Multidetector Computed Tomography Angiography Research Articles

Diagnostic Approach to Penetrating Neck Trauma: What You Need to Know.

Diagnostic evaluation of penetrating neck trauma has evolved considerably over the last several decades. The contemporary approach to these injuries is based primarily on clinical signs of injury and multidetector computed tomographic angiography (MDCTA). The neck is evaluated as a unit, rather than relying on the surface anatomy zones in which external injuries are seen to guide the workup of internal injuries. This "no-zone" approach safely spares many patients from negative explorations and unnecessary invasive tests. The purpose of this review is to describe an evidence-based approach to the diagnostic evaluation of penetrating neck trauma, including indications for adjunctive testing beyond physical exam and MDCTA.

Thoracic Aortic Plaque Burden and Prediction of Cardiovascular Events in Patients Undergoing 320-row Multidetector CT Coronary Angiography.

Wide volume scan (WVS) coronary computed tomography angiography (CCTA) enables aortic arch visualization. This study assessed whether the thoracic aortic plaque burden (TAPB) score can predict major cardiovascular adverse events (MACE) in addition to and independently of other obstructive coronary artery disease (CAD) attributes. This study included patients with suspected CAD who underwent CCTA (n=455). CCTA-WVS was used to assess CAD and the prognostic capacity of TAPB scores. Data analysis included the coronary artery calcification score (CACS), CAD status and extent, and TAPB score, calculated as the sum of plaque thickness and plaque angle at five thoracic aortic segments. The primary endpoint was MACE defined as a composite event comprised of ischemic stroke, acute coronary syndrome, and cardiovascular death. During a mean follow-up period of 2.8±0.9 years, 40 of 455 (8.8%) patients experienced MACE. In the Cox proportional hazards model adjusted for clinical risks (Suita cardiovascular disease risk score), we identified TAPB score (T3) as a predictor of MACE independent of CACS ＞400 (hazards ratio [HR], 2.91; 95% confidence interval [CI], 1.26-6.72; p=0.012) or obstructive CAD (HR, 2.83; 95% CI, 1.30-6.18; p=0.009). The area under the curve for predicting MACE improved from 0.75 to 0.795 (p value=0.008) when TAPB score was added to CACS ＞400 and obstructive CAD. We found that comprehensive non-invasive evaluation of TAPB and CAD has prognostic value in MACE risk stratification for suspected CAD patients undergoing CCTA.

The Associations Between Abdominal Obesity and Coronary Artery Calcification in Chronic Kidney Disease Population.

Cardiovascular disease (CVD) is the primary cause of mortality in chronic kidney disease (CKD) patients, with metabolic disorders exacerbating this risk. Compared with body mass index, waist circumference (WC) has been proposed as a more effective indicator of abnormal visceral fat. However, the associations among CKD, abnormal WC, and CVD remain understudied. A cross-sectional study in Taiwan (July 2006 to May 2016) involved 10,342 participants undergoing self-paid health checkups at a single medical center. Physical examinations and blood samples were taken to assess metabolic parameters, and renal function was evaluated using the Chronic Kidney Disease Epidemiology Collaboration formula. Coronary artery calcification (CAC) scores were determined through coronary 256-slice multidetector computed tomography angiography, with a CAC score of >0 Agatston unit (AU) and ≥ 400 AU denoting positive CAC and severe CAC, respectively. Sex-based comparisons were conducted between individuals with CKD and those without CKD. In the CKD group, both sexes exhibited significantly elevated levels for systolic blood pressure, serum fasting blood glucose (FBG), and hemoglobin A1c (HbA1c) as well as reduced serum high-density lipoprotein cholesterol. Examination of the associations of abnormal WC revealed that for both sexes, individuals with abdominal obesity (AO) were significantly older and had higher systolic/diastolic blood pressure, serum FBG, HbA1c, and lipid profiles compared with those without AO. Multiple logistic regression analysis revealed that CKD patients exhibited a more pronounced association with severe CAC scores compared with AO patients (odds ratios [ORs]: 2.7 and 1.4, respectively). Furthermore, the combined effects of AO and CKD (AO[+]/CKD[+]) resulted in increased risks of positive CAC (OR: 2.4, 95% confidence interval [CI]: 1.6-3.5) and severe CAC (OR: 4.4, 95% CI: 1.4-14.2). Abdominal obesity significantly raised the odds of CAC and was associated to a 4.4-fold increased risk of severe CAC in CKD patients.

