Differential Diagnosis of Colonic Strictures: Pictorial Review with Illustrations from Computed Tomography Colonography

2015 ◽  
Vol 66 (3) ◽  
pp. 259-271 ◽  
Author(s):  
Daniel Wan ◽  
Silvio G. Bruni ◽  
John A. Dufton ◽  
Paul O'Brien
Keyword(s):  
Computed Tomography ◽  
Gold Standard ◽  
Ct Colonography ◽  
Imaging Modality ◽  
Mount Sinai Hospital ◽  
Imaging Features ◽  
University Of Toronto ◽  
Pictorial Review ◽  
Ct Features

Strictures of the colon can lead to significant morbidity requiring surgical management. The etiology of strictures is broad and generally categorized as benign, malignant, or pseudostrictures. Computed tomography (CT) is a crucial imaging modality in the assessment and characterization of colonic pathologies but colonoscopy remains the diagnostic gold standard. However, in the setting of incomplete colonoscopy due to strictures, the imaging features of CT will be relied on. This review will focus on the CT features of different colon pathologies leading to strictures and will be illustrated with images from 10 years of experience with CT colonography at our institutions from 2002-2012 (Hotel Dieu Hospital, Queen's University and Mount Sinai Hospital, University of Toronto).

scholarly journals Clinicopathological and imaging features of pulmonary alveolar microlithiasis in a dog – a case report

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Ana Canadas Sousa ◽  
Joana C. Santos ◽  
Clara Landolt ◽  
Catarina Gomes ◽  
Patrícia Dias-Pereira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Ground Glass Opacity ◽  
Imaging Features ◽  
Ct Guided ◽  
Pulmonary Alveolar Microlithiasis ◽  
Reticular Pattern ◽  
Pulmonary Parenchyma ◽  
Alveolar Microlithiasis ◽  
Ct Features

Abstract Background The aetiology of pulmonary alveolar microlithiasis (PAM) in animals is still unknown. In humans, this pulmonary disorder is a rare autosomal recessive disorder triggered by a mutation in the gene SLC34A2, which causes deposition and aggregation of calcium and phosphate in the pulmonary parenchyma with formation of microliths. Although histopathological examination is required for a definite diagnosis, in humans, imaging modalities such as computed tomography can demonstrate typical patterns of the disease. This is the first description of the computed tomographic (CT) features of a histologically confirmed PAM in dogs. Case presentation The following report describes a case of a 7-year-old female Boxer dog evaluated for paroxysmal loss of muscle tone and consciousness with excitement. The main differential diagnoses considered were syncope, seizures, and narcolepsy-cataplexy. The results of the complete blood count, serum biochemistry panel, urinalysis, arterial blood pressure, echocardiography, abdominal ultrasound, Holter monitoring, and ECG were all within normal limits. Additional exams included thoracic radiographs, head and thorax CT, bronchoalveolar lavage (BAL), and CT-guided cytology. Thoracic radiographs revealed micronodular calcifications in the lungs, with sandstorm appearance. Computed tomography of the thorax showed the presence of numerous mineralized high-density agglomerates of multiple sizes throughout the pulmonary parenchyma, a reticular pattern with ground glass opacity and intense mineralized fibrosis of the pleural lining. Head CT was unremarkable. BAL and CT-guided cytology were inconclusive, but imaging features strongly suggest the diagnosis of PAM, which was histologically confirmed after necropsy. Conclusions This case report contributes to the clinicopathological and imaging characterization of pulmonary alveolar microlithiasis in dogs. In this species, the diagnosis of PAM should be considered when CT features evidence a reticular pattern with ground glass opacity and the presence of an elevated number and size of calcifications.

scholarly journals Early Computed Tomography Findings of Novel Coronavirus Disease 2019 (COVID-19) Pneumonia

2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Pinar Diydem Yilmaz ◽  
Cengiz Kadiyoran ◽  
Suleyman Bakdik ◽  
Necdet Poyraz ◽  
Hulya Vatansev
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Pleural Thickening ◽  
Halo Sign ◽  
Ct Findings ◽  
Novel Coronavirus ◽  
Ct Features

