Multislice Computed Tomography Examination Research Articles

DETERMINATION OF LOCAL DIAGNOSTIC REFERENCE LEVEL (LDRL) VALUES OF MSCT IMAGING AND IMAGE NOISE IN CT BRAIN, THORAX, AND ABDOMEN EXAMINATIONS AT DR. SOETRASNO REMBANG HOSPITAL

Multislice CT (MSCT) uses a lower radiation dose per slice than single-slice CT, but patients often receive a higher total dose with MSCT. Therefore, dose control is needed to monitor patients. This study aims to analyze and determine local DRL values and image noise for non-contrast MSCT examinations of the brain, thorax, and abdomen at RSUD dr. Soetrasno Rembang. The method used is a cross-sectional survey with secondary data from 640 patients who underwent MSCT examinations, grouped by age: infants (0-4 years), children (5-14 years), and adults (≥15 years). The analysis showed that several local DRL values for CT Brain, CT Thorax, and CT Abdomen exceeded the national DRL of Indonesia. The DRL value based on CTDIvol for CT Brain is 40.40 mGy across all age groups. The DRL value based on DLP for CT Brain is 1056.4 mGy.cm (infants), 1197 mGy.cm (children), and 1511.5 mGy.cm (adults). For CT Thorax in adults, the DRL value based on CTDIvol is 17.35 mGy, and based on DLP is 981.6 mGy.cm. For CT Abdomen in adults, the DRL value based on CTDIvol is 17.33 mGy, and based on DLP is 1314.4 mGy.cm. The image noise values obtained, namely CT Brain, was 4.43 HU, CT Thorax was 20.88 HU, and CT Abdomen was 10.28 HU, which is not much different from previous research. Keywords: Local Diagnostic Reference Level (LDRL), Multislice CT (MSCT), Image Noise, CT Brain, CT Thorax, CT Abdomen.

Study on the evaluative value of abdominal multi-slice spiral CT examination for distant metastasis and regional lymph node metastasis in colorectal cancer.

Study on the evaluative value of abdominal multi-slice spiral CT examination for distant metastasis and regional lymph node metastasis in colorectal cancer.

Acute intracranial hemorrhage in 76 COVID-19 patients during the first and second pandemic waves

Background/Aim. There is limited data on the frequency of intracranial hemorrhage (ICrH) in the first wave [beta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] and second wave (delta variant of SARS-CoV-2) coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to analyze the appearance of ICrH in COVID-19 patients (CP). Methods. Among 505 CP treated at the Special Hospital for Cerebrovascular Diseases ?Sveti Sava? intermittently during the 2020-2021 period, ICrH was diagnosed in 76 (15.1%) patients. The available information from the medical records regarding clinical, demographic, as well as radiological data (multislice computed tomography examination of the endocranium) was collected and analyzed. Results. In the first wave, out of 308 CP, 63 (20.5%) were diagnosed with ICrH. In the second wave, out of 197 CP, ICrH was diagnosed in 13 (6.6%) patients, which was a statistically significant difference (p < 0.002). There was no statistically significant difference for the presence of hyper-tension (p = 0.271), diabetes mellitus (p = 0.558), and chronic obstructive pulmonary disease (p = 0.794) among CP with ICrH comparing the two waves of the pandemic. However, a statistically significant difference was proven in the frequency of patients with atrial fibrillation and anticoagulant drug therapy (p = 0.021 each). There was no statistically significant difference in the frequency of patients with fever (p = 0.637), fatigue (p = 0.587), hemiparesis (p = 0.831), respiratory symptoms (p = 0.289), and loss of consciousness (p = 0.247). D-dimer values in the second pandemic wave were statistically significantly lower (p = 0.003). The combina-tion of ischemic stroke and ICrH was six times more common in the second wave (p = 0.003). However, cer-ebral parenchymal hemorrhage was two times less frequent (p = 0.001) in the second wave but with statisti-cally higher frequencies of multifocal (23.1%) and dif-fuse type (36.4%) of ICrH (p = 0.007). Combined hem-orrhages, as well as subarachnoid and subdural subtypes, were more common in the second wave (23.1% each). Fatal outcomes occurred in 38.1% of patients in the first wave compared to 69.2% in the second wave (p = 0.039). Conclusion. In the first pandemic wave of COVID-19, ICrH in CP was significantly more frequent and D-dimer was singled out in laboratory analyses, the values of which were statistically significantly higher in comparison with second wave. In the second wave of COVID-19, parenchymal ICrH was less frequent and multifocal and diffuse ICrH were more common in CP with ICrH. The mortality rate was very high in the sec-ond wave.

