Modern possibilities of interventional radiology in the elimination of percutaneous nephrolithiasis surgery hemorrhagic complications

Рurpose. To increase the treatment eff ectiveness of patients with various forms of nephrolithiasis based on the development and integration of interdisciplinary approaches to the choice of surgical access. Materials and methods. The study was based on clinical and laboratory data and the results of surgical treatment of 133 patients with various forms of urolithiasis. Results. The analysis of complications of percutaneous surgery is shown by the example of 133 patients with various forms of nephrolithiasis, who underwent PCNL (percutaneous nephrolithotomy). The inclusion of highly informative methods of visualization of urinary stones, multispiral computed tomography with 3D-visualization and densitometry namely in the algorithm of examination of patients with nephrolithiasis is justifi ed. The possibilities of interventional radiology in the elimination of hemorrhagic complications of percutaneous surgery of urolithiasis, including staghorn nephrolithiasis, are presented. Conclusion. The eff ectiveness of the creation of multidisciplinary surgical teams, including specialists in the fi eld of interventional radiology, for the interpretation of diagnostic results, as well as the prevention and elimination of intra- and postoperative hemorrhagic complications, is proven.

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The Prevalence of Nephrolithiasis in Patients with Primary Gout: A Cross-sectional Study Using Helical Computed Tomography

The Journal of Rheumatology ◽

10.3899/jrheum.081128 ◽

2009 ◽

Vol 36 (9) ◽

pp. 1958-1962 ◽

Cited By ~ 14

Author(s):

TORU SHIMIZU ◽

HIROSHI HORI

Keyword(s):

Computed Tomography ◽

Confidence Interval ◽

Laboratory Data ◽

Helical Computed Tomography ◽

Cross Sectional ◽

Patients Âgés ◽

Primary Gout ◽

Stone Formers ◽

Significant Difference ◽

History Of

Objective.To investigate the prevalence of nephrolithiasis in gouty patients by computed tomography (CT) imaging and to compare it with the “prevalence” of urolithiasis calculated from histories of urinary tract calculus.Methods.The kidneys of 383 male patients with primary gout were examined using an unenhanced 2-row helical CT detector, imaging at 2 mm collimation and a helical pitch of 3. The urolithiasis history of the 383 patients was investigated by inquiry. Patients’ ages, body mass index, and laboratory data from a 1-hour clearance test were determined.Results.CT scans confirmed nephrolithiasis in 103 (26.9%, 95% confidence interval 22.5%–31.6%) of the 383 gouty patients, and history of urinary calculus was positive in 65 (17.0%, 95% confidence interval 13.4%–21.1%) of the 383. However, 64 (62%) of the 103 stone-formers identified by CT had no history of urolithiasis. There was a significant difference between the ages of the 103 stone-formers identified by CT and the 65 stone-formers identified from the history.Conclusion.The prevalence of nephrolithiasis obtained using CT was 26.9% in the 383 patients with primary gout. Our results imply that we cannot determine an accurate prevalence of urolithiasis from a patient’s history. Most of the “prevalence” reported in the past may not correspond to a statistically justifiable one, but instead to the “cumulative incidence” during the contraction period of gout. Thus, the prevalence of nephrolithiasis confirmed by a cross-sectional method and the “prevalence” of urolithiasis calculated from patients’ calculus histories should be clearly distinguished.

