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Purpose of the study. A comprehensive quantification of ectopic fat depots using modern methods of radiation diagnosis in patients with ischemic heart disease.Patients and methods. The study included 76 patients with a verified diagnosis of ischemic heart disease (IHD). The control group consisted of 32 people without clinical manifestations of IHD. All patients to assess the area and volume of visceral adipose tissue, as well as measuring the volume of paraaortic adipose tissue at the level of the abdominal aorta were performed multispiral computed tomography (MSCT) at the level of L3–L5 vertebrae. In order to visualize and morphometry pericoronary and paraaortic adipose tissue at the level of the thoracic aorta, patients in both groups were performed MSCT angiography of the coronary arteries with ECG synchronization. To visualize the epicardial fat depot with an assessment of the thickness of the adipose tissue layer, magnetic resonance imaging (MRI) of the heart was performed.Results. During the comparative analysis, significantly higher values of quantitative indicators of the main ectopic fat depots were noted in patients with coronary artery disease. Estimation of the prevalence of obesity according to BMI data in the compared groups showed no significant differences. Considering the standard values of the area and volume of visceral adipose tissue, the prevalence of obesity was significantly higher in the group of patients with IHD. Conducted correlation analysis showed the relationship of quantitative indicators of ectopic visceral, para-aortic and epicardial fat depots. Moreover, in the group of patients with IHD, stronger correlations were found between the fat depots of different localization (r = 0,71, p = 0,013 in group with IHD and r = 0,59, p = 0,039 in group without IND).Conclusion. Modern tomographic methods allow for a comprehensive quantification of ectopic fat depots. Significantly higher morphometry indices of the studied fat depots in patients with coronary artery disease demonstrate the need to develop a unified diagnostic algorithm for reliable stratification of cardiometabolic risk.

Objective. To assess accuracy in calculating the values of end-diastolic and end-systolic volumes (EDV and ESV), ejection fraction (EF), and left ventricular (LV) mass, which are obtained according to ECG-synchronized myocardial perfusion scintigraphy (ECG-MPS) on a CZT camera versus those of cardiac multislice computed tomography (MSCT).Material and methods. Thirty-four patients (mean age, 62 ± 5 years) with suspected coronary heart disease or its previously established diagnosis were examined. All the patients underwent MSCT coronary angiography and myocardial perfusion scintigraphy with 99mTc-methyxy-isobutyl-isonitrile. For a comparative analysis, the investigators used the EDV, ESV, FV and LV mass values determined by ECG-MPS at rest and cardiac MSCT. The studies were conducted on a 64-slice SPECT/CT hybrid scanner (Discovery 570c, GE Healthcare, USA).Results. The analysis of the results obtained by both methods revealed statistically significant differences in the values of EDV (MSCT: 168 (145–210) ml; ECG-MPS: 112 (94–141) ml; p < 0.05), ESV (MSCT: 72 (49–83) ml; ECG-MPS: 44 (32–66) ml; p < 0.05), and LV mass (MSCT: 123 (107–143) g; ECG-MPS: 140 (124–168) g; p < 0.05). There were no significant differences in LV EF (MSCT: 64 (54–69)%; ECG-MPS: 61 (50–66)%; p > 0.05). There was a statistically significant correlation between the values of EDV, ESV, and LV mass (r = 0.81; r = 0.78; r = 0.82, respectively, p < 0.05) and a mean correlation of LV EF (r = 0.66; p < 0.05). The Bland–Altman analysis showed that the values of EDV, ESV, and LV mass had statistically significant differences. The consistency limits for the indicators were as follows: EDV, 9–105 ml; ESV, 9–55 ml; LV mass, 51.6–20.7 g. There was a measurement consistency only for EF (consent limits, 16.9–18.4%; p < 0.05). Linear regression equations were calculated, which allow determination of exact values for the volume indices and LV mass according ECG-MPS data.Conclusion. The scintigraphic method versus MSCT yields significantly smaller volumes (EDV and ESV) and higher LV mass. The ECG-MPS values for EDV, ESV, EF, and LV mass have a statistically significant strong correlation with MSCT findings. At the same time, a good consistency of measurements was found only for LV EF.

Digital implant guides have enabled "repair⁃oriented" implant restoration to become a reality by allowing an implant to be designed for an ideal site, maximizing the use of existing alveolar bone, and increasing the predictabili⁃ ty of the restorative effect. This paper reviews the classification of digital guides and the related factors affecting the ac⁃ curacy of digital guides to provide a reference for clinical doctors in practical applications. Digital guides can be divid⁃ ed into the categories of mucosal support, bone support, dental support and mixed support according to the retention mode. The manufacture and use of digital implant guides involve a series of processes, such as data acquisition, design and manufacture of the implant guide, and guided surgery. The accuracy of digital implant guides depends on all accu⁃ mulated and interactive errors involved in the process from data acquisition to surgery. According to the process of guide plate fabrication and implant placement, errors in all aspects can be reduced to improve the accuracy of guide plate application.

Objective. To estimate the density of calcium deposits of atherosclerotic plaques of coronary and carotid arteries in patients with diabetes mellitus (DM) type 2 using multislice computed tomography (MSCT).Material and methods. 251 patients with multifocal atherosclerosis (MA) were examined using MSCT. Determined equivalent density of calcium deposits (EDCD) atherosclerotic plaque of coronary and carotid arteries.Results. According to the data of MSCT in patients with MA irrespective of concomitant diabetes was a high incidence of calcification of the coronary and carotid arteries. In Group 1 EDCD coronary arteries was 0.235 (0.214; 0.254) mg/mm3, in the group 2 - 0,219 (0,192; 0,242) mg/mm3. EDCD of carotid arteries in patients with diabetes was 0.183 (0.171; 0.193) mg/mm3, in patients without diabetes - 0.226 (0.199; 0.247) mg/mm3. There was a significant difference in the groups EDCD values for coronary (p = 0.017), and the carotid (p = 0.000003) artery.Conclusion. Using index EDCD obtained on the basis of routine MSCT coronary and carotid arteries in patients with MA with DM compared with those without diabetes had significantly higher density calcifications in projection of coronary and low density of calcium deposits carotid arteries without regard to the degree of Agatston calcification scale.

The article describes a rare case of metastatic pulmonary choriocarcinoma manifested with hemoptysis. Obstacles and pitfalls of the diagnosis of uterine choriocarcinoma with atypical manifestation were discussed. The patterns of pulmonary metastases of uterine choriocarcinoma and contribution of cross-sectional imaging modalities to diagnostic work-up were described. For the first time diffusion weighted magnetic resonance imaging of the chest was used for the follow-up examination and diagnosis of the recurrence of the disease.This case is of interest due to unusual clinical and radiological presentation of uterine choriocarcinoma. The article is aimed to radiologists to be familiar with this disease to provide its early diagnosis and timely treatment.

