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Pseudolipomas of Glisson's capsule are rare benign subcapsular liver lesions that typically affect older men. They are composed of degenerating fat that is thought to originate from a detached epiploic appendage. On Computed Tomographic (CT) imaging, pseudolipomas of Glisson's capsule are well-circumscribed and hypoattenuating compared to the hepatic parenchyma. This case report examines three consecutive CT studies in the same patient that show the pseudolipoma migrating to a hepatic subcapsular location over a period of 4.5 months. To our knowledge, this is the first documented case of a pseudolipoma migrating over time and it supports the hypothesis of a migrating epiploic appendage forming a pseudolipoma of Glisson's capsule. A comprehensive review of relevant literature and a discussion of the presented case are provided.

Compare colonic distension using CT colonography (CTC) and CT with water enema (CTWE) in the same patients.Twenty-seven patients who underwent both CTC and CTWE, considering separately supine (CTC-S) and prone (CTC-P) acquisition of CTC were included. The colon was divided into six segments, performing both a qualitative and quantitative analysis.Adequate distension of sigmoid colon was more frequently achieved with CTC-P and CTWE compared to CTC-S (P.05). CTC-P and CTWE showed better distension of the left colon compared to CTC-S (P.01 and P=.03 regarding sigmoid colon, respectively; P=.01 and P=.03 regarding descending colon, respectively).Computed tomography (CT) studies of the colon should be customized to fulfill the clinical query.

We evaluated the performance of a new volume computed tomographic (CT) scanner with regards to image quality and signal homogeneity. Twenty-four subjects were prospectively enrolled. Subjects had prior imaging with rate control. Quantitative analyses performed placing regions of interest in myocardium, blood pool, and aorta. Image quality and diagnostic interpretability were assessed using Likert scales. Median heart rate was 60 and 57 bpm for volume and 64-slice coronary CT angiography (P=.02). Improvement in homogeneity was demonstrated within myocardium (30% improvement), blood pool (73%), and aorta (73%). Improvement in image quality observed at per-patient/per-segment level. Pilot study confirmed improvements in signal homogeneity and diagnostic interpretability, despite imaging at higher heart rates.

We presented a 27-year-old male diagnosed with intraosseous schwannoma of the ilium. Computed tomographic images revealed a well-demarcated, lobulated, expansile, osteolytic lesion in the right supraacetabular region of the ilium. In addition, an intratumoral punctate calcification and a sclerotic rim were observed. T2-weighted magnetic resonance (MR) images demonstrated a heterogeneously hyperintense lesion with a hypointense rim. Major parts of the lesion, excluding some central areas, were enhanced on gadolinium-enhanced MR images. Pathological examination revealed an intraosseous schwannoma. Our findings indicate that intraosseous schwannoma should be considered when images demonstrate a well-demarcated, lobulated, expansile, osteolytic lesion with a sclerotic rim.

Our aim was to evaluate clinical management and outcomes in cancer patients who had an indeterminate Computed Tomographic Pulmonary Angiogram (CTPA) for the assessment of pulmonary embolus. We reviewed 1000 CTPA studies and identified 251 limited (indeterminate) CTPA. We examined follow-up imaging and reviewed clinical management decisions and any positive diagnosis of venous thromboembolic disease (VTE) within the subsequent 90 days. 60 patients (23.9%) had a follow-up imaging study within five days. 8 had a positive study for VTE disease within 5 days. 3 patients (1.2%) were placed on anticoagulation therapy based on the limited CT result.