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Computed Tomography-Based Interventional Radiology in the Musculoskeletal System

Multi-Detector CT Imaging ◽

10.1201/b15604-30 ◽

2013 ◽

pp. 497-516

Keyword(s):

Computed Tomography ◽

Interventional Radiology ◽

Musculoskeletal System

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Planning Method for Safety Neurosurgical and Computed Tomography Contrast-Data Set Visualization

Annals of Advanced Biomedical Sciences ◽

10.23880/aabsc-16000115 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Husham Farouk Ismail Saied

Keyword(s):

Computed Tomography ◽

Tracking System ◽

Optical Tracking ◽

Planning System ◽

Surgical Instrument ◽

Optical Tracking System ◽

Data Set ◽

Strict Adherence ◽

Surgical Access ◽

The Brain

Discussed the issues' associated with the development of a computed neurosurgery planning system. An important part is to determine the value of invasive surgical access. The study purpose is to design a methodology for finding the shortest distance between surgical target and peripheral point of the brain tissue with strict adherence considering the type of the brain anatomical structure existing in the path of surgical track (risk map), these two condition used in companion to determine the risk value of the surgical access. The study method consists of two algorithms for calculating the shortest surgical access to the target and assuring the safety by avoiding high-density tissues identification method “internal map” describing the anatomy of the brain such as bones. An algorithm for automatic identification of brain vascular system also was designed. The structural diagram of the contrast data visualization system, using computed tomography data, was thoroughly discussed. Also, trying to contribute in solving issues facing developers of modern medical imaging visualization systems to select the most appropriate method from the whole arsenal of algorithms and processing models concerning displaying brain surgical zone using image registration and optical tracking system. The visualization of the target zone is carried out according to an internal reference landmark points inside the center of the brain as well as an automatic algorithm for contour recognition was applied. Moreover, the optical tracking system was used to assess the navigation accuracy of determining the position of the surgical instrument outside the patient head. Algorithms necessary for operational planning also was included, and the proposed method was applied in a pilot study with simulation mode to human brain model, in order to target a specific surgical zone, and as a result, the system suggested (24) possible surgical track, among them, were selected the best and safest access. The total error of a surgical instrument targeting was less than 3 mm (in average 2.6 mm).

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Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia

European Radiology ◽

10.1007/s00330-020-07271-0 ◽

2020 ◽

Author(s):

Davide Ippolito ◽

Maria Ragusi ◽

Davide Gandola ◽

Cesare Maino ◽

Anna Pecorelli ◽

...

Keyword(s):

Computed Tomography ◽

Lung Volume ◽

Laboratory Data ◽

Ground Glass Opacity ◽

Invasive Ventilation ◽

Lung Volumes ◽

Total Lung Volume ◽

Reactive Protein ◽

Absolute Volume ◽

Patient’S Outcome

Abstract Objectives To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes. Methods All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated. Results A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC (r = 0.369), neutrophils (r = 0.446), platelets (r = 0.182), CRP (r = 0.190), PaCO2 (r = 0.176), HCO3− (r = 0.284), and PaO2/FiO2 (P/F) values (r = − 0.344). CONS-V/TLV significantly correlated with WBC (r = 0.294), neutrophils (r = 0.300), lymphocytes (r = −0.225), CRP (r = 0.306), PaCO2 (r = 0.227), pH (r = 0.162), HCO3− (r = 0.394), and P/F (r = − 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/TLV, CT score, and invasive ventilation by ET were found (all p < 0.05). Conclusion The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation. Key Points • Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient’s outcome, in particular concerning invasive ventilation.

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Utility of Immediate Postprocedural Cone Beam Computed Tomography Scan in the Detection of Ischemic and Hemorrhagic Complications in Pediatric Neurointerventional Surgery

World Neurosurgery ◽

10.1016/j.wneu.2019.12.003 ◽

2020 ◽

Vol 135 ◽

pp. e405-e409

Author(s):

Melissa A. LoPresti ◽

Jeffrey M. Treiber ◽

Visish M. Srinivasan ◽

Gouthami Chintalapani ◽

Stephen R. Chen ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Computed Tomography Scan ◽

Hemorrhagic Complications ◽

Tomography Scan

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Combined visualization of echinoderm hard and soft parts using contrast-enhanced micro-computed tomography

Zoosymposia ◽

10.11646/zoosymposia.15.1.19 ◽

2019 ◽

Vol 15 (1) ◽

pp. 172-191 ◽

Cited By ~ 1

Author(s):