The Effect of Using Black Tea as an Alternative Diuretic on Multislice Computed Tomography (MSCT) Urography Examination

The MSCT urography examination requires patient preparation, such as fasting and drinking water.In addition,some hospitals use water,furosemide to accelerate the increase in urine volume.However,Furosemide is a chemical diuretic that is feared to increase the workload of the kidneys. So a natural alternative is needed, namely black tea.This study aims to determine the effect of black tea as an alternative diuretic on the urography MSCT examination. This is quasi-experimental research conducted at RSUD by Dr. Soehadi Prijonegoro Sragen,Central Java. Respondents in this study consisted of 18 outpatients with an MSCT urography examination. These respondents were divided into three groups, namely the group of mineral water, furosemide,and black tea, and three radiology doctors. The scanning process uses MSCT 128 Slice and then tracks MSCT urography with the Curved Multiplanar Reconstruction (MPR) application.Data obtained from observations,questionnaires,and interviews with radiologists was then processed and analyzed using quantitative methods.Normal distributed data was analyzed using the ANOVA test. The results showed a significant difference from the assessment of kidney HU,liver HU, and ureteral dilatation in the mineral water, furosemide, and black tea test groups with sig values.<0.05.Black tea increases Hounsfield Unit (HU) values in the kidneys,lungs,liver,and ureteral dilation, as a tracking picture shown in the Curved Multiplanar Reconstruction(MPR) application. This confirms that black tea can be used as a natural diuretic alternative for some reasons:effective, fast, easy, and inexpensive.It makes it easier to track kidney stones.The operation of curved multiplanar reconstruction(MPR) applications during reconstruction can display more optimal image results to support more accurate diagnostic information.

The Application of Frontal and Maxillary Sinuses Indices for Computed Tomography-Based Sex Estimation of a Brazilian Population

This investigation aimed to compare the sexing accuracy of frontal (FS) and maxillary (MS) sinus indices with multislice computed tomography (MSCT) in Brazilian adults. This cross-sectional study was conducted on 100 MSCT examinations (50 males and 50 females). The height, width, and diameter of the FSs and MSs were obtained with the RadiAnt software to measure four indexes (I): FSI-1 and MSI-1 (both width/ diameter); FSI-2 and MSI-2 (both height/diameter). Areas under receiver operating characteristic curves (AUROC) were determined. Sensitivity, specificity, likelihood ratio (LR), and accuracy values ​​were also calculated. The highest area under the ROC curve for the FS was obtained by the FSI-1 (0.712 ± 0.052; p < 0.001), whereas for the MS it was found in the MSI-2 (0.431 ± 0.058; p = 0.232). FSI-1 showed greater specificity (64%) in predicting female sex as well as greater accuracy (64%) and LR (3.16). MSI-1 had the highest sensitivity value (68%) in estimating male sex and the second highest LR value (2.13). The FSI-1 developed in the present study exhibited higher accuracy compared to the other evaluated indices, which reinforces its importance for future studies with other populations.

Three-dimensional image study of accelerated maxillary expansion in oral breathing kids

ObjectiveTo evaluate, by a three-dimensional study, the volumetric and integumentary effects of rapid maxillary expansion on the nose, in mouth breathing kids with maxillary hypoplasia, in the short term, assessing the possible interference of gender, growth and age on the results achieved. Methods120 mouth breathing patients with maxilla hypoplasia were divided into an Experimental Group treated by rapid maxillary expansion (n = 104, 62 males and 42 females, mean age 10.1 years, SD = 2.10, ranging from 5.1 to 13.9 years); and Control Group, constituted by 16 patients (9 males and 7 females, mean age 9.3 years, SD = 2.1 years, ranging from 6.1 to 13.2 years). Patients in the experimental group underwent multislice computed tomography examinations at two different times: (T1) pre-expansion and (T2) post-expansion. The control group was submitted to the same tests at the same time intervals. Six soft tissue variables of the nose were studied, besides the volume and area of the nasal cavity, and the measurement and comparison of data between T1 and T2 were performed using the Dolphin Imaging 11.7 Premium software. ResultsThe experimental group showed significant mean increases in all soft tissue variables studied (p < 0.005), yet there were no significant changes in the control group. In the comparison between groups, only inclination of the nasal dorsum did not present any significant change. ConclusionRapid maxillary expansion may alter the nasal shape and physiology, by anatomical changes in the nose soft tissues, making it an important aid in the treatment of mouth breathing in childhood. Level of evidenceThe soft tissues of the nose play an important role in nasal shape and physiology and facial esthetics, and since they are directly related to the nasal valves, they are fundamental for maintenance and stability of the nasal breathing pattern.

