p = 0,014) apresentaram frequências significativamente superiores. Medidas de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo para árvore em brotamento, um dos principais achados tomográficos característicos da TBP, foram, respectivamente, 71.0%, 73,1%, 75,9% e 67,9%. Conclusão: A TCMD apresentou medidas preditivas confiáveis para os principais achados tomográficos no diagnóstico de TBP, sendo uma ferramenta segura para o diagnóstico da doença em pacientes com suspeita clínica. Também se mostrou adequada para selecionar os pacientes para exames mais complexos e invasivos entre os com alta suspeita clínica de TBP e baciloscopia negativa.

4.
Medicina (Ribeirao Preto, Online) ; 56(1)abr. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1442330

ABSTRACT

Objective: Describe incidental tomographic in the sample, correlating them with risk factors for chest diseases and sociodemographic data. Methods: This is a retrospective and observational study covering 162 patients admitted to the COVID sector of the HU/UFJF, from April 1, 2020, to July 7, 2021, with a confirmed laboratory diagnosis of COVID-19. The variables were described in absolute and relative frequencies. The comparison of the correlation between the outcome variable (the tomographic findings) for independent samples was performed using Pearson's chi-square test (without correction) or Fisher's test when relevant. Results: Of the 162 patients, 15.4% had a solitary pulmonary nodule; 14.8% had multiple pulmonary nodules; 1.8%, lung mass; 3.1%, mediastinal mass, and 9.3% had mediastinal adenomegaly. Findings such as excavations, pleural effusion, emphysema, PTE, pneumothorax, chronic interstitial disease, cavitation, aneurysms, and significant atheromatosis, classified in this study in the "Other" category showed impressive results, with an overall prevalence of 81.5%. This study demonstrated that 34% of patients had two or more types of incidental CT findings and that 88.3% of patients had at least some type of incidental CT finding. Conclusion: The pandemic of SARS-CoV-2 infections has brought a series of challenges and lessons learned to healthcare teams around the world. The massive implementation of highly sensitive diagnostic methods, such as chest tomography, ends up bringing an additional challenge, which is to deal with incidental findings, making good clinical reasoning necessary to avoid unnecessary investigations and not leave without diagnosis and treatment of diseases in early and asymptomatic stages (AU)


Objetivo: Descrever os achados incidentais tomográficos na amostra, correlacionando-os com fatores de risco para doenças torácicas e dados sociodemográficos. Método: Trata-se de um estudo retrospectivo e observacional, abrangendo 162 pacientes admitidos no setor COVID do HU/UFJF, no período de 1º de abril de 2020 a 7 de julho de 2021, com diagnóstico laboratorial confirmado de COVID-19. As variáveis em frequências absolutas e relativas foram descritas. A comparação da correlação entre a variável desfecho (os achados tomográficos) para amostras independentes foi realizada por meio do teste qui-quadrado de Pearson (sem correção) ou Fisher quando pertinente. Resultado: Dos 162 pacientes, 15,4% apresentavam nódulo pulmonar solitário; 14,8%, nódulos pulmonares múltiplos; 1,8%, massa pulmonar; 3,1%, massa mediastinal e 9,3%, adenomegalia mediastinal. Achados como escavações, derrame pleural, enfisema, TEP, pneumotórax, intersticiopatia crônica, cavitação, aneurismas e ateromatose significativa, classificados, neste estudo, na categoria "Outros", apresentaram resultados impactantes, com uma prevalência global de 81,5%. Este estudo demonstrou que 34% dos pacientes apresentavam 2 ou mais tipos de achados tomográficos incidentais e que 88,3% dos pacientes apresentavam pelo menos algum tipo de achado tomográfico incidental. Conclusão: A pandemia de infecções pelo SARS-CoV-2 trouxe uma série de desafios e aprendizados para as equipes de saúde em todo o mundo. A realização maciça de métodos diagnósticos de elevada sensibilidade, como a tomográfica de tórax, acaba por trazer um desafio adicional, que é o de lidar com achados incidentais, fazendo-se necessário um bom raciocínio clínico para evitar investigações desnecessárias e não deixar sem diagnóstico e tratamento doenças em fases iniciais e assintomáticas


Subject(s)
Humans , Tomography, X-Ray Computed , Incidental Findings , Multidetector Computed Tomography , COVID-19
5.
Radiol. bras ; Radiol. bras;56(1): 36-41, Jan.-Feb. 2023. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1422526

ABSTRACT

Resumo Transplantes pulmonares são procedimentos progressivamente mais realizados em todo o mundo como opção para tratamento de doenças pulmonares em estágio terminal. Apesar dos avanços laboratoriais, da técnica cirúrgica e da seleção de doadores e receptores, a mortalidade nesses procedimentos ainda é significativa, em razão de complicações típicas dos pacientes transplantados. Este trabalho consiste em uma revisão da literatura acerca do tema, ilustrando as complicações abordadas por meio de imagens de tomografia computadorizada.