ALEXANDER ZIEGLER

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

3D Visualization ◽

Soft Part ◽

Three Dimensional ◽

Ethanol Solution ◽

Micro Computed Tomography ◽

Soft Tissue Contrast ◽

Contrast Enhanced ◽

Tissue Contrast

Recent studies have shown that micro-computed tomography (µCT) must be considered one of the most suitable techniques for the non-invasive, three-dimensional (3D) visualization of metazoan hard parts. In addition, µCT can also be used to visualize soft part anatomy non-destructively and in 3D. In order to achieve soft tissue contrast using µCT based on X-ray attenuation, fixed specimens must be immersed in staining solutions that include heavy metals such as silver (Ag), molybdenum (Mo), osmium (Os), lead (Pb), or tungsten (W). However, while contrast-enhancement has been successfully applied to specimens pertaining to various higher metazoan taxa, echinoderms have thus far not been analyzed using this approach. In order to demonstrate that this group of marine invertebrates is suitable for contrast-enhanced µCT as well, the present study provides results from an application of this technique to representative species from all five extant higher echinoderm taxa. To achieve soft part contrast, freshly fixed and museum specimens were immersed in an ethanol solution containing phosphotungstic acid and then scanned using a high-resolution desktop µCT system. The acquired datasets show that the combined visualization of echinoderm soft and hard parts can be readily accomplished using contrast-enhanced µCT in all extant echinoderm taxa. The results are compared with µCT data obtained using unstained specimens, with conventional histological sections, and with data previously acquired using magnetic resonance imaging, a technique known to provide excellent soft tissue contrast despite certain limitations. The suitability for 3D visualization and modeling of datasets gathered using contrast-enhanced µCT is illustrated and applications of this novel approach in echinoderm research are discussed.

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High resolution computed tomography and magnetic resonance imaging in the pre-operative assessment of cochlear implant patients

The Journal of Laryngology & Otology ◽

10.1258/002221503322334495 ◽

2003 ◽

Vol 117 (9) ◽

pp. 692-695 ◽

Cited By ~ 26

Author(s):

T. G. Gleeson ◽

P. D. Lacy ◽

M. Bresnihan ◽

R. Gaffney ◽

P. Brennan ◽

...

Keyword(s):

Computed Tomography ◽

Magnetic Resonance ◽

Cochlear Implant ◽

High Resolution Computed Tomography ◽

Time Of Surgery ◽

Surgical Access ◽

Significant Difference ◽

Mri Scans ◽

Operative Assessment ◽

Ct And Mri

Optimal imaging protocols for cochlear implantation have yet to be determined. Pre-operative computed tomography (CT) and magnetic resonance image (MRI) scans are used to assess cochlear anatomy and patency, to delineate surgical access, and to aid in choice of side for implantation. However, opinion still differs as to which modality provides more information in pre-operative assessment, or if, indeed, a combination of the two is superior.The first 88 patients on the Irish National Cochlear Implant Programme (NCIP) were retrospectively studied to determine the accuracy of pre-operative CT and MRI in predicting abnormalities at the time of surgery. Correlation with surgical findings was determined in three separate groups of patients (those who had CT only, those who had MRI only, and those who had both CT and MRI performed).Of the 24 patients that had both CT and MRI performed, both modalities had a 79 per cent correlation with surgical findings. CT and MRI reports concurred in 75 per cent of cases. Specificity and negative predictive value were high (86 per cent and 90 per cent, respectively). CT alone (47 cases) correlated with surgery in 39 cases (83 per cent); MRI alone (17 cases) correlated in 15 cases (88 per cent).The findings of this study suggest that CT and MRI are effective at predicting normal inner ear anatomy, and thus at predicting the patient and the cochlea most suitable for implantation. Both modalities are useful in determining the side of implantation, thus avoiding potential surgical difficulties in cases of unilateral abnormalities. There was no significant difference between the ability of MRI and CT to detect abnormalities at the time of surgery. In this series the combination of CT and MRI has not been shown to be superior to either modality used alone, although anecdotal evidence to the contrary was noted.

