Multislice CT Research Articles

Association between psychological stress and mandibular condyle structure: an analytical cross-sectional study

ObjectiveThe potential influence of psychological factors on temporomandibular joint disorders has been clinically documented. To date, all research examining the impact of psychological stress on the temporomandibular joint has been conducted on animals. This study aims to explore the relationship between psychological stress and the structure of the human mandibular condyle.MethodsThis cross-sectional study was performed on individuals, who were referred to the radiology division of 5th Azar Hospital for head and neck Computed Tomography (CT) scans. All participants completed a perceived stress questionnaire to determine their level of stress. Bone density and cortical bone thickness were measured as indicators of mandibular condyle structure. Based on multi-slice CT scan data, bone density was calculated in the anterior, middle, and posterior mandibular condyle. The cortical bone thickness was also measured at the anterior and posterior mandibular condyle. Statistical analysis was performed in R 4.0.2 software.ResultsSeventy individuals, aged 18–59 years, participated in this study. The CT scans revealed a decrease in Hounsfield units (HU) and bone mineral density (BMD) in both the anterior and posterior regions. However, in the high-stress group, there was no significant difference in cortical bone thickness in the anterior and posterior regions of the condyle, nor in HU and BMD in the middle region of the condyle. An inverse correlation was observed between BMD and perceived stress in the anterior, middle, and posterior regions of both condyles.ConclusionThe current findings indicate that recent psychological stress is associated with changes in the structure of the condyle.

Lumbar Pedicle Dimensions Using CT Scan in Adults of South-Eastern Nigeria as Related to Transpedicular Fixation.

Transpedicular fixation depends on accuracy of the entry points, angle of insertion and pedicular isthmus width for adequate screw insertion. Preoperative measurements of pedicle dimensions reduce the chances of failure during insertion. These pedicle dimensions (transverse diameter, longitudinal diameter, and maximum length of purchase [MLP]) vary with sex and race. Such data, from a large-scale study, are not available for our population. The study aims to evaluate the dimensions of pedicle that are relevant for pedicle screw fixation in Southeast Nigerian population. A prospective multi-slice CT based clinical anatomy study done at Memfys Hospital for Neurosurgery, Enugu. This study is on the lumbar pedicle dimensions that are related to transpedicular fixation (transverse and longitudinal diameters of the pedicle, MLP, pedicle transverse and longitudinal angles of inclination). Sample size (273) was calculated with the confidence interval formula based on the number of patients that present for images. Consent and ethical approval were obtained. The mean values are as follow: LD1 8.22 mm, LD2 7.73 mm, LD3 7.40 mm, LD4 7.16 mm, LD5 6.87 mm TD1 5.05 mm, TD2 5.31 mm, TD3 6.72 mm, TD4 8.27 mm, TD5 11.31 mm, MLP1 46.60 mm, MLP2 47.97 mm, MLP3 47.14 mm, MLP4 45.54 mm, MLP5 43.47 mm TA1 17.8°, TA2 19.34°, TA3 20.80°, TA4 22.00°, TA5 25.70° LA1 19.42°, LA2 18.61°, LA3 18.00°, LA4 17.09°, LA5 16.40°. Unlike transverse diameter, transverse angle, longitudinal dimension, longitudinal angle (LA), MLP there was significant correlation between age and mean LA. The mean values also correlated significantly with the gender. The mean values varied with the different vertebral levels and was good correlations between some of the parameters with age and gender.

Enhanced Diagnostic Precision: Assessing Tumor Differentiation in Head and Neck Squamous Cell Carcinoma Using Multi-Slice Spiral CT Texture Analysis.