Asthma and obesity prevalence in population have increased over the last years. In the Global Strategy for Asthma Management and Prevention (GINA, 2017) the “asthma-obesity” phenotype is identified, it has certain clinical features, disease course and response to therapy. One of the hypotheses explaining the relationship between asthma and obesity is the systemic inflammation theory. The visceral adipose tissue (VAT) plays a key role in this hypothesis, it produces various adipokines, imbalance of which results in the state of mild inflammation. With that only the body mass index (BMI) is used to diagnose obesity in asthma patients, but BMI doesn’t take into account the amount of VAT in the body.The clinical case of a patient with asthma in combination with third degree of obesity is presented. Additionally the patient was given a multislice computed tomography to measure the visceral and subcutaneous fat areas, followed by an evaluation of the obtained data and a collation of the parameters with clinical and anthropometric characteristics.

In the pattern of abdominal complications after cardiac surgery, acute mesenteric ischemia is rare but high-mortality pathology. In the initial stages, the disease has no specific signs, which makes it difficult to perform early multislice computed tomography to diagnose it. Risk stratification and an individual approach to the choice of diagnostic and therapeutic measures aimed at early restoration of mesenteric blood flow will reduce the mortality in this complication.

Objectives: There is very limited evidence to support the common practice of preparative fasting prior to contrast-enhanced computerized tomography (CT). This study examined the effect of withholding fasting orders, prior to contrast-enhanced CT, on the incidence of aspiration pneumonitis and adverse gastrointestinal symptoms. Methods: This randomized controlled trial enrolled hospitalized patients referred for non-emergency, contrast-enhanced CT scan to either at least 4 h of fasting or to an unrestricted consumption of liquids and solids up to the time of CT. The primary outcome was incidence of aspiration pneumonitis and the secondary outcomes were rates of adverse gastrointestinal symptoms (nausea and/or vomiting). Results: After excluding participants with incomplete follow-up, a total of 1080 participants were assigned to the fasting group and 1011 were assigned to the non-fasting group. Aspiration pneumonitis was not identified in either group. The mean time of fasting in the fasting group was 8.4 ± 1.6 h. Rates of nausea and vomiting were not statistically different between the fasting group compared with the non-fasting group, 6.6% vs. 7.6% (p = 0.37) and 2.6% vs. 3.0% (p = 0.58), respectively. A subgroup analysis of patients who were required to drink oral contrast agent (n = 1257) showed that rates of nausea and vomiting were not statistically different between the fasting and non-fasting groups, 6.8% vs. 8.0% (p = 0.42) and 2.6% vs. 3.6% (p = 0.3), respectively. Conclusions: Withholding fasting orders prior to contrast-enhanced CT was not associated with a greater risk of aspiration pneumonitis or a significant increase in rates of adverse gastrointestinal symptoms. Trial registration: ClinicalTrials.gov: NCT03533348 Key Points: • Is fasting necessary prior to contrast-enhanced computed tomography (CT)? • In this randomized clinical study including 2091 participants referred to non-emergency contrast-enhanced CT scan, withholding preparative fasting was not associated with a greater risk of aspiration pneumonitis or clinically significant increase in rates of adverse gastrointestinal symptoms. • Eating and drinking prior to contrast-enhanced CT can be allowed and are not associated with an increased risk of aspiration pneumonitis. [ABSTRACT FROM AUTHOR]

Background Coronary vasospasm can present like an acute coronary syndrome (ACS) with an intense vasoconstriction resulting in total or near-total occlusion of one or more of the coronary vessels. Definitive diagnosis can be made by intracoronary provocation testing. Case summary A 37-year-old Caucasian male and smoker was admitted with chest pain. Highly sensitive troponin-I was positive at 63 ng/L (99th percentile upper reference limit, <15 ng/L) with a repeat value of 45 ng/L three and a half hours later which was of clinical significance. Serial electrocardiography (ECG) showed no ischaemic changes. Coronary angiography revealed several distal and side branch stenoses; however, angiographic appearances were atypical of coronary plaque. A differential diagnosis of spontaneous coronary artery dissection was suspected although the patient was pain free during the procedure. Computed tomography coronary angiography (CTCA) demonstrated normal coronary arteries, confirmed on repeat invasive coronary angiography. Cold pressor testing was unsuccessful in reproducing vasospasm. Acute coronary syndrome treatment was discontinued, he received smoking cessation advice and Amlodipine 5 mg daily was started. He has experienced no further episodes of cardiac chest pain on follow-up consultation 7 months later. Discussion This is an unusual case of persistent, extensive coronary vasospasm in a patient without ongoing chest pain or ischaemic ECG changes. Intracoronary nitrates are usually effective at relieving coronary spasm. Cold pressor testing has poor sensitivity for diagnosing vasospasm when compared to intracoronary provocation testing using either acetylcholine or ergonovine. Multi-slice CTCA may help to discriminate coronary plaque from coronary vasospasm when there is diagnostic uncertainty. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to compare post-mortem CT findings with necropsy findings in domestic cats. Methods: Post-mortem CT and necropsies were performed in 20 cadavers of domestic cats. The sensitivity, specificity and agreement between the post-mortem CT and necropsy findings were determined. Results: There were a total of 315 post-mortem findings; 183 were identified by post-mortem CT and 132 were identified by necropsy. Post-mortem CT demonstrated a higher sensitivity to identify the findings mainly in bones. The higher indices of agreement between post-mortem CT and necropsy were related to abnormalities of pleural space, bones and joints. Conclusions and relevance: This study demonstrated that post-mortem CT and necropsy provided different information. Thus, their use in conjunction with each other might improve the understanding of the cause of death and the identification of post-mortem lesions. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims Tricuspid regurgitation (TR) is a frequent valvular heart disease with relevant adverse impact on patients' prognosis. Adequate TR imaging and evaluation is challenging. In this study, we aimed to compare different imaging modalities (echocardiography and multi‐slice computed tomography) for the assessment of tricuspid valve (TV) function and geometry. Methods We retrospectively investigated patients that presented to University Hospital Bonn, Germany, between September 2018 and March 2019, who underwent comprehensive echocardiography and multi‐slice computed tomography (MSCT) to evaluate TR. MSCT was considered the reference approach for dimensional assessment of TV anatomy and echocardiography (transthoracic echocardiography + transesophageal echocardiography) for functional assessment of TV. We used Spearman's Rank order correlation, Bland‐Altman analysis, and intra‐class correlation to compare the different imaging modalities. Results Forty patients (Mean Age ± SD: 77.5 ± 7.1 years; 35% female) with high grade TR (effective regurgitant orifice area, EROA: 0.49 ± 0.3 cm2, RegVol: 49.5 ± 13.4 mL) were included. There was a statistically significant but moderate correlation between 2D‐TEE and MSCT for anteroposterior (AP) (r = 0.68, 95% confidence interval [CI]: 0.44‐0.93, P = .05; intraclass correlation [ICC]: 0.77, P = .03) and septolateral (SL) diameters (r = 0.71, 95% CI: 0.33‐0.93, P = .03; ICC = 0.76, P = .05). MSCT and 3D‐TEE showed a strong correlation for determination of TV annulus area (r = 0.94, 95% CI: 0.57‐0.98, P = .002; ICC = 0.95, P = .4), perimeter (r = 0.9, 95% CI: 0.6‐0.98, P = .002; ICC = 0.97, P = .3) and diameters (AP‐Diameter: r = 0.73, 95% CI: 0.06‐0.94, P = .03; ICC = 0.83, P = .09; SL‐Diameter: r = 0.86, 95% CI: 0.47‐0.97, P = .02; ICC = 0.95, P = .1). Only 3D‐TEE allowed for direct measurement of planimetric EROA, which exhibited a significant difference from calculated EROA (0.49 ± 0.4 cm2, 0.67 ± 0.17 cm2, P = .05; r = 0.93, 95% CI: 0.5 to 0.99, P = .006). According to Bland‐Altman analysis, we found a relevant agreement between MSCT and 3D‐TEE only for TV area (bias: −1.95, 95% limits of agreement −3.6 to −0.1). Conclusion Only 3D‐TEE allowed for sufficient simultaneous functional and dimensional assessment of TR in our cohort.

