scholarly journals Paraspinal Fat Stranding as an Unexpected Finding on Body Computed Tomography: A Key to Early Detection of Spinal Osteomyelitis

2020 ◽  
Vol 10 ◽  
pp. 6
Author(s):  
Eric L. Chen ◽  
Michael Rosenberg ◽  
Nitu Saran ◽  
Burce Ozgen ◽  
Karen Xie ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Early Detection ◽  
Soft Tissues ◽  
Ct Scans ◽  
Unexpected Finding ◽  
Reactive Protein ◽  
Spinal Osteomyelitis ◽  
Clinically Significant ◽  
Fat Stranding ◽  
Body Ct

Objective: At present, early detection of spinal osteomyelitis is a challenge. Patients may present with non-specific symptoms and diagnostic imaging studies may be obtained for seemingly unrelated complaints. Paraspinal fat stranding on body computed tomography (CT) as a sign of osteomyelitis is easily overlooked and has not been reported in the literature to our knowledge. The purpose of this study is to review findings on body CT that points to unsuspected spinal osteomyelitis. Material and Methods: A retrospective review of patients with spinal osteomyelitis who also had concomitant chest, abdominal, or pelvic CT scans between August 2013 and February 2017 yielded 10 patients who had confirmed osteomyelitis (ages between 51 and 75, mean age 64.8). Images and medical records were reviewed. Results: The age of the patients ranged from 51 to 75 years (median value, 64). All patients had multiple underlying medical illnesses, and half of them had a known preceding infection such as sepsis or urinary tract infection. At presentation, three patients had a fever and two patients had neurologic deficits. Seven out of eight patients had elevated C-reactive protein and erythrocyte sedimentation rate, five patients had leukocytosis, and four patients had positive blood cultures. Paravertebral fat stranding and endplate erosions were observed in 9 and 6 cases, respectively, on initial body CT for unrelated indications, and subsequent magnetic resonance imaging confirmed osteomyelitis discitis. Conclusion: Clinically significant, but initially unsuspected, spinal pathology such as osteomyelitis may present on body CT scans. Earlier diagnosis of spinal osteomyelitis can be made by performing a focused evaluation of the paraspinal soft tissues and including osteomyelitis in the differential diagnosis, particularly in high-risk patients.

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.

THE EFFECT OF COMPUTED TOMOGRAPHY CURRENT REDUCTION ON PROXIMAL FEMUR SUBJECT-SPECIFIC FINITE ELEMENT MODELS

2017 ◽  
Vol 17 (01) ◽  
pp. 1750012 ◽  
Author(s):  
CRISTINA FALCINELLI ◽  
ENRICO SCHILEO ◽  
FABIO BARUFFALDI ◽  
LUCA CRISTOFOLINI ◽  
FULVIA TADDEI
Keyword(s):  
Computed Tomography ◽  
Finite Element ◽  
Soft Tissues ◽  
Ct Scans ◽  
Human Cadaver ◽  
Biomechanical Models ◽  
Tube Current ◽  
Subject Specific ◽  
Fresh Frozen ◽  
Current Reduction

Many studies have addressed the modulation of computed tomography (CT) parameters, and particularly of tube current, to obtain a good compromise between the X-ray dose to the patient and the image quality for diagnostic applications. This study aimed at evaluating the influence of dose reduction by means of tube current reduction on the CT-based subject-specific finite element (FE) modeling. To this aim, CT scans at stepwise reduced values of tube current from 180[Formula: see text]mAs to 80[Formula: see text]mAs were performed on: (i) a densitometric phantom, to quantify the changes in the calibration equation; (ii) a fresh-frozen, water submersed, human cadaver femur, to quantify changes in geometry reconstruction and material mapping from CT, as well as strain prediction accuracy, based on the in vitro strain measurements available; (iii) a fresh-frozen human cadaver thigh with soft tissues attached, to quantify FE results changes in conditions similar to those found in vivo. The results showed that the tube current reduction does not affect the 3D modeling and the femur FE analysis. Our pilot study highlights the possibility of performing CT scans with reduced dose to generate biomechanical models, although a confirmation by performing larger studies with clinical CT data is needed.

scholarly journals Rhabdomyolysis following coronary angiography: an unexpected detection on 99mTc-methyl diphosphonate bone scintigraphy

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Kavita Arumugam ◽  
Muhammad Adib Abdul Onny ◽  
Iskandar Mirza Amran ◽  
Subapriya Suppiah ◽  
Chen Siew Ng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Bone Scintigraphy ◽  
Soft Tissues ◽  
Specific Antigen ◽  
Contrast Material ◽  
Whole Body ◽  
Emission Computed Tomography ◽  
Unexpected Finding ◽  
Life Threatening

