scholarly journals The Influence of Mesenteric Defects Closure on the Use of Computed Tomography for Abdominal Pain 5 Years After Laparoscopic Gastric Bypass—a Post Hoc Analysis of a Randomized Clinical Trial

2021 ◽  
Author(s):  
Demir Amanda ◽  
Påhlson Elin ◽  
Norrman Eva ◽  
Erik Stenberg
Keyword(s):  
Computed Tomography ◽  
Gastric Bypass ◽  
Abdominal Pain ◽  
Ct Scans ◽  
Radiation Doses ◽  
Radiological Findings ◽  
Total Radiation Dose ◽  
Mesenteric Defects ◽  
Post Hoc ◽  
Risk Of Cancer

Abstract Background Abdominal pain after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common and unwanted complication that typically leads to further exploration through radiology. Concerns have been raised regarding the consequences of this radiation exposure and its correlation with the lifetime risk of cancer. The aim of this study was to evaluate the differences in computed tomography (CT) use between LRYGB patients with open and closed mesenteric defects and to assess the radiological findings and radiation doses. Methods This subgroup analysis included 300 patients randomized to either closure (n = 150) or nonclosure (n = 150) of mesenteric defects during LRYGB. The total number of CT scans performed due to abdominal pain in the first 5 postoperative years was recorded together with the radiological findings and radiation doses. Results A total of 132 patients (44%) underwent 281 abdominal CT scans, including 133 scans for 67 patients with open mesenteric defects (45%) and 148 scans for 65 patients with closed mesenteric defects (43%). Radiological findings consistent with small bowel obstruction or internal hernia were found in 31 (23%) of the scans for patients with open defects and in 18 (12%) of the scans for patients with closed defects (p = 0.014). The other pathological and radiological findings were infrequent and not significantly different between groups. At the 5-year follow-up, the total radiation dose was 82,400 mGy cm in the nonclosure group and 85,800 mGy cm in the closure group. Conclusion Closure of mesenteric defects did not influence the use of CT to assess abdominal pain. Graphical abstract

scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

scholarly journals CT Scans in Young People in Great Britain: Temporal and Descriptive Patterns, 1993–2002

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Mark S. Pearce ◽  
Jane A. Salotti ◽  
Nicola L. Howe ◽  
Kieran McHugh ◽  
Kwang Pyo Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Great Britain ◽  
Young People ◽  
Older Patients ◽  
Age Groups ◽  
Ct Scans ◽  
Radiation Doses ◽  
High Radiation ◽  
Radiology Information Systems ◽  
The North

Background. Although using computed tomography (CT) can be greatly beneficial, the associated relatively high radiation doses have led to growing concerns in relation to potential associations with risk of future cancer. Very little has been published regarding the trends of CT use in young people. Therefore, our objective was to assess temporal and other patterns in CT usage among patients aged under 22 years in Great Britain from 1993 to 2002.Methods. Electronic data were obtained from the Radiology Information Systems of 81 hospital trusts within Great Britain. All included patients were aged under 22 years and examined using CT between 1993 and 2002, with accessible radiology records.Results. The number of CT examinations doubled over the study period. While increases in numbers of recorded examinations were seen across all age groups, the greatest increases were in the older patients, most notably those aged 15–19 years of age. Sixty percent of CT examinations were of the head, with the percentages varying with calendar year and patient age.Conclusions. In contrast to previous data from the North of England, the doubling of CT use was not accompanied by an increase in numbers of multiple examinations to the same individual.

scholarly journals Trends of Computed Tomography Scan Usage among Adults and Children in Yazd Province, Iran, before the Outbreak of COVID-19

2021 ◽  
Author(s):  
Ghazale Perota ◽  
Hamidreza Masjedi ◽  
Hamed Zamani ◽  
Saman Dalvand ◽  
Reza Omidi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scans ◽  
Annual Growth Rate ◽  
Compound Annual Growth Rate ◽  
Area Of Interest ◽  
Adults And Children ◽  
Potential Risks ◽  
Risk Of Cancer ◽  
Average Contribution ◽  
Head Neck

