Search

PURPOSEWhen a suspected hepatic alveolar echinococcosis (AE) lesion is detected on a contrast enhanced computed tomography (CT) scan, an additional triphasic or non-enhanced CT scan is required to determine the presence of calcification and enhancement. As a result, imaging costs and exposure to ionizing radiation will increase. We can create a non-enhanced series from routine contrast-enhanced images using dual-energy CT (DECT) and virtual non-enhanced (VNE) images. This study’s objective is to assess virtual non-enhanced DECT reconstruction as a potential diagnostic tool for hepatic AE.METHODSTriphasic CT scans and a routine dual energy venous phase were acquired using a third-generation DECT system. A commercially available software package was used to generate VNE images. Individual evaluations were conducted by two radiologists.RESULTSThe study population consisted of 100 patients (30 AE, 70 other solid liver masses). All AE cases were diagnosed [no false positives/negatives, 95% confidence interval (CI) sensitivity: 91.3%–100%; 95% CI specificity: 95.3%–100%]. Interrater agreement was k: 0.79. In total, 33 (33.00%) of the patients had AE, which was detected using both true non-enhanced (TNE) and VNE images. The mean dose-length product of a standard triphasic CT was significantly higher than biphasic dual-energy VNE images.CONCLUSIONIn terms of diagnostic confidence, VNE images are comparable with actual non-enhanced imaging when evaluating hepatic AE. Further, VNE images could replace TNE images with a substantial radiation dose reduction. Advances in knowledge: hepatic cystic echinococcosis and AE are serious and severe diseases with high fatality rates and a poor prognosis if managed incorrectly, especially AE. Moreover, VNE images produce equal diagnostic confidence to TNE images for assessing liver AE, with a significant reduction in radiation dose.

PURPOSETo evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta.METHODSThis study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded.RESULTSIschemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations.CONCLUSIONAbdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.

Background: Computerized tomography (CT) has been increasingly utilized in the differential diagnosis of acute chest pain. Combining the triple rule out CT angiography (TRO-CT) approach with dual-energy CT (DECT) can enhance the diagnostic capability by identifying myocardial perfusion deficiencies. This combination can yield a quadruple-rule-out computed tomography angiography (QRO-CT) technique. The aim of this study is to determine the efficacy of the QRO-CT. Methods: Intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated. The myocardial dark spots on the color-coded iodine map were identified as perfusion deficiencies. Pulmonary arteries and aorta were also evaluated. Results: The study population consisted of 211 patients. The sensitivity, specificity, and positive and negative predictive values of QRO-CT for pulmonary embolism were 93.5%, 100%, 100%, and 95.3%, respectively. For obstructive coronary artery disease, the values were 96.1%, 93.4%, 89.2%, and 97.7%, respectively. For myocarditis, the values were 69.2%, 100%, 100%, and 93.6%, respectively. Conclusions: the QRO-CT method may successfully evaluate myocardial perfusion deficits, hence expanding the differential diagnosis capabilities of the standard TRO-CT method for myocarditis. It can provide useful information on myocardial perfusion, which may influence the choice to perform invasive catheterization in cases of coronary artery obstruction.

The concept of inequalities in time scales has attracted the attention of mathematicians for a quarter century. And these studies have inspired the solution of many problems in the branches of physics, biology, mechanics and economics etc. In this article, new principles of non-linear integral inequalities are presented in time scales via diamond-α dynamic integral and the nabla integral.

A considerable number of research has been carried out on the generalized Lebesgue spaces Lp(x) and boundedness of different integral operators therein. In this study, a new approach for weighted increasing near the origin and decreasing near infinity exponent function that provides a boundedness of the Hardy’s operator in variable exponent space is given.

Objective: The aim of this study was to compare additive diagnostic values of magnetic resonance (MR) arthrography with volumetric interpolated breath-hold examination (VIBE) sequence and multidetector computed tomography (MDCT) arthrography for diagnosis and grading of talar osteochondral lesions. Methods: MDCT arthrography and MR arthrography with three dimensional VIBE sequence were performed in 27 patients. Findings of MR arthrography and MDCT arthrography images were compared with arthroscopic findings. Sensitivity, specificity, and accuracy rates were calculated for both MR arthrography and MDCT arthrography imaging findings. Results: For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MR arthrography were 95%, 73%, 90%, respectively; For grade I osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography were 96%, 79%, 81%. For grade IV osteochondral lesions; sensitivity, specificity and accuracy rates of MDCT arthrography and MR arthrography were 100%. For grade II lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 80%, 76%, 77%, respectively; for grade III lesions, the sensitivity, specificity and accuracy rates of the MR arthrography were 78%, 68%, 75%. For grade II osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 91%, 81%, 86%; for grade III osteochondral lesions; the sensitivity, specificity and accuracy rates of the MDCT arthrography were 90%, 83%, 89%; For grade II and III osteochondral lesions, MDCT arthrography had higher sensitivity, specificity and accuracy rates than MR arthrography. MDCT arthrography had higher diagnostic performance than MR arthrography for detection of grade II and III lesions (p = 0.041 and p = 0.038, respectively). Conclusion: MDCT arthrography appears to be more reliable than MR arthrography with three dimensional VIBE sequence for accurate detection and grading of osteochondral lesions. Level of evidence: Level III, Diagnostic Study. Keywords: Osteochondral lesion, Computed tomography, Arthrography, Ankle, Magnetic resonance imaging

Postpartum hemorrhage is one of the major causes of maternal mortality. There are medical and surgical options to control the bleeding, some of which can impair future fertility. Transcatheter arterial embolization might be a useful option in the management of intractable postpartum bleeding before the consideration of more invasive and radical methods. In this report, we report a 33-year-old patient who presented with primary postpartum hemorrhage due to vaginal laceration and was eventually treated with transcatheter arterial embolization.

Abstract Background Vaccine-preventable diseases cause significant morbidity and mortality worldwide and in developing countries in particular. Information on coverage and reasons for non-vaccination is vital to enhance overall vaccination activities. Of the several survey techniques available for investigating vaccination coverage in a given setting, the Lot Quality Technique (LQT) remains appealing and could be used in developing countries by local health personnel of district or rural health authorities to evaluate their performance in vaccination and many other health-related programs. This study aimed to evaluate vaccination coverage using LQT in a selected semi-urban setting in Turkey. Methods A LQT-based cross-sectional study was conducted in Kecioren District on a representative sample of residents aged 12–23 months in order to evaluate coverage for routine childhood vaccines, to identify health units with coverage below 75%, and to investigate reasons for non-vaccination. Results Based on self-reports, coverage for BCG, diphtheria-pertussis-tetanus (DPT-3), oral polio-3, hepatitis-3, and measles vaccines ranged between 94–99%. Coverage for measles was below 75% in five lots. The relatively high educational and socioeconomic status of parents in the study group alone could not minimize the "considerable" risk of vaccine-preventable diseases in the District and dictates a continuity of efforts for improving vaccination rates, with special emphasis on measles. We believe that administrative methods should be backed up by household surveys to strengthen vaccination monitoring and that families should be trained and motivated to have their children fully vaccinated according to the recommended schedule and in a timely manner. Conclusion This study identified vaccine coverage for seven routine vaccines completed before the age of 24 months as well as the areas requiring special attention in vaccination services. The LQT, years after its introduction to health-related research, remains an appealing technique for rapid evaluation of the extent of a variety of local health concerns in developing countries, in rural areas in particular, and is very efficient in determining performance of individual subunits in a given service area. Training of local health personnel on use of the LQT could expedite response to local health problems and could even motivate them in conducting their own surveys tailored to their professional interests.