Multidetector Computed Tomography Research Articles

Age estimation based on sternebral fusion in a sample of Egyptian population using three-dimensional computed tomography scanning

ObjectivesAge estimation is a critical medico-legal issue in forensic medicine and sternebral fusion is recently supposed to be a helpful tool. Multidetector computed tomography (MDCT) scanning could provide three-dimensional (3D) imaging of the sternebral fusion. This study aimed to develop age estimation models based on the sternebral fusion state using MDCT scanning in a sample of Egyptians. Material and MethodsThe study included thoracic MDCT images of 261 Egyptians. The stage of sternebral fusion was evaluated in the 3D reconstructed images generated using Vitrea® software. Fusion between sternebrae 1&2, sternebrae 2&3, and sternebrae 3&4 were staged as non-fusion, partial fusion, and complete fusion. Scores 1, 2, and 3 were given to the three stages, respectively and their sum was the total sternebral fusion score. ResultsSignificant positive correlations were observed between all sternebral fusions and the participants’ chronological age. Stages of sternebral fusion significantly contributed to age estimation using simple and multiple linear regression models (P < 0.001 for each). Using calibration curves, the total sternebral fusion score and the multivariate models had the best performance to predict the chronological age. At cut-off > 6, total sternebral fusion score was an excellent predictor for the age of 18 with areas under the curve = 0.943 and 0.952, in females and males respectively. ConclusionThe developed models based on sternebral fusion stages can be used for forensic age estimation in the studied Egyptian sample. A total sternebral fusion score > 6 efficiently distinguished those aged 18 years.

Visualization of anatomical structures in the carpal region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography

IntroductionIn the diagnostics of orthopedic diseases in the horse, diagnostic imaging often plays a decisive role. Cone beam computed tomography (CBCT) imaging is used in both human and small animal medicine and becoming increasingly popular. To see whether CBCT imaging can be useful in the diagnosis of orthopedic diseases of the carpal region of the horse and to explore possible limitations we compared CBCT images with multidetector computed tomography (MDCT) images of the carpal region of equine cadaveric specimens.Materials and methodsTwenty-eight forelimbs from fifteen horses, slaughtered for reasons unrelated to this study, were examined. Native and contrast enhanced CBCT and MDCT scans were performed. Anatomical structures were blindly evaluated by three independent experienced observers using a visual scoring system previously reported and adapted to the equine carpal region. A descriptive evaluation was carried out as well as Spearman’s rank correlation and interobserver agreement was shown by percent agreement (PA).ResultsVisualization of osseous structures was excellent in both MDCT and CBCT. Articular cartilage could only be assessed in contrast enhanced scans whereby MDCT showed a slightly better visualization than CBCT. Soft tissue structures were generally difficult to assess. An exception were the medial and lateral palmar intercarpal ligament, which could not be visualized in native but were well visualized in contrast enhanced scans in both MDCT and CBCT images.Discussion/conclusionFor the evaluation of osseous structures and some intraarticular ligaments after contrast enhancement, CBCT serves as a reliable diagnostic imaging modality for the equine carpal region. However, soft tissue structures and cartilage are imaged more reliably using MDCT.

Spondylodiscitis of the thoraco-lumbar spine: diagnostic performance of dual-energy CT vs MRI.

