CT Scan Findings Research Articles

Clinicopathological, Endoscopic and Radiological Evaluation of Intestinal Tuberculosis among Nepalese Patients at a Tertiary Care Center

Background: Intestinal tuberculosis is often difficult to diagnose due to its insidious onset and nonspecific and protean manifestations. Delay or failure of diagnosis is associated with significant complications like perforation, abscess, fistula and strictures. The objective of the study was to provide a descriptive analysis of clinical, endoscopic, radiological and pathological findings in these patients. Methods: A prospective study including 52 hospitalized patients was done between April 2018 to 2020 at Tribhuwan University Teaching Hospital. Statistical analyses were done by Microsoft excel version 16. Results: Males were 63% while females were 37 %. The average age was 37 years. 84% had abdominal pain followed by abdominal distension (50%), chronic diarrhea (51%) and cough (21%). Abnormal chest X-Ray was found in (37%) among whom (53%) had sputum positive for tubercular Bacilli. Common CT scan findings were thickening and heterogenous enhancement of bowel loops (79%), lymphadenopathy (56%) and ascites (44%). Endoscopically, commonly involved sites were terminal Ileum (95%), cecum (77%) and ascending colon (42%). Frequent finding were ulcers (83%), patulous and deformed Ileocecal valve (33%), mucosal nodularity (38%), hypertrophic mucosa (21%) and strictures (11%). Biopsies revealed granulomas in (77%) specimens. (65%) of them had central caseous necrosis. Among 10 subjects undergoing needle aspiration of lymphnodes, (70%) had central caseous necrosis. Those with coexisting peritoneal involvement had a mean ascitic fluid adenosine deaminase level of 73 ± 8 IU/L. Conclusion: Intestinal tuberculosis remains a major concern in developing countries. A composite analysis of the clinical manifestations, CT scan, endoscopic findings and pathological examination of the biopsies aid in making a proper and timely diagnosis so as to prevent complications and mortality.

Prostate-Specific Membrane Antigen Expression in Patients With Differentiated Thyroid Cancer With Thyroglobulin Elevation and Negative Iodine Scintigraphy Using 68Ga-PSMA-HBED-CC PET/CT.

Prostate-specific membrane antigen (PSMA) is a member of superfamily of zinc-dependent exopeptidases that is robustly expressed in prostate cancer cells and nonprostatic solid tumor neovasculature including microvessels of thyroid tumors. Its expression in differentiated thyroid cancer (DTC) has been confirmed in many recent studies, but systematic studies exploring PSMA expression in patients with DTC with thyroglobulin elevation and negative iodine scintigraphy (TENIS) are lacking. The aim of the present study was to evaluate the role of PSMA scan in TENIS patients with DTC. Nine consecutive patients with DTC with proven TENIS syndrome (6 men and 3 women with age range 29-68 years and mean age of 48 years) underwent 18F-FDG PET/CT as per the institution protocol. Thereafter, they were subjected to 68Ga-PSMA-HBED-CC PET/CT as per the institution protocol within a week of FDG PET imaging. Prostate-specific membrane antigen expression (SUVmax) in the lesions was compared with 18F-FDG PET and CT scan findings. In 5 of 9 patients with TENIS, the metastatic lesions showed PSMA expression. A total of 14 lesions were seen on the CT scan. Prostate-specific membrane antigen PET detected 9 of 14 lesions (64.28%) (SUVmax ranging from 10.1 to 45.67; median SUVmax of 16.31), whereas FDG PET was positive in 11 of 14 lesions (78.57%). The lesions that showed PSMA uptake was localized to bones (5 of 9) and lungs (4 of 9). Two lesions that were localized to iliac crest and acetabulum were missed on FDG PET but were seen on CT and PSMA PET scan. The results of this pilot study indicate that 68Ga-HBED-CC-PSMA PET/CT demonstrates PSMA expression in TENIS patients with lesions being localized to the bones and lungs. 68Ga-PSMA PET/CT could be useful for the identification of TENIS patients who might benefit from PSMA-targeted radionuclide therapy.