Abstract Background Bone scintigraphy is an appropriate tool in the management of cancers for the detection of bone metastasis. Technetium 99 m-methylene diphosphonate (99mTc-MDP) is commonly used as a bone-seeking agent. The bones take up 99mTc-MDP through a process called chemisorption, which is more evident in areas of increased osteoblastic activities. Nevertheless, extra-osseous 99mTc-MDP uptake is an infrequent occurrence, which warrants a thorough clinical assessment to evaluate such findings. An example of extraosseous uptake discovery is rhabdomyolysis, which requires prompt recognition and immediate management. Rhabdomyolysis secondary to an adverse reaction towards iodinated contrast material is a rare condition that warrants a high index of clinical suspicion. Case presentation We present a case of a 75-year-old gentleman with underlying benign prostatic hypertrophy, and chronic kidney disease who had undergone a coronary angiography examination and intervention for ischemic heart disease. Pre-scheduled bone scintigraphy with 99mTc-MDP for the work-up of raised serum prostate-specific antigen (PSA) was performed 2 weeks post coronary angiography examination. Whole-body bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) images showed an unexpected finding of extensive extra-osseous uptake in the muscles and soft tissues. Additional investigations confirmed the diagnosis of rhabdomyolysis. Nevertheless, despite the prompt recognition, administration of treatment and supportive care, the patient succumbed to life-threatening complications. Conclusion This case highlights the importance of recognising and identifying the pattern of extra-osseous uptake on bone scintigraphy imaging to ensure early intervention of severe and life-threatening conditions such as rhabdomyolysis.

SPECIFIC CHARACTERISTICS OF BONE STRUCTURES ON CT-SCANS OF PATIENTS WITH SINONASAL INVERTED PAPILLOMAS

2019 ◽  
Vol 65 (4) ◽  
pp. 590-595
Author(s):  
Arkadiy Naumenko ◽  
Kseniya Sapova ◽  
Oleg Konoplev ◽  
Svetlana Astashchenko ◽  
Igor Chernushevich
Keyword(s):  
Computed Tomography ◽  
Tumor Recurrence ◽  
Inverted Papilloma ◽  
Ct Scans ◽  
Precise Localization ◽  
Sinonasal Inverted Papilloma ◽  
Bone Structures ◽  
Inverted Papillomas

Precise localization and excision of the originating site of a sinonasal inverted papilloma is essential for decreasing tumor recurrence. In this study we evaluated the use of preoperative computed tomography (CT) to pinpoint the attachment/origi-nating sites of the tumor.

The Frequency of Random Findings on Abdominal / Pelvis Computed Tomography in Pediatric Trauma Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Betül Tiryaki Baştuğ
Keyword(s):  
Computed Tomography ◽  
Incidental Findings ◽  
Pediatric Population ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Injured Child ◽  
Level 3 ◽  
Male Patients ◽  
Clinically Significant ◽  
Discharge Summaries

Aims: In this study, we aimed to find the percentage of random pathologies and abdominopelvic region anomalies that are not related to trauma in pediatric patients. Background: An abdominal assessment of an injured child usually involves computed tomography imaging of the abdomen and pelvis (CTAP) to determine the presence and size of injuries. Imaging may accidentally reveal irrelevant findings. Objectives: Although the literature in adults has reviewed the frequency of discovering these random findings, few studies have been identified in the pediatric population. Methods: Data on 142( 38 female, 104 male) patients who underwent CTAP during their trauma evaluation between January 2019 and January 2020 dates were obtained from our level 3 pediatric trauma center trauma records. The records and CTAP images were examined retrospectively for extra traumatic pathologies and anomalies. Results: 67 patients (47%) had 81 incidental findings. There were 17 clinically significant random findings. No potential tumors were found in this population. Conclusion: Pediatric trauma CTAP reveals random findings. For further evaluation, incidental findings should be indicated in the discharge summaries.

scholarly journals Metacarpal Bony Dimensions Related to Headless Compression Screw Sizes

2019 ◽  
Vol 12 (S 01) ◽  
pp. S39-S44
Author(s):  
Michael Okoli ◽  
Kevin Lutsky ◽  
Michael Rivlin ◽  
Brian Katt ◽  
Pedro Beredjiklian
Keyword(s):  
Computed Tomography ◽  
Fracture Fixation ◽  
Ct Scans ◽  
Compression Screw ◽  
Metacarpal Head ◽  
Headless Compression Screw ◽  
Metacarpal Bones ◽  
Headless Compression Screws ◽  
The Mean ◽  
Distal Aspect