We sought to determine the prevalence of sternoclavicular (SC) joint calcium pyrophosphate dihydrate (CPPD) crystal deposition and its association with age, osteoarthritis, and atlantoaxial CPPD crystal deposition. In 209 consecutive patients, computed tomographic examinations of the cervical spine were retrospectively reviewed. Overall prevalence of CPPD crystal deposition in the SC joint was 17.2% (36/209), which increased with age (P

The aim of this study was to evaluate the image quality of hand tendons using dual-energy computed tomographic gemstone spectral imaging (DECT GSI) compared with conventional CT images.Forty patients scanned with GSI mode on DECT were enrolled. The 65-keV optimal contrast-to-noise ratio for viewing hand tendons was selected. The image quality of monochromatic GSI images (65 keV) and conventional CT images was compared with two different methods including a subjective method and an objective method by two radiologists, respectively.In the subjective method, the image quality in GSI images was superior to conventional CT images (P.05). And in the objective method, the beam-hardening artifacts in the phalanges of finger space were reduced markedly, with hand tendons displaying more clearly in GSI images (P.05). There was no significant difference between the two radiologists in both methods, with good correlation (kappa=0.75, kappa=0.85).DECT GSI with the optimal 65-keV monochromatic images could reduce the artifacts and increase image quality significantly in hand tendons imaging. It might be very useful in detecting tendon diseases in routine work.

Purpose The purpose was to evaluate the utility of computed tomographic laser mammography (CTLM) as an adjunct examination to mammography in women with dense breast tissue. Methods We retrospectively compared the findings of mammography, CTLM, and adjunct CTLM to mammography with pathology of 155 women scheduled for biopsy or surgery. Results Positive lesions were observed more significantly in malignant than benign lesions. The sensitivity of mammography vs. mammography+CTLM was 34.4% vs. 81.57% among extremely dense breasts and 68.29% vs. 95.34% among heterogeneously dense breasts. Conclusion CTLM could distinguish benign lesions from malignant lesions and is not affected by breast density.

A 64-year-old man was referred to our hospital with progressive loss of function in his right upper and lower extremities. Unenhanced computed tomographic showed a high-density nodular lesion in the left basal ganglion with surrounding hypoattenuation. Brain magnetic resonance imaging demonstrated a predominantly cystic mass with multiple internal septa and an eccentric solid component showing enhancement. Histological examination revealed organizing blood clot and piloid gliosis. This unusual appearance of a mass-like organizing blood clot should be considered in the differential diagnosis when an encapsulated cystic mass with nodular component following the signal characteristics of old blood on MRI is encountered.

Objective The objective of this study was to elucidate the imaging and pathological features of extraskeletal mesenchymal chondrosarcomas (EMCs). Methods Imaging findings of eight EMC cases were retrospectively analyzed. Results Soft tissue masses with different patterns of mineralization were found in five cases on computed tomographic scans. On magnetic resonance images, peripherally located EMCs demonstrated mixed signal intensity on T2-weighted images and heterogeneous enhancement with both calcified and noncalcified areas. Conclusion EMCs exhibited several characteristic imaging features, which when used in combination with the mineralization pattern, enhancement of the calcified area, and signal intensity feature might have diagnostic value for this rare tumor.

The objective of the study was to evaluate the computed tomographic (CT) features and growth rates of pulmonary metastases from colorectal cancer (CRC) on serial CT scans. The study included 17 patients (28 pulmonary metastases) who underwent metastasectomy from CRC. The characteristic CT features include well-defined round or oval nodules in the peripheral or subpleural/fissural lung with frequent feeding vessel sign. The mean tumor volume doubling time was calculated as 160 days. With these growth rates, short-term follow-up (i.e., 5–6 months) would be helpful.

Appendiceal diverticulitis is a rare pathologic entity that is difficult to diagnose on clinical grounds because of an indolent course and atypical presenting symptoms. However, the characteristic computed tomographic (CT) features should suggest the correct diagnosis, and an appendectomy should be performed. Despite its rarity, radiologists should be aware of this condition and the findings on CT because of the higher risk of perforation than in appendicitis and the potential association with appendiceal neoplasms.

Objective The objective of this study was to utilize computed tomographic peritoneography (CTP) to assess distribution prior to intraperitoneal chemotherapy for advanced mullerian cancer. Methods Nineteen patients were submitted to CTP. A novel 6-point peritoneal distribution index was developed and applied to the patients prospectively. Results The median peritoneal distribution index was 6 (range, 4–6). The most common region for incomplete peritoneal distribution correlated to the right subphrenic space. Conclusion Further studies are needed to determine the impact of inadequate distribution on recurrence and survival.

