Soft Tissue Window Research Articles

Feasibility analysis of high pitch cervical spine CT in uncooperative patients with acute cervical spine trauma: An initial experience.

Cervical computed tomography (CT) often suffers from examination failure in uncooperative patients with acute cervical spinal trauma. Therefore, this study aimed to evaluate the feasibility of using high-pitch cervical CT (HP-CT) in such populations. A total of 95 patients with acute neck/head-neck trauma who underwent HP-CT (n = 29) or standard cervical CT (SD-CT, n = 66) from October 2020 to June 2021 were included in this study. Differences in patient characteristics between the HP-CT group and the SD-CT group were firstly compared. Then, the objective image quality based on the mean score of the signal-to-noise ratio (SNR)/contrast noise ratio (CNR) was evaluated, while double-blind five-point scoring was adopted for the subjective evaluation. Finally, radiation doses in HP-CT and SD-CT were compared. Furthermore, the Student t test and/or Mann–Whitney U test were performed to analyze differences in patient characteristics, image quality, and radiation dose between the two regimes. A total of 17 cases of cervical spine fractures were found in 95 patients, including 6 cases in the HP-CT group and 11 cases in the SD-CT group. The average age of patients who received HP-CT was higher than that of those who received SD-CT, and the scan time using HP-CT was shorter than that SD-CT. The differences were statistically significant (both, P < .05). In addition, there was no significant difference between HP-CT and SD-CT in terms of sex, body mass index, field of view (FOV), and scan length (all P > .05). The SNR/CNR at the middle and upper neck was not significantly different between HP-CT and SD-CT (all P > .05). However, the SNR/CNR at the lower neck in HP-CT was lower than that in SD-CT (all P < .05). There was no significant difference in the subjective scores between HP-CT and SD-CT images in both the soft tissue and bone window (P = .129 and 0.649, respectively). The radiation dose in HP-CT was lower than that in SD-CT (all P < .05). With a scan time reduction of 73%, radiation dose reduction of 10%, and similar image quality, high-pitch cervical CT was of feasibility to evaluate cervical spine injury in uncooperative patients with acute cervical spine trauma.

Combined Disruption of the Thoracic Spine and Costal Arch Fracture: An Indicator of a Severe Chest Trauma.

Blunt high-energy chest trauma is often associated with thoracic and abdominal organ injuries. Literature for a hyperextension-distraction mechanism resulting in a costal arch fracture combined with a thoracic spine fracture is sparse. A 65-year-old male suffered a fall from a height of six meters. Initial X-ray of the chest shows left-sided high-riding diaphragm and CT scan proves anterior cartilage fracture, posterolateral serial rib fractures, traumatic intercostal pulmonary hernia, avulsion of the diaphragm, and 7th thoracic vertebral fracture. An exploratory thoracotomy was performed and the rupture of the diaphragm, creating a two-cavity injury, had been re-fixed, the pulmonary hernia was closed, and locking plate osteosyntheses of the fractured ribs including the costal arch were performed. We generally recommend surgical therapy of the thorax to restore stability in this severe injury entity. The spine was fixed dorsally using a screw-rod system. In conclusion, this thoracovertebral injury entity is associated with high overall injury severity and life-threatening thoracoabdominal injuries. Since two-cavity traumata and particularly diaphragmatic injuries are often diagnosed delayed, injuries to the costal arch can act as an indicator of severe trauma. They should be detected through clinical examination and assessment of the trauma CT in the soft tissue window.

The potential of computed tomography in odontometry: application to a Mesolithic dog

