scholarly journals Computed Tomography Imaging Features of Malignant “Triton” Tumor for Its Clinical Diagnosis: Report of Two Cases

2020 ◽  
Author(s):  
Yuan Li ◽  
Chun Zeng ◽  
Ning Jiang ◽  
David P. Molloy ◽  
Qiling Peng ◽  
...  

Abstract Background: malignant triton tumors (MTTs) are an extremely rare subtype of malignant periphery nerve sheave tumors (MPNSTs). Clinical diagnosis of MTTs is difficult before surgery due to its low incidence and the lack of knowledge. Therefore, to describe and summarize the computed tomography (CT) imaging characteristics of malignant triton tumors (MTTs) is of great assistance for early and preoperative diagnosis.Case presentation: Two case reports were closely observed in our hospital, with the presumptive diagnosis of MTT by CT scan examination before surgery. The diagnosis of MTT was eventually confirmed by immunochemical (IHC) assay, which verified speculation of CT scans. Huge, irregular, well-circumscribed lobulated mass-like shadows can be observed from these patients by CT scans. Besides, heterogeneity of density within the body of tumor was well-established by CT scans, together with linear septum. Meanwhile, CT scans demonstrated that calcifications were remarkable at the margin of tumor body. Conclusions: Some CT image features from two cases admitted to our hospital were presented as a reference for the preoperative diagnosis of MTTs: (i) enormity of mass-like shadow; (ii) presence of well-circumscribed lobulated shape; (iii) septum within the well-defined mass accompanied with hemorrhage, necrosis and cystic changes as well as calcification, especially within neurofibromatosis type 1 (NF-1) patients.

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Fuguang Ji ◽  
Shuai Zhou ◽  
Zhangshuan Bi

The clinical characteristics and vascular computed tomography (CT) imaging characteristics of patients were explored so as to assist clinicians in diagnosing patients with atherosclerosis. 316 patients with atherosclerosis who were hospitalized for emergency treatment were treated with rapamycin (RAPA) in the hospital. A group of manually delineated left ventricular myocardia (LVM) on the patient’s coronary computed tomography angiography (CCTA) were selected as the region of interest for imaging features extracted. The CCTA images of 80% of patients were randomly selected for training, and those of 20% of patients were used for verification. The correlation matrix method was used to remove redundant image omics features under different correlation thresholds. In the validation set, CCTA diagnostic parameters were about 40 times higher than the manually segmented data. The average dice similarity coefficient was 91.6%. The proposed method also produced a very small centroid distance (mean 1.058 mm, standard deviation 1.245 mm) and volume difference (mean 1.640), with a segmentation time of about 1.45 ± 0.51 s, compared to about 744.8 ± 117.49 s for physician manual segmentation. Therefore, the deep learning model effectively segmented the atherosclerotic lesion area, measured and assisted the diagnosis of future atherosclerosis clinical cases, improved medical efficiency, and accurately identified the patient’s lesion area. It had great application potential in helping diagnosis and curative effect analysis of atherosclerosis.


2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 380-380
Author(s):  
John Chang ◽  
Madelyn Bartels ◽  
Kelsey Beyer ◽  
Ashley Maitland ◽  
Richard Taft Peterson ◽  
...  

380 Background: Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths. At present, the best 5-year survival is 25% for resectable PDAC. For small (1 cm) stage 1 PDAC, resection has resulted in much better survival. The goal of this study was to evaluate the appearance and location of early undiagnosed PDAC on computed tomography scans (CT) prior to diagnosis with the goal of minimizing missing early PDAC. We also categorize the errors as either perceptive or cognitive. Methods: PDAC cases were retrospectively reviewed from 1/1/2012 through 12/31/2018 from our tumor registry, identifying 81 cases with paired CT scans both at the time of and prior to diagnosis. Among these, 31 contained imaging features considered diagnostic or suspicious for early PDAC(38%). These “errors” were classified by radiologic features and as well as by location. In addition, errors were classified into “perceptive errors" when the first study was read as normal, and as “cognitive errors” when the report noted an abnormality but failed to note suspicion for malignancy. Results: Among the 31 undiagnosed PDAC, 18 had features of an identifiable mass (58%), 9 had pancreatic ductal dilatation (29%), and 4 had evidence of perivascular soft tissue (13%). 44% of undiagnosed tumors were located in the head-neck, 39% in the body, and 17% in the tail. Perceptive errors were found in 58% and 42% were cognitive. No significant differences were seen between perceptive and cognitive errors based on suspicious features. Conclusions: Radiologic findings of early PDAC was retrospectively evident in more than one third of cases in which prior imaging was performed. These findings are most often masses or ductal dilatation. Location of these undiagnosed tumors were distributed throughout the gland. This study identifies the radiologic features of undiagnosed PDAC which may provide an opportunity for future prospective studies and improved technology which may improve early detection of pancreatic cancer.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Hideki Ota ◽  
Hideki Kawai ◽  
Tsubasa Matsuo

