Ultrasonography (USG) and multi-detector computerized tomography (MDCT) evaluation of thyroid swellings

Background: Thyroid ultrasound has undergone a dramatic transformation from the cryptic deflections on an oscilloscope produced in A-mode scanning, to barely recognizable B-mode images, followed by initial low resolution gray scale, and now modern high resolution images. Aim: The aim of the present study was to evaluate the diagnostic role of ultrasonography (USG) and multi-detector computed tomography (MDCT) in thyroid swellings, compare the ultrasonographic findings with multi-detector computed tomographic findings and to correlate the radiological findings with histopathological examination (HPE). Materials and methods: The present study was carried out in the Department of Radiology, Kamineni Institute of Medical Sciences, Narketpally. In this study, 50 patients with thyroid gland swellings diagnosed clinically, referred to Radiology Department were selected during the period from October 2008 to September 2010. Histopathological examination was acquired in 35 cases. The study was carried out to observe the sensitivity, specificity and diagnostic accuracy of USG and MDCT in thyroid gland swellings. Results: Maximum number of patients belonged to the age group of 21-40 years that was 27 cases (54.00%) and maximum number of patients were females – 41 cases (82.00%). Most common diagnosis was multi-nodular goitre on USG-16 cases (32.00%) and MDCT- 14 cases (28.00%), solitary thyroid nodule is common in the right lobe of thyroid by USG -5 cases (62.50%) and MDCT5 cases (62.50%). Most common malignancy was papillary carcinoma of thyroid -5 cases (62.50%) and most common inflammatory disorder was hashimoto’s thyroiditis -5 cases (10.00%). Naveen Kumar S, Vidyadhara Rani P. Ultrasonography (USG) and multi-detector computerized tomography (MDCT) evaluation of thyroid swellings. IAIM, 2017; 4(9): 145-155. Page 146 Conclusion: The present study has concluded that USG is the fast and cost-effective modality of imaging investigation of choice in thyroid diseases and for differential diagnosis of thyroid nodules. MDCT is superior to ultrasound in evaluating retrosternal extension, relations and infiltrations in large lesions. It is also very helpful in evaluating extra-capsular, mediastinal, vascular invasion, lymph nodal involvement and metastasis. MDCT is very crucial in preoperative planning in malignancies of thyroid and large benign lesions.

Discussions of Multi-Detector Computed Tomography (MDCT) dose assessment based on information in DICOM images / 中华放射医学与防护杂志

Objective To establish an accuracy test method for MDCT dose assessment based on information in DICOM images.Methods The type of MDCT studied in this paper was widely used in clinical practice.A software package developed by java language was used to automatically read doserelated information from DICOM files of MDCT.The CTDIvol and DLP of each pectoral or abdominal scan was calculated based on these information and the basic scan parameters such as collimation,mAs and pitch.The calculated values were compared with the displayed values.Results For pectoral scans,the difference between the calculated and displayed values was between-2％-8％ for CTDIvol,and-2％-5％ for DLP.For abdominal scan,the difference between the calculated and displayed values was 0-2％ for CTDIvol,and-2％-3％ for DLP.Conclusions This method is useful for MDCT dose assessment and is worth disseminating its application for general use.

Reducing of Craniofacial Radiation Dose Using Automatic Exposure Control Technique in the 64 Multi-Detector Computed Tomography / 의학물리

