Computed Tomography to Diagnose Blunt Diaphragm Injuries: Not Ready for Prime Time

Diaphragm injuries after blunt trauma are uncommon but require early diagnosis to expedite repair. The advancing technology of computed tomography (CT) scanners has improved the detection of almost all traumatic injuries; however, the literature regarding the diagnostic accuracy of CT scan for blunt diaphragm injuries is lacking. The purpose of this study was to determine the CT scan findings in the setting of known blunt diaphragm injury. We performed a retrospective review of all blunt trauma patients with a known diaphragm injury confirmed at laparotomy who also had a preoperative CT scan of the torso. Every CT scan was retrospectively reviewed by a board-certified radiologist for evidence of diaphragm injury as well as associated abdominal and thoracic injuries. Forty-two patients sustaining blunt trauma had preoperative CT scans of the torso and a diaphragm injury confirmed at laparotomy. Only 57 per cent of CT scans showed evidence of diaphragmatic injury. The most common thoracic injury identified was a pulmonary contusion (79%). Although the advancement of imaging technology has markedly improved the diagnosis and management of blunt traumatic injuries, the detection of diaphragm injuries using CT continues to be low and reconstructions do not help in finding diaphragm injuries.

Download Full-text

Otosclerosis in a Nonendemic Population: Utility of CT Scan and Correlation with Audiometry and Surgical Outcome

Ear Nose & Throat Journal ◽

10.1177/014556131809700612 ◽

2018 ◽

Vol 97 (6) ◽

pp. 156-162

Author(s):

Lu Hui Png ◽

Jing-Yin Pang ◽

Amit Karandikar ◽

Julian Park Nam Goh ◽

Seng Beng Yeo ◽

...

Keyword(s):

Computed Tomography ◽

Data Analysis ◽

Ct Scan ◽

Surgical Outcome ◽

Preoperative Diagnosis ◽

Density Ratio ◽

Region Of Interest ◽

Ct Scans ◽

Paget Disease ◽

Preoperative Ct

The incidence of otosclerosis in nonendemic patients is low, and preoperative diagnosis can be challenging. The aim of this study was to evaluate computed tomography (CT) findings in patients with otosclerosis and determine their correlation with audiometric findings and surgical outcome in a nonendemic population. We retrospectively reviewed 17 patients from August 2011 to August 2013 with surgically confirmed otosclerosis who underwent preoperative high-resolution CT scans and pre- and postoperative audiometry. Otosclerotic foci were identified on the scans. The density ratio of these foci was calculated and compared with pre- and postoperative audiometric parameters. One patient with Paget disease was excluded from the study. A total of 19 ears were operated on and included in the data analysis. CT scans were normal in 4 ears (21.1%). Hypodense lesions were detected in the remaining 15 (78.9%) ears and the region of interest mapped out. The density ratio was obtained between the hypodense area and adjacent normal labyrinthine bone. No statistically significant correlation was found between the density ratio and any of the audiometric parameters tested (p > 0.05). The diagnosis of otosclerosis in nonendemic areas is challenging. A preoperative CT scan can be useful when otosclerotic foci are present. However, the density ratio of the otosclerotic foci did not correlate with audiometric parameters or surgical outcome.

Download Full-text

Diagnostic Accuracy of Magnetic Resonance Imaging and Computed Tomography Scan in Young Athletes With Spondylolysis

Clinical Pediatrics ◽

10.1177/0009922819832643 ◽

2019 ◽

Vol 58 (6) ◽

pp. 671-676

Author(s):