Background: Novel coronavirus disease (COVID-19) pneumonia is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is highly contagious and threatens human health. Chest computed tomography (CT) is an accurate imaging modality for diagnosis and follow-up. Objectives: To investigate early CT features of COVID-19 pneumonia. Methods: Retrospective study. Sixty-three patients with COVID-19 pneumonia (28 men, 35 women; age range, 21 - 85 years; mean, 59 years) confirmed by reverse transcription-polymerase chain reaction (RT-PCR) were enrolled in this retrospective study and CT findings were evaluated. Patients were classified into three groups for estimating COVID-19 pneumonia, according to CT features. Results: Nineteen (30%) patients classified as out of COVID-19 pneumonia had normal CT findings. Twenty-eight (44%) patients, classified as highly suggestive for COVID-19 pneumonia, had typical findings for COVID-19 pneumonia. In highly suggestive for COVID-19 pneumonia group most common CT features were peripheral (64%), multilobar (96%), patchy, and round (54%) ground-glass opacity (GGO) (57%). Air bronchogram (93%), crazy-paving patterns (79%), and vascular thickening (61%) were the most common special findings. We only detected these rare findings such as halo sign, reverse halo sign, lymphadenopathy, pleural and pericardial effusion, pleural thickening, and fibrotic lines in patients with COVID-19 with chronic diseases. Conclusions: The early CT findings are peripheral, multilobar, patchy, and round ground glass opacities accompanied by vascular thickening, crazy-paving pattern, or air bronchogram sign. Rare findings are only seen in the presence of concomitant diseases.

scholarly journals Computed tomography imaging of resuscitative endovascular balloon occlusion of the aorta (REBOA): pearls and pitfalls

2021 ◽  
Author(s):  
Ryo Aoki ◽  
Yusuke Kobayashi ◽  
Shintaro Nawata ◽  
Hiroyuki Kamide ◽  
Toh Yamamoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Balloon Occlusion ◽  
Imaging Features ◽  
Radiological Findings ◽  
Computed Tomography Imaging ◽  
Aortic Cross Clamp ◽  
Tomography Imaging ◽  
Resuscitative Thoracotomy ◽  
Pictorial Review ◽  
Endovascular Balloon Occlusion

AbstractResuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in patients with hemorrhagic shock who develop massive subdiaphragmatic bleeding. This procedure enables rapid and less invasive aortic blockade compared to resuscitative thoracotomy and aortic cross-clamp procedures. However, the REBOA procedure is often blindly performed in the emergency department without fluoroscopy, and the appropriateness of the procedure may be evaluated on computed tomography (CT) after REBOA. Therefore, radiologists should be familiar with the imaging features of REBOA. We present a pictorial review of the radiological findings of REBOA along with a description of the procedure, its complications, and pitfalls.

Benefit of a Sharp Computed Tomography Angiography Reconstruction Kernel for Improved Characterization of Intracranial Aneurysms

2013 ◽  
Vol 10 (1) ◽  
pp. 97-105 ◽  
Author(s):  
Brian O'Meara ◽  
Jason P. Rahal ◽  
Alexandra Lauric ◽  
Adel M. Malek
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Imaging Modality ◽  
Cerebral Aneurysms ◽  
Matched Pair ◽  
Aneurysm Neck ◽  
Smooth Kernel ◽  
Significant Difference ◽  
Reconstruction Kernel