Dual-energy computed tomography (DECT) could combine the high-resolution bone window images made available by multi-detector CT technology with its capability to identify bone marrow edema (BME) in the spine, for diagnosing spondylodiscitis. Our objective was to compare the diagnostic performance of contrast-enhanced MRI and non-contrast DECT to identify spondylodiscitis of the thoraco-lumbar spine. This prospective study included 77 consecutive participants (39 males; mean age of 61) who underwent DECT and MRI (within 7 days) between January 2020 and October 2023. DECT data were post-processed on a dedicated offline workstation (SyngoVia® VB20) by using a three-material decomposition algorithm. Four radiologists, blinded to clinical data, evaluated non-contrast DECT and contrast-enhanced MRI images. The diagnosis of spondylodiscitis was based on vertebral edema, disc edema, endplate erosions, and paraspinal involvement. Diagnostic accuracy values were calculated by using biopsy as a standard of reference. A multi-reader multi-case analysis was performed. Biopsy revealed a diagnosis of spondylodiscitis in 46 patients (60%). Thoracic and lumbar spondylodiscitis were diagnosed in 37/46 (80%) and 9/46 (20%) patients, respectively. DECT and MRI overall sensitivity, specificity, and AUC were 0.91, 0.89, and 0.90, and 0.94, 0.93, and 0.93, respectively. At lumbar and thoracic levels, the difference between AUC values between DECT and MRI was not significant (p = 0.15). For DECT and MRI, a very good inter-reader agreement was achieved (k = 0.90 and k = 0.97, respectively). Contrast-enhanced MRI represents the most accurate imaging tool for the diagnosis of spondylodiscitis. However, only a non-significant drop in diagnostic performance was achieved by evaluating non-contrast DECT images. Question To compare the diagnostic performance of contrast-enhanced MRI and non-contrast DECT for identifying spondylodiscitis of the thoraco-lumbar spine. Findings MRI was not significantly superior compared to DECT in diagnosing spondylodiscitis, whereas the inter-reader agreement was near perfect for both MRI and DECT. Clinical relevance DECT represents a fast and accurate imaging tool for the demonstration of BME, erosions, and peri-vertebral inflammation in thoraco-lumbar spondylodiscitis.

Clinical Feasibility of 5.0 T MRI/MRCP in Characterizing Pancreatic Cystic Lesions: Comparison with 3.0 T and MDCT.

Objectives: To assess the feasibility of 5.0 T magnetic resonance imaging (MRI) in characterizing pancreatic cystic lesions (PCLs), compared with 3.0 T MRI and multidetector computed tomography (MDCT). Methods: Thirty-five patients with PCLs underwent 5.0 T MR alongside 3.0 T MR or MDCT. Two observers measured subjective and objective image quality scores. The consistency of two observers between 5.0 T and 3.0 T was calculated by intraclass correlation coefficients. The characteristics of PCLs and their specific diagnosis, as well as benignity/malignancy, were evaluated across MDCT, 3.0 T, and 5.0 T MRI. Results: The 5.0 T MR demonstrated significantly higher subjective image quality and SNR on T1WI compared to that in 3.0 T MR (p < 0.05). The 5.0 T MRI identified more cyst lesions than the 3.0 T MRI (40 and 32) and MDCT (82 and 56). The sensitivity, specificity, and accuracy for differentiating benign from malignant lesions with 5.0 T MRI (75%, 100%, and 91.4%, respectively) surpassed those of 3.0 T MRI and MDCT. The accuracy of the specific diagnosis of PCLs at 5.0 T MRI (80%) was superior to 3.0 T MRI and MDCT. Conclusions: 5.0 T MRI exhibits certain superiority in delineating details of PCLs and in clinical diagnostic accuracy, outperforming MDCT and 3.0 T MRI while maintaining sufficient image quality.

Forensic age estimation in adults based on multidetector computed tomography analysis of bone density in the medial meta-epiphyseal region of clavicle.

The aim of this study was to investigate the potential of using multidetector computed tomography (MDCT) to measure the bone mineral density (BMD) in the medial meta-epiphyseal region of clavicle (MERC) for adult age estimation. A total of 1064 chest MDCT scans from individuals aged 21 to 102years were utilized to determine the MERC BMD. The Mimics software was used for the BMD measurements, and the average BMD of both MERC was also calculated. Regression analysis was conducted with chronological age as a dependent variable and MERC BMD as an independent variable to establish a mathematical model for age estimation. The mean absolute error (MAE) was calculated to evaluate the accuracy of the regression model using an independent validation sample. Among all the models, the cubic regression model showed the highest correlation between MERC BMD and chronological age and also provided the most accurate age prediction for both males and females (MAE = 9.41 for males, MAE = 10.38 for females). Our study suggests that BMD measured by MERC can be utilized for age estimation in adults when more reliable indicators are not available.

