Computed Tomography vs Laryngography: A Comparison of Relative Diagnostic Value

1981 ◽  
Vol 89 (4) ◽  
pp. 579-586 ◽  
Author(s):  
William H. Friedman ◽  
Carol R. Archer ◽  
Vernon L. Yeager ◽  
George P. Katsantonis
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Laryngeal Cancer ◽  
Ct Scanning ◽  
Diagnostic Value ◽  
Ct Scans ◽  
Fourth Generation ◽  
Partial Laryngectomy ◽  
Routine Basis

The computed tomography (CT) scans and laryngograms of 25 patients with laryngeal cancer were compared and evaluated in an assessment of the diagnostic accuracy of each modality in the supraglottis glottic, and subglottic regions. Fourth generation scanners were used in these patients, all of whom subsequently underwent laryngectomy or partial laryngectomy. The clinical superiority of CT scanning was evident in several areas—confirming clinical impressions that laryngography is not as accurate as CT, is frequently misleading, and offers no significant advantages over CT. In this regard, we now believe that computed tomography is the most important radiologic adjunct in the diagnosis of laryngeal cancer, and we no longer order the laryngogram on a routine basis.

scholarly journals Cerebral Cavernous Hemangioma in a Dog

2019 ◽  
Vol 47 ◽  
Author(s):  
Viviane Motta dos Santos Moretto ◽  
Luciana Maria Curtio Soares ◽  
Esthefanie Nunes ◽  
Uiara Hanna Araújo Barreto ◽  
Valéria Régia Franco Sousa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endothelial Cells ◽  
Cavernous Hemangioma ◽  
Clinical Signs ◽  
Ct Scanning ◽  
Ct Scans ◽  
Elastic Fibers ◽  
Post Contrast ◽  
The Right ◽  
The Brain

Background: Cerebral cavernous hemangioma is a rare neoplasm of vascular origin in the brain, characterized by abnormally dilated vascular channels surrounded by endothelium without muscle or elastic fibers. Presumptive diagnosis is performed by magnetic resonance or computed tomography (CT) scanning and can be confirmed by histopathology. The prognosis of intracranial cavernous hemangioma is poor, with progression of clinical signs culminating in spontaneous death or euthanasia. The purpose of this paper is to report a case of cerebral cavernous hemangioma in a dog, presenting the clinical findings, tomographic changes, and pathological findings.Case: This case involved a 2-year-old medium sized mixed breed female dog presenting with apathy, hyporexia, ataxia, bradycardia, dyspnea, and seizure episodes for three days. Hemogram and serum biochemistry of renal and hepatic function and urinalysis did not reveal any visible changes. CT scanning was also performed. The scans revealed a hyperdense nodule of 15.9 x 14 mm, with well defined borders, and a hypodense halo without post-contrast enhancement and mass effect in the right parietal lobe was observed in both transverse and coronal sections. Based on the image presented in the CT scans, the nodule was defined as a hemorrhagic brain lesion. The animal died after a seizure. The right telencephalon was subjected to necropsy, which revealed a reddish-black wel-defined nodule 1.7 cm in diameter extending from the height of the piriform lobe to the olfactory trine at the groove level and extending towards the lateral ventricle, with slight compression and deformation of the thalamus but no other macroscopic alterations in the other organs. The histopathology indicated that this nodular area in the encephalus contained moderate, well-delimited but unencapsulated cellularity, composed of large vascular spaces paved with endothelial cells filled with erythrocytes, some containing eosinophilic fibrillar material (fibrin) and others with organized thrombus containing occasional neutrophil aggregates. The endothelial cells had cytoplasm with indistinct borders, elongated nuclei, scanty crust-like chromatin, and cellular pleomorphism ranging from discrete to moderate, without mitotic figures.Discussion: The histological findings characterized the morphological changes in the brain as cavernous hemangioma, and the growth and compression of this neoplasm were considered the cause of the clinical signs of this dog. The main complaint was seizures, although ataxia and lethargy were also noted. These clinical signs are often related to changes in the anterior brain and brainstem. The literature does not list computed tomography as a complementary diagnostic method in cases of cerebral cavernous hemangioma in dogs, but CT scanning was useful in confirming cerebral hemorrhage. The main differential diagnosis for cerebral cavernous hemangioma would be a hamartoma, but what differentiates them histologically is the presence of normal interstices between the blood vessels, since no intervening neural tissue occurs in the case of cerebral hemangioma. Therefore, even in the absence of immunohistochemistry to more confidently confirm a cavernous hemangioma, the clinical signs, CT scans and especially the pathological findings were consistent with a case of cerebral cavernous hemangioma, a benign neoplasm with a poor prognosis due to the severe neurological changes it causes and its difficult treatment.