Clinical Presentation of Iranian Patients Affected with COVID-19: A Thousand Faces Disease

Thecoronavirus disease 2019 (COVID-19) pandemic in Iran is part of the worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The present study aimed to demonstrate the clinical characteristics of patients affected by COVID-19, in our tertiary teaching hospital. Medical records and compiled data of 668 patients with suspected COVID-19 were obtained retrospectively between January to April 2020. The present study outcomes included demographic features of infected patients, underlying diseases and conditions, the relationship between the results of reverse transcription-polymerase chain reaction (RT-PCR) or CT-scan with the manifestations of the disease, mortality rate, and age distribution of fatalities among men and women. The median age of hospitalized patients was 63 years old (from 18 to 94). The patients' chief complaints in the admission time were cough, dyspnea, fever, and gastrointestinal problems, respectively. Hospitalized patients' common comorbidities were hypertension (HTN), and cardiovascular disease (CVD) (24%), diabetes mellitus (DM) (21.5%), asthma, or chronic obstructive pulmonary disease (COPD) (6%), or other underlying diseases (15.5%). One-third of patients had no comorbidity according to the data of medical records. In hospitalized patients, 169 (84.5%) had positive RT-PCR, and 156 (78%) had positive chest CT findings. The mortality rate of males was higher than females (66.3% vs. 33.3%) and in patients with positive RT-PCR compared to patients with positive chest CT-scan findings. The majority of deaths had a history of DM or HTN/CVD in their medical records. The chief complaint of patients was cough. DM and HTN or CVD were the common underlying disease related to death in hospitalized cases. Besides, the hospitalization and mortality rate in males was higher than in females. About 87% of dead hospitalized cases had positive RT-PCR results, and this rate was 82% for chest CT results.

Role of Radiologic Computed Tomography in Evaluating Coronavirus (COVID-19) Patients

Objective: Coronavirus (Covid 19) is a dangerous viral disease that principally targets the respiratory system of human beings. The main objective of this study is to evaluate the significant effects resulting from Covid19 using radiologic CT scanning technology. Methods: The recent study was conducted in order to evaluate covid19 among the local public. The sample size for this study consisted of two hundred and thirty (230) patients diagnosed with coronavirus and underwent a chest computed tomography scan. The study was conducted at Najran city, between the period from September to December 2020. Results: The results showed that it is possible to diagnose the complications of coronavirus that affects the respiratory tract in an accurate manner using chest CT imaging and the main results revealed that coronavirus COVID-19 affected all, but males more than female. (50-60) Age group was the big distribution while acute respiratory failure is the most common clinical etiology. The CT scan findings revealed that bilateral pneumonia was the common complication with a high incidence rate of 32% percent and blood coagulation achieved 5% percent as the minimum distribution result. Conclusion: The sensitivity of the CT scans in assessing COVID-19 was significantly high, it has the efficiency to assess complications of COVID-19 in an accurate manner, and therefore it has been proposed to use CT scan as a complementary method in covid-19 diagnosis. More studies on coronavirus disease were recommended by the author.

COVID-19 in Cancer and Non-cancer Patients

Background: There is a global concern for the susceptibility of patients with cancer to the adverse effects of novel coronavirus disease (COVID-19). Nevertheless, there is a signal of potentially increased vulnerability of patients with cancer to more COVID-19-induced mortality, this notion needs to be further evaluated in various societies with different cancer epidemiology and practice. Objectives: To investigate the outcomes of cancer patients admitted due to COVID‐19 and compare them with data of COVID‐19 infected patients without a history of cancer. Methods: In this case-control study, the medical records of patients with cancer (Ca+ patients) who infected with COVID-19 were evaluated and compared with patients without a medical history of cancer (Ca- patients). Clinical data were collected from 19 February 2020 to 17 May 2020. The extracted data were classified into demographics, underlying medical conditions, clinical manifestations, imaging and laboratory findings, and clinical outcomes. Results: A total of 24 Ca+ patients were compared with 44 Ca- patients in terms of clinical manifestations and outcomes of COVID-19. The Ca- patients significantly developed more dry cough (75.0% vs 29.2%, P = 0.01) and fever (72.7% vs 45.8%, P = 0.02). Findings of the chest CT scan was comparable between groups, except for pleural effusion and lymphadenopathy that exclusively reported in Ca+ patients. (3% and 4%, respectively). At the end of observation, 13 (19.1%) patients died from COVID-19. This rate was significantly higher in Ca+ patients (41.7 vs 6.8%, P = 001). Likewise, Ca+ patients experienced more mechanical ventilation (25.0 vs 4.7%, P = 0.01). However, the rate of ICU admission was comparable between groups (P = 0.29). Conclusions: The patients with cancer had a higher rate of mechanical ventilation and COVID-19-induced mortality.

