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Background: Congenital rib deformity is a common thoracic deformity that has a potentially far-reaching impact on the growth and lung function development of young children. Early diagnosis and accurate assessment of congenital rib deformity is of great importance. This study was to retrospectively analyze the number, location, and types of deformities, imaging features as well as clinical symptoms of children with congenital rib deformities. Methods: Children who were diagnosed with congenital rib deformities between October 2019 and October 2021 in our hospital were included in this study. The rib deformities were analyzed according to the imaging results of chest X-ray and 3D volume rendering multidetector computed tomography (MDCT). The data were analyzed using SPSS 22.0. Results: A total of 472 male and 186 female children with rib deformities were detected in this study, with a male to female ratio of approximately 2.54:1. Of the deformed ribs, 417 (63.4%) were located on the right side, usually single and unilateral. The most common type of the detected rib deformity were bifid ribs (95.14%). Rib deformity was most common in the fourth rib (46.62%). The majority (76.16%, n = 428) of rib deformities were incidental findings and asymptomatic. Conclusions: Congenital rib deformities in pediatric patients included in our hospital were more frequently observed in males than females, more frequently detected on the right than on the left side. The most common type of rib deformity is the bifid rib. MDCT examination are of great value in the diagnosis of rib deformity and can help guide clinical treatment. [ABSTRACT FROM AUTHOR]

Introduction: Chronic rhinosinusitis (CRS), with or without nasal polyps, is characterized by the inflammation of the nose and paranasal sinuses. To make the diagnosis of CRS, a patient must exhibit 2 or more of the following symptoms for at least 12 weeks time period: nasal obstruction, nasal blockage, or congestion, and/or nasal discharge (which could be anterior or posterior nasal drip), along with possible facial pain or pressure, and/or a reduction or loss of smell. This diagnosis must be supported by observable disease signs, which can be identified through an endoscopic examination showing nasal polyps, mucopurulent discharge, or edema/mucosal obstruction. Methods: A prospective study will be conducted on all the patients with clinical diagnosis and suspicious of CRS, referred from OPD / wards of ENT and HNS to the department of radiodiagnosis of Muzaffarnagar Medical college, for diagnosis and evaluation of patients. Diagnosis will be made based on clinical and radiological findings. A brief clinical history of the patient will be taken from the patient or by the attendant. Results: In this study involving 40 participants, nasal mass was observed in 42.5%, while nasal bleed occurred in 47.5% of participants. X-ray opacification of sinuses varied, with opacification in all sinuses seen in 22.5% of cases and various bilateral and unilateral patterns in others. Polypoidalmass was present in 12.5% of participants. Bony changes included erosion in5% and sclerosis in 22.5% of cases. Deviated nasal septum was observed, with left deviation noted in 10% and right deviation in 15% of participants. Conclusion: this study of 40 participants revealed a male predominance and a mean age of 39.8 years, with no significant age difference between genders. Common symptoms included nasal obstruction, nasal discharge, sneezing, headache, facial puffiness, and altered smell. Nasal mass and nasal bleed were frequent, while X-ray opacification of sinuses showed diverse patterns. Polypoidal masses were observed in a notable percentage of participants. [ABSTRACT FROM AUTHOR]

Background: Functional single ventricle (FSV) is a rare and complex cardiac malformation. FSV is a broad term including various cardiac structural anomalies in which one ventricle is severely underdeveloped. We aimed to accurately diagnose FSV and its different subtypes using multidetector computed tomography (MDCT). Methods: Eighteen patients with suspected FSV underwent cardiac computed tomography angiography (CTA), and the results were compared to those of echocardiography. Results: MDCT could accurately diagnose FSV and its different subtypes. It detected FSV of left ventricular morphology in 77.8% with the most common associated subtype is double inlet left ventricle (DILV) and FSV of right ventricular morphology in 22.2% with double outlet right ventricle (DORV) as the commonest variant. MDCT was superior to echocardiography in defining the dominant ventricle in 22.2% of cases and detection of the associated extracardiac anomalies in 38.9% of patients. MDCT could assess the connection and state of palliative shunts in the 4 patients with earlier interventions. Conclusion: MDCT can diagnose FSV and the associated extracardiac malformation and is indispensable in pre and postoperative follow up. [ABSTRACT FROM AUTHOR]

Total anomalous pulmonary venous connection (TAPVC) is anomalous drainage of all pulmonary veins into systemic circulation. The intracardiac type typically entails the drainage of all the pulmonary veins into the right atrium, via the coronary sinus. The connection of the pulmonary veins directly into the right atrium is exceptionally rare and has been primarily reported with right atrial isomerism. Herein, we presented a remarkable case of TAPVC in a 10-year-old male child, distinguished by an unconventional drainage of all the pulmonary veins directly into the right atrium, with normal coronary sinus and absent right atrial isomerism. Intriguingly, computed tomography imaging revealed a combination of incredibly rare coexistent pulmonary, vascular, and skeletal anomalies. These anomalies included absence of pulmonary fissures in the right lung, presence of left circumflex aortic arch with bovine branching pattern, bilateral cervical ribs, and C7 vertebral fusion anomalies. To our knowledge, this unique combination of coexistent anomalies has not been previously reported in scientific literature in the background of rare drainage pattern of TAPVC. [ABSTRACT FROM AUTHOR]

Abstract Background Congenital rib deformity is a common thoracic deformity that has a potentially far-reaching impact on the growth and lung function development of young children. Early diagnosis and accurate assessment of congenital rib deformity is of great importance. This study was to retrospectively analyze the number, location, and types of deformities, imaging features as well as clinical symptoms of children with congenital rib deformities. Methods Children who were diagnosed with congenital rib deformities between October 2019 and October 2021 in our hospital were included in this study. The rib deformities were analyzed according to the imaging results of chest X-ray and 3D volume rendering multidetector computed tomography (MDCT). The data were analyzed using SPSS 22.0. Results A total of 472 male and 186 female children with rib deformities were detected in this study, with a male to female ratio of approximately 2.54:1. Of the deformed ribs, 417 (63.4%) were located on the right side, usually single and unilateral. The most common type of the detected rib deformity were bifid ribs (95.14%). Rib deformity was most common in the fourth rib (46.62%). The majority (76.16%, n = 428) of rib deformities were incidental findings and asymptomatic. Conclusions Congenital rib deformities in pediatric patients included in our hospital were more frequently observed in males than females, more frequently detected on the right than on the left side. The most common type of rib deformity is the bifid rib. MDCT examination are of great value in the diagnosis of rib deformity and can help guide clinical treatment.

