High-resolution Computed Tomography Scans Research Articles

Correlation Between Vestibular Disorders and Superior Semicircular Dehiscence on High-resolution Computed Tomography at Tam Anh Ho Chi Minh General Hospital.

Superior semicircular canal dehiscence (SSCD) is a pathologic condition within the inner ear characterized by various vestibular manifestations. Numerous studies have reported an incidence rate of SSCD ranging from 3.6% to 9% in the general population. The objective of this medical study was to evaluate the prevalence of superior SSCD and investigate its correlation with vestibular symptoms among patients who underwent high-resolution computed tomography (HRCT) scans. To the best of our knowledge, there is limited research and awareness regarding SSCD in Vietnam. In addition, the secondary aim of our investigation is to assess the prevalence of SSCD in Vietnam and compare it with findings from previous studies worldwide. This retrospective study was conducted at Tam Anh Ho Chi Minh General Hospital from March 2022 to February 2024. Medical records and HRCT scans of the patients were collected. Patients were categorized into two groups: those with and without vestibular disorders. SSCD was defined as the absence of bone overlying the superior semicircular canal facing toward the dura of the middle cranial fossa. Statistical analysis was performed to determine the correlation between vestibular symptoms and the presence of SSCD. A total of 362 patients (including 151 men and 211 women) were recruited. The prevalence of SSCD was 10.2% according to the HRCT scan results. The study found that 18.33% of patients with vestibular disorders had SSCD on HRCT scans, whereas only 6.2% of patients without vestibular disorders exhibited SSCD, indicating a significant association (p-value <0.001). These findings highlight the importance of considering SSCD as a potential etiology in patients presenting with vestibular symptoms and emphasize the diagnostic utility of HRCT.

Pulmonary cryptococcosis in non-HIV-infected individuals: HRCT characteristics in 58 patients.

The aim of this study is to delineate the distinctive high-resolution computed tomography features of pulmonary cryptococcosis in non-HIV-infected patients. This retrospective analysis encompasses high-resolution computed tomography scans from 58 patients with histologically confirmed pulmonary cryptococcosis, focusing on the diagnostic challenges and the factors that lead to misdiagnosis. Analysis of computed tomography scans from these patients indicated that nodular or mass-like presentations were evident in 32 cases (55.2%), consolidation presentations in 7 cases (12.1%), and mixed presentations in 19 cases (32.8%). Lesions were predominantly located in the lower lobes of the lungs (40 cases, 69.0%) and in peripheral zones (55 cases, 94.8%). Notable radiographic signs included the presence of the burr sign in 55 cases (94.8%), lobulation sign in 53 cases (91.4%), halo sign in 53 cases (91.4%), and air bronchogram in 46 cases (79.0%). Moreover, 24 cases (41.4%) exhibited necrosis or cavitation, mediastinal lymphadenopathy was noted in 6 cases (10.3%), and pleural effusion was present in 5 cases (8.6%). Lesions were devoid of calcification. Pulmonary cryptococcosis ought to be contemplated in the differential diagnosis when computed tomography imaging exhibits patterns including, but not limited to, lower lobe and peripheral distribution, a broad base abutting the pleura, clustered growth with a propensity for fusion, air bronchogram within lesions, and peripheral halo sign.

AUTOMATED CLASSIFICATION OF EMPHYSEMA USING CONVOLUTIONAL NEURAL NETWORKS

The analysis of CT scans for emphysema diagnosis can be formulated as a computer vision problem, where predefined patterns are used to automatically classify the images. This paper investigates a method for classifying emphysema subtypes in High-Resolution Computed Tomography (HRCT) scans using convolutional neural networks (CNNs). This classification is crucial for accurate diagnosis and management of emphysema, a chronic lung disease causing shortness of breath. Our approach leverages transfer learning to extract informative features from HRCT images labeled as centrilobular (CLE), paraseptal (PLE), panlobular (PSE), and non-emphysematous (NT). We evaluate various CNN architectures, with InceptionV3 demonstrating exceptional performance, achieving an accuracy of 98% while effectively distinguishing between all subtypes. The trained InceptionV3 model is then integrated into a user-friendly front-end application developed using Streamlit and ngrok. This application allows real-time emphysema classification from HRCT scans, potentially aiding clinicians in diagnosis and treatment decisions. Keywords:- Emphysema classification ,Transfer Learning,CNN,InceptionV3,Streamlit , Ngrok