Preoperative T and N Restaging of Rectal Cancer After Neoadjuvant Chemoradiotherapy: An Accuracy Comparison Between MSCT and MRI.

BackgroundIt is well established that magnetic resonance imaging (MRI) is better than multi-slice computed tomography (MSCT) for the accurate diagnosis of pretreatment tumor (T) and node (N) staging of rectal cancer. However, the diagnostic value of MRI and MSCT in local restaging of rectal cancer after neoadjuvant chemoradiotherapy (NCRT) is controversial. The aim of this study is to investigate the performance of the two imaging exams in restaging of patients with rectal cancer.MethodsPatients with rectal cancer from April 2015 to April 2021 were analyzed retrospectively. The inclusion criteria are as follows: 1) diagnosis of rectal cancer through pathology; 2) NCRT had been performed; 3) all patients had undergone both MSCT and MRI examination before the surgery. Exclusion criteria are as follows: 1) incomplete clinical and imaging data; 2) previous history of pelvic surgery. Two radiologists performed T and N staging of patient images. Diagnostic accuracy, consistency analysis, and error restaging distribution of the two imaging exams for T and N restaging of rectal cancer were assessed using postoperative pathological staging as the gold standard.ResultsA total of 62 patients (49 men; mean age: 59 years; age range 29–83 years) were included in the study. The diagnostic accuracy of MSCT and MRI for T restaging was 51.6% (95% CI 39.3%–63.9%) and 41.9% (95% CI 29.6%–54.2%), respectively, and no statistical difference was found between them (p > 0.05). The diagnostic accuracy of MSCT and MRI for N restaging was 56.5% (95% CI 44.2%–68.8%) and 53.2% (95% CI 40.8%–65.6%), respectively, and no statistical difference was found between them (p > 0.05). The consistency analysis showed that T restaging (κ = 0.583, p < 0.001) and N restaging (κ = 0.644, p < 0.001) were similar between MSCT and MRI. There was no significant difference in the distribution of over, accurate, or low staging in T restaging (p > 0.05) and N restaging (p > 0.05) between MSCT and MRI.ConclusionsMSCT and MRI have similarly poor performance in the diagnosis of preoperative T and N restaging of rectal cancer after NCRT. Neither of them cannot effectively stage the ypT0-1 of rectal cancer. These findings may be of clinical relevance for planning less imaging exam.

Morphometric analysis of the mandibular condyle of hyperdivergent individuals with class II and class III skeletal patterns / Análise morfométrica do côndilo mandibular de indivíduos hiperdivergentes com padrões esqueléticos de classe II e classe III

Introduction: to compare the condyle morphology of individuals with hyperdivergent skeletal patterns in class ii and class iii skeletal patterns. Methods: multislice computed tomography examinations of 41 individuals (82 temporomandibular joints), aged 18 to 42, with an accentuated vertical growth pattern, of whom 21 had a class ii skeletal pattern and 20, a class iii skeletal pattern were evaluated retrospectively. The following measurements were taken: width (d1), thickness (d2), horizontal angle (a1), and anterior angle (a2) of the condyle. The normality of data distribution was verified by means of descriptive statistics, graphical analysis, and the shapiro-wilk test. The student’s-t test was used to compare the measurements between the groups tested. The pearson correlation was used to identify correlations among quantitative measurements. A 5% level of significance was used for all tests. Results: there was statistically significant difference between groups for the four measurements analyzed (p 0.05). D1 and d2 values were lower for hyperdivergent individuals with a class ii skeletal pattern. A1 was higher for hyperdivergent individuals with a class ii skeletal pattern, and a2, higher for hyperdivergent individuals with a class iii skeletal pattern. Conclusions: hyperdivergent individuals with a class ii pattern have a condyle with a smaller thickness and width, than individuals with a class iii pattern, and these characteristics should be considered when planning the orthodontic and orthognathic treatments.

