Journal of Clinical Imaging Science最新文献

Objectives: Cardiac computed tomography (CCT) plays a key role in diagnosing congenital heart disease (CHD), emphasizing the need for specialized protocols in newborns due to CHD's complexity. The aim is to explore the relationship between peak enhancement time (PET) and various parameters during CHD assessment with CCT.

Material and methods: The study involved 38 CHD patients undergoing CCT, with observations made on their heart rate, respiratory rate, saturation, cardiac output, weight, height, and age. The PET for each case was determined, and Spearman's rank correlation was employed to evaluate the association between these parameters and the PET.

Results: The median PET was 20.63 s, with a mean aortic Hounsfield unit of 512.16 ± 160.56. A moderate negative correlation was found between PET and both heart rates (r = -0.42, P = 0.009) and respiratory rates (r = -0.41, P = 0.01), whereas a negligible positive correlation (r = 0.19, P = 0.25) was observed with SpO2. A moderate positive correlation was noted between PET and both weight (r = 0.44, P = 0.005) and height (r = 0.40, P = 0.01). In addition, there were significant differences in median PET across different age categories.

Conclusion: The findings conclude that PET during CCT is significantly associated with heart rate and respiratory rate. An increase in these rates corresponds to a notable decrease in PET. Consequently, the study recommends minimizing scan delays in CCT for patients exhibiting higher heart rates.

The realm of precision medicine, particularly its application within various sectors, shines notably in neuroradiology, where it leverages the advancements of three-dimensional (3D) printing technology. This synergy has significantly enhanced surgical planning, fostered the creation of tailor-made medical apparatus, bolstered medical pedagogy, and refined targeted therapeutic delivery. This review delves into the contemporary advancements and applications of 3D printing in neuroradiology, underscoring its pivotal role in refining surgical strategies, augmenting patient outcomes, and diminishing procedural risks. It further articulates the utility of 3D-printed anatomical models for enriched comprehension, simulation, and educational endeavors. In addition, it illuminates the horizon of bespoke medical devices and prosthetics, illustrating their utility in addressing specific cranial and spinal anomalies. This narrative extends to scrutinize how 3D printing underpins precision medicine by offering customized drug delivery mechanisms and therapies tailored to the patient's unique medical blueprint. It navigates through the inherent challenges of 3D printing, including the financial implications, the need for procedural standardization, and the assurance of quality. Prospective trajectories and burgeoning avenues, such as material and technological innovations, the confluence with artificial intelligence, and the broadening scope of 3D printing in neurosurgical applications, are explored. Despite existing hurdles, the fusion of 3D printing with neuroradiology heralds a transformative era in precision medicine, poised to elevate patient care standards and pioneer novel surgical paradigms.

Desmoplastic fibroma (DF) is an uncommon benign bone tumor that typically affects the facial bones, with cerebral cranium involvement being extremely rare. We report a unique case of DF in the parietal bone of a 28-year-old woman, notable for its rapid growth during pregnancy-a phenomenon not previously documented. The imaging features of this case also differ from all but one previously reported case. The patient underwent surgical removal, and histopathology confirmed the diagnosis of DF (collagenous fibroma). After 17 months of follow-up, no local recurrence was observed. We also provide a comprehensive review of 32 cases involving DF of the cerebral cranium, analyzing clinical features, imaging findings, treatment methods, and recurrence patterns. This case highlights the importance of considering DF in the differential diagnosis of cranial lesions, particularly in pregnant patients with rapid tumor growth. Complete surgical resection with a wide margin remains the recommended treatment to minimize recurrence risk.

Dual left anterior descending (LAD) coronary artery is a rare anatomical variant with significant clinical implications. Recognizing this variant is crucial for accurate diagnosis and effective management, particularly in the context of revascularization strategies. We present a 71-year-old male with a history of dyspnea on exertion with baseline wall motion abnormality on a transthoracic stress echocardiography irreversible after exercise. Coronary computed tomography angiography revealed a dual LAD system: The left short LAD (LAD1) originating from the left main coronary artery and the right LAD (LAD2) arising separately from the right coronary cusp, distinct from the right coronary artery ostium. Having different origins and courses, both LADs supply the LAD territory. Our case is notable for two main reasons: The rarity of this particular type of dual LAD anatomy and the unique course of the LAD2, which, to our knowledge, has not been described in any previous case report. Although rare, dual LAD coronary artery should be considered in patients with atypical short LAD. Comprehensive imaging and a thorough understanding of coronary artery variants are essential for accurate diagnosis and effective management.

Objective: The objective of this study was to evaluate complete contrast staining (CCS) of HCC during drug-eluting bead transarterial chemoembolization (DEBTACE) first session for response prediction.

Methods: Forty-one patients with solitary HCC who underwent DEBTACE were retrospectively enrolled and divided into two groups based on contrast staining of HCC using two-dimensional (2D) fluoroscopy during the first session of DEBTACE. Both groups underwent one or two sessions of DEBTACE to achieve a complete response. Responses were evaluated using the modified Response Evaluation Criteria in Solid Tumors. A comparison of the complete response between the CCS and non-CCS groups was performed, and the prediction value was studied.

Results: CCS in 2D fluoroscopy during the first session of drug-eluting bead chemoembolization was observed in 22 (53.7%) patients. Well-defined HCC and super-selective chemoembolization were significantly associated with CCS. Complete response was observed in 54.54%, 90%, and 95.45% of CCS patient groups after the first session, second session, and cumulative sessions of TACE, respectively. Complete responses were 10.52%, 29.41%, and 36.84% in the non-CCS group after the first, second, and cumulative sessions of TACE, respectively.

