Comparison of CT Scan and Bone Mineral Densitometry for Diagnosing Osteoporosis and Osteopenia in Patients with Chronic Kidney Disease

CT and MR findings in synovial chondromatosis of the temporo-mandibular joint: Our experience and review of literature

Comparison of Sagittal Computed Tomography and Plain Film Radiography in a Scaphoid Fracture Model

To compare computed tomography (CT) with magnetic resonance imaging (MRI) for the presumptive diagnosis and localization of acute and subacute low-grade subarachnoid hemorrhage (SAH). We consecutively enrolled 45 patients clinically suspected of low-grade SAH, comparing them with a control group. We obtained axial nonenhanced CT scans as well as fluid-attenuated inversion recovery (FLAIR) and T2-weighted gradient echo (T2*) MRI sequences at 1.0 T. Two neuroradiologists scrutinized the presence of blood at 26 different regions in the intracranial subarachnoid space (SAS). Three of 45 patients had normal CT and MRI scans, and SAH was excluded by lumbar puncture. We demonstrated SAH on CT scans in 28 of 42 (66.6%) patients, T2* sequences in 15 of 42 (35.7%) patients, and FLAIR sequences in 42 of 42 (100%) patients. Fluid-attenuated inversion recovery sequences were superior to CT in 16 of the 26 evaluated regions. The FLAIR sequence was superior for presumptive diagnosis and localization of acute and subacute low-grade SAH, representing a potential tool in this setting.

This retrospective study compared computed tomography (CT) imaging to routine dental periapical radiographs in diagnosing radiolucencies around endodontically treated teeth. Of the 244 CT scans evaluated, 104 had no teeth on the scan. On the remaining 140 scans, 353 teeth fell into the following categories: 59 maxillary molars, 30 mandibular molars, 66 maxillary premolars, 56 mandibular premolars, and 141 anterior teeth. Positive and negative predictive values were calculated, as were sensitivity, specificity, and prevalence assuming the CT scan was the test standard. For the total tooth population periapical radiograph - CT slice sensitivity was 52, specificity was 90, the positive predictive value (PPV) was 97, the negative predictive value (NPV) was 25, and the prevalence 85. In the population studied, the CT scan had a greater ability to show radiolucencies that were not evident on periapical radiographs.

Assessment of asbestos-induced pleural disease by computed tomography — correlation with chest radiograph and lung function

To determine the ability of bone density to predict fractures in very elderly women, we examined the association of bone density with non-spine, hip, wrist and humerus fractures in 8699 Caucasian women aged 65-79 years and 1005 women aged 80 years and older who were participants in the prospective Study of Osteoporotic Fractures. Follow-up averaged 4.9 (+/- 1.0) years after baseline measurement of appendicular bone density (single-photon absorptiometry; Osteon-Osteo Analyzer) and 2.9 (+/- 0.6) years after measurement of hip and anteroposterior lumbar spine bone density (dual-energy X-ray absorptiometry; Hologic QDR 1000) at a later examination. In general, measurements of bone density in the oldest women retained their predictive value for fractures. Among women aged 80 and over a 1 standard deviation decrease in bone density of the distal radius was associated with an increased risk of non-spine (relative risk: 1.6; 95% confidence interval: 1.3, 1.8), wrist (1.7; 1.2, 2.4) and humerus fracture (2.9; 1.8, 4.7), while a 1 standard deviation decrease in femoral neck bone density was associated with an increased risk of non-spine (1.9; 1.6, 2.4), humerus (2.4; 1.2, 4.7) and hip fracture (2.1; 1.4; 3.2). However, only trochanteric but not femoral neck fractures were associated with low bone density in these oldest women. The excess risk of fracture in women with below-median bone density was greater in those aged 80 years and over compared with the younger women: 38.4 v 20.4 per 1000 woman-years for non-spine fracture and 12.2 v 3.2 per 1000 woman-years for hip fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