Evaluation of the degenerative lumbar osseous morphology using zero echo time magnetic resonance imaging (ZTE-MRI)

To determine and compare the performance of zero echo imaging (ZTE) with conventional MRI sequences on lumbar osseous morphology in patients suspected with lumbar degeneration with multi-slice computed tomography (MSCT) as standard reference. 22 subjects with concerned lumbar degeneration were recruited. All subjects were scanned with ZTE sequence after routine conventional MR sequences on a 3.0T system and also received MSCT examination. Image quality was assessed. The quantitative and qualitative parameters of lumbar osseous morphology on MSCT, ZTE and MRI images were evaluated by three musculoskeletal radiologists independently. Inter-reader and inter-modality reliability and the difference between the modalities were calculated. There was no difference for the osseous parameters between modalities, including axial orientation (p = 0.444), IAD (p = 0.381), lateral recess (p = 0.370), pedicle width (p = 0.067), pedicle height (p = 0.056), and osteophyte grade (p = 0.052). The measurement of the foramina diameter was statistically different between conventional MRI and MSCT (p < 0.05) but not between the MSCT and ZTE (p = 0.660). Conventional MRI was more likely to miss cortical bone abnormalities. ZTE appeared blurrier in cortical bone than MSCT, especially in cases with severe lumbar degeneration. The inter-reader agreement between MSCT and ZTE-MRI was higher than between MSCT and conventional MRI. ZTE-MRI could offer more cortical bone details than conventional MRI images and might be a valid alternative to CT for lumbar osseous morphology assessment to some extent.

Multislice Spiral Computed Tomography under Hybrid Iterative Reconstruction Algorithm in Staging Diagnosis of Bladder Cancer and Ceramide Glycosylation

This study was to discuss the application of multislice spiral computed tomography (CT) in the staging diagnosis of bladder cancer and the effect of ceramide glycosylation. The hybrid iterative reconstruction algorithm was applied. Immunohistochemistry and western blot were used to detect the normal bladder tissues (30 cases) of GCS in group 1 (100 cases) and group 2. The scanned images of all the research objects were obtained, the images with the iterative reconstruction algorithm were reconstructed, and statistical analysis on the CT value under the algorithm was conducted. The results showed that the image quality, blood vessel sharpness, average image score, signal-to-noise ratio, and radiation dose after the spiral CT and iterative reconstruction algorithm all increased, while the noise value decreased. The optical density value of glucosylceramide synthase in group 2 patients increased by 71%, and the optical density value of group 1 increased by 29%. The optical density expression of glucosylceramide synthase in group 1 patients was significantly higher than that in the control group, and there was a statistical difference between the two ( P &lt; 0.05 ). Among the results of multislice spiral CT for tumor staging, the lesions larger than 5 cm and in the range of 1.1–2 cm in diameter were more sensitive. In 41 patients, there were multiple lesions. A total of 142 cancer lesions were found. The diameter of the tissue ranged from 0.5 to 6.8 cm, with an average diameter of 2.03 ± 0.35 cm. The optical density of glucosylceramide synthase in the group 1 was 5526, and the optical density in group 2 was 2576. The OD expression of GCS in group 1 was greatly higher in contrast to that in group 2, and there was a statistical difference between the two groups ( P &lt; 0.05 ). The multislice spiral CT examination under this algorithm found that the diagnosis and staging accuracy of lesions with a diameter greater than 5 cm and tumor diameters in the range of 1.1 to 2 cm was higher. The image processed by the hybrid iterative reconstruction algorithm had good effect, high definition, and accuracy.

COVID-19 in Egypt after a year: the first and second pandemic waves from the radiological point of view; multi-center comparative study on 2000 patients

BackgroundOne year has passed since the announcement of COVID-19 as a pandemic and two waves had already stricken Egypt. The authors witnessed several atypical radiological features through the second pandemic wave, either early at the active infective stage or delayed at the post-infectious convalescent period. They believed every radiologist should be familiar with these features. Therefore, they performed this comparative study on 2000 Egyptian patients using multi-slice computed tomography (MSCT) to highlight the radiological differences between the first and second pandemic waves and correlate them to the clinical status.ResultsThis random multi-center comparative study was retrospectively conducted on 2000 COVID-19 Egyptian patients; 1000 patients were registered at the first pandemic wave from April 2020 till September 2020, while the other 1000 patients were registered at the second pandemic wave from October 2020 till March 2020. Follow up CT examinations were performed for 49 and 122 patients through the first and second pandemic waves respectively. MSCT examinations were carefully evaluated by four expert consulting radiologists who came to a consensus. Meanwhile, the correlation with the clinical outcome was performed by two consulting pulmonologists. During the second pandemic wave, the prevalence rate of the “crazy-paving” pattern had significantly increased by 1.3 times (P value = 0.002). Additionally, the prevalence rate of the “air-bubble” sign had significantly increased by 1.9 times (P value = 0.02). Similarly, the presence of enlarged mediastinal lymph nodes (> 1 cm in short-axis diameter) had significantly increased by 1.7 times (P value = 0.036). Furthermore, the prevalence rate of pericardial effusion had significantly increased by 2.5 times (P value = 0.003). The above-mentioned signs were correlated to increased clinical severity and higher rates of hospitalization. Unexpectedly, other atypical radiological signs were only encountered through the second pandemic wave, including bronchiectatic changes (2.5%), “head-cheese” pattern (0.8%), cavitation (0.5%), and “bulls-eye” sign (0.2%). The prevalence rate of post-COVID fibrosis had doubled through the second wave but not in a significant way (P value = 0.234). Secondary fungal infection was only encountered throughout the second pandemic wave in four patients. COVID-19 reinfection was encountered in a single patient only during the second pandemic wave.ConclusionAfter 1 year from the announcement of COVID-19 as a pandemic, the radiological presentation of COVID-19 patients showed some significant differences between its first and second waves.

