Correlation Of Computed Tomography Findings Research Articles

Comparison of Radiography and Computed Tomography for Evaluation of Third Carpal Bone Fractures in Horses.

Radiographs underestimate the extent of bone injury in horses with third carpal bone (C3) fractures (Fx). We aimed to describe bone pathologies identified using computed tomography (CT) and compare the diagnostic value of digital radiography (DR) and CT in horses with C3 Fx. CT images of 15 racehorses with C3 Fx and 10 controls were reviewed (Part 1) then DR and CT images of 26 racehorses (24 Thoroughbred, 2 Standardbred) with C3 Fx (Part 2) were evaluated. Agreement on fracture geometry and concomitant bone lesions was tested between DR and CT using the kappa statistic (Part 2). For agreement analysis, 38 limbs were used (27 Fx carpi from 26 horses and 11 contralateral carpi). Intermodality agreement was good for recognition of displacement, fair for comminution, articular surface bone loss and osseous fragmentation, and poor-slight for recognition of whether the Fx was complete, additional fissures and lucencies. CT provides more detailed information than DR regarding bone pathology and fracture configuration in horses with C3 fracture. Correlation of CT findings with clinical information and outcome needs to be explored; however, the more accurate diagnosis possible with CT is likely valuable when deciding on the most appropriate management and for surgical planning.

Role of percutaneous CT-guided biopsy in the characterisation of pleural diseases.

Computed tomography (CT)-guided biopsy is emerging as a preferred and safe method for obtaining tissue samples in pleural diseases. This study aimed to evaluate the diagnostic yield and safety of percutaneous CT-guided biopsy in pleural diseases and to find CT findings predictive of malignant neoplastic pleural disease. This retrospective study included 77 patients with pleural disease who underwent CT-guided pleural biopsies from July 2013 to May 2020. All procedures were performed with a coaxial semi-automatic biopsy device. Histopathology was performed in all cases, and additional tests such as immunohistochemistry (IHC) or microbiological analysis were carried out depending on clinical suspicion. The correlation of CT findings with final diagnosis was performed by Chi-square, Fisher's exact test and logistic regression analysis. The overall technical success rate of CT-guided pleural biopsy was 100% with a diagnostic yield of 96.1%. No major complication was encountered, with minor complications encountered in the form of minimal pneumothorax and chest pain. Malignant pleural conditions constituted the largest group including metastatic adenocarcinoma as the most common (31.2%), followed by metastatic squamous cell carcinoma and mesothelioma. Tubercular pleural involvement was the second most common category (16.9%). The cartridge-based nucleic acid amplification test (CB-NAAT) assay had 90% sensitivity on pleural tissue in tubercular cases. CT features predictive of malignancy were irregular and nodular pleural thickening, mediastinal and diaphragmatic pleural involvement and mediastinal/chest wall invasion. There was a good correlation between higher pleural thicknesses with malignant outcome. Percutaneous CT-guided biopsy is a safe method for obtaining pleural tissue samples with high diagnostic yield. CT findings provide clues, which favour malignant pleural involvement.

English

BACKGROUND The primary lung masses (tumours) are those that originate from the lung tissue. Although most primary pulmonary tumours are carcinomas, a large histological spectrum of benign and malignant tumours of the lung exists. Although chest xray is still considered to be the primary imaging modality of lungs, computed tomography (CT) not only shows the segments that are involved but also the extent of involvement. We wanted to study the sensitivity and specificity of CT in the diagnosis of primary neoplastic lesions of lung, study the CT patterns of different histological variants of bronchogenic carcinoma, and correlate CT findings with CT guided fine needle aspiration and cytology (FNAC) findings. METHODS The present descriptive cross-sectional study was conducted among 34 patients suspected clinically of having lung neoplasms, in Gauhati Medical College and Hospital, Guwahati, Assam from December 2010 to November 2011. RESULTS Considering FNAC / histopathological examination (HPE) as the gold standard, the positive predictive value and false negative value of CT scan for diagnosis of neoplastic lesions of lung were 97 % and 3 % respectively, in our study. Among our study population, mean age with lung tumours was 61 years, highest number of cases was seen in the age group of 51 - 60 years (35 %); Males and females affected were 27 (79.41 %), and 7 in number (20.59 %), respectively. CONCLUSIONS CT is more sensitive in the detection of neoplastic lesions of the lung and associated hilar / mediastinal adenopathy than chest roentgenography. CT has a high efficacy in detecting neoplastic lesions of lung, delineating its lobar and segmental anatomy, thereby helping surgical resection of lung. In this study, CT guided FNAC and cytological findings correlated well with CT diagnosis of primary neoplastic lesions of lung. KEYWORDS Primary Lung Tumour, Contrast Enhanced Computed Tomography (CECT), Fine Needle Aspiration and Cytology (FNAC)