Abstract BACKGROUND: Computed tomography angiography (CTA) is the first-line imaging modality used for cerebral aneurysms because of its speed and sensitivity for detection, although digital subtraction angiography is often required for more detailed aneurysm shape delineation. OBJECTIVE: To determine whether a sharper CTA reconstruction kernel can better characterize an aneurysm and improve decision-making before intervention. METHODS: Fifteen patients presenting with aneurysmal subarachnoid hemorrhage underwent 64-row CTA. CTA data were reconstructed using the default H20f smooth kernel and a H60f sharp kernel and compared with contemporaneous catheter 3-dimensional rotational angiography (3DRA). Aneurysm neck, width, and aspect ratio measurements were made using intensity line plots of identical projections on all imaging datasets and compared by matched-pair statistics. RESULTS: Aneurysm neck measurements from the H20f smooth kernel revealed overestimation compared with both the sharp kernel (greater by 0.64 ± 0.21 mm, P < .01) and 3DRA (greater by 0.68 ± 0.19 mm, P < .01). There was no statistically significant difference between 3DRA and the sharp kernel CTA measurements. Neck measurements correlated well between the H60f kernel and 3DRA but not between the H20f Kernel and 3DRA (R 0.97 vs 0.86). CONCLUSION: H60f sharp CTA kernel reconstruction provides more accurate anatomic characterization of cerebral aneurysms than the H20f smooth kernel at the expense of less visually pleasing reconstructions. Because it does not require additional contrast, radiation, or imaging hardware and is more similar to 3DRA, it may aid in selecting the appropriate treatment strategy before to evaluation by catheter-based angiography.

scholarly journals Accuracy of High-Resolution Computed Tomography Chest in Diagnosing Pulmonary Tuberculosis by taking AFB culture findings as Gold Standard

2021 ◽  
Vol 15 (6) ◽  
pp. 1429-1430
Author(s):  
M. Amin ◽  
M. Javed ◽  
A. Noreen ◽  
M. Mehboob ◽  
N. Pasha ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Pulmonary Tuberculosis ◽  
Gold Standard ◽  
Imaging Modality ◽  
Sufficient Accuracy ◽  
Male Population ◽  
High Resolution Computed Tomography ◽  
Pulmonary Tb ◽  
High Resolution Ct

Aim: To determine the accuracy of high resolution CT Chest (HRCT) for diagnosis of pulmonary tuberculosis (PTB) by taking AFB culture findings as gold standard. Methods: This validation study was conducted in patients referred for HRCT Chest for diagnosis of pulmonary tuberculosis in OPD/ Radiology unit of CH & ICH within duration of 6 months from September-2020 to February -2021. Patients with suspicion of PTB were included. In all patients, sputum samples were obtained and the AFB test was performed for diagnosis of PTB. After that high resolution CT Chest (HRCT) was performed for diagnosis of PTB. Results: Mean age was 54.67 ± 12.36 years. Male population 54% and female was 46%. AFB culture results for pulmonary. TB was positive in 44 patients and was negative in 56 patients. HRCT findings were positive for pulmonary TB in 46 patients and were negative in 54 patients (Table 1). The sensitivity of HRCT was 81.8%, specificity of HRCT was 82.1%, PPV was 78.3% and NPV was 85.2% (Table 2). Conclusion: HRCT Chest has a sufficient accuracy for PTB diagnosis taking AFB culture results as gold standard. So HRCT Chest can be opted as imaging modality of choice in patients having mixed plain radiographs findings. This will aid in early identification and starting treatment of PTB. Keywords: Accuracy, high resolution computed tomography, pulmonary tuberculosis.

scholarly journals Role of helical CT and MRI in the evaluation of spinal dysraphism

2017 ◽  
Vol 4 (1) ◽  
pp. 124
Author(s):  
S. Kanagarameswara Kumaran ◽  
P. Chirtrarasan
Keyword(s):  
Statistical Data ◽  
Imaging Modality ◽  
Spinal Dysraphism ◽  
Helical Ct ◽  
Imaging Features ◽  
Occult Spinal Dysraphism ◽  
Medical College ◽  
Ct And Mri

