Role Of CT Scan Research Articles

The role of CT scan in imaging and diagnosing kidney diseases

The role of CT scan in imaging and diagnosing kidney diseases

CT image classification of COVID-19 based on VGG16 image classification algorithm

This paper introduces the background of the novel coronavirus outbreak and the role of CT scanning in diagnosis, as well as the importance of automated CT image analysis system. COVID-19, a highly contagious respiratory disease caused by the novel coronavirus, has caused millions of infections and hundreds of thousands of deaths worldwide since it broke out in Wuhan, China, in early 2020. CT scan is a commonly used diagnostic means to help doctors determine the extent and location of lung lesions, but due to the large number of COVID-19 patients, doctors have a large workload, so automated CT image analysis system is needed to assist doctors in rapid diagnosis. With the continuous training process, the accuracy of the training set of automated CT image analysis system is gradually stabilized at 90%. The accuracy of the test set exceeds 85%, and the prediction effect is good. The loss of training set and test set became smaller and the training accuracy gradually improved. According to the confusion matrix, 6 CT images that should have been COVID-19 were predicted to be non-COVID-19, 57 CT images that should have been non-COVID-19 were predicted to be COVID-19, and the remaining images were predicted correctly, and the prediction effect of the model was good, which could predict the COVID-19 images more accurately. The application of automated CT image analysis system can greatly reduce the work burden of doctors, improve the efficiency and accuracy of diagnosis, and provide strong technical support for the prevention, control and treatment of COVID-19. At the same time, the continuous optimization and improvement of the system will also provide more effective technical means for future epidemic prevention and control and medical diagnosis. However, there are still some problems and challenges in the application of automated CT image analysis system. For example, there may be bias in the models training data, resulting in inaccurate model predictions. At the same time, the case data in different regions are quite different, so targeted training and optimization are needed. Therefore, it is necessary to continuously improve and optimize the system to improve its prediction effect and reliability. In conclusion, the application of automated CT image analysis system provides strong technical support for the prevention, control and treatment of the novel coronavirus pneumonia, which can quickly and accurately diagnose lung lesions and provide better treatment and care for patients. With the continuous development and improvement of the technology, the application prospect of the system will be broader and make greater contributions to the cause of human health.

A detailed statistical analysis of the performance of CO-RADS and CT-severity score in the diagnosis of COVID-19 pneumonia compared to RT-PCR test: a prospective cohort study

BackgroundReports from international studies regarding the role of CT scan and RT-PCR test in the diagnosis of coronavirus disease has been a subject of controversy. The purpose of this study was to statistically compare the performance of CT in reporting chest CT scans of coronavirus disease according to Coronavirus Disease Reporting and Data System (CO-RADS) and CT severity score (CTSS) with the performance of RT-PCR test.ResultsThe analyzed CT scans of 144 participants were consistent with CO-RADS 1 (n = 38), CO-RADS 2 (n = 11), CO-RADS 3 (n = 35), CO-RADS 4 (n = 23), and CO-RADS 5 (n = 37). CTSS in CO-RADS 1 was (0.9 ± 4), CO-RADS 2 (4 ± 2), CO-RADS 3 (10.2 ± 2), CO-RADS 4 (14 ± 6) and CO-RADS 5 (19 ± 7). There was direct correlation between CO-RADS groups and CTSS (p < 0.001). The mean total CTSS was 10 ± 9 for the whole study population. Ninety-five CT scans were compatible with CO-RADS 3, 4 or 5 and 49 CT scans were compatible with CO-RADS 1 or 2, with a positive rate of 66% (95% CI 49%, 65%), PPV (55.41%), NPV (45.18%), accuracy (86.8%) and the overall sensitivity (93.18%) and specificity (76.8%) of CT in detecting COVID-19 pneumonia when categorized and analyzed according to CO-RADS and CTSS. Sixty-four patients had positive initial RT-PCR tests and 80 patients had negative initial RT-PCR test, with a positive rate of 44.4% (95% CI 35%, 51%), PPV (41.13%), NPV (59.51%), accuracy (74.3%), sensitivity (64.2%) and specificity (93.9%). The Kappa (κ) value of average inter-reader agreement was 88% (95% CI 80%, 96%).ConclusionsRT-PCR test showed higher specificity and NPV compared to CT in detecting COVID-19 pneumonia, while CT showed higher sensitivity, PPV, accuracy and positive rate, respectively. CT was superior to RT-PCR test in detecting COVID-19 pneumonia especially at early stages of the disease.