CT guided biopsy of lung lesions

Introduction: Computed Tomography (CT) Biopsy is a corrigible coruscate procedure that corrected the discrepancy of the results between final biopsy and unguided Biopsy. CT guidance permits biopsy of nearly all lesions regardless of size and position. Recognition of the accuracy of biopsy and simple methods of treating pneumothorax has brought this method within the reach of most radiologist and pathologist. Infections and other neoplastic process may be proven by this method. In cases of malignancy of the lungs, cytopathological examination of material obtained by CT guided biopsy offers a quick and specific diagnosis which help clinicians implement appropriate anticancer measures like chemotherapy and radiotherapy. The present study is undertaken to determine the accuracy and efficacy of percutaneous biopsy in diagnosis of various lung lesions, and correlate the concordance with available results and available other methods. An interest to analyse the age, gender, topographic distribution and cytopathological diagnosis of thoracic mass lesions using CT guided biopsy is specially stepped in the current study. Aim: To assess the role of Computed tomography (CT) guided biopsy in the diagnosis of thoracic mass lesion and to analyse and compare the results with other studies. To evaluate the diagnostic accuracy and complication of Computed tomography (CT) guided biopsy in thoracic masses. To know the pathological spectrum of thoracic mass lesions and to correlate CT findings with cytopathological report. Methods: This Prospective study was done at Nizam’s Institute of medical sciences, Hyderabad, surrounded by thickly populated districts which provide surplus material for doing research work and is also fully equipped with all the required modes and means for researches and health care. This study was conducted totally at indoor site including both OPD and IPD males and females from both urban and rural exclusively adults. Fifty one cases having Lung masses both malignant and benign were selected and subjected to CT guided biopsy. Statistical analysis was carried out by Using SPSS soft ware version 12. Results: Majority of the patients with lung masses in present study were males who constituted 66.6% and the females were 33.4%. Minimum age was of 22yrs and maximum age was of 92 yrs from the patients of this study. The mean age is 57 yrs. The chief etiological factor for the initiation of the pathogenesis of lung masses was found to be smoking. Out of the total cases included for the study 49% were malignant and 37% were benign lung masses. The complications observed were very few only in 8 cases (15.8%) in total of 51 cases selected for the study. The pneumothorax was noticed in 13.7% and haemoptysis in 1.9%. Conclusion: This CT guided biopsy stands as fruitful topic for study will be to elucidate the diagnostic and prognostic procedures in chest. This procedure of diagnosis with prosaic complications like Pneumothorax or Haemothorax or Haemoptysis and with its mosaic results outstands and extends its scope of study.

Everolimus-induced pneumonitis in neuroendocrine neoplasms: correlation of CT findings and clinical signs.

Everolimus, a mammalian target of rapamycin (mTOR)-inhibitor, is approved for the treatment of advanced neuroendocrine neoplasms (NEN). A rare major adverse event is the occurrence of drug-induced pneumonitis. To evaluate the correlation between clinical signs and computed tomography (CT) findings in everolimus-induced pneumonitis in patients with NEN. Ninety patients with NEN treated with everolimus were retrospectively enrolled (approved by our Institutional Review Board). All patients received chest CTs before the initiation of everolimus and during the treatment along with physical examinations. Clinical signs of pneumonitis were scored (symptomatic score) according to CTCAE v5.0. Pulmonary function tests (PFT) were evaluated if available. CT images were analyzed based on the severity of interstitial lung disease (ILD), the overall pneumonitis extent (PnE), and regarding presence of typical lung opacification patterns. Follow-up examinations of patients with pneumonitis were analyzed. Pneumonitis was diagnosed in 18 (20%) patients. There was no significant correlation between symptomatic score or PFT and ILD score or PnE. In case of a cryptogenic organizing pneumonia pattern (n = 14), symptomatic scores were significantly lower (P = 0.035) than in case of other opacification patterns (n = 4). In the follow-up analysis, we could identify four different clinical courses. CT detects everolimus-induced pneumonitis at a subclinical stage. In this setting, CT findings, clinical severity, and PFT do not clearly correlate. Opacification pattern analysis seems to be of importance when assessing the severity of CT findings. Asymptomatic patients with positive CT findings should be closely monitored to timely initiate specific treatment.