Coincidence of Asymptomatic Aorto-left Atrial Fistula and Aneurysmatic Aberrant Right Subclavian Artery: The Relevance of Multidetector Computed Tomography Angiography

Coincidence of Asymptomatic Aorto-left Atrial Fistula and Aneurysmatic Aberrant Right Subclavian Artery: The Relevance of Multidetector Computed Tomography Angiography

EVALUATION OF ANATOMICAL VARIATIONS OF EXTRARENAL RENAL ARTERIAL VASCULATURE IN VOLUNTARY KIDNEY DONORS

Objective: The present study was aimed at evaluating the variations in extrarenal renal arterial vasculature in voluntary kidney donors who had undergone Multi-Detector Computed Tomography (MDCT) renal angiography for preoperative workup. Methods: A retrospective hospital based cross-sectional study was carried out in a tertiary care Army hospital in Delhi from Jan 2019 to June 2020. All voluntary kidney donors included in the study underwent Multi-Detector Computed Tomography Angiography (MDCTA) of renal arteries as a part of routine pre-operative imaging protocol and were referred by the treating physician/surgeon for MDCTA study. Retrospective analysis of the image datasets was undertaken by the principal investigator and individual patient consent was waived off by the institutional Ethics committee. Results: The mean age of study participants was 45.9±10.2 y. Accessory renal artery was relatively more common on left side (p-value 0.001). There was statistically no significant difference between gender and the presence of accessory renal artery. There was statistically no significant difference on the comparison of side and gender with distance of segmentary bifurcation of MRA. The orthogonal diameters at the origin of the MRA and accessory renal artery on both sides were also comparable. Origin of accessory renal arteries were caudal to MRA was more frequently seen. Early segmentary bifurcation of MRA was commoner on the right side. Conclusion: The study emphasizes the importance of meticulous preoperative assessment, highlighting the need for surgeons to be cognizant of the potential variations in extrarenal renal artery anatomy. Such awareness is crucial for planning successful kidney transplant surgeries.

Role of Multidetector Computed Tomography Angiography in Association with Virtual Computed Tomography in Diagnosis of Aortic Dissection

Role of Multidetector Computed Tomography Angiography in Association with Virtual Computed Tomography in Diagnosis of Aortic Dissection

Unusual Cause and Treatment of Uncontrolled Hypertension

Median arcuate ligament syndrome (MALS) is a rare benign condition typically affecting young females. It usually presents with chronic abdominal pain, nausea, vomiting and weight loss. They are usually diagnosed incidentally on MDCT angiography. We report a rare adult male of MALS which presented with a recurrent hypertensive urgency without any abdominal pain leading to an extensive workup and incidental diagnosis of MALS which was successfully treated by angioplasty with stenting of celiac trunk without any complication.

Value of Pre-procedural Multi-detector Computed Tomography Angiography in Prediction of Outcome in Recanalization for Coronary Chronic Total Occlusion

Value of Pre-procedural Multi-detector Computed Tomography Angiography in Prediction of Outcome in Recanalization for Coronary Chronic Total Occlusion

Pro-Inflammatory Biomarkers and Progression of Atherosclerosis in Patients with Myocardial Infarction with Non-Obstructive Coronary Artery Disease: 1-Year Follow-Up.