This study explores the efficacy of texture analysis by using preoperative multi-slice spiral computed tomography (MSCT) to non-invasively determine the grade of cellular differentiation in head and neck squamous cell carcinoma (HNSCC). In a retrospective study, MSCT scans of patients with HNSCC were analyzed and classified based on its histological grade as moderately differentiated, well-differentiated, or poorly differentiated. The location of the tumor was categorized as either in the bone or in soft tissues. Segmentation of the lesion areas was conducted, followed by texture analysis. Eleven GLCM parameters across five different distances were calculated. Median values and correlations of texture parameters were examined in relation to tumor differentiation grade by using Spearman's correlation coefficient and Kruskal-Wallis and Dunn tests. Forty-six patients were included, predominantly female (87%), with a mean age of 66.7 years. Texture analysis revealed significant parameter correlations with histopathological grades of tumor differentiation. The study identified no significant age correlation with tumor differentiation, which underscores the potential of texture analysis as an age-independent biomarker. The strong correlations between texture parameters and histopathological grades support the integration of this technique into the clinical decision-making process.

Juxtaposed Atrial Appendage in Congenital Heart Diseases: Evaluation by multi-slice CT a retrospective study.

Juxtaposed Atrial Appendage in Congenital Heart Diseases: Evaluation by multi-slice CT a retrospective study.

Coronary Bypass Surgery Guided By Multislice Computed Tomography Angiography In A Low Surgical Risk Population

Coronary Bypass Surgery Guided By Multislice Computed Tomography Angiography In A Low Surgical Risk Population

The Photon-Counting CT Enters the Field of Cochlear Implantation: Comparison to Angiography DynaCT and Conventional Multislice CT.

Cochlear duct length (CDL) measurement plays a role in the context of individualized cochlear implant (CI) surgery regarding an individualized selection and implantation of the CI electrode carrier and an efficient postoperative anatomy-based fitting process. The level of detail of the preoperative temporal bone CT scan depends on the imaging modality with major impact on CDL measurements and CI electrode contact position determination. The aim of this study was to evaluate the accuracy of perioperative CDL measurements and electrode contact determination in photon-counting CT (PCCT). Ten human fresh-frozen petrous bone specimens were examined with a first-generation PCCT. A clinically applicable radiation dose of 27.1 mGy was used. Scans were acquired before and after CI insertion. Postoperative measurement of the CDL was conducted using an otological planning software and 3D-curved multiplanar reconstruction. Investigation of electrode contact position was performed by two respective observers. Measurements were compared with a conventional multislice CT and to a high-resolution flat-panel volume CT with secondary reconstructions. Pre- and postoperative CDL measurements in PCCT images showed no significant difference to high-resolution flat-panel volume CT. Postoperative CI electrode contact determination was also as precise as the flat-panel CT-based assessment. PCCT and flat-panel volume CT were equivalent concerning interobserver variability. CDL measurement with PCCT was equivalent to flat-panel volume CT with secondary reconstructions. PCCT enabled highly precise postoperative CI electrode contact determination with substantial advantages over conventional multislice CT scanners.

Pulmonary, aorta, and coronary arteries post-arterial switch in transposition of great arteries: intermediate-term surveillance utilizing conventional echocardiography and cardiac multislice computed tomography

BackgroundArterial switch operation (ASO) is the standard surgical choice for D-transposition of great arteries (D-TGA). However, the implications of ASO on pulmonaries, coronaries, and aorta have not been adequately investigated. The current study evaluates arterial morphologic changes post-ASO at intermediate-term surveillance.MethodsFrom May 2021 to May 2022, patients with D-TGA who underwent ASO for more than six months were recruited. Preoperative and operative data were collected. Patients were assessed using echocardiography (ECHO) and multislice CT angiography (MSCT) to evaluate pulmonary, coronary, and aortic arterial anatomy.ResultsTwenty patients were included with median age of 11 (10-23.25) days at ASO and 14 (7.25–32.75) months on last follow-up. Neo-aortic regurgitation was detected in 12(60%) and neo-pulmonary regurgitation in 3 (15%). Using ECHO, complete evaluation of pulmonary arteries (PAs) was not achieved in 35% and incomplete coronaries assessment in 40% of cases. No stenosis was detected in coronaries using MSCT, although coronary anomalies were found in 9/20 (45%). Dilated Aortic annulus was detected in 16/20 (80%), dilated aortic root in 18/20 (90%), and dilated sinotubular junction in 70%. Right PA stenosis was diagnosed in 10/20 (50%) and left PA(LPA) stenosis in 7/20 (35%). Although Z-score of PAs did not correlate with aortic data, LPA bending angle was positively correlated to neo-aortic root diameter and Z-score (rho = 0.65,p = 0.016; rho = 0.69,p = 0.01), respectively.ConclusionEchocardiography alone is not a conclusive surveillance tool for detecting late post-ASO anatomic changes in D-TGA patients. Cardiac MSCT should be considered for comprehensive evaluation on the intermediate-term follow-up post-ASO to accurately track morphologic abnormalities in the aorta, pulmonary, and coronary arteries.

