Journal of Clinical Imaging Science最新文献

Objectives: We aim to investigate the predictive value of [^99mTc] pertechnetate thyroid scintigraphy in determining the permanence of congenital hypothyroidism (CH).

Material and methods: A retrospective analysis of [^99mTc] pertechnetate thyroid scans performed for evaluation of CH at the Nuclear Medicine Unit of a hospital in Hong Kong between January 1, 2008, and December 31, 2018, was conducted. Scintigraphic findings and parameters at diagnosis, including thyroid stimulating hormone (TSH), free thyroxine (fT4), gender, and gestational age, were reviewed. The need for lifelong thyroxine replacement therapy was reviewed.

Results: The study included 85 subjects, with 74 (87.1%) presenting with eutopic thyroid and 11 (12.9%) showing thyroid dysgenesis. Patients with scintigraphic evidence of thyroid dysgenesis required permanent thyroid hormone replacement therapy. Among the patients with eutopic thyroid, a higher TSH level was associated with the need for lifelong thyroid hormone replacement therapy (cutoff TSH value 18.72 mIU/L, sensitivity 77.3% and specificity 53.8%). Gender, gestational age, and fT4 did not show significant differences between the transient and permanent CH groups in patients with eutopic thyroid.

Conclusion: Scintigraphic findings of thyroid dysgenesis indicate a high prevalence of permanent CH. In patients with eutopic thyroid, higher TSH levels predict the requirement for lifelong thyroid hormone replacement therapy. These results provide insights into the prediction of CH and aid in individualized treatment decisions for patients with CH.

Objectives: The objective of this study was to evaluate the relationship between the aortomesenteric angle at end-inspiration and end-expiration and its variation rate with several anthropometric parameters.

Material and methods: Sagittal reconstructed computed tomography (CT) images of 59 patients who underwent contrast-enhanced CT at end-inspiration and end-expiration between 2015 and 2020 were reviewed. All these patients underwent dynamic contrast CT during both inspiration and expiration for adrenal venous sampling purposes. Two experienced radiologists measured the aortomesenteric angle during both end-inspiration and end-expiration, and its variation rate. Pearson's or Spearman's correlation analysis was used to assess correlations between the angle or variation rate and height, weight, body mass index (BMI), visceral fat, subcutaneous fat, and diaphragm motion.

Results: The aortomesenteric angle was significantly larger at end-expiration (88.65 ± 25.15, 95% confidence interval [CI] 82.09-95.20) compared to end-inspiration (62.22 ± 21.90, 95% CI 56.51-67.93, P < 0.001). The aortomesenteric angles at both end-inspiration and end-expiration correlated significantly with weight, BMI, visceral fat, and subcutaneous fat. The strongest correlation was between aortomesenteric angle and visceral fat at both end-inspiration (r = 0.523, P < 0.001) and end-expiration (r = 0.546, P < 0.001). The variation rate correlated only with diaphragm motion (r = 0.550, P < 0.001).

Conclusion: The aortomesenteric angle at end-expiration was significantly larger than at end-inspiration, with the strongest correlation found between the angle and visceral fat.

Coronary artery ectasia (CAE) is defined as a dilation exceeding 1.5 times the diameter of an adjacent normal artery, predominantly affecting males. Myocardial bridging (MB) is a condition in which the coronary artery runs intramurally within myocardial tissue. Coronary computed tomography angiography (CCTA) offers high-resolution imaging, facilitating accurate diagnosis of these conditions. This report presents the first documented case of a 78-year-old female with CAE and superficial MB coexisting in the same segment of the left anterior descending artery that was detected incidentally by CCTA.

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.