The Cochlear Cleft: CT Correlation With Histopathology.

To show the histologic correlate of the cochlear cleft, a small low density focus just anterior to the oval window seen on computed tomography (CT) in three temporal bone specimens. Three temporal bone specimens donated to the National Temporal Bone Registry from patients aged 34 weeks gestation, 42 years, and 89 years with cochlear clefts seen on CT were studied. Review and comparison of postmortem high-resolution CT and temporal bone histopathology MAIN OUTCOME MEASURE:: Correlation of CT findings with temporal bone histopathology. The cochlear cleft visible on CT as a pericochlear lucency anterior to the oval window corresponds to fatty marrow in areas of incomplete endochondral ossification of the otic capsule. The cochlear cleft is distinct from the fissula ante fenestram and can be present in adults. In these three cases, the cochlear cleft represents an area of fatty marrow from incomplete ossification of the otic capsule and can be present in adults. Care should be taken when interpreting temporal bone CT to avoid mistaking the cochlear cleft for true pathology (otosclerosis) of the temporal bone.

Influenza H1N1 virus-associated pneumonia often resembles rapidly progressive interstitial lung disease seen in collagen vascular diseases and COVID-19 pneumonia; CT-pathologic correlation in 24 patients

PurposeTo describe computed tomography (CT) findings of influenza H1N1 virus-associated pneumonia (IH1N1VAP), and to correlate CT findings to pathological ones. MethodsThe study included 24 patients with IH1N1VAP. Two observers independently evaluated the presence, distribution, and extent of CT findings. CT features were divided into either classical form (C-form) or non-classical form (NC-form). C-form included: A.) broncho-bronchiolitis and bronchopneumonia type, whereas NC-forms included: B.) diffuse peribronchovascular type, simulating subacute rheumatoid arthritis-associated (RA) interstitial lung disease (ILD) and C.) lower peripheral and/or peribronchovascular type, resembling dermatomyositis-associated ILD and COVID-19 pneumonia. In 10 cases with IH1N1VAP where lung biopsy was performed, CT and pathology findings were correlated. ResultsThe most common CT findings were ground-glass opacities (24/24, 100 %) and airspace consolidation (23/24, 96 %). C-form was found in 11 (46 %) patients while NC-form in 13 (54 %). Types A, B, and C were seen in 11(46 %), 4 (17 %), and 9 (38 %) patients, respectively. The lung biopsy revealed organizing pneumonia in all patients and 6 patients (60 %) showed incorporated type organizing pneumonia that was common histological findings of rapidly progressive ILD. ConclusionIn almost half of patients of IH1N1VAP, CT images show NC-form pneumonia pattern resembling either acute or subacute RA or dermatomyositis-associated ILD and COVID-19 pneumonia.

Longitudinal Follow-up of Patients With Tracheobronchomalacia After Undergoing Tracheobronchoplasty: Computed Tomography Findings and Clinical Correlation.

The purpose of this study was to evaluate intermediate and long-term changes in expiratory tracheal collapsibility by computed tomography (CT) in patients with tracheobronchomalacia following surgical treatment with tracheobronchoplasty and to correlate CT findings with clinical findings. Between 2003 and 2016, 18 patients with tracheobronchomalacia underwent tracheobronchoplasty and were imaged preoperatively and postoperatively at both intermediate and long-term intervals. Imaging included end-inspiratory and dynamic expiratory phase scans. The cross-sectional area of the airway lumen was measured at 2 standard levels (1 cm above the aortic arch and carina). These measurements were used to calculate % collapsibility. Clinical findings recorded included a questionnaire on symptomatology and a 6-minute walk test. Before surgery, expiratory collapsibility of the upper trachea was 72%±25% (mean±SD) and that of the lower trachea was 68%±22%. On intermediate follow-up (mean, 1.5 y), collapsibility significantly decreased to 37%±21% at the upper trachea and 35%±19% at the lower trachea (P<0.001). On long-term follow-up (mean, 6 y), collapsibility increased to 51%±20% at the upper trachea and 47%±17% at the lower trachea and was significantly worse than on intermediate follow-up (P=0.002). However, collapsibility on long-term follow-up remained significantly lower than preoperative collapsibility (P=0.015). Clinical findings showed a similar trend as quantitative CT measurements. Expiratory tracheal collapsibility substantially decreases after tracheobronchoplasty on intermediate follow-up. At long-term follow-up, tracheal collapsibility shows a modest increase, but remains significantly lower than the preoperative baseline. Quantitative measurements from dynamic CT have the potential to play an important role as imaging biomarkers for assessing response to tracheobronchoplasty.