Objective: to study changes in the cross sectional optic nerve diameter (OND), by using multislice computed tomography (MSCT), in patients with mild traumatic brain injury (TBI), as well as those with severe (including mixed) TBI before and after craniotomy; to assess whether this technique can be integrated with a whole-body MSCT protocol in severe mixed TBI (MTBI).Material and methods. OND was retrospectively studied in two selected groups of patients with injuries (a total of 51 patients): Group 1 (n = 40) included 2 subgroups (n = 20 in each) with mild TBI or severe MTBI; Group 2 (n = 11) comprised 2 subgroups with severe TBI who had undergone decompressive (n = 6) or osteoplastic (n = 5) craniotomy with subsequent OND measurement after 12–18 hours. Results. Primary brain MSCT showed that the average OND was 6.12±1,01 mm in severe MTBI and 4.4±0.19 mm in mild TBI (Student’s t = 5.707). After decompressive craniotomy, there was a decrease in OND from 6.26±0.27 to 5.38±0.22 mm (Student’s t = 2.486).Conclusion. Among the patients with severe MTBI, the OND at primary MSCT is significantly greater than that in patients with mild TBI, which may be due to elevated intracranial pressure, as shown by the literature data. There is a statistically significant decrease in OND after decompressive craniotomy and removal of the brain compressive factor. Whole-body MSCT revealed no technical obstacles to the application of an OND measurement technique.

Objective. To develop a method for investigating the perculiarities of the structure of the nasolacrimal duct orifice according to the data of multislice computed tomography (MSCT).Material and methods. The structure of the nasolacrimal duct orifice was investigated in 96 cases in 65 people, including healthy volunteers (n=29), patients with dacryostenosis (n=45), and those with unilateral dacryocystitis (n=22). The type of the nasolacrimal duct orifice was identified using the developed procedure on the basis of the data of contrast-enhanced MSCT of the lacrimal passages. For verification, the investigators used retrograde probing of the nasolacrimal duct in all cases.Results. There were four possible types of the structure of the nasolacrimal duct orifice. Five cases showed discordance between the type of nasolacrimal duct office and the MSCT type identified by retrograde probing. The accuracy of the developed procedure to identify the type of the nasolacrimal duct orifice was 94.8%.Conclusion. The developed methodology based on CT is noninvasive, can reliably identify the type of the structure of the nasolacrimal duct orifice, and may be included in the algorithm for examination of patients with lacrimation disorders.

The paper describes a clinical case of planning knee arthroplasty using up-to-date radiological methods. The possibilities and advantage of multislice computed tomography (MSCT) are assessed. MSCT allows the careful planning of knee replacement and also estimation of the position of components after arthroplasty with smaller amounts of radiation of the patient for a short time.

As they are asymptomatic or have a nonspecific, anatomical variations of the ribs are usually detected as incidental findings on imaging studies. They may be isolated changes or can be related to anomalies or clinical syndromes. Such variations are easily overlooked on conventional radiography and computed tomography if they are not actively investigated, mainly because most indications for a chest X-ray studies aim to evaluate the lung parenchyma and mediastinal structures. The objective of this pictorial essay was to use multislice computed tomography images to illustrate the imaging aspects of the main anatomical variations and congenital anomalies of the ribs. [ABSTRACT FROM AUTHOR]

Objective: To compare the diagnostic performance of contrast-enhanced CT with that of MRI in the detection of cartilage invasion in patients with laryngo-hypopharyngeal cancer.Methods: A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting diagnostic accuracy of CT and/or MRI in detecting cartilage invasion from laryngo-hypopharyngeal cancer between 2000 and 2018. The pooled sensitivity and specificity, and their 95% confidence intervals were calculated for CT and MRI using bivariate random effects modeling. Subgroup and meta-regression analyses were performed. Indirect comparison was also performed by univariable meta-regression.Result: Fourteen articles including 776 patients were included in the systematic review and meta-analysis: eight for CT, and six for MRI. CT and MRI showed pooled sensitivities of 66% (95% CI, 49-80%) and 88% (95% CI, 79-93%), and pooled specificities of 90% (95% CI, 82-94%) and 81% (95% CI, 76-84%), respectively. MRI showed significantly higher sensitivity than CT (p = 0.02). The specificities showed no statistically significant difference between CT and MRI (p = 0.39). The CT studies showed heterogeneity and a threshold effect, while MRI showed neither heterogeneity nor threshold effect. In the meta-regression analysis for CT, the type of cartilage analyzed (thyroid only vs. thyroid/cricoid/arytenoid, p < 0.001) was a significant factor influencing the heterogeneity in the diagnostic performance of the CT studies.Conclusions: In conclusion, MRI has significantly higher sensitivity than CT for detecting cartilage invasion in patients with laryngo-hypopharyngeal cancer, without a significant difference in the specificity.Key Points: • MRI has significantly higher sensitivity than CT for detecting cartilage invasion in patients with laryngo-hypopharyngeal cancer. [ABSTRACT FROM AUTHOR]