Anatomic information of urinary tract MSCT using tracking and intravenous urography in case of urolithiasis

Urolithiasis is a stone in the urinary tract area. In previous studies, the use of reconstructed tracking on Multislice Computed Tomography (MSCT) non-contrast urography was able to produce an image of the urinary tract. Intravenous Urography (IVU) examination is a radiographic examination of the urinary system using positive contrast media that is inserted intravenously. This study aims to optimization of information on the anatomy of the urinary tract is needed to help diagnose urolithiasis. This type of research is an experimental observational approach with a comparison of the MSCT anatomical information tracking technique with an IVU examination. The subjects of this study were patients who performed an MSCT and IVU examination with 3 respondents from Radiology Specialists. The data collected is from April to November 2019. The sample used was 60 samples. Non-contrast urography MSCT with tracking technique obtained more optimal results in assessing each anatomy compared to IVU. The overall value of anatomical image non contrast urographic MSCT images with tracking techniques obtained a total value of 2179, While the overall value of the anatomical image on the IVU examination was 1977. MSCT non-contrast urography with tracking is more optimal in establishing the diagnosis in cases of urolithiasis, but IVU examination excels in assessing the function of the urinary tract.

Estimation of Aortic Valve Calcium Score Based on Angiographic Phase Versus Reduction of Ionizing Radiation Dose in Computed Tomography.

The aim of the study was to evaluate the estimation efficacy of aortic valve calcium score (AVCS) based on the multislice computed tomography (MSCT) angiographic phase. The evaluation of the reduced amount of ionizing radiation dose was performed because of this estimation. The study included 51 consecutive patients who qualified for transcatheter aortic valve implantation (TAVI) (78.59 ± 5.72 years). All subjects underwent MSCT: in the native phase dedicated to AVCS as well as angiographic phases aimed to morphologically assess the aortic ostium and arterial accesses for TAVI. Based on the native phase, an AVCS assessment was performed for axial reconstructions at 3.0 mm and 2.0 mm slice thickness (AVCSnative3.0 and AVCSnative2.0). Based on the angiographic phase AVCS was estimated for axial reconstruction at 0.6 mm slice thickness with increased values of lesion density in aortic valve cusps/aortic valve annulus, which is considered a calcification, from a typical value of 130 HU to 500 HU and 600 HU (AVCSCTA0.6 500 HU and AVCSCTA0.6 600 HU). Mathematical formulations were developed, allowing for AVCS native calculation based on AVCS values estimated based on the angiographic phase: AVCSnative3.0 = 813.920 + 1.510 AVCSCTA0.6 500 HU; AVCSnative3.0 = 1235.863 + 1.817 AVCSCTA0.6 600 HU; AVCSnative2.0 = 797.471 + 1.393 AVCSCTA0.6 500 HU; AVCSnative2.0 = 1228.310 + 1.650 AVCSCTA0.6 600 HU. The amount of a potential reduction in dose length product (DLP) in the case of AVCS estimation was 4.45 ± 1.54%. In summary, relying solely on the angiographic phase of MSCT examination before TAVI, it is possible to conclusively estimate AVCS. This estimation results in a marked reduction in radiation dose in MSCT.

Sexual dimorphism of the mandibular conformational changes in aging human adults: A multislice computed tomographic study by geometric morphometrics.