Intestinal Obstruction: Role of MDCT with Surgical Correlation

Background: To evaluate efficacy of CT (computed tomography) in diagnosis of the presence and cause of obstruction along with correlation of CT findings with the operative findings. Subjects and Methods: This prospective study included evaluation of forty patients, clinically suspected of intestinal obstruction by CT examination whose surgical follow up data was available. All patients (age >18yrs) clinically suspected for intestinal obstruction were included. Results: Highly significant correlation was found between CT and operative findings in diagnosis of the cause of obstruction with p value of <0.01 and cohen’s kappa value ranging from 0.8 to 1 (highly significant correlation). Conclusion: MDCT (Multi detector computed tomography) by using its multiplanar and 3D capabilities is highly accurate and specific in detecting the presence of intestinal obstruction and it can demonstrate the exact site of obstruction in high percent of cases, hence is helpful for appropriate treatment plan and management of the patient.

Correlation between high-resolution computed tomography temporal bone findings and surgical findings in patients with inflammatory diseases of the middle ear

Background: With the advent of high-resolution computed tomography (HRCT), more information can be obtained about the anatomy of the middle ear, soft tissue pathologies, and the complications of middle ear disease process as compared to the conventional diagnostic methods. Aims: This study aims to study the spectrum of HRCT temporal bone findings in inflammatory middle ear diseases as well as correlate computed tomography (CT) with intraoperative findings. Settings and Design: This is a cross-sectional study including all consecutive patients presenting to the ear, nose, and throat department with a provisional diagnosis of inflammatory middle ear disease requiring surgical management and referred to department of radiodiagnosis for HRCT temporal bone. Materials and Methods: The HRCT findings of 58 such patients were compared with the intraoperative findings. Statistical Analysis Used: Interrater agreement Kappa was used to find agreement between CT and surgical findings. Diagnostic test was used to find out sensitivity, specificity, negative predictive value, and positive predictive value of CT taking surgery as gold standard. P

Ground glass opacities management in the lung cancer screening era.

Pulmonary ground glass opacity (GGO) is becoming an important clinical dilemma in oncology as its diagnosis in clinical practice is increasing due to the introduction of low dose computed tomography (CT) scan and screening. The incidence of cancer in GGO has been reported as high as 63%. The purpose of this manuscript is to review best available evidence papers on management of GGO in lung cancer to address the following questions: (I) how to correlate CT findings with malignancy; (II) when and who operate? (III) how to perform intraoperative detection of intrapulmonary GGO? (IV) wedge, segmentectomy or lobectomy? Taking a cue from a clinical scenario, a review on PubMed was conducted. The words search included: "Lung ground glass opacity". The research was limited to human and adults. We considered all published articles from 1990 to April 2017, which reported on at least sufficient data, to be eligible. The literature search was limited to articles in English. A total of 1,211 articles have been found. Interestingly, while in 1991, only one paper was published on low-dose high-resolution CT, in 2016, 126 papers have been published. Most cited and recent papers have been chosen for discussion. Many recent papers have been published from Asian groups. It is clearly not possible to conclude from these data what is the best strategy for GGO in the lung cancer screening era. Certainly, when there is uncertainty, personal opinion and experience should not influence decision making, on the contrary decision should be taken by a multidisciplinary team.