Analysis of The Value of Multi-Slice Spiral CT and Magnetic Resonance Imaging in The Diagnosis of Carpal Joint Injury

Analysis of The Value of Multi-Slice Spiral CT and Magnetic Resonance Imaging in The Diagnosis of Carpal Joint Injury

MSCT-semiotics of vertebrae in patients with cervical spine stenosis

Introduction The number of surgical interventions on the cervical spine for stenosis has been constantly increasing. This fact proves that there is a need for careful preoperative preparation that would consider the complexity of the intervention and the age of the patients.Purpose To substantiate the need to include the MSCT data processing algorithm of bone tissue density of vertebral bodies and arches to assess their quality for planning osteoplastic decompressive laminoplasty in patients with cervical spine stenosis due to degenerative changes.Material and methods This single-center retrospective study investigated qualitative and quantitative characteristics of the spine with radiography and multislice computed tomography (MSCT) in 82 patients with degenerative diseases of the cervical spine and associated spinal canal stenosis (CSS).Results and discussion The data obtained indicate a tendency for the total density of the cervical vertebrae to increase from C3 to C5 and to decrease caudally, with minimal density in C7 without signs of osteoporosis. A similar trend is characteristic of trabecular bone. The density of the osteon layer of the vertebral arch cortex differs significantly from the density of the outer and inner plates. The total density of the compact layer of the vertebral arch cortex exceeds 785.15 ± 38.4 HU.Conclusion The data obtained justify the need to include the study of the density of vertebral bodies, vertebral arches, and its thickness in the MSCT data processing algorithm to develop a plan for surgical intervention in patients with cervical spine stenosis in order to obtain objective data on the quality of the bone.

Diagnostic value of high-resolution ultrasound combined with multi-slice computer tomography (MSCT) for pediatric intra-abdominal hernias: a retrospective study

IntroductionTo explore the diagnostic value of high-resolution ultrasound combined with multi-slice computer tomography (MSCT) for pediatric intra-abdominal hernias (IAHs), and to analyze the potential causes for missed diagnosis and misdiagnosis of IAHs in children.MethodsA retrospective analysis was conducted on 45 children with surgically confirmed IAHs. The diagnostic rate of IAHs by preoperative high-resolution ultrasound combined with MSCT was compared with that of intraoperative examination, and the potential causes for missed diagnosis and misdiagnosis by the combination method were analyzed.ResultsForty-five cases of pediatric IAHs were categorized into primary (25/45, 55.5%) and acquired secondary hernias (20/45, 44.5%). Among children with primary hernias, mesenteric defects were identified as the predominant subtype (40%). Acquired secondary hernias typically resulted from abnormal openings in the abdominal wall or band adhesions due to trauma, surgery, or inflammation. In particular, adhesive band hernias were the major type in children with acquired secondary hernias (40%). The diagnostic rate of high-resolution ultrasound was 77.8%, with “cross sign” as a characteristic ultrasonic feature. Among 10 cases of missed diagnosis or misdiagnosis, 5 were finally diagnosed as IAHs by multi-slice computer tomography (MSCT). Overall, the diagnostic rate of pediatric IAHs by preoperative ultrasound combined with radiological imaging reached 88.9%.DiscussionIAHs in children, particularly mesenteric defects, are prone to strangulated intestinal obstruction and necrosis. High-resolution ultrasound combined with MSCT greatly enhances the diagnostic accuracy of pediatric IAHs.