Purpose: Excessive use of Computed Tomography (CT) has become a worrying issue due to the potential risks resulting from radiation exposure. This study was carried out to investigate trends in CT usage in Yazd Province, Iran. Materials and Methods: In the current study, patients were categorized according to their sex and age into two general groups, pediatrics (<18 years old) and adults (≥18 years old), each group falling into multiple subcategories. The performed CT scans were classified into six categories, based on the anatomical area of interest, including head/neck, chest, spine, abdomen-pelvis, extremities, and CT angiography (CTA). The data were collected from 2015 to 2018. Results: The mean number of CT scans increased by the Compound Annual Growth Rate (CAGR) of 11%. Across the procedures, head/neck (with an average contribution of 52% to all CT scans) was the most frequently examined region, whereas CTA had the lowest percentage (2%). More than half of the scans are performed on people over the age of 90, and among those aged<18 years old the most CT scan rates are related to 13-18-year-olds. Conclusion: The number of CT examinations is clearly increasing in Yazd Province. Some of this increase may be warranted because of the improvements in the diagnostic power of CT. The estimated number of pediatric CT scans has risen more than past. Due to the risk of cancer, efforts should be made to reduce unnecessary CT scans.

scholarly journals The Role of Imaging in the Preoperative Assessment of Patients with Nasal Obstruction and Septal Deviation—A Retrospective Cohort Study

2020 ◽  
Author(s):  
Narin Nard Carmel-Neiderman ◽  
Ahmad Safadi ◽  
Anat Wengier ◽  
Tomer Ziv-Baran ◽  
Anton Warshavsky ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Nasal Obstruction ◽  
Retrospective Cohort Study ◽  
Nasal Septum ◽  
Retrospective Cohort ◽  
Preoperative Planning ◽  
Preoperative Assessment ◽  
Ct Scans ◽  
Radiological Findings

Abstract Introduction Isolated nasal obstruction (INO) is a common complaint of multiple etiology. The preoperative evaluation of patients presenting with nasal obstruction and deviated nasal septum (DNS) does not typically include imaging. The benefits of performing computed tomography (CT) in the preoperative setting are inconclusive. Objective Assessing the contribution of preoperative CT to the surgical treatment of non-sinusitis patients presenting with INO and DNS. Methods A retrospective cohort study on patients referred to surgery for nasal obstruction due to DNS or turbinate hypertrophy between 2006 and 2015. Data was retrieved from patients' medical charts. The CT scans and clinical data were reassessed by a second surgeon blinded to the patients' clinical course. Results Seventy of the 843 patients (8.06%) who underwent endoscopic sinonasal procedures during the study period had presented with INO and met the inclusion criteria. Thirty-eight (55.88%) of them underwent CT scans during their preoperative assessment. Modification of the initial preoperative planning based on the radiological findings was required in 32 cases (84.2%). When reassessed by a second blinded surgeon, 58% of cases required surgical modification rather than classical submucosal resection of nasal septum and turbinate reduction (P = 0.048). Conclusion Computed tomography was found beneficial in the preoperative planning for patients with INO. The original surgical plan based upon physical examination findings was modified based on radiological findings in 84.2% of the patients.

scholarly journals Giant Liver Hydatid Cyst

2012 ◽  
Vol 18 (1) ◽  
pp. 50-53
Author(s):  
Viviana Cuzic ◽  
C. Tica ◽  
F. Enache ◽  
Cristina Mihai ◽  
Adriana Bălăşa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Abdominal Mass ◽  
Clinical Suspicion ◽  
Radiological Findings ◽  
Liver Hydatid Cyst ◽  
Worldwide Distribution ◽  
Echinococcus Cyst ◽  
Abdominal Malignancy

AbstractHydatiosis due to Echinococcus granulosus is an endemic parasitic zoonosis characterized by worldwide distribution. The most commonly involved anatomical locations are the liver and lung. The autors present a 12-year-old patient with a giant hepatic echinococcus cyst misdiagnosed as an abdominal malignancy during formal investigation. The patient was admitted to the hospital complaining for abdominal pain and with an important abdominal distention. Abdominal computed tomography revealed a giant abdominal mass: 23/21 cm, resembling a tumor, adherent to the liver edges and parietal peritoneum. The patient was taken into operation, and an a giant liver hydatid cyst was removed despite the radiological findings and the preoperative clinical suspicion.