Total anomalous pulmonary venous connection (TAPVC) is anomalous drainage of all pulmonary veins into systemic circulation. The intracardiac type typically entails the drainage of all the pulmonary veins into the right atrium, via the coronary sinus. The connection of the pulmonary veins directly into the right atrium is exceptionally rare and has been primarily reported with right atrial isomerism. Herein, we presented a remarkable case of TAPVC in a 10-year-old male child, distinguished by an unconventional drainage of all the pulmonary veins directly into the right atrium, with normal coronary sinus and absent right atrial isomerism. Intriguingly, computed tomography imaging revealed a combination of incredibly rare coexistent pulmonary, vascular, and skeletal anomalies. These anomalies included absence of pulmonary fissures in the right lung, presence of left circumflex aortic arch with bovine branching pattern, bilateral cervical ribs, and C7 vertebral fusion anomalies. To our knowledge, this unique combination of coexistent anomalies has not been previously reported in scientific literature in the background of rare drainage pattern of TAPVC.

Abstract Background The posterior ethmoid sinuses have a complex anatomy and a highly variable normal structure. The posterior ethmoid Onodi cell needs careful assessment because of its proximity to the optic nerve and the internal carotid artery canal. Recognising the distinctions is essential for optimal pre-op preparation. Sphenoid sinus surgery can now be performed without worrying about compromising vital structures like the internal carotid artery or optic nerve. Preoperative radiological assessment is a quick and easy way to check for ethmoid cell pneumatisation differences. Aim and objectives To determine the pneumatisation patterns of Onodi cells among the North-East Indian population using 16-slice multidetector computed tomography (MDCT). Results Nine-hundred MDCT paranasal sinuses were analysed over a period of 0–2 years, out of which 220 cases showed the presence of Onodi cell. Type I were 89 cases (40.45%, CI 32.00–48.90), Type II were 128 cases (58.18%, CI 49.72–66.63), and 3 cases with Type III cell (1.36%, CI 0.18–2.54). Conclusion The most prevalent pneumatisation pattern is Type II. The pneumatisation patterns of Onodi cells can be best detected and evaluated by multiplanar MDCT imaging. Sinus surgeons need a firm grasp of pneumatisation patterns to avoid damaging the optic nerve and internal carotid artery canal during operations.

Background: The posterior ethmoid sinuses have a complex anatomy and a highly variable normal structure. The posterior ethmoid Onodi cell needs careful assessment because of its proximity to the optic nerve and the internal carotid artery canal. Recognising the distinctions is essential for optimal pre-op preparation. Sphenoid sinus surgery can now be performed without worrying about compromising vital structures like the internal carotid artery or optic nerve. Preoperative radiological assessment is a quick and easy way to check for ethmoid cell pneumatisation differences. Aim and objectives: To determine the pneumatisation patterns of Onodi cells among the North-East Indian population using 16-slice multidetector computed tomography (MDCT). Results: Nine-hundred MDCT paranasal sinuses were analysed over a period of 0–2 years, out of which 220 cases showed the presence of Onodi cell. Type I were 89 cases (40.45%, CI 32.00–48.90), Type II were 128 cases (58.18%, CI 49.72–66.63), and 3 cases with Type III cell (1.36%, CI 0.18–2.54). Conclusion: The most prevalent pneumatisation pattern is Type II. The pneumatisation patterns of Onodi cells can be best detected and evaluated by multiplanar MDCT imaging. Sinus surgeons need a firm grasp of pneumatisation patterns to avoid damaging the optic nerve and internal carotid artery canal during operations. [ABSTRACT FROM AUTHOR]

In present study 200 cases of acute pancreatitis were evaluated and following conclusions were made. MDCT is an excellent imaging modality in diagnosis of acute pancreatitis with depiction of pancreas, peri pancreatic changes and also associated complications. No significant correlation seen between pancreatic enzymes and severity of pancreatitis. Significant correlation with modified CT severity index and length of hospital stay, interventions, organ failure is noted. MCTSI is good indicator for outcome of patient especially with the organ failure and also length of stay. CECT with modified CT severity index shows good correlation with grading of severity of pancreatitis and extent of disease process. CT is the most sensitive and specific imaging modality for the evaluation of acute pancreatitis and its complications. [ABSTRACT FROM AUTHOR]

Mesenteric ischemia diagnosis is challenging, with an overall mortality of up to 50% of cases despite advances in treatment. The main problem that affects the outcome is delayed diagnosis because of non-specific clinical presentation. Multi-Detector CT Angiography (MDCTA) is the first-line investigation for the suspected diagnosis of vascular abdominal pathologies and the diagnostic test of choice in suspected mesenteric bowel ischemia. MDCTA can accurately detect the presence of arterial and venous thrombosis, determine the extent and the gastrointestinal tract involved, and provide detailed information determining the subtype and the stage progression of the diseases, helping clinicians and surgeons with appropriate management. CT (Computed Tomography) can differentiate forms that are still susceptible to pharmacological or interventional treatment (NOM = non-operative management) from advanced disease with transmural necrosis in which a surgical approach is required. Knowledge of CT imaging patterns and corresponding vascular pathways is mandatory in emergency settings to reach a prompt and accurate diagnosis. The aims of this paper are 1. to provide technical information about the optimal CTA (CT Angiography) protocol; 2. to explain the CTA arterial and venous supply to the gastrointestinal tract and the relevant ischemic pattern; and 3. to describe vascular, bowel, and extraintestinal CT findings for the diagnosis of acute mesenteric ischemia. [ABSTRACT FROM AUTHOR]

Background Unicuspid aortic valve (UAV) represents a rare congenital anomaly characterized by two subtypes: acommissural unicuspid aortic valve and unicommissural unicuspid aortic valve. Acommissural UAV is often diagnosed and corrected during the neonatal period due to haemodynamic instability. Unicommissural UAV leads to aortic stenosis (AS) in early adulthood. The diagnostic challenge associated with UAV primarily stems from its eccentric orifice opening and valvular calcification, resulting in difficult visualization of the commissures and localization of the orifice plane. This case report aims to demonstrate the unique morphological features of UAV through a comprehensive analysis using multimodality imaging. Case summary A 61-year-old woman presented to the emergency department for recurrent episodes of dyspnoea. Severe AS was diagnosed on transthoracic echocardiography (TTE) by Doppler haemodynamic measurement. However, follow-up transesophageal echocardiography (TEE) and CT transcatheter aortic valve replacement showed moderate AS by planimetry. Following this, patient was monitored closely, but her dyspnoea kept worsening. Cardiovascular magnetic resonance (CMR) was performed due to persistent dyspnoea, identifying UAV with eccentric loophole orifice with unicommissural attachment and opposite free leaflet edge. The patient was managed medically. Discussion TTE is the test of choice for AS that defines valvular morphology by direct visualization and grades the severity by haemodynamic measurement. However, the accuracy of TTE can be limited by poor acoustic windows and heavy valvular calcification. TEE measures aortic valve area (AVA) by planimetry that requires accurate localization of the AV orifice plane. Similarly, it applies to multi-detector computed tomography (MDCT). While CMR is expensive and mainly available in tertiary centres, it can provide additional information when there is discordance. [ABSTRACT FROM AUTHOR]