Background: Spinal dysraphism is a complex congenital anomaly involving the spine and spinal cord. Some lesions seldom require imaging. The aim was to study the usefulness of helical CT and MRI in the evaluation of various presentation of spinal dysraphism, to identify, characterize the lesions and its association with other anomalies which helps in giving an accurate diagnosis based on specific imaging findings.Methods: Seventy patients including 33 males and 37 females’ age ranging from 1year to 30 years clinically suspicious for spinal dysraphism were evaluated using helical CT and MRI in the Department of Radiodiagnosis, Government Kilpauk Medical College and Hospital, Chennai, India.Results: Statistical data analyzed based on imaging findings.56 patients were of open spinal dysraphism type and 14 patients were of occult spinal dysraphism. Different imaging features in spinal dysraphism were evaluated to give composite diagnosis for management.Conclusions: Helical CT and MRI are adjuvant in evaluating cases of spinal dysraphism. MRI is excellent in characterizing the soft tissue spinal anomalies of spinal dysraphism helical CT is an excellent imaging modality for characterization of vertebral bony anomalies.

scholarly journals Adrenal imaging: anatomy and pathology (literature review)

2021 ◽  
Vol 67 (3) ◽  
pp. 26-36
Author(s):  
T. A. Korb ◽  
V. Yu. Chernina ◽  
I. A. Blokhin ◽  
O. O. Aleshina ◽  
A. V. Vorontsov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Literature Review ◽  
Imaging Modality ◽  
Magnetic Resonance Tomography ◽  
Lesion Detection ◽  
Dual Energy Ct ◽  
Emission Computed Tomography ◽  
Imaging Features ◽  
Adrenal Imaging

This literature review focuses on the normal adrenal gland anatomy and typical imaging features necessary to evaluate benign and malignant lesions. In particular, adenoma, pheochromocytoma, metastases and adrenocortical carcinoma were discussed as some of the most common lesions. For this purpose, a review of relevant local and international literature sources up to January 2021 was conducted.In many cases, adrenal incidentalomas have distinctive features allowing characterization using noninvasive methods. It is possible to suspect a malignant nature and promptly refer the patient for the necessary invasive examinations in some cases. ­Computed tomography, especially with intravenous contrast enhancement, is the primary imaging modality because it enables differential diagnosis. Magnetic resonance tomography remains a sensitive method in lesion detection and follow-up but is not very specific for determining the malignant potential. Positron emission computed tomography also remains an additional method and is used mainly for differential diagnosis of malignant tumors, detecting metastases and recurrences after surgical treatment. Ultrasound has a limited role but is nevertheless of great importance in the pediatric population, especially newborns. Promising techniques such as radiomics and dual-energy CT can expand imaging capabilities and improve diagnostic accuracy.Because adrenal lesions are often incidentally detected by imaging performed for other reasons, it is vital to interpret such findings correctly. This review should give the reader a broad overview of how different imaging modalities can evaluate adrenal pathology and guide radiologists and clinicians.

scholarly journals Ultrasound of Small Bowel Obstruction: A Pictorial Review

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 617
Author(s):  
Nicola Rosano ◽  
Luigi Gallo ◽  
Giuseppe Mercogliano ◽  
Pasquale Quassone ◽  
Ornella Picascia ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Imaging Modality ◽  
Ct Scanning ◽  
Pictorial Review ◽  
Abnormal Peristalsis ◽  
Initial Imaging

Small bowel obstruction (SBO) is a common condition requiring urgent attention that may involve surgical treatment. Imaging is essential for the diagnosis and characterization of SBO because the clinical presentation and results of laboratory tests may be nonspecific. Ultrasound is an excellent initial imaging modality for assisting physicians in the rapid and accurate diagnosis of a variety of pathologies to expedite management. In the case of SBO diagnosis, ultrasound has an overall sensitivity of 92% (95% CI: 89–95%) and specificity of 93% (95% CI: 85–97%); the aim of this review is to examine the criteria for the diagnosis of SBO by ultrasound, which can be divided into diagnostic and staging criteria. The diagnostic criteria include the presence of dilated loops and abnormal peristalsis, while the staging criteria are represented by parietal and valvulae conniventes alterations and by the presence of free extraluminal fluid. Ultrasound has reasonably high accuracy compared to computed tomography (CT) scanning and may substantially decrease the time to diagnosis; moreover, ultrasound is also widely used in the monitoring and follow-up of patients undergoing conservative treatment, allowing the assessment of loop distension and the resumption of peristalsis.