Nonmetric sex estimation in a contemporary Indonesian population: a validation study using clinical pelvic MSCT scans

Klales et al. (2012) is a popular standard for the estimation of skeletal sex. Since its publication, a number of studies have demonstrated that population-specific applications of Klales improve classification accuracy. However, it has also been shown that age appears to affect the expression of dimorphism in the pelvis across the lifespan. As such, the present study examines the accuracy of Klales, and the modified global standard of Kenyhercz et al. (2017), in a contemporary Indonesian population, including quantifying the effect of age. Pelvic multi-slice CT scans of 378 individuals (213 female; 165 male) were analysed in OsiriX®. Both standards were tested and Indonesian-specific models thereafter derived.When applied to the Indonesian sample, both the Klales and Kenyhercz standards resulted in lower classification accuracy relative to the original studies. In considering the Indonesian-specific models, the ventral arc was the most accurate for the classification of sex, at 93.3% with a − 3.0% sex bias. The accuracy of the three-trait model was 94.4%, with a − 5.5% sex bias. Age was shown to significantly affect the distribution of pelvic trait scores. As such, age-dependent models were also derived, with the standard for individuals between 30 and 49 years the most accurate, at 93.1% and a sex bias of − 4.0%. Accuracy was lower in individuals aged ≥ 50 years, at 91.3% and a sex bias of 4.1%. These findings support the importance of establishing population-specific standards and to facilitate improved accuracy and capabilities for forensic practitioners in Indonesia.

Diagnostic and Management Value of Multi-Slice Computed Tomography in Esophageal Jujube Pit Impaction

Objective: The diagnostic value of multi-slice computed tomography (MSCT) in esophageal jujube pit impaction was explored in this study. Methods: A retrospective analysis was performed on MSCT data obtained from a cohort of 40 patients experiencing esophageal jujube pit impaction. The study period encompassed the interval from December 2018 to November 2019. The analysis involved examining the age distribution of the patients, the location of the jujube pit impaction, its connection to the esophagus, associated complications, and the methods used for treatment. All imaging results were compared with the outcomes of surgical or endoscopic interventions. Results: (1) Out of 40 patients, 30 individuals were 58 years old or above, constituting 75% of the study sample. (2) In 80% of the instances (32 cases), the jujube pit was located in the initial segment of the esophagus, exhibiting a spindle shape with varying levels of central low density. (3) We examined the correlation between the angle of the impacted jujube pit and the esophageal longitudinal axis, categorizing 2 cases as longitudinal impaction, 16 as oblique impaction, and 22 as transverse impaction. Among the 40 cases, 28 displayed only slight thickening of the esophageal wall at the impaction site, while 9 cases exhibited heightened periesophageal fat density, and 3 showed small periesophageal air bubbles. (4) Endoscopic evaluation identified damage to the esophageal mucosa in 35 instances and the formation of esophageal perforation in 5 cases. Among patients with perforation, one or both ends of the jujube pit had penetrated the esophageal wall, accompanied by different levels of surrounding inflammatory encapsulation. Conclusion: MSCT is crucial for pinpointing jujube pit impaction and its relation to the esophageal wall and nearby structures, aiding in preoperative and postoperative complications. It is highly feasible for endoscopic cases but limited in complex ones needing thoracoscopy or open-heart surgery.

Bone Density of the Midpalatal Suture After Surgically Assisted Rapid Maxillary Expansion: A Retrospective Cohort Study