Amy M. West ◽

Pierre A. d’Hemecourt ◽

Olivia J. Bono ◽

Lyle J. Micheli ◽

Dai Sugimoto

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Ct Scan ◽

False Negative ◽

False Negative Rate ◽

Ct Scans ◽

Resonance Imaging ◽

Young Athletes ◽

Negative Rate

The objective of this study was to determine diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) scans in young athletes diagnosed with spondylolysis. A cross-sectional study was used. Twenty-two young athletes (14.7 ± 1.5 years) were diagnosed as spondylolysis based on a single-photon emission CT. Following the diagnosis, participants underwent MRI and CT scan imaging tests on the same day. The sensitivity and false-negative rate of the MRI and CT scans were analyzed. MRI test confirmed 13 (+) and 9 (−) results while CT test showed 17 (+) and 5 (−) results. The sensitivity and false-negative rate of MRI were, respectively, 59.1% (95% confidence interval [CI] = 36.7% to 78.5%) and 40.9% (95% CI = 21.5% to 63.3%). Furthermore, the sensitivity and false-negative rate of CT scan were 77.3% (95% CI = 54.2% to 91.3%) and 22.7% (95% CI = 0.09% to 45.8%). Our results indicated that CT scan is a more accurate imaging modality to diagnose spondylolysis compared with MRI in young athletes.

Download Full-text

The Effect of Contrast-enhanced Computed Tomography (CT) Scans on the Calculated Dose of Radiotherapy in a Thorax Phantom

International Journal of Cancer Management ◽

10.5812/ijcm.84158 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Athar Ehtiati ◽

Payman Hejazi ◽

Mohsen Bakhshandeh ◽

Ali Jabbary Arfaee ◽

Eftekhar Rajab Bolookat ◽

...

Keyword(s):

Computed Tomography ◽

Contrast Media ◽

Ct Scan ◽

Treatment Planning ◽

Tumor Volume ◽

Ct Scans ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

Background: Despite the benefits of contrast-enhanced computed tomography (CT) scans in better tumor volume delineation, it can affect the accuracy of dose calculation in radiation therapy. This study examined this effect on a thorax phantom. Objectives: The influence of different variables including the concentrations of the Visipaque contrast media, tumor sizes, and CT scan energies on the dose measurement was examined. Methods: Transparent cylinders containing the contrast media were inserted in the lung area of the phantom and the CT scans were made. Non-enhanced CT scans were also acquired. Treatment planning using 2 opposite fields was performed on the CT scans and the doses were calculated in the treatment planning system. The results of the 2 sets of enhanced and non-enhanced CT scans were compared. Results: The correlation between concentration and the percentage of mean dose of the tumor volume was significant in 2 of the tumor sizes. The differences in the mean doses of the 2 plans were examined and more than 3% increase was observed in higher concentrations of the contrast media. Conclusions: According to this study, the suitable concentration of the contrast media administered and the CT scan energy should be considered. This would help to decrease the discrepancies between the calculated and delivered dose in radiotherapy treatments to a clinically acceptable level. The importance of time delays for CT scans after administration of the contrast media is emphasized.

Download Full-text

Enlargement of Post-Traumatic Intracerebral Haematoma: Incidence and Time Course

Journal of International Medical Research ◽

10.1177/147323000503300113 ◽

2005 ◽

Vol 33 (1) ◽

pp. 119-122 ◽

Cited By ~ 1

Author(s):

WG Liu ◽

Y Yao ◽

JY Zhou ◽

XF Yang

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Time Course ◽

Ct Scans ◽

Intracerebral Haematoma ◽

Automated Method ◽

Haematoma Volume ◽

Traumatic Intracerebral Haematoma ◽

Radiographic Criterion ◽

Post Traumatic

We retrospectively assessed the incidence and time course of enlargement in posttraumatic intracerebral haematoma (PTICH). Computed tomography (CT) scans from 165 patients who underwent a scan within 72 h and a repeat scan within 120 h of the onset of trauma were examined. A semi-automated method using region deformation-based segmentation was used to calculate the haematoma volume. The presence of haematoma enlargement was also determined based on a consensus by five observers. Seventy cases (42%) showed enlargement of the haematoma. The frequency of haematoma enlargement decreased as the interval between the onset of trauma and the initial scan increased. The discriminant value of the ratio of the haematoma volume in the second scan to that in the initial scan was ascertained, and the cut-off value for haematoma enlargement was determined to be 1.45. The radiographic criterion for enlargement in PTICH on CT scan was, therefore, defined as a ≥ 1.45 times increase in haematoma volume.