Abstract Lung transplantation is becoming increasingly more common as an alternative treatment for end-stage lung disease. Despite advances in laboratory testing, surgical technique, and donor/recipient selection, lung transplantation is still associated with significant mortality, due to postoperative complications. This paper consists of a brief review of postoperative complications in lung transplant recipients, illustrating those complications with computed tomography images.

6.
Article in Chinese | WPRIM | ID: wpr-993353

ABSTRACT

Objective:To study the value of imaging features of extrapancreatic nerve plexus in predicting early postoperative recurrence of ductal adenocarcinoma of pancreatic head.Methods:The clinical, imaging and pathological data of patients with ductal adenocarcinoma of pancreatic head undergoing pancreati-coduodenectomy at the Hepatobiliary Pancreatic Center of Beijing Tsinghua Changgung Hospital, Tsinghua University from January 2014 to April 2022 were retrospectively analyzed. A total of 73 patients were included, including 51 males and 22 females, aged (66.1±9.0) years old. The patients were followed up by telephone or outpatient review, who were divided into two groups according to the recurrence within 6 months after surgery: the recurrence group ( n=26) and the non-recurrence group ( n=47). Streaks or soft-tissue densities in the distribution area of extrapancreatic nerve plexus, difference in CT values between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus, maximum tumor diameter, and regional lymph node enlargement were compared between the two groups. Results:The incidences of streaks or soft-tissue densities showing in the distribution area of extrapancreatic nerve plexus were 80.8%(21/26) in the recurrence group and 51.1%(24/47) in the non-recurrence group, respectively. A CT value difference ≥15 HU between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus occurred in 50.0%(13/26) patients of the recurrence group and 25.5%(27/47) of the non-recurrence group, respectively. Maximum tumor diameter ≥25 mm were found in 80.8% (21/26) patients of the recurrence group and 57.4% (27/47) of the non-recurrence group, respectively. ≥3 reginal lymph node enlargement showed in 65.4% (17/26) patients of the recurrence group and 31.9% (15/47) of the non-recurrence group, respectively (all P<0.05). The risk of early postoperative recurrence increased in patients with a CT value difference ≥15 HU between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus ( OR=3.609, 95% CI: 1.099-11.855), and regional lymph node enlargement ≥ 3 ( OR=4.665, 95% CI: 1.400-15.545) (all P<0.05). And these two independent risk factors were combined to predict early postoperative recurrence of ductal adenocarcinoma of pancreatic head with an area under receiver operating characteristic curve of 0.748, sensitivity of 92.3%, and specificity of 48.9% ( P<0.001). Conclusion:≥ 15 HU CT value difference between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus and ≥ 3 regional lymph node enlargement are independent risk factors for the early postoperative recurrence of pancreatic head ductal adenocarcinoma, which could provide more predictive information preoperatively.

