CT quantification of COVID-19 pneumonia extent to predict individualized outcome.

OBJECTIVES:  This study aimed to predict individual COVID-19 patient prognosis at hospital admission using artificial intelligence (AI)-based quantification of computed tomography (CT) pulmonary involvement. BACKGROUND: Assessing patient prognosis in COVID-19 pneumonia is crucial for patient management and hospital and ICU organization. METHODS: We retrospectively analyzed 559 patients with PCR-verified COVID-19 pneumonia referred to the hospital for a severe disease course. We correlated the CT extent of pulmonary involvement with patient outcome. We also attempted to define cut-off values of pulmonary involvement for predicting different outcomes. RESULTS:  CT-based disease extent quantification is an independent predictor of patient morbidity and mortality, with the prognosis being impacted also by age and cardiovascular comorbidities. With the use of explored cut-off values, we divided patients into three groups based on their extent of disease: (1) less than 28 % (sensitivity 65.4 %; specificity 89.1 %), (2) ranging from 28 % (31 %) to 47 % (sensitivity 87.1 %; specificity 62.7 %), and (3) above 47 % (sensitivity 87.1 %; specificity, 62.7 %), representing low risk, risk for oxygen therapy and invasive pulmonary ventilation, and risk of death, respectively. CONCLUSION: CT quantification of pulmonary involvement using AI-based software helps predict COVID-19 patient outcomes (Tab. 4, Fig. 4, Ref. 38).

Cerebral artery reverse flow as an indicator of critical intracranial hypertension in fetal intracranial hemorrhage: Case report.

OBJECTIVE: Intracranial hemorrhage (ICH) is a rare serious fetal event. It manifests via non-specific sonographic findings such as: ventriculomegaly, increased periventricular echogenity, hyperechogenic ependyma and presence of avascular intracranial masses. Severe ICH causes an increase in fetal intracranial pressure, which can be quantified in utero by the presence of reverse flow in the middle cerebral artery (MCA-REDF). Retrograde flow in the middle cerebral artery indicates already deteriorating circulatory conditions in the fetal brain with loss of autoregulatory mechanisms and critical damage to the vascular supply. Detection of this finding allows to improve the diagnosis of ICH and also affects the prognosis and management of pregnancy. We report the case of critical intracranial hypertension in fetal intracranial hemorrhage manifested by cerebral artery reverse flow.

Internal carotid artery anatomy - not always straightforward.

OBJECTIVES: To present a rare variant of internal carotid artery anatomy. METHODS: Case report presenting CT angiography finding of internal carotid anatomy variant. RESULTS: We present the case of an unusual origin of the occipital artery from cervical portion of the internal carotid artery as an incidental finding during CT angiography of the carotid arteries. In discussion, we discuss the possible embryological basis, incidence and prevalence of such finding and its possible clinical implications. CONCLUSION: One of the specific aspects of carotid arteries is their straightforward anatomy - the cervical portion of internal carotid artery, unlike the external carotid, does not give origin to any branches - this aspect is even used as a highlight for orientation, e.g. during ultrasound examination. However, although rare, variants exist, and sometimes can have clinical importance - in the endovascular access or surgical treatment.

A new comprehensive Classification Scheme for ECU Tendon Problems at the Wrist.

Based on a systematic review of the literature, description of previous classification schemes and new anatomical knowledge, a new comprehensive classification scheme for ECU tendon problems at the wrist is described.

Large Thoracic Lymphadenopathy and Pulmonary Nodules in Young Man.

CASE PRESENTATION: A 33-year-old man with obesity, systemic arterial hypertension, and psoriasis who had been treated previously with little success by a pulmonologist for chronic unproductive irritant cough came to the outpatient pulmonary department because of profuse cough and short syncope (probably cough-induced). Chest radiography revealed widened mediastinum with lobular, polycyclic contours that was suspected to be a large mediastinal lymphadenopathy or mediastinal mass.

Gastroenteropancreatic neuroendocrine neoplasm - a complex presentation in imaging methods.

Neuroendocrine neoplasms comprise an ever greater ratio of primary gastrointestinal tract tumors, thanks to the improving diagnostics. The clinical presentation can be quite diverse depending on the type of the tumor. Imaging methods - both the spectrum of radiological methods and methods of nuclear medicine - are an integral part of the diagnostics. This article presents a case report of a 65-year old female patient, whose routine abdominal US scan performed as part of a preventive check-up revealed a suspicious liver incidentaloma. The case report presents the image of the pathology in various imaging modalities, radiologic and molecular/hybrid methods used in the differential diagnostic process of the lesion, as well as findings in follow-up examinations after histological verification of the lesion and an outline of further approach and treatment.