Clinical, radiological and histopathological features of patients with familial pulmonary fibrosis

BackgroundIn familial pulmonary fibrosis (FPF) at least two biological relatives are affected. Patients with FPF have diverse clinical features.Research questionWe aimed to characterize demographic and clinical features, re-evaluate high-resolution computed tomography (HRCT) scans and histopathology of surgical lung biopsies, assess survival and investigate the suitability of risk prediction models for FPF patients.Study designA retrospective cohort study.MethodsFPF data (n = 68) were collected from the medical records of Oulu University Hospital (OUH) and Oulaskangas District Hospital between 1 Jan 2000 and 11 Jan 2023. The inclusion criterion was pulmonary fibrosis (PF) (ICD 10-code J84.X) and at least one self-reported relative with PF. Clinical information was gathered from hospital medical records. HRCT scans and histology were re-evaluated.ResultsThirty-seven (54.4%) of the patients were men, and 31 (45.6%) were women. The mean ages of the women and men were 68.6 and 61.7 years, respectively (p = 0.003). Thirty-seven (54.4%) patients were nonsmokers. The most common radiological patterns were usual interstitial pneumonia (UIP) (51/75.0%), unclassifiable (8/11.8%) and nonspecific interstitial pneumonia (NSIP) (3/4.4%). Pleuroparenchymal fibroelastosis (PPFE) was observed as a single or combined pattern in 13.2% of the patients. According to the 2022 guidelines for idiopathic pulmonary fibrosis (IPF), the patients were categorized as UIP (31/45.6%), probable UIP (20/29.4%), indeterminate for UIP (7/10.3%) or alternative diagnosis (10/14.7%). The histopathological patterns were UIP (7/41.2%), probable UIP (1/5.9%), indeterminate for UIP (8/47.2%) and alternative diagnosis (1/5.9%). Rare genetic variants were found in 9 patients; these included telomerase reverse transcriptase (TERT, n = 6), telomerase RNA component (TERC, n = 2) and regulator of telomere elongation helicase 1 (RTEL1, n = 1). Half of the patients died (n = 29) or underwent lung transplantation (n = 5), with a median survival of 39.9 months. The risk prediction models composite physiology index (CPI), hazard ratio (HR) 1.07 (95.0% CI 1.04–1.10), and gender-age-physiology index (GAP) stage I predicted survival statistically significantly (p<0.001) compared to combined stages II and III.ConclusionsThis study confirmed the results of earlier studies showing that FPF patients’ radiological and histopathological patterns are diverse. Moreover, radiological and histological features revealed unusual patterns and their combinations.

Dependability of Electrode to Modiolus Distance in Patients Specific Electrode Selection: A Cadaveric Model Study.

This study aims to discern the disparities in the electrode-to-modiolus distance (EMD) between cochleostomy and round window approaches when performed sequentially in the same temporal bone. Additionally, the study seeks to identify the cochlear metrics that contribute to these differences. A cross-sectional study was conducted, involving the sequential insertion of a 12-electrode array through both round window and cochleostomy approaches in cadaveric temporal bones. Postimplantation high-resolution CT scans were employed to calculate various parameters. A total of 12 temporal bones were included in the imaging analysis, revealing a mean cochlear duct length of 32.892 mm. The EMD demonstrated a gradual increase from electrode 1 (C1) in the apex (1.9 ± 0.07 mm; n = 24) to electrode 12 (C12) in the basal turn (4.6 ± 0.24 mm; n = 12; p < 0.01). Significantly higher EMD values were observed in the cochleostomy group. Correlation analysis indicated a strong positive correlation between EMD and cochlear perimeter (CP) (rs = 0.64; n = 12; p = 0.03) and a strong negative correlation with the depth of insertion (DOI) in both the middle and basal turns (rs = - 0.78; n = 20; p < 0.01). Additionally, EMD showed a strong negative correlation with the DOI-CP ratio (rs = -0.81; n = 12; p < 0.01). The cochleostomy group exhibited a significantly higher EMD compared with the round window group. The strong negative correlation between EMD and DOI-CP ratio suggests that in larger cochleae with shallower insertions, EMD is greater than in smaller cochleae with deeper insertions. NA Laryngoscope, 134:4736-4744, 2024.