7.
Article in Chinese | WPRIM | ID: wpr-993411

ABSTRACT

Objective:To develop a preoperative CT image segmentation algorithm based on artificial intelligence deep learning technology for total hip arthroplasty (THA) revision surgery, and to verify and preliminarily apply it.Methods:A total of 706 revision cases with clear CT data from April 2019 to October 2022 in Chinese PLA General Hospital were retrospectively analyzed, including 520 males, aged 58.45±18.13 years, and 186 females, aged 52.23±16.23 years. All of them were unilateral, and there were 402 hips on the left and 304 hips on the right. The transformer_unet convolutional neural network was constructed and trained using Tensorflow 1.15 to achieve intelligent segmentation of the revision THA CT images. Based on the developed three-dimensional planning system of total hip arthroplasty, an intelligent planning system for revision hip arthroplasty was preliminarily constructed. Dice overlap coefficient (DOC), average surface distance (ASD) and Hausdorff distance (HD) parameters were used to evaluate the segmentation accuracy of transformer_unet, full convolution network (FCN), 2D U-shaped Net and Deeplab v3 +, and segmentation time was used to evaluate the segmentation efficiency of these networks.Results:Compared with the FCN, 2D U-Net, and Deeplab v3+ learning curves, the transformer_unet network could achieve better training effect with less training amount.The DOC of transformer_unet was 95%±4%, the HD was 3.35±1.03 mm, and the ASD was 1.38±0.02 mm; FCN was 94%±4%, 4.83±1.90 mm, 1.42±0.03 mm; 2D U-Net was 93%±5%, 5.27±2.20 mm, and 1.46±0.02 mm, respectively. Deeplab v3+ was 92%±4%, 6.12±1.84 mm, 1.52±0.03 mm, respectively. The transformer_unet coefficients were better than those of the other three convolutional neural networks, and the differences were statistically significant (all P<0.05). The segmentation time of transformer_unet was 0.031±0.001 s, FCN was 0.038±0.002 s, 2D U-Net was 0.042±0.001 s, Deeplab v3+ was 0.048±0.002 s. The segmentation time of transformer_unet was less than that of the other three convolutional neural networks, and the difference was statistically significant ( P<0.05). Based on the results of previous studies, an artificial intelligence assisted preoperative planning system for THA revision surgery was initially constructed. Conclusion:Compared with FCN, 2D U-Net and Deeplab v3+, the transformer_unet convolutional neural network can complete the segmentation of the revision THA CT image more accurately and efficiently, which is expected to provide technical support for preoperative planning and surgical robots.

8.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;38(2): 244-247, 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1431513

ABSTRACT

ABSTRACT Introduction: Left internal thoracic artery to left anterior descending artery (LITA-LADA) grafting has become a fundamental part of coronary artery bypass grafting (CABG). This grafting has led to an increased use of other arterial conduits, of which the radial artery (RA) is the most popular. Whether RA can have the same long-term patency as LITA is controversial. The objective of this study is to access the long-term clinical follow-up and, when available, the patency rate of RA grafts. Methods: Twenty-six patients from a previous study with critical stenosis in all target vessels underwent complete arterial CABG with LITA and RA grafts from 1996 to 2003. They all underwent midterm multidetector computed tomography after surgery with the association of at least one patent LITA and one patent RA graft. Results: Twelve patients (46%) are alive with no angina symptoms. Six patients underwent a second image exam 12 to 16 years (average of 14 years) after surgery, with a total of six LITA-LADA and 14 RA grafts with 100% patency rate. Clinical follow-up five to 23 years after surgery (average of 14 years) showed only one death 12 years after surgery related to coronary artery disease (CAD) (3,8%). Another 12 patients died of non-CAD. Conclusion: Patients with midterm associated LITA and RA patent grafts show similar optimal long-term patency rates of both types of grafts with excellent clinical outcome.

9.
Rev. argent. radiol ; 86(2): 102-114, jun. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1387608

ABSTRACT

Resumen Dentro del amplio espectro de los tumores pancreáticos, el adenocarcinoma es el que presenta mayor frecuencia. A pesar de los avances de los métodos imagenológicos y de las técnicas quirúrgicas, el carcinoma de páncreas sigue siendo uno de los tumores más agresivos. Su diagnóstico oportuno, y sobre todo la determinación de su resecabilidad, sirven para sectorizar aquellos pacientes candidatos a cirugía de aquellos en quienes esta no resultaría beneficiosa, sumando además los riesgos adicionales que dicho tratamiento implica. En el presente trabajo queremos mencionar los aspectos clínico-epidemiológicos fundamentales del carcinoma de páncreas y describir sus características imagenológicas y criterios de resecabilidad utilizando la tomografía computada multidetector (TCMD) con protocolo específico para glándula pancreática.


Abstract Within the wide spectrum of pancreatic tumors, adenocarcinoma is the one with the highest frequency. Despite advances in imaging methods and surgical techniques, pancreatic carcinoma continues to be one of the most aggressive tumors. Its timely diagnosis and especially the determination of its resectability serve to sectorize those patients who are candidates for surgery, those in whom it would not be beneficial, also adding the additional risks that said therapy implies. In the present work we want to mention the fundamental clinical-epidemiological aspects of pancreatic carcinoma, describe its imaging characteristics and resectability criteria using multidetector computed tomography with a specific protocol for the pancreatic gland.