Aims. To compare the efficacy of computed tomography from endoscopic examination in diagnosing and staging laryngeal carcinoma. Methods. From February 2019 to July 2020, we conducted a retrospective study on patients with laryngeal carcinoma. After receiving a clinical diagnosis of laryngeal masses, patients underwent indirect laryngoscopy evaluation before being referred for computed tomography (CT) scans. A postimaging biopsy was undertaken via direct laryngoscopy. Imaging features of the tumor, such as size, level of invasion, and tumor staging, were analyzed. Results. The mean age was 61±11, with 90% of male patients. The risk of laryngeal cancer for those patients who were active smokers (93.5%) and alcohol consumers (67.7%). The most common symptom was hoarseness (93.5%). In CT image, more than half of the cancers were carcinoma of the glottis (29%) and two regions, supraglottis and glottis (22.6%), while the less common cancers were the subglottic (3.2%) and all three regions (9.7%) carcinoma, especially true vocal cord (67.7%) is the most common site starting carcinoma. The percentage of tumor spreading to paraglottic space and pre-epiglottic space was 50% and 30.6%, respectively. The most common stage of laryngeal cancer in CT was the T3 stage (35.5%). Compared to laryngoscopy, there is a weak agreement (Kappa=0.518) in staging in laryngeal cancer in CT. Conclusion. MDCT is better in staging of laryngeal cancer in the T3 and T4 stages as compared to laryngoscopy. [ABSTRACT FROM AUTHOR]

ObjectiveTo develop a model that integrates radiomics features and clinical factors to predict upper gastrointestinal bleeding (UGIB) in patients with decompensated cirrhosis.Methods104 decompensated cirrhosis patients with UGIB and 104 decompensated cirrhosis patients without UGIB were randomized according to a 7:3 ratio into a training cohort (n = 145) and a validation cohort (n = 63). Radiomics features of the abdominal skeletal muscle area (SMA) were extracted from the cross-sectional image at the largest level of the third lumbar vertebrae (L3) on the abdominal unenhanced multi-detector computer tomography (MDCT) images. Clinical-radiomics nomogram were constructed by combining a radiomics signature (Rad score) with clinical independent risk factors associated with UGIB. Nomogram performance was evaluated in calibration, discrimination, and clinical utility.ResultsThe radiomics signature was built using 11 features. Plasma prothrombin time (PT), sarcopenia, and Rad score were independent predictors of the risk of UGIB in patients with decompensated cirrhosis. The clinical-radiomics nomogram performed well in both the training cohort (AUC, 0.902; 95% CI, 0.850–0.954) and the validation cohort (AUC, 0.858; 95% CI, 0.762–0.953) compared with the clinical factor model and the radiomics model and displayed excellent calibration in the training cohort. Decision curve analysis (DCA) demonstrated that the predictive efficacy of the clinical-radiomics nomogram model was superior to that of the clinical and radiomics model.ConclusionClinical-radiomics nomogram that combines clinical factors and radiomics features has demonstrated favorable predictive effects in predicting the occurrence of UGIB in patients with decompensated cirrhosis. This helps in early diagnosis and treatment of the disease, warranting further exploration and research.

The persistent challenge of ventricular tachycardia (VT) ablation lies in the elevated morbidity and mortality due to the underlying disease progression and the complexity of the arrhythmogenic substrate. As imaging methods are evolving, substrate-based VT ablation is moving closer to the realm of precision medicine.

[Display omitted] [ABSTRACT FROM AUTHOR]

Introduction-Coronary artery anomalies (CAA) are the genetic abnormalities which are generally asymptomatic. However, these anomalies can cause chest pain, syncope, arrhythmias, MI (myocardial infarction) or unexpected death. Multidetector row-computed tomography (MDCT) has been introduced as the best modality for coronary imaging. In the current study, we tried to evaluate the CAV including anomalies using 64-Slice MDCT coronary angiography in selected population. Material and Method-The current study was a cross-sectional and observational in nature, carried out at Biyani Diagnostic Centre, Dhule, Maharashtra from December 2022 to November 2023. A total of 106 patients were included in the study after applying inclusion and exclusion criteria. Philips Brilliance 64-slice MDCT was used for imaging modality. Data were restructured by retrospective gating in end-diastolic phase or end-systolic phase to clearly figure the 'right coronary artery (RCA)'. For evaluation of CAA, CAV and coronary artery stenosis (CAS), the 3D radiological image of complex anatomy of the coronary artery tree was axially projected. CAV was considered based on American Heart Association (AHA) scheme. All the collected data were statistically analyzed by descriptive statistics using Microsoft excel 2010. Result- The study included 106 patients with age range of 22-74 years and mean age of 52.9±9.5years. in the current study, Right dominance was seen in 90(84.90%), left dominance in 12(11.32%), and co-dominance was observed in 4(3.77%) patients. Smaller branches like conus artery, sinus node artery and septal branches were seen in most of the patients in our study. Type II (partially supplying apex) LAD variation was found to be the commonest among study subjects. As far as coronary anomalies are concerned, it showed prevalence of 15.09% in our study. The most common was the coronary arteries running within the myocardium i.e. myocardial bridging. The present study found 2(1.88%) cases of malignant anomalies. Conclusion- In the current study, CAV was present in most of the patients. Although, prevalence rate of CAA was found to be 15.09%, with the left coronary artery anomalies to be more common than right coronary artery anomalies. MDCT modality is tremendously helpful in indicating the presence CAV and CAA and it gives complete and exact information about the anatomy of coronary artery. This information can be vital for correct diagnosis and treatment plan of the patients as in case of interventional procedures. [ABSTRACT FROM AUTHOR]

Extracorporeal membrane oxygenation (ECMO) was established as a treatment for severe cardiac or respiratory disease. Intra-device clot formation is a common risk. This is based on complex coagulation phenomena which are not yet sufficiently understood. The objective was the development and validation of a methodology to capture the key properties of clots deposed in membrane lungs (MLs), such as clot size, distribution, burden, and composition. One end-of-therapy PLS ML was examined. Clot detection was performed using multidetector computed tomography (MDCT), microcomputed tomography (μCT), and photography of fiber mats (fiber mat imaging, FMI). Histological staining was conducted for von Willebrand factor (vWF), platelets (CD42b, CD62P), fibrin, and nucleated cells (4′, 6-diamidino-2-phenylindole, DAPI). The three imaging methods showed similar clot distribution inside the ML. Independent of the imaging method, clot loading was detected predominantly in the inlet chamber of the ML. The μCT had the highest accuracy. However, it was more expensive and time consuming than MDCT or FMI. The MDCT detected the clots with low scanning time. Due to its lower resolution, it only showed clotted areas but not the exact shape of clot structures. FMI represented the simplest variant, requiring little effort and resources. FMI allowed clot localization and calculation of clot volume. Histological evaluation indicated omnipresent immunological deposits throughout the ML. Visually clot-free areas were covered with leukocytes and platelets forming platelet-leukocyte aggregates (PLAs). Cells were embedded in vWF cobwebs, while vWF fibers were negligible. In conclusion, the presented methodology allowed adequate clot identification and histological classification of possible thrombosis markers such as PLAs.

