CT In Preoperative Assessment Research Articles

Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs).

For the precise preoperative evaluation of complex congenital heart diseases (CHDs) with reduced radiation dose exposure, we assessed the diagnostic validity and reliability of low-dose prospective ECG-gated cardiac CT (CCT). Forty-two individuals with complex CHDs who underwent preoperative CCT as part of a prospective study were included. Each CCT image was examined independently by two radiologists. The primary reference for assessing the diagnostic validity of the CCT was the post-operative data. Infants and neonates were the most common age group suffering from complex CHDs. The mean volume of the CT dose index was 1.44 ± 0.47 mGy, the mean value of the dose-length product was 14.13 ± 5.4 mGy*cm, and the mean value of the effective radiation dose was 0.58 ± 0.13 mSv. The sensitivity, specificity, PPV, NPV, and accuracy of the low-dose prospective ECG-gated CCT for identifying complex CHDs were 95.6%, 98%, 97%, 97%, and 97% for reader 1 and 92.6%, 97%, 95.5%, 95.1%, and 95.2% for reader 2, respectively. The overall inter-reader agreement for interpreting the cardiac CCTs was good (κ = 0.74). According to the results of our investigation, low-dose prospective ECG-gated CCT is a useful and trustworthy method for assessing coronary arteries and making a precise preoperative diagnosis of complex CHDs.

The Role of Multi-slice CT in Preoperative Assessment of Temporal bone in patients prepared to cochlear implantation

Abstract Background MDCT plays a critical role in evaluation and management of different causes of hearing loss which require many therapeutic techniques including cochlear implantation. In general, most causes of hearing impairment are best diagnosed using computed tomography scan of the temporal bone using bone algorithm and windowing techniques. Patients and Methods The study included a total of 20 patients referred to the Radiodiagnosis department from the E.N.T department in EL-Galaa Military Hospital. CT was done for assessment of the cochlear state prior to the cochlear implantation operation. The CT was used to delineate the different cochlear and middle ear anatomy and to orient and modify the surgical strategy. Results Only 18 patients from 20 patients underwent cochlear implantation, the other two cases were diagnosed as Otosclerosis & Bilateral longitudinal fractures. Patients with multiple other congenital anomalies in the external or internal ear had the cochlear implantation in the other ear (To raise the % of success). Conclusion MDCT is the technique of choice in preoperative assessment of patient of SNHL.

Values in preoperative assessment of occlusion and intra-operative guidance of 64 row spiral CT in percutaneous coronary intervention for chronic coronary occlusion

To instigate the values of 64 row spiral CT in pre-operative assessment of the occlusion and intra-operative guidance in percutaneous coronary intervention for chronic total occlusion (CTO) in coronary heart disease. Fifteen coronary disease patients planned to receive percutaneous coronary intervention underwent 64-row spiral CT-coronary angiography and coronary angiography (CAG). The diagnostic effects of these 2 techniques were compared. Seventeen CTO lesions were confirmed. MSCT succeeded to show the lengths of the 17 CTO lesions with a calcification identification rate of 76.4%, significantly higher than that of the CAG (41.5%). By cross-section examination, MSCT succeeded to detect the occlusion degree of the calcified lesions, and showed that 3 CTO lesions were occluded at a rate < 50%, and 10 lesions at a rate > or = 50%. Twelve complete occlusion lesions in 11 patients underwent PCT, success was seen in 6 of which and failure in the other 6. Univariate analysis showed that the length of lesion, branching at the proximal site, formation of bridging lateral branch, form of occlusion end, and calcification were all not significantly related to the success or failure of intervention. The percentage of the calcification area > or = 50% in the intervention failure group was 83.3%, significantly higher than that in the intervention success group (16.7%, P = 0.05). 3-D images of coronary artery could be obtained by MSCT to show all the complete occlusive lesions. 64-MSCT demonstrates a remarkable ability to identify silicified lesions, can re-establish 3-D images of coronary artery, and effectively guide the intervention therapy.

Value of multidetector ct in preoperative assessment of ureteropelvic junction obstruction

Ureteropelvic junction (UPJ) obstruction may be caused by the presence of an aperistaltic dysplastic segment at the UPJ. Besides this intrinsic etiology, extrinsic factors, mainly crossing vessels, may be the causative factor. The controversy regarding the functional significance of vessels crossing at the UPJ is not a new one, though this debate has been resurrected in recent years because of improved detection due to advent of advanced imaging techniques like multidetector row computed tomography (MDCT) and fast magnetic resonance imaging. We present two similar cases where MDCT proved the crossing renal vessel (CRV) to be the cause for UPJ obstruction.