Investigation of the changes in CT scan findings in patients with head trauma referred to the emergency department of Shahid Bahonar Hospital in Kerman in 2020

Investigation of the changes in CT scan findings in patients with head trauma referred to the emergency department of Shahid Bahonar Hospital in Kerman in 2020

Correlation Between Serum CA-125 Level and CT Scan Findings of Abdominal Tuberculosis Resembling Ovarian Mass

Background: Female patients with clinical abdominal tumors generally undergo abdominal CT scan and serum CA-125 level examination. Thirty-three percent of patients with pelvic inflammatory disease and abdominal tuberculosis also had elevated blood CA-125 level. CT scan, which is an imaging modality with ionizing radiation, is important for diagnosing ovarian tumors. It is very common to find discrepancy between abdominal tumor?s preoperative diagnosis and postoperative diagnosis, which turns out to be abdominal tuberculosis. This study aims to determine the correlation between serum CA-125 levels with abdominal CT scan findings in abdominal TB resembling ovarian mass. Methods: This was a correlative analytic study with a retrospective approach which was conducted at Dr. Soetomo General Hospital, Surabaya. The sample of this study was medical records from all patients with abdominal tuberculosis who had undergone histopathological examination. Serum CA-125 levels, surgery, and histopathological examination data were obtained from medical records and statistical analysis was performed. Results: The distribution of the lesion extension degree varied, but most were included in moderate degree (59.1%). In terms of CA-125 level, most patients had significant increase (72.7%) of their CA-125 level. There was a negative correlation (rho = -0.096) which was not significant (p = 0.671 with ?=0.05) between serum CA 125-levels and the extension degree of abdominal tuberculosis lesion resembling ovarian tumors. Conclusion: There is a negative and insignificant correlation between serum CA-125 level and the degree of abdominal tuberculosis lesion extension resembling ovarian tumor.

A DIRE WOLF IN WOLF'S CLOTHING

Objective: Takotsubo cardiomyopathy is often attributed to women over 60 years of age as a result of an emotional event stress. Pheochromocytoma is a rare etiology that can mimic Takotsubo cardiomyopathy through hypersecretion of catecholamines. This case is that of a patient presenting with atypical Takotsubo cardiomyopathy fortuitously discovered in a context of intense paroxysmal migraine. Design and method: A 38 year old female patient with a medical history of migraine, depression, anorexia, and an active smoking attends the emergency for frontal-orbital migraine headache, bilateral otalgia and myodesopsia. arterial blood pressure at 175/95 mmHg,The patient received analgesic treatment and a cerebral CT scan was performed with a normal outcome. Her ECG showS incidental findings of ST depression in V1-V2 and negative T waves in upper lateral leads(DI, AVL). HS troponin levels are elevated. The patient received a triple antithrombotic therapy transferred to our hospital for emergency coronary angiogram. Upon arrival, the patient is asymptomatic, BP 145/75 mmHg, and received emergency coronary angiogram revealing a healthy coronary artery up and the ventriculography detected a ballooning of the left ventricle. TTE findings are an altered LVEF estimated at 40%, apical akinesia and hypokinesia of the adjacent segments, an apical ballooning. The rest of the TEE is normal. Takotsubo is evoked. hospitalization is marked by a normalization of the patient's ECG. 2 days after the coronography, the patient presents with intense recurrence of migraines, ST depression on leads V1-V2 and a severe hypertensive crisis at 220/160mmHg. After initiating an IV antihypertensive treatment, there is a regression of the symptomatology and electrocardiographic changes. Results: Atypical Takotsubo associated with HTN crisis resulted in the panel of secondary HTN. CT scan findings show an adrenal mass. The normetanephrine values and total metanephrine values are elevated. These elements are in favor of a pheochromocytoma. Conclusions: The patient presented an atypical picture of ACS. The initial diagnosis associated with paroxysmal hypertensive flare-ups are the result of an underlying pheochromocytoma. It is important not to settle for a diagnosis of exclusion without mentioning all possible etiologies and thus reduce the morbidity and mortality of this pathology.