scholarly journals Diagnostic value of contrast-enhanced ultrasound versus computed tomography for hepatocellular carcinoma: a retrospective, single-center evaluation of 234 patients

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093015 ◽  
Author(s):  
Vincent Schwarze ◽  
Constantin Marschner ◽  
Wiebke Völckers ◽  
Sergio Grosu ◽  
Giovanna Negrão de Figueiredo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Ct Scans ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Single Center ◽  
Experienced Radiologist ◽  
Contrast Enhanced

Objective Hepatocellular carcinoma (HCC) is the most common cause of primary liver cancer. A major part of diagnostic HCC work-up is based on imaging findings from sonography, computed tomography (CT), or magnetic resonance imaging (MRI) scans. Contrast-enhanced ultrasound (CEUS) allows for the dynamic assessment of the microperfusion pattern of suspicious liver lesions. This study aimed to evaluate the diagnostic value of CEUS compared with CT scans for assessing HCC. Methods We performed a retrospective, single-center study between 2004 and 2018 on 234 patients with suspicious liver lesions who underwent CEUS and CT examinations. All patients underwent native B-mode, color Doppler and CEUS after providing informed consent. Every CEUS examination was performed and interpreted by a single experienced radiologist (European Federation of Societies for Ultrasound in Medicine and Biology level 3). Results CEUS was performed on all included patients without occurrence of any adverse effects. CEUS showed a sensitivity of 94%, a specificity of 70%, a positive predictive value of 93% and a negative predictive value of 72% for analyzing HCC compared with CT as the diagnostic gold standard. Conclusions CEUS has an excellent safety profile and shows a high diagnostic accuracy in assessing HCC compared with corresponding results from CT scans.

Accessing Implantable Ports: An Opportunistic Computed Tomography-Based Audit

2017 ◽  
Vol 22 (4) ◽  
pp. 193-198
Author(s):  
Timothy E. Murray ◽  
Damien C. O'Neill ◽  
Michael J. Lee
Keyword(s):  
Computed Tomography ◽  
Nursing Staff ◽  
Silicone Rubber ◽  
Ct Scanning ◽  
Ct Scans ◽  
Exit Channel ◽  
Needle Puncture ◽  
Local Policy ◽  
P Values ◽  
Port Access

Abstract Aim: Implantable ports are typically inserted by interventional radiologists or surgeons; however, daily maintenance, access, and de-access are often performed by members of nursing staff in accordance with manufacturers' guidelines and local policy. An audit of port access using retrospective computed tomography (CT) scanning was proposed. Methodology: Across a 4-year period, all CT scans performed for any reason while a port was accessed were reviewed. Results: Fifty-four CT scans of accessed ports were included. Mean depth of tissue between skin and port was 3.74 mm, and between port and pectoralis major was 5.91 mm. Port tilt in side-to-side and up-down axes measured 6.9° and 10.6°, respectively. Mean distance from needle to center of the septum was 1.96 mm. Mean distance from center of the chamber to the needle tip was 2.73 mm. In 2 cases (3.7%), the needle bevel was malpositioned, with the bevel still within the silicone-rubber septum. Mean angulation of the access needle from perpendicular was 11.5°. Angulation of the needle correlated with port tilt (r = 0.37; P = .006). Angle of the needle bevel relative to the port exit channel was 140.8°. No significant correlation between needle bevel directionality and needle angle, depth of port, or tilt of port was detected (all P values > .21). Conclusions: Variability in accessing of implantable ports is described relative to research- and manufacturer-recommended needle bevel angle, needle puncture angle, and central puncture position. The extent to which such deviation influences port function deserves focused clinical research.

scholarly journals Diagnostic value of lung ultrasound versus chest CT in COVID-19