Diagnostic Approach and Differences between Spinal Infections and Tumors.

A systematic review of the literature about differential diagnosis between spine infection and bone tumors of the spine. The differential diagnosis between spine infection and bone tumors of the spine can be misled by the prevalence of one of the conditions over the other in different areas of the world. A review of the existing literature on suggestive or even pathognomonic imaging aspects of both can be very useful for correctly orientating the diagnosis and deciding the most appropriate area for biopsy. The purpose of our study is to identify which imaging technique is the most reliable to suggest the diagnosis between spine infection and spine bone tumor. A primary search on Medline through PubMed distribution was made. We identified five main groups: tuberculous, atypical spinal tuberculosis, pyogenic spondylitis, and neoplastic (primitive and metastatic). For each group, we evaluated the commonest localization, characteristics at CT, CT perfusion, MRI, MRI with Gadolinium, MRI diffusion (DWI) and, in the end, the main features for each group. A total of 602 studies were identified through the database search and a screening by titles and abstracts was performed. After applying inclusion and exclusion criteria, 34 articles were excluded and a total of 22 full-text articles were assessed for eligibility. For each article, the role of CT-scan, CT-perfusion, MRI, MRI with Gadolinium and MRI diffusion (DWI) in distinguishing the most reliable features to suggest the diagnosis of spine infection versus bone tumor/metastasis was collected. Definitive differential diagnosis between infection and tumor requires biopsy and culture. The sensitivity and specificity of percutaneous biopsy are 72% and 94%, respectively. Imaging studies can be added to address the diagnosis, but a multidisciplinary discussion with radiologists and nuclear medicine specialists is mandatory.

Diagnostic Accuracy of Ocular Ultrasonography in Identifying Raised Intracranial Pressure among Pediatric Population

Introduction: Role of CT scan, MRI, ophthalmoscopy, direct monitoring by a transducer probe in identifying raised intracranial pressure (ICP) in emergency department is limited. There are few studies correlating elevated optic nerve sheath diameter (ONSD) measured by point of care ultrasound (POCUS) with raised ICP in pediatrics emergencies. We studied the diagnostic accuracy of ONSD, crescent sign, and optic disc elevation in identifying increased ICP in pediatrics. Methods: Prospective observational study was done between April 2018 and August 2019 after ethics approval. Out of 125 subjects, 40 patients without clinical features of raised ICP were recruited as external controls and 85 with clinical features of raised ICP as study subjects. Their demographic profile, clinical examination, and ocular ultrasound findings were noted. This was followed by CT scan. Out of 85 patients, 43 had raised ICP (cases) and 42 had normal ICP (disease controls). Diagnostic accuracy of ONSD in identifying raised ICP was evaluated using STATA. Results: The mean ONSD in case group was 5.5 ± 0.6 mm, 4.9 ± 0.5 mm in disease control group and external control group was 4.8 ± 0.3 mm. Cut-off of ONSD for raised ICP at ≥4.5 mm had a sensitivity and specificity of 97.67% and 10.98%, while ≥5.0 mm showed a sensitivity and specificity of 86.05% and 71.95%. Crescent sign and optic disc elevation had good correlation with increased ICP. Conclusion: ONSD ≥5 mm by POCUS identified raised ICP in pediatric population. Crescent sign and optic disc elevation may function as additional POCUS signs in identifying raised ICP.

The Role of CT Scan in Pediatric Airway Foreign Bodies.

