Computed Tomography after Skull Base Resection

1989 ◽  
Vol 100 (3) ◽  
pp. 218-223
Author(s):  
Yosef P. Krespi ◽  
Michael H. Weiss ◽  
Deborah L. Reede ◽  
Thomas Bergeron
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Ct Scanning ◽  
Ct Scans ◽  
Reconstructive Procedures ◽  
Serial Ct

We have obtained serial CT scans in the evaluation and follow-up of 80 patients with lesions of the skull base. CT scanning has been useful for assessment of recurrence in this group of patients, many of whom underwent complex ablative and reconstructive procedures.

Early ischemic lesion on computed tomography: predictor of poor outcome among survivors of aneurysmal subarachnoid hemorrhage

2007 ◽  
Vol 107 (6) ◽  
pp. 1074-1079 ◽  
Author(s):  
Jari Siironen ◽  
Matti Porras ◽  
Joona Varis ◽  
Kristiina Poussa ◽  
Juha Hernesniemi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Independent Predictor ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Ct Scans ◽  
Ischemic Lesion ◽  
Poor Outcome ◽  
Serial Ct ◽  
Early Lesion

Object Identifying ischemic lesions after subarachnoid hemorrhage (SAH) is important because the appearance of these lesions on follow-up imaging correlates with a poor outcome. The effect of ischemic lesions seen on computed tomography (CT) scans during the first days of treatment remains unknown, however. Methods In 156 patients with SAH, clinical course and outcome, as well as the appearance of ischemic lesions on serial CT scans, were prospectively monitored for 3 months. At 3 months after SAH, magnetic resonance imaging was performed to detect permanent lesions that had not been visible on CT. Results Of the 53 patients with no lesions on any of the follow-up CT scans, four (8%) had a poor outcome. Of the 52 patients with a new hypodense lesion on the first postoperative day CT, 23 (44%) had a poor outcome. Among the remaining 51 patients with a lesion appearing later than the first postoperative morning, 10 (20%) had a poor outcome (p < 0.001). After adjusting for patient age; clinical condition on admission; amounts of subarachnoid, intracerebral, and intraventricular blood; and plasma glucose and D-dimer levels, a hypodense lesion on CT on the first postoperative morning was an independent predictor of poor outcome after SAH (odds ratio 7.27, 95% confidence interval 1.54–34.37, p < 0.05). Conclusions A new hypodense lesion on early postoperative CT seems to be an independent risk factor for poor outcome after SAH, and this early lesion development may be more detrimental to clinical outcome than a later lesion occurrence.

Short Observation Period and Aggressive Discharge of Patients With Head Injury and Serial CT Scans

2021 ◽  
pp. 000313482110635
Author(s):  
Jordan Perkins ◽  
Jacob Shreffler ◽  
Danielle Kamenec ◽  
Alexandra Bequer ◽  
Corey Ziemba ◽  
...  
Keyword(s):  
Ct Scanning ◽  
Ct Scans ◽  
New Findings ◽  
Serial Ct ◽  
Radiographic Interpretation ◽  
Evidence Based Guidelines ◽  
Head Computed Tomography ◽  
Repeat Imaging ◽  
Observation Period ◽  
Negative Conversion

Background: Many patients undergo two head computed tomography (CT) scans after mild traumatic brain injury (TBI). Radiographic progression without clinical deterioration does not usually alter management. Evidence-based guidelines offer potential for limited repeat imaging and safe discharge. This study characterizes patients who had two head CTs in the Emergency Department (ED), determines the change between initial and repeat CTs, and describes timing of repeat scans. Methods: This retrospective series includes all patients with head CTs during the same ED visit at an urban trauma center between May 1st, 2016 and April 30th, 2018. Radiographic interpretation was coded as positive, negative, or equivocal. Results: Of 241 subjects, the number of positive, negative, and equivocal initial CT results were 154, 50, and 37, respectively. On repeat CT, 190 (78.8%) interpretations were congruent with the original scan. Out of the 21.2% of repeat scans that diverged from the original read, 14 (5.8%) showed positive to negative conversion, 1 (.4%) showed positive to equivocal conversion, 2 (.88%) showed negative to positive conversion, 20 (8.3%) showed equivocal to negative conversion, and 14 (5.8%) showed equivocal to positive conversion. Average time between scans was 4.4 hours, and median length of stay was 10.2 hours. Conclusions: In this retrospective review, most repeat CT scans had no new findings. A small percentage converted to positive, rarely altering clinical management. This study demonstrates the need for continued prospective research to update clinical guidelines that could reduce admission and serial CT scanning for mild TBI.

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.