Objectives: To evaluate the bone density in the midpalatal suture after 10 months of surgically assisted rapid maxillary expansion (SARME) with the separation of the maxilla into 2 segments. Methods: Sixty multislice computed tomography (MCT) from 20 patients undergoing SARME were analyzed in 3 periods of time (1 MCT per patient on each occasion): (1) 1 week before surgery, (2) postsurgery immediately after completing the expander activation, and (3) 10 months after the expander activation. On all occasions, the bone density was measured in Hounsfield units on MCT scans in axial and coronal sections, in the anterior (A1), middle (A2), and posterior (A3) regions of the midpalatal suture. Results: The mean percentage values of bone density in Hounsfield units, from the 10-month postactivation period to preoperative in the A1, A2, and A3 regions were 68.38%, 38.21%, and 55.90%, respectively, in the axial norm, and 64.06%, 36.81%, and 55.50% in coronal norm (A1 = A3>A2), with no significant difference in the tomographic cuts (P >0.05). There was no correlation between patient age or amount of expansion in the expander and bone density. Conclusions: The bone density in the midpalatal suture 10 months after SARME is lower than preexpansion. A denser new bone formation along the suture concentrates closer to the extremities rather than in the central region. Although the maturation of the new bone formation in the midpalatal suture is lower 10 months after SARME, it appears to be sufficient for satisfactory clinical results, regardless of patient age or the amount of expansion in the expander.

Multi-slice CT angiography of a ruptured MCA bifurcation berry aneurysm: Clinical images

Multi-slice CT angiography of a ruptured MCA bifurcation berry aneurysm: Clinical images

The Return of the Warrior: Combining Anthropology, Imaging Advances, and Art in Reconstructing the Face of the Early Medieval Skeleton

Reconstructing the face from the skull is important not only for forensic identification but also as a tool that can provide insight into the appearance of individuals from past populations. It requires a multidisciplinary approach that combines anthropological knowledge, advanced imaging methods, and artistic skills. In the present study, we demonstrate this process on the skull of an early medieval warrior from Croatia. The skeletal remains were prepared and scanned using multi-slice computed tomography (MSCT) and examined using standard anthropological and radiological methods. The analysis revealed that the remains belonged to a 35–45-year-old male individual who had suffered severe cranial trauma, probably causing his death. From MSCT images, we reconstructed a three-dimensional (3D) model of the skull, on which we digitally positioned cylinders demarking the soft tissue thickness and created the face with a realistic texture. A 3D model of the face was then optimized, printed, and used to produce a clay model. Sculpturing techniques added skin textures and facial features with scars and trauma manifestations. Finally, after constructing a plaster model, the model was painted and refined by adding fine details like eyes and hair, and it was prepared for presentation in the form of a sculpture.

Anatomical Annulus Predictors of New Permanent Pacemaker Implantation Risk After Balloon-Expandable Transcatheter Aortic Valve Implantation

New-generation transcatheter-heart-valves (THV) have significantly improved technical success and procedural safety of transcatheter-aortic-valve-implantation (TAVI) procedures, but incidence of permanent pacemaker implantation (PPI) remains a concern.The study aimed to assess the role of anatomical annulus features in determining peri-procedural conduction disturbances leading to new-PPI following TAVI with the last generation Edwards Sapien balloon-expandable valves (BEV). In the context of a prospective single-center registry, we integrated clinical and procedural predictors of PPI with anatomical data derived from multi-slice-computed-tomography (MSCT). A total of 210 consecutive patients treated with balloon expandable Edwards THV were included in the study from 2015 to 2023. Technical success was achieved in 197 (93.8%) procedures, and 26 patients (12.4%) required new-PPI at 30-day follow-up (median time-to-implantation 3 days). At the univariable logistic-regression analysis, pre-procedural right bundle branch block (RBBB; OR:2.24 [95%CI:1.01-4.97], p=0.047), annulus eccentricity ≥0.25 (OR:5.43 [95%CI:2.21-13.36], p<0.001), calcium volume at annulus of the right coronary cusp (RCC) >48 mm3 (OR:2.60 [95%CI:1.13-5.96], p=0.024) and prosthesis implantation depth greater than membranous septum length (OR:2.17 [95%CI: 1.10-4.28], p=0.026) were associated with new-PPI risk. At multivariable analysis pre-procedural RBBB (OR:2.81 [95%CI:1.01-7.85], p=0.049), annulus eccentricity ≥0.25 (OR:4.14 [95%CI:1.85-9.27], p<0.001), and annulusRCC calcium >48 mm3 (OR:2.89 [95%CI:1.07-7.82], p=0.037) were confirmed as independent predictors of new-PPI. In conclusion, specific anatomical features of the aortic valve annulus might have an additive role in determining the occurrence of conduction disturbances in patients undergoing TAVI with BEV. This suggests the possibility to use the MSCT to improve the prediction of post-TAVI new-PPI risk.