10.
Radiol. bras ; Radiol. bras;55(3): 156-160, May-june 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1387084

ABSTRACT

Abstract Objective: To compare the degree of coronary stenosis (≥ 50% luminal narrowing) determined by coronary computed tomography angiography (CCTA) with that determined by invasive coronary angiography (ICA), using segment-by-segment analysis. Materials and Methods: This was a retrospective study of the records of patients who underwent CCTA and ICA between January 2014 and June 2018 at a general hospital in Brazil. Receiver operating characteristic curve analysis was applied, and the areas under the curve were used in order to assess the overall accuracy of the methods. Results: The degree of coronary stenosis was evaluated in a total of 844 arterial segments. The diagnostic performance of CCTA was good, with a sensitivity of 82.3%, a specificity of 96.4%, and a negative predictive value of 97.7% (95% CI: 96.5-98.5). In the segment-by-segment analysis, CCTA had excellent accuracy for the left main coronary artery and for other segments. Conclusion: In clinical practice at general hospitals, CCTA appears to have diagnostic performance comparable to that of ICA.


Resumo Objetivo: O objetivo do estudo é comparar os graus de estenose coronariana (≥ 50% de redução luminal) determinados pela tomografia computadorizada e pelo cateterismo, utilizando uma análise segmento a segmento. Materiais e Métodos: Estudo retrospectivo conduzido em pacientes que foram submetidos a tomografia computadorizada e a cateterismo, de janeiro de 2014 a junho de 2018, em um hospital geral. A análise da curva característica de operação do receptor foi utilizada para a análise da acurácia. Resultados: Na avaliação dos vasos, em um total de 844 segmentos, o desempenho da tomografia computadorizada foi bom, com sensibilidade de 82,3%, especificidade de 96,4% e valor preditivo negativo de 97,7% (IC 95%: 96,5-98,5). Na análise segmento a segmento, o tronco da coronária esquerda, assim como outros segmentos, apresentaram excelente acurácia. Conclusão: A tomografia computadorizada mostrou bom desempenho diagnóstico quando comparada com o cateterismo na prática diária de um hospital geral.

11.
Article in Portuguese | LILACS | ID: biblio-1402295

ABSTRACT

Objetivo: Avaliar a associação entre o grau de comprometimento pulmonar (CP) na TC de tórax dos pacientes com COVID-19 com fatores de risco e desfechos. Métodos: Estudo observacional e retrospectivo com 284 pacientes com COVID-19. Avaliou-se idade, sexo, quadro clínico, saturação na admissão, fatores de risco, tempo de sinto-mas, porcentagem de CP, tempo de internação em enfermaria, UTI e de IOT, e óbito. Foram divididos três grupos conforme o grau de CP. Resultados: 167 pacientes possuíam comprometimento <25%; 80, 25-50%; e 37, >50%. O grupo com maior comprometimento pulmonar possuía maior idade, mais homens e maior presença de tosse, dispneia e alguma comorbidade. Também apresentou menor saturação à admissão, maior necessidade de IOT, in-ternação em enfermaria ou UTI e maior mortalidade. O CP, IOT e idade foram fatores preditores de mortalidade.Conclusões: O grau de CP aparenta estar significativamente associado a alguns parâmetros clínicos, necessidade de internação, intubação e óbito (AU)


Objective: To assess the association between the degree of lung involvement (LI) on chest CT scans of COVID-19 patients, risk factors and outcomes. Methods: Observational and retrospective study of 284 COVID-19 patients. Age, sex, clinical presentation, oxygen saturation on admission, risk factors, time after symptom onset, percentage of LI, length of stay in ward and ICU, duration of ETI, and death were assessed. 3 groups were created according to the LI. Results: 167 patients had an involvement of <25%; 80, 25-50%; and 37, >50%. The group with gre-ater LI was older, had more males and a higher incidence of cough, dyspnea and some comorbidity. Moreover, the group with greater LI had lower saturation on admission, more ETI, more admissions to the ward or ICU, and higher mortality. LI, ETI and age were predictors of mortality. Conclusion: The degree of LI appears to be significantly associated with some clinical parameters, need for hospitalization, intubation, and death (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Retrospective Studies , Risk Factors , COVID-19/complications , Intensive Care Units , Length of Stay , Lung Diseases/physiopathology
12.
Einstein (São Paulo, Online) ; 20: eAO6953, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1375364