A large odontometric reference database is essential for a clear and reliable differentiation between the teeth of dogs and wolves found in archaeological contexts. However, the data compilation of skeletal material is a slow process because access to dog remains may be difficult. The expansion of a dental database could benefit from computed tomography (CT) scans performed on live dogs during medical appointments and archived in veterinary clinics. To enable it, however, the reliability and accuracy of digital measurements must first be validated. This is the main objective of this paper.We tested the accuracy of dental measurements obtained from CT scans of deceased modern dogs and one Mesolithic dog. CT measurements were obtained using multi-planar reconstruction (MPR) (bi-dimensional images) and three-dimensional volume rendering (3D VR), either using bone or soft tissue windows. Then, measurements were compared with data obtained with a conventional caliper (Fischer Darex®, France). The sample comprised 25 maxillary fourth premolars and 17 maxillary canines. Measurements included the mesiodistal length (MDL) and the vestibular palatine width (VPW). Intra- and inter-observer variations were assessed by calculating the technical error of measurement (TEM). This approach was also used to assess the level of agreement between both techniques, complemented by a Bland-Altman analysis.Intra-observer (TEM = 0.52% to 5.98%) and inter-observer variations (TEM = 3.15% to 7.14%) were relatively small for most standard measurements, windows, and CT approaches. In the case of the MPR approach, the soft tissue window provided less observer variation on the fourth premolar; the same occurred for the bone window regarding the canine. The soft tissue window generally provided less observer variation with the VR approach. CT and caliper agreement ranged from 2.89% to 7.31% (MPR), and from 2.92% to 9.42% (3D VR). At least 91% of the CT measurements were within the Bland-Altman 95% confidence interval. We were able to carry out a thorough odontometric study of the Muge dog skull – a specimen dated to the Mesolithic period, using the MPR approach (with both bone and soft tissue windows).Both the MPR and VR CT scan approaches were validated, thus confirming digital data as an alternative way to generate more comprehensive odontometric references.

Assessment of low-dose paranasal sinus CT imaging using a new deep learning image reconstruction technique in children compared to adaptive statistical iterative reconstruction V (ASiR-V)

PurposeTo compare the effects of deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction V (ASiR-V) on image quality in low-dose computed tomography (CT) of paranasal sinuses in children.MethodsLow-dose CT scans of the paranasal sinuses in 25 pediatric patients were retrospectively evaluated. The raw data were reconstructed with three levels of DLIR (high, H; medium, M; and low, L), filtered back projection (FBP), and ASiR-V (30% and 50%). Image noise was measured in both soft tissue and bone windows, and the signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of the images were calculated. Subjective image quality at the ethmoid sinus and nasal cavity levels of the six groups of reconstructed images was assessed by two doctors using a five-point Likert scale in a double-blind manner.ResultsThe patients’ mean dose-length product and effective dose were 36.65 ± 2.44 mGy·cm and 0.17 ± 0.03 mSv, respectively. (1) Objective evaluation: 1. Soft tissue window: The difference among groups in each parameter was significant (P < 0.05). Pairwise comparisons showed that the H group’ s parameters were significantly better (P < 0.05) than those of the 50% post-ASiR-V group. 2. Bone window: No significant between-group differences were found in the noise of the petrous portion of the temporal bone or its SNR or in the noise of the pterygoid processes of the sphenoids or their SNRs (P > 0.05). Significant differences were observed in the background noise and CNR (P < 0.05). As the DLIR intensity increased, image noise decreased and the CNR improved. The H group exhibited the best image quality. (2) Subjective evaluation: Scores for images of the ethmoid sinuses were not significantly different among groups (P > 0.05). Scores for images of the nasal cavity were significantly different among groups (P < 0.05) and were ranked in descending order as follows: H, M, L, 50% post-ASiR-V, 30% post-ASiR-V, and FBP.ConclusionDLIR was superior to FBP and post-ASiR-V in low-dose CT scans of pediatric paranasal sinuses. At high intensity (H), DLIR provided the best reconstruction effects.

Optimising a 3D convolutional neural network for head and neck computed tomography segmentation with limited training data.

Convolutional neural networks (CNNs) are increasingly used to automate segmentation for radiotherapy planning, where accurate segmentation of organs-at-risk (OARs) is crucial. Training CNNs often requires large amounts of data. However, large, high quality datasets are scarce. The aim of this study was to develop a CNN capable of accurate head and neck (HN) 3D auto-segmentation of planning CT scans using a small training dataset (34 CTs). Elements of our custom CNN architecture were varied to optimise segmentation performance. We tested and evaluated the impact of: using multiple contrast channels for the CT scan input at specific soft tissue and bony anatomy windows, resize vs. transpose convolutions, and loss functions based on overlap metrics and cross-entropy in different combinations. Model segmentation performance was compared with the inter-observer deviation of two doctors' gold standard segmentations using the 95th percentile Hausdorff distance and mean distance-to-agreement (mDTA). The best performing configuration was further validated on a popular public dataset to compare with state-of-the-art (SOTA) auto-segmentation methods. Our best performing CNN configuration was competitive with current SOTA methods when evaluated on the public dataset with mDTA of mm for the brainstem, mm for the mandible, mm for the left parotid and mm for the right parotid. Through careful tuning and customisation we trained a 3D CNN with a small dataset to produce segmentations of HN OARs with an accuracy that is comparable with inter-clinician deviations. Our proposed model performed competitively with current SOTA methods.