China was the epicenter for the novel coronavirus disease (COVID-19), which quickly spread to other Asian countries and later to Western countries; subsequently, COVID-19 was categorized as a pandemic by the World Health Organization. Diagnosis primarily depends on viral detection in respiratory samples; however, available kits are limited, lack high sensitivity, and have a long turnaround time for providing results. In this scenario, computed tomography has emerged as an efficient and available high-sensitivity method, allowing radiologists to readily recognize findings related to COVID-19. The objective of this article is to demonstrate the main tomographic findings in symptomatic respiratory patients with COVID-19 to assist medical professionals during this critical moment. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of different intraradicular posts on the dimensions of computed tomography (CT) images in cone-beam and fan-beam equipment.Materials and Methods: : A total of 15 root canals of bovine teeth were instrumented up to a file #50 and root-filled by the active lateral condensation technique. The teeth were randomly divided into three groups, according to the type of intraradicular post: 1) tight fiberglass post; 2) anatomical fiberglass post; and 3) metal post. The root canals were desobturated in 10 mm and tomographic images were acquired in two devices, a cone-beam and fan-beam equipment. Then, the intraradicular posts were cemented using an automix self-conditioning and self-adhesive resin cement, and the final acquisitions of the CT images were performed for analysis. The diameter of the canal was compared before and after cementation of the intraradicular posts. The t-test was used between the initial and final measurements of each tomograph and also between the cone-beam and fan-beam tomographs (α = 0.05).Results: The anatomical fiberglass post presented the smallest dimensional change among the initial and final measurements, followed by the tight fiberglass post, with the metal post being the material that showed the most considerable dimensional difference in the cone-beam.Conclusion: All of the intraradicular posts used promoted a change in the size of the CT image. The fan-beam scanner promoted greater dimensional change in the images. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) affects millions of people worldwide and can remain undiagnosed for years. It is a major cause of cerebrovascular stroke (CVS); hence, early detection is extremely important in order to decrease the risk of CVS. We conducted a retrospective observational study looking into the prevalence of silent AF in 3299 patients admitted from January 2014 to December 2017 in a tertiary care stroke specialized center. Ischemic CVS was confirmed either by using multislice computed tomography (MSCT) or magnetic resonance imaging (MRI) of the brain. AF was diagnosed by electrocardiography (ECG) at the time of admission or during the hospital stay. Patients with a history of AF were excluded from the study. Results: Of the 3299 patients admitted by acute ischemic CVS, 707 (21.43%) had a history of AF and thus were excluded from the study. Of the remaining 2592 patients eligible for the study, 1666 (64.27%) were males with a mean age of 56.06 years (± 16.01). A total of 2313 (89.24%) patients remained in sinus rhythm throughout the hospital stay, 211 (8.14%) patients were in AF on admission, and 68 (2.62 %) patients developed AF during their hospital stay. The total number of newly diagnosed patients with AF was 279 (10.76%). Conclusion: The prevalence of de novo atrial fibrillation in patients presented with acute cerebrovascular stroke is high. The implementation of good screening programs can significantly reduce the risk of disabilities and morbidities. [ABSTRACT FROM AUTHOR]

Aim Of the Study: Skeletal muscle metastases (SMM) are a rare entity, mainly detected at autopsy. Nevertheless, radiological and nuclear medicine imaging can contribute to the diagnosis with a significant impact on the treatment and prognosis of neoplastic patients. This study aimed to systematically review the features of SMM at imaging considering the primary tumors and the sites of occurrence.Materials and Methods: We conducted a systematic search of three electronic database (i.e., PubMed, Science Direct, and Web of Science) up to May 2019, without any language or time interval restriction. Two reviewers performed the search and selection process, data extraction, and synthesis. We resolved disagreements by consensus and/or involving a third reviewer. The included studies have been classified according to the Oxford Centre for Evidence Based Medicine (CEBM) grading system.Results: Out of 8598 and 1077 articles respectively for radiological and hybrid imaging, 29 papers were included. According to CEBM, twelve were level 4. Computed tomography (CT) is mainly applied and, despite the existence of CT and magnetic resonance-based classifications, these are rarely used. Positron emission tomography/CT allowed the detection of small and subtle lesion also in the extremities. Muscles of the trunk were mostly affected and mainly respiratory tumors are associated with this type of metastatic spread.Conclusion: Radiological and hybrid imaging allow a precise characterization of SMM. However, a more systematic approach, including also the application of available classification systems, may increase the diagnostic accuracy for this rare type of metastases.Key Points: • Skeletal muscle metastases have heterogeneous characteristics at imaging but mostly abscess-like features and high metabolic activity are described. • Skeletal muscle metastases mainly affect the muscles of the trunk. • Pulmonary, urological, and gastrointestinal cancers are the most frequent cause of skeletal muscle metastases. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the diagnostic accuracy of stress myocardial blood flow ratio (SFR), a novel parameter derived from stress dynamic computed tomographic perfusion (CTP), for the detection of hemodynamically significant coronary stenosis. A comprehensive cardiac computed tomographic protocol combining coronary computed tomographic angiography (CTA) and CTP can provide a simultaneous assessment of both coronary artery anatomy and ischemia. Patients with chest pain scheduled for invasive angiography were prospectively enrolled in this study. Stress dynamic CTP was performed followed by coronary CTA using a second-generation dual-source computed tomographic system. At subsequent invasive angiography, fractional flow reserve was performed to identify hemodynamically significant stenosis. For each coronary territory, SFR was defined as the ratio of hyperemic myocardial blood flow (MBF) in an artery with stenosis to hyperemic MBF in a nondiseased artery. The diagnostic accuracy of SFR to identify hemodynamically significant stenosis was determined against the reference standard of invasive fractional flow reserve ≤0.80. A total of 82 patients (mean age 58.5 ± 10 years) with 101 vessels with either 1- or 2-vessel disease were included. By FFR, 48 (47.5%) vessels were deemed hemodynamically significant. Hyperemic MBF and SFR were lower for vessels with hemodynamically significant lesions (95.1 ± 32.4 ml/100 ml/min vs. 142.5 ± 31.2 ml/100 ml/min and 0.66 ± 0.14 vs. 0.90 ± 0.07, respectively; p < 0.01 for both). When compared with ≥50% stenosis by CTA, the specificity for detecting ischemia by SFR increased from 43% to 91%, while the sensitivity decreased from 95% to 62%. Accordingly, the positive and negative predictive values were 85% and 73%, respectively. The combination of stenosis ≥50% by CTA and SFR resulted in an area under the curve of 0.91, which was significantly higher compared with hyperemic MBF (area under the curve = 0.79; p = 0.013). Calculation of SFR by dynamic CTP provides a novel and accurate method to identify flow-limiting coronary stenosis. [ABSTRACT FROM AUTHOR]