Castleman's disease is an uncommon lymphoproliferative disorder of unknown etiology, most often involving the mediastinum. It has 2 distinct clinical forms: unicentric and multicentric. Unicentric Castleman's disease arising from an intrapulmonary lymph node is rare, and establishing a preoperative diagnosis of this disease is very difficult mainly due to a lack of specific imaging features. We report a case of intrapulmonary unicentric Castleman's disease in an asymptomatic 19-year-old male patient who was accurately diagnosed by preoperative computed tomography (CT). The mass was incidentally found on a routine chest X-ray. A subsequent dynamic CT showed a well-defined, hypervascular, soft-tissue mass with small calcifications located in the perihilar area of the right lower lung. Three-dimensional CT (3D-CT) angiography indicated that the mass was receiving its blood supply through a vascular network at its surface that originated from 2 right bronchial arteries. The clinical history and CT findings were consistent with a diagnosis of unicentric Castleman's disease, and we safely and successfully removed the tumor via video-assisted thoracoscopic surgical lobectomy. This case shows that the imaging characteristics of these rare tumors on contrast-enhanced CT combined with 3D-CT angiography can be helpful in reliably establishing a correct preoperative diagnosis.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Doh Young Lee ◽  
Tack-Kyun Kwon ◽  
Myung-Whun Sung ◽  
Kwang Hyun Kim ◽  
J. Hun Hah

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.


2020 ◽  
Author(s):  
Zhehao Lyu ◽  
Meiji Ren ◽  
Lian-Ming Wu ◽  
Yuxin Yang ◽  
Yi-Bo Lu ◽  
...  

Abstract Background: In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A novel coronavirus was detected, capable of infecting humans, on 6 January 2020 and termed COVID-19. By 16 February 2020, there were 51857 confirmed cases with 2019-nCoV (COVID-19) pneumonia in 25 countries. COVID-19 can also lead to acute respiratory distress syndrome (ARDS).Methods: 149 patients with 2019 Novel Coronavirus (COVID-19)pneumonia(68 males, 81 females, ages 1-89)from 6 research centers in China were diagnosed with positive 2019 Novel Coronavirus(COVID-19)nucleic acids antibodies. And their high-resolution computed tomography(HRCT) imaging datas were evaluated.Results: 136/149(91.3%)patients had a clear history of exposure to Wuhan. Fever (122/149, 81.9%)and cough(83/149, 55.7%)were the most common symptoms. The main imaging characteristics within 4 days of onset included 30(20.13%) cases of pure ground glass opacities (P<0.05), 38(25.50%) cases of GGO with reticulation(P<0.01), 12(8.05%) cases of consolidation(P<0.01). In the 5-8 days group, the main imaging features included 71(47.65%) cases of pGGO(P<0.05), 69(46.31%) cases of GGO with reticulation(P<0.01). In the 9-12 days group, the main feature was 85(57.04%) cases with GGO with reticulation(P<0.01). In the group of 13-16 days group, the main imaging characteristics included 48(32.21%) cases of GGO with reticulation(P < 0.01), 34(22.82%) cases of consolidation(P<0.01).Conclusion: Patients infected with COVID-19 pneumonia show more chest CT characteristics within 5-8 days after the onset of disease. The main manifestations included pGGO, GGO with reticulation, consolidation and GGO with consolidation.