Machine learning for lung texture analysis on thin-section CT: Capability for assessments of disease severity and therapeutic effect for connective tissue disease patients in comparison with expert panel evaluations

2021 ◽  
pp. 028418512110449
Author(s):  
Yoshiharu Ohno ◽  
Kota Aoyagi ◽  
Daisuke Takenaka ◽  
Takeshi Yoshikawa ◽  
Yasuko Fujisawa ◽  
...  
Keyword(s):  
Machine Learning ◽  
Texture Analysis ◽  
Disease Severity ◽  
Thin Section ◽  
Ct Scans ◽  
Normal Lung ◽  
Quantitative Index ◽  
Serial Ct ◽  
Ct Texture Analysis

Background The need for quantitative assessment of interstitial lung involvement on thin-section computed tomography (CT) has arisen in interstitial lung diseases including connective tissue disease (CTD). Purpose To evaluate the capability of machine learning (ML)-based CT texture analysis for disease severity and treatment response assessments in comparison with qualitatively assessed thin-section CT for patients with CTD. Material and Methods A total of 149 patients with CTD-related ILD (CTD-ILD) underwent initial and follow-up CT scans (total 364 paired serial CT examinations), pulmonary function tests, and serum KL-6 level tests. Based on all follow-up examination results, all paired serial CT examinations were assessed as “Stable” (n = 188), “Worse” (n = 98) and “Improved” (n = 78). Next, quantitative index changes were determined by software, and qualitative disease severity scores were assessed by consensus of two radiologists. To evaluate differences in each quantitative index as well as in disease severity score between paired serial CT examinations, Tukey's honestly significant difference (HSD) test was performed among the three statuses. Stepwise regression analyses were performed to determine changes in each pulmonary functional parameter and all quantitative indexes between paired serial CT scans. Results Δ% normal lung, Δ% consolidation, Δ% ground glass opacity, Δ% reticulation, and Δdisease severity score showed significant differences among the three statuses ( P < 0.05). All differences in pulmonary functional parameters were significantly affected by Δ% normal lung, Δ% reticulation, and Δ% honeycomb (0.16 ≤r2 ≤0.42; P < 0.05). Conclusion ML-based CT texture analysis has better potential than qualitatively assessed thin-section CT for disease severity assessment and treatment response evaluation for CTD-ILD.

Ethiodized oil emulsion 13 in computed tomography of hepatoma.

1984 ◽  
Vol 2 (2) ◽  
pp. 118-123 ◽  
Author(s):  
J P Dutcher ◽  
P J Haney ◽  
N O Whitley ◽  
R Finley ◽  
P Pearl ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scanning ◽  
Tumor Location ◽  
Oil Emulsion ◽  
Accurate Definition ◽  
Enhanced Ct ◽  
Ethiodized Oil ◽  
Definition Of

Six patients with biopsy-proven hepatoma were prospectively evaluated both by conventional computed tomography (CT) and by scans using ethiodized oil emulsion 13 (EOE 13) as a contrast agent. EOE 13 infusion resulted in marked improvement in the demonstration of the neoplasm in all cases and allowed more accurate definition of tumor extent than was possible with standard scanning techniques. In two cases EOE 13 enhancement was essential for complete radiographic depiction of tumor location, size, and extent. EOE 13 also proved to be of considerable value in assessment of therapeutic response in three patients, permitting more objective determination of tumor growth or regression. EOE 13--enhanced CT scanning provides a valuable means of staging patients presenting with hepatoma and is a reliable, accurate means of radiographic follow-up.

scholarly journals Clinically significant incidental findings during preoperative computed tomography of patients undergoing cardiac surgery

2020 ◽  
Vol 31 (5) ◽  
pp. 629-631
Author(s):  
Davorin Sef ◽  
Inderpaul Birdi
Keyword(s):  
Computed Tomography ◽  
Cardiac Surgery ◽  
Incidental Findings ◽  
Preoperative Assessment ◽  
Female Gender ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Clinically Significant ◽  
Work Up

Abstract With the development of minimally invasive cardiac surgery, chest and abdominal computed tomography (CT) scans are becoming an integral part of preoperative assessment and planning. Therefore, the number of incidental findings (IFs) detected with CT is rising. We aimed to investigate the frequency of clinically significant IFs on chest and abdominal CT scans performed during the preoperative assessment of patients undergoing adult cardiac surgery in a 2-year period. In a cohort of 401 patients (mean age 67.4 ± 12.3, female gender 28.9%, median logistic EuroSCORE 5.8 [0.9, 90.5]) who underwent chest or abdominal CT imaging during the study period, we identified 75 patients (18.7%) with clinically significant IFs who needed a further treatment or work-up to confirm the diagnosis or postoperative follow-up. Our data indicate that clinically significant IFs in patients referred for cardiac surgery are frequent. It is important to identify clinically significant Ifs, as a clear postoperative follow-up plan should be made.