Background: Studies have shown the value of CT brain imaging in adults with first-time seizures, but there are no recommendations regarding emergent brain CTs in persons with an established seizure disorders. Our study aimed to derive a clinical decision instrument (CDI) to determine which patients with status epilepticus (SE) require emergent brain imaging.Methods: This was a retrospective chart review of patients who presented to our emergency department with SE between 2010 and 2018. Patients with first-time seizures were excluded. A priori, we defined high risk criteria for emergent imaging as well as positive findings on brain CT. High risk criteria included known malignancy, trauma, and immunosuppression. Positive CT scans included findings such as intracranial hemorrhage (ICH) and mass.Results: We identified 214 patients who met inclusion criteria Of the 181 patients without high risk criteria, 3% had positive CT scans. Of the 33 patients with high risk criteria, 10% had positive CT scans. The sensitivity, specificity, PPV, and NPV for our initial CDI were 38%, 85%, 9%, and 97%. Adding the criterion of prior ICH would have lowered our miss rate to 0.6%. Modifying our CDI to 1) History of ICH, 2) Malignancy, 3) Immunosuppression, and 4) Trauma would result in a CDI with sensitivity, specificity, PPV, and NPV of 87.5%, 87.4%, 21.2%, and 99.5%.Conclusions: By using four criteria to identify high risk patients, we can defer CT scanning in the vast majority of patients with SE and known seizure disorders. This CDI should be prospectively validated before adoption. [ABSTRACT FROM AUTHOR]

Purpose: To clarify unique non-contrast CT (NCCT) characteristics for early recognition of Schistosomal associated appendicitis (SAA) differentiating from Non-schistosomal associated appendicitis (NSA).Material and Methods: Clinical and pathological data of 50 cases with SAA and 60 cases with NSA who underwent emergency appendectomy were retrospectively compared to pre-surgical NCCT features such as direct and indirect signs of acute appendicitis as well as appendicoliths, colon calcifications as diagnostic criteria. Statistical methods such as Chi-square (χ2), t-tests, Principal component analysis (PCA), Binary Logistic regression (LR) and Factor Analysis (FA) were utilized to observe differences and isolate recognizable CT features of SAA. Pre and post hoc diagnostic performance of all criteria was calculated as sensitivity, specificity, and the Odds Ratio (OR).Results: Age > 50 years, diameter > 13 mm, pneumatosis, peri appendiceal abscess, focal wall defect, perforation; Orbital, linear and point types of appendicular wall calcifications; sigmoid colon and cecal curvilinear calcifications were observed as unique characteristics with a sensitivity of 84-95% and specificity of 91-98% in predicting SAA by OR of 6.2 times. Pre and post hoc hypothetical analysis did not show any significance for all other factors.Conclusion: Factors such as elderly age, CT features such as larger appendicular diameter, appendicular wall calcifications along with sigmoid colon, and cecal calcifications, signs of perforation or abscess are characteristic for early recognition of SAA. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess by multislice computed tomography (MSCT) imaging geometry of the ascending aorta, the aortic root, the aortic annulus and the left ventricle outflow tract (LVOT) in aortic stenosis (AS) patients, to compare aortic root morphology in patients with AS with healthy controls and to evaluate sex differences. Fifty patients with severe AS and 50 age- and gender-matched controls who underwent MSCT were included in the study. The dimensions of the LVOT, the aortic annulus, the aortic root, the ascending aorta, and the volume of the aortic root were retrospectively assessed and a comparison was made between patients with severe tricuspid AS and controls. Patients with tricuspid AS in comparison with controls had smaller dimensions of the sinus of Valsalva resulting in reduction of the aortic root volume, whereas the dimensions of the other structures were comparable. MSCT revealed larger annular, LVOT and the sinus of Valsalva dimensions and the aortic root volume in men than women. Men with AS differed from healthy men only in regard to the dimensions of the sinus of Valsalva, while women showed significant differences also in the LVOT, and the aortic annulus. MSCT showed accurately aortic root remodeling in tricuspid AS patients and indentified sex-dependent differences. Women with tricuspid AS differ from healthy women more than men did. A high degree of the variability in the aortic root dimensions requires further careful research. [ABSTRACT FROM AUTHOR]

Multidetector computed tomography has come a long way in a short time, quickly becoming a standard tool in the cardiac imaging armamentarium. The promise of plaque imaging, combined with both anatomical visualization and stenosis detection, has made this a preferred first line test of many cardiologists and radiologists. This test is well suited to rule out coronary artery disease (obstruction) and still diagnosing subclinical plaque, with may be a good target for anti-atherosclerotic therapies. There has been recent criticism against CT imaging, and cardiac CT specifically, due to the high radiation doses that being employed. New advances have allowed for dramatic dose reductions. These include more routinely performed methods such as dose modulation, and newer methods such as prospective gating or minimizing the field of view. This paper will review the different applications to reduce cardiac CT radiation doses to nominal levels, potentially expanding the applications of cardiac CT by removing one of the biggest barriers.

Objective – to determine the clinical significance and capabilities of radiodiagnosis of the calcium milk phenomenon in urology. Material and methods. In 1989–2014, a total of 59 patients with calyceal diverticula (CDs) were followed up with ultrasound, plain intravenous urography (IVU), and 64-slice spiral computed tomography (MSCT). Results. Nine (15%) patients were found to have a calcium milk phenomenon as echo-positive by ultrasonography and as X-ray contrast-positive by IVU and MSCT of the CD cavity contents shifting during polypositional examination. Instead of repeated CT scanning, delayed IVU was performed to reduce radiation exposure. Conclusion. Polypositional examination revealing the shifting horizontal level of calcium milk must be necessary performed in the radiodiagnosis of the calcium milk phenomenon. The clinical significance of the calcium milk phenomenon, like multiple small stones detected in CD, is the lack of indications for telelithotripsy. Calcium milk in the renal cysts is of no clinical significance.

Objective. To present the diagnosis of and treatment policy for severe cystic adenomatoid malformation (CAM) of the lung in newborn infants, allowing one to rule out a fatal outcome and to ensure good quality of life in the future. Material and methods. The authors describe their own 12 clinical cases in newborn infants with the histologically verified diagnosis of type 1 CAM with a pronounced mass effect, as well as pregnancy management tactics, the time and algorithm of postnatal radiation examination, a treatment method and give long-term results. Results. The traced long-term results are predominantly good (77.8%); there are no poor outcomes or mortality in this patient group. Conclusion. The prognosis for life in severe forms of CAM with a high risk of antepartum fetal demise can be favorable if there is a correct pregnancy management tactics, early examination, and surgical treatment. Computed tomography and computed tomographic angiography are main postnatal diagnostic techniques that determine the further tactics of a neonatal surgeon. Emergency surgery is indicated after the diagnosis of type 1 CAM with a pronounced mass effect is confirmed.