February 2022 Medical Image of the Month: Multifocal Micronodular Pneumocyte Hyperplasia in the Setting of Tuberous Sclerosis

No abstract available. Article truncated at 150 words. A 22-year-old man with a known diagnosis of Tuberous Sclerosis Complex (TSC) presents for a follow-up unenhanced chest CT to re-evaluate pulmonary nodules seen in the lung bases on a prior abdominal CT. The patient also has a history of multiple renal lesions consistent with lipid-poor angiomyolipomas based on previous abdominal MRI findings. The chest CT demonstrated multiple scattered, randomly distributed sub-centimeter pulmonary nodules of solid or subsolid morphology [Figure 1A]. Those nodules visible in the lung bases on the prior abdominal CT had remined stable over the 12-month interval consistent with multifocal microscopic pneumocyte hyperplasia (MMPH)[Figure 1B,C]. Myocardial fatty foci (MFF) were visualized in the heart on soft tissue window display settings [Figure 2A] as were multiple scattered sclerotic bone lesions on bone window display settings [Figure 2B,C]. No pulmonary cysts were seen to suggest lymphangioleiomyomatosis (LAM) and there were no thoracic lymphangiomas. MMPH represents a benign hamartomatous proliferation …

Prognostic Role of Subcutaneous and Visceral Adiposity in Hospitalized Octogenarians with COVID-19.

Background: We investigated the prognostic significance of visceral and subcutaneous adiposity in octogenarians with COVID-19. Methods: This paper presents a monocentric retrospective study that was conducted in acute geriatric wards with 64 hospitalized patients aged 80+ who had a diagnosis of COVID-19 and who underwent a chest CT scan. A quantification of the subcutaneous, visceral, and total fat areas was performed after segmentations on the first abdominal slice caudal to the deepest pleural recess on a soft-tissue window setting. Logistic regression models were applied to investigate the association with in-hospital mortality and the extent of COVID-19 pneumonia. Results: The patients had a mean age of 86.4 ± 6.0 years, and 46.9% were male, with a mean BMI of 24.1 ± 4.4Kg/m2 and mortality rate of 32.8%. A higher subcutaneous fat area had a protective effect against mortality (OR 0.416; 0.183–0.944 95% CI; p = 0.036), which remained significant after adjustments for age, sex, and BMI (OR 0.231; 0.071–0.751 95% CI; p = 0.015). Inversely, higher abdominal circumference, total fat area, subcutaneous fat area, and visceral fat were associated with worse COVID-19 pneumonia, with the latter presenting the strongest association after adjustments for age, sex, and BMI (OR 2.862; 1.523–5.379 95% CI; p = 0.001). Conclusion: Subcutaneous and visceral fat areas measured on chest CT scans were associated with prognosis in octogenarians with COVID-19.

Symptoms: Middle Ear Mass and Hearing Loss

Symptoms: Middle Ear Mass and Hearing Loss

Update of the EPTN atlas for CT- and MR-based contouring in Neuro-Oncology

Background and purposeTo update the digital online atlas for organs at risk (OARs) delineation in neuro-oncology based on high-quality computed tomography (CT) and magnetic resonance (MR) imaging with new OARs. Materials and methodsIn this planned update of the neurological contouring atlas published in 2018, ten new clinically relevant OARs were included, after thorough discussion between experienced neuro-radiation oncologists (RTOs) representing 30 European radiotherapy-oncology institutes. Inclusion was based on daily practice and research requirements. Consensus was reached for the delineation after critical review. Contouring was performed on registered CT with intravenous (IV) contrast (soft tissue & bone window setting) and 3 Tesla (T) MRI (T1 with gadolinium & T2 FLAIR) images of one patient (1 mm slices). For illustration purposes, delineation on a 7 T MRI without IV contrast from a healthy volunteer was added. OARs were delineated by three experienced RTOs and a neuroradiologist based on the relevant literature. ResultsThe presented update of the neurological contouring atlas was reviewed and approved by 28 experts in the field. The atlas is available online and includes in total 25 OARs relevant to neuro-oncology, contoured on CT and MRI T1 and FLAIR (3 T & 7 T). Three-dimensional (3D) rendered films are also available online. ConclusionIn order to further decrease inter- and intra-observer OAR delineation variability in the field of neuro-oncology, we propose the use of this contouring atlas in photon and particle therapy, in clinical practice and in the research setting. The updated atlas is freely available on www.cancerdata.org.