Correlation of CT Findings and Clinical Characteristics of Pneumocystis Pneumonia in Patients with Acquired Immunodeficiency Syndrome

Background: Pneumocystis pneumonia (PCP) is the most common opportunistic infection, and it is difficult to diagnose as PCP. The aim of this study was to assess whether CT findings or clinical characteristics contribute to early diagnosis of PCP. Method: Twenty-six patients with AIDS and PCP received medical treatment at the Kurume University Hospital between 1999 and 2018. None of the patients with AIDS had been diagnosed as HIV positive until the episode of PCP. In this study, the correlation between computed tomography (CT) findings and clinical characteristics were analyzed in patients with AIDS and PCP. The number of patients with PCP is not that high in Japan; therefore, it is difficult to diagnose patients with PCP in the clinic. Results: This study included 24 men and 2 women, and the mean age was 47.8 years. The mean CD4 cell count was 65.7 cells/μl, HIV-viral load was 680 × 104 copy, β-D-glucan (βDG) level was 234 pg/ml, and mean time till diagnosis was 41.3 days; 14 patients had hypoxemia. Twelve patients had PCP, 10 had cytomegalovirus (CMV) infection, 2 had Cryptococcus infection, 1 had Entamoeba histolytica infection, 1 had non-tuberculous mycobacteria infection, and 1 had Toxoplasma infection. CT images of the patients showed 10 cases with ground-glass opacity (GGO), 13 with consolidation, 1 with small nodules, 2 with a cavity, and 1 with cyst formation. Nine cases revealed peripheral distribution with peripheral sparing, 1 had pleural fluid, and 6 had lymph node enlargement. The mean time till diagnosis and cough were significantly correlated with lymphadenopathy. Patients with consolidation were more likely to be infected with CMV. Conclusion: GGO, combined with peripheral distribution and peripheral sparing, was the most common CT finding. When consolidation was present in PCP patients as shown in CT images, the patients were more likely to be infected with CMV.

The computed tomographic angiography finding of hepatic artery dissection after living donor liver transplantation; what is the clinical significance?

ObjectiveTo correlate computed tomography (CT) findings of hepatic artery dissection (HAD) to clinical manifestations of arterial insufficiency and biliary stricture after living donor liver transplantation (LDLT). MethodsAmong 737 consecutive patients, we retrospectively reviewed incidence, CT findings, and complications of the HAD. ResultsHADs occurred in 43 patients, exclusively in recipient arteries. Most were resolved with recovery of true lumen without specific treatment. Five patients had insignificant hepatic arterial infarctions, and incidence of biliary stricture did not significantly differ with control group. ConclusionsHADs frequently occurred shortly after LDLT. Most HADs spontaneously improved and did not affect incidence of late biliary stricture.

Computerized tomography and clinical correlation of stroke diagnosis in University of Port Harcourt teaching hospital

The burden of stroke is high and is not only attributable to its high mortality but also its consequent high morbidity. Wrong clinical diagnosis has a high significance for patient outcome. Thus the need for accurate stroke diagnosis. Certainty of stroke diagnosis is markedly enhanced by computed tomography (CT) which has remained the most important brain imaging test fo r stroke in an emergency. This study was done to confirm clinical diagnosis of stroke using CT as seen in University of Port Harcourt Teaching Hospital (UPTH) and to determine the varying presenta tions and other findings which could mimic stroke clinically. This was a prospective study of 203 subjects with clinical diagnosis of stroke who had CT of the brain performed during a 12month period (November 2012 to November 2013). A 2-slice helical CT was used to obtain images in the axial plane. Images were classified as normal or abnormal scans. Abnormal scans were analyzed as ischaemic infarcts, intracerebral haemorrhage, subarachnoid haemorrhage (SAH), subdural haematoma, abscess, neoplasm, meningitis, and cerebral atrophy. The clinical diagnosis, age, sex and time of presentation of the patients were recorded. Statistical analysis was done with the Statistical Package for the Social Sciences (SPSS) software version 20. 0. Means were compared using Student's t test. Pearson's correlation coefficient was used to correlate CT findings with clinical diagnosis, age, and sex. P values < 0.05 were considered significant. The age distribution of the study population ranged from 6-90 years with a mean of 58.3+ 14.9years. Males were predominant at 51.7% of the sample size. The clinical diagnosis of stroke was confirmed in 74.9% of subjects while stroke mimics accounted for 13.3%, the rest (11.8%) were normal. This gave a misdiagnosis rate of 25.1%. Specific clinical di agnosis of stroke subtype (ischaemic or haemorrhagic) was correct in only 60% of cases. Despite a good rate of accurate clinical stroke diagnosis, a significant rate is misdiagnosed with potential for grave implication on patient morbidity. CT should be an essential aspect of stroke management.

Role of multislice computed tomography in evaluation and management of intestinal obstruction.