scholarly journals Differences in radiation dose for computed tomography of the brain among pediatric patients at the emergency departments: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xi Min Tan ◽  
Mohammad Taufik Bin Mohamed Shah ◽  
Shu-Ling Chong ◽  
Yong-Kwang Gene Ong ◽  
Peck Har Ang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Emergency Departments ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Radiological Protection ◽  
Radiation Doses ◽  
Reference Levels ◽  
Ct Brain ◽  
Risk Of Cancer

Abstract Background Computed tomography (CT) is associated with a risk of cancer development. Strategies to reduce radiation doses vary between centers. We compared radiation doses of CT brain studies between pediatric and general emergency departments (EDs), and determine the proportion studies performed within the reference levels recommended by the International Commission on Radiological Protection (ICRP). Methods A retrospective review was carried out in a healthcare network consisting of one pediatric ED and three general hospital EDs. Pediatric patients less than 16 years old with CT brain studies performed between 1 January 2015 and 31 December 2018 were included. Information on demographic, diagnosis, volume-averaged computed-tomography dose index and dose length product (DLP) were collected. Effective dose was then calculated from DLP using conversion factors, termed k-coefficients which were derived using a 16 cm head CT dose phantom. Results Four hundred and seventy-nine CT brain studies were performed – 379 (79.1%) at the pediatric ED. Seizure (149, 31.1%), head injury (147, 30.7%) and altered mental status (44, 9.2%) were the top three ED diagnoses. The median effective dose estimates were higher in general than pediatric EDs, particularly for those aged > 3 to ≤6 years old [1.57 mSv (IQR 1.42–1.79) versus 1.93 mSv (IQR 1.51–2.28), p = 0.047], > 6 to ≤10 years old [1.43 mSv (IQR 1.27–1.67) versus 1.94 mSv (IQR 1.61–2.59), p = 0.002) and > 10 years old (1.68 mSv (IQR 1.32–1.72) versus 2.03 mSv (IQR 1.58–2.88), p < 0.001). Overall, 233 (48.6%) and 13 (2.7%) studies were within the reference levels recommended by ICRP 60 and 103 respectively. Conclusions Radiation doses for CT brain studies were significantly higher at general EDs and less than half of the studies were within the reference levels recommended by ICRP. The development of diagnostic reference levels (DRLs) as a benchmark and clinical justification for performing CT studies can help reduce the radiation risks in the pediatric population.

scholarly journals Proxalutamide (GT0918) Improves Lung Injury in Hospitalized COVID-19 Patients - an Analysis of the Radiological Findings of the Proxa-Rescue AndroCoV Trial

2021 ◽  
Author(s):  
Flavio A Cadegiani ◽  
Daniel N Fonseca ◽  
Michael N Correia ◽  
Rnan N Barros ◽  
Dirce C Onety ◽  
...  
Keyword(s):  
Placebo Group ◽  
Lung Injury ◽  
Ct Scan ◽  
Lung Parenchyma ◽  
Chest Ct ◽  
Ct Scans ◽  
Radiological Findings ◽  
Post Hoc Analysis ◽  
Post Hoc ◽  
Chest Ct Scan