Association Between CT Scan Findings and Mortality in Covid-19 Cases

Background: Covid-19 epidemia is a worldwide infectious viral disease initiating from December 2019from Wuhan, China. Recognition of the prognostic role of imaging findings is important to improve theoutcomes in patients. Accordingly, regarding the lack of studies in this era among Iranian patients, this studywas done to determine the association between CT scan findings and mortality in Covid-19 cases.Methods: In this prognostic prospective cohort study, 192 consecutive patients with established Covid-19disease by clinical findings, and laboratory results in Besat Hospital, Tehran, Iran in March and April 2020were enrolled. The findings in CT scan were involved zone and lobe, ground glass, consolidation, groundglass with reticular, reverse hallo sign, microvascular dilation sign, fibrotic streaks, sub pleural line, airbronchogram, Bronchus distortion, broncheiectasis, pleural thickening, pleural reaction, and pleural effusion.According to involvement degree the points in CT scan were 0, 1, and 2 for lack of lung parenchymainvolvement, less than 50 percent involvement, and more than 50 percent involvement.Results: The involved zones were significantly differed between survived and dead cases (P=0.001). Asshown in Table 4, the scores of CT scan for lung involvement and also number of involved lobes werediffered across the alive and dead cases (P=0.001) the mean hospital stay was 7.1 (5.6) and 5.7 (2.5) days thatwas same across the groups (P=0.325). There were significant differences between groups for consolidation,ground glass plus reticular pattern, fibrotic streaks, sub-pleural line, air bronchogram, bronchiectasis, pleuralthickening, pleural effusion, and pleural reaction (P < 0.05).Conclusion: Totally, according to the obtained results it may be concluded that CT scan is useful prognosticmodality to predict the mortality among patients with Covid-19 disease. Consolidation, ground glass plusreticular pattern, fibrotic streaks, sub-pleural line, air bronchogram, bronchiectasis, pleural thickening,pleural effusion, and pleural reaction are the man CT scan findings predicting higher mortality rate in thesepatients.

Clinical and obstetric characteristics of pregnant women with Covid-19: A case series study on 26 patients

ObjectiveTo evaluate the clinical characteristics and outcomes of pregnant women with Covid-19. Materials and methodsThis case series study was performed to investigate demographic, clinical and obstetric characteristics of 26 pregnant women with COVID-19 referring to a university hospital of Kashan during the epidemic of COVID-19 (March to May 2020). ResultsThe mean gestational age of the patients at admission and delivery was 31.8 ± 5.2 and 36.3 ± 3.4 weeks, respectively. The most common symptoms were fever (96.2%) followed by dyspnea and cough (30.8%). The findings of lung CT scan showed abnormalities confirming the pneumonia in 22 patients (84.6%). Cesarean section was performed in 69.2% of the mothers. The most common maternal–fetal outcome was preterm delivery (38%). Two mothers were transferred to the ICU due to deterioration in clinical condition and they underwent mechanical ventilation without any maternal death. The most common neonatal outcomes were prematurity (38%) and low birth weight (34.6%). No cases of confirmed COVID-19 were observed in the neonates. ConclusionClinical manifestations and laboratory and radiographic findings in pregnant women with COVID-19 are similar to the general population. Common outcomes of pregnancy and delivery in mothers included increased rate of preterm delivery and cesarean section. The most prevalent neonatal outcomes included prematurity and LBW. Careful monitoring of pregnant women with COVID-19 is recommended.

CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?