ABSTRACT

ABSTRACT Objective: To evaluate anthropometric and clinical data, muscle mass, subcutaneous fat, spine bone mineral density, extent of acute pulmonary disease related to COVID-19, quantification of pulmonary emphysema, coronary calcium, and hepatic steatosis using chest computed tomography of hospitalized patients with confirmed diagnosis of COVID-19 pneumonia and verify its association with disease severity. Methods: A total of 123 adults hospitalized due to COVID-19 pneumonia were enrolled in the present study, which evaluated the anthropometric, clinical and chest computed tomography data (pectoral and paravertebral muscle area and density, subcutaneous fat, thoracic vertebral bodies density, degree of pulmonary involvement by disease, coronary calcium quantification, liver attenuation measurement) and their association with poorer prognosis characterized through a combined outcome of intubation and mechanical ventilation, need of intensive care unit, and death. Results: Age (p=0.013), body mass index (p=0.009), lymphopenia (p=0.034), and degree of pulmonary involvement of COVID-19 pneumonia (p<0.001) were associated with poor prognosis. Extent of pulmonary involvement by COVID-19 pneumonia had an odds ratio of 1,329 for a poor prognosis and a cutoff value of 6.5 for increased risk, with a sensitivity of 64.9% and specificity of 67.1%. Conclusion: The present study found an association of high body mass index, older age, extent of pulmonary involvement by COVID-19, and lymphopenia with severity of COVID-19 pneumonia in hospitalized patients.

13.
Einstein (São Paulo, Online) ; 20: eAO0061, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1384791

ABSTRACT

ABSTRACT Objective To compare inter-rater reliability, diagnostic accuracy, and extension of pulmonary involvement in children with suspected COVID-19 submitted to supine or supine and lateral decubitus computed tomography imaging. Methods Retrospective study carried out between March 2020 and March 2021 with patients submitted to reverse transcription-polymerase chain reaction testing and chest computed tomography. Patients were divided into two groups: supine or supine and lateral decubitus imaging. Standardized reporting systems of computed tomographic findings in COVID-19 and chest computed tomography score were used. Results One hundred and seventeen patients were enrolled. Moderate to substantial inter-rater reliability was observed for standardized reporting systems (weighted kappa, 0.553-0.764; p<0.001). Inter-rater reliability for the chest computed tomography score was substantial (weighted kappa, 0.620-0.670; p<0.001). Standardized reporting systems failed to predict COVID-19 in children, regardless of additional lateral decubitus imaging (area under the receiver operating characteristic curve, 0.491-0.608). Chest computed tomography scores assigned to lateral decubitus images were significantly lower. Conclusion Additional lateral decubitus imaging does not improve the accuracy of standardized reporting systems of computed tomographic findings in COVID-19 but may provide a more accurate estimation of lung involvement in uncooperative patients.

14.
Rev. argent. radiol ; 86(3): 199-210, 2022. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1407209

ABSTRACT

Resumen El derrame pericárdico (DP) es una entidad frecuente en la práctica diaria, que puede ocurrir por un amplio rango de patologías. Los métodos por imágenes constituyen una herramienta diagnóstica clave en la evaluación del pericardio. El ecocardiograma transtorácico (ETT) se considera de primera línea por su costo-efectividad. La tomografía computarizada multicorte (TCMC), por su parte, representa un valioso complemento ante limitaciones del ETT y en la evaluación de urgencia del paciente con sospecha de DP. El objetivo del trabajo es mostrar la utilidad y rol de la TCMC, mediante la medición de densidades, para estimar la etiología del DP, ilustrado con casos de nuestra institución.


Abstract Pericardial effusion (PE) is a common entity in daily practice, which can occur due to a wide range of conditions. Imaging methods are a key diagnostic tool in the evaluation of the pericardium. Transthoracic echocardiogram (TTE) is the first line imaging method because of its cost-effectiveness. Multi-slice Computed Tomography (MSCT), on the other hand, represents a valuable complement to the limitations of TTE and in emergency evaluation of the patient with suspected PE. The objective of this review is to show the usefulness and role of the MSCT —through the measurement of densities— to estimate the etiology of PE, illustrated with cases of our Institution.