2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Ntombizakhona B.A. Mthalane ◽  
Nondumiso N.M. Dlamini

Background: Tuberculosis (TB) is a worldwide infectious disease burden, especially in non-developed countries, with increased morbidity and mortality among human immunodeficiency virus (HIV)-infected patients. Extrapulmonary TB is rare and renal TB is one of the commonest manifestations. The end result of renal TB is end-stage renal disease; however, this can be avoided if the diagnosis is made early. The diagnosis of renal TB is challenging because of the non-specific presentation and low sensitivity of clinical tests. Although the sequel of TB infection in the kidney causes varying manifestations depending on the stage of the disease, multidetector computed tomography (MDCT) is capable of demonstrating early findings. We performed a 20-year scoping review of MDCT findings in renal TB to promote awareness.Aim: To identify specific MDCT imaging characteristics of renal TB, promote early diagnosis and increase awareness of the typical imaging features.Methods and material: We searched published and unpublished literature from 1997 to 2017 using a combination of search terms on electronic databases. We followed the Joanna Briggs Institute guidelines.Results: A total of 150 articles were identified, of which 145 were found through electronic search engines and 5 were obtained from grey literature. Seventy-nine articles that fulfilled our inclusion criteria were reviewed. These included original research, case reports, literature review, organisational reports and grey literature.Conclusion: Multidetector computed tomography can reproduce images comparable with intravenous excretory urography; together with advantages of being able to better assess the renal parenchyma and surrounding spaces, it is important in suggesting the diagnosis of renal TB and clinicians should consider including MDCT when investigating patients with recurrent urinary tract infection not responding to usual antimicrobial therapy. 


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ragesh Panikkath ◽  
Deepa Panikkath ◽  
Sian Yik Lim ◽  
Kenneth Nugent

Hemiparesis ipsilateral to a cerebral lesion can be a false localizing sign. This is due to midline shift of the midbrain resulting in compression of the contralateral pyramidal fibers on the tough dural reflection tentorium cerebelli. This may result in partial or complete damage to these fibers. Since these fibers are destined to cross in the medulla and innervate the opposite side of the body, this causes hemiparesis ipsilateral to the site of cerebral lesion. Computed tomography (CT) scans have not been used to support the diagnosis of this entity until now. We report a 68-year-old woman with a subdural hematoma who developed ipsilateral hemiparesis without any other explanation (Kernohan’s notch). The CT of the head showed evidence of compression of the midbrain contralateral to the hematoma and was useful in the diagnosis. The purpose of this report is to increase the awareness of this presentation and to emphasize the utility of CT scans to support the diagnosis.


2006 ◽  
Vol 13 (6) ◽  
pp. 311-316 ◽  
Author(s):  
Mark O Turner ◽  
John R Mayo ◽  
Nestor L Müller ◽  
Michael Schulzer ◽  
J Mark FitzGerald

BACKGROUND: Computed tomography (CT) scans are used extensively to investigate chest disease because of their cross-sectional perspective and superior contrast resolution compared with chest radiographs. These advantages lead to a more accurate imaging assessment of thoracic disease. The actual use and evaluation of the clinical impact of thoracic CT has not been assessed since scanners became widely available.OBJECTIVE: To identify patterns of utilization, waiting times and the impact of CT scan results on clinical diagnoses.DESIGN: A before and after survey of physicians who had ordered thoracic CT scans.SETTING: Vancouver General Hospital – a tertiary care teaching centre in Vancouver, British Columbia.SUBJECTS: Physicians who had ordered CT scans.INTERVENTION: Physicians completed a standard questionnaire before and after the CT scan result was available.MEASUREMENTS: Changes in the clinical diagnosis, estimates of the probabilities for the diagnosis both before and after the CT scan, and waiting times.RESULTS: Four hundred fifty-four thoracic CT cases had completed questionnaires, of whom 80% were outpatients. A change in diagnosis was made in 48% of cases (25% with a normal CT scan and 23% with CT scan findings that indicated a different diagnosis). The largest change in probability scores for the clinical diagnosis before and after the CT scan was 43.9% for normal scans, while it was 36.3% for a different diagnosis and 26.3% for the same diagnosis. High-priority scans were associated with decreased waiting time (−7.89 days for each unit increase in priority).CONCLUSIONS: The CT scan results were associated with a change in diagnosis in 48% of cases. Normal scans constituted 25% of the total and had the greatest impact scores. Waiting times were highly correlated with increased urgency of the presenting problem.


2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Joandes Henrique Fonteque ◽  
Anderson Fernando De Souza ◽  
Thiago Rinaldi Muller ◽  
Ronaldo Paiva Moreno Gonçalves ◽  
Milena Carol Sbrussi Granella ◽  
...  