The aims and objectives of this study were: i) to evaluate the efficacy of computed tomography (CT) imaging in diagnosing the presence, level, degree, and cause of intestinal obstruction, and the role of CT in detecting presence of complications; ii) to assess impact of CT in decision making and management (surgical/conservative); iii) to correlate CT findings with intra operative findings whenever possible. A prospective study of 40 patients presented in outpatient/emergency department with features suggestive of intestinal obstruction. Multislice contrast enhanced computed tomography of whole abdomen was done in all patients after preliminary investigations. Whenever indicated, patients were explored. Statistical analysis was performed to determine the efficacy of multidetector computed tomography (MDCT) in diagnosing intestinal obstruction and its complications. Out of 40, 30 patients underwent exploratory laparotomy and it was found that MDCT was 85% sensitive and 70% specific in diagnosing bowel obstruction. Association between MDCT findings suggestive of obstruction and intra-operative findings turn out to be significant (P=0.003). MDCT findings were consistent with intraoperative findings in 22 out of 30 patients (73%). MDCT is sensitive and specific in determining the presence of bowel obstruction and should be recommended for patients with suspected bowel obstruction because it affects outcome in these patients.

Development of a Computed Tomography-Based Scoring System for Necrotizing Soft-Tissue Infections

Necrotizing soft-tissue infections (NSTIs) are associated with significant morbidity and mortality, but a definitive nonsurgical diagnostic test remains elusive. Despite the widespread use of computed tomography (CT) as a diagnostic adjunct, there is little data that definitively correlate CT findings with the presence of NSTI. Our goal was the development of a CT-based scoring system to discriminate non-NSTI from NSTI. Patients older than 17 years undergoing CT for evaluation of soft-tissue infection at a tertiary care medical center over a 10-year period (2000-2009) were included. Abstracted data included comorbidities and social history, physical examination, laboratory findings, and operative and pathologic findings. NSTI was defined as soft-tissue necrosis in the dictated operative note or the accompanying pathology report. CT scans were reviewed by a radiologist blinded to clinical and laboratory data. A scoring system was developed and the area under the receiver operating characteristic curve was calculated. During the study period, 305 patients underwent CT scanning (57% men; mean age, 47.4 years). Forty-four patients (14.4%) evaluated had an NSTI. A scoring system was retrospectively developed (table). A score >6 points was 86.3% sensitive and 91.5% specific for the diagnosis of NSTI (positive predictive value, 63.3%; negative predictive value, 85.5%). The area under the receiver operating characteristic curve was 0.928 (95% confidence interval, 0.893-0.964). The mean score of the non-NSTI group was 2.74. We have developed a CT scoring system that is both sensitive and specific for the diagnosis of NSTIs. This system may allow clinicians to more accurately diagnose NSTIs. Prospective validation of this scoring system is planned.

Necrotic stercoral colitis: Importance of computed tomography findings

To study the computed tomography (CT) signs in facilitating early diagnosis of necrotic stercoral colitis (NSC). Ten patients with surgically and pathologically confirmed NSC were recruited from the Clinico-Pathologic-Radiologic conference at Chang Gung Memorial Hospital, Taoyuan, Taiwan. Their CT images and medical records were reviewed retrospectively to correlate CT findings with clinical presentation. All these ten elderly patients with a mean age of 77.1 years presented with acute abdomen at our Emergency Room. Nine of them were with systemic medical disease and 8 with chronic constipation. Seven were with leukocytosis, two with low-grade fever, two with peritoneal sign, and three with hypotensive shock. Only one patient was with radiographic detected abnormal gas. Except the crux of fecal impaction, the frequency of the CT signs of NSC were, proximal colon dilatation (20%), colon wall thickening (60%), dense mucosa (62.5%), mucosal sloughing (10%), perfusion defect (70%), pericolonic stranding (80%), abnormal gas (50%) with pneumo-mesocolon (40%) in them, pericolonic abscess (20%). The most sensitive signs in decreasing order were pericolonic stranding, perfusion defect, dense mucosal, detecting about 80%, 70%, and 62.5% of the cases, respectively. Awareness of NSC and familiarity with the CT diagnostic signs enable the differential diagnosis between NSC and benign stool impaction.