The aging process has an impact on mandibular bone morphology and can therefore affect shape sexual dimorphism. Understanding the effect of senescence on mandibular shape changes is particularly important to correctly estimate the sex of an individual and predict age-related conformational modifications. The purpose of this study was to assess age-related changes in mandibular shape and sexual dimorphism. The study sample comprised 160 Multi Slice Computed Tomography examinations of individuals aged 40 to 79 years. Geometric morphometric analysis of fourteen osteometric landmarks was used to examine sexual dimorphism and patterns of mandibular shape variation with age. Results showed that mandibular sexual dimorphism of shape remained significant with aging. Conformational changes occurred between 50 and 70 years and were different for male and female individuals. Females presented earlier and more marked age-related shape changes than males. These observations suggest that mandibular senescence is a sexually dimorphic process since its onset, rate, and the areas subjected to conformational changes differ from male to female individuals. Senescence-related changes present substantial variability, and further investigation is required to determine precisely the age that marks their onset.

TEKNIK MULTISLICE COMPUTED TOMOGRAPHY (MSCT) CERVICAL PADA KASUS TRAUMA

Background: Cervical trauma is a very common injury of severity and varying prognosis. Cervical CT Scan is an examination of the cervical spine including other tissues using the MSCT tool to find out the anatomy on the cervical spine with axial, sagittal, coronal. The purpose of this study was to know the technique and result of cervical MSCT images in case trauma.&#x0D; Methods: This type of research is library research (library research), which is a series of research related to the method of collecting library data or research where the object of research is explored through a variety of library information (books, proceedings, articles, and scientific journals). Literature research or literature review is research that critically examines or reviews the knowledge, ideas, or findings contained in the academic-oriented literature, and formulates theoretical and methodological contributions to certain topics. The focus of the literature research that the author has done is related to the Cervical Multislice Computed Tomography (MSCT) technique in cases of trauma.&#x0D; Results: Based on the results of images on MSCT cervical trauma cases to obtain anatomical information that is able to show the firm boundaries of the corpus lamina, spinosus process, tranverse process, and fragment fracture, using axial, sagittal, and coronal slice recontruction.&#x0D; Conclusions : Based on a review of several journal literature, the cervical MSCT examination technique in trauma cases used a 64 x collimation 0.6 mm, with axial section reconstruction of 1 mm thickness, coronal and sagittal sections of 1.5 mm thickness, 3D, and volume rendering. In severe polytrauma patients the technique is performed with the addition of an intravenous contrast material. The results of images on MSCT cervical trauma cases to obtain anatomical information that is able to show the firm boundaries of the corpus, lamina, spinous process, transverse process, and fragment fractures, using axial, sagittal, and coronal slice reconstruction.

Role of multislice computed tomography in evaluation of thoracic complications in patients with chronic renal failure

Background The incidence of chronic renal failure (CRF) is increasing worldwide. With the expanded use of hemodialysis treatment and extended life of patients with chronic renal failure, large numbers of thoracic complication of CRF patients are being increased. The radiological findings of the thoracic complications in patients with CRF are multiple. Aim To study the role of multislice computed tomography (MSCT) in the evaluation of thoracic complications in patients with CRF. Patients and methods A total of 30 patients with CRF who presented with chest diseases were included in this study (13 females and 17 males). All patients underwent detailed history taking, clinical examination, laboratory studies, and MSCT examination. Results Pleural effusion was the most common complication found in 19 (63.3%) patients, pulmonary infection was the second most common complication detected in 16 (53.3%) patients, followed by mediastinal lymphadenopathy presented in six (20%) patients, pulmonary nodules presented in six (20%) patients, pericardial effusion presented in four (13.3%) patients, pulmonary thromboembolism, hydropneumothorax, vascular calcification, and pleural thickening presented in three (10%) patients each, then, cardiomegaly presented in two (6.7%) patients, and finally, lung cancer presented in one (3.3%) patient. Conclusion MSCT was effective to illuminate a wide spectrum of thoracic complications in symptomatic patients with CRF and was the most sensitive imaging modality for detection of these complications.

Coronary artery anomalies in tetralogy of Fallot patients evaluated by multi slice computed tomography; myocardial bridge is not a rare finding.