To evaluate whether supine or prone positioning improves pelvicalyceal and ureteral opacification at multi-detector row computed tomographic (CT) urography.We retrospectively reviewed the CT urograms of 114 consecutive patients performed for hematuria. Using a "split-bolus" technique, all patients were imaged 340 s after the injection of intravenous contrast, 63 in the supine and 51 in the prone position. The right and left pelvicalyceal systems and ureters were divided into six segments: anterior calyces, posterior calyces, renal pelvis, proximal ureter, mid ureter, and distal ureter. Two readers rated the opacification of each segment in consensus on a four-point scale from 0 (no opacification) to 3 (excellent opacification). Opacification scores were compared between supine and prone CT urograms using generalized estimating equation models.Supine positioning resulted in higher opacification scores of the renal pelvis and the posterior calyces than prone positioning (P.01). Prone positioning resulted in higher opacification scores of the anterior calyces only (P.01). No significant differences were seen between the supine and prone opacification scores for the proximal, mid, or distal ureters (P values all.5).Supine positioning results in overall greater opacification of the pelvicalyceal system compared to prone positioning at CT urography.

We present three cases of malignant superior vena cava obstruction demonstrating infraphrenic venous collaterals, one of which showed intense focal hepatic enhancement on computed tomographic scan. Infraphrenic venous collaterals and focal liver enhancement are uncommon but specific computed tomographic features of superior vena cava obstruction.

Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare condition of the rectosigmoid colon that primarily affects middle-aged men. IMHMV typically presents as proctosigmoiditis and often requires surgical resection due to complications throughout the protracted clinical course. It can be differentiated from idiopathic chronic inflammatory bowel disease by histopathologic examination of surgically resected colon specimens. This report describes a rare case of IMHMV presenting as left hemicolitis in a 64-year-old male. We also describe potentially distinguishing computed tomographic and angiographic findings that may aid in the diagnosis of IMHMV.

Gastric duplication is a rare congenital developmental abnormality usually encountered in children. Nearly all reported cases of this entity describe noncommunicating-type duplication cysts. We present an extremely rare case of complete gastric duplication, involving two separate gastric lumens with proximal and distal communication, incidentally discovered in an elderly male in association with various congenital anomalies not previously reported in literature, as diagnosed with computed tomographic scan and upper gastrointestinal endoscopy.

Early detection through low-dose computed tomographic screening for lung cancer and implementation of smoking cessation can reduce mortality related to lung cancer. While studies delineating the relationship between smoking cessation strategies and lung cancer screening programs remain sparse, we aim to review available data on their importance both individually and synergistically. Strategies and obstacles for implementation are also discussed.

Pancreatic metastases are rare but are thought to be most commonly from renal cell carcinoma (RCC). These metastases can present many years after the initial tumor is resected, and accordingly, these patients require prolonged imaging follow-up. Although the computed tomographic findings of these metastases have been extensively reviewed in the literature, little has been written about the magnetic resonance imaging appearance of these metastases. Pancreatic metastases from RCC are typically T1 hypointense and T2 hyperintense. After intravenous administration of gadolinium, they are typically hypervascular and less commonly hypovascular. Chemical shift and diffusion-weighted imaging can aid in the diagnosis of these metastases.

Sclerosing hemangioma (SH) is a relatively rare, benign neoplasm of the lung. Although there are relatively characteristic imaging findings, biopsy remains the definitive diagnostic test. We report the radiology and pathology of a patient with a SH, with emphasis on the computed tomographic and (18)F-fluorodeoxyglucose positron emission tomography findings, and review the literature on this unusual tumor.

We retrospectively analyzed contrast-enhanced computed tomography (CE-CT) findings in 18 patients with pure invasive lobular carcinoma (ILC). The features were divided into five types: an ill-defined and inhomogeneous mass with or without regional heterogeneous enhancement, a spiculated inhomogenous mass, a regional heterogeneous enhancement, and a normal finding. The correlation between tumor size on pathological examination was better with size estimation on CE-CT than that on mammography and sonography. CE-CT may provide additional information on the characteristics and extent of this carcinoma.