Perspectives in Smoking Related Interstitial Lung Diseases

Abstract Interstitial lung disease is a generic term encompassing a wide range of unrelated conditions that have in common a tendency to cause shortness of breath and/or cough associated with bilateral abnormal opacity of various types on conventional chest X-rays or high-resolution computed tomography scans, symptoms including dyspnea, wheezing, cough, and/or sputum production. This study aimed to show that cigarette smoke is a powerful inducer of inflammation and the cause-effect relationship between cigarette smoking and interstitial diseases – respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) and desquamative interstitial pneumonia (DIP). We bring to your attention the cases of two patients, heavy smokers with HRCT images suggestive for RB-ILD and DIP. The patients present to the on-call room with dry cough, exertional dyspnea and receive corticosteroid treatment with the recommendation to cease smoking. An approach would be to target high-risk populations, such as older adults with a history of smoking for early diagnosis of parenchymal lung diseases (e.g. ILD and chronic obstructive pulmonary disease) or lung cancer.

Microsurgical and Descriptive Three-Dimensional Analysis of the Subarticular Trigone: A Guidemap for Standardizing Lateral Recess Decompression.

Background Lateral recess decompression has remained a cornerstone spinal procedure for decades. Despite its popularity, a significant lack of evidence in the literature exists concerning microsurgical anatomy and pertinent surgical landmarks, resulting in non-standardized nomenclature, descriptions, and surgical approaches. Objective This study provides an in-depth microsurgical and descriptive analysis of the subarticular trigone (SAT), serving as an anatomical guide and a tool to foster consistency in nomenclature and standardization of surgical approaches. Methods We analyzed 35 high-resolution lumbar spine CT scans, employing three-dimensional (3D) processing techniques. The SAT is introduced to delineate the bony prominence enveloping the superiomedial quadrant of the pedicle. The SAT encompasses two zones: (1) a superior zone above the superior pedicular line, corresponding to the medial part of the body of the ascending facet (AF), and (2) an inferior zone between the superior and middle pedicular lines, corresponding to the root of the AF and the medial pars/superior lamina. The superior subarticular point (SSP) and medial subarticular point (MESP) serve as key reference landmarks. The SAT forms the roof of the lateral recess and the region requiring resection during decompression of the traversing root in this anatomical corridor. Various measurements, including SSP and MESP to lateral pars, tip of the facet and spino-laminar junction distance, mean width of the sublaminar ridge (SLR), and percentage of the facet that requires resection for adequate SAT decompression, were carried out. Results The mean distance of the SSP to the lateral pars ranges from 7 to 9.2 mm, to the tip of the descending from 9.3 to 10.1 mm, and to the spino-laminar junction from 6.7 to 8.1 mm. The MESP is located at a mean distance of 5.4-6.9 mm from the medial pedicular line. The mean width of the SLR varies from 18.6 to 29.4 mm. Finally, the percentage of total facet width that needs to be removed to adequately decompress the SAT extends from 32% at L4 to 36% at L1. Conclusions This study presents comprehensive insights into the surgical, descriptive, and correlative anatomy of the lateral recess, emphasizing the SAT. The extrapolated data offer a framework for achieving uniformity in surgical planning and advocate for standardized nomenclature.

Approach to interstitial lung disease associated with systemic sclerosis—A survey to pulmonologists and rheumatologists in Colombia

IntroductionInterstitial lung disease is a leading cause of mortality in patients with systemic sclerosis. Currently, there is a lack of consensus regarding screening, rescreening, diagnosis, and follow-up practices in interstitial lung disease associated with systemic sclerosis (SSc-ILD) in Colombia. MethodsA structured survey focused on clinical practices in patients with SSc-ILD was conducted. Members of the Asociación Colombiana de Neumología y Cirugía de Tórax (Asoneumocito) and the Asociación Colombiana de Reumatología (Asoreuma) were invited to participate from March 2023 to May 2023. ResultsWe surveyed 51 pulmonologists and 44 rheumatologists. Overall, 51.6% reported having access to multidisciplinary team discussion in ILD. Among the 95 participants, 78.9% would routinely perform a high-resolution computed tomography scan of the chest once a diagnosis of systemic sclerosis was established. This practice is more frequent among rheumatologists (84.1%) than among pulmonologists (74.5%). Approximately half of the participants would rescreen patients annually with computed tomography scan (56.8%) if baseline images were negative.Spirometry (81.1%), diffusing capacity of the lung for carbon monoxide (80.0%), and 6-min walk test (55.8%) were the most frequently performed tests upon diagnosis of systemic sclerosis. During follow-up, participants would consider repeating pulmonary function tests mostly every 6 months. ConclusionsScreening of SSc-ILD is high among pulmonologists and rheumatologists. Decision-making on diagnosis and follow-up is similar between specialties, but there are variations in their frequency and indications. Further research is needed to evaluate how to adapt recommendations for assessing SSc-ILD in different settings.

