The use of echo density to quantify pulmonary right-to-left shunt in transthoracic contrast echocardiography

Abstract Aims Transthoracic contrast echocardiography (TTCE) is the recommended screening tool to detect pulmonary right-to-left shunt (RLS) caused by pulmonary arteriovenous malformations (PAVMs). We assessed a novel method to quantify the RLS using the change in echo density (ED) following contrast injection. Methods and results An analysis of 437 consecutive patients [58% female, 47 years, interquartile range (IQR) 33–60] who underwent TTCE for the detection of a pulmonary RLS. Using ImageJ (National Institutes of Health), the change in ED was measured for each patient. This method was strongly correlated (Spearman’s ρ = 0.89; P < 0.0001) with our standard method based on a four-point grading scale (no, mild, moderate, and severe RLS). In patients without a history of embolotherapy (n = 334), a PAVM was detected with chest computed tomography (CT) in 66 and embolotherapy was judged possible in 35 of these patients. The median increase in ED was higher in the latter: +20.1% (IQR 12.3–34.0) compared to non-treatable PAVM +0.2% (IQR −0.2 to 1.1). The specificity to detect treatable PAVMs increased from 87% to 90% when using the novel method without affecting the sensitivity (of 100%). Using the optimal cut-off value of +4.5% increase in ED, 8/74 (11%) needed chest CT-scans—individuals with a moderate or severe RLS—were no longer required without missing any treatable PAVM. Conclusions The use of ED quantification for pulmonary RLS is promising; resulting in a substantial decrease in the number of chest CT scans needed. However, this method and the threshold should be validated in an independent study population.

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Thoracic textilomas: CT findings

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132014000500010 ◽

2014 ◽

Vol 40 (5) ◽

pp. 535-542 ◽

Cited By ~ 6

Author(s):

Dianne Melo Machado ◽

Gláucia Zanetti ◽

Cesar Augusto Araujo Neto ◽

Luiz Felipe Nobre ◽

Gustavo de Souza Portes Meirelles ◽

...

Keyword(s):

Chest Pain ◽

Early Identification ◽

Heart Surgery ◽

Chest Ct ◽

Ct Scans ◽

Radiopaque Marker ◽

History Of ◽

The Right ◽

Pericardial Involvement ◽

Pleural Involvement

OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication.

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Spectrum of Chest Computerised Tomography (CT) findings of Covid 19 in Indian Population

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0901.09 ◽

2021 ◽

Vol 9 (1) ◽

pp. 43-49

Author(s):

Shravya Boini ◽

Vikas Chennamaneni ◽

Vamshi Kiran Diddy ◽

Momin Sayed Kashif

Keyword(s):

Lower Lobe ◽

Ground Glass Opacity ◽

Ct Images ◽

Chest Ct ◽

Ct Scans ◽

Ground Glass ◽

Study Cohort ◽

Study Population ◽

Ct Features

Background: To analyze the chest computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia. Methods: This was a prospective descriptive study comprising 202 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and CT severity scoring was done Results: Among the total study cohort of 202 patients, 152 were males and 50 were females .From July 07, 2020, to september07, 2020, totally 202 laboratory-confirmed patients with COVID-19 underwent chest CT. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and the affected lung lobes. Furthermore, the initial CT scan and the follow-up CT scans were compared. Results were patients (98.5%) had two or more opacities in the lung and 3 (1.5%) patients has negative chest CT. 183 (90.6%) patients had only ground-glass opacities; 13 patients (6.4%) had ground-glass and consolidative opacities; and 3 patients (1.5%) had only consolidation. A total 192 of patients (96.5%) showed two or more lobes involved. The opacities tended to be both in peripheral and central 7 (3.5%) or purely peripheral distribution 192 (96.5%). 177 patients (88.9%) had the lower lobe involved.8 patients showed complete resolution of lung findings. Conclusion: In this study population, the typical CT features of COVID 19 pneumonia are ground glass opacity with or without consolidation, which is patchy and peripheral, predominantly in lower lobes.