Subject(s)
Humans , Male , Female , Pericardial Effusion , Pericardium/pathology , Pneumopericardium/diagnostic imaging , Pericardial Fluid , Pericarditis , Tomography, X-Ray Computed , Heart Failure
15.
CorSalud ; 13(3)sept. 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1404447

ABSTRACT

RESUMEN En diciembre de 2019 se informaron casos de una neumonía grave en la ciudad de Wuhan, China. En enero de 2020 fue identificado el nuevo virus, SARS-CoV-2, que producía esta enfermedad altamente contagiosa denominada COVID-19, y alcanzó nivel de epidemia en marzo de ese propio año. Existe un protocolo establecido para su diagnóstico, donde se encuentran los estudios de imagen, entre ellas la tomografía de tórax con técnica de energía dual. Las características de los hallazgos anatómicos pulmonares y vasculares en las imágenes tomográficas de pacientes con COVID-19, su distribución, y la relación con el tiempo transcurrido desde el inicio de los síntomas, juegan un papel importante en el control y tratamiento de esta enfermedad, lo que refleja el valor diagnóstico de esta técnica.


ABSTRACT In December 2019 some cases of a severe pneumonia were reported in the city of Wuhan, China. In January 2020, the new virus, SARS-CoV-2, which produced this highly contagious disease called COVID-19, was identified and it reached epidemic level in March 2020. There is an established protocol for its diagnosis, which includes imaging studies, including chest dual energy computed tomography. The characteristics of pulmonary and vascular anatomical findings in tomographic images of patients with COVID-19, their distribution, and their relationship with the time elapsed since the onset of symptoms, play an important role in the control and treatment of this disease, reflecting the diagnostic value of this technique.

16.
Medisan ; 25(4)2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1340211

ABSTRACT

Introducción: El trauma torácico se encuentra entre las primeras causas de muerte, fundamentalmente en personas jóvenes. Objetivos: Caracterizar a una población operada por traumatismos torácicos según variables clinicoepidemiológicas y describir los hallazgos tomográficos posquirúrgicos. Métodos: Se llevó a cabo un estudio observacional y descriptivo de 48 pacientes atendidos en el Servicio de Radiología del Provincial Clínico-Quirúrgico Docente Saturnino Lora de Santiago de Cuba, de enero del 2016 a diciembre del 2018, a los cuales se les realizó tomografía computarizada multidetector. Resultados: Los traumas torácicos predominaron en personas jóvenes del sexo masculino, asociadas fundamentalmente a acciones violentas que provocaron traumas abiertos. La contusión pulmonar resultó ser el hallazgo tomográfico inicial más frecuente, en tanto, el neumotórax persistente y el hemotórax coagulado constituyeron los hallazgos tomográficos más influyentes en la decisión de una reintervención quirúrgica. Conclusiones: La tomografía es un medio diagnóstico que permite una descripción detallada del estado posoperatorio de los órganos afectados, con un alto valor orientativo para decidir procedimientos quirúrgicos posteriores.


Introduction: The thoracic trauma is among the first causes of death, fundamentally in young people. Objectives: To characterize a population operated due to thoracic trauma according to clinical epidemiological variables and describe the postsurgical tomographic findings. Methods: An observational and descriptive study of 48 patients assisted in the Radiology Service of Saturnino Lora Teaching Clinical Surgical Provincial Hospital was carried out in Santiago de Cuba, from January, 2016 to December, 2018, to whom a multidetector computed tomography was carried out. Results: The thoracic traumas prevailed in young male people, fundamentally associated with violent actions that caused open traumas. The lung contusion was the most frequent initial tomographic finding, as long as, the persistent pneumothorax and the coagulated hemothorax constituted the most influential tomographic findings in the decision of a surgical reintervention. Conclusions: Tomography is a diagnostic means that allows a detailed description of the postoperative state in the affected organs, with a high orientative value to decide later surgical procedures.


Subject(s)
Thoracic Injuries/surgery , Thoracic Injuries/epidemiology , Multidetector Computed Tomography , Pneumothorax/surgery , Thoracic Injuries/diagnostic imaging , Hemothorax/surgery
17.
Radiol. bras ; Radiol. bras;54(4): 261-264, July-Aug. 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1287756

ABSTRACT

Abstract Almost two decades ago, it became possible to use coronary computed tomography for the noninvasive assessment of the coronary arteries. That is an extremely accurate method for detecting or excluding coronary artery disease, even the subclinical forms. This pictorial essay aims to show the main imaging findings in 47 coronary computed tomography scans acquired at a general hospital between January 2014 and June 2018. The most common findings were atheromatous plaques (in 87%) and stents (in 34%). There were also incidental findings, not directly related to coronary artery disease, such as pulmonary nodules and aortic stenosis.