Coronary artery fistulas, a rare anomaly, are represented by an abnormal communication between the coronary arteries and other vascular structures or cardiac chambers and, in most cases, are detected incidentally. Regularly, they do not cause important pathological changes, but if the symptoms persist, they need to be treated. The hemodynamic impact depends on the localization and size of the fistulas. Noninvasive imaging techniques, such as magnetic resonance imaging and multislice computed tomography, are widely used for the detection of coronary anomalies. The presence of symptoms (angina, dyspnea) is the primary indication for the surgical or percutaneous closure of the communications; therefore, a systematic follow-up is indicated in all cases. We present four cases of coronary artery fistulas, without important hemodynamic complications, detected by multislice computed tomography coronary angiography.

Objective: The aim of this study was to assess the role of multislice computed tomography (MSCT) using 2D and 3D images in evaluation of different types of Le Fort fractures. Subjects and methods: 30 cases referred from the Emergency unit in Zagazig University Hospital were included in this study, based on clinical evidence of facial trauma, they underwent multislice computed tomography (MSCT) examination and were shown to be positive for pterygoid fractures. All patients subjected to non contrast MSCT in axial cuts. Multiplanar reformatted (MPR) images were acquired using the machine software in sagittal and coronal planes. Finally images were transferred to a workstation for reconstruction of 3D images. Results: Sensitivity of multislice computed tomography (MSCT) in detecting compound Le Fort fractures for radiologists A, B and C was 94.4%, 66.7% and 100% respectively. Sensitivity of MSCT in detecting isolated Le Fort fractures for radiologists A, B and C was 100%. The difference between radiologists A, B and C in detecting Le Fort fractures types was insignificant. Good agreement between radiologists A, B, C and intraoperative findings. Conclusion: Both 2D-CT and 3D-CT are the best methods in imaging of Le Fort fractures.

Abstract Introduction The inferior turbinate (IT) is the most susceptible turbinate to enlargement causing nasal obstruction. The common belief ascribes most of the enlargement of the IT to mucosal elements. Objective This study aimed to investigate the detailed computed tomography (CT) measurement of the IT in asymptomatic adult by determining the thickness of both the non-bony (mucosa) and bony parts and their relation to nasal air space in different related areas of the nose. Methods We included in the study paranasal CT scans of 108 individuals (216 IT) that had no paranasal pathology. We acquired axial images with multiplanar reformates to obtain delicate details in coronal and sagittal planes for all subjects. We took separate measurements of the thickness of the medial mucosa, bones, and lateral mucosa of the IT on the anterior and posterior portions of ITs. We also measured the air space of the nasal cavity between the septum and IT anteriorly and posteriorly. Results The difference in the air space between nasal septum, anterior and posterior ends of IT was extremely statistically significant (P

Aims and Objectives: The aim of this is to identify and classify maxillofacial fractures using multislice computed tomography (CT) and identify the advantages of three-dimensional (3D) rendered images over two-dimensional axial images in evaluating maxillofacial injuries. Materials and Methods: This was a descriptive study. Multislice CT evaluation was done on 60 patients with maxillofacial injuries using a 16-slice CT scanner. 3D rendered images, as well as coronal reformatted images, were reconstructed. Statistical Analysis: Descriptive study. Results: Individuals within the age group of 36–45 years were most commonly affected by maxillofacial injuries with males being more common. The most common cause of these injuries was road traffic accident in 40 (80%) cases. The mandible was the most involved region observed in 37 cases, maxillary and nasoorbitoethmoid region being the next common regions seen in 32 (53.3%) cases. 3D rendered images were similar or superior to axial images (in the assessment of fractures) in most patients and were inferior when the fractures involved the thin bones of the orbital region. Conclusion: This study demonstrates that Multislice CT with 3D images provides better perception of the pattern of the fracture lines, and the displacement of the bony fragments thus helping in the faster and improved communication of the information to the referring physician. However, the 3D images alone have a limited role in evaluating orbital region fractures and also when there is minimal displacement of the fractured fragment.

Amaç: Çok kesitli bilgisayarlı tomografi ile yapılan koroner kalsiyum skorlaması sırasında kalp dışı bulguları incelemek. Materyal ve Metod: Çalışmaya 190 çok kesitli bilgisayarlı tomografi ile koroner kalsiyum skorlaması yapılan hasta alındı. Kalp dışı bulgular Minor, Major A-B olarak tanımlandı. Bulgular: Çalışmaya alınan hastalardan 80’inde 177 kalp dışı bulgu tespit edildi (42.1%). Bu hastaların 40’ında minor bulgular (21%), 40’ında major bulgular (21%) mevcuttu. Majör B bulgular aort anevrizması, akciğerde kitle, akciğer nodülleri ve infiltrasyonları, pnömonektomi, böbrek üstü bezde nodüler kalınlaşma ve karaciğer kitle lezyonlarını içermektedir. Sonuç: Kalp dışı bulgular sık görülür. Bu bulguları raporlayan radyolog ve/veya kardiyologlar, bu bulguların sıklığı ve önemi konusunda dikkatli olmalıdırlar.

OBJECTIVES To investigate differences in chest computed tomography (CT) and chest radiographs (CXRs) of Pneumocystis jirovecii pneumonia (PJP) between renal transplant recipients (RTRs) and human immunodeficiency virus (HIV)-positive patients. METHODS From 2005 to 2012, 84 patients with PJP (RTR n = 24; HIV n = 60) were included in this retrospective multicentre study. Written informed consent was obtained. CT scans and CXRs were recorded within 2 weeks after the onset of symptoms. PJP diagnosis was confirmed either by cytology/histology or successful empirical treatment. Two blinded radiologists analysed the conventional chest films and CT images, and recorded the radiological lung parenchyma patterns, lymph node enlargement and pleural pathologies (pneumothorax, effusion). The radiological features of the two subgroups were compared. RESULTS Consolidations and solid nodules prevailed on CT in RTRs (91.7 ± 5.6% vs 58.3 ± 6.4% with HIV, p = 0.019 and 91.7 ± 5.6% vs 51.6 ± 6.5% with HIV, p = 0.005). HIV-positive patients with PJP showed more atelectasis (41.7 ± 6.4% vs 4.2 ± 4.1% in RTRs, p = 0.017) and hilar lymph node enlargement (23.3 ± 5.5% vs 0.0 ± 0.0% in RTRs, p = 0.088). Ground glass opacification was found in all cases. Pneumothorax was a rare complication, occurring in 3% of the HIV-positive patients; no pneumothorax was found in the RTRs. On CXR, the basal lungs were more affected in HIV-positive patients as compared with RTRs (p = 0.024). CONCLUSIONS PJP on CT differs substantially between RTRs and HIV-positive patients. Physicians should be aware of such differences in order not to delay treatment, particularly in renal transplant recipients.