Fungal carotiditis with aneurysm - a rare complication of mucormycosis: presentation and management

During the COVID-19 pandemic, cases of mucormycosis (ROCM) had increased drastically, especially in the second wave. Most of these cases involved the paranasal sinuses, orbit and occasionally brain. This case report presents a rare case of mucormycosis complicated with a mycotic aneurysm of the petrous part of the internal carotid artery (ICA). A 43-year-old man presented with left-sided facial weakness for which high resolution computed tomography scan of the Temporal bones was done. A scrutiny of the computed tomography temporal bone showed evidence of osteomyelitis extending to the petrous apex around the foramen Lacerum. Computed tomography and magnetic resonance imaging of the paranasal sinus done later confirmed the diagnosis of mucormycosis. The patient underwent endoscopic surgical debridement of the nose and sinuses, with post-operative amphotericin B. After 3 weeks, the patient presented with bouts of profuse nasal bleed. Computed tomography angiogram showed an aneurysm in the petrous segment of the ICA suggestive of mycotic carotiditis complicated from mucormycosis spread along the skull base. It was successfully managed neurosurgically by a bypass shunting procedure. Mucormycosis is a disease that typically has an aggressive and startling fatality rate. ICA aneurysm is an uncommon occurrence in mucormycosis. Subjects with ROCM should be examined for brain and vascular involvement. Computed tomography angiogram should be performed as soon as possible if the skull base is involved in the ICA area. Morbidity and mortality can often be reduced by early diagnosis and interventions by a multidisciplinary team.

Canal cholesteatoma: an alarming sequela of congenital aural atresia

Congenital aural atresia is an external ear malformation that may have diverse clinical presentations ranging from conductive hearing loss to the formation of canal cholesteatoma. Canal cholesteatoma, once developed can aggressively erode the bony boundaries of the middle ear cleft and lead to dangerous complications. Here we present the clinical outlook and surgical management of a child with congenital aural atresia with extensive canal cholesteatoma and complications. A twelve-year-old girl with congenital aural atresia and microtia of the right ear presented with right sided infra-auricular abscess with overlying skin ulceration. She also had right sided grade 4 facial paralysis. Pure tone audiometry revealed severe conductive hearing loss on the right side. In contrast, a high-resolution computed tomography scan showed extensive soft tissue on the right side completely destroying the posterior bony canal wall, with erosion of the sigmoid plate and the mastoid tip. We performed a right sided modified radical mastoidectomy and canal atresia repair along with the removal of the necrotic and infected tissues. The little girl recovered uneventfully with improved facial nerve function and without any sign of cholesteatoma recidivism. In congenital aural atresia, early surgical intervention is the key to prevent the formation of canal cholesteatoma and subsequent complications.

The inner ear and stapes of the basal mammaliaform Morganucodon revisited: new information on labyrinth morphology and promontorial vascularization

Abstract Based on high-resolution computed tomography scanning, we provide new insights into the inner ear and stapedial morphology of Morganucodon from the Early Jurassic of St Brides. At the base of mammaliaforms, Morganucodon plays a pivotal role in understanding the sequence of character acquisition from basal cynodonts to mammals, including the detachment of the middle ear and the evolution of high-frequency hearing. Advancements in imaging technology enabled us to revise or newly describe crucial anatomy that was not accessible for the original description of Morganucodon. Based on 37 petrosals, we can confirm that the apex of the cochlear canal is expanded in Morganucodon, suggestive of a lagena macula. A gently raised crest along the abneural margin is reminiscent of (although much shallower than) the secondary lamina base of other Mesozoic mammaliaforms. The venous circum-promontorial plexus, which surrounded the inner ear in several basal mammaliaforms, was connected to the cochlear labyrinth in Morganucodon through numerous openings along the secondary lamina base. Two petrosals contain fragmentary stapes, which differ substantially from previously described isolated stapes attributed to Morganucodon in having peripherally placed crura and an oval and bullate footplate. Based on the revised stapedial morphology, we question the traditional view of an asymmetrical bicrural stapes as the plesiomorphic condition for Mammaliaformes.