Introduction: Variations in the branching pattern of the Arch of Aorta (AoA) are common in patients undergoing contrast-enhanced Multidetector Computed Tomography, the identification of which is crucial in managing patients undergoing cardiovascular/neck surgeries and interventions. Methods: This prospective cross-sectional study involved 513 patients who were sent to the Department of Radiology for evaluation of various pathologies of chest and neck between August 2018 and July 2019. After approval from the Institutional Review Committee {Reference No: 11(6-11) E2/075/076}, contrast-enhanced computed tomography images were evaluated with variations in branches of the left-sided arch of the aorta and symptoms associated. Results: Variations in branches of the arch of aorta were seen in 69 (13.45%; 95% CI: 10.60%-16.71%) of cases, left common carotid artery and brachiocephalic trunk having common origin or common trunk was 51(9.94%). The mean age was 52.4±20 years (Range 3 months to 92 years) with male to female ratio of 1.3:1. Conclusions: Contrast-enhanced computed tomography is the modality of choice for the detection of the variations in branches of AoA, recognition of which is crucial in vascular intervention and surgical procedures to reduce the postoperative morbidity and mortality of the patients.

Background: Jaw lesions comprise a broad spectrum of odontogenic and nonodontogenic lesions. They may be cysts, tumors, or tumor-like lesions. Clinical presentation of this vast spectrum of pathology is nonspecific. On imaging, they may be classified as radiolucent, mixed, or radioopaque. Based on this broad categorization of imaging appearances and few specific imaging characteristics if present, it may be possible to diagnose a particular jaw lesion or at least reach a narrow differential diagnosis. Aim & Objective:1. Comparative evaluation of MDCT and 1.5T MRI in radiographically detected jaw lesions.2. Study roll of MDCT and 1.5T MRI in diagnosis of jaw lesions Methodology: Study design: A Prospective Study. Study setting: Radio diagnosis department of Basaveshwara Medical College and Hospital, Chitradurga. Study duration: from July 2022 to June 2023. Study population: The study population included all the cases with jaw lesions patients admitted at a tertiary care center Sample size: 50 Results: Majority of cases found in 46-65 years age group 17 (34%) followed by above 65 years age group 15 (30%), 31-45 years 13 cases (26%) and 5 cases in 18-30 years age group. Most of cases were males 30 (60%) and 20 females (40%). MDCT shows most of cases were Ameloblastoma 12 followed by Keratocysticodontogenic tumor 10, Periapical cyst 7, Osteomyelitis 6, Dentigerous cyst 4, Odontoma 4, Cementoblatsoma 2, Osteogenic Sarcoma 2, Osteochondroma 2. 1.5T MRI shows majority of cases were Ameloblastoma 12 followed by Keratocysticodontogenic tumor 9, Periapical cyst 8, Osteomyelitis 6, Odontoma 5, Dentigerous cyst 4, Cementoblatsoma 2, Osteogenic Sarcoma 2, Osteochondroma 2. Conclusion: MRI could be effectively useful to the typing of different expansive lesion, and to evaluate the possible infiltration of the soft tissue. This information is decisive in the differential diagnosis between the benign lesions and major aggressive odontogenic tumours and in the surgical planning. [ABSTRACT FROM AUTHOR]

Introduction: Small bowel obstruction accounts for 60%-85% of cases of intestinal obstruction. MDCT is now readily available and has advantages over classic helical CT in the imaging of the mesenteric vasculature and of the bowel. Multidetector CT provides good spatial and contrast resolution, multiplanar reconstructions and more efficient scanning with few or no artifacts. Aims and objectives: To assess the role of MDCT in evaluation of clinically suspected acute small bowel obstruction. Methodology: This was a prospective study conducted on 50 patients suffering from clinically suspected acute small bowel obstruction in Department of Radiodiagnosis and Imaging, Govt. Medical College, Amritsar. The final diagnosis was confirmed by pathological correlation, post-operative data and clinical response to medical treatment. Multi Detector Computed Tomography imaging was performed for each patient. The data was tabulated and subjected to statistical analysis. Results: Majority of participants (40%) belonged to age group 41 to 60 years. There were 60% males and 40% females. The most common frequent cause of intestinal obstruction among the examined patients was adhesive bowel obstruction, followed by obstructed hernia, intussusception and gall stone ileus. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MDCT on diagnosis of small intestinal obstruction was found to be 100%, 95.65%, 66.67%, 100% and 96.00% respectively. Conclusion: MDCT has high sensitivity and specificity to diagnose and determine the causes of bowel obstruction. It can be used in clinical practice as a modality for detecting intestinal obstruction which can aid in reducing the morbidity and mortality of patients with small intestine obstruction. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to evaluate the role of solid organ and hollow viscous injury in blunt abdominal trauma patients using multi-detector computerized tomography, accurately diagnose the type of injury at the earliest and help the clinician in management, study the grades or severity of solid organ injuries, and correlate CT findings in trauma patients with management strategies followed either operatively or conservatively. Methods: This was a hospital-based prospective study conducted among 69 patients who underwent CT evaluation in the Department of Radio Diagnosis, S.C.B. Medical College, Cuttack, over a period of two years from November 2020 to October 2022, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: Hemoperitoneum (85.5%) was the most common finding in blunt abdominal trauma. Pain in the abdomen was the most common clinical symptom, followed by guarding and rigidity. Among solid organ injuries, the spleen was the most frequently injured organ. Among splenic injuries, intraparenchymal hematoma was the most common type of splenic injury, followed by subcapsular hematoma. Among hepatic injuries, liver laceration was the commonest lesion. The right lobe of the liver involves 70% of cases. Renal injury is noted in 17.39% of cases of BAT; subcapsular hematoma and contusion contribute 25 each, and renal laceration occurs in 50% of cases. 7.49% of patients had pancreatic injuries, of which 40% were pancreatic contusions and 60% were pancreatic lacerations. The most common associated injury was fractures, followed by head and chest injuries, which were found more often with blunt trauma. Conclusion: The sensitivity of a CT scan in determining the type of lesion is 100%. MDCT imaging gives accurate diagnostic pathology of the various intraabdominal organ injuries in BAT, thereby helping the clinicians undertake conservative or surgical management. [ABSTRACT FROM AUTHOR]

Tetralogy of Fallot is reported as the most common congenital cardiac disorder in with reported 7 to 10 % incidence in human population worldwide. It is not only the most common cyanotic heart disease also the most frequent of the complex congenital heart disease presenting in adults. The intracardiac spectrum of this cardiac anomaly are detected on echocardiography such as ventricular septal defect with overriding of aorta and right ventricular hypertrophy. Pulmonary stenosis can also be detected on echo through pressure gradients even if it s not directly visualized. However, the extra-cardiac associations and manifestations do create room for noninvasive imaging through muti detector CT (MDCT) scans. We report a case of Tetralogy of Fallot with its presurgical multidetector CT Angiogram that contribute to the presurgical planning. [ABSTRACT FROM AUTHOR]