Samples of peripheral venous blood were collected upon admission and on days 2, 4, and 7 of hospitalization and after 1 year. An extended multiplex analysis was performed in blood serum. Multidetector-computed tomography coronary angiography was performed on day 7 and 1 year after acute myocardial infarction to assess the progression of atherosclerosis. The level of high-sensitive C-reactive protein (hsCRP) was elevated upon admission in MINOCA patients compared to MI-CAD patients (p = 0.05), but it was comparable in two groups at other time points and did not exceed the reference range after 1 year. Despite comparable levels of cytokines CXCL-6, LIGHT, CCL-8, and endocan-1 in patients in both groups, MINOCA patients had a greater increase in pro-inflammatory cytokines PlGF, oncostatin M, IL-20, and CCL-15 sVCAM-1 in the early post-infarction period and in CCL-21, sVCAM-1, oncostatin M, and PlGF after 1 year. We observed significant differences in the dynamics of the following biomarkers between patients with MI-CAD and MINOCA: the dynamics of concentrations of CCL21 (p = 0.002), LIGHT (p = 0.03), and endocan-1 (p = 0.03) after 1 year compared to day 1 in MI-CAD and MINOCA patients was opposite, while the dynamics of CXCL6 (p = 0.04) and endocan-1 (p = 0.02) differed between groups when evaluated after 1 year compared to day 7 of the early post-infarction period. In the MINOCA group, factors associated with atherosclerosis progression were concentrations of sVCAM-1 and CCL-21, while in the MI-CAD group, concentrations of CCL-8 and CXCL6 were the main determinants of atherosclerosis progression. This small study showed that MINOCA and MI-CAD patients exhibited differences in a pro-inflammatory biomarker profile in the early post-infarction period and after 1-year follow-up, which implies distinct inflammatory pathways involved in atherogenesis during MINOCA. The key factors that were associated with atherosclerosis progression in MINOCA patients are sVCAM-1 and CCL-21, which may suggest a complex genesis of atherosclerosis progression due to structurally altered plaques and changes in the microcirculatory bed. In MI-CAD patients, CCL-8 and CXCL-6 were the key biomarkers associated with atherosclerosis progression. Further large-scale studies are required to confirm our data.

Hepatocellular carcinoma vascularization: CT angiography variations identifying arteries feeding the tumour

BackgroundHepatic arterial anatomy is important in performing many surgical and endovascular procedures. Familiarity with variations in the hepatic arterial anatomy is essential to achieving adequate embolization. In some patients, in addition to anatomic variations of the hepatic arteries, different extrahepatic collateral arteries may provide partial or total vascular supply to hepatocellular carcinoma (HCC), which makes transcatheter arterial chemoembolization (TACE) technically challenging. We aim to evaluate the different feeding vessels of HCC using multi-detector computed tomography angiography (MDCTA) as a pre-procedural step before planning suitable management.ResultsOne hundred patients with 150 focal HCC lesions were involved in our study. The anatomy of the blood supply and the morphological characteristics of HCC, including the size, location, and history of previous hepatitis, were quantitatively assessed and statistically analysed. The number of patients who had classic hepatic arterial supply for the HCC lesions in our study was 54 (54%). The number of patients with additional extrahepatic supply is 26, while the number of patients with anatomical vascular variants is 20. Among these 26 patients with extrahepatic (parasitic) blood supply, six patients were supplied by the right inferior phrenic artery, four patients were supplied by the right internal mammary artery, and two patients were supplied by each other type of extrahepatic feeder, which are the left inferior phrenic artery, left internal mammary artery, left gastric artery, cystic artery, right lumbar artery, direct branch from the aorta, omental arteries, right renal artery, and LHA from the LGA. Twelve of the 20 patients with anatomical vascular variants had replaced RHA from the SMA; four patients had replaced LHA from the LGA; two patients had replaced RHA from the GDA; and two patients had replaced CHA from the SMA. Only 50 cases of CT findings were correlated with the data from the interventional procedures of these patients.ConclusionsBecause of the differences in HCC blood supply between typical, parasitic, and anatomical vascular variants, MDCTA has significant clinical significance prior to TACE and any interventional procedure.

Angiographic challenges of spinal dural and epidural arteriovenous fistulas: report on 45 cases.