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Pre-ECMO Coagulopathy does not Increase the Occurrence of Hemorrhage during Extracorporeal Support

The International Journal of Artificial Organs ◽

10.5301/ijao.5000577 ◽

2017 ◽

Vol 40 (5) ◽

pp. 250-255 ◽

Cited By ~ 2

Author(s):

Pilar Anton-Martin ◽

Lakshmi Raman ◽

Nikhil Thatte ◽

Jefferson Tweed ◽

Vinai Modem ◽

...

Keyword(s):

Cohort Study ◽

Extracorporeal Membrane Oxygenation ◽

Retrospective Cohort ◽

Pediatric Patients ◽

Laboratory Data ◽

Factors Associated ◽

Cannulation Site ◽

Common Diagnosis ◽

Hemorrhagic Complications ◽

Extracorporeal Support

Introduction and methods Observational retrospective cohort study to evaluate the association between precannulation coagulopathy and the occurrence of hemorrhage during extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric patients at a tertiary children's hospital. Results Of 241 patients supported with ECMO between January 2009 and December 2014, 175 (72.6%) had precannulation coagulation laboratory data and were included in the study. Of the eligible patients, 84 (48%) were identified as coagulopathic and 91 (52%) were noncoagulopathic. In the coagulopathic group, sepsis (27.3%) was the most common diagnosis leading to ECMO. Over half of the patients in both groups (55.9% of the coagulopathic and 52.7% of the noncoagulopathic group) developed hemorrhagic complications during ECMO support. The most frequent bleeding sites for both groups were the cannulation site (24%), the chest tube site (17%), and intracranial (10%). Pre-ECMO coagulopathy was not associated with higher incidence of hemorrhage during extracorporeal support (p = 0.76). Conclusions Pre-ECMO coagulopathy was frequent in our cohort but did not increase the occurrence of hemorrhage during extracorporeal support. Although the identification of factors associated with hemorrhage is key to safely managing ECMO anticoagulation, the implication of precannulation coagulopathy seems to be minimal.

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3D Nondestructive Visualization and Evaluation of TRISO Particles Distribution in HTGR Fuel Pebbles Using Cone-Beam Computed Tomography

Science and Technology of Nuclear Installations ◽

10.1155/2017/3857075 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Gongyi Yu ◽

Yi Du ◽

Xincheng Xiang ◽

Yuan Liu ◽

Ziqiang Li ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

3D Visualization ◽

Production Quality ◽

Cone Beam ◽

Production Quality Control ◽

Cross Sectional ◽

X Ray ◽

Projection Images ◽

Triso Particles

A nonuniform distribution of tristructural isotropic (TRISO) particles within a high-temperature gas-cooled reactor (HTGR) pebble may lead to excessive thermal gradients and nonuniform thermal expansion during operation. If the particles are closely clustered, local hotspots may form, leading to excessive stresses on particle layers and an increased probability of particle failure. Although X-ray digital radiography (DR) is currently used to evaluate the TRISO distributions in pebbles, X-ray DR projection images are two-dimensional in nature, which would potentially miss some details for 3D evaluation. This paper proposes a method of 3D visualization and evaluation of the TRISO distribution in HTGR pebbles using cone-beam computed tomography (CBCT): first, a pebble is scanned on our high-resolution CBCT, and 2D cross-sectional images are reconstructed; secondly, all cross-sectional images are restructured to form the 3D model of the pebble; then, volume rendering is applied to segment and display the TRISO particles in 3D for visualization and distribution evaluation. For method validation, several pebbles were scanned and the 3D distributions of the TRISO particles within the pebbles were produced. Experiment results show that the proposed method provides more 3D than DR, which will facilitate pebble fabrication research and production quality control.

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