Mesenteric ischemia diagnosis is challenging, with an overall mortality of up to 50% of cases despite advances in treatment. The main problem that affects the outcome is delayed diagnosis because of non-specific clinical presentation. Multi-Detector CT Angiography (MDCTA) is the first-line investigation for the suspected diagnosis of vascular abdominal pathologies and the diagnostic test of choice in suspected mesenteric bowel ischemia. MDCTA can accurately detect the presence of arterial and venous thrombosis, determine the extent and the gastrointestinal tract involved, and provide detailed information determining the subtype and the stage progression of the diseases, helping clinicians and surgeons with appropriate management. CT (Computed Tomography) can differentiate forms that are still susceptible to pharmacological or interventional treatment (NOM = non-operative management) from advanced disease with transmural necrosis in which a surgical approach is required. Knowledge of CT imaging patterns and corresponding vascular pathways is mandatory in emergency settings to reach a prompt and accurate diagnosis. The aims of this paper are 1. to provide technical information about the optimal CTA (CT Angiography) protocol; 2. to explain the CTA arterial and venous supply to the gastrointestinal tract and the relevant ischemic pattern; and 3. to describe vascular, bowel, and extraintestinal CT findings for the diagnosis of acute mesenteric ischemia.

INTRODUCTION This descriptive cross-sectional study was conducted from June to August 2023, at the Department of Radiodiagnosis & Medical Imaging, Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal, examined a total of fifty-nine patients. The examination protocol comprised triphasic techniques, which included unenhanced, nephrographic, and excretory phases, utilizing a MDCT scanner. The descriptive data were analyzed using SPSS version 20 and presented in the form of a number and percentage. MATERIAL AND METHODS A total 59 patients, 32 were male and 27 were female. Mean age of patients were 44.17±15.66 years, with the majority (28.81%) falling within the age range of 20-30 years. Abdominal pain was the most common symptom (79.66%), followed by hematuria (18.64%). Urolithiasis was the most frequent diagnosis (47.46%), followed by ureterohydronephrosis (22.03%) and hydronephrosis (18.64%). Inflammatory change/infection affected 13.56% of patients, while congenital abnormalities were the least prevalent (3.39%). RESULTS MDCT urography is considered the optimal modality for detecting a broad range of urinary tract abnormalities, due to its utilization of a combination of unenhanced, nephrographic-phase, and excretory-phase imaging techniques. [ABSTRACT FROM AUTHOR]

Aims and objectives: 1) To study the role of MDCT in the evaluation of clinically suspected bowel pathologies. 2) To study the imaging characteristics of various bowel pathologies and narrow down the differential diagnosis using MDCT. 3) To correlate the imaging findings with operative findings/ cytohistopathology/ clinical outcomes if any. 4) To determine the sensitivity, specificity and accuracy of MDCT in the evaluation of bowel pathologies. Material and Methods: 50 patients with suspected bowel pathologies who were referred to the Department of Radiodiagnosis were included in this study. Results: The study had 60% males and 40% females This study showed male predominance. All the 50 patients in the study presented with abdominal pain. Weight loss, fever, vomiting and diarrhoea/constipation were the other complaints by the patients. The predominant wall enhancement pattern was homogenous. We observed that mucosa was affected in maximum number of cases. Based on the length of the bowel maximum cases in our study showed focal involvement. The cases in our study showed equal proportion of the large and small bowel involvement. Maximum cases in our study showed moderate mural thickness. Ascites was present in 88% cases in the present study. Necrotic and non-necrotic nodes were observed in 42% and 38% cases respectively. Pulmonary tuberculosis, liver microabscesses, metastases, peritoneal abscess, diverticulae and ovarian malignancy were the associated abnormalities in our study. On MDCT, tuberculosis followed by the malignancy were the maximum number of cases reported. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MDCT on diagnosis of tuberculosis was found to be 91.67%, 92.11%, 78.57%, 97.22% and 92.00% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MDCT on diagnosis of malignancy found to be 66.67%, 97.56%, 85.71%, 93.02% and 92.00% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MDCT on diagnosis of other cases was found to be 100% each. Conclusion: The present study confirms the high diagnostic accuracy of MDCT in bowel diseases. MDCT is a powerful diagnostic tool for the study of bowel disorders, including inflammatory disease, neoplasms, and mechanical obstruction. MDCT enterography is a dedicated technique that allows proper visualization of the entire bowel wall to detect abnormal mural thickening and analyse its type, length, and pattern of enhancement. [ABSTRACT FROM AUTHOR]

Multi-detector computed tomography (MDCT) is the gold standard non-invasive tool for evaluating aortic root dimensions. We assessed the agreement between 4D TEE and MDCT-derived aortic valve annular dimensions, coronary ostia height, and minor dimensions of sinuses of Valsalva (SoV) and sinotubular junction (STJ). In this prospective analytical study, we measured the annular area, annular perimeter, area-derived diameter, area-derived perimeter, left and right coronary ostial heights, and minor diameters of the SoV and the STJ using ECG-gated MDCT and 4D TEE. TEE measurements were calculated semi-automatically by the eSie valve software. We enrolled 43 adult patients (27 males, median age: 46 years). We found strong correlations and good agreement between the two modalities in annular dimensions (area, perimeter, area-derived diameter, and perimeter-derived diameter), left coronary ostial height, minimum STJ diameter, and minimum SoV diameters. Moderate correlations, and agreement, with relatively large differences between the 95% LOA, were demonstrated for the right coronary artery ostial height. 4D TEE correlates well with MDCT in measuring aortic annular dimensions, coronary ostial height, SoV minor diameter, and sinotubular junction minor diameter. Whether this can affect clinical outcomes is unknown. It could replace MDCT if the latter is unavailable or contraindicated. [ABSTRACT FROM AUTHOR]

PURPOSETo explore the utility of four-phase computed tomography (CT) in distinguishing renal oncocytoma with central hypodense areas from clear cell renal cell carcinoma (ccRCC).METHODSEighteen patients with oncocytoma and 63 patients with ccRCC presenting with central hypodense areas were included in this study. All patients underwent four-phase CT imaging including the excretory phases later than 20 min after contrast injection. Two blinded experienced radiologists visually reviewed the enhancement features of the central hypodense areas in the excretory phase images and selected the area demonstrating the greatest degree of enhancement of the tumor in the corticomedullary phase images. Regions of interest (ROIs) were placed in the same location in each of the three contrast-enhanced imaging phases. Additionally, ROIs were placed in the adjacent normal renal cortex for normalization. The ratio of the lesion to cortex attenuation (L/C) for the three contrast-enhanced imaging phases and absolute de-enhancement were calculated. The receiver operating characteristic curve was used to obtain the cut-off values.RESULTSComplete enhancement inversion of the central areas was observed in 12 oncocytomas (66.67%) and 16 ccRCCs (25.40%) (P = 0.003). Complete enhancement inversion combined with L/C in the corticomedullary phase lower than 1.0 (P < 0.001) or absolute de-enhancement lower than 42.5 HU (P < 0.001) provided 86.42% and 85.19% accuracy, 61.11% and 55.56% sensitivity, 93.65% and 93.65% specificity, 73.33% and 71.43% positive predictive value (PPV), and 89.39% and 88.06% negative predictive value (NPV), respectively, for the diagnosis of oncocytomas. Combined with complete enhancement inversion, L/C in the corticomedullary phase lower than 1.0 and absolute de-enhancement lower than 42.5 HU provided 87.65%, 55.56%, 96.83%, 83.33%, and 88.41% of accuracy, sensitivity, specificity, PPV, and NPV, respectively, for the diagnosis of oncocytomas.CONCLUSIONThe combination of enhancement features of the central hypodense areas and the peripheral tumor parenchyma can help distinguish oncocytoma with central hypodense areas from ccRCC.