The localization of the fistula level in spinal dural arteriovenous fistulas (dAVFs) and epidural arteriovenous fistulas (edAVFs) remains a diagnostic challenge. Consecutive patients with spinal dAVFs and edAVFs in the thoracic, lumbar, and sacral regions were included. The primary endpoint was to describe the characteristics of patients who required angiography with multiple catheterizations of segmental arteries (10 or more). Forty-five patients (median age 69years; male 89%; dAVFs, n = 31; edAVFs, n = 14) were included. Spinal dAVFs commonly developed in the thoracic region and edAVFs in the lumbosacral region. Fistulas were predicted at the correct level or plus/minus 2 level in less invasive examinations using multi-detector CT angiography (n = 28/36, 78%) and/or contrast-enhanced MR angiography (n = 9/14, 64%). We encountered diagnostic challenges in the localization of fistulas in 6 patients. They underwent angiography a median of 2 times. In each patient, spinal levels were examined at a median of 25 levels with a median radiation exposure of 3971mGy and 257ml of contrast. Fistulas were finally localized at the high thoracic region (T4-6) in 3 patients, the sacral region (S1-2) in 2, and the lumbar region (L3) in 1. Four patients were diagnosed with edAVFs and 2 with dAVFs. The correlation coefficient between the fistula level and the rostral end of the intramedullary T2 high-signal intensity on MRI was interpreted as none. In patients in whom less invasive examinations failed for fistula localization, high thoracic or sacral AVFs need to be considered.

Quantitative and Qualitative Characteristics of Atherosclerotic Plaques on Carotid Arteries in Patients with Antiphospholipid Syndrome: The Role of MDCT Angiography.

Antiphospholipid syndrome (APS) is an autoimmune disease characterised by arterious and venous thrombosis, miscarriage, and the presence of antiphospholipid antibodies (aPL) in the blood. As we know, APS is also characterised by accelerated atherosclerotic degeneration with an increased risk of thrombosis in all blood vessels, including the carotid arteries. Carotid artery stenosis can manifest in many different ways. The aim of this study is to present the results of our multidetector computerised tomography angiography (MDCTA) analysis of the carotid arteries in patients with primary and secondary APS compared with a control group. This study examined 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients with secondary antiphospholipid syndrome (SAPS). The results were compared with a control group also comprising 50 patients. The groups were analysed with respect to age, sex and the presence of well-established risk factors for vascular disease. The study was conducted using MDCTA, where we analysed the quantitative and qualitative (morphologic) characteristics of carotid artery lesions. Patients from the control group had significantly elevated levels of cholesterol and triglycerides in comparison with patients with PAPS and SAPS (p < 0.001 and p < 0.05). The results show that carotid artery lesions were significantly more common in patients with APS (PAPS, n = 40, CI95: 0.50-0.75, p = 0.0322 and SAFS, n = 54, CI95: 0.59-0.80, p = 0.0004) than within the control group (n = 23). There was a statistically significant difference between patients with APS and the control group with respect to lesions in the distal segments (n = 27, CI95: 0.67-0.95, p = 0.0001), bulbi and proximal segments (n = 21, CI95: 0.84-1.00, p = 0.000005). The number of patients with one lesion (L) (n = 27) was significantly greater than the number of those with three (n = 10, CI95: 0.56-0.86, p = 0.0051) or four (n = 3, CI95: 0.73-0.98, p = 0.00001) lesions. There were also more patients with two lesions (n = 24) than those with four (n = 3) (CI95: 0.71-0.97, p = 0.00005). Carotid artery stenosis was shown as a percentage of the carotid artery lumen diameter (%DS). Stenosis of up to 30%, was more common in patients in the PAPS group (n = 12) than in the control group (n = 3) (CI95: 0.52-0.96, p = 0.0201), while the SAPS group (n = 17) had an even larger disparity (CI95: 0.62-0.97, p = 0.0017). We observed a highly significant difference in the frequency of stenoses between 30% and 50% DS between the PAPS group (n = 24) and the control group (n = 7) (CI95: 0.59-0.90, p = 0.0023), as well as the SAPS group (n = 30) (CI95: 0.65-0.92, p = 0.0002). A qualitative analysis of plaque morphology revealed that patients with PAPS had significantly more soft tissue lesions (n = 23) compared with calcified lesions (n = 2) (CI95: 0.74-0.99, p = 0.00003), as well as more mixed plaques (n = 9) and calcified plaques (n = 2) (CI95: 0.48-0.98, p = 0.0348). Patients within the SAPS group had significantly more soft tissue (n = 35) than calcified lesions (n = 3) (CI95: 0.79-0.98, p = 0.00000021), as well as more mixed lesions (n = 21) compared with calcified (n = 3) (CI95: 0.68-0.97, p = 0.0002). Our study shows that subclinical manifestations of carotid artery lesions were more common in patients with APS. We came to the conclusion that MDCTA is an accurate diagnostic method because it is a safe method that provides us with a great quantity of accurate information about the characteristics of atheromatous plaques, which aids us in the further planning of treatment for patients with APS.