IDENTIFICATION OF THE AETIOLOGY OF GASTROINTESTINAL PERFORATION: CLINICAL AND MDCT CLUES

A common medical emergency that has a high fatality rate between 30 and 50 % is perforation of the gastrointestinal tract (GIT). Oesophageal perforations can cause rapid chest pain, odynophagia, and vomiting gastroduodenal perforations can cause acute, severe abdominal pain and colonic perforations typically advance more slowly, resulting in localized abscesses or secondary bacterial peritonitis. Sepsis, an abscess that resembles an abdominal mass, or delayed symptoms are among the subsets of people who may present. Ancillary findings may indicate underlying problems that require more examination after initial closure of the ruptured bowel, while direct multidetector computed tomography (MDCT) findings confirm the diagnosis and localize the perforation site. Findings from MDCT scans include extraluminal gas, gut wall thickening, apparent discontinuity in the intestinal wall, extraluminal contrast, aberrant mural enhancement, localized fat stranding and/or free fluid, and localized abscess or phlegmon in confined perforations. In order to highlight the MDCT and clinical signs suggestive of the underlying aetiology and localization of the perforated site, this paper will examine the range of MDCT results found in GIT perforation. I. KEY POINTS Extraluminal gas, wall discontinuity or thickness, and fat stranding are signs of a GIT perforation. There is a spectrum of abundance to absence in pneumoperitoneum and extraluminal oral contrast. Additional observations include masses, faecal impaction, ischemia, foreign substances, and excessive wall thickening. The presence of a ruptured peptic ulcer suggests supramesocolic pneumoperitoneum and hyperenhancing gastric wall. Iatrogenic perforation is indicated by ascites and/or persistent or growing free air after surgery.

Empiric embolization by vasospasm therapy for acute lower gastrointestinal bleeding: a preliminary report

To report the preliminary result of empiric embolization for angiographycally-negative lower gastrointestinal bleeding (LGIB) by using the pharmaco-induced vasospasm technique with or without the adjunctive use of intra-arterial multi-detector computed tomography (MDCT). 23 LGIB patients with positive MDCT findings but negative angiographic results underwent empiric pharmaco-induced vasospasm therapy. The presumed bleeding artery was semi-selectively catheterized, and a segment of bowel was temporarily spasmed with bolus injection of epinephrine and immediately followed by 4-h’ vasopressin infusion. The rebleeding, primary and overall clinical success rates were reported. MDCT showed 19 bleeders in the SMA territory and 4 bleeders in the IMA territory. Early rebleeding was found in 6 patients (26.1%): 2 local rebleeding, 3 from new-foci bleeding and 1 uncertain. Of the 10 small bowel bleeding patients, only 1 out of the 7 who underwent intra-arterial MDCT showed rebleeding, whereas 2 out of the 3 without intra-arterial MDCT rebled. No patients exhibited procedure-related major complications, including bowel ischemia and cardiopulmonary distress. The overall clinical success rate was 91.3% (21/23) with a 30-day mortality rate of 26.1% (2 of the 6 patients had early rebleeding). Empiric pharmaco-induced vasospasm therapy, when localized with/without adjunctive intra-arterial MDCT, seems to be a safe and effective method to treat angiographically-negative LGIB patients.

Elucidating the mechanism of rapid functional recovery following atrial fibrillation ablation in patients with left ventricular systolic dysfunction