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 &gt; .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 PET-CT and Occupational Exposure in Oncological Patients

2020 ◽  
Vol 2 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Mikhail Osipov ◽  
Andrey Vazhenin ◽  
Anna Kuznetsova ◽  
Irina Aksenova ◽  
Daria Vazhenina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Occupational Exposure ◽  
Radiation Risk ◽  
Ct Scans ◽  
Study Group ◽  
Oncological Patients ◽  
Clinical Center ◽  
Pet Ct

The paper describes the results of retrospective epidemiological study on low dose effects of diagnostic radiation exposure to humans. The data used in the study has been collected from archives of Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine during the project for creating the local electronic database of Ozyorsk patients examined with computed tomography (CTDB). The study group consisted of oncological patients who have received positron-emission computed tomography (PET-CT). All patients in the study group were residents of Ozyorsk – the town in South Ural where the “Mayak” production association, also known as 1st Russian nuclear enterprise is located. The main purpose of the study was to understand whether the number of PET-CT scans, as well as other radiation risk factors influences the mortality in the exposed group. The follow-up period started in 2010 since the first PET-CT scans has been performed, and ended in June, 2019. Radiation dose for oncological patients exposed to PET-CT has been compared with the cumulative dose from occupational exposure. Vital status and cause of death of patients who died to the end of follow-up has been established using the data of National Cancer Registry in part located in the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine. Cancer mortality has been analysed depending on age of patient, sex, number of PET-CT examinations, and presence of occupational exposure, using the logistic regression model. Main radiation risk factors influencing cancer mortality has been established.

scholarly journals Anatomical and Radiological Study of Jugular Foramen

2019 ◽  
Vol 08 (03) ◽  
pp. 121-125
Author(s):  
Ajay Kumar ◽  
Alok Tripathi ◽  
Shobhit Raizaday ◽  
Shilpi Jain ◽  
Satyam Khare ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Skull Base ◽  
Jugular Foramen ◽  
Ct Scans ◽  
Transverse Diameter ◽  
Radiological Study ◽  
Significant Difference ◽  
Human Skulls ◽  
The Right

Abstract Background and Aim The purpose of present study was to obtain comprehensive data of morphometric and anatomical details of jugular foramen. Materials and Methods The study was performed on 30 dry adult human skulls along with computed tomography (CT) scans from 30 adult patients. The parameters observed were dimensions, shape, margins, confluence, septations, and distance from jugular foramen to mastoid base. Result In the dry skull observations, only anteroposterior diameter (APD) was significantly different between the right and left side, while for the CT scan observations both transverse diameter and APD exhibit significant difference. Conclusion We believe that data from the present study will help radiologists and neurosurgeons for diagnosis and treatment of skull base pathology around jugular foramen.

Ossification of the pterygoalar and pterygospinous ligaments: a computed tomography analysis of infratemporal fossa anatomical variants relevant to percutaneous trigeminal rhizotomy

2020 ◽  
Vol 132 (6) ◽  
pp. 1942-1951
Author(s):  
Tomasz Matys ◽  
Tariq Ali ◽  
Fulvio Zaccagna ◽  
Damiano G. Barone ◽  
Ramez W. Kirollos ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Infratemporal Fossa ◽  
Maximum Intensity Projection ◽  
Contralateral Side ◽  
Surgical Anatomy ◽  
Ct Scans ◽  
Surgical Approaches ◽  
Cross Sectional ◽  
Radiological Anatomy

OBJECTIVEOssification of pterygoalar and pterygospinous ligaments traversing the superior aspect of the infratemporal fossa results in formation of osseous bars that can obstruct percutaneous needle access to the trigeminal ganglion through the foramen ovale (FO), interfere with lateral mandibular nerve block, and impede transzygomatic surgical approaches. Presence of these ligaments has been studied on dry skulls, but description of their radiological anatomy is scarce, in particular on cross-sectional imaging. The aim of this study was to describe visualization of pterygoalar and pterygospinous bars on computed tomography (CT) and to review their prevalence and clinical significance.METHODSThe authors retrospectively reviewed 200 helical sinonasal CT scans by analyzing 0.75- to 1.0-mm axial images, maximum intensity projection (MIP) reconstructions, and volume rendered (VR) images, including views along the anticipated axis of the needle in percutaneous Hartel and submandibular approaches to the FO.RESULTSOssified pterygoalar and pterygospinous ligaments were readily identifiable on CT scans. An ossified pterygoalar ligament was demonstrated in 10 patients, including 1 individual with bilateral complete ossification (0.5%), 4 patients with unilateral complete ossification (2.0%), and 5 with incomplete unilateral ossification (2.5%). Nearly all patients with pterygoalar bars were male (90%, p < 0.01). An ossified pterygospinous ligament was seen in 35 patients, including 2 individuals with bilateral complete (1.0%), 8 with unilateral complete (4%), 8 with bilateral incomplete (4.0%), 12 with bilateral incomplete (6.0%) ossification, and 5 (2.5%) with mixed ossification (complete on one side and incomplete on the contralateral side). All pterygoalar bars interfered with a hypothetical needle access to the FO using the Hartel approach but not the submandibular approach. In contrast, 54% of complete and 24% of incomplete pterygospinous bars impeded the submandibular approach to the FO, without affecting the Hartel approach.CONCLUSIONSThis study provides the first detailed description of cross-sectional radiological and applied surgical anatomy of pterygoalar and pterygospinous bars. Our data are clinically useful during skull base imaging to predict potential obstacles to percutaneous cannulation of the FO and assist in the choice of approach, as these two variants differentially impede the Hartel and submandibular access routes. Our results can also be useful in planning surgical approaches to the skull base through the infratemporal fossa.

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