Aortic root diameter, main pulmonary artery diameter/aortic root diameter and pericardial fat volume as predictors of occlusive coronary artery disease.

The clinical relevance of aortic root diameter (ARD) and main pulmonary artery diameter (MPAd) or pericardial fat volume (PFV) in the assessment of coronary artery disease (CAD) is largely unknown. We aimed to assess the relationship of pericardial fat volume (PFV), ARD, MPAd, and MPAd/ARD ratio with occlusive CAD (stenosis>50%).This cross-sectional study included patients who had chest pain suggestive of CAD and underwent a 64-multislice multi-detector CT angiography exam to exclude occlusive CAD presence. A total of 145 patients were enrolled in this study. The mean age was 54±10 years, 51% were males. The mean PFV, ARD, MPAd, and MPAd/ARD ratio in all patients were 155 cm3, 29.9 mm, 23.4 mm and 0.8, respectively. On univariate analysis, PFV (OR (CI)=1.1 (1.01-1.3), P<0.01), ARD (OR (CI)=1.2 (1.1-1.4), P<0.01), and MPAd/ARD ratio (OR (CI)= 0.2 (0.1-0.5), p=0.02) showed significant association with occlusive CAD presence. After adjusting for cardiac risk factors, only PFV (OR (CI)=1.1 (1.02-1.3), p<0.01), but not ARD (OR (CI)=0.9(0.3-2), p=0.85) or MPAd/ARD ratio (OR (CI)=0.1(0.1-2), p=0.69), was independently associated with occlusive CAD. In conclusion, increased PFV, but not ARD or MPAd/ARD ratio, showed a significant and independent association with occlusive CAD presence in patients with chest pain suggestive of CAD.

Multi-Detector Computed Tomography Angiographic Evaluation of Extremity Vascular Trauma: Case Series

Objective: The purpose of this article is to review the multidetector computed tomography (MDCT) angiography within the evaluation of extremity trauma. Trauma could be a great public health dilemma in developing and developed countries and regularly involves teenagers. Among different kinds of trauma, vascular injuries of the extremities need special consideration because they’ll be threatening to limb and life. Vascular injury going to exsanguination and hemorrhagic shock is second to central nervous system injury; thus, imaging diagnosis is crucial for the trauma victim as early as possible from admission to the hospital. Although the speed of successful management of those injuries has been increased because of proper pre hospitalization, early referral of patients to specialized trauma centers, and proper surgical interventions, these injuries remain a challenging problem, especially in developing countries.&#x0D; Conclusion: With the rising trend of road traffic accidents and violence, vascular injuries have become a significant contributor of limb loss, with increased morbidity and mortality. MDCT Angiography has become the most non-invasive diagnostic imaging vascular triage tool applicable to all or any varieties of extremity trauma. Axial sections, multiplanar reconstructions and 3D volume-rendered images should aid within the detection and improve the interpretation of such vascular injuries, osseous and soft-tissue injuries which could be of immense help to the clinician planning surgical procedures.  