Background: The occurrence of congenital defects in the sheep is estimated to be between 0.2% and 2%. For congenital anatomical alterations, diagnostic imaging allows objective understanding and evaluation, and is a great aid in the formulation of clinical decisions. Most of these anomalies are diagnosed by radiography; but computed tomography (CT) can provide important additional information. In the current literature there are no descriptions of the use of radiography andCT for a more detailed evaluation of the anatomical structures in cases of congenital cervical malformations in lambs. The objective of this study is to report the clinical, radiographic and tomographic findings in two cases of congenital cervical vertebral malformation in lambs.Cases: Two lambs with cervical morphological alterations since birth were attended. A 4-month-old mixed-breed lamb, weighing 11 kg, with lateroventrocaudal deviation of the neck was observed to the right side, not yielding to the attempt of repositioning. The owner reported that these changes were identified since birth, leading to difficulties in suckling colostrum, necessitating artificial feeding. With the growth of the animal, worsening of the cervical deviation resulted in the impossibility of grazing. The radiographs of the cervical spine identified marked scoliosis, and the axis presented small dimensions and morphological changes with a slight loss of atlantoaxial articular relationship. Spondylopathies were detectedalong the cervical spine. Other lamb of the Lacaune breed, weighing 4.2 kg, was presented shortly after birth with changes in the shape and posture of the neck, difficult locomotion and in sternal decubitus. The owner reported that the lamb came from a twin eutocic birth, with the other lamb being apparently normal. The animal was unable to ingest the colostrum, in which the sheep was milked and colostrum was offered through a bottle. Lateroventrocaudal deviation of the neck to the left side did not yield to the repositioning attempt, the mandible also presented left lateral deviation. The radiographs of the cervical spine showed morphological changes in atlas, and it was not possible to delimit its wings; itwas also observed that the dorsal blade was parallel to the spinal process of the axis. The presence of a hypoattenuating linear left lateral image of the dorsal arch and a right ventro-lateral aspect of the atlas body was identified with slightly irregular and sclerotic margins, suggesting fracture lines. The body of the axis presented a conformational alteration withirregular contours and a large free fragment in the cranial aspect, suggestive of being the odontoid process, with rotation and deviation to the left in relation to the atlas. The right lateral cranial articular process of the third cervical vertebra (C3) presented a conformational change and important lateral rotation of the axis. Mild stenosis of the medullary canal was observed in the segment adjacent to C3. The euthanasia was recommended.Discussion: Congenital cervical malformations in sheep are rare in the literature and may lead to serious decrease in the quality of life of the animals. Computed tomography was superior to radiography in morphological evaluation in cases of congenital cervical malformations in sheep. However, both diagnostic methods were important to establish the best clinical behavior. The etiology of most congenital malformations is unknown, simply because of the complexity of the mechanismsthat lead to the formation of an abnormality. The isolated episodes of this anomaly, in the herd without previous alterations, suggest a non-infectious cause, probably similar among the cases, but not established. The information presented can be used to validate clinical reasoning in future cases similar to those described, where imaging features are not available.Keywords: anomalies, fetus, radiography, computed tomography.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jin Li ◽  
Qian Xu ◽  
Cunhua Mao ◽  
Yuliang Liu

As one of the conventional methods of lung cancer detection, computed tomography (CT) usually requires the use of contrast agents to enhance the imaging effect. Conventional iodine contrast agents have poor signal-to-noise ratio and are prone to adverse reactions. It is necessary to find more effective and safe contrast agents for CT scans. The gold nanoparticles with secondary electron effect and photoelectric absorption effect can prolong the display time of the patient’s blood circulation after being injected into the patient’s body, which makes the nanocontrast agent a research hotspot in the field of CT imaging. In this study, ultrasmall gold nanoclusters with a diameter of about 5 nm were used as the contrast agent in CT scans. It was found that CT scans based on nanocontrast agents can obtain high-quality lung cancer imaging images, and the patient has no obvious adverse reactions. When observing the CT image, it was found that the stage of lung cancer patients can be clearly distinguished through the CT scan image. When analyzing the consistency of CT imaging and pathological classification, the Kappa value was 0.810, indicating that the two have a high degree of consistency. Therefore, this study believes that the imaging characteristics of primary lung tumors based on nanocontrast agents are highly correlated with their pathological types.


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