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Follow-up of pulmonary right-to-left shunt in hereditary haemorrhagic telangiectasia

European Respiratory Journal ◽

10.1183/13993003.01588-2015 ◽

2016 ◽

Vol 47 (6) ◽

pp. 1750-1757 ◽

Cited By ~ 20

Author(s):

Veronique M.M. Vorselaars ◽

Sebastiaan Velthuis ◽

Repke J. Snijder ◽

Cornelis J.J. Westermann ◽

Jan A. Vos ◽

...

Keyword(s):

Arteriovenous Malformations ◽

Contrast Echocardiography ◽

Neurological Complications ◽

Hereditary Haemorrhagic Telangiectasia ◽

Pulmonary Arteriovenous Malformations ◽

Initial Screening ◽

History Of ◽

Transthoracic Contrast Echocardiography

Pulmonary arteriovenous malformations (PAVMs) are associated with severe neurological complications in hereditary haemorrhagic telangiectasia (HHT). Transthoracic contrast echocardiography (TTCE) is recommended for screening of pulmonary right-to-left shunts (RLS). Although growth of PAVMs is shown in two small studies, no studies on follow-up with TTCE exist.All HHT patients underwent a second TTCE 5 years after initial screening. Patients with a history of PAVM embolisation were excluded. Pulmonary RLS grade on TTCE after 5 years was compared to the grade at screening.200 patients (53.5% female, mean±sd age at screening 44.7±14.1 years) were included. Increase in RLS grade occurred in 36 (18%) patients, of whom six (17%) underwent embolisation. The change in grade between screening and follow-up was not more than one grade. Of patients with nontreatable pulmonary RLS at screening (n=113), 14 (12.4%) underwent embolisation. In patients without pulmonary RLS at initial screening (n=87), no treatable PAVMs developed during follow-up.Within 5 years, no treatable PAVMs developed in HHT patients without pulmonary RLS at initial screening. Increase in pulmonary RLS grade occurred in 18% of patients, and never increased by more than one grade. Of patients with nontreatable pulmonary RLS at initial screening, 12% underwent embolisation.

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Lung Cancer Detection and Classification from Chest CT Scans Using Machine Learning Techniques

2021 1st International Conference on Artificial Intelligence and Data Analytics (CAIDA) ◽

10.1109/caida51941.2021.9425269 ◽

2021 ◽

Author(s):

Amjad Rehman ◽

Muhammad Kashif ◽

Ibrahim Abunadi ◽

Noor Ayesha

Keyword(s):

Machine Learning ◽

Lung Cancer ◽

Cancer Detection ◽

Chest Ct ◽

Machine Learning Techniques ◽

Ct Scans ◽

Learning Techniques ◽

Lung Cancer Detection

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Ct-Caps: Feature Extraction-Based Automated Framework for Covid-19 Disease Identification From Chest Ct Scans Using Capsule Networks

ICASSP 2021 - 2021 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP) ◽

10.1109/icassp39728.2021.9414214 ◽

2021 ◽

Author(s):

Shahin Heidarian ◽

Parnian Afshar ◽

Arash Mohammadi ◽

Moezedin Javad Rafiee MD ◽

Anastasia Oikonomou MD ◽

...

Keyword(s):

Feature Extraction ◽

Chest Ct ◽

Ct Scans ◽

Disease Identification

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Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

La radiologia medica ◽

10.1007/s11547-021-01390-4 ◽

2021 ◽

Author(s):

Martina Pecoraro ◽

Stefano Cipollari ◽

Livia Marchitelli ◽

Emanuele Messina ◽

Maurizio Del Monte ◽

...

Keyword(s):

Chest Ct ◽

Ct Scans ◽

Imaging Biomarker ◽

Cross Sectional ◽

Mri Scans ◽

Magnetic Resonance Imaging Mri ◽

Sectional Analysis ◽

Ct And Mri ◽

Interlobular Septal Thickening

Abstract Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.