Radiological image analysis based on the combined application value of multislice spiral CT and abdominal lavage in patients with acute purulent appendicitis

ObjectiveThe primary objective of this study is to conduct a clinical investigation involving abdominal lavage in patients with acute purulent appendicitis. The study aims to systematically assess the impact of abdominal lavage on complications within one week post-surgery and, in particular, focuses on the application value of multislice spiral CT in confirming these complications. By delving into the effects of different lavage timings on surgical outcomes and postoperative recovery, the study aims to provide scientific evidence for improving the efficacy of surgical treatment for acute purulent appendicitis. MethodsA total of 150 patients diagnosed with purulent appendicitis were selected for this study. They were divided into three groups: one group underwent preoperative abdominal lavage, another group underwent postoperative abdominal lavage , and a third group did not undergo abdominal lavage. The study aimed to compare the therapeutic outcomes among the three groups of patients. Additionally, the efficacy of the treatments was assessed by utilizing multislice spiral CT scans to confirm factors such as the abdominal abscess rate and the maximum diameter of abdominal abscesses one week postoperatively. ResultsThe operative time for patients in the experimental group showed no significant difference compared to the control group. However, postoperative pain scores were significantly lower in the experimental group (p<0.05), and the recovery time for gastrointestinal function was shortened (p<0.05) compared to the control group. The incidence of postoperative complications significantly decreased in the experimental group (p<0.05), while the control group exhibited higher complications. Additionally, the postoperative recovery status of patients in the experimental group was superior to that of the control group. ConclusionPerforming abdominal lavage in cases of purulent appendicitis can significantly alleviate postoperative pain, facilitate the recovery of gastrointestinal function, reduce the incidence of postoperative complications, and enhance overall surgical recovery. Therefore, we recommend using abdominal lavage during laparoscopic appendectomy to improve the surgical outcomes and postoperative recovery quality for patients. However, further large-scale studies are necessary to validate these results.

Can Angiography Be Planned Based on Specific CT Signs of Ongoing Soft Tissue Bleeding in COVID-19 Patients Receiving Anticoagulants?

Background. Anticoagulant therapy is recommended as basic medical treatment for COVID-19 patients with risk factors. At the same time, it is accompanied by a large number of hemorrhagic complications. Massive bleeding into abdominal and chest walls soft tissues as well as retroperitoneal space significantly worsens the course of underlying disease.Objective: to assess the prognostic value of specific CT signs and their correlation with angiography data for the diagnosis of ongoing bleeding into soft tissues in COVID-19 patients.Material and methods. A retrospective study was conducted, in which multi-slice computed tomography (MSCT) and angiography data were assessed and compared in 60 COVID-19 patients with spontaneous bleeding into chest and abdominal wall soft tissues as well as retroperitoneal space. A retrospective analysis of MSCT was carried out to identify symptoms specific to coagulopathic bleeding into soft tissues: contrast agent extravasation, hematocrit effect, and signal flare phenomenon.Results. Contrast agent extravasation identified by MSCT was confirmed in 57 (95%) patients. More often (39 (68.4%) patients), extravasation was detected in MSCT arterial phase. In MSCT venous phase it was noted in 17 (29.8%) cases, in delayed phase – in 1 (1.8%) patient. With native MSCT, hematoma contained clots and fluid level (hematocrit effect) in 43 (71.7%) patients, in 17 (28.3%) patients it had a homogeneous structure. With intravenous contrast, in 39 (90.7%) cases with fluid level the signal flare phenomenon was established, which was more often detected in the arterial phase (33 (84.6%) cases). Extravasation was detected on angiography in 27 (45%) patients; they underwent therapeutic embolization. In another 15 patients preventive embolization was performed. When extravasation into hematoma without fluid level on MSCT (13 cases), extravasation on angiography was detected in 4 (30.8%) patients. In the presence of extravasation into hematoma with fluid level, but without signal flare phenomenon (4 patients) it was noted on angiography in 1 case. In the presence of all three signs (extravasation, hematocrit effect, and signal flare phenomenon – 39 patients), the incidence of extravasation on angiography was the highest – 56.4% (p = 0.028), and patients more often required therapeutic embolization.Conclusion. Detection of extravasation, fluid level and signal flare phenomenon on MSCT in the structure of spontaneous hematoma in COVID-19 patients corresponded to ongoing bleeding and more often required embolization than in isolated extravasation.