Background: The clinical course of cystic fibrosis (CF) patients with the Gly551Asp mutation (class III) is not well characterised, particularly in terms of structural lung disease. Data on whether the clinical severity of Gly551Asp patients differs from Phe508del homozygous patients is divergent. Aims: We aimed to compare computed tomography (CT) outcomes in patients with the Gly551Asp mutation against the most common CF mutation, Phe508del (severe class II genotype). We hypothesised that structural lung disease will be less severe in Gly551Asp patients. Methods: All patients in the AREST CF cohort with the Gly551Asp mutation and one severe genotype, with accompanying PRAGMA-CF scores were included. Age-matched CT scans from Phe508del homozygous CF patients were randomly selected. The extent of total disease (%Dis) and trapped air (%TA) were determined from the PRAGMA score. Linear mixed model analysis was used to compare CT outcomes of both genotype groups, accounting for age and repeated visits with p Results: Seventeen patients with the Gly551Asp mutation (44 CT scans) and 136 homozygous Phe508del patients (348 CT scans) were included, with median (range) age of 3 (0-11) years. Differences in %Dis and %TA between Gly551Asp and homozygous Phe508del patients were -0.11(-0.79,0.57) p=0.750 and 0.13(-2.47,2.72) p=0.923, respectively. Conclusions: A significant difference in structural lung disease was not detected between both groups, suggesting that patients with the Gly551Asp mutation have as severe lung disease as patients with severe genotypes in childhood. Therefore, Gly551Asp patients could be selected for more intensive clinical follow-up.

The correct differentiation between unilateral and bilateral adrenal involvement in patients with primary aldosteronism (PA) is of utmost importance to justify surgical treatment. The aim of this study was to determine the accuracy of adrenal imaging compared to adrenal venous sampling (AVS), histopathology and postoperative outcome. The data of all patients with unequivocal AVS who underwent unilateral laparoscopic adrenalectomy for primary aldosteronism between May 2004 and April 2015 were entered in this retrospective study. We compared computed tomography (CT) and magnetic resonance imaging (MRI) results with corresponding AVS data, histopathology findings and postoperative outcome. A total of 175 patients underwent unilateral laparoscopic adrenalectomy for primary aldosteronism. AVS was successful in 152 patients and postoperative outcome available in 148 patients. Despite unilateral disease according to AVS results, bilateral normal glands were seen in 15 MRI (17·2%) and 7 CT scans (8·5%), respectively. Unilateral enlargement of the nonhypersecreting adrenal gland was found in three MRI (3·5%) and 10 CT scans (12·2%) of patients who showed aldosterone hypersecretion deriving from the contralateral gland. Fifteen MRI (17·2%) and 18 CT scans (22·0%) revealed bilateral adrenal pathology despite unilateral aldosterone hypersecretion. The accuracy of CT and magnetic resonance imaging in predicting unilateral disease is poor. AVS appears to be an essential diagnostic step to identify those patients who may benefit from unilateral adrenalectomy.

Myocysticercosis: Experience with imaging and therapy

We describe hook trauma to the roof of the mouth in Dolphinfish Coryphaena hippurus and compare computed tomography (CT) scanning to gross necropsy (GN) as a technique for diagnosing hooking injury in fish. Forty‐two Dolphinfish carcasses spanning a range of hook injuries were collected and CT scanned, and 33 of those carcasses were evaluated using GN. Specimens were hooked either in the roof of the mouth, the eye via the roof or upper jaw, or the jaw (control group). In 75% of roof‐hooked individuals, GN revealed nondisplaced to comminuted fractures of the bones of the suspensorium, hematomas in and laceration of the extraocular muscles, and/or damage to the optic nerve. These injuries have the potential to compromise vision and therefore decrease postrelease survival rates of obligate sight‐feeding species such as the Dolphinfish. We evaluated the effectiveness of CT scanning to diagnose injury and found that CT could efficiently and accurately identify fractures and some soft‐tissue damage, but some injuries found in GN (e.g., optic nerve damage) were not observed on CT scans. Based on our findings, it is likely that mortality is greater in Dolphinfish when hooked in the roof of the mouth than when hooked in the jaw. This study demonstrates a novel technique that was effective at diagnosing hooking injuries associated with the roof of the mouth.

To compare computed tomography (CT) with open neck exploration in determining prevertebral invasion by squamous cell carcinoma of the oropharynx or hypopharynx. Retrospective analysis using the findings at open neck exploration and results of histopathologic studies as the criterion standards. Tertiary care referral center. Twenty-nine of 40 patients with advanced squamous cell carcinoma of the oropharynx or hypopharynx treated between January 1, 1986, and December 31, 1994, were selected for analysis based on CT findings of posterolateral extension of the primary tumor placing the prevertebral muscle (PVM) at risk. All study patients had no previous therapy and underwent neck exploration to determine resectability. Overall accuracy of CT in predicting PVM status was 55.2%. The sensitivity of preoperative CT for PVM invasion was 50%; the specificity was 61%. Using an estimate of 21% for the prevalence of PVM invasion, the predictive value of a positive CT scan was 0.254 and the predictive value of a negative CT scan was 0.821. Open neck exploration correctly predicted PVM status in all cases. Open neck exploration is superior to CT to evaluate possible PVM invasion by squamous cell carcinoma of the oropharynx or hypopharynx. The predictive value of a negative CT scan for PVM invasion is high, so it may be useful in treatment planning. Patients with advanced squamous cell carcinoma of the oropharynx or hypopharynx at risk for PVM invasion who are otherwise surgical candidates should be considered for open neck exploration to determine resectability most accurately.