Wide array of anatomical variations and pathologies affect the inferior vena cava (IVC). Multidetector computed tomography remains the most important modality to diagnose and evaluate the extent of involvement. The congenital variations such as duplication, anomalous course of renal veins, azygos continuation of IVC, etc., remain clinically indolent and are detected incidentally in abdominal imaging. This article describes the various congenital variants which include abnormalities in drainage, failure of development, and regression of the IVC. This article also highlights the important pathological conditions such as Budd–Chiari syndrome, primary and secondary neoplasms of the IVC, bland thrombosis, and retrograde opacification of the IVC.

Cone-beam computed tomography (CBCT), derived from multidetector row CT (MDCT), has a high spatial resolution and has recently been applied to various organs. One of the severe limitations common to CBCT and MDCT is metal artifacts. In particular, streak metal artifacts (SMAs) between multiple metal materials often hinder diagnosis. However, no studies have quantitatively compared the strength of SMAs in MDCT and CBCT. Nomura et al. reported an evaluation method specialized in SMAs of CBCT using the Gumbel distribution (GD), which can also be applied to SMAs of MDCT (Oral Surg Oral Med Oral Pathol Oral Radiol 131: 494–502, 2021, https://doi.org/10.1016/J.OOOO.2020.08.031). This study aimed to quantitatively compare SMAs occurring between titanium materials on MDCT and CBCT images using the GD-based method. The SMAs were investigated as follows: A hydroxyapatite block was sandwiched between two titanium rods to generate an SMA. They were placed in an acrylic phantom, simulating a human head, and scanned using an MDCT scanner and two CBCT scanners. The obtained images were analyzed using Gumbel plots and location parameters, and the SMA strength was calculated. The results showed that the SMAs on the MDCT images were significantly weaker than those on the CBCT images. In the CBCT scans, a smaller volume CT dose index value caused stronger SMAs. These results indicate that MDCT is more advantageous than CBCT in terms of SMA reduction when bone morphology between titanium materials must be evaluated. The characteristic should be considered in clinical cases. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate the results of conservative management of blunt splenic trauma according to the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) in 2018 by embolization. Methods: This observational study included 50 patients (42 men and 8 women) with splenic injury who underwent multidetector computed tomography (MDCT) and embolization. Results: According to the 2018 AAST-OIS, 27 cases had higher grades than they did according to the 1994 AAST-OIS. The grades of two cases of grade II increased to grade IV; those of 15 cases of grade III increased to grade IV; and four cases of grade IV increased to grade V. As a result, all patients underwent successful splenic embolization and were stable at discharge. No patients required re-embolization or conversion to splenectomy. The mean hospital stay was 11.8± 7 days (range, 6– 44 days), with no difference in length of hospital stay among grades of splenic injury (p > 0.05). Conclusion: Compared with the AAST-OIS 1994, the AAST-OIS 2018 classification is useful in making embolization decisions, regardless of the degree of blunt splenic injury with vascular lacerations visible on MDCT. [ABSTRACT FROM AUTHOR]

In the transition from the operative to the conservative approach for the polytraumatized patients who undergo blunt trauma, diagnostic imaging has assumed a pivotal role, currently offering various opportunities, particularly in the follow-up of these patients. The choice of the most suitable imaging method in this setting mainly depends on the injury complications we are looking for, the patient conditions (mobilization, cooperation, medications, allergies and age), the biological invasiveness, and the availability of each imaging method. Computed Tomography (CT) represents the "standard" imaging technique in the polytraumatized patient due to the high diagnostic performance when a correct imaging protocol is adopted, despite suffering from invasiveness due to radiation dose and intravenous contrast agent administration. Ultrasound (US) is a readily available technology, cheap, bedside performable and integrable with intravenous contrast agent (Contrast enhanced US—CEUS) to enhance the diagnostic performance, but it may suffer particularly from limited panoramicity and operator dependance. Magnetic Resonance (MR), until now, has been adopted in specific contexts, such as biliopancreatic injuries, but in recent experiences, it showed a great potential in the follow-up of polytraumatized patients; however, its availability may be limited in some context, and there are specific contraindications, such as as claustrophobia and the presence non-MR compatible devices. In this article, the role of each imaging method in the body-imaging follow-up of adult polytraumatized patients will be reviewed, enhancing the value of integrated imaging, as shown in several cases from our experience. [ABSTRACT FROM AUTHOR]

Background: Benign nephrectomy to treat patients with renal inflammatory disease in cases of severe urinary infection represents a diagnostic and management challenge because of significant inflammatory, fibrotic, and infectious components. Among renal inflammatory diseases, fistulization and invasiveness to adjacent structures are some of the hallmarks of xanthogranulomatous pyelonephritis (XGP). The aims of this study were as follows 1. to retrospectively determine key demographic and clinical features of XGP among benign nephrectomies; 2. to assess the CT preoperative diagnostic accuracy; and 3. to define the imaging characteristics of the CT stage. Material and Methods: A retrospective review of clinical, laboratory, and radiological features and operative methods of patients who underwent benign nephrectomy with histologically proven XGP was performed. Results: XPG was diagnosed in 18 patients over a 4-year (2018–2022) period. XGP represented 43.90% among benign nephrectomies. The mean age of the patients was 63 years, and the sex prevalence was higher in women (72.22%). Symptoms were vague and not specifically referrable to urinary tract disorders and unilateral (100%), with the left kidney affected in 61.11% of cases. Staghorn calculi and stone disease were the most common underlying cause (72.22%). All patients underwent CT. The preoperative CT imaging accuracy for renal inflammatory disease was 94.44% and indeterminate in 5.56%. A suspected diagnosis of XGP was formulated in 66.67% (12/18; 2 stage II/10 stage III), meanwhile, in 33.33% (6 patients with stage I), a non-specific diagnosis of renal inflammatory disease was formulated. CT was reported according to the Malek and Elder classification and staged in the stage I nephric form (33.33%), stage II perinephric form (11.11%), stage III paranephric form (55.56%). Conclusions: The CT diagnostic accuracy for kidney inflammatory disease was extremely high, whereas the suspected diagnosis of XGP was formulated preoperatively in only 66.67% of high-stage disease, where the hallmarks of invasiveness and fistulization of the pathology increased the diagnostic confidence. [ABSTRACT FROM AUTHOR]