The purpose of this article is to report two cases of pedicular stress fracture of the lumbar spine which is an uncommon cause of low back and leg pain. The relevant literature is reviewed and features of the cases that differ from those already reported are highlighted. One of our cases of pediculolysis is the first in the literature for that is caused by rotational instability induced by laminectomy. The remodeling of the fractured pedicle was striking when compared with its normal counterpart. To the authors' knowledge this is the first report of a pediculolysis with T2-weighted imaging findings. In addition we report the computed tomographic (CT) and magnetic resonance (MR) imaging findings of a healed pediculolysis that has not been reported previously. (C) 2002 Elsevier Science Inc. All rights reserved.

Radiologic–pathologic correlation was evaluated as a quality assurance tool by documenting error rates of 18 radiologists interpreting computed tomographic (CT) scans for acute appendicitis in 763 patients. The departmental error rate was 3.1%. Meaningful individual error rates could be determined in only the seven radiologists who interpreted ≥30 CT scans for acute appendicitis. Radiologic–pathologic correlation is an effective departmental monitor of interpretive accuracy, but individual accuracy can be assessed only for radiologists reading a large number of cases with pathologic proof.

Introduction The objective of this study is to identify computed tomography (CT) features of local recurrence (LR) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods Two hundred eighteen patients underwent SBRT for lung cancer from January 1st, 2006 to March 1st, 2011. Signs of LR recorded: opacity with new bulging margin, opacification of air bronchograms, enlarging pleural effusion, new or enlarging mass, and increased lung density at the treatment site. Results A new bulging margin at the treatment site was the only feature significantly associated with LR ( P Conclusion Most CT features classically associated with LR following conventional radiation therapy are unreliable for predicting LR following SBRT.

To compare multiphase and single-phase corticomedullary contrast-enhanced computed tomographic (CT) imaging in the differentiation of renal cell carcinoma (RCC) subtype.Pathology records were reviewed from January 2008 to March 2013. The final cohort consisted of 79 patients (57 men, 22 women; mean age: 64±13). Quantitative tumor percentage enhancement (TE), cortical enhancement, and tumor-to-cortex enhancement (TCI) indexes were calculated.Single-phase evaluations showed significantly lower mean TE and TCI for papillary tumors when compared with clear cell and cromophobe tumors (P.01). Comparison of receiver operating characteristic curve analyses did not show significant differences between both evaluation methods.Accuracy of RCC subtype differentiation with single-phase corticomedullary contrast-enhanced CT is comparable to multiphasic imaging.

Our objective was to compare plaque volumes of multidetector computed tomographic images reconstructed using adaptive statistical iterative reconstruction (ASIR), model-based iterative reconstruction (MBIR), and filtered back projection (FBP). We reviewed 25 patients for a total of 50 extremities imaged on the same scanner. Calcified plaque FBP volume (3468.2±2634.8 mm 3 ) was higher than ASIR (2548.1±2166.5 mm 3 ). Calcified plaque FBP volume was higher than MBIR (mean=2345.7±1935.4 mm 3 ). Our findings suggest that traditional FBP methods overestimate disease compared to newer reconstruction methods.

Giant cell tumor is among the rare tumors of the bone. We present a case of metacarpal giant cell tumor with radiographic, computed tomographic (CT) and histologic findings, as well as grey scale and Doppler sonographic features. We also present the "doughnut"-shaped appearance on scintigraphy of the lesion, which has not been shown on a metacarpal giant cell tumor.

We present a case of an 8-year-old girl with an infected urachal cyst containing an appendicolith found secondary to an appendico-urachal cyst fistula caused by perforated appendicitis. The clinical features and computed tomographic manifestations of this unusual case are discussed.