Impact of Diabetes Duration and Control on the Extent and Severity of Coronary Artery Disease in Egyptian Patients: Evaluation by Coronary CT Angiography

Abstract Background Diabetes mellitus (DM) has reached epidemic proportions worldwide and approximately 40% of diabetics die due to ischemic heart disease, 15% from other forms of heart disease, principally congestive heart failure, and about 10% from stroke. The role of DM in CAD progression is now universally accepted. Aim of the Work To explore the association between diabetes duration and control on the extent of coronary artery disease (CAD) using coronary computed tomography angiography (CCTA). Patients and Methods This study is a cross sectional observational study that included 100 diabetic patients who were eligible for CT coronary angiography. They were evaluated in the diabetic outpatient clinic of the internal affairs ministry Hospitals for symptoms suggestive of CAD or for preoperative cardiovascular system risk stratification. CT coronary angiography was performed in all patients, and CACS was calculated using Agatston score. CCTA was analyzed for the site and severity of stenosis. For each patient, the number of diseased vessels was calculated through the assignment of one, two, and three or left main (LM) coronary artery vessels. Results The prevalence of atherosclerotic coronary artery disease among diabetics in the studied population was 78%, moderate to severe degree of obstructive lesions was found in 81% of them as detected by CTCA. Coronary calcification was found in 65% of diabetic patients. Coronary calcium score showed a significant positive correlation with age (p-value =0.002), HB1c level and the Triglycerides, cholesterol and LDL levels. The severity of atherosclerotic coronary artery disease was significantly associated with dyslipidemia. On the other hand, the extent of coronary affection was associated with the duration of diabetes. Among the studied subjects, the LAD was the most frequently affected artery (60% of patients). Low risk diabetics (zero calcium and no atherosclerotic plaques) had a mean duration of DM &amp;lt; 10 years with controlled lipid profile. Conclusion Based on the results of the current study, we can draw several conclusions. Diabetic patients are at risk for significant CAD with or without calcium burden. Extensive significant CAD is associated with long standing diabetes. Uncontrolled diabetes mellitus and the presence of dyslipidemia augment the process of atherosclerosis and the severity of the disease. Younger patients with controlled diabetes and lipid profile have a more favorable coronary anatomy profile and a favorable outcome. The LAD is the artery of predilection in diabetics. Abbreviations ASCVD: Atherosclerotic cardiovascular disease; BP: Blood pressure; CABG: Coronary artery bypass graft; CAD: Coronary artery disease; CCTA: Coronary computed tomography angiography; CVD: Cardiovascular disease; DM: Diabetes mellitus; HDL-c: High density lipoprotein cholesterol; HS: Highly significant; IQR: Inter-quartile range; LAD: Left anterior descending; LCX: Left circumflex; LDL-c: Low density lipoprotein cholesterol; LM: Left main; MDCT: Multidetector coronary CT angiography; MSCT: Multi-slice computed tomography; NS: Non significant; PCI: Percutaneous coronary intervention; RCA: Right coronary artery; S: Significant; TC: Total cholesterol; TG: Triglycerides

PENETRATING NECK INJURY EVALUATION AND MANAGEMENT

Objective: To study the prevalence of penetrating neck injuries in north-west Rajasthan. Methods: This was a cross-sectional study on 50 patients with penetrating injury to the neck and of either sex fulfilling inclusion and exclusion criteria, who visit our Trauma Centre and ENT OPD at PBM hospital Bikaner during 01 Jan 2022 to 01 Jan 2023. Patients was evaluated and resuscitated as per Advanced Trauma Life Support Protocols. If the patient is stable a multi-detectorcomputed tomography (MDCT) Angiography will be done and treatment was done accordingly. All patients were observed for at least 48 hours prior to discharge. Follow up of all patients was done at 4 weeks and 3 months post discharge. Results: Mean age of study population was 31.53 ± 9.24 yr with age range of 18–70 yr. Maximum 90% caseswere male; 54% cases were urban. 48% cases were in II zone, followed by 24% in III rd zone, 16% in IVth Zone, whereasminimum 12% had injury in multiple zones. conservative treatment was done in 34% cases, 33 cases were treated by surgery out of which 57.57% were treated by surgical debridement and primary wound closure, 88% cases were cured and1(2%) case were died. Conclusion: A proper evaluation, rapid air way intervention and proper surgical repair are essential for a successful outcome. Early management of laryngeal injury within first 24 hours seems to bear the bestresults for air way and voice.