Impact of Multiparametric Stone Measurement in Noncontrast Computer Tomography on Ureterorenoscopic Stone Removal

Purpose: Low-dose computer tomography (NCCT) is the standard imaging modality for patients with acute flank pain with a suspicion of urolithiasis. The stone size is usually measured 2D by a radiologist. We compared 3D stone measurement using different windows to the 2D measurement and evaluated the clinical impact on ureterorenoscopic stone removal (URS). Methods: One hundred sixty-four patients (201 stones) with a preoperative NCCT, following a URS within 4 weeks, were included in this study. Stone location, number and size of stones, operating time, and laser lithotripsy were documented. Stones were measured in 3D using bone and soft tissue window. The maximum diameter was compared to the radiological report. The U test, Kruskal-Wallis, and regression were used for statistical analyses. Results: Almost two-thirds (64.68%; 130 stones) of stone measurements in 3D with the bone window were lower than the radiologist reports in 2D. One-third (34.83%; 70 stones) of stone measurements were higher and 0.5% (1 stone) reported the same size. Using the 3D soft tissue window, 81.09% (163 stones), 17.91% (37 stones), and 1% (2 stones) of stones were measured bigger, smaller, or had the same measurement results, respectively. In the clinical setting, we could calculate a cutoff for laser lithotripsy at a maximum stone diameter of 5.70 mm (p < 0.01) with the 3D and 6.01 mm with the 2D measurements, respectively, and found a significant correlation between maximum stone diameter and operating time (p < 0.01) and number of stones and operating time (p < 0.01 with and p = 0.02 without laser). Conclusion: 3D stone measurement with bone window seems to be more accurate than 2D measurement, but 2D is sufficient for planning stone treatment.

Cranial Structure of Varanus komodoensis as Revealed by Computed-Tomographic Imaging.

Simple SummaryWe investigated the head of Komodo dragons using CT imaging. Cross-sections show that all cranial bones can be delineated, while soft tissue structures are evident but not clearly identifiable without an anatomical atlas. Additional three-dimensional reconstructed and maximum intensity projection images of the head were presented to depict bony structures. The anatomical structures identified on the CT images could help further assess the head of the Komodo dragon.This study aimed to describe the anatomic features of the normal head of the Komodo dragon (Varanus komodoensis) identified by computed tomography. CT images were obtained in two dragons using a helical CT scanner. All sections were displayed with a bone and soft tissue windows setting. Head reconstructed, and maximum intensity projection images were obtained to enhance bony structures. After CT imaging, the images were compared with other studies and reptile anatomy textbooks to facilitate the interpretation of the CT images. Anatomic details of the head of the Komodo dragon were identified according to the CT density characteristics of the different organic tissues. This information is intended to be a useful initial anatomic reference in interpreting clinical CT imaging studies of the head and associated structures in live Komodo dragons.

Comparison of Urinary Calculi Size Between Bone and Soft Tissue Window in Computed Tomography

