ABSTRACT
BACKGROUND/PURPOSE: To evaluate the value of 3D reconstructed computed tomography (CT) imaging for patients with double outlet right ventricle (DORV). METHODS: CT images were obtained preoperatively from 17 patients who ranged in age from 5 days to 5 years. Reconstructed 3D images were created using gradient-shading surface rendering, which allowed partial subtraction of the anterior sections of the virtual heart to view the interior. Interpretations of CT, echocardiography and cine-cardioangiography were compared and verified from surgical findings, autopsy, and consensus upon review of all imaging and diagnostic tests. RESULTS: Three subaortic, seven subpulmonary, six non-committed, and one double-committed subtypes of ventricular septal defect (VSD) were observed. The 3D electron beam CT images provided good delineation of the spatial relationship inside the heart. The range of diagnostic accuracy for all VSD types in DORV was 88-100% for 3D CT, 71-94% for echocardiography, and 60-100% for cine-cardioangiography. In comparison, 3D CT offered better diagnostic accuracy for all variants of DORV. CONCLUSION: 3D constructed CT imaging is a good modality for differentiating VSD type in DORV. It allowed us to directly evaluate the inside of cardiac chambers for the right ventricular outlet, great arterial root, and determine the VSD relationships.
Subject(s)
Double Outlet Right Ventricle/diagnostic imaging , Child, Preschool , Female , Humans , Imaging, Three-Dimensional , Infant , Infant, Newborn , Male , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: CT patterns of anomalous brachiocephalic veins are presented with reconsideration of the structure's embryogenesis. CONCLUSION: With advancements in central line procedures and corrective cardiac surgery, and the widespread use of noninvasive imaging techniques, the clinical importance of identification of the anomalous brachiocephalic vein is shown.
Subject(s)
Brachiocephalic Veins/abnormalities , Iohexol/analogs & derivatives , Tomography, X-Ray Computed/methods , Adolescent , Adult , Brachiocephalic Veins/diagnostic imaging , Brachiocephalic Veins/embryology , Chi-Square Distribution , Child , Child, Preschool , Contrast Media , Female , Humans , Image Processing, Computer-Assisted , Infant , Infant, Newborn , Male , Retrospective StudiesABSTRACT
The most commonly involved sites of cryptococcosis are the lungs and the central nervous system. Cryptococcal osteomyelitis is a rare complication of disseminated cryptococcosis, and the vertebraes are the most common site of this infection. The most common underlying disease is sarcoidosis, followed by tuberculosis and previous steroid therapy. Conservative treatment alone or treatment with a combination of the medical and surgical curettage is successful in most cases. We report a case of cryptococcal osteomyelitis in a 63-year-old immunocompetent male who presented with lower back pain over the sacral region for several years. Radiologic studies showed a pulmonary mass and a radiolytic lesion involving the left ischial bone, which mimicked pulmonary malignancy with bone metastasis. Biopsy of the lung mass and the bone lesion revealed abundant cryptococcal organisms, and cryptococcal osteomyelitis was diagnosed.
Subject(s)
Bone Marrow Diseases/diagnostic imaging , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Cryptococcosis/diagnostic imaging , Lung Diseases, Fungal/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Diagnosis, Differential , Humans , Male , Middle Aged , RadiographyABSTRACT
BACKGROUND: To establish a reference of tracheal size in children with congenital heart disease to allow detection of airway stenosis. METHODS: We conducted a retrospective study using existing data from children referred for computed tomography (CT) scanning. From January 1999 to February 2001, 540 consecutive children with congenital heart disease who received electron beam CT scanning at our hospital were considered eligible for inclusion in the study. After exclusion criteria were considered, 99 children (50 girls and 49 boys; aged 4 days to 16 years 10 months) were enrolled in the study. Tracheal width was measured at three levels on CT images. The relationship between tracheal width and the patient's height, weight, age, and sex were analyzed by multiple regression and formula transformation. RESULTS: Height was the most effective parameter for predicting the transverse diameter of the intrathoracic trachea, and tracheal size could be predicted based on height using the established equations. In addition, tracheal width increased from the thoracic inlet to the carina. Reference curves based on the subject's height were created for convenient use. CONCLUSIONS: Tracheal stenosis in children with congenital heart disease may be diagnosed by comparing the size of the trachea of the individual to the 95% confidence interval of predicted values based on the patient's height.
Subject(s)
Heart Defects, Congenital/diagnostic imaging , Tomography, X-Ray Computed , Trachea/diagnostic imaging , Tracheal Stenosis/diagnostic imaging , Adolescent , Body Height , Child , Child, Preschool , Female , Heart Defects, Congenital/complications , Heart Defects, Congenital/pathology , Humans , Infant , Infant, Newborn , Male , Trachea/pathology , Tracheal Stenosis/complicationsABSTRACT
This study was undertaken to delineate tracheobronchial anomalies associated with congenital heart disease. From June 1995 to December 2000, 1,245 children with congenital heart disease underwent cardiac electron beam computed tomography with 3-dimensional reconstruction on an independent workstation. Tracheobronchial anomalies are strongly associated with congenital heart disease and accompanying tracheal stenosis is not uncommon. With 3-dimensional reconstruction, electron beam computed tomography provided excellent anatomic definition of the central tracheobronchial abnormalities.