Abstract Introduction Successful sinus rhythm restoration by catheter ablation (CA) of atrial fibrillation (AF) rapidly improves cardiac function in patients with left ventricular (LV) systolic dysfunction. However, the underlying mechanism of this recovery remains unknown. Purpose To elucidate the mechanism of the functional recovery after CA of AF and systolic dysfunction. Methods We retrospectively examined 4001 consecutive patients who underwent first-time CA of AF between 2012 and 2021 at our institution. Of them, 505 patients had baseline LV ejection fraction (LVEF) of &amp;lt;50%. Among them, we enrolled 454 patients who received electrocardiogram-gated contrast-enhanced 256-slice multi-detector computed tomography (MDCT) (Brilliance iCT, Philips Medical Systems, Cleveland, Ohio) both at baseline and 3 months after CA. Changes in LV measures, wall thickness, and LV mass were examined based on MDCT data. Results A reduction of LV end-systolic volume (LVESV) (from 71 ± 37 ml to 46 ± 34 ml, p &amp;lt;0.001) and improvement of LVEF (from 39 ± 9% to 62 ± 14%, p &amp;lt;0.001) were observed after CA. However, there was no significant change in LV end-diastolic volume (LVEDV) (from 118 ± 49 ml to 116 ± 46 ml, p = 0.13). Mean wall thickness during diastole did not change (from 7.1 ± 1.4 mm to 7.1 ± 1.4 mm, p = 0.94), either. However, wall thickness during systole significantly changed after CA (from 10.0 ± 1.7 mm to 12.7 ± 2.8 mm, p &amp;lt;0.001). As a result, there was no significant change in LV mass after CA (from 84.3 ± 28.7 g to 84.4 ± 28.1 g, p = 0.88). A regression analysis revealed a significant inverse correlation between the delta LVEF and delta LVESV (r = -0.59, p &amp;lt;0.001). However, the delta LVEF was not correlated with the delta LVEDV and delta LV mass. Conclusions The rapid improvement of LVEF after CA of AF was attributed to a decrease in the LVESV. Unchanged LV mass indicated that this functional recovery was solely a mechanical issue, without evidence of myocyte regression.

Impact of waist circumference and abdominal fat distribution on coronary artery disease severity stratified by computed tomography-derived SYNTAX score

Abstract Background Waist circumference (WC) is the most convenient anthropometric measure of obesity. Recently, abdominal fat distribution (AFD) has been identified as a more important risk factor for coronary artery disease (CAD) than the absolute amount of adipose tissue. However, studies examining the impact of body composition indicators (BCIs) on CAD severity are lacking. The computed tomography (CT)-derived SYNTAX score (CT-SXscore) is a feasible method for grading CAD severity based on coronary CT angiography (CTA) findings. Purpose This study was aimed to evaluate the association between BCI and CAD severity using the CT-SXscore. Methods We enrolled consecutive patients with suspected CAD who underwent CTA using a 320-row multidetector CT scanner between October 2014 and March 2020. Plain abdominal CT was also performed at the umbilical level to measure the visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas. The total adipose tissue (TAT) area was calculated as the sum of VAT and SAT. To assess the AFD, the VAT/SAT (V/S) ratios were also calculated as the VAT area divided by the SAT area in each case. WC was measured by tracing the body contour at the umbilical level in CT images. The severity of coronary artery stenosis was assessed using CTA. Significant stenosis was defined as a stenosis diameter of ≥50%. The CT-SXscore was calculated in patients with more than one significant stenoses. Each stenotic lesion was evaluated to calculate the CT-SXscore in the same manner as the invasive coronary angiography assessment. We assessed the effects of BCI [i.e., WC, body mass index (BMI), each adipose tissue area, and V/S ratios] on the CT-SXscores. Results 308 eligible patients (mean age, 70.9 ± 10.6 years; 69.5% males) were evaluated. The median values of WC, BMI, TAT, SAT, VAT, and V/S ratio were 84.8 cm, 23.6 kg/m2, 198.2 cm2, 111.8 cm2, 81.0 cm2, and 0.67, respectively. Although WC showed a significant correlation with BMI, TAT, SAT, and VAT area, no correlation was observed between WC and V/S ratio (Figure1). The CT-SXscore showed no association with WC, BMI, and TAT area; however, it exhibited a weak negative correlation with the SAT area and a weak positive correlation with the VAT area. Additionally, a strong correlation was observed between the CT-SXscore and V/S ratio. In the multivariate regression analysis, WC, BMI, TAT, SAT, and VAT were no longer associated with the CT-SXscore after adjusting for traditional coronary risk factors, whereas the V/S ratio remained as the only independent predictor of CAD severity based on the CT-SXscore (Figure2). Conclusions WC was strongly correlated with other BCIs, except for the V/S ratio; however, it could not be identified as a predictive factor of CAD severity. Among the BCIs, only the V/S ratio was an independent predictor of CAD severity, indicating that the AFD revealed by the V/S ratio may be a more important risk factor for progression of CAD than other BCIs.Figure1Figure2

CCTA and CTP imaging for detecting clinically suspected in-stent restenosis: a meta-analysis