We evaluated and compared the radiological images of the spine of 111 patients affected by myeloma, bone metastases, and fractures secondary to osteoporosis demonstrated in low-dose computed tomographic (CT) scans and those demonstrated in conventional radiographic studies. From the analysis of the data obtained, it appears that the duration of the CT procedure is definitely shorter and that its diagnostic sensitivity is superior to that of conventional radiography. We should mention that the dose of radiation delivered by CT scanning does not constitute an unfavorable element in patients, usually elderly, for whom CT scanning was indicated.

Two cases of right double inferior vena cava (RDIVC) were observed on computed tomography. In one case, the duplicated IVCs were both located to the right of the abdominal aorta and were nearly on the same coronal plane. In the other case, the right IVC showed partial duplication. The right ureter coursed posterior to the lateral IVC, then emerged between the duplicated IVC in both cases. The findings from the two cases presented in this report showed novel anatomical differences, likely attributable to different embryologic processes, as compared to previously reported cases of RDIVC.

The purpose of this study was to assess the attenuation characteristics of the Alloderm Biologic Mesh Spacer (ABMS) in the abdomen and pelvis. Of nine patients with ABMS, five underwent multidetector computed tomographic scans at 1, 4, and 7 months postsurgery. Two patients underwent positron emission tomography-computed tomography (PET-CT). The pre- and postcontrast images were evaluated for attenuation characteristics of ABMS. The PET-CT scans were reviewed for [18F]-fluorodeoxyglucose (FDG) uptake. We observed increase in the attenuation characteristics of the spacers on follow-up imaging (P

Objective The objective was to evaluate the efficacy of diffusion-weighted imaging (DWI) in predicting the development of vascularization in hypovascular hepatocellular lesions (HHLs). Materials and methods Forty-two HHLs that were diagnosed by computed tomographic (CT) arteriography were evaluated retrospectively. The lesion on DWI was classified as isointense, hypointense, or hyperintense. Follow-up studies that included intravenous dynamic CT or magnetic resonance imaging were performed. Results The 730-day cumulative developments of vascularization in hypointense, isointense, and hyperintense lesions were 17%, 30%, and 40%, respectively. The differences among these developments were not statistically significant. Conclusion The signal intensity on DWI showed no significant difference in the development of vascularization.

We report a case of pathologically proved actinomycosis that presented unusual computed tomographic (CT) features: a soft-tissue retroperitoneal mass encasing the adjacent ureter resulting in hydronephrosis and spreading into the intraperitoneal space with a stellate pattern. The role of CT in monitoring the response to antibiotic treatment is also discussed.

The newer anticancer therapies, the routine employment of cross-sectional imaging modalities for staging and follow-up, and the increased survival rate of patients with neoplastic lesions have markedly widened the range of pathological and imaging features of secondary neoplasms. Moreover, the changes occurring in morphological and structural aspects of metastases may be the direct effect of the improved therapeutic tools, and in turn may offer revealing clues to the clinician regarding the outcome of therapy itself. The scope of this essay is to show the atypical computed tomographic (CT) aspects of a series of metastatic lesions. We selected the lesions on the basis of their unusual structural features, such as calcification; hemorrhage; superinfection; pseudocystic, cystic, and lipoid appearance; and hypervascularity. A highly detailed assessment of such changes is nowadays possible and appears mandatory.

Cavitary otosclerosis is a rare presentation of otosclerosis, especially when it involves the anterior wall of the internal auditory canal. Recognizing the computed tomographic imaging features of this process is crucial since cavitary otosclerosis may be a cause of a "third window phenomenon", resulting in conductive hearing loss and can cause cerebrospinal fluid leak and electrode misplacement at cochlear implantation. We present a case of bilateral cavitary otosclerosis in a patient with gradual hearing loss followed by a review of literature of this rare but important entity.