Assessment of Non–Small Cell Lung Cancer Perfusion: Pathologic-CT Correlation in 15 Patients

To assess tumor perfusion with multi-detector row computed tomography (CT) in patients with non-small cell lung carcinoma and to correlate CT findings with pathologic results. This study was approved by the local Ethics Committee, and all patients provided written informed consent, which included information on the radiation exposure at the CT examinations. Fifteen consecutive patients (mean age, 60.5 years ± 7.7 [standard deviation]), including 14 men (mean age, 59.9 years ± 7.5) and one woman (age, 70 years) with histologically proved non-small cell lung carcinoma were prospectively enrolled. Overall, pathologic-CT correlations were examined in 31 focal tumoral zones. Comparative analysis was performed by using the χ(2) or the Fisher exact test for categoric data. For numeric data, group comparisons were performed by using the Mann-Whitney test. Whole-tumor coverage (mean height, 4.3 cm ± 2.1) was possible in all patients with generation of colored parametric maps of volume transfer constant (K(trans)) and blood volume (BV) by using Patlak analysis. Of the 12 areas that showed high BV, 10 (83%) had a high K(trans); in all 12 cases, the vascular score was high, confirming the presence of numerous tumoral vessels. Nineteen areas showed low BV; when observed concurrently with a high K(trans) (seven of 19), the mean vessel number per area was significantly higher than that seen in areas with low BV and low K(trans) (12 of 19) (P = .038), suggestive of tumoral vessels associated with high interstitial pressure. Whole-tumor perfusion analysis is technically feasible with 64-detector row CT, with two patterns suggestive of high tumoral vascularity. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10100181/-/DC1.

Prognostic value of multidetector computed tomography in bowel infarction

This study aimed to correlate computed tomography (CT) findings and outcomes in patients affected by bowel infarction. Twenty-seven patients with bowel infarction due to vascular obstruction were evaluated with multidetector CT (MDCT) to establish the prognostic value of CT findings and their correlation with the origin of the ischaemia. The chi-square test was used to analyse the results (p</=0.05). MDCT images allowed recognition of the nature of ischaemia in all cases. In particular, arterial occlusion was found in 67% of patients and venous obstruction in 33%. The overall mortality rate was 63%. Outcome closely correlated with the kind of vascular obstruction, with a mortality rate of 89% in arterial forms and 11% in venous forms. Bowel-wall hyperdensity (2/9 venous occlusions), loss of wall enhancement (1/9 venous occlusions, 2/18 arterial occlusions) and wall thickening (8/9 venous obstructions, 2/18 arterial occlusions) were predictive of good outcome. Bowel-loop dilatation (4/9 venous occlusions, 13/18 arterial occlusions), intramural pneumatosis (1/9 venous occlusions, 17/18 arterial occlusions), mesenteric venous gas (2/9 venous occlusions, 11/18 arterial occlusions), portal venous gas (1/9 venous occlusions, 4/18 arterial occlusions), pneumoperitoneum (8/18 arterial occlusions) and pneumoretroperitoneum (1/18 arterial occlusions) were predictive of poor outcome. Ascites (6/9 venous occlusions, 12/18 arterial occlusions) did not add any prognostic information. MDCT is able to detect the nature of bowel ischaemia and provide important prognostic information.

Congenital Pulmonary Airway Malformation

Congenital pulmonary airway malformation (CPAM) is classified into 5 subtypes (types 0 to 4). We attempted to correlate computed tomography (CT) findings with those of pathologic examination and evaluated the predictability of the CPAM subtype. We retrospectively reviewed CT findings in 13 pathologically proven cases of CPAM seen between 1981 and 2005. Patient's age ranged from 4 days to 5 years and 10 months. Six were boys and 7 were girls. According to CT findings, lesions with a cyst larger than 2.5 cm, lesions with cysts 2.5 cm or less and solid lesions were classified into groups A, B, and C, respectively. We assumed that Stocker's types 1 and 4, type 2, and types 0 and 3 would correspond to CT groups A, B, and C, respectively. Then, we assessed whether this assumption is correct or not. Eight, 3, and 2 cases were diagnosed as groups A, B, and C, respectively. All of the 8 cases diagnosed as group A were Stocker's type 1. One of the 3 cases diagnosed as group B was type 2, but the remaining 2 were type 1 and type 4, respectively. One of the 2 cases diagnosed as group C was type 3 but the other was type 2. Lesions with the largest cyst being larger than 2.5 cm was type 1. It seemed, however, difficult to distinguish among types 1, 2, and 4 when they consisted of small cystic components and between types 2 and 3 when they appeared as a solid lesion.