Hepatic arterial variations detected at multidetector computer tomography angiography in the Romanian population.

Our purpose was to determine the prevalence of normal hepatic vascularization and variations of the hepatic arteries using multidetector computed tomography (MDCT) angiography. These variants should be known before any surgery of the upper abdomen, the downside being that there aren't many studies on large groups of patients using high-specialized imaging. This study was carried out on 4192 patients. We performed MDCT angiography on each one of the patients and had a specialized team observe the images. Using Michels' classification, the normal anatomy (type I) was present in 3392 (80.91%) cases, while abnormal hepatic arteries were observed in 800 (19.08%) cases. The variations were distributed as follows: type II in 40 (0.95%) cases, type III in 442 (10.54%) cases, type IV in 13 (0.31%) cases, type V in 285 (6.79%) cases, type VI in 12 (0.28%) cases, type VII in 3 (0.07%) cases, type VIII in 108 (2.57%) cases, type IX in 6 (0.14%) cases and type X in one case (0.02%). 170 (4.05%) unclassified cases were observed. Using Hiatt's classification, the variations were: type II in 325 (7.75%) cases, type III in 454 (10.83%) cases, type IV in 124 (2.95%) cases, type V in 6 cases (0.14%) and type VI in 69 (1.64%) cases. 102 (2.43%) unclassified cases were observed. We observed well-known variations of the hepatic arterial pattern and also found a large number of rare, unclassified cases.

Role of Multidetector Computed Tomography Coronary Angiography in Evaluation of Coronary Bifurcation Angles as a Predictor of Coronary Artery Disease

Role of Multidetector Computed Tomography Coronary Angiography in Evaluation of Coronary Bifurcation Angles as a Predictor of Coronary Artery Disease

Diagnostic efficiency of anatomic features measured by 320- slice multi-detector computed tomography angiography in evaluating the severity of aortic coarctation

Diagnostic efficiency of anatomic features measured by 320- slice multi-detector computed tomography angiography in evaluating the severity of aortic coarctation

The accuracy of non-contrast brain CT scan in predicting the presence of a vascular etiology in patients with primary intracranial hemorrhage

Spontaneous intraparenchymal cerebral hemorrhages (SIPH) account for 10–15% of acute strokes. Sorting these patients according to the risk of harboring an underlying vascular etiology may help selecting the patients who would mostly benefit from Multidetector CT Angiography (MDCTA). The aim of this study was to evaluate the accuracy of Non-Contrast brain CT (NCCT) in predicting possible vascular etiologies in patients with SIPH. In this retrospective study, we evaluated the NCCT of 334 patients who presented with SIPH from March 2017 to March 2021 and we looked for vascular etiologies in the CTA which was performed for these patients. We used NCCT criteria to predict the presence of any vascular etiologies in SIPH patients and proposed a scoring system based on these criteria which might predict the risk of vascular ICH (VICH score). Out of 334 evaluated patients, 9.3% had an underlying vascular etiology. Independent predictors of the vascular etiology included: age < 46 years, no history of hypertension and coagulation disorders, lobar hemorrhages, and presence of significant perilesional edema. We used these criteria and NCCT classification to create a practical scoring system to predict the risk of vascular ICH (VICH). In our study, VICH score ≥ 4 had 51.6% sensitivity and 96.4% specificity for predicting a positive MDCTA as the maximum optimal cut-off point. The VICH score seemed to be successful in predicting vascular etiologies in this retrospective cohort of 334 patients. This scoring system can be used to select patients if there are limited resources to perform CT angiography.