Knowledge of anatomical variations of the hepatic artery from its origin to intrahepatic segmentation is of utmost importance for planning upper abdominal surgeries including liver transplantation, pancreatoduodenectomy, and biliary reconstruction. The origin and branching pattern of the hepatic artery was thoroughly described by the classification of Michels and Hiatt. Some rare variations of the hepatic artery were classified by Kobayashi and Koops. By the use of the multidetector computed tomography (MDCT) technique, the branching pattern of the hepatic artery can be visualized quite accurately. Unawareness of these arterial variations may lead to intraoperative injuries such as necrosis, abscess, and failure of the liver and pancreas. The origin and course of the aberrant hepatic arteries are crucial in the surgical planning of carcinoma of the head of the pancreas and hepatobiliary surgeries. In liver transplant surgeries, to minimize intraoperative bleeding complications and postoperative thrombosis, exact anatomy of the branching of the hepatic artery, its variations and intrahepatic course is of utmost importance. This review discusses variations in the anatomy of the hepatic artery from its origin to branching by the use of advanced imaging techniques and its effect on the liver, pancreatic, biliary and gastric surgeries. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) is a prevalent symptom of cardiovascular disease, which is a major worldwide health problem. Dyslipidemia, characterized by aberrant lipid levels, significantly contributes to CAD development and progression. Objective: This study aimed to investigate whether a correlation exists between dyslipidemia, as assessed by lipid profile parameters, and CAC in individuals presenting with chest pain and a low to intermediate PTP for CAD, utilizing multidetector computed tomography (MDCT) imaging. Methods: An observational cross-sectional study on 100 patients at CT scan Units in El-Mokattam Health Insurance Hospital and Benha University Hospitals. The patients underwent a comprehensive diagnostic work-up including full medical history, clinical examination, blood tests, ECG, and transthoracic echocardiography (TTE) in addition to MDCT for coronary artery calcification (CCS) measurement. Results: Ca2+ score had a mean value of 466.6 ± 147.9. 38 (38%) patients had Ca2+ score % < 400 and 62 (62%) patients had Ca2+ score % > 400. A significant positive correlation was found between Ca2+ score and age, cholesterol, LDL, and TG (r=0.647, 0.772, 0.717, r=0.651, respectively with P<0.001). There was a significant negative correlation between Ca2+ score and HDL (r= -0.826, P<0.001). Conclusions: There was a significant association between calcium score and age, lipid profile, as well as HTN, smoking, DM, and ischemic heart disease family history. Furthermore, it was found that patients with a Ca2+ score > 400 had a higher incidence of hyperlipidemia and were generally older than those with a lower calcium score. [ABSTRACT FROM AUTHOR]

Neoplasia of the tubular genital tract in goats, while rarely described, is most commonly reported as uterine adenocarcinoma, leiomyoma, or leiomyosarcoma. In this retrospective, single‐center, case series, medical records were searched for goats with a computed tomography (CT) diagnosis of tubular genital mass and a definitive histologic (surgical biopsy or necropsy) diagnosis of malignant neoplasia. Data recorded from CT images were presence of peritoneal/retroperitoneal fluid, urinary tract obstruction, abdominal lymphadenomegaly, additional abdominal nodules/masses, and pulmonary nodules. For masses, maximum cross‐sectional area, contrast enhancement, and uterine luminal fluid accumulation were also recorded. Seven goats met the inclusion criteria (leiomyosarcoma n = 5, adenocarcinoma n = 2). Both goats with adenocarcinoma had upper urinary tract obstruction, moderate to severe regional lymphadenopathy, peritoneal fluid, and peritoneal or hepatic nodules/masses; one goat with adenocarcinoma was discharged and subsequently euthanized, and the other had palliative mass debulking and was lost to follow up. Goats with leiomyosarcoma had infrequent, mild peritoneal fluid and mild sublumbar lymphadenopathy. Of the goats with leiomyosarcoma, two were euthanized at or near the time of CT imaging, two were euthanized at the time of surgery due to perceived mass non‐resectability, and one had mass regression approximately four months post ovariohysterectomy but was subsequently lost to follow up. Five goats had pulmonary nodules, three of which had pathologic confirmation (pulmonary metastasis in a single patient with adenocarcinoma, and lungworm granulomas in two goats with leiomyosarcoma). Severe sublumbar lymphadenopathy and obstructive uropathy were sequelae in the two caprine patients with genital adenocarcinoma, and in none with leiomyosarcoma. [ABSTRACT FROM AUTHOR]

Background: For the diagnosis of congenital heart disorders (CHDs), echocardiography and catheter angiography are the two main cardiac imaging techniques. Yet, each modality has its limitations and drawbacks. Modern developments in multidetector computed tomography (MDCT) methods have been made in response to the rising frequency of CHDs. These techniques aid in the confirmation of the diagnosis, offer more specific information about the CHDs, and aid in the preoperative evaluation. Objective: The aim of the current study is to evaluate the potential benefit of MDCT for the diagnosis of pediatric CHDs. Patients and Methods: A prospective study included 100 patients of pediatric age group presented to Radiology Department at Zagazig and Menoufia Universities by different clinical picture. All patients underwent MDCT and echocardiography (either transthoracic or transesophageal), while only 40 patients underwent invasive catheterization/operation. Results: MDCT was superior to echo in detecting sinus Venus and unroof coronary atrial septal defect (ASD) while echo was superior in other types, Echo detected ventricular septal defects (VSD) in 43 cases while MDCT in 37cases. MDCT was superior in detection pseudo-coarctation, major aortopulmonary collateral arteries (MAPCAS), peripheral pulmonary stenosis, venous anomalies as well as coronary arteries anomalies. The agreement between MDCT and echo was very good in truncus arteriosus, good in aortic coarctation, moderate in aortic arch abnormalities and left SVC while being fair in persistent left SVC and anomalous pulmonary venous return (APVR). Conclusion: An important non-invasive diagnostic method for assessing congenital cardiac and extra cardiac great vessels is MDCT. Cardiovascular MDCT is an adjunct to cardiac echocardiography, particularly in complicated heart problems. [ABSTRACT FROM AUTHOR]

Wide array of anatomical variations and pathologies affect the inferior vena cava (IVC). Multidetector computed tomography remains the most important modality to diagnose and evaluate the extent of involvement. The congenital variations such as duplication, anomalous course of renal veins, azygos continuation of IVC, etc., remain clinically indolent and are detected incidentally in abdominal imaging. This article describes the various congenital variants which include abnormalities in drainage, failure of development, and regression of the IVC. This article also highlights the important pathological conditions such as Budd–Chiari syndrome, primary and secondary neoplasms of the IVC, bland thrombosis, and retrograde opacification of the IVC. [ABSTRACT FROM AUTHOR]