Solid waste-based low-carbon autoclaved aerated concrete: Relationship between engineering properties and microstructure

A novel low-carbon autoclaved aerated concrete (AAC) was developed to enhance the high valuable use of solid waste in production, incorporating furnace slag, metro shield sand, and quartz tailings sand as 100 % siliceous raw materials, constituting 60 % of the total weight. In this study, comprehensive analyses were conducted on its engineering properties, including density, compressive, flexural, and splitting tensile strengths, and thermal conductivity. Advanced techniques such as X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), and high-resolution Industrial CT scanner (X-CT) were employed to examine AAC's material composition, hydration products, and pore structure characteristics at the microscale. The results indicated that the addition of 10 % furnace slag resulted in a specific increase of 5.5 % in compressive strength. However, escalating the furnace slag content to 30 % proved detrimental to the toughness and dry shrinkage of AAC. The microstructure analysis indicates that the use of furnace slag can improve the connectivity and roundness of pores and reduce the probability of large pores (>0.01 mm3), which will reduce the risk of damage localization. Furthermore, furnace slag in AAC enhanced sustainability and cost-effectiveness compared to metro shield sand and quartz tailings sand. Based on the TOPSIS model, an optimal AAC mixture, considering engineering performance, economy, and sustainability, was derived by blending the three types of solid wastes.

Design of ANCHOR-RA: a multi-national cross-sectional study on screening for interstitial lung disease in patients with rheumatoid arthritis

BackgroundPatients with rheumatoid arthritis (RA) are at risk of developing interstitial lung disease (ILD), which is associated with high mortality. Screening tools based on risk factors are needed to decide which patients with RA should be screened for ILD using high-resolution computed tomography (HRCT). The ANCHOR-RA study is a multi-national cross-sectional study that will develop a multivariable model for prediction of RA-ILD, which can be used to inform screening for RA-ILD in clinical practice.MethodsInvestigators will enrol consecutive patients with RA who have ≥ 2 of the following risk factors for RA-ILD: male; current or previous smoker; age ≥ 60 years at RA diagnosis; high-positive rheumatoid factor and/or anti-cyclic citrullinated peptide (titre > 3 x upper limit of normal); presence or history of certain extra-articular manifestations of RA (vasculitis, Felty’s syndrome, secondary Sjögren’s syndrome, cutaneous rheumatoid nodules, serositis, and/or scleritis/uveitis); high RA disease activity in the prior 12 months. Patients previously identified as having ILD, or who have had a CT scan in the prior 2 years, will not be eligible. Participants will undergo an HRCT scan at their local site, which will be assessed centrally by two expert radiologists. Data will be collected prospectively on demographic and RA-related characteristics, patient-reported outcomes, comorbidities and pulmonary function. The primary outcomes will be the development of a probability score for RA-ILD, based on a multivariable model incorporating potential risk factors commonly assessed in clinical practice, and an estimate of the prevalence of RA-ILD in the study population. It is planned that 1200 participants will be enrolled at approximately 30 sites in the USA, UK, Germany, France, Italy, Spain.DiscussionData from the ANCHOR-RA study will add to the body of evidence to support recommendations for screening for RA-ILD to improve detection of this important complication of RA and enable early intervention.Trial registrationclinicaltrials.gov NCT05855109 (submission date: 3 May 2023).

Radiological Evaluation of Middle Cranial Fossa Dura in Patients with Unilateral Cholesteatoma.

Cholesteatoma is a common disease of the middle ear cleft associated with several complications, Surgery is the mainstay for the management of such a pathological condition, however, complications may occur including intracranial ones due to violation of middle cranial fossa dura. Anatomical variations have been reported and High-resolution CT scan is the major tool for detecting such variations. In this study, we aim to determine if there is a difference between tegmen height between both sides of patients with unilateral cholesteatoma. 21 patients were recruited for such study all underwent HRCT and the tegmen height was determined in two coronal planes, the first between the central point of the Henle spine and the tegmen, the other between the plane of both lateral canals and the roof of the middle ear. The tegmen height measurements showed that the affected side had significantly lower tegmen height Henle spine (6.30 ± 1.54 vs. 9.03 ± 1.34 (mm); p < 0.001) relative to the healthy side. Also, coronal plane measurement has shown statistical significance for tegmen height (2.98 ± 0.79 vs. 4.15 ± 0.76 (mm); p = 0.01) in comparison to the healthy side. The percentage of difference between both sides as regards tegmen height of Henle's spine and coronal measurement was 30.32% and 28.2%, respectively. A significant difference was found in tegmen height between healthy and diseased sides in patients with unilateral cholesteatoma.