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Clinical and chest CT presentations from 27 patients with COVID-19 pneumonia in Mogadishu, Somalia: a descriptive study

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00302-2 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Yahye Garad Mohamed ◽

Mohamed Farah Yusuf Mohamud ◽

M. Sabri Medişoğlu ◽

Ihsan Yavuz Atamaca ◽

Ibrahim Hussein Ali

Keyword(s):

Sore Throat ◽

Pulmonary Nodules ◽

Ground Glass Opacity ◽

Chest Ct ◽

First Case ◽

Abnormal Chest ◽

Lower Lung ◽

History Of ◽

Normal Chest ◽

Bilateral Lung

Abstract Background Coronavirus disease 2019 (COVID-19) is an acute viral pneumonia that had recently been found in humans. The first case was discovered in Wuhan, Hubei province, China, in December 2019. In this article, we aimed to demonstrate the clinical and radiological characteristics of COVID-19 patients in Somalia from 20 March 2020 to 20 April 2020. Results Twenty-seven patients that had a positive RT-PCR test between 20 March 2020 and 20 April 2020 were retrospectively observed. This study included 19 (70.4%) males and 8 (29.6%) females, and the mean age and range were 43 years (SD ± 14.0) and 27–70 years, respectively. The majority (59.3%) of COVID-19-infected patients had no obvious history of exposure to infected patients. The participants of our study mostly presented with dry cough 24 (88.9%) patients, fever 19 (70.4%), myalgia 18 (66.6%), and sore throat 16 (59.3%). Twenty-five of 27 patients had abnormal chest CT, while 2 (7.4%) patients had normal chest CT. The most common patterns of abnormality seen on chest CT in patients with COVID-19 were ground-glass opacity (GGO) 74.1%, crazy paving pattern 18.5%, consolidation 14.8%, and mixed GCO 11.1%. Also, the most common predominant lesion distributions were bilateral lung involvement (88.9%), peripheral distribution (77.8%), and lower lung predominance (63%). Particularly, lung cavitation, discrete pulmonary nodules, pleural effusion, and underlying pulmonary fibrosis or emphysema had not been observed. Conclusion Dry cough, fever, myalgia, and sore throat were the most clinical presentations. GGO, crazy paving pattern, patchy consolidation, and mixed GCO were the typical chest CT manifestations.

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Interrogating the Egypto-Sudanic Arabic Connection

Languages ◽

10.3390/languages6030123 ◽

2021 ◽

Vol 6 (3) ◽

pp. 123

Author(s):

Thomas A. Leddy-Cecere

Keyword(s):

The Novel ◽

Present Contribution ◽

Phonological Processes ◽

Verbal Inflection ◽

Segmental Phonology ◽

Language Data ◽

History Of ◽

Novel Method ◽

Dialect Classification ◽

Arabic Speaking

The Arabic dialectology literature repeatedly asserts the existence of a macro-level classificatory relationship binding the Arabic speech varieties of the combined Egypto-Sudanic area. This proposal, though oft-encountered, has not previously been formulated in reference to extensive linguistic criteria, but is instead framed primarily on the nonlinguistic premise of historical demographic and genealogical relationships joining the Arabic-speaking communities of the region. The present contribution provides a linguistically based evaluation of this proposed dialectal grouping, to assess whether the postulated dialectal unity is meaningfully borne out by available language data. Isoglosses from the domains of segmental phonology, phonological processes, pronominal morphology, verbal inflection, and syntax are analyzed across six dialects representing Arabic speech in the region. These are shown to offer minimal support for a unified Egypto-Sudanic dialect classification, but instead to indicate a significant north–south differentiation within the sample—a finding further qualified via application of the novel method of Historical Glottometry developed by François and Kalyan. The investigation concludes with reflection on the implications of these results on the understandings of the correspondence between linguistic and human genealogical relationships in the history of Arabic and in dialectological practice more broadly.

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