Purpose: To evaluate in three dimensions (3D) the human endosalpinx and reconstruct its surface along its different anatomical segments, without the injection or insertion of luminal contrasts, using confocal microtomography (micro-CT). Material and methods: 15 fallopian tubes (FT) from 14 women in reproductive age from procedures for benign disease or sterilization were selected. The specimens were fixed in formalin and stained with Lugol solution. Micro-CT studies were conducted on the specimens using protocols adapted from biological studies, to acquire images to reconstruct in 3D the endosalpinx surface. Results: From these specimens, 6 presented the intra-mural segment, 14 presented the isthmus and 15 presented the ampulla and fimbria segment of the FT. The specimen presented tissue definition, and contrast sufficient for FT endosalpinx morphological analysis and lumen definition. The intramural portion presented initially a mucosal projection toward the lumen, bending on its own axis, and increased numbers of projections towards the isthmic portion, where the projections become longer more numerous. The endosalpinx becomes more tortuous, the lumen diameter increases and the mucosal projections become more bulky in the ampullary portion, with the projections less present on the antimesenteric side. The infundibular portion is marked with the organized and predictable endosalpinx, the abdominal ostium is cleared demonstrated, with the reduction of the endosalpinx volume. The fimbria demonstrated a small relation between fringes and intratubal endosalpinx. Conclusions: Microscopic anatomy of different segments of the human FT mucosa can be analyzed and reconstructed in 3D with histological correlation using micro-CT. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the performance of a novel three-dimensional (3D) joint convolutional and recurrent neural network (CNN-RNN) for the detection of intracranial hemorrhage (ICH) and its five subtypes (cerebral parenchymal, intraventricular, subdural, epidural, and subarachnoid) in non-contrast head CT.Methods: A total of 2836 subjects (ICH/normal, 1836/1000) from three institutions were included in this ethically approved retrospective study, with a total of 76,621 slices from non-contrast head CT scans. ICH and its five subtypes were annotated by three independent experienced radiologists, with majority voting as reference standard for both the subject level and the slice level. Ninety percent of data was used for training and validation, and the rest 10% for final evaluation. A joint CNN-RNN classification framework was proposed, with the flexibility to train when subject-level or slice-level labels are available. The predictions were compared with the interpretations from three junior radiology trainees and an additional senior radiologist.Results: It took our algorithm less than 30 s on average to process a 3D CT scan. For the two-type classification task (predicting bleeding or not), our algorithm achieved excellent values (≥ 0.98) across all reporting metrics on the subject level. For the five-type classification task (predicting five subtypes), our algorithm achieved > 0.8 AUC across all subtypes. The performance of our algorithm was generally superior to the average performance of the junior radiology trainees for both two-type and five-type classification tasks.Conclusions: The proposed method was able to accurately detect ICH and its subtypes with fast speed, suggesting its potential for assisting radiologists and physicians in their clinical diagnosis workflow.Key Points: • A 3D joint CNN-RNN deep learning framework was developed for ICH detection and subtype classification, which has the flexibility to train with either subject-level labels or slice-level labels. • This deep learning framework is fast and accurate at detecting ICH and its subtypes. • The performance of the automated algorithm was superior to the average performance of three junior radiology trainees in this work, suggesting its potential to reduce initial misinterpretations. [ABSTRACT FROM AUTHOR]

Volumetric and radiomic analysis of atherosclerotic plaques on coronary CT angiography have been shown to predict high-risk plaque morphology and to predict patient outcomes. However, there is limited information whether image reconstruction algorithms and preprocessing steps (type of binning, number of bins used for discretization) may influence parameter values. We retrospectively identified 60 coronary lesions on coronary CT angiography (CTA). All images were reconstructed using filtered back projection (FBP), hybrid (HIR) and model-based (MIR) iterative reconstruction. Plaques were segmented manually on HIR images and copied to FBP and MIR images to ensure identical voxels were analyzed. Overall, 4 volumetric and 169 radiomic parameters were calculated. Intra-class correlation coefficient (ICC) was used to assess reproducibility between image reconstructions, while linear regression analysis was used to assess the effect of preprocessing steps done before calculating radiomic metrics. All volumetric and radiomic metrics had ICC>0.90 except for first-order statistics: mode, harmonic mean, minimum (0.45, 0.76, 0.84; respectively) and gray level co-occurrence (GLCM) parameters: inverse difference sum and sum variance (0.01, 0.04; respectively). Among GLCM parameters 90% were significantly affected by the type of binning and 100% by the number of bins. In case of gray level run length matrix parameters 100% of metrics were affected by both preprocessing steps. Volumetric and radiomic statistics are robust to image reconstruction algorithms. However, all radiomic variables were affected by preprocessing steps therefore, showing the need for standardization before being implemented into everyday clinical practice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aims to assess the value of ultrasound real-time shear wave elastography (US-SWE) for evaluation of nonalcoholic fatty liver disease (NAFLD) in a rabbit model compared with multislice computed tomography (MSCT). MATERIAL AND METHODS: Twenty-six rabbits were fed with high-fat, high-cholesterol diet and six rabbits were fed with a standard diet. All rabbits were performed with MSCT and US-SWE at various time points to measure changes in liver parenchyma. The diagnostic efficiency of US-SWE was analyzed using receiver operating characteristics (ROC) curves compared with MSCT based on the liver pathology. RESULTS: The statistically significant differences in the areas under the ROC curves between using MSCT and US-SWE modalities were detected to discriminate between normal vs. NAFLD or higher severity pathology. Similarly, for normal or NAFLD vs. borderline or NASH livers, statistically significant differences between using US-SWE and MSCT modalities were also detected for nonalcoholic steatohepatitis (NASH) vs. lower severity pathology. CONCLUSIONS: MSCT, but not US-SWE, had a better ability to differentiate normal or NAFLD livers from higher severity NAFLD livers. However, the diagnostic efficiency of US-SWE was superior to that of MSCT for differentiating NASH from normal or lower severity NAFLD. [ABSTRACT FROM AUTHOR]