Resumo Há quase duas décadas, tornou-se possível a avaliação não invasiva das coronárias por meio da angiotomografia. Esta é bastante importante para excluir ou detectar doença arterial coronariana, mesmo que subclínica. Este ensaio tem o objetivo de mostrar os principais achados de imagem em 47 angiotomografias realizadas de janeiro de 2014 a junho de 2018 em um hospital geral. Os achados mais frequentes foram a presença de placas ateromatosas (87%) e stents (34%). Além desses, houve também achados incidentais não relacionados diretamente com doença arterial coronariana, como nódulos pulmonares e estenose aórtica.

18.
Int. j. morphol ; 39(3): 869-875, jun. 2021. ilus, tab
Article in English | LILACS | ID: biblio-1385413

ABSTRACT

SUMMARY: Liver plays an important role in many events such as bile production, blood filtration and metabolic functions. The liver is supplied by the hepatic arterial system. The hepatic arterial system anatomy has a variable structure and the rate of variation is high. In our study, we aimed to determine the diameters and variation of the arteries supplying the liver with multidetector computed tomography images. In this study, hepatic arterial system variations of 500 cases whose abdominal region was imaged with multi- detector computed tomography were evaluated and the diameters of the related arteries were measured. The mean diameters of classical and variational anatomy were determined in this study. According to mean measurements of classical and variational anatomy were abdominal aorta 21.95 mm, celiac artery 7.2 mm, common hepatic artery 4.3 mm, proper hepatic artery 2.93 mm, right hepatic artery 2.92 mm, left hepatic artery 2.51 mm and abdominal aorta 21.85 mm, celiac artery 6.99 mm, common hepatic artery 5.07 mm, proper hepatic artery 3.83 mm, right hepatic artery 2.87 mm ve left hepatic artery 2.09 mm respectively. When evaluated in terms of variations, 85.6 % of the cases had branching according to Type I, 14.4 % of the cases had different branching patterns. Type III (87.5 %) was the most observed variation among them. As a result of the study, it was determined that the arterial diameters vary according to the state of variation and that the arterial diameter of men are greater than that of women.


RESUMEN: El hígado juega un papel importante en diferentes eventos, tal como la producción de bilis, la filtración de sangre y las funciones metabólicas. El hígado está irrigado por el sistema arterial hepático. La anatomía del sistema arterial hepático tiene una estructura variable y la tasa de variación es alta. En nuestro estudio, nuestro objetivo fue determinar los diámetros y la variación de las arterias que irrigan el hígado con imágenes de tomografía computarizada multidetector. Se evaluaron las variaciones del sistema arterial hepático de 500 casos y se obtuvieron imágenes con tomografía computarizada de detectores múltiples abdominales y se midieron los diámetros de las arterias relacionadas. Se determinaron los diámetros medios de la anatomía clásica y variacional. Según las medidas medias de la anatomía clásica y variacional fueron aorta abdominal 21,95 mm, arteria celíaca 7,2 mm, arteria hepática común 4,3 mm, arteria hepática propia 2,93 mm, arteria hepática derecha 2,92 mm, arteria hepática izquierda arteria 2,51 mm y parte abdominal de la aorta 21,85 mm, arteria celíaca 6,99 mm, arteria hepática común 5,07 mm, arteria hepática propia 3,83 mm, arteria hepática derecha 2,87 mm y arteria hepática izquierda 2,09 respectivamente. Cuando se evaluó en términos de variaciones, el 85,6 % de los casos tenían ramificaciones según el Tipo I, el 14,4 % de los casos tenían diferentes patrones de ramificación. El tipo III (87,5 %) fue la variación más observada entre ellos. Como resultado del estudio, se determinó que los diámetros arteriales varían según el estado de variación y que el diámetro arterial de los hombres es mayor que el de las mujeres.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Multidetector Computed Tomography , Anatomic Variation , Hepatic Artery/diagnostic imaging , Liver/diagnostic imaging , Hepatic Artery/anatomy & histology , Liver/blood supply
19.
CorSalud ; 13(1): 51-58, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1345920