2020 ◽  
Vol 11 (2) ◽  
pp. 5-18
Author(s):  
S. S. Petrikov ◽  
I. E. Popova ◽  
V. M. Abuchina ◽  
R. Sh. Muslimov ◽  
L. T. Khamidova ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Lung Diseases ◽  
Structural Changes ◽  
Lung Ultrasound ◽  
Ground Glass Opacity ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Ct Scans ◽  
Chest Computed Tomography ◽  
Ct Data

Lung ultrasound demonstrates a high diagnostic value in the assessment of lung diseases.Aim. To determine the diagnostic accuracy of lung ultrasound compared to chest computed tomography (CT) in the diagnosis of lung changes in COVID-19. Materials and methods. The retrospective study included 45 patients (28 men) aged 37 to 90 years who underwent polypositional lung ultrasound with an assessment of 14 zones. The study compared lung echograms with chest CT data in assessing the prevalence of the process and the nature of structural changes. The diagnostic accuracy, sensitivity, and specificity of lung ultrasound in comparison with CT scans were determined, 95% confidence intervals (CI) were calculated.Results. In 44 patients (98%), CT revealed pathological changes with subpleural localization in both lungs. Of these, in 30 cases, the inflammation was limited only to the subpleural parts, and in 14 cases, the changes spread to the basal parts of the lungs, while ultrasound revealed changes at the depth of the lesion no more than 4 cm. The lesion of 10–11 zones according to lung ultrasound corresponds to CT 1–2 degrees, the lesion of 13–14 zones — CT 3–4 degrees. The sensitivity of ultrasound to detect lung changes of various types was ≥ 92%. The highest sensitivity of 97.9% (95% CI: 92.8–99.8%) was determined for small consolidations on the background of interstitial changes (degree 1A+, 1B+), which corresponded to “crazy-paving” pattern on CT. The specificity depended on the nature of the changes and varied from 46.7 to 70.0%. Diagnostic accuracy was ≥ 81%, the maximum values of 90.6% (95% CI: 85.6–94.2%) were obtained for moderate interstitial changes (grade 1A) corresponding to ground-glass opacity (type one) according to CT data.Conclusion. The sensitivity of ultrasound to detect lung changes in COVID-19 is more than 90%. Lung ultrasound has some limitations: inability to determine the prevalence of the process clearly and identify centrally located areas of changes in the lung tissue.