We aim to determine the utility of CT scan as a method to accurately confirm pediatric airway foreign bodies (AFBs), the current gold standard of which is chest X-ray as the primary imaging modality in the investigation screening of AFBs with progression to microlaryngobronchoscopy. A retrospective cohort study ofchildren diagnosed with suspected AFBs between July 2019 and June 2020 was conducted. The primary outcome of missed AFBs from radiologic investigations was recorded. A total of 226 childrenwith an average age of 1.94 years were included in this study. One hundred and two children were eventually admitted to the hospital for microlaryngobronchoscopy.A total of 89 cases were initially examined by chest X-ray with the diagnosis confirmed in 26 cases. The initial examination was chest CT scan in 105 cases, of which the diagnosis was confirmed in 46 cases. The initial examination was chest CT scan with airway reconstruction in 32 cases, and the diagnosis was confirmed in 17 cases. Patients with negative chest CT scan with airway reconstruction were observed to have resolution of symptoms with no further need for bronchoscopy. Chest CT scan with airway reconstruction had the highest rate of confirmed diagnosis of pediatric AFBs on initial scanning, followed by chest CT scan, and finally chest X-ray with fluoroscopy; there was no missed diagnosis in chest CT scan with airway reconstruction. Chest CT scan with airway reconstruction can accurately and quickly detect AFBs and reduce unnecessary bronchoscopy.

Role of CT Scan in Constrictive Pericarditis Presenting with Refractory Ascites – Review of Literature

Constrictive Pericarditis (CP) is a rigid, thick noncompliant, fibrotic, and/or calcific pericardium. Early diagnosis of CP is difficult due to its vague symptoms, deceptive course and absence of usual cardiopulmonary signs. In this case report, we represent a 27-year-old male who came to our hospital with a distended abdomen and breathlessness. Because of predominant symptoms of abdominal distention and breathlessness, the patient was advised for Contrast-Enhanced Computed Tomography (CECT) of the chest and abdomen. Interestingly, the CT scan raised the possibility of constrictive pericarditis as the underlying aetiology for all of his symptoms which was confirmed using echocardiography and right heart catheterisation CP. The patient underwent surgical pericardiectomy, and the post-surgery period was uneventful; he did not require further paracentesis and was discharged in stable condition.

EP10.01-015 The Role of CT-Scan as a Body Composition Tool in Oncogene-Addicted Advanced Non-Small Cell Lung Cancer (aNSCLC) Patients.

Sarcopenia causes shorter survival and severe treatment-induced toxicities in aNSCLC pts, including oncogene -addicted ones treated with tyrosine kinase inhibitors (TKIs). The CT-scan, routinely used in follow-up, may also be an additional tool for assessing body composition. The aim of the present study was to define an algorithm, combining radiological data with clinical parameters, in order to achieve early identification of malnourished patients with oncogene-addicted aNSCLC.

Role of CT scan in assessing Post-acute COVID sequalae-A

A variety of chest imaging findings have been described in patients with COVID-19. Use of imaging could be useful for the diagnosis of patients with suspected COVID-19 and in patients diagnosed with COVID-19, to inform management. Our study aimed at assessing the significance of CT scan usage in determining the lung injury in patients as post-acute COVID sequalae having COVID 19 after a 3 month followup and to study the various findings in post-acute COVID sequalae through CT scan.

The Role of CT Scan In Diagnosis Of Early Stroke

The Role of CT Scan In Diagnosis Of Early Stroke

Role of ct scan in diagnosis of pulmonary complications in children with hematological malignancy

Role of ct scan in diagnosis of pulmonary complications in children with hematological malignancy

Spontaneous pneumothorax, with or without pulmonary cysts, in patients with COVID-19 pneumonia.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) affects mainly the lungs causing pneumonia and complications like acute respiratory distress syndrome. Pneumothorax is a rare manifestation of the disease. This report is a description of a series of patients with COVID-19 and spontaneous pneumothorax, some of them with associated pulmonary cysts. Cases were collected retrospectively. We included clinical data from medical records and described radiologic findings. Patients that developed pneumothorax during mechanical ventilation were excluded. Ten cases were included in this report, nine of them were male. The median age of our series was 62 years (IQR = 57-68). The median days since the onset of symptoms until the development of pneumothorax was 27 (IQR = 17-31), most cases developed after the second week of the diagnosis of pneumonia. Two cases required invasive mechanical ventilation, but pneumothorax occurred after ventilator weaning. Three cases showed subpleural pulmonary cysts. Cysts and pneumothorax are rare manifestations of SARS-CoV-2 pneumonia with mechanisms not completely understood. This report highlights the role of CT scan in diagnosis of COVID-19 complications.