ABSTRACT

RESUMEN Introducción: Los avances tecnológicos en tomografía computarizada han hecho posible la evaluación de estructuras pequeñas y móviles, como las arterias coronarias y el resto del corazón. La tomografía cardíaca aporta información anatómica y funcional. Objetivo: Identificar los valores de las principales medidas anatómicas de las cavidades cardíacas y los grandes vasos, y compararlos con los valores de referencia utilizados. Método: Se realizó un estudio analítico de investigación y desarrollo con un universo de 325 pacientes normotensos, no obesos, sin enfermedad estructural cardiopulmonar o de grandes vasos, arritmia o enfermedad coronaria significativa, de donde se seleccionaron 100 pacientes por muestreo probabilístico aleatorio simple, a quienes se les realizó tomografía computarizada cardíaca de doble fuente en el Cardiocentro Ernesto Che Guevara, Santa Clara, Cuba. Resultados: Las mediciones ventriculares izquierda y derecha mostraron diferencias con la mayoría de los valores referenciales. Los diámetros de la aorta, aumentaron con la edad, fueron superiores en los hombres y difieren de los valores de referencia con excepción del medido en eje corto de la raíz aórtica en telediástole, y el diámetro en eje corto de la aorta descendente en telesístole. La arteria pulmonar mostró diferencias significativas con relación a los valores de referencia. Conclusiones: Las mediciones de las cavidades cardíacas y los grandes vasos basados en las técnicas tomográficas constituyen una necesidad en determinados grupos poblacionales para lograr una estandarización adecuada debido a su gran variabilidad en relación a distintas variables. La diferencia significativa con los valores de referencia indica le necesidad de estudios multicéntricos con poblaciones mayores para lograr su homogeneidad.


ABSTRACT Introduction: Technological advances in computed tomography have made it possible to assess small, mobile structures such as the coronary arteries and the rest of the heart. Cardiac tomography provides anatomical and functional information. Objective: To identify the values of the main anatomical sizes of the cardiac chambers and great vessels, and compare them with the reference values. Method: An analytical research and development study was conducted with a population of 325 normotensive, non-obese patients without cardiopulmonary or great vessel structural disease, arrhythmia or significant coronary artery disease. One hundred patients were selected by simple random probability sampling, who underwent dual-source cardiac computed tomography at the Cardiocentro Ernesto Che Guevara, Santa Clara, Cuba. Results: Left and right ventricular measurements showed differences when compared with most reference values. Aortic diameters increased with age. They were higher in men and were different from the reference values except for the short-axis diameter of the aortic root in end-diastole and short-axis diameter of the descending aorta in end-systole. The pulmonary artery showed significant differences in relation to the reference values. Conclusions: Measurements of cardiac chambers and great vessels by tomographic techniques are necessary in certain population groups to achieve adequate standardization due to their great variability in relation to different variables. The significant difference with the reference values indicates the need for multicenter studies with larger populations to achieve homogeneity.


Subject(s)
Reference Values , Coronary Vessels , Multidetector Computed Tomography , Computed Tomography Angiography
20.
Article in Chinese | WPRIM | ID: wpr-988325

ABSTRACT

Objective To establish a neural network model based on enhanced CT for distinguishing ISUP grade of clear cell renal cell carcinoma (ccRCC). Methods We collected 131 cases of ccRCC, with 92 cases of low ISUP grade and 39 cases of high ISUP grade. Patients were divided into training set and validation set according to 5:5 stratified sampling. The enhanced CT images of each ccRCC patient were evaluated by the radiologist. Recursive feature elimination (RFE) was used to reduce the dimension of patients' general features and enhanced CT features, which was used for neural network modeling and validation. Results Patients' general features and enhanced CT features were verified by RFE method and then reduced to 14 features. The top 5 features were growth pattern, necrosis, enlargement of lymph nodes, tumor size and capsule. The AUC of the neural network model based on these 5 features in training set was 0.8844 (95%CI: 0.8062-0.9626), sensitivity was 89.47% and specificity was 82.61%; and those in validation set were 0.7924 (95%CI: 0.6567-0.9280), 75.00% and 86.96%, respectively. Conclusion The neural network model of ccRCC ISUP grade based on enhanced CT has relatively high diagnostic efficiency.

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