Computed Tomography is an important technique for imaging the urinary calculi using cross sectional images. The size and site of the calculi are significant aspect that are necessary for treatment. Therefore, present study aims to compare diameters of calculi measured using bone and soft tissue window settings in CT and also determinesmost frequent site for occurrence of calculi in urinary system. This is a retrospective study including total of 126 patients (91 males, 35 females, age range: 20-50 years). The patients who had undergone non contrast enhanced computed tomography of Kidney Ureter and Bladder (NCCT KUB) and diagnosed with urinary calculi were included in study. For each calculus found on CT image, two diameters such as maximum diameter and perpendicular diameter was measured on coronal plane using soft tissue and bone window settings. Site of calculi was also noted.To compare diameters measured using soft tissue and bone window settings Wilcoxon signed ranks test was used.Mean of maximum diameter and perpendicular diameter of the calculi measured by soft tissue and bone window settings in CT was 0.74±0.5, 0.82 ±1.8 and 0.79 ± 0.5 ,0.67 ± 0.49 respectively. It was found that there was significant difference in diameters of calculi measured using soft tissue and bone window setting (p&lt;0.0001). The study concludes that there was mean difference of0.08 cms and 0.12 cms for maximum axial diameter and perpendicular diameter respectively measured using soft tissue and bone window settings in CT. Calculi in kidneys was most common site in our study population.

Morphological speculation of the MHPD and related clinical projections.

The concept of mesopancreas has been brought into focus nowadays. Studies on membrane morphology of pancreas are clinically significant in determining an ideal surgical route for a "holy plane". In this paper, we aimed to observe the structure of the peripancreatic membranes and its interactions with adjacent tissues; tentatively put forward the proposition of mesohepatopancreaticoduodenum (MHPD) and explore in depth in surgical local resection. 33 cadavers were examined in the experiment, including 30 for gross anatomy and 3 for histological observation after transection. The histological characteristics of the membrane covering the pancreas were proved by Masson and Bielschowsky silver staining and further explored in clinical application and testified in a surgical scenario. All above were carried out through traditional procedures. The anterior surface membrane of the pancreas was intact and the posterior portion expanding to the pancreaticoduodenum enclosed the surface of the duodenum and the pancreatic head, which could be easily isolated from the posterior abdominal wall. The posterior surface membrane around the body and tail wrapped the pancreatic parenchyma, which created a soft-tissue window for the posterior abdominal wall. Then, dense connective tissue adhesions were detected between the celiac artery and the superior mesenteric artery. The embryonic origin of the mesopancreas and the surgical procedures were reviewed and inspected based on the proposition of MHPD and above results. We hope that this study could stir up our interest in the advancement of imaging diagnoses and minimally invasive surgical treatment of pancreas.

STUDY ON THE OPTIC NERVE VARIATIONS IN RELATION TO POSTERIOR PARANASAL SINUSES USING CT IN TERTIARY CARE CENTRE

Background and objectives: Optic nerve has a close relationship with the posterior paranasal sinuses. Depending on the degrees of pneumatization of these sinuses, the optic nerve may indent the sinus wall or protrude into them, predisposing the nerve to injury during sinus surgeries. Aim was to analyse the optic nerve variations in relation to the posterior paranasal sinuses and to categorize the subjects as per DeLano's classification.&#x0D; Methods: Cross-sectional study was conducted on 336 patients above 16 years of age who underwent computed tomographic evaluation of head and brain. From volume data, multiplanar reconstructions were made in axial, coronal and sagittal planes and analysed in both bone and soft-tissue windows. Relationship of optic nerve with posterior paranasal sinuses were categorised into 4 types according to DeLano's classification. Bony dehiscence of optic canal and pneumatization of anterior clinoid process were also assessed.&#x0D; Results: 672 optic nerves were assessed, the most common optic nerve type identified was type 1 (62.6%), followed by type 2 (18.6%). Types 3 and 4 were seen equally in number (9.6% each). Dehiscence of optic nerve canal and pneumatization of anterior clinoid process (ACP) was seen respectively on 66 (9.8%) and 75 (11.2%) sides. Compared to type 1 and 4 optic nerves, dehiscence of bony optic canal was statistically more significant in type 2 and 3 nerves. 45.5% individuals with anterior clinoid process pneumatization had associated optic canal dehiscence, which was found to be statistically significant.&#x0D; Conclusion: Optic nerve variations were identified and classified according to DeLano’s classification. The range was within international limits and type 1 was the most common occurrence. When compared to other similar studies among Indian population, disparity observed in the frequency of optic nerve types and bony optic canal dehiscence in our study, were probably due to differences in ethnicity and size of study group. Association of bony optic canal dehiscence with type 2 &amp; 3 optic nerves and ACP pneumatization with type 3 optic nerve was found to be statistically significant, making them more vulnerable to injury during surgery. Knowledge of optic nerve relation with posterior paranasal sinuses, and its identification in preoperative computed tomography (CT) scan are important to avoid injury to optic nerve.&#x0D; Keywords: Optic nerve, sphenoid sinus, posterior ethmoid cell, Onodi cell, anterior clinoid process pneumatization, optic canal dehiscence.