Introduction: Antiandrogen are good candidates against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) due to the inhibition of its entry into host cells by the suppression of TMPRSS2, an enzyme that primes the SARS-CoV-2 spike (S) protein and is key for its cell entry. Proxalutamide is a second-generation nonsteroidal anti-androgen (NSAA) with strong activities on androgen receptor (AR) antagonism, suppression of AR nuclear expression, and downregulation of the membrane-attached angiotensin converting enzyme-2 (ACE2). The efficacy of proxalutamide was previously demonstrated for early COVID-19 patients, and has now demonstrated efficacy to reduce deaths in hospitalized COVID-19 patient in a double-blind, placebo-controlled randomized clinical trial (RCT). Whether radiological changes would follow the improvement in clinical outcomes with proxalutamide is not established. The present post-hoc analysis aims to evaluate whether proxalutamide improves lung injury observed through chest computed tomography (CT) scans, in addition to the clinical improvement, thus providing further objective evidence of the drug response in COVID-19. Methods: This is a post-hoc analysis of the radiological findings of a double-blinded, placebo-controlled, prospective, two-arm RCT (The Proxa-Rescue AndroCoV Trial) with all enrolled patients from the three participating institutions of the city of Manaus, Amazonas, Brazil, that had at least two chest CT scans during hospitalization. The quantification of lung parenchyma involvement was performed by independent board-certified radiologists with expertise in analysis of COVID-19 images, that were blind to the assigned intervention in the RCT. A first chest CT scan was performed upon randomization and a second CT scan was performed approximately five days later, whenever patient transportation was feasible. Results: Of the 395 patients initially evaluated, 72 and 179 patients from the proxalutamide and placebo arms, respectively, were included (n=251). Baseline and clinical characteristics, interval between first and second chest CT scans, and percentage of lung parenchyma affected in the baseline chest CT scan were similar between groups. In the second chest CT scan, the percentage of lungs affected (Median - IQR) was 35.0% (25.0-57.5%) in the proxalutamide group versus 67.5% (50.0-80.0%) in the placebo group (p < 0.001). The absolute and relative change between the second and first chest CT scans (Median - IQR) were -15.0 percent points (p.p.) (-30.0 - 0.0p.p.) and -25.0% (-50.0 - 0.0%) in the proxalutamide group, respectively, and +15.0p.p. (0.0 - +30.0p.p.) and +32.7% (0.0 - +80.0%) in the placebo group, respectively (p < 0.001 for both absolute and relative changes). Conclusion: Proxalutamide improves lung opacities in hospitalized COVID-19 patients when compared to placebo. (NCT04728802)

SPECIFIC CHARACTERISTICS OF BONE STRUCTURES ON CT-SCANS OF PATIENTS WITH SINONASAL INVERTED PAPILLOMAS

2019 ◽  
Vol 65 (4) ◽  
pp. 590-595
Author(s):  
Arkadiy Naumenko ◽  
Kseniya Sapova ◽  
Oleg Konoplev ◽  
Svetlana Astashchenko ◽  
Igor Chernushevich
Keyword(s):  
Computed Tomography ◽  
Tumor Recurrence ◽  
Inverted Papilloma ◽  
Ct Scans ◽  
Precise Localization ◽  
Sinonasal Inverted Papilloma ◽  
Bone Structures ◽  
Inverted Papillomas

Precise localization and excision of the originating site of a sinonasal inverted papilloma is essential for decreasing tumor recurrence. In this study we evaluated the use of preoperative computed tomography (CT) to pinpoint the attachment/origi-nating sites of the tumor.

scholarly journals Metacarpal Bony Dimensions Related to Headless Compression Screw Sizes

2019 ◽  
Vol 12 (S 01) ◽  
pp. S39-S44
Author(s):  
Michael Okoli ◽  
Kevin Lutsky ◽  
Michael Rivlin ◽  
Brian Katt ◽  
Pedro Beredjiklian
Keyword(s):  
Computed Tomography ◽  
Fracture Fixation ◽  
Ct Scans ◽  
Compression Screw ◽  
Metacarpal Head ◽  
Headless Compression Screw ◽  
Metacarpal Bones ◽  
Headless Compression Screws ◽  
The Mean ◽  
Distal Aspect

Abstract Introduction The purpose of this study is to determine the radiographic dimensions of the finger metacarpals and to compare these measurements with headless compression screws commonly used for fracture fixation. Materials and Methods We analyzed computed tomography (CT) scans of the index, long, ring, and small metacarpal bones and measured the metacarpal length, distance from the isthmus to the metacarpal head, and intramedullary diameter of the isthmus. Metacarpals with previous fractures or hardware were excluded. We compared these dimensions with the size of several commercially available headless screws used for intramedullary fixation. Results A total of 223 metacarpals from 57 patients were analyzed. The index metacarpal was the longest, averaging 67.6 mm in length. The mean distance from the most distal aspect of the metacarpal head to the isthmus was 40.3, 39.5, 34.4, and 31 mm for the index, long, ring, and small metacarpals, respectively. The narrowest diameter of the isthmus was a mean of 2.6, 2.7, 2.3, and 3 mm for the index, long, ring, and small metacarpals, respectively. Of 33 commercially available screws, only 27% percent reached the isthmus of the index metacarpal followed by 42, 48, and 58% in the long, ring, and small metacarpals, respectively. Conclusion The index and long metacarpals are at a particular risk of screw mismatch given their relatively long lengths and narrow isthmus diameters.

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