EP.TU.465Role of CT scan as initial investigation in colorectal rapid access patients

BackgroundWe looked into CT colonoscopies and CT abdomen and pelvis which were booked as initial investigation in patients referred via the colorectal rapid access pathway. These tests were directly booked following the referral after a nurse led triage.As per our colorectal straight to test protocol (STT) any patients over the age of 75 or unfit individuals will have a CT colonoscopy (virtual colonoscopy) instead of colonoscopy. CT trunk was used during COVID pandemic as the initial investigation when the aerosol generating procedures were stopped. CT trunks are also the initial investigation as per the STT protocol when patients are referred with suspected abdominal mass, weight loss or abdominal pain.MethodsRetrospective analysis of prospective electronic data base of colorectal STT referrals from Feb 2020 to end of October 2020.ResultsTotal no colorectal STT referrals -1524CT colonoscopies and CT trunks booked as initial investigation 420(27.55%)Patients who refused to have the scans due to COVID 93/420 (22.14%)Colorectal cancer diagnosis 25/327 (7.64%)Non-colorectal cancer diagnosis 20/327(6.11%) Incidental AAA 15/327(4.58%)Normal examination 91/327(27.82%)Colonic polyps 27/327(8.25%)Diverticular disease 92/327(28.13%)ConclusionCT colonoscopies and CT trunks form part of initial diagnostic tool in the colorectal rapid access patients. They are particularly useful in high risk patients who cannot tolerate colonoscopy. These investigations complement the lower GI endoscopy. These scans also identify non-colorectal malignancies and retroperitoneal pathology such as AAA.CT trunks were useful tools during COVID 19 Pandemic.

The Management of Acute Colonic Diverticulitis in the COVID-19 Era: A Scoping Review.

Background and Objective: During the COVID-19 pandemic, health systems worldwide made major changes to their organization, delaying diagnosis and treatment across a broad spectrum of pathologies. Concerning surgery, there was an evident reduction in all elective and emergency activities, particularly for benign pathologies such as acute diverticulitis, for which we have identified a reduction in emergency room presentation with mild forms and an increase with more severe forms. The aim of our review was to discover new data on emergency presentation for patients with acute diverticulitis during the Covid-19 pandemic and their current management, and to define a better methodology for surgical decision-making. Method: We conducted a scoping review on 25 trials, analyzing five points: reduced hospital access for patients with diverticulitis, the preferred treatment for non-complicated diverticulitis, the role of CT scanning in primary evaluation and percutaneous drainage as a treatment, and changes in surgical decision-making and preferred treatment strategies for complicated diverticulitis. Results: We found a decrease in emergency access for patients with diverticular disease, with an increased incidence of complicated diverticulitis. The preferred treatment was conservative for non-complicated forms and in patients with COVID-related pneumonia, percutaneous drainage for abscess, or with surgery delayed or reserved for diffuse peritonitis or sepsis. Conclusion: During the COVID-19 pandemic we observed an increased number of complicated forms of diverticulitis, while the total number decreased, possibly due to delay in hospital or ambulatory presentation because of the fear of contracting COVID-19. We observed a greater tendency to treat these more severe forms by conservative means or drainage. When surgery was necessary, there was a preference for an open approach or a delayed operation.