scholarly journals PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer

2018 ◽  
Vol 22 (7) ◽  
pp. 1-114 ◽  
Author(s):  
Paula Ghaneh ◽  
Robert Hanson ◽  
Andrew Titman ◽  
Gill Lancaster ◽  
Catrin Plumpton ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Diagnostic Accuracy ◽  
Cost Effective ◽  
Diagnostic Value ◽  
Pet Ct ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Background Pancreatic cancer diagnosis and staging can be difficult in 10–20% of patients. Positron emission tomography (PET)/computed tomography (CT) adds precise anatomical localisation to functional data. The use of PET/CT may add further value to the diagnosis and staging of pancreatic cancer. Objective To determine the incremental diagnostic accuracy and impact of PET/CT in addition to standard diagnostic work-up in patients with suspected pancreatic cancer. Design A multicentre prospective diagnostic accuracy and clinical value study of PET/CT in suspected pancreatic malignancy. Participants Patients with suspected pancreatic malignancy. Interventions All patients to undergo PET/CT following standard diagnostic work-up. Main outcome measures The primary outcome was the incremental diagnostic value of PET/CT in addition to standard diagnostic work-up with multidetector computed tomography (MDCT). Secondary outcomes were (1) changes in patients’ diagnosis, staging and management as a result of PET/CT; (2) changes in the costs and effectiveness of patient management as a result of PET/CT; (3) the incremental diagnostic value of PET/CT in chronic pancreatitis; (4) the identification of groups of patients who would benefit most from PET/CT; and (5) the incremental diagnostic value of PET/CT in other pancreatic tumours. Results Between 2011 and 2013, 589 patients with suspected pancreatic cancer underwent MDCT and PET/CT, with 550 patients having complete data and in-range PET/CT. Sensitivity and specificity for the diagnosis of pancreatic cancer were 88.5% and 70.6%, respectively, for MDCT and 92.7% and 75.8%, respectively, for PET/CT. The maximum standardised uptake value (SUVmax.) for a pancreatic cancer diagnosis was 7.5. PET/CT demonstrated a significant improvement in relative sensitivity (p = 0.01) and specificity (p = 0.023) compared with MDCT. Incremental likelihood ratios demonstrated that PET/CT significantly improved diagnostic accuracy in all scenarios (p < 0.0002). PET/CT correctly changed the staging of pancreatic cancer in 56 patients (p = 0.001). PET/CT influenced management in 250 (45%) patients. PET/CT stopped resection in 58 (20%) patients who were due to have surgery. The benefit of PET/CT was limited in patients with chronic pancreatitis or other pancreatic tumours. PET/CT was associated with a gain in quality-adjusted life-years of 0.0157 (95% confidence interval –0.0101 to 0.0430). In the base-case model PET/CT was seen to dominate MDCT alone and is thus highly likely to be cost-effective for the UK NHS. PET/CT was seen to be most cost-effective for the subgroup of patients with suspected pancreatic cancer who were thought to be resectable. Conclusion PET/CT provided a significant incremental diagnostic benefit in the diagnosis of pancreatic cancer and significantly influenced the staging and management of patients. PET/CT had limited utility in chronic pancreatitis and other pancreatic tumours. PET/CT is likely to be cost-effective at current reimbursement rates for PET/CT to the UK NHS. This was not a randomised controlled trial and therefore we do not have any information from patients who would have undergone MDCT only for comparison. In addition, there were issues in estimating costs for PET/CT. Future work should evaluate the role of PET/CT in intraductal papillary mucinous neoplasm and prognosis and response to therapy in patients with pancreatic cancer. Study registration Current Controlled Trials ISRCTN73852054 and UKCRN 8166. Funding The National Institute for Health Research Health Technology Assessment programme.

scholarly journals Diagnostic Accuracy of CT Scans in Blunt Abdomical Trauma

2021 ◽  
Vol 15 (10) ◽  
pp. 3503-3505
Author(s):  
Azmat Ali ◽  
Nadia Khattak ◽  
Adnan Ahmed ◽  
Jawad Ali Memon ◽  
Maimoona Afsar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Clinical Manifestations ◽  
Retroperitoneal Hematoma ◽  
Ct Scans ◽  
Internal Bleeding ◽  
Wide Range

Background and Aim: Blunt abdominal trauma may lead to a serious situation that necessitates prompt diagnosis and treatment. The intra-abdominal injury effective diagnosis is difficult in patient’s management in such cases. The present study aims to evaluate the diagnostic accuracy of computed tomography scans in active internal bleeding following abdominal trauma. Materials and Methods: This cross-sectional study was carried out on 84 blunt abdominal trauma patients in the Department of Radiology Hayatabad Medical Complex, Peshawar for duration of six months from January 2021 to June 2021. All the patients with no clinical manifestations underwent diagnostic CT scans. Those who had a positive CT scan underwent laparotomy. The remaining patients were monitored for 24 hours and were discharged in case of no serious issues. Demographic details, patient information, trauma mechanism, CT scan indications, and findings, and laparotomy results were recorded. Regarding injured organs, specificity, sensitivity, and diagnostic accuracy of CT scans were determined. For individual cases, CT scans specificity, sensitivity, and accuracy were calculated. SPSS version 20 was used for data analysis. Results: This study included 84 patients, out of which 73 (86.9%) were male and 11(13.1%) were female. Patients aged 20-40 years were more prevalent 47 (56%), followed by those aged over 40 years were 20 (23.8%) and 10 to 19 years old were 17 (20.2%). Liver and spleen injuries had the highest CT scan sensitivity of 87.5% and 96.7% respectively. On the other hand, The CT scan's specificity was high in the injured kidneys (94%) and retroperitoneal hematoma 97.3% compared to other organ’s injuries. The diagnostic accuracy of CT scans in the identification of liver, kidney injuries, spleen, and retroperitoneal hematoma injuries was 93.7%, 92.3%, 96.2%, and 92.3% respectively. Conclusion: Our study found that CT scans are capable of detecting a wide range of injuries. CT scans are exceptionally valuable for assessing blunt abdominal injuries with active internal bleeding patients Furthermore, CT investigation is quick and extensively accessible. CT can produce high-resolution images with MPR and scanning protocol. Keywords: Diagnostic Accuracy; Abdominal Trauma Injuries, Computed Tomography (CT)

scholarly journals Use of Computed Tomography Compression Ratio in Diagnosis of Disc Injuries and Posterior Ligamentous Complex Injuries in Osteoporotic Thoracolumbar Compression Fractures