Objective This study was designed to assess the value of computed tomography (CT) in determining the nature of papillary thyroid microcarcinomas (PTMCs). Methods Four hundred fifty-two thyroid CT scan cases with pathological data at our department that were performed from January 2011 to January 2012 were analyzed, of which a total of 87 tumors in 73 cases were confirmed as 0.5–1.0 cm diameter PTMC; the CT images of PTMC were analyzed, suitable window width (W) and window level (L) of PTMC were determined, as well as observation of the density and shape of tumors, tumor boundaries before and after contrast enhancement, thyroid edge interruption, calcification, lymph node metastasis, and complications. Results Plain scan W 140–180, L 80–120 and contrast-enhanced scan W 160–200, L 110-150 were conducive to the display of PTMC. Among 87 tumors in this group, aside from 10 tumors and intratumoral calcification that were not shown up, plain CT scans of 77 (88.5%) tumors showed homogeneous low density; 59(67.8%) tumors were irregular shaped; 64 (73.6%) tumors showed plain thyroid scan edge interruption; after contrast enhancement, 65 (74.7%) tumor contours were relatively obscure compared with plain scan, and relative low-density range of the tumors narrowed down; 16 (18.4%) tumors were calcified, of which 15 (93.8%) were fine granular calcifications; lymph node metastasis were found pathologically in 18 (24.7%) cases, of which 8 (44.4%, 8/18) cases were CT findings. Among the 10 (11.4%) tumors that did not show up on CT, 7 were complicated with Hashimoto's thyroiditis, 2 were masked by clavicle artifacts, and 1 was masked by nodular goiter. Conclusion Plain scan W 140–180, L 80–120 and contrast-enhanced scan W 160–200, L 110–150 were conducive to the display of PTMC. The tumor-shaped irregularity, smaller relative low-density area after contrast enhancement than plain scan, thyroid edge interruption, fine granular calcification, and neck lymph node abnormalities contributed to the diagnosis of PTMC; Hashimoto's thyroiditis, clavicle artifacts, and nodular goiter could mask the tumor, which required adequate attention.

Objective The objective was to present computed tomographic (CT) findings of generalized lymphangiomatosis in young adults that was at first misdiagnosed with malignancy. Materials and methods We reviewed the clinical and radiological findings of three young adults who had histologically confirmed generalized lymphangiomatosis. Results Bony lesions were cystic forms and appeared as variably sized, well-circumscribed, irregular, microlobulated-contour, multiseptated masses. Lymphangiomas involving soft tissue were similar to bony lesions on CT. Conclusion CT features of generalized lymphangiomatosis may be useful to prevent invasive procedures in young subjects. Generalized lymphangiomatosis involving bones in young adults shows less extensive and aggressive osteolytic pattern than known features in child.

This study tests whether the utilization of an electronic breath-hold monitoring device improves breath-hold reproducibility during computed tomographic (CT) scanning. Two cohorts of 40 patients underwent dual-phase abdominal CT scans, either with a breath-hold monitoring device or with the standard breath-holding technique. Two blinded readers measured the differences in diaphragmatic position between phases. There was no statistical difference in diaphragmatic position ( P =.14) between the monitored (8.5±11.5 mm) and control (5.6±5.2 mm) cohorts. Ten percent of patients from the monitored cohort had greater than 20 mm of deviation, versus 0%–2.5% for the control cohort. Reproduction of breath-holding position remains challenging, even with a monitoring system.

We report the case of a 52-year-old female with multiple medical complaints and extensive prior clinical and imaging workup who presented to the emergency department with weakness and recurrent episodes of abdominal pain. She had had multiple inconclusive routine computed tomographic (CT) examinations. A 7-mm small bowel tumor was diagnosed on CT enterography and subsequently confirmed to be a carcinoid tumor of the ileum by enteroscopy and at surgery. The diagnosis was suggested prospectively utilizing CT enterography performed in the emergency radiology suite.

Anomalies of third or fourth branchial apparatus origin are very uncommon and present as recurrent neck infections or thyroiditis with a predominant left-sided involvement. Radiological diagnosis requires a high index of suspicion and is critical for initiation of proper treatment. We describe a case of branchial sinus of pyriform fossa with external fistulization that presented in adulthood and was diagnosed on computed tomographic scan. The radiological features of this rare anomaly are revisited.