Symptoms: Clogged Ears and Muffled Hearing

Symptoms: Clogged Ears and Muffled Hearing

Anatomic Interactive Atlas of the Loggerhead Sea Turtle (Caretta caretta) Head.

Simple SummaryBecause several diseases have been reported affecting the head of sea turtles, accurate anatomic knowledge of this body part is necessary. We provide an open access, anatomic, interactive atlas of the head of the loggerhead sea turtle (Caretta caretta), to facilitate anatomic learning using osteology, gross dissection, and computed tomography (CT) images. Using segmentation and visualization software, relevant anatomic structures were identified and colored in all images, and a computer atlas was developed. This atlas, composed of 55 images, provides an interactive anatomic resource for veterinarians, biologists, researchers, and students involved in loggerhead sea turtle conservation.The head of the sea turtle is susceptible to congenital, developmental, traumatic, and infectious disorders. An accurate interpretation and thorough understanding of the anatomy of this region could be useful for veterinary practice on sea turtles. The purpose of this study was to develop an interactive two-dimensional (2D) atlas viewing software of the head of the loggerhead sea turtle (Caretta caretta) using images obtained via osteology, gross dissections, and computed tomography (CT). The atlas is composed of 10 osteology, 13 gross dissection, 10 sagittal multiplanar reconstructed CT (bone and soft tissue kernels), and 22 transverse CT (bone and soft tissue windows) images. All images were segmented and colored using ITK-SNAP software. The visualization and image assessment were performed using the Unity 3D platform to facilitate the development of interactive content in 2D. This atlas can be useful as an interactive anatomic resource for assessment of the head of loggerhead sea turtles.

Feasibility of Pediatric Low-Dose Facial CT Reconstructed with Filtered Back Projection Using Adequate Kernels.

PurposeTo evaluate the feasibility of pediatric low-dose facial CT reconstructed with filtered back projection (FBP) using adequate kernels.Materials and MethodsWe retrospectively reviewed the clinical and imaging data of children aged < 10 years who underwent facial CT at our emergency department. The patients were divided into two groups: low-dose CT (LDCT; Group A, n = 73) with a fixed 80-kVp tube potential and automatic tube current modulation (ATCM) and standard-dose CT (SDCT; Group B, n = 40) with a fixed 120-kVp tube potential and ATCM. All images were reconstructed with FBP using bone and soft tissue kernels in Group A and only bone kernel in Group B. The groups were compared in terms of image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Two radiologists subjectively scored the overall image quality of bony and soft tissue structures. The CT dose index volume and dose-length product were recorded.ResultsImage noise was higher in Group A than in Group B in bone kernel images (p < 0.001). Group A using a soft tissue kernel showed the highest SNR and CNR for all soft tissue structures (all p < 0.001). In the qualitative analysis of bony structures, Group A scores were found to be similar to or higher than Group B scores on comparing bone kernel images. In the qualitative analysis of soft tissue structures, there was no significant difference between Group A using a soft tissue kernel and Group B using a bone kernel with a soft tissue window setting (p > 0.05). Group A showed a 76.9% reduction in radiation dose compared to Group B (3.2 ± 0.2 mGy vs. 13.9 ± 1.5 mGy; p < 0.001).ConclusionThe addition of a soft tissue kernel image to conventional CT reconstructed with FBP enables the use of pediatric low-dose facial CT protocol while maintaining image quality.