2021 ◽  
Vol 18 (4) ◽  
Author(s):  
Dong Liu ◽  
Dan Zhong ◽  
Aihong Cao
Keyword(s):  
Computed Tomography ◽  
Compression Ratio ◽  
Body Height ◽  
The Elderly ◽  
Diagnostic Value ◽  
Ct Scans ◽  
Posterior Ligamentous Complex ◽  
Compression Fractures ◽  
Study Population ◽  
Magnetic Resonance Imaging Mri

Background: Osteoporotic compression fractures are common among the elderly. It is important to predict the posterior ligamentous complex (PLC) and disc injuries in computed tomography (CT) scans of patients with magnetic resonance imaging (MRI) contraindications. Objectives: To determine the role of the CT compression ratio (CTCR) in diagnosing PLC and disc injuries and to compare it with the loss of vertebral body height (LOVBH) in osteoporotic thoracolumbar compression fractures. Patients and Methods: A total of 91 consecutive patients with vertebral fractures were included as the study population. The PLC and disc injuries were assessed using MRI, and the following radiological parameters were determined based on CT scans for further MRI examinations: CTCR, LOVBH, local kyphosis (LK), interspinous widening (ISW), vertebral translation (VBT), and posterior structures fractures (PSF). Statistical analysis was performed to identify the diagnostic value of CT features in PLC and disc injuries. Results: The PLC injuries were detected in 9/91 cases, and the number of disc injuries was 47/91. Neither CTCR nor LOVBH was associated with PLC injuries (P > 0.05). However, the CTCR was associated with disc injuries (P < 0.05), with an optimal threshold of 1.755 (sensitivity, 68.1%; specificity, 79.5%), while the LOVBH was not significantly associated with disc injuries. Based on the results, VBT was significantly related to PLC and disc injuries (P < 0.05). Conclusion: The injured vertebral CTCR was associated with disc injuries rather than PLC injuries, suggesting that compression fractures are relatively stable with less PLC injury. Overall, CTCR is a useful indicator reflecting the compression degree of the injured vertebrae; it is also a valid predictor of disc injuries.

Otosclerosis: Incidence of Positive Findings on High-Resolution Computed Tomography and Their Correlation to Audiological Test Data

2005 ◽  
Vol 114 (9) ◽  
pp. 709-716 ◽  
Author(s):  
Ilka C. Naumann ◽  
Beat Porcellini ◽  
Ugo Fisch
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Sodium Fluoride ◽  
Bone Conduction ◽  
Ct Scanning ◽  
Ct Scans ◽  
High Resolution Computed Tomography ◽  
Computed Tomographic ◽  
Mixed Hearing Loss ◽  
Temporal Bone Ct

Objectives: Computed tomographic (CT) scanning with slices of 1 mm or more has not been sufficient to demonstrate otosclerotic foci in most cases to date. Methods: We investigated the validity of CT scans with a 0.5-mm cubical scan technique, with and without planar reconstruction, and correlated these findings with audiological data. Forty-four temporal bone CT scans from 30 patients with conductive or mixed hearing loss were evaluated. Results: Otosclerotic foci were visualized in 74% of the cases. With reconstruction at the workstation, the sensitivity increased to 85%. Whereas in fenestral otosclerosis a correlation was found between the size of the focus and the air-bone gap, no correlation was seen between the size of the focus and bone conduction thresholds with cochlear involvement. Otosclerotic foci in patients treated with sodium fluoride were smaller than those in patients without treatment. This finding may indicate a beneficial effect of sodium fluoride on otosclerotic growth. Conclusions: High-resolution CT scans are a valid tool that can be used to confirm, localize, and determine the size of clinically suspected otosclerotic foci.

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