Evaluation of MSCT severity scoring for prediction of mortality among patients with COVID-19

BackgroundLung CT imaging may reveal COVID-19 abnormalities earlier than RTPCR. CT may be more sensitive than RT-PCR for diagnosing COVID-19-related pneumonia.AimThis study assesses the accuracy of multi-slice computed tomography (MSCT) grading in predicting COVID-19 mortality.MethodsCOVID-19 RT-PCR. For severity scores, all patients’ clinical examinations, history, and chest MSCT data were collected.ResultsAccording to the chest MSCT score, 102 (51.5%), 70 (35%), and 28 (14%) patients had mild, moderate, and severe illness. Out of the patients, 62 (31%) died, and 69% survived. Patients with severe MSCT scores showed a considerably greater mean age than other groups (P < 0.001). Moreover, this group had a considerably higher mean BMI (P < 0.001), and a majority (57.1%) were obese (P < 0.001). Compared to the mild group, the moderate and severe groups had significantly increased rates of diabetes, hypertension, and liver disease (P < 0.001). The moderate group had a greater rate of no comorbidities (P < 0.001). A severe MSCT score was linked to increased leucocytes, C-reactive protein, ESR, ferritin, d-dimer, HbA1c, and fasting blood sugar, as well as decreased mean lymphocytes (P < 0.001). Severe MSCT scores were linked to increased ICU admissions (P < 0.001) and increased demand for advanced mechanical ventilation and oxygen assistance (P < 0.001). A severe MSCT score was associated with the highest death rate, followed by a moderate MSCT score. Low mortality rates were observed in mild MSCT-scored patients (P < 0.001).ConclusionMSC T score severity is a reliable and noninvasive way to predict COVID-19 mortality

Oblique projections in the analysis of multislice computed tomography data in gunshot wounds

Background. The purpose is to determine the place and role of oblique projections in the analysis of multislice computed tomography (MSCT) data in gunshot wounds. Materials and me­thods. More than 3,300 MSCT studies performed in wounded and traumatized patients over a certain period in the Military Medical Clinical Center of the Northern Region of the Medical Forces Command were prospectively studied. All the wounded were male, the average age was 42.1 ± 2.4 years. MSCT of the head, thoracic and abdominal organs, pelvis, and limbs was performed. The frequency of using oblique projections and their informativeness were studied. Results. A prospective study demonstrated that coronal, axial, sagittal projections, and 3D modeling were used in 100 % of cases, and in 21.4 % — oblique projections to improve MSCT results. The distribution by localization of MSCT was as follows: head — 32.9 %, neck — 7.6 %, chest organs — 32.2 %, abdominal organs — 22.3 %, limbs — 5.0 %. MSCT in angiomode was performed in 3.5 % of injured and traumatized patients: head — 27.2 %, neck — 18.4 %, chest organs — 28.9 %, abdominal organs — 23.7 %, limbs — 1.8 %. Oblique projections in MSCT data analysis were used when studying the wound channel in 82.3 % of cases, to improve the visualization of vessels during MSCT in angiomode — in 12.6 % and to improve the visualization of bone fracture lines — in 5.1 %. Conclusions. In the structure of MSCT studies, the head, thoracic organs, abdominal organs, neck, and limbs prevail by localization (in descending order). Oblique projections are used is 1/5 of cases and allow to improve the visualization of the direction of the wound channel, vessels during angiography and lines of flat and long tubular bone fractures.