Simulated Injuries of the Sheep Ossicular Chain: Correlations With Their Radiological Images.

Hypothesis We hypothesized that a sheep temporal bone would be a suitable model to study correlations between simulated middle ear injuries and their radiological appearances. Simulated ossicular chain injuries correlate well with their radiological images, and post-processing techniques provide optimal visualization of the sheep ossicles. Background The subtle ossicular trauma may be difficult to assess due to the small size of the structures. The precise radiological and clinical correlations of the ossicular injuries are not well documented. Methods The most common traumatic ossicular chain injuries were systematically simulated in the sheep temporal bone model. The images of the temporal bones were obtained with a high-resolution computed tomography scanner. The values of the dislocations were measured from the obtained images as well as in the temporal bones using calipers. Two observers independently evaluated the fine structures of the auditory ossicles using oblique multiplanar reconstructions (MPRs) and maximum intensity projections (MIPs). All segments of the facial nerve were also visualized. Results Optimal visualization planes of the sheep's middle ear joints have been obtained. The coincidence of simulated ossicular injuries in the specimens and MIPs was 40%. All structures of the ossicular chain were clearly distinguished except for the stapes footplate. Evaluation of the traumatic changes of the incudostapedial joint was challenging. Conclusions The sheep temporal bone is a suitable model for studying the correlations between pathological alterations in the ossicular chain and their radiological appearances. The post-processing MIP technique provides a more accurate and easier diagnosis of traumatic ossicular chain injuries than MPRs alone.

Effects of process parameters and geometry on dimensional accuracy and surface quality of thin strut heart valve frames manufactured by laser powder bed fusion

Laser powder bed fusion (LPBF) is one of the most popular metal additive manufacturing technologies, which has found its applications in high-value sectors such as aerospace and biomedical devices. Some recent studies on the LPBF of stents have demonstrated its feasibility in the fabrication in thin strut structures including heart valve frames, as used in transcatheter aortic valve implantation (TAVI) for the treatment of severe aortic stenosis. The state of the art method of laser cutting TAVI frame limits the scope for novel concepts which are made possible by additive manufacturing. However, the surface quality and dimensional accuracy of LPBF parts are lower than that produced by laser cutting. To start the development of new TAVI concepts, the feasibility of manufacturing thin frames by LPBF has been investigated based on the SAPIEN 3 frame by Edwards Lifesciences. In this study, simplified frames with strut size from 0.3 to 0.5 mm have been successfully manufactured. The effects of strut size, strut angle, laser power and scan speed on the dimensional accuracy and surface quality were systemically studied. In addition, a representative SAPIEN 3 frame was manufactured and assessed with high-resolution X-ray CT scans. Good overall dimensional accuracy and low porosity were obtained for the SAPIEN 3 frame. However, inclined struts were found to have relatively low dimensional accuracy and poor surface quality.

Non-Cystic Fibrosis-Related Bronchiectasis in Children: Are Bacteria Always to Blame?

Background: Bronchiectasis isa structural alteration characterized by the dilation of bronchial walls due to inflammation, resulting in a loss of elasticity and muscle function. They are more common in adults than children and have various etiologies (such as chronic infections, particularly in developing countries, or immunodeficiencies in industrialized nations), with up to 40% being idiopathic. Case presentation: We reported the case of a nine-year-old child who, following two lower respiratory tract infections (a severe H1N1 influenza pneumonia and a milder episode caused by M. pneumoniae), developed bronchiectasis without underlying predisposing conditions. Discussion: Bronchiectasis is a morphological alteration of the bronchi, which can develop subsequently to lung infections and may remain clinically silent even for a long time. The most common associated symptoms include productive cough, persistent rales, therapy-resistant “asthma,” and recurrent lung infections. High-Resolution CT (HRCT) scans are the gold standard for their diagnosis, while their management requires a comprehensive approach, including pharmacological and psychosocial measures. It is always advisable to investigate the underlying etiology to eventually establish a causal treatment. Conclusion: This study aims to emphasize that not only bacteria but also viral infections and their associated inflammatory impact on lung tissue can contribute to the development of bronchiectasis. This study aims to implement current knowledge regarding non-cystic fibrosis-related bronchiectasis and to underscore the significance of post-acute instrumental reassessment in lower respiratory tract infections, especially when severe.