Abstract Background The evaluation of coronary artery stents via Coronary Computed Tomography Angiography (CCTA) can be compromised by artefacts, potentially undermining its diagnostic accuracy. The integration of CT Perfusion (CTP) with CCTA (CCTA+CTP) has been proposed to enhance the diagnostic yield in detecting in-stent restenosis (ISR). Purpose This meta-analysis aims to assess the diagnostic performance of CCTA and combined CCTA+CTP in detecting ISR. Methods A comprehensive literature search of studies from 2005 to 2022 identified 13,747 articles. Inclusion criteria comprised the utilization of multidetector CT scanners with ≥64 slices and invasive coronary angiography as the reference standard. Studies that systematically evaluated stent patency in asymptomatic patients as part of their protocol were excluded. Results After removing duplicates, screening titles and abstracts, and conducting full-text reviews, 20 studies met the inclusion criteria (17 CCTA, 3 CCTA+CTP). Data on 2,674 CCTA-assessed stents and 752 CCTA+CTP-assessed stents were analyzed. The meta-analysis revealed that CCTA alone achieved a sensitivity of 90% (95% CI; 84-94%) and a specificity of 89% (95% CI; 86-92%)(Figure 1). CCTA+CTP exhibited comparable diagnostic performance, with a per-stent sensitivity of 88% (95% CI; 80-94%) and a specificity of 88% (95% CI; 84-93%) (Figure 2). The summary Receiver Operating Characteristic (sROC) Area Under the Curve (AUC) was 0.96 (95% CI; 0.94-0.97) for CCTA and 0.96 (95% CI; 0.89-1.00) for CCTA+CTP, indicating a high overall performance for both diagnostic modalities. Conclusion Utilizing contemporary imaging hardware, both CCTA and CCTA+CTP demonstrate high diagnostic performance in evaluating ISR. The findings suggest that the presence of coronary artery stents should not preclude the use of these non-invasive diagnostic tests in clinical practice.Figure 1Figure 2

Analysis of imaging features and clinical manifestations in children with congenital rib deformities: a retrospective study

BackgroundCongenital rib deformity is a common thoracic deformity that has a potentially far-reaching impact on the growth and lung function development of young children. Early diagnosis and accurate assessment of congenital rib deformity is of great importance. This study was to retrospectively analyze the number, location, and types of deformities, imaging features as well as clinical symptoms of children with congenital rib deformities.MethodsChildren who were diagnosed with congenital rib deformities between October 2019 and October 2021 in our hospital were included in this study. The rib deformities were analyzed according to the imaging results of chest X-ray and 3D volume rendering multidetector computed tomography (MDCT). The data were analyzed using SPSS 22.0.ResultsA total of 472 male and 186 female children with rib deformities were detected in this study, with a male to female ratio of approximately 2.54:1. Of the deformed ribs, 417 (63.4%) were located on the right side, usually single and unilateral. The most common type of the detected rib deformity were bifid ribs (95.14%). Rib deformity was most common in the fourth rib (46.62%). The majority (76.16%, n = 428) of rib deformities were incidental findings and asymptomatic.ConclusionsCongenital rib deformities in pediatric patients included in our hospital were more frequently observed in males than females, more frequently detected on the right than on the left side. The most common type of rib deformity is the bifid rib. MDCT examination are of great value in the diagnosis of rib deformity and can help guide clinical treatment.

Comparative Assessment of Aortic Annulus Diameters between 3D Transesophageal Echocardiography and Cardiac MDCT in Patient with Sclerocalcific Aortic Stenosis

Comparative Assessment of Aortic Annulus Diameters between 3D Transesophageal Echocardiography and Cardiac MDCT in Patient with Sclerocalcific Aortic Stenosis

Cone-beam CT volumetry: a new method for evaluating osteotomy healing - a clinical evaluation and MDCT comparison.