Download Full-text

Prospective Study of the Correlation Between Postoperative Computed Tomography Scan and Primary Surgeon Assessment in Patients With Advanced Ovarian, Tubal, and Peritoneal Carcinoma Reported to Have Undergone Primary Surgical Cytoreduction to Residual Disease 1 cm or Less

Journal of Clinical Oncology ◽

10.1200/jco.2007.12.2317 ◽

2007 ◽

Vol 25 (31) ◽

pp. 4946-4951 ◽

Cited By ~ 44

Author(s):

Dennis S. Chi ◽

Pedro T. Ramirez ◽

Jerrold B. Teitcher ◽

Svetlana Mironov ◽

Debra M. Sarasohn ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Residual Disease ◽

Advanced Ovarian Cancer ◽

Ct Scans ◽

Eligibility Criteria ◽

Primary Surgery ◽

The Right ◽

Analysis Scale ◽

Tomography Scan

Purpose To compare surgeons' operative assessments of residual disease (RD) to those identified on postoperative computed tomography (CT) scans in patients with advanced ovarian carcinoma reported to have undergone optimal primary cytoreduction. Patients and Methods All patients at one of two institutions, who were scheduled to have primary surgery for presumed advanced ovarian cancer, were asked to consent to a postoperative CT scan if cytoreduction to ≤ 1 cm RD was reported. CT scan findings were graded using a qualitative analysis scale from 1 (normal) to 5 (definitely malignant). Results From January 2001 to September 2006, 285 patients were enrolled. A total of 78 patients met eligibility criteria and had postoperative CT scans. In 41 cases (52%), postoperative scan findings correlated with the surgical report of no RD more than 1 cm, and in seven cases (9%), the CT findings were indeterminate. In 10 cases (13%), more than 1 cm RD was noted by the radiologist as probably malignant, and in 20 cases (26%), definitely malignant. In these 30 cases, the radiologically reported median largest residual mass was 1.9 cm (range, 1.1 to 5.1), with RD more than 1 cm reported most commonly in the right upper quadrant (15 patients [50%]) and central abdomen (nine patients [30%]). Conclusion There was only a 52% correlation between surgeons' assessments and postoperative CT scan evaluations of RD in patients reported to have undergone optimal cytoreduction. Further study is required to determine whether this lack of correlation is due to rapid interval tumor regrowth, RD underestimated by the surgeons, and/or overestimated by the radiologists; and to determine the clinical implications of these discrepancies.

Download Full-text

Imperial Needs, Imperial Methods: Chimú Ceramic Manufacturing Process Through CT Scan Analysis of Stirrup-Spout Bottles

Latin American Antiquity ◽

10.7183/1045-6635.27.2.238 ◽

2016 ◽

Vol 27 (2) ◽

pp. 238-256

Author(s):

Valentine Wauters

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Manufacturing Process ◽

Ceramic Production ◽

Ct Scans ◽

Manufacturing Processes ◽

Ceramic Assemblage ◽

Ceramic Manufacturing ◽

Industrial Level ◽

Ct Scan Analysis

The stirrup-spout bottle is one of the most representative forms in the Chimú (A.D. 900-1470) ceramic repertoire. I discuss the ceramic assemblage of this coastal culture and describes more precisely the various manufacturing processes of the stirrup-spout bottle. Although molds used to produce these complex vessels are known today, only little information has been published on the various stages involved in their manufacture. My purpose is to contribute to this research using medical imaging computed tomography (CT) scans of intact stirrup-spout vessels. Based on my findings, I propose that changes in the construction of these vessels correlated with a transition in ceramic production to a semi-industrial level during the time of the Chimú Empire.