Clinical application of high-resolution spiral CT scanning in the diagnosis of auriculotemporal and ossicle

Precision and intelligence in evaluating the complexities of middle ear structures are required to diagnose auriculotemporal and ossicle-related diseases within otolaryngology. Due to the complexity of the anatomical details and the varied etiologies of illnesses such as trauma, chronic otitis media, and congenital anomalies, traditional diagnostic procedures may not yield accurate diagnoses. This research intends to enhance the diagnosis of diseases of the auriculotemporal region and ossicles by combining High-Resolution Spiral Computed Tomography (HRSCT) scanning with Deep Learning Techniques (DLT). This study employs a deep learning method, Convolutional Neural Network-UNet (CNN-UNet), to extract sub-pixel information from medical photos. This method equips doctors and researchers with cutting-edge resources, leading to groundbreaking discoveries and better patient healthcare. The research effort is the interaction between the CNN-UNet model and high-resolution Computed Tomography (CT) scans, automating activities including ossicle segmentation, fracture detection, and disruption cause classification, accelerating the diagnostic process and increasing clinical decision-making. The suggested HRSCT-DLT model represents the integration of high-resolution spiral CT scans with the CNN-UNet model, which has been fine-tuned to address the nuances of auriculotemporal and ossicular diseases. This novel combination improves diagnostic efficiency and our overall understanding of these intricate diseases. The results of this study highlight the promise of combining high-resolution CT scanning with the CNN-UNet model in otolaryngology, paving the way for more accurate diagnosis and more individualized treatment plans for patients experiencing auriculotemporal and ossicle-related disruptions.

Review of High-Resolution Computed Tomography Chest Incidental Findings in COVID and Post-COVID Era in PIMS Hospital Islamabad

Objective: To scrutinize the frequency of alternative pulmonary infectious diseases, and incidental findings ofthe High resolution CT scan chest in COVID-19 screening trials during peak and late COVID era.Study Design: A cross-sectional study.Place and Duration of Study: The study was carried out at the Department of Radiology, Pakistan Institute ofMedical Sciences (PIMS), Islamabad, Pakistan from June 2021 to June 2022.Methods: High-resolution computed tomography (HRCT) scan chest reports of 191 patients were analyzedfrom the Peak COVID period from May 2020 to May 2021 and 191 reports of patients in the late COVID periodfrom June 2021 to June 2022. Reports were evaluated for any alternative disease process or incidental findings,further classified according to their clinical significance.Results: Incidental findings were seen in 60% of scans in the Peak period of SARS-CoV-2 infection and 75% in the late COVID era. The mean age group of patients in the peak period was 50.76 years and in the late COVID period was 56.65 years, with significant male predominance (76%) in the peak period. Around 30.5% and 56.7% of “major" incidental findings in each peak and late COVID period were recorded, respectively, with Pulmonarynodule being the most frequent incidental finding in the peak period and Tuberculosis often repeatedlyencountered incidental finding in the late COVID period.Conclusion: Incidental findings appear in more than half of the High-resolution CT chest scans in suspectedCOVID-19 patients, with a substantial number requiring further workup. How to cite this: Shahid S, Isani A, Abbasi HW, Rizvi A, Mubarik HH. Review of High-Resolution Computed Tomography Chest Incidental Findings in COVID and Past COVID Era. Life and Science. 2024; 5(2): 237-243. doi: http://doi.org/10.37185/LnS.1.1.417

UNSUPERVISED AIRWAY TREE CLUSTERING WITH DEEP LEARNING: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) LUNG STUDY.

High-resolution full lung CT scans now enable the detailed segmentation of airway trees up to the 6th branching generation. The airway binary masks display very complex tree structures that may encode biological information relevant to disease risk and yet remain challenging to exploit via traditional methods such as meshing or skeletonization. Recent clinical studies suggest that some variations in shape patterns and caliber of the human airway tree are highly associated with adverse health outcomes, including all-cause mortality and incident COPD. However, quantitative characterization of variations observed on CT segmented airway tree remain incomplete, as does our understanding of the clinical and developmental implications of such. In this work, we present an unsupervised deep-learning pipeline for feature extraction and clustering of human airway trees, learned directly from projections of 3D airway segmentations. We identify four reproducible and clinically distinct airway sub-types in the MESA Lung CT cohort.