Cross-sectional survey. Assessment of subaxial cervical facet injuries using the AO Spine Subaxial Cervical Spine Injury Classification System is based on CT scan findings. However, additional radiological evaluations are not directly considered. The aim of this study is to determine situations in which spine surgeons request additional radiological exams after a facet fracture. A survey was sent to AO Spine members from Latin America. The evaluation considered demographic variables, routine use of the Classification, as well as the timepoint at which surgeons requested a cervical MRI, a vascular study, and/ or dynamic radiographs before treatment of facet fractures. There was 229 participants, mean age 42.9 ± 10.2 years; 93.4% were men. Orthopedic surgeons 57.6% with 10.7 ± 8.7 years of experience in spine surgery. A total of 86% used the Classification in daily practice. An additional study (MRI/vascular study/and dynamic radiographs) was requested in 53.3%/9.6%/43.7% in F1 facet injuries; 76.0%/20.1%/50.2% in F2; 89.1%/65.1%/28.4% in F3; and 94.8%/66.4%/16.6% in F4. An additional study was frequently required: F1 72.5%, F2 86.9%, F3 94.7%, and F4 96.1%. Spine surgeons generally requested additional radiological evaluations in facet injuries, and MRI was the most common. Dynamic radiographs had a higher prevalence for F1/F2 fractures; vascular studies were more common for F3/F4 especially among surgeons with fewer years of experience. Private hospitals had a lower spine trauma cases/year and requested more MRI and more dynamic radiographs in F1/F2. Neurosurgeons had more vascular studies and dynamic radiographs than orthopedic surgeons in all facet fractures.

Blow-in Fracture of Orbital Roof. A Case Report

Orbital fractures may be accompanied with severe damage of the eye bulb and other intraorbital tissues. Early clinical findings can be very mild, therefore it is vital to actively seek not only for any damage done to the soft tissues of the orbit, but also for extraorbital complications such as liquorrhea or meningitis. We report a relatively rare case of blow-in fracture of orbital roof in eleven years old boy. Patient was admitted to the emergency care after falling off a bicycle without impaired consciousness. During admission ophthalmologist evaluated the condition as severe contusion of the left bulb, with hemophthalmia and retinal comotosis. Due to significant swelling of eye lids and periorbital hematoma, it was not possible to perform specific tests to objectify possible oculomotor disorder and diplopia. CT scan findings show dislocated fracture of orbital roof with fragments reaching into the musculus rectus superior. For high risk of bulbus penetration and muscle damage a surgical intervention with bone fragments removal was performed using endoscopic assisted frontal orbitotomy. After operation patient had no signs of functional eye disorder.

Intravenous Immunoglobulin Therapy in COVID-19 Disease

High dose IVIG has been an appropriate immunomodulatory treatment option for prophylaxis of severe infections in autoimmune and inflammatory diseases [1]. It is suggested that the plasma levels of pro-inflammatory cytokines are higher in COVID-19 patients with severe clinical course and there is a cytokine storm related to the severity of the disease. Therefore, IVIG is presented as a treatment option in severe COVID-19 patients [2]. Mechanisms suggesting the benefit of IVIG in SARS-CoV2 therapy can be counted as; neutralizing antibodies binding to the ACE2 receptor to prevent viral entry into the cell, blocking receptors associated with the target cell and preventing pathogens from damaging the cell [3,4]. In addition, IVIG has IgG dimers that inhibit FcR activation on natural immune effector cells. This prevents antibody-dependent enhancement (ADE), a paradoxical condition that allows the pathogen to enter the cell [5,6]. It has also been observed to improve coagulation abnormalities in septic patients that deteriorate due to inflammatory events in the pathogenesis of COVID-19 [7]. In previous studies of SARS and MERS, the benefit of IVIG treatment has been demonstrated [8]. Wang et al. reported that 40 patients with SARS were given IVIG, 22 of whom had severe cytopenia, and a significant improvement in leukocyte and platelet counts was noted after IVIG [9]. In a case series reported by Cao et al., IVIG was given 0.3-0.5 g per kg weight per day for five days to 3 patients with severe COVID-19 pneumonia diagnosed by CT scan. It was reported that patients showed a rapid recovery 2 days after IVIG treatment and their CT scan findings were improved. In addition, no side effects were reported in any of the 3 patients [10]. Lanza et al. reported an increased need for oxygen in 42-year-old woman diagnosed with COVID-19 on the 6th day and bilateral infiltration and consolidation worsened in the CT findings, and the radiological findings and blood values were rapidly improved after 4 days of high-dose IVIG treatment [3]. IVIG can interrupt the storm of inflammatory factors at an early stage, enhance immune function. Ling and colleagues recommended early initiation of IVIG treatment for severe and critical type COVID-19 patients [11]. In summary, early use of IVIG therapy in selected cases for COVID-19 pneumonia has been reported to shorten hospital stay, reduce the need for mechanical ventilation, and benefit patients' early recovery. More controlled studies are needed to demonstrate therapeutic benefits of this IVIG therapy.