Download Full-text

Prediction of Extrathyroidal Extension Using Ultrasonography and Computed Tomography

International Journal of Endocrinology ◽

10.1155/2014/351058 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Doh Young Lee ◽

Tack-Kyun Kwon ◽

Myung-Whun Sung ◽

Kwang Hyun Kim ◽

J. Hun Hah

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Extrathyroidal Extension ◽

Ct Scans ◽

Imaging Features ◽

Predictive Values ◽

Preoperative Prediction ◽

Ct Findings ◽

Sensitivity Specificity ◽

Thyroid Capsule

Objectives. The aim of the present study was to evaluate the value of high-resolution ultrasound (US) and computed tomography (CT) scan for preoperative prediction of the extrathyroidal extension (ETE).Methods. We analyzed the medical records of 377 patients with papillary thyroid carcinoma (PTC) with preoperative US and CT scan to calculate the sensitivity, specificity, and positive and negative predictive values of characteristics imaging features (such as contact and disruption of thyroid capsule) for the presence of ETE in postoperative pathologic examination. We also evaluated the diagnostic power for several combinations of US and CT findings.Results. ETE was present in 174 (46.2%) based on pathologic reports. The frequency of ETE was greater in the patients with greater degrees of tumor contact and disruption of capsule, as revealed by both US and CT scans (positive predictive value of 72.2% and 81.8%, resp.). Considering positive predictive values and AUC of US and CT categories, separately or combined, a combination of US and CT findings was most accurate for predicting ETE (83.0%, 0.744).Conclusions. This study suggests that ETE can be predicted most accurately by a combination of categories based on the findings of US and CT scans.

Download Full-text

The prognostic significance of supradiaphragmatic lymphadenopathy identified on preoperative computed tomography scan in patients undergoing primary cytoreduction for advanced stage epithelial ovarian cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16512 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16512-e16512

Author(s):

V. Kolev ◽

S. Mironov ◽

O. Mironov ◽

C. Moskowitz ◽

N. M. Ishill ◽

...

Keyword(s):

Computed Tomography ◽

Ovarian Cancer ◽

Overall Survival ◽

Ct Scan ◽

Epithelial Ovarian Cancer ◽

Median Survival ◽

Residual Disease ◽

Prognostic Significance ◽

Prognostic Impact ◽

Preoperative Ct

e16512 Background: It has been hypothesized and shown in animal studies that the supradiaphragmatic lymph nodes serve as the principal nodes for lymphatic drainage of the entire peritoneal cavity. The purpose of this study was to determine the prognostic significance of enlarged supra-diaphragmatic nodes noted on preoperative computed tomography (CT) scan in patients with advanced epithelial ovarian cancer (EOC). Methods: We performed a retrospective chart review of all patients (pts) with FIGO stage III and IV EOC who had preoperative CT scans of the supradiaphragmatic region and primary cytoreductive surgery at our institution between 1997 and 2004. All scans were retrospectively reviewed by one board-certified radiologist (SM). To evaluate survival, Kaplan-Meier methods were used, with log rank Pvalues for comparisons. Results: A total of 212 eligible pts who underwent attempted primary cytoreduction followed by platinum-based systemic chemotherapy were identified for evaluation. With a median follow-up time of 52 mos, there were 135 deaths and a median overall survival of 48 mos (95% CI: 44–53). Of the 212 pts, 44 (21%) had supradiaphragmatic adenopathy with nodes >1 cm, while 168 (79%) did not have adenopathy in this distribution. None of the 44 pts with adenopathy had the enlarged nodes removed at primary cytoreduction. The median survival was 49 mos for pts with and 48 mos for patients without adenopathy (p = 0.46). In total, 155 (73%) patients underwent optimal cytoreduction (residual disease ≤ 1 cm). In the optimally cytoreduced pts, the median survival for the 125 pts without supradiaphragmatic adenopathy was 52 mos (95%CI: 45–59) compared to 51mos (95%CI: 41–58) for the 30 pts with supradiaphragmatic adenopathy (p = 0.33). Conclusions: Although a previous study has shown that supradiaphragmatic adenopathy was associated with poorer overall survival in EOC patients, our study did not confirm these findings. In our study, enlarged supradiaphragmatic nodes noted on preoperative CT scan did not have significant prognostic impact and therefore their clinical significance remains uncertain. No significant financial relationships to disclose.