Fracture healing complications remain a major problem in trauma monitoring. An open wedge osteotomy of the distal radius provides a unique way of evaluating fracture healing. Since the introduction of cone-beam computed tomography (CBCT) at our institution, it has become the method of choice for assessing hand and wrist bones. To date, CT volumetry has been validated for multidetector CT (MDCT) but not for CBCT. To assess osteotomy healing using CBCT volumetry and to evaluate two different segmentation techniques. A total of 36 patients were surgically treated for malunited distal radius fractures with open-wedge osteotomy either leaving the void empty (open wedge empty [OWE]) or filled with bone graft substitutes (BGS). They were scanned using CBCT and MDCT postoperatively and after 3, 6, and 12 months. Segmentation was performed both manually and semi-automatically for volumetric measurement. Inter- and intra-observer reliability were assessed using intraclass correlation (ICC). The median osteotomy volume in the OWE group postoperatively was 0.87 cm3 (range=0.42-2.72). At 3 months, all but one of the OWE volumes had diminished to half or less of their initial volume. In the BGS group, the median postoperative volume was 1.30 cm3 (range=0.73-1.81) and at 12 months, 76% of the initial volume remained. Reliability between CBCT and MDCT volumetry expressed as ICC was ≥0.96. ICC for the two segmentation techniques was ≥0.99 and ICC for inter-observer reliability ≥0.97. CBCT volumetry is a reliable tool and comparable to MDCT to quantify bone healing of an osteotomy.

Puffed-Cheek CT Improved Evaluation of Buccal Mucosal Neoplasm in Contest to Conventional CT Scan

Background: Oral cancer is a frequent cancer in our country, most people are affected by this cancer are older age. Accurate evaluation of this cancer difficult due to close proximity of bones and soft tissue. So for improve diagnostic accuracy Puffed cheek maneuver should be used with traditional Multidetector Computed Tomography (MDCT).Objective: To determine the improved diagnostic accuracy of Puffed cheek Computed Tomography (PCCT) in evaluation of buccal mucosa tumors in contest to non puffed cheek Computed Tomography.Materials and Methods: This descriptive cross sectional study was carried out in Radiology and Imaging department of Khwaja Yunus Ali Medical College and Hospital from 2022(January) to 2023(July). Cases were referred from different department. After meeting the inclusion criteria patients were subjected for CT scan. Imaging was performed from paranasal sinus and neck region with axial sections from pituitary fossa to arch of aorta, after injection of intravenous iodinated contrast media, multiplanar sagittal, coronal reformation images were obtained. Puffed cheek manoeuvre was performed to separate gingival and oral buccal mucosa in all the cases for improved detailed evaluation. The CT result were then compared with non puffed cheek scans results. Results: Among 30 patients 7 cases were missed by conventional CT scan, thirteen patients showed a mass in the oral cavity that were inseparable from 2 mucosal surfaces. Puffed-cheek images clearly showed the mass and surface of tumor involvement. Other 10 patients in conventional CT showed mass in the margins of tongue, oral cavity but extension and infiltration of surrounding structures by the lesion could not be well delineated, puffed-cheek images clearly showed the specific location, extension, adjacent muscles and other structures infiltration. Conclusion: Puffed cheek CT gives better performance to diagnosis the small buccal mucosal tumors, any irregularity, thickening, more detailing of mucosal surface of oral cavity than conventional CT scan, so can helps in choosing the management &amp; surgical approach also. KYAMC Journal Volume: 15, No: 01, April 2024: 29-32.

Diagnostic Performance of Computed Tomography in Laryngeal Carcinoma and its Extension

Background: Laryngeal carcinoma is a common malignant neoplasm of the head and neck with high incidence of new malignancies worldwide every year. Several imaging techniques including magnetic resonance imaging (MRI) and computed tomography (CT) scans are widely used to detect laryngeal carcinoma. Of them, CT scan is relatively cheaper, easily available and sensitive in the evaluation of laryngeal carcinoma. Objective: To find out the diagnostic performance of CT scan in laryngeal carcinoma and its extensions. Methodology: This cross-sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical CollegeHospital, Dhaka, during the period of July, 2016 to June, 2018 for a period of 2(two) years. A total of 50 samples were included purposively. The enrolled patients were attending outpatient department (OPD) or admitted in indoor and referred to the Radiology and Imaging department for CT scan. All the enrolled cases had laryngectomy and resected tissues were sent for histopathological examination. Data collection was done by the principal investigator and a preformed questionnaire was used during data collection. Following completion of data collection, it was analyzed by SPSS 20.0. Results: Age range of the patients was from 18 to 84 years, with the mean age of 61.2 years + 13.4 years standard deviation and a male-female ratio of about 7.3:1. By multidetector CT scan, majority (32, 64.00%) of the tumours were found confined in a specific area with no extension, followed by 12 (24.00%) involving both supraglottic and glottic region. On the other hand, by histopathology, almost all (47, 94.00%) of the cases were found malignant and majority of the malignant cases (31, 65.96%) were found without nodal metastasis. Validity tests of CT in the diagnosis of laryngeal carcinoma revealed sensitivity, specificity, accuracy and positive predictive values of 97.9%, 66.7%, 96% and 97.9% respectively. In case of nodal metastases, the sensitivity, specificity, accuracy and positive predictive value were 93.8%, 97%, 96% and 93.8% respectively. Conclusion: Contrast enhanced CT scan has good role in detecting nodal metastases, but had complementary role in detecting laryngeal carcinoma. Journal of Monno Medical College December, 2023; 9 (2): 63-67