Based on coronary angiography and interoperative inspection, anomalous origin of coronary artery crossing the right ventricular outflow tract (RVOT) is common in tetralogy of Fallot (TOF) patients. However, other coronary anomalies may be underestimated due to the overlying myocardium, epicardial fat, or adhesions due to previous palliative surgery. Currently, coronary artery visibility dramatically improved by multislice computed tomography (MSCT). We performed this study to assess the coronary arteries anatomy in TOF patients using MSCT.All TOF patients underwent MSCT examination at our centre from 2013 till 2019 were included. Assessment of the coronary arteries’ origin and course were performed. Presence of myocardial bridge were assessed, and indexed RV mass was calculated.318 TOF patients were included, median age 2 years (range 1 month–46 years), 175 males (55%). The abnormal coronary artery origin and course were detected in 20 patients (6%); coronary artery crossed RVOT in 13 patients (65%), 5 patients (25%) had a retro-aortic course and 2 patient (10%) had inter-arterial course. Myocardial bridges of left anterior descending artery or/and right coronary artery were reported in 100 patients (36%), no myocardial bridge of left circumflex was reported. RV mass was 29.0 ± 21.1 g/m2. There was no correlation between RV mass and presence of myocardial bridges.MSCT is a useful imaging modality for detection of coronary arteries anomalies in TOF patients. Coronary artery crossing RVOT is not the only abnormal course and myocardial bridging is not a rare finding. Further studies are needed to demonstrate the clinical significance of these observations.

КОМПЛЕКСНАЯ ЛУЧЕВАЯ ДИАГНОСТИКА У ПАЦИЕНТОВ С ДИСФУНКЦИЕЙ ВИСОЧНО-НИЖНЕЧЕЛЮСТНОГО СУСТАВА (ВНЧС)

Purpose. Сonducting a comprehensive analysis of clinical and radiological data in patients with temporomandibular joint (TMJ) dysfunction at the stages before and after conservative and dental types of treatment using multislice computed tomography (MSCT) and magnetic resonance imaging (MRI). Materials and methods. The present study included the results of clinical and radiological examinations at the stages before and after conservative and dental types of treatment of 36 patients (31 women and 5 men) in the age range of 18-52 years. All patients were divided into four groups depending on the clinical manifestations of temporomandibular joint dysfunction. Group I (n = 11; 30.3%) - patients with pain syndrome with TMJ dysfunction; Group II (n = 14; 39.2%) - patients with manifestation of acoustic effects in TMJ dysfunction and group III (n = 5; 13.7%) - patients with degenerative changes in bone tissue. Group IV (n = 6; 16.8%) - was a control group – volunteers without clinical manifestations of TMJ dysfunction. Patients of all groups underwent radiological diagnostic methods at various stages of treatment: MSCT examination at treatment and 12 months after the initial examination; MRI - at treatment, at 6 and 12 months. Results. According to the study, it was revealed that the asymmetric arrangement of the heads of the condylar processes of the lower jaw (n = 14; 42.4%) was noted in view of the violation of the biomechanics of the act of chewing. The presence of pronounced dystrophic processes on the part of the lesion in groups I, II, III was regarded by us as changes as a result of functional overload, which was indirectly confirmed by the regression of the process after the complex treatment. The posterior position of the head of the condylar process of the lower jaw was found much more often than any other localization, especially in the destructive process of the cartilaginous component in 20 patients (60.6%). According to MSCT data, the size of the joint space before and after the treatment was modernized: in the anterior section from 1.761.8 to 3.08.51.5 mm; in the middle section from 1.181.7 to 1.862.5mm after treatment and in the back section from 0.802.5 to 3.421.3mm after treatment In the absence of violations of the integrity of the dentition and trauma in the anamnesis in 25 patients (75.7%), a predominance of the active function of the masticatory muscles on the leading side was noted. According to MRI data, the volumetric characteristics of the lateral pterygoid muscles before and after treatment ranged from 17.81.9 to 15.12.5 mm; medial pterygoid muscles from 13.351.5 to 11.211.5 mm and the masticatory muscles proper from 18.531.5 to 14.221.6 mm. A statistically significant increase in the volumetric parameters (thickness) of the masticatory muscles in 25 patients (75.7%) indicates a functional overload of the masticatory apparatus, since the volumetric characteristics of the studied muscles became comparable with the data of the control group (n=6; 16,8%) after the treatment. Changes in the parameters of the articular disc, MRI studies revealed the following changes before and after the treatment: in the anterior region from 2.32.6 to 2.72.7 mm, in the central region from P 1 - I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia. 2 - Tver State Medical University. Tver, Russia. RUSSIAN ELECTRONIC JOURNAL OF RADIOLOGY | www.rejr.ru | REJR. 2021; 11 (1):88-102 DOI: 10.21569/2222-7415-2021-11-1-88-102 Страница 90 0.52,9 to 1.91.7 mm, in the posterior section from 3.22.7 to 4.32.1 mm. Bone density indicators of patients (n = 31; 100.0%) varied from +234.55.8 HU (in group III) to +565.55.9 HU (in group I) during the primary study, which made it possible to differentiate the severity of osteoporotic changes in bone tissue to correct the treatment. Conclusion. The use of highly informative methods of radiological diagnostics (MSCT, MRI) in patients with TMJ dysfunction is an integral part both at the stage of initial consultation and after treatment.