Conclusion: CCS of HCC using 2D fluoroscopy during DEBTACE is a predictor of a favorable response after two sessions of treatment.

Objectives: The objective of this study was to determine how often myocardial infarctions are retrospectively visible on conventional, non-gated, non-cardiac computed tomography (CT) scans. Our goal was to evaluate a cohort of patients with myocardial infarctions visible on cardiac magnetic resonance imaging (MRI) to determine how often the area of infarction was retrospectively visible by preceding, conventional CT. We also sought to evaluate how often the diagnosis of myocardial infarction was reported at the time of initial study review.

Material and methods: The Institutional Review Board approval was obtained for the creation and retrospective analysis of a database of patients undergoing cardiac MRI. We started with a cohort of 252 patients who had undergone cardiac MRI at our institution, over a 4-year period. We identified 160 patients who had a myocardial infarct visible on MRI.

Results: Of the 160 patients who had been identified as having an infarct on cardiac MRI, 54 patients had undergone a recent (within 30 days) conventional CT scan, usually done for non-cardiac indications. In addition to the review of reports, non-cardiac CT scans were also evaluated retrospectively by two experienced, cardiothoracic imaging physicians, including a radiologist and a cardiologist. In 26 of these patients (48.1%), an infarct was visible on the CT images. In 12 of these 26 cases (46.1%), the infarct was noted in the initial report. In the remaining 14 of these 26 cases (53.8%), the infarct was unrecognized at the time of initial study interpretation.

Conclusion: Our retrospective analysis demonstrates that myocardial infarctions may be frequently observed on non-gated, non-cardiac CT scans but may be underrecognized and under-reported.

Objectives: The study aimed to evaluate the relationship between maxillary sinus volume and various sinonasal anatomical variants, as detected by multi-detector computed tomography, and their associations with chronic rhinosinusitis (CRS).

Material and methods: A case-control study was conducted with 103 patients presenting with chronic sinonasal symptoms (cases) and 50 asymptomatic individuals (controls). A 128-slice computed tomography scanner was used to measure maxillary sinus volume and assess anatomical variants, such as a deviated nasal septum (DNS), concha bullosa (CB), and agger nasi cells. Exclusion criteria included previous sinonasal surgery, malignancy, craniofacial trauma, and lack of consent. Statistical analysis was performed using t-tests for continuous variables and Chi-square tests for categorical data. Receiver operating characteristic curve analysis was utilized to determine a DNS angle cutoff for predicting CRS.

Results: Anatomical variants were significantly more frequent in cases than in controls. The left-sided DNS was predominant in cases, while the right-sided DNS was more common in controls. The mean DNS deviation angle was notably larger in cases (10.84° ± 7.87) than in controls (5.55° ± 5.02). Maxillary sinus volume was significantly smaller in cases (9.69 cc on the left side and 10.23 cc on the right side) compared to controls (18.57 cc and 18.46 cc, respectively), with female patients exhibiting smaller volumes than males. Agger nasi cells were detected in 51.5% of cases versus 8.0% of controls. A strong association was found between CB and contralateral DNS. The optimal DNS deviation angle cutoff for predicting CRS was identified as 12.7°.

Conclusion: This study shows that CRS is linked to smaller maxillary sinus volumes, with males having larger sinus volumes than females. A DNS and larger deviation angles were associated with a higher risk of sinus inflammation, with angles over 12.7° predicting the onset of the condition. The presence of CB and agger nasi cells also contributed to the development of CRS.

Pulmonary sequestration is a malformation of lung tissue such that a zone of pulmonary parenchyma exists in isolation from the bronchopulmonary tree. This condition is typically treated with surgical resection, but an increasing number of sequestrations are being treated with arterial embolization. We report interventions that were performed at two institutions on patients 53-70 years old. One patient presented with chronic cough and the two other patients presented with hemoptysis. Two of the cases were managed solely by endovascular embolization of the arteries supplying the pulmonary sequestration. In one patient, embolization was performed to debulk the sequestration, followed by surgical resection. These cases suggest transcatheter embolization may be an effective treatment in adult patients with symptomatic pulmonary sequestrations.

Portal vein (PV) anomalies are rare during embryonic development, with very few cases of duplicated PVs reported. This case reveals a new PV trunk anomaly, where computed tomography venography imaging shows three portal veins. The superior mesenteric vein and inferior mesenteric vein join to form a trunk that divides into two branches: One entering the liver (PV1) and the other ascending to join the splenic vein. The splenic vein then divides into two branches in the neck of the pancreas (PV2 and PV3), both entering the liver. The three PVs vary in thickness and all enter the liver through the first hepatic portal. Understanding the normal structure and anatomy of the PV is important for successful surgical planning. This case involves three main trunks of the PV, which is an extremely rare type of PV duplication anomaly. Reporting this case aims to enhance the awareness and understanding of PV duplication anomalies among clinicians and radiologists.

Granulomatous prostatitis (GP) is a rare form of chronic prostatitis with reported incidence of 0.65-1.5%. Radiological features of GP overlap with those of prostate adenocarcinoma. The following magnetic resonance imaging characteristics can suggest the diagnosis in an appropriate clinical setting: Diffuse or focal nodular low T2 signal, high signal on diffusion-weighted imaging with corresponding low apparent diffusion coefficient signal, and post-contrast imaging with lesion enhancement or rim-enhancing in the setting of caseous necrosis or abscess formation. Even with suspicion on imaging, the overlapping imaging features with prostate adenocarcinoma necessitate biopsy for confirmatory diagnosis. Here, we report a case of a 70-year-old man with GP in the setting of prior intravesicle bacillus Calmette-Guérin administration.