Abstract Introduction The purpose of this study is to determine the radiographic dimensions of the finger metacarpals and to compare these measurements with headless compression screws commonly used for fracture fixation. Materials and Methods We analyzed computed tomography (CT) scans of the index, long, ring, and small metacarpal bones and measured the metacarpal length, distance from the isthmus to the metacarpal head, and intramedullary diameter of the isthmus. Metacarpals with previous fractures or hardware were excluded. We compared these dimensions with the size of several commercially available headless screws used for intramedullary fixation. Results A total of 223 metacarpals from 57 patients were analyzed. The index metacarpal was the longest, averaging 67.6 mm in length. The mean distance from the most distal aspect of the metacarpal head to the isthmus was 40.3, 39.5, 34.4, and 31 mm for the index, long, ring, and small metacarpals, respectively. The narrowest diameter of the isthmus was a mean of 2.6, 2.7, 2.3, and 3 mm for the index, long, ring, and small metacarpals, respectively. Of 33 commercially available screws, only 27% percent reached the isthmus of the index metacarpal followed by 42, 48, and 58% in the long, ring, and small metacarpals, respectively. Conclusion The index and long metacarpals are at a particular risk of screw mismatch given their relatively long lengths and narrow isthmus diameters.

scholarly journals Cross-sectional anatomy, computed tomography, and magnetic resonance imaging of the banded houndshark (Triakis scyllium)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sang Wha Kim ◽  
Adams Hei Long Yuen ◽  
Cherry Tsz Ching Poon ◽  
Joon Oh Hwang ◽  
Chang Jun Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Imaging Techniques ◽  
Evolutionary Developmental Biology ◽  
Phylogenetic Position ◽  
Ct Scanner ◽  
Resonance Imaging ◽  
Cross Sectional

AbstractDue to their important phylogenetic position among extant vertebrates, sharks are an invaluable group in evolutionary developmental biology studies. A thorough understanding of shark anatomy is essential to facilitate these studies and documentation of this iconic taxon. With the increasing availability of cross-sectional imaging techniques, the complicated anatomy of both cartilaginous and soft tissues can be analyzed non-invasively, quickly, and accurately. The aim of this study is to provide a detailed anatomical description of the normal banded houndshark (Triakis scyllium) using computed tomography (CT) and magnetic resonance imaging (MRI) along with cryosection images. Three banded houndsharks were scanned using a 64-detector row spiral CT scanner and a 3 T MRI scanner. All images were digitally stored and assessed using open-source Digital Imaging and Communications in Medicine viewer software in the transverse, sagittal, and dorsal dimensions. The banded houndshark cadavers were then cryosectioned at approximately 1-cm intervals. Corresponding transverse cryosection images were chosen to identify the best anatomical correlations for transverse CT and MRI images. The resulting images provided excellent detail of the major anatomical structures of the banded houndshark. The illustrations in the present study could be considered as a useful reference for interpretation of normal and pathological imaging studies of sharks.

scholarly journals Conditional CT Strategy—An Effective Tool to Reduce Negative Appendectomy Rate and the Overuse of the CT

2021 ◽  
Vol 10 (11) ◽  
pp. 2456
Author(s):  
Raminta Luksaite-Lukste ◽  
Ruta Kliokyte ◽  
Arturas Samuilis ◽  
Eugenijus Jasiunas ◽  
Martynas Luksta ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Sensitivity And Specificity ◽  
Surgical Outcomes ◽  
Imaging Modality ◽  
Ct Scans ◽  
Negative Appendectomy ◽  
Transabdominal Ultrasound ◽  
First Choice ◽  
Negative Appendectomy Rate

(1) Background: Diagnosis of acute appendicitis (AA) remains challenging; either computed tomography (CT) is universally used or negative appendectomy rates of up to 30% are reported. Transabdominal ultrasound (TUS) as the first-choice imaging modality might be useful in adult patients to reduce the need for CT scans while maintaining low negative appendectomy (NA) rates. The aim of this study was to report the results of the conditional CT strategy for the diagnosis of acute appendicitis. (2) Methods: All patients suspected of acute appendicitis were prospectively registered from 1 January 2016 to 31 December 2018. Data on their clinical, radiological and surgical outcomes are presented. (3) Results: A total of 1855 patients were enrolled in our study: 1206 (65.0%) were women, 649 (35.0%) were men, and the median age was 34 years (IQR, 24.5–51). TUS was performed in 1851 (99.8%) patients, and CT in 463 (25.0%) patients. Appendices were not visualized on TUS in 1320 patients (71.3%). Furthermore, 172 (37.1%) of 463 CTs were diagnosed with AA, 42 (9.1%) CTs revealed alternative emergency diagnosis and 249 (53.8%) CTs were normal. Overall, 519 (28.0%) patients were diagnosed with AA: 464 appendectomies and 27 diagnostic laparoscopies were performed. The NA rate was 4.2%. The sensitivity and specificity for TUS and CT are as follows: 71.4% and 96.2%; 93.8% and 93.6%. (4) Conclusion: A conditional CT strategy is effective in reducing NA rates and avoids unnecessary CT in a large proportion of patients. Observation and repeated TUS might be useful in unclear cases.

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