Anthropological and forensic significance of facial soft tissue thickness in Montenegrin population

A lack of soft tissue leads to difficulties in facial reconstruction and further identification in the absence of DNA (deoxyribonucleic acid), finger print and dental data. If these data are not available, then identification based on facial soft tissue thickness (FSTT) is the next reliable method. There is no data in the literature about facial soft tissue thickness in Montenegrin population. Once the measurement is performed, a software algorithm based on the multidetector computerized tomography (MDCT) imaged bone structures and use of FSTT would be able to provide a useful picture of the face for identification purposes. This prospective research was performed by MDCT head examinations of 83 adults aged 18–85, living in Montenegro. The FSTT was measured at eight central points (glabella (GL), nasion (NA), rhinion (RHI), mid-philtrum (MID), upper lip (UL), lower lip (LL), mental eminence (ME), and the point beneath the chin (BC)), and five bilateral points (frontal tubers (FT), supraorbital (SO), external orbital marginal point (EX), zygomatic arch (ZY), and middle masseter (MST)). It was observed that the points RHI, MID, UL, LL, ME, FT, SO and MST are thicker in men compared to women. With an increase in BMI, FSTT in the central points also increases, as well as bilaterally at the ZY, FT, SO and MST points. With aging, there is an increase of the thickness of the FSTT at the RHI and bilaterally at the EX and ZY, while at the MID, LL and MST, the thickness decreases with aging, in both sexes.

Role of Multi-Detector Computed Tomography in Evaluating Traumatic Brain Injuries in Taif City, Kingdom of Saudi Arabia

Background: Traumatic brain injury (TBI) represents a major percentage of admissions to hospital due to frequent trauma to this region and is considered a life-threatening situation because of that, MDCT is necessary to provide rapid diagnosis and best management that leads to successful treatment. Multi-detector Computed Tomography (MDCT) has a critical and significant rule for early evaluation and patient triage. Aim: This study aimed to evaluate the findings that occur due to head injuries using MDCT. Material and Method: An analytical retrospective study of 200 patients with head injuries were examined by CT, the study extended from January 2024 to September 2024. 128 slice CT systems (Siemens Medical system) were applied to investigate patients with head trauma at King Abdul-Aziz Specialist Hospital (KAASH )in Ta'if City, Saudi Arabia. Results: A total of 200 head trauma 136 (68%) males and 64(32%) females, were examined via head CT and presented with various types of trauma. The findings have noticed that brain injuries were significantly higher in the male population (68%) than in the female population (32%). Based on age groups, the incidence percentage of TBI was 34%, occurring in the age group 18-27 years. The most common cause of injury in patients presenting with head trauma was road traffic accidents, comprising 63% of cases. The isolated skull fracture was most frequently seen 35% of cases. Our study reveals that Subdural hematoma (52%) was the most frequent lesion noted in traumatic patients. Conclusion: Non-enhanced computed tomography( NECT) is considered the gold standard and the most informative diagnostic modality in the evaluation of Traumatic brain injuries and it is essentially to triage patients to observation, surgical, or medical management.

Pixel to Pathology: A Prospective Cross-Sectional Study on the Role of Multidetector Computed Tomography in the Evaluation of Malignant Large Bowel Lesions With Histopathological Correlation.