Vitamin D receptor gene is one of candidate genes related to osteoporosis expansion. The association of ApaI, TaqI, BsmI polymorphisms in vitamin D receptor gene with bone metabolism and density has been area of interest in many studies. This study was conducted to further investigate the association between the ApaI, TaqI, BsmI polymorphisms and bone density. This study was analytical study. Centers for bone density measurement in southwestern Iran. In this analytical study, 200 participants aged 45- and above 45-year-old women referring the centers of bone density measurement participated. The bone density of femoral neck and lumbar vertebrae was measured using dual-energy X-ray absorptiometry method. Based on t-score, the participants were assigned into patients (n=130) and healthy individuals (n=70). Different genotypes of ApaI (AA/Aa/aa), TaqI (TT/Tt/tt), and BsmI (BB/Bb/bb) were determined by PCR-RFLP. The data on bone density and PCR-RFLP were analysed by chi-square and ANOVA. Also, triad combination of the genotypes was statistically analysed. For each genotype combination, chi-square was run between the patients and control group and p-value was calculated. No significant association was seen between ApaI polymorphism and bone density (p>0.05). TaqI and BsmI polymorphisms had a significant association with femoral neck's bone density (p<0.05), but these polymorphisms were not significantly associated with lumbar vertebrae's (p>0.05). Patients with homozygous dominant TT genotype had the least bone density in femoral neck compared to other genotypes. Lumbar vertebrae's bone density was similar in three TaqI genotypes. The patients with homozygous recessive bb genotype had the least bone density in femoral neck and lumbar vertebrae compared to other genotypes. TaqI and BsmI polymorphisms could be desirable markers in diagnosis of women at risk of osteoporosis in the studied region in Iran. Therefore, these women will receive suitable medical treatment at proper time.

To compare computed tomography (CT) and magnetic resonance (MR) imaging in the diagnosis and follow-up of necrotizing external otitis. CT and MR imaging were performed in seven patients at diagnosis and at 6 and 12 months after initiation of therapy. Imaging findings were compared and correlated with the clinical course of the disease. Cortical bone erosion was best seen on CT scans (n = 5 vs n = 0 on MR images) and failed to normalize with cure. Subtemporal soft-tissue abnormalities (n = 7 with both modalities) were better appreciated with MR imaging and had low signal intensity on T1- and T2-weighted images. Soft-tissue changes improved but did not disappear completely with treatment. CT is preferred at initial diagnosis, as small cortical erosions are better seen. Either modality can be used to follow up soft-tissue evolution. MR imaging may be better for evaluation and follow-up of meningeal enhancement and changes within the osseous medullary cavity.

Clinical Utility of Computed Tomography and Magnetic Resonance Imaging for Diagnosis of Posterior Reversible Encephalopathy Syndrome after Stem Cell Transplantation in Children and Adolescents

We previously reported that the periosteal reaction (PR) in medication-related osteonecrosis of the jaw (MRONJ) is a poor prognostic factor in surgical cases, but it is not clear how PR changes during conservative therapy. The purpose of this retrospective study was to compare computed tomography (CT) findings at the first visit and during follow-up visits in MRONJ patients subjected to conservative therapy and to investigate factors associated with the exacerbation of PR during conservative therapy. Sixteen patients with MRONJ of the lower jaw who underwent conservative therapy and experienced a PR on CT images at the first visit and underwent CT examination again after 6 months or more were enrolled in the study. Clinical features and CT findings (extent of osteolytic lesion, extent of PR, type of PR, and changes during conservative treatment) were investigated. On the second CT scan, the osteolytic lesion improved in 4 patients, had not changed in 5, and deteriorated in 7, whereas the PR improved in 5 patients, had not changed in 4, and deteriorated in 7 patients. PR was significantly deteriorated in patients who continued to receive antiresorptive agents during conservative treatment and in patients with deteriorated osteolytic lesions. PR in MRONJ often expands during conservative therapy and the PR type progresses from the attached type to the gap type, and the irregular type, but discontinuation of antiresorptive agent may improve PR as well as osteolytic lesions.