Objectives: Although ultrasound (US) is a standard modality for the assessment of cervical lymph node metastasis in patients with thyroid cancer, there is an increasing trend in the number of articles describing the use of contrast-enhanced computed tomography (CT). The purpose of this systematic review and meta-analysis was to evaluate the diagnostic performance of CT in the diagnosis of metastatic cervical lymph nodes and to identify the parameters responsible for heterogeneity in diagnostic performance.Methods: Ovid-MEDLINE and EMBASE databases were searched up to May 22, 2018, for studies on the diagnostic performance of CT. The pooled sensitivity and specificity of all studies were calculated. In addition, subgroup analysis and meta-regression analysis were performed to evaluate factors responsible for heterogeneity.Results: Seventeen (6378 patients, 11,590 lymph nodes) studies were included. The pooled sensitivity was 55% (95% CI, 47-63%), and the pooled specificity was 87% (95% CI, 90-95%). Higgins I2 statistic demonstrated substantial heterogeneity in the sensitivity (I2 = 96.3%) and specificity (I2 = 93.8%). In a per-neck level subgroup analysis, the Higgins I2 statistic demonstrated reduced heterogeneity in both sensitivity and specificity. In the meta-regression analysis, variation in the CT protocols, such as contrast amount, scan phase, and reconstruction slice thickness, was a statistically significant factor causing heterogeneity.Conclusions: CT demonstrated acceptable diagnostic performance in the pre- and postoperative diagnosis of metastatic cervical lymph nodes in patients with thyroid cancer. Variation in the CT protocols was a main factor causing heterogeneity among the included studies.Key Points: • The role of contrast-enhanced computed tomography (CT) needs to be reassessed. • CT demonstrated acceptable diagnostic performance in the diagnosis of metastatic cervical lymph nodes in patients with thyroid cancer in the meta-analysis. • Variation in the CT protocols was a main factor causing heterogeneity in the meta-regression analysis. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the imaging findings of cone-beam computed tomography (CBCT) in displaying subtle structures of the tympanic segment of the facial nerve canal in human cadaver heads compared with multi-slice computed tomography (MSCT). Methods: Between January 2017 and July 2017, images of the tympanic segment of the facial nerve canal acquired from 73 human cadaver ears by both CBCT and MSCT were prospectively studied. Then, images of the lateral and inferior walls of the tympanic segment were scored using standard imaging slices through a four-point rating scale. Subsequently, the detailed findings of these two imaging modalities were recorded and compared, including interruptions of the bony walls, thread-like bony tubes connected with the walls, and separations in the cavity. The Wilcoxon signed-rank test was used to investigate the differences between scores derived by CBCT and MSCT. Results: The mean score in the inferior and lateral walls by CBCT were significantly higher than that by MSCT (P = 0.000–0.005), which ranged from 2.0 (1.5, 2.5) to 3.5 (3.0, 4.0), and from 1.5 (1.0, 2.0) to 3.5 (2.5, 4.0), respectively. The interruption of the walls was most common at the anterior part of the inferior wall (38/73 cases). Furthermore, thread-like bony tubes were evident in 18 ears, which connected with the anterior part of the inferior wall (18/73 cases). Moreover, separation was found in 22 ears in the posterior part (22/73 cases). Conclusions: CBCT can readily demonstrate subtle imaging findings of the tympanic segment of the facial nerve canal. [ABSTRACT FROM AUTHOR]

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The paper describes a case of mandibular osteonecrosis in a patient who has received a radiotherapy cycle for tongue cancer. It deals with estimating the capacities of radiodiagnostic techniques to detect local tissue responses manifesting as radionecrosis after radiotherapy. To assess bone changes, clinical and laboratory examinations and comprehensive radiodiagnosis were made, which could validly evaluate the bone structures and soft tissues, determine the degree of injury, and identify complications. X-ray studies established that when evaluating the bone tissue, multislice computed tomography (MSCT) and cone-beam computed tomography (CBCT) were comparable in their diagnostic efficiency; however, MSCT was of greater informative value for the detection of soft tissue changes. CBCT may be successfully used during and after jaw osteonecrosis treatment as a control technique to evaluate its efficiency.

Objective: to estimate the possibilities of using and systematizing computed tomographic findings in patients with toxic phosphorus necrosis of the jaw.Material and methods. The investigation enrolled 87 patients diagnosed as having toxic phosphorus osteonecrosis. Radiation examination consisted of two stages: primary and repeated radiologic examinations in the postoperative period (final examination before hospital discharge). All the patients underwent skull X-ray and multislice computed tomography (MSCT).Results. Clinical and radiation examination revealed toxic phosphorus osteonecrosis of the maxilla and mandible in 29 (33%) cases. Osteonecrosis affected only the mandible in 40 (46%) cases and only the maxilla in 18 (21%) cases. In all the patients, computed tomography showed main trends in the X-ray semiotics of toxic phosphorus necrosis of the facial skeleton, such as periostitis; osteosclerosis; development a lesion having a “soap-bubble” appearance; nonspecific and inflammatory bone destruction. The bone, being destroyed, was replaced by pus; inflammatory granulations were absent; osteonecrosis occurred. These processes were characterized by the absence of an obvious demarcation zone along the edges of the process. Sequestration commonly occurred to form sinus tracts. The process involved the adjacent bones; there were reactive changes in the accessory sinuses.Conclusion. MSCT data are of highly informative value in evaluating the status of bone tissue and teeth and in detecting a concomitant abnormality in patients with osteonecrosis of the facial skeleton and may be used to plan surgical treatment for this category of patients.

Objective: to investigate the quantitative X-ray manifestations of gonarthrosis in patients in different age groups.Material and methods. The results of radiography, computed tomography, and 64-slice multidetector computed tomography (MDCT) were analyzed in 86 patients aged 18 to 70 years with arthrosis deformans of the knee.Results. Knee radiographic anatomic changes in arthrosis deformans are accompanied by the characteristic rearrangement of the femoral and tibial condyles. Quantitative bone density changes appear as an overall decrease in the bone mineral density of the femoral and tibial condyles in 18–35-year-old patients with arthrosis deformans (p

Objective: to determine the capabilities of multislice computed tomography (MSCT) in the differential diagnosis of tumors and inflammatory diseases of the cecum, appendix, and ascending colon.Material and methods. The investigation analyzed the complete data of medical records and the results of diagnosis in the patients admitted in 2009 to 2013 to the Treatment andRehabilitation Center for right iliac pains. The results of MSCT were compared with those of histological verification. Results. The sensitivity and specificity of MSCT for diagnosing right iliac tumors were 97.6 and 97.8%, respectively. Those of MSCT for diagnosing right iliac inflammatory diseases were 95.1 and 97.3%, respectively. The investigation showed that the accuracy of MSCT for diagnosing right iliac tumors and inflammatory diseases was 94.1%.Conclusion. MSCT is the method of choice in the diagnosis and differential diagnosis of right iliac tumors and inflammatory diseases.