Objective: The benefits of erythropoietin (EPO) or mesenchymal stem cell (MSC) application during spinal fusion were discussed in the literature. Still, the effect of the combination may enhance favorable outcomes. This study compared the efficacy of MSCs and EPO treatments separately and together in a rat model. Materials and Methods: This study was designed as an experimental, controlled animal study. The groups consisted of EPO or MSC application or both: PreS - EPO + MSC (EPO starting 24 h before the surgery) or PostS - EPO + MSC (EPO starting 72 h after the surgery) with control groups. Experimental posterolateral L4-L5 spinal fusion was performed. Plain radiographs and multi-detector computed tomography scans were performed for the rats preoperatively and at the 3rd and 6th weeks. Using the Mimics Innovation Suite, 3D models of the fusion site were reconstructed, volume analysis and volumetric changes in these periods were calculated. Manuel palpation assessment and histopathological analyses were also performed to assess the fusion. Results: Radiologically, the fusion rate at weeks 3 and 6 were significantly higher in the EPO + MSC groups than that in the EPO group alone. The highest bone-volume increase was detected in the PostS - EPO + MSC groups. The PreS - EPO + MSC-3 group and the PostS - EPO + MSC-6 group had the highest fusion rates according to manual palpation (p=0.048, 71.4%). The EPO groups had lower fusion rates compared to those in the control and MSC groups (14.3 % both at the 3rd and 6th weeks). The PreS - EPO + MSC-3 group had the highest histological score among the groups. The EPO-6 and PostS - EPO + MSC-6 groups had the lowest scores with respect to histological examination. Conclusion: The combination of EPO + MSC application showed additionally significant benefits according to radiological and histological examination, but EPO adversely affected the fusion. [ABSTRACT FROM AUTHOR]

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Abstract Background The importance of thymic CT-grading and presence of thymic rebound hyperplasia during COVID-19 infection were only investigated in a few studies. This multivariate study aims to evaluate the relation between thymus CT-grading and rebound during COVID-19 infection and the following: (1) the patients' age, (2) the patients' blood lymphocytic count, (3) the CT-volumetry of the diseased lung parenchyma, (4) the patient's clinical course and prognosis, and finally (5) the final radiological diagnosis. Results Multicenter retrospective analyses were conducted between March and June 2021 on 325 adult COVID-19 patients with positive PCR results and negative history of malignant or autoimmune diseases. They included 186 males and 139 females (57.2%:42.8%). Their mean age was 40.42 years ± 14.531 SD. Three consulting radiologists performed CT-grading of the thymus gland (grade 0–3) and CT-severity scoring (CT-SS) of the pathological lung changes in consensus. Two consulting pulmonologists correlated the clinical severity and blood lymphocytic count. Pearson correlation coefficient (r) and linear regression analyses were statistically utilized. Sub-involuted thymus (with CT-grade 0:2) was detected in 42/325 patients (12.9%); all of them had a mild clinical course and low CT-SS (0–1). Thymic rebound hyperplasia was the only positive CT-finding in 15/325 patients (4.6%) without pathological lung changes. A weak positive significant correlation was proved between thymic grade and patient's age, clinical course, and CT-SS (r = 0.217, 0.163, and 0.352 with p ≤ 0.0001,

• Age, gender and body weight have influence on facial soft tissue thickness. • Facial soft tissue thickness is influenced by geographic origin. • Measurments of the facial soft tissue thickness can be used for personal identification. • There is no data about facial soft tissue thickness of Montenegrin population. A lack of soft tissue leads to difficulties in facial reconstruction and further identification in the absence of DNA (deoxyribonucleic acid), finger print and dental data. If these data are not available, then identification based on facial soft tissue thickness (FSTT) is the next reliable method. There is no data in the literature about facial soft tissue thickness in Montenegrin population. Once the measurement is performed, a software algorithm based on the multidetector computerized tomography (MDCT) imaged bone structures and use of FSTT would be able to provide a useful picture of the face for identification purposes. This prospective research was performed by MDCT head examinations of 83 adults aged 18–85, living in Montenegro. The FSTT was measured at eight central points (glabella (GL), nasion (NA), rhinion (RHI), mid-philtrum (MID), upper lip (UL), lower lip (LL), mental eminence (ME), and the point beneath the chin (BC)), and five bilateral points (frontal tubers (FT), supraorbital (SO), external orbital marginal point (EX), zygomatic arch (ZY), and middle masseter (MST)). It was observed that the points RHI, MID, UL, LL, ME, FT, SO and MST are thicker in men compared to women. With an increase in BMI, FSTT in the central points also increases, as well as bilaterally at the ZY, FT, SO and MST points. With aging, there is an increase of the thickness of the FSTT at the RHI and bilaterally at the EX and ZY, while at the MID, LL and MST, the thickness decreases with aging, in both sexes. [ABSTRACT FROM AUTHOR]

Aortic-valve-stenosis (AS) is a frequent degenerative valvular-disease and carries dismal outcome under-medical-treatment. Transvalvular pressure gradient reflects severity of the valve-disease but is highly dependent on flow-conditions and on other valvular/aortic characteristics. Alternatively, aortic-valve-area (AVA) represents a measure of aortic-valve lesion severity conceptually essential and practically widely-recognized but exhibits multiple-limitations. We analyzed the 4D multi-detector computed tomography(MDCT) of 20 randomly selected patients with severe AS. For each-patient, we generated the 3D-model of the valve and of its calcifications, and we computed the anatomical AVA accounting for the 3D-morphology of the leaflets in three-different-ways. Finally, we compared our results vs. Doppler-based AVA E measurements and vs. 2D-planimetric AVA-measurements. 3D-reconstruction and identification of the cusps were successful in 90% of the cases. The calcification patterns where highly-variable over patients, ranging from multiple small deposits to wide and c-shaped deposits running from commissure-to-commissure. AVA E was 82 ± 15 mm2. When segmenting 18 image planes, AVA Tight , AVA Proj-Ann , AVA Proj-Tip and their average AVA Ave were equal to 80 ± 16, 88 ± 20, 93 ± 21 and 87 ± 19 mm2, respectively, while AVA Plan was equal to 143 ± 50 mm2. Linear-regression of the three measurements vs. AVA E yielded regression slopes equal to 1.26, 1.13 and 0.93 for AVA Proj-Ann , AVA Proj-Tip and AVA Tight , respectively. The respective Pearson-coefficients were 0.85,0.86 and 0.90. Conversely, when comparing AVA Plan vs. AVA E , linear regression yielded a slope of 1.73 and a Pearson coefficient of 0.53. We described a new-method to obtain a set of flow-independent quantifications that complement pressure gradient measurements and combine the advantages of previously proposed methods, while bypassing the corresponding-limitations. • A new CT based method to obtain a set of flow-independent quantifications that complement pressure gradient measurements is proposed. • By 4D multi-detector computed tomography of 20 randomly selected patients with severe AS the anatomical AVA is computed accounting for the 3D morphology of the leaflets in three different ways. • Results were compared to Doppler-based AVA E measurements and vs. 2D planimetric AVA measurements, highlighting high feasibility and showing previously undescribed anatomical details. [ABSTRACT FROM AUTHOR]