Download Full-text

Multi-Institutional Reciprocal Validation Study of Computed Tomography Predictors of Suboptimal Primary Cytoreduction in Patients With Advanced Ovarian Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.07.7800 ◽

2007 ◽

Vol 25 (4) ◽

pp. 384-389 ◽

Cited By ~ 154

Author(s):

Allison E. Axtell ◽

Margaret H. Lee ◽

Robert E. Bristow ◽

Sean C. Dowdy ◽

William A. Cliby ◽

...

Keyword(s):

Computed Tomography ◽

Ovarian Cancer ◽

Predictive Models ◽

Cross Validation ◽

Residual Disease ◽

Advanced Ovarian Cancer ◽

High Accuracy ◽

Ct Scans ◽

Preoperative Ct ◽

Accuracy Rates

Purpose Identify features on preoperative computed tomography (CT) scans to predict suboptimal primary cytoreduction in patients treated for advanced ovarian cancer in institution A. Reciprocally cross validate the predictors identified with those from two previously published cohorts from institutions B and C. Patients and Methods Preoperative CT scans from patients with stage III/IV epithelial ovarian cancer who underwent primary cytoreduction in institution A between 1999 and 2005 were retrospectively reviewed by radiologists blinded to surgical outcome. Fourteen criteria were assessed. Crossvalidation was performed by applying predictive model A to the patients from cohorts B and C, and reciprocally applying predictive models B and C to cohort A. Results Sixty-five patients from institution A were included. The rate of optimal cytoreduction (≤ 1 cm residual disease) was 78%. Diaphragm disease and large bowel mesentery implants were the only CT predictors of suboptimal cytoreduction on univariate (P < .02) and multivariate analysis (P < .02). In combination (model A), these predictors had a sensitivity of 79%, a specificity of 75%, and an accuracy of 77% for suboptimal cytoreduction. When model A was applied to cohorts B and C, accuracy rates dropped to 34% and 64%, respectively. Reciprocally, models B and C had accuracy rates of 93% and 79% in their original cohorts, which fell to 74% and 48% in cohort A. Conclusion The high accuracy rates of CT predictors of suboptimal cytoreduction in the original cohorts could not be confirmed in the cross validation. Preoperative CT predictors should be used with caution when deciding between surgical cytoreduction and neoadjuvant chemotherapy.

Download Full-text

Can a CT be Omitted in Pediatric Minor Head Trauma?

Journal of Pediatric Neurology ◽

10.1055/s-0037-1604420 ◽

2017 ◽

Vol 16 (01) ◽

pp. 001-007

Author(s):

Maria Sinzig ◽

Eveline Achatz ◽

Günter Fasching ◽

Christoph Arneitz

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Radiation Exposure ◽

Head Trauma ◽

Neurological Status ◽

Ct Scans ◽

Minor Head Trauma ◽

Pediatric Ct ◽

Ct Protocol ◽

In Infants And Children

AbstractThis study aimed to evaluate the need for radiation exposure in pediatric minor head trauma. Symptomatic patients after minor head trauma were observed for at least 24 hours in a 13-month period. A computed tomography (CT) scan was performed on children with a depressed neurological status. Two hundred fourteen patients with a mean age of 9.3 years were included. An intracranial hemorrhage (ICH) was diagnosed in three (1.4%) patients. The overall CT rate was 10.7%. The study concluded that neuro-observation without initial CT scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.

Download Full-text