Study of Traumatic Head Injuries Using Computed Tomography

The aim of this retrospective research was to study traumatic head injury (THI) using CT scan and to classify the types of head trauma fractures and types of hemorrhages. Methods and Results: The current study included 53 THI patients (43/81.1%) males and 10/18.9% females) with positive and negative CT scan findings. A complete clinical history and patients’ data were taken from CT reports, which included age, gender, type of trauma, associated injury, and CT findings with their percentages. The study was carried out in Taif city in King Abdelaziz Hospital and King Faisal Hospital. The distribution of various etiologies of THI has shown that the most common etiology was road traffic accident (RTA) (45.3%). The typical age for THI was between 21 to 30 years old (26.4%). The distribution of the traumatic causes for each age group is shown in Table 1. The typical age for RTA was the age group of 11-20 years (33.3%), for falls – the age groups of 0-10 years (33.3%) and over 60 years of age (33.3%). The frequency of various CT findings of THI was as follows: intracranial hemorrhage (56.6%), fracture (39.6%), pneumocephalus (22.6%), contusion (22.6%), foreign body (11.3%), and proptosis (3.8%). The distribution of fracture cases, according to their types, was as follows: a linear fracture (76.2%), comminuted fracture (23.8%), basilar fracture (14.3%), and depressed fracture (9.5%). The frontal bone was the most affected site with fractures (30.7%). Conclusion: CT is an appropriate clinical modality used in the management of THI patients in the emergency department. CT has the advantage of being fast, safe, available, sensitive to most acute post-traumatic injuries, accurate in identifying the head abnormalities such as fractures and hemorrhage during the first 24 hours after injury, which is beneficial in the early assessment, therapy planning, monitoring, and long-term patient care.

Neural classification of Norwegian radiology reports: using NLP to detect findings in CT-scans of children

BackgroundWith a motivation of quality assurance, machine learning techniques were trained to classify Norwegian radiology reports of paediatric CT examinations according to their description of abnormal findings.Methods13.506 reports from CT-scans of children, 1000 reports from CT scan of adults and 1000 reports from X-ray examination of adults were classified as positive or negative by a radiologist, according to the presence of abnormal findings. Inter-rater reliability was evaluated by comparison with a clinician’s classifications of 500 reports. Test–retest reliability of the radiologist was performed on the same 500 reports. A convolutional neural network model (CNN), a bidirectional recurrent neural network model (bi-LSTM) and a support vector machine model (SVM) were trained on a random selection of the children’s data set. Models were evaluated on the remaining CT-children reports and the adult data sets.ResultsTest–retest reliability: Cohen’s Kappa = 0.86 and F1 = 0.919. Inter-rater reliability: Kappa = 0.80 and F1 = 0.885. Model performances on the Children-CT data were as follows. CNN: (AUC = 0.981, F1 = 0.930), bi-LSTM: (AUC = 0.978, F1 = 0.927), SVM: (AUC = 0.975, F1 = 0.912). On the adult data sets, the models had AUC around 0.95 and F1 around 0.91.ConclusionsThe models performed close to perfectly on its defined domain, and also performed convincingly on reports pertaining to a different patient group and a different modality. The models were deemed suitable for classifying radiology reports for future quality assurance purposes, where the fraction of the examinations with abnormal findings for different sub-groups of patients is a parameter of interest.

Lung Ultrasound Findings Compared to Chest CT Scan in Patients with COVID-19 Associated Pneumonia: A Pilot Study

Introduction: Lung US has been reported to be as useful as a chest CT scan and much better than a chest x-ray for the evaluation of pneumonia. Objective: This study aimed to compare the findings of lung ultrasound (US) and chest CT scan of patients with COVID-19-associated pneumonia in the Emergency Department (ED). Methods: This retrospective observational pilot study was carried out on confirmed COVID-19 patients in the isolation corona ward of the Imam Hussein Hospital ED from March 15 to March 22, 2020. After obtaining demographic data, the patients underwent a pulmonary bedside US examination, with the patients in the sitting position, turning their back to the examiner. A 10-point lung US was performed. Each lung was divided into two areas: posterior (three zones) and lateral (two zones). The patients’ lung ultrasound and chest CT scan as the standard imaging were blindly reviewed and recorded. The clinical value of ultrasound was evaluated with different severity of lung involvement according to CT severity score. Results: Nineteen patients (38 zones), including 13 males, were evaluated with a mean age of 62.5±16.8 years. B2 lines and consolidation observed in the US examinations were significantly correlated with ground-glass opacity and consolidation observed in CT scan examinations, respectively (p <0.0001). US sensitivity and specificity of finding B2 lines were 90% and 100%, respectively. Also, the sensitivity and specificity of US in identifying consolidation were 82% and 100%, respectively. In the lungs with moderate and severe lobar involvement, US findings were significantly correlated (p <0.05) with CT scan findings. Conclusions: Ultrasound evaluation is a safe, fast, and rapid technique for the evaluation of patients with moderate to severe COVID-19-associated pneumonia. It is a reproducible procedure and can be implemented by the operator after a short course of training.

Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature.

Background:Traumatic acute subdural hematoma (ASDH) is an oft encountered entity in neurosurgery. While resolution of such thick SDHs usually takes time, certain cases of rapid spontaneous resolution have also been reported. This article attempts to review the pathophysiology, clinical and radiological features of such cases, as well as provide an insight into decision making for their management.Methods:Electronic literature search was done to look for similar cases of spontaneous rapid resolution of ASDH. Five of authors cases have been described. Their clinical and radiological features along with those of cases from literature search were tabulated and analyzed.Results:A total of 44 relevant cases were included for analyses. Of these, 39 cases were from 33 articles found in existing literature and 5 cases were from author's collection. The M:F ratio was 25:19 with a mean age was 41.84(SD-4.094) years. Twenty -six patients showed “Rapid” neurological improvement (</= 24 hours) while “gradual” neurological improvement (>24 hours) occurred in 10 patients. The mean hematoma resolution time on CT scan was 13.78 hours (SD 16.46) ranging from 1- 72 hours. Twenty-nine patients showed redistribution of hematoma, most commonly to tentorium and falx cerebelli. CT scan findings were classified into 5 types as per the nature of hypodensity around hematoma. The geometric mean time to resolution of hematoma was least for type 2 (7.27 hours) and type 1(7.52 hours) patients.Conclusion:Selected patients of ASDH with rapid neurological improvement and specific CT findings may show spontaneous resolution of ASDH. Multicentric studies with larger study population may provide better insight into the nature and outcomes of such entities.

Performance of an artificial intelligence tool with real-time clinical workflow integration - Detection of intracranial hemorrhage and pulmonary embolism.

Performance of an artificial intelligence tool with real-time clinical workflow integration - Detection of intracranial hemorrhage and pulmonary embolism.

Thoracic CT Scan Findings in Patients with HIV/TB co-infection before and after treatment

Thoracic CT Scan Findings in Patients with HIV/TB co-infection before and after treatment

Abdominal tuberculosis CT-scan findings in comparison to malignant ovarian tumor CT-scan findings in general, a retrospective observation

Background: Abdominal TB is an infection caused by Mycobacterium TB (TB) that involves the gastrointestinal tract, peritoneum, lymph nodes, and/or solid organs. Female pelvic TB is a relatively rare type of extrapulmonary TB, and little literature has been reported to date. Because of its rarity, computed tomography (CT) findings of female pelvic tuberculosis have not been fully elucidated and are easily misdiagnosed as Advanced Ovarian Malignancy (AOM) or Pelvic Inflammatory Disease (PID) without pathological findings. This study aimed to determine abdominal TB CT-Scan findings that resembled malignant ovarian tumor. Methods: This study was a descriptive study with a retrospective design using patient medical records. The study population was abdominal tumor patients who were suspected with malignant ovarian tumor and were examined by CT-Scan. Data taken from medical records of ovarian tumor patients were patients’ characteristics and CT findings of abdominal TB tumor patients that resembled malignant ovarian tumor. Results: From 22 samples, most groups belonged to 21-40-years age group. Moss masses were bilateral (46.6%), had solid cystic component (63.6%), lobulated contour (50%), and all mass presented with enhancement. Ascites (81.9%), peritoneal thickening and enhancement (68.2%), and omental involvement (54%) were also found. Conclusion: CT-scan findings in abdominal tuberculosis patients which resembled malignant ovarian tumors have similarities with findings in previous literatures, such as mass, ascites, and omental involvement findings