Colorectal lesions can present as a mass or as focal or diffuse thickening of the colon wall and may also be associated with abnormalities in the perienteric region. Multidetector computed tomography (MDCT) enables simultaneous imaging of both extracolonic structures and the gut wall. It is instrumental in assessing tumor extent, detecting pericolic dissemination, including lymph node involvement, and identifying metastases. This study aims to evaluate the role of MDCT in diagnosing large bowel lesions in patients referred from the surgery department with suspected large bowel pathology and to correlate MDCT findings with histopathological results. In the Department of Radiodiagnosis at Mahatma Gandhi Medical College and Research Institute (MGMCRI), Pondicherry, this study was carried out from February 2023 to January 2024 over a one-year span. CT imaging was carried out utilizing a GE Optima 128 Slice MDCT scanner for instances of clinically suspected large bowel pathology. IV contrast, rectal, oral (positive), and plain CT were the imaging protocols that were used. Thirty of the 45 patients were female, and 15 were male; most of the patients were in the 46-60 age range. Twenty-three of the 24 instances with a CT diagnosis of malignancy had a histological confirmation. On CT, all 21 benign lesions were correctly detected. Benign lesions showed homogenous attenuation, mild symmetric wall thickening, and diffuse bowel involvement. Heterogeneous attenuation, pronounced asymmetric wall thickening, and localized bowel involvement were observed in malignant lesions. For the diagnosis and differentiation of benign from malignant colon and rectum lesions,MDCThas shown itself to be an excellent technique. MDCT provides additional information about related pericolic abnormalities, lymph node presence, neighboring organ infiltration, and distant metastases in addition to identifying the lesions.

Role of Multidetector Computed Tomography Urography in Evaluating Obstructive Uropathy in a Tertiary Hospital in Rural India.

This study aims to evaluate the role of multidetector computed tomography (MDCT) urography in cases of obstructive uropathy to determine the cause, side, site, and level of obstruction and to differentiate between acute and chronic cases of obstructive uropathy based on imaging features. Using Cochran's formula, a sample sizeof 121 patients was calculated. The patients underwent computed tomography (CT) urography to assess the obstructing agents causing obstructive uropathy. The conducted scan had four phases: the non-contrast phase, corticomedullary phase, nephrographic phase, and excretory phase. We assessed the obstructive agents and the changes they caused in the urinary tract. A total of 74 patients (61.16%) had calculus as their obstructive agent, followed by stricture (14.88%). The obstructive agents were intraluminal in 102 patients (84.3%) and extraluminal in 19 patients (15.7%). The ureter was the most common site of obstruction, accounting for 41.32%. The acute cases were 66 (54.55%), and the chronic cases were 55 (45.45%). A statistically significant (p<0.05) association was found using the chi-square test in the comparison of the enhancement and excretion of the kidneys and the type of case (acute or chronic). A statistically significant (p<0.05) association was found using the chi-square test in the comparison of the distribution of the secondary findings, such as perinephric fat stranding and perinephric fluid collection, and thetype of case (acute or chronic). MDCT urography is a highly reliable method of imaging the cause of obstructing agents in cases of obstructive uropathy and the damage caused by them. The type of enhancement and excretion and the secondary findings play an important role in determining the acuteness or the chronicity of the obstructive agent.

Evolving capabilities of computed tomography imaging for transcatheter valvular heart interventions - new opportunities for precision medicine.

The last decade has witnessed a substantial growth in percutaneous treatment options for heart valve disease. The development in these innovative therapies has been mirrored by advances in multi-detector computed tomography (MDCT). MDCT plays a central role in obtaining detailed pre-procedural anatomical information, helping to inform clinical decisions surrounding procedural planning, improve clinical outcomes and prevent potential complications. Improvements in MDCT image acquisition and processing techniques have led to increased application of advanced analytics in routine clinical care. Workflow implementation of patient-specific computational modeling, fluid dynamics, 3D printing, extended reality, extracellular volume mapping and artificial intelligence are shaping the landscape for delivering patient-specific care. This review will provide an insight of key innovations in the field of MDCT for planning transcatheter heart valve interventions.