Dual-source and prospective gated low dose neonatal cardiac computed tomography in evaluation of congenital heart disease

BackgroundThere are very limited studies describing radiation dose using prospective gated dual-source Cardiac CT in neonates. ObjectivesThe aim of this study is to describe the radiation exposure parameters in newborns using modern fast CT scanner (prospective gated dual-source technique) and the role of CT scan in providing useful information for optimal management planning. MethodsRetrospective review of 60 neonates who underwent cardiac CT at our Children's Hospital between November 2019 to November 2020 using the Siemens Somatom Force Dual-Source scanner (Siemens Medical Solutions, Malvern, PA, USA) and prospective gated technique. Patient demographic information, total dose length product (DLP), computed tomographic dose index volume (CTDIvol), patient average heart rate during the scan, indication for the study and patient diagnosis were reviewed. The estimated effective radiation dose was calculated using a previously published conversion rate. Both quantitative and qualitative image quality was evaluated at satellite workstation. ResultsMedian effective radiation dose for the computed tomographic angiography (CTA) was 0.31 mSv. The median total DLP was 8 mGycm and median CTDIvol was 2.46 mGy. The average image noise was 23 with calculated average signal to noise ratio of 22 and average contrast to noise ratio of 19. The qualitative image quality was excellent or good in all of our study subjects with no repeat CT scan needed due to image quality. ConclusionUsing newer generation dual-source fast scanners with prospective ECG-triggered technique, cardiac CT can be done with very low dose in neonates. Cardiac CT provides better understanding of complex congenital heart disease for optimal management planning when echocardiography does not answer the clinical question.

Role of CT Scan in Diagnosis of COVID-19 Infection- A Review

Since it was declared a worldwide pandemic, COVID-19 has ravaged almost all over the world and has overloaded several health-care systems. The pandemic also resulted in job losses as a result of lengthy shutdowns, which burdened the global economy. Even though significant clinical research progress has led to a better perceiving of the virus (SARS-CoV-2) nature and the disease (COVID-19) management, preventing the virus's spread has become a major concern as SARS-CoV-2 continues to wreak havoc around the world. Several countries suffered from the second or third wave of viral disease outbreaks, primarily caused by the mutation of SARS-CoV-2. Imaging is critical in the diagnosis and follow-up of patients with new coronavirus-infected pneumonia (NCIP). The primary imaging modality in clinically suspected cases is CT scan and it is useful for monitoring imaging changes following therapy. Therefore, CT is regarded as a useful diagnostic technique for clinically suspected cases of COVID-19. CT has the ability to detect patients who have a negative reverse transcription–polymerase chain reaction (RT-PCR) but are highly suspicious of NCIP in terms of clinical problems. In addition, the results of a CT scan may also reveal information concerning the severity of the condition. In this review article, the diagnosis of COVID-19 is discussed and CT characteristics are defined based on the newest research for the diagnosis and management of COVID-19.

Multidetector Computed Tomography (MDCT) Evaluation of Traumatic Brain Injury in Head Trauma Patients in Tertiary Hospital of Eastern Region of Nepal

Introduction: Traumatic brain injury (TBI) in patients with head trauma is common cause for emergency visits to hospital affecting all age groups. It is one of important leading cause of death and disability worldwide besides leading to neurological disease burden. Noncontrast enhanced Multidetector computed tomography (MDCT) is imaging modality of choice for detection of various intracranial lesions.&#x0D; Objectives: This study was done to analyse various imaging findings on MDCT in traumatic head injury patients along with association of CT findings with clinical manifestation and mechanism of injury.&#x0D; Methodology: In this ethically approved prospective study, CT scan was done in 224 consecutive patients with head injury from November 2020 to February 2021. The various imaging findings seen in CT scan were documented in proforma. The data collected was analyzed with appropriate statistical test and statistical significance was calculated.&#x0D; Results: Total of 224 patients with diagnosis of head injury were included in the study. The male to female ratio was 2.86 and most common age group involved was between 20-40years (41.1%). The most common mode of injury was road traffic accidents (57.6%) and most of the patients presented with history of altered sensorium (35.7%). About 47.3% patients showed abnormal findings on CT scan with scalp lesion was most common findings (82%) followed by skull fractures (54.7%) and cerebral contusions (43.4%). Patients with history of RTA had more abnormal CT scan (62%) than fall injury and physical assault. Statistically significant association seen between CT scan findings with Glasgow Coma Scale and RTA (P&lt;0.05).&#x0D; Conclusion: The present study showed well documented role of CT scan in diagnosis of TBI besides detection of spectrum of intracranial lesions in patients with head trauma. Road traffic accident is most common mode of head injury with most of the victims are young middle age active male.