Dedifferentiated liposarcoma, one of five subtypes of liposarcomas, occurs as a consequence of the progression of well-differentiated liposarcoma to dedifferentiation. Liposarcoma arising from the subserosa of small bowel that can mimic the appearance of mesenteric liposarcoma or teratoma is extremely rare. Here, we report a case of dedifferentiated liposarcoma that developed in the subserosal layer of the jejunum and metastasized to the mesentery.

Hemangiopericytoma (HPC) is a rare mesenchymal tumor generally occurring in adults and originating from the pericytes. The tumor more commonly affects the soft tissues of the extremities, the pelvis, and the retroperitoneum. We describe the computed tomographic and magnetic resonance appearance of a patient affected by HPC of the duodenum.

The aim of this study was to identify criteria for nodule characterization on chest computed tomography in patients with soft tissue sarcomas. In 195 patients, a total of 194 benign and 117 malignant subcentimeter lung nodules were retrospectively analyzed according to lesion size, shape, margins, density, and localization. Benign lesions more frequently displayed complex shape and were of ground-glass density (P

The aim of this study was to evaluate the impact of window settings on measurement of colon polyps with CT virtual colonoscopy with experiment. Twenty-four artificial polyps' diameter were measured and scanned 10 times with identical scan parameters using a 64-multidetector computed tomographic scanner. The diameter of each polyp was measured using lung window and abdominal soft tissue window settings and compared with the actual diameter. The lung window setting offers accurate measurement of colon polyps.

Purpose To compare image quality and patient radiation dose in a group of patients who underwent 320-detector computed tomography coronary angiography performed with prospective electrocardiogram (ECG) gating with image quality and radiation dose in a group of patients matched for clinical features who underwent 320-detector computed tomographic (CT) coronary angiography performed with retrospective ECG gating. Materials and Methods This study was approved by our institutional human research committee. All patients had clinical indications for coronary computed tomography angiography (CTA). Two independent reviewers separately scored coronary artery segment image quality for 480 cardiac CT studies in prospective group and retrospective group (240 in each group). Reviewer variability was calculated. Estimated effective radiation dose was compared for prospective versus retrospective ECG gating. Results The two groups matched well for clinical characteristics and CT parameters. There was good agreement for coronary artery segment image quality scores between the independent reviewers ( k =0.73). Of the 6408 coronary artery segments scored, there were no coronary artery segments that could not be evaluated in each group. Image quality scores were not significantly different ( P >.05). Mean patient radiation dose was 76.50% lower for prospective gating (4.2 mSv) than for retrospective gating (18.1 mSv) ( P Conclusion Use of 320-detector CT coronary angiography performed with prospective ECG gating has similar subjective image quality scores but 76.50% lower patient radiation dose when compared with use of retrospective ECG gating.

The diagnosis of cardiac sarcoidosis can be difficult to establish. We present the case of a 33-year-old woman in whom a contrast-enhanced helical computed tomographic examination of the thorax demonstrated an interventricular septal mass. Subsequent open biopsy confirmed cardiac sarcoidosis.

Pheochromocytomas are adrenal tumors that are diagnosed with time-consuming 24-h urine collection studies. Adrenal hemorrhage is a rare but serious complication of pheochromocytomas that has been reported in only about 50 cases [Sutton MG, Sheps SG, Lie JT. Prevalence of clinically unsuspected pheochromocytomas. Review of a 50-year autopsy series. Mayo Clin Proc 1981;56:354-360]. We had a patient with a classic presentation of pheochromocytoma complicated with hypertensive crisis leading to spontaneous adrenal hemorrhage. We report the computed tomographic (CT) findings of ruptured pheochromocytoma that helped us in early detection and treatment of this life-threatening complication.

An elongation of the internal carotid artery should be classified as a tortuosity or a kink. Tortuosity of the carotid artery is rarely seen in otolaryngologic practice. In videolaryngoscopic examination, bilateral pyriform sinus narrowing was found in one patient and unilateral pyriform sinus narrowing in the other patient. Computed tomographic scans showed tortuous internal carotid artery in both patients. Awareness of the possible internal carotid artery tortuosity is very important to prevent serious complications during laryngeal and pharyngeal surgical procedures.