The purpose of this study was to evaluate the usefulness of reducing of craniofacial radiation dose using automatic exposure control (AEC) technique in the 64 multi-detector computed tomography (MDCT). We used SOMATOM Definition 64 multi-detector CT, and head of whole body phantom (KUPBU-50, Kyoto Kagaku CO. Ltd). The protocol were helical scan method with 120 kVp, 1 sec of rotation time, 5 mm of slice thickness and increment, 250 mm of FOV, 512x512 of matrix size, 64x0.625 mm of collimation, and 1 of pitch. The evaluation of dose reducing effect was compared the fixed tube current of 350 with AEC technique. The image quality was measured the noise using standard deviation of CT number. The range of craniofacial bone was to mentum end from calvaria apex, which devided three regions: calvaria~superciliary ridge (1 segment), superciliary ridge~acanthion (2 segment), and acanthion~mentum (3 segment). In the fixed tube current technique, CTDIvol was 57.7 mGy, DLP was 640.2 mGy.cm in the all regions. The AEC technique was showed that 1 segment were 30.7 mGy of CTDIvol, 340.7 mGy.cm of DLP, 2 segment were 46.5 mGy of CTDIvol, 515.0 mGy.cm of DLP, and 3 segment were 30.3 mGy of CTDIvol, 337.0 mGy.cm of DLP. The standard deviation of CT number was 2.622 with the fixed tube current technique and 3.023 with the AEC technique in the 1 segment, was 3.118 with the fixed tube current technique and 3.379 with the AEC technique in the 2 segment, was 2.670 with the fixed tube current technique and 3.186 with the AEC technique in the 3 segment. The craniofacial radiation dose using AEC Technique in the 64 MDCT was evaluated the usefulness of reducing for the eye, the parotid and thyroid with high radiation sensitivity particularly.

Incidental Non-Cardiac Findings of a Coronary Angiography with a 128-Slice Multi-Detector CT Scanner: Should We Only Concentrate on the Heart?

OBJECTIVE: To evaluate the spectrum, prevalence, and significance of incidental non-cardiac findings (INCF) in patients referred for a non-invasive coronary angiography using a 128-slice multi-detector CT (MDCT). MATERIALS AND METHODS: The study subjects included 1,044 patients; 774 males (mean age, 59.9 years) and 270 females (mean age, 63 years), referred for a coronary CT angiography on a 128-slice MDCT scanner. The scans were acquired from the level of the carina to just below the diaphragm. To evaluate INCFs, images were reconstructed with a large field of view (> 300 mm) covering the entire thorax. Images were reviewed in the axial, coronal, and sagittal planes, using the mediastinal, lung, and bone windows. The INCFs were classified as severe, indeterminate, and mild, based on their clinical importance, and as thoracic or abdominal based on their locations. RESULTS: Incidental non-cardiac findings were detected in 56% of patients (588 of 1,044), including 435 males (mean age, 65.6 years) and 153 females (mean age, 67.9 years). A total of 729 INCFs were observed: 459 (63%) mild (58% thoracic, 43% abdominal), 96 (13%) indeterminate (95% thoracic, 5% abdominal), and 174 (24%) severe (87% thoracic, 13% abdominal). The prevalence of severe INCFs was 15%. Two severe INCFs were histologically verified as lung cancers. CONCLUSION: The 128-slice MDCT coronary angiography, in addition to cardiac imaging, can provide important information on the pathology of the chest and upper abdomen. The presence of severe INCFs is not rare, especially in the thorax. Therefore, all organs in the scan should be thoroughly evaluated in daily clinical practice.

MDCT and Gd-EOB-DTPA Enhanced MRI Findings of Adrenal Adenoma Arising from an Ectopic Adrenal Gland within the Liver: Radiologic-Pathologic Correlation

We report a case of an adenoma arising from an ectopic adrenal gland mimicking a hepatocellular carcinoma in a heavy alcohol abuser. A MDCT showed a 2.7 low-attenuating nodule in segment VII of the liver through all CT phases. Compared to a precontrast image, however, a subtle enhancement was noted on the arterial phase CT image. On T1 weighted in- and opposed-phase MR images, an abundant fat component within the lesion was seen. Dynamic contrast-enhanced MR images after administration of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) more clearly depicted hypervascularity and wash-out of the lesion on arterial and portal phases, respectively. On delayed hepatobiliary phase MR images, obtained 20 minutes after Gd-EOB-DTPA administration, subtle uptake or retention of the contrast agent by the lesion was suspected. A tumorectomy was performed and adrenal adenoma from an ectopic adrenal gland within the liver was confirmed.