An Eight-week Follow-up Study in Patients With COVID-19 Respiratory Failure: Delayed Recovery or Lung Sequel

In recent months, coronavirus disease 2019 (COVID-19) is a significant global health problem that has a tremendous negative impact on the human being, and almost all countries of the world have been affected by the disease. CT imaging techniques have an important role in the primary diagnosis of pneumonia secondary to COVID-19; moreover, the level of pulmonary involvement in CT scan is one of the criteria for disease severity in the acute phase of COVID-19 pneumonia. Still, the role of CT scan in the follow-up period is unknown.

The value of computed tomography in assessing the risk of death in COVID-19 patients presenting to the emergency room.

ObjectiveThe aims of this study were to develop a multiparametric prognostic model for death in COVID-19 patients and to assess the incremental value of CT disease extension over clinical parameters.MethodsConsecutive patients who presented to all five of the emergency rooms of the Reggio Emilia province between February 27 and March 23, 2020, for suspected COVID-19, underwent chest CT, and had a positive swab within 10 days were included in this retrospective study. Age, sex, comorbidities, days from symptom onset, and laboratory data were retrieved from institutional information systems. CT disease extension was visually graded as < 20%, 20–39%, 40–59%, or ≥ 60%. The association between clinical and CT variables with death was estimated with univariable and multivariable Cox proportional hazards models; model performance was assessed using k-fold cross-validation for the area under the ROC curve (cvAUC).ResultsOf the 866 included patients (median age 59.8, women 39.2%), 93 (10.74%) died. Clinical variables significantly associated with death in multivariable model were age, male sex, HDL cholesterol, dementia, heart failure, vascular diseases, time from symptom onset, neutrophils, LDH, and oxygen saturation level. CT disease extension was also independently associated with death (HR = 7.56, 95% CI = 3.49; 16.38 for ≥ 60% extension). cvAUCs were 0.927 (bootstrap bias-corrected 95% CI = 0.899–0.947) for the clinical model and 0.936 (bootstrap bias-corrected 95% CI = 0.912–0.953) when adding CT extension.ConclusionsA prognostic model based on clinical variables is highly accurate in predicting death in COVID-19 patients. Adding CT disease extension to the model scarcely improves its accuracy.Key Points • Early identification of COVID-19 patients at higher risk of disease progression and death is crucial; the role of CT scan in defining prognosis is unclear. • A clinical model based on age, sex, comorbidities, days from symptom onset, and laboratory results was highly accurate in predicting death in COVID-19 patients presenting to the emergency room. • Disease extension assessed with CT was independently associated with death when added to the model but did not produce a valuable increase in accuracy. Supplementary InformationThe online version contains supplementary material available at 10.1007/s00330-021-07993-9.

The role of imaging in the management of non-traumatic subarachnoid hemorrhage: a practical review

The purpose of this review is to understand the role of imaging in the diagnosis and management of non-traumatic subarachnoid hemorrhage (SAH). SAH is a life-threatening emergency and a relatively common entity, the most common etiology being ruptured aneurysms. Multiple conundrums exist in literature at various steps of its imaging workup: diagnosis, management, and follow-up. We target our review to highlight the most effective practice and suggest efficient workup plans based on literature search, and describe in detail the clinical diagnostic and prognostic scales, role of CT scan, lumbar puncture, and MR, including angiography in the diagnosis and workup of SAH and its complications, and try to simplify the conundrums. Practical knowledge of imaging workup of SAH can help guide correct management of these patients, so as to reduce morbidity and mortality without resource overutilization.