Characterization of the interatrial septum by high-field cardiac MRI: a comparison with multi-slice computed tomography

BackgroundAssessment of the interatrial septum (IAS) has become an attractive area of interest for a variety of important interventional procedures. Newer imaging modalities like multi-slice computed tomography (MSCT) and cardiac MRI (CMR) can provide higher resolution and wider field of view than echocardiography. Moreover, high-field (3-Tesla) CMR can even enhance spatial and temporal resolution.The characteristics of the interatrial septum were retrospectively studied in 371 consecutive subjects (201 men, 31–73 years old) in whom MSCT was performed primarily for non-invasive evaluation of the coronary arteries. All subjects underwent both MSCT and MRI scans within 0–30 day’s interval. A 3D volume covering the whole heart was acquired across the heart with and without contrast enhancement. Also, patients underwent cardiac MSCT examinations using 64-row MSCT scanners.ResultsThe mean scan time of MSCT was 10.4 ± 2.8 s and 9.7 ± 2.9 min for CMR. The mean length of IAS by CMR and CT was 39.65 ± 4.6 mm and 39.28 ± 4.7 mm, respectively. The mean maximal thickness of IAS by CMR and CT was 3.1 ± 0.97 mm and 3.15 ± 0.95 mm, respectively. The mean thickness of fossa ovalis by CMR and CT was 1.04 ± 0.36 mm and 1.04 ± 0.44 mm, respectively. The mean length of fossa ovalis by CMR and CT was 12.8 ± 3.7 mm and 12.8 ± 3.5 mm, respectively. Finally, the mean angle of IAS by CMR and CT was identical (155 ± 9.2°). Measurements of various morphological features of IAS showed no statistically significant difference between CMR and CT, with an excellent correlation and close relationship regarding IAS length, maximal IAS thickness, fossa ovalis thickness, fossa ovalis length, and IAS angle (r = 0.98, 0.98, 0.95, 0.96, and 0.92, respectively).ConclusionWhole-heart 3D acquisition at 3-T MRI using a free-breathing technique provides a valuable non-invasive imaging tool for excellent assessment of the interatrial septum—as compared to MSCT—that may have significant clinical implication for diagnostic purposes and therapeutic interventional procedures, as it may facilitate planning, improve outcome, and shorten its duration.

The Imaging Performances of Contrast-Enhanced Ultrasound, Computed Tomography, and Magnetic Resonance Imaging for Extrahepatic Cholangiocarcinoma

Objective: To compare the imaging performances of contrast-enhanced ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), thereby explore their values and significances in clinical practices of diagnosing extrahepatic cholangiocarcinoma. Methods: A total of 56 patients with extrahepatic cholangiocarcinoma were included as research objects. All the patients underwent contrast-enhanced ultrasound examination, enhanced MRI examination, and multi-slice helical CT (MSCT) examination. The major contents of analysis and observation included the location of the lesion, the range, the features of blood flow signal, the echoes of lesions at various phases, the enhancement levels, and the morphology. Then, the tabu search algorithm was applied to reconstruct the images, thereby completing the construction of the image objective function. Results: In terms of histopathological typing, 9 papillary adenocarcinomas, 22 invasive adenocarcinomas, and 25 poorly-to-moderate differentiated adenocarcinomas were found. In terms of ultrasound results, 27 lesions were isoechoic, 23 lesions were hypoechoic, and 6 lesions were hyperechoic. In terms of MRI results, 66% of the patients had hyperechoic lesions during the arterial phase, and 55.1% of the patients had isoechoic lesions during the portal phase. During the delay phase, 30.3% of the patients had isoechoic lesions, and 58.9% of the patients had hyperechoic lesions. Conclusion: Contrast-enhanced ultrasound, CT, and MRI had magnificent values and significance in the clinical diagnosis of extrahepatic cholangiocarcinoma, which could be widely applied in the diagnosis and treatment of extrahepatic cholangiocarcinoma. In addition, the contrast-enhanced ultrasound and CT could be used as an effective supplementary basis for enhanced MRI diagnosis. These three diagnostic methods had respective advantages and could be used in combination.