scholarly journals Pyonephrosis Ultrasound and Computed Tomography Features: A Pictorial Review

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 331
Author(s):  
Stefania Tamburrini ◽  
Marina Lugarà ◽  
Michele Iannuzzi ◽  
Edoardo Cesaro ◽  
Fiore De Simone ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Host Response ◽  
Bacterial Infections ◽  
Pictorial Review ◽  
The Common ◽  
Extrarenal Complications ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Fluid Levels ◽  
Ct Features

Urinary tract infections (UTIs) are the most frequent community-acquired and healthcare-associated bacterial infections. UTIs are heterogeneous and range from rather benign, uncomplicated infections to complicated UTIs (cUTIs), pyelonephritis and severe urosepsis, depending mostly on the host response. Ultrasound and computed tomography represent the imaging processes of choice in the diagnosis and staging of the pathology in emergency settings. The aim of this study is to describe the common ultrasound (US) and computed tomography (CT) features of pyonephrosis. US can make the diagnosis, demonstrating echogenic debris, fluid/fluid levels, and air in the collecting system. Although the diagnosis appears to be easily made with US, CT is necessary in non-diagnostic US examinations to confirm the diagnosis, to demonstrate the cause and moreover to stage the pathology, defining extrarenal complications. In emergency settings, US and CT are differently used in the diagnosis and staging of pyonephrosis.

ROLE OF TRIPLE PHASE CONTRAST ENHANCED COMPUTED TOMOGRAPHY IN HEPATIC LESIONS AND THEIR CYTOPATHOLOGICAL CORRELATION

2021 ◽  
pp. 29-33
Author(s):  
Sandeep Kaur ◽  
Chaitanya Tapasvi ◽  
Sarita Nibhoria ◽  
Divya Soin
Keyword(s):  
Computed Tomography ◽  
Phase Contrast ◽  
Imaging Modality ◽  
Medical College ◽  
Contrast Enhanced ◽  
Highly Sensitive ◽  
Hepatic Lesions ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

AIMS: To evaluate the enhancement patterns of hepatic lesions on triple phase contrast enhanced computed tomography and to correlate the CT ndings of hepatic lesions with cytological ndings on ne needle aspiration cytology (FNAC). Settings and Design: This prospective observational study was carried out at Department of Radiodiagnosis, Gobind Singh Medical College and Hospital, Faridkot. The study was approved by the Institutional Ethics Committee. Source of Data: A total of 75 patients who had hepatic lesions on ultrasonography and clinical suspicion of focal hepatic lesions were referred for CECT abdomen. Findings of Triple phase CT for hepatic lesions were correlated with cytopathological ndings. Methods and Material: A Triphasic CECT abdomen was performed on Siemens Somatom Perspective 128 slice scanner in the Department of Radiodiagnosis, Guru Gobind Singh Medical College and Hospital, Faridkot. The entire liver was scanned successively, in arterial, portovenous and delayed phases. A 5mm collimation and 5mm/sec table speed were used. After obtaining a digital scout view, unenhanced scan of the liver was obtained.1.5ml/kg body weight of 300mgI/ml iodinated contrast material was administered by using a pressure injector at a rate of 3.0 mL/s using a pressure injector.USG/CT guided FNAC was done. CT imaging ndings were classied as benign or malignant by correlating them with cytopathological ndings. Results: The present study inferred that Triple phase CECT is a highly sensitive and specic imaging modality for detection and characterization of hepatic lesions with an overall sensitivity and specicity of 100.00 % (95% C.I. 92.45% to 100%) and 92.86% (95% C.I. 76.50% to 99.12%)respectively when correlated with cytopathological ndings. Conclusions: It is inferred from our study that triple phase CECT is highly sensitive and specic imaging modality for detection and characterization of hepatic lesions with wide availability in the present scenario.

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