Post Chemo Lung Toxicity: A Less Visited Domain

Background: Post-anticancer chemotherapy changes in lung parenchyma is an important and challenging aetiology for radiologists presenting not uncommonly in cancer patients. Early diagnosis of post-chemotherapy lung toxicity have serious implications on patient's health.Objective: To evaluate post-chemotherapy cancer patients for pulmonary toxicity and establish their association with frequency of chemotherapy cycles and time lapse since last cycle.Material and Methods: This retrospective study was conducted in Kuwait teaching Hospital from January 2018 till December 2018. A total of 204 patients were evaluated with age ranging from 3 to 78 years including 63 male and 141 female patients. Chest CT scan had been done on16 slice Toshiba CT scanner in Radiology department of Kuwait Teaching Hospital. Images were evaluated in axial, coronal and sagittal planes and in lung and soft tissue window on workstation. Data like patient age ,gender , malignancy , number of chemotherapy cycles received , time lapse since last chemotherapy cycle, common CT manifestations of lung toxicity and CT lung findings unrelated to chemotherapy regimens ;was collected and subjected to statistical analysis. Results: Out of the total 204 patients, who already had anticancer therapy, 135 patients (66.2%) did not show any pulmonary abnormality on CT chest . 11 patients (5.4%) showed chemotherapy related pulmonary findings on CT. 46 patients (22.5%) showed CT chest findings which were incidental and irrelevant to chemotherapy.12 patients (5.9%) had both chemotherapy related pulmonary toxicity changes and incidental findings. The types of post chemotherapy CT lung changes were divided into ground-glass haze, ground glass haze with bronchiectasis, ground glass haze with septal thickening giving crazy paving appearance, patches of consolidation and reticular thickening. 10 patients had sole finding of ground glass haze only (43.5%) whereas 4 patient showed ground glass haze with bronchiectatic changes(17.4 %) and 2 patients depicted a crazy paving appearance (8.7%). Significant association (p=0.00) was noted between number of chemotherapy cycles and above mentioned CT lung findings .No positive correlation was present between time lapse since last chemotherapy cycle and these CT lung findings. Conclusion: Ground glass attenuation was found to be the most profounding feature of post chemotherapy lung CT changes.

Effects of kernel and window setting combinations on assessments of small and complicated vasculature in computed tomography angiographic images of dogs with and without tumors.

To evaluate the effect of kernel and window settings on the assessment of small and complicated vasculature in CT angiographic (CTA) images of kidneys, jejunum with mesentery, and tumors in dogs. 20 healthy dogs and 20 dogs with tumors. Images from CTA performed previously in dogs were reconstructed with 3 different combinations of kernel and window settings (soft kernel with soft tissue window, soft kernel with bone window, and sharp kernel with bone window), and reconstructed images of the left kidney and the jejunum with the mesentery in healthy dogs and tumors in affected dogs were evaluated by reviewers blinded to the settings. For images of kidney and jejunum with mesentery, reviewers' scores for the conspicuity of vascularity in the arterial phase and the differentiation of the organs from the adjacent structures were significantly higher when viewed in bone window (vs soft tissue window) regardless of kernel setting. For images of head and gastrointestinal tumors, reviewers' scores for differentiation of intratumoral vasculature were higher when viewed in sharp kernel with bone window versus other setting combinations. However, the conspicuity of gastrointestinal, hepatic, or splenic tumoral vessels from the adjacent structures had higher reviewer scores for images in soft kernel with soft tissue window, compared with other setting combinations. Results indicated that reconstruction of CTA images with sharp kernel combined with bone window settings might have clinical utility in evaluating and planning treatments for dogs with various tumors; however, additional research is warranted to further identify effects of various kernel and window setting combinations on assessments of small and complicated vasculature in larger and more diverse populations of dogs with and without tumors.

Computed tomographic and radiographic morphology of the pastern and coffin joints of One-Humped Camel (Camelus dromedarius).

The objective of the current study was to describe the structures of the pastern and coffin joints in dromedary camel using x-ray, bone and soft tissue windows computed tomography (CT) and three-dimensional volume rendering (3DVR) of CT imaging. 3DVR of CT was obtained at the slight flexed dorsal view, plantar view, dorsolateral view and lateral view which explained all the surfaces and structures of the digit bony parts even the parts of the articular surface. The processed images of 3DVR of CT showed different patterns of the cortical, cancellous, subchondral bones and medullary cavity of the bones of the digits. The present study showed clearly all the hard and soft tissues in the pastern and coffin joints of the camel in CT images; however, the plantar ligaments of the pastern joint and ligaments of the navicular cartilage identified on CT images. The CT soft tissue window visualized the joint cavity and their pouches and tendon sheath of the flexor tendons better than the bone window CT. The radiographic, CT and 3D images could be used as a normal reference for the interpretation of some clinical diseases in the pastern and coffin joints of the camel.