Tatsuya Oki, Akitoshi Inoue, Y. Nagatani, Maya Oki, Yoshiyuki Watanabe
The thyroid gland is most frequently involved in immune-related adverse events (irAEs) by nivolumab. We reviewed the thyroid function and thyroid gland volume and volume change ratio between baseline and follow-up CT (volume follow-up/volume baseline) in 24 patients treated with nivolumab for lung cancer and renal cell carcinoma. Among them, four (16.7%) demonstrated nivolumab-induced thyroid dysfunction that shows either hypothyroidism or hyperthyroidism. Three and one cases were treated with nivolumab for lung cancer and renal cell carcinoma, respectively. Two patients with hypothyroidism (cases 1 and 2) showed reduced thyroid volume (volume change ratio: 0.80 and 0.84) on computed tomography (CT) images. Besides, remarkably diminished CT attenuation of the thyroid gland was observed in a patient with hypothyroidism (case 2). One of the two patients with hyperthyroidism showed increased thyroid volume (volume change ratio: 1.32) (case 3), whereas no difference in the thyroid gland volume was observed between the previous and follow-up CT in another patient with hyperthyroidism (case 4). Thyroid volume change ratio >0.1 was observed even in 6 of 20 (30%) patients without thyroid dysfunction. Considering the wide use of nivolumab in cancer treatment, radiologists should be aware that changes in the thyroid volume and attenuation on CT are associated with thyroid dysfunction caused by nivolumab, as well as thyroid volume may change even in patients with normal thyroid function during nivolumab therapy.
{"title":"Computed tomography imaging findings of nivolumab-induced thyroid dysfunction","authors":"Tatsuya Oki, Akitoshi Inoue, Y. Nagatani, Maya Oki, Yoshiyuki Watanabe","doi":"10.25259/JCIS_194_2021","DOIUrl":"https://doi.org/10.25259/JCIS_194_2021","url":null,"abstract":"The thyroid gland is most frequently involved in immune-related adverse events (irAEs) by nivolumab. We reviewed the thyroid function and thyroid gland volume and volume change ratio between baseline and follow-up CT (volume follow-up/volume baseline) in 24 patients treated with nivolumab for lung cancer and renal cell carcinoma. Among them, four (16.7%) demonstrated nivolumab-induced thyroid dysfunction that shows either hypothyroidism or hyperthyroidism. Three and one cases were treated with nivolumab for lung cancer and renal cell carcinoma, respectively. Two patients with hypothyroidism (cases 1 and 2) showed reduced thyroid volume (volume change ratio: 0.80 and 0.84) on computed tomography (CT) images. Besides, remarkably diminished CT attenuation of the thyroid gland was observed in a patient with hypothyroidism (case 2). One of the two patients with hyperthyroidism showed increased thyroid volume (volume change ratio: 1.32) (case 3), whereas no difference in the thyroid gland volume was observed between the previous and follow-up CT in another patient with hyperthyroidism (case 4). Thyroid volume change ratio >0.1 was observed even in 6 of 20 (30%) patients without thyroid dysfunction. Considering the wide use of nivolumab in cancer treatment, radiologists should be aware that changes in the thyroid volume and attenuation on CT are associated with thyroid dysfunction caused by nivolumab, as well as thyroid volume may change even in patients with normal thyroid function during nivolumab therapy.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"14 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82900807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kapoor, Tushar Kapoor, Aakaar Kapoor, Apurva Kapoor, R. Kapoor, Veronica Arora, Deepak Mehar
We report a rare case of isolated congenital absence of the bilateral femur diagnosed antenatally in an 18-19 weeks fetus on a level II scan. The bilateral femur bones were not visualized with normal bilateral tibia and fibula. The fetus was followed with a routine growth scan at 32-33 weeks along with a fetal MRI, which showed similar findings. The antenatal findings were confirmed clinically as well as with a postnatal follow-up X-Ray (infantogram) of the baby. Trio whole-exome sequencing was performed for the child as well as both the parents, which did not reveal any clinically significant variant that could explain the patient’s phenotype.
{"title":"Isolated congenital absence of bilateral femur: A rare case report with antenatal diagnosis and postnatal follow-up","authors":"A. Kapoor, Tushar Kapoor, Aakaar Kapoor, Apurva Kapoor, R. Kapoor, Veronica Arora, Deepak Mehar","doi":"10.25259/JCIS_219_2021","DOIUrl":"https://doi.org/10.25259/JCIS_219_2021","url":null,"abstract":"We report a rare case of isolated congenital absence of the bilateral femur diagnosed antenatally in an 18-19 weeks fetus on a level II scan. The bilateral femur bones were not visualized with normal bilateral tibia and fibula. The fetus was followed with a routine growth scan at 32-33 weeks along with a fetal MRI, which showed similar findings. The antenatal findings were confirmed clinically as well as with a postnatal follow-up X-Ray (infantogram) of the baby. Trio whole-exome sequencing was performed for the child as well as both the parents, which did not reveal any clinically significant variant that could explain the patient’s phenotype.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"32 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78894310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nguyen Thai Binh, T. Hoa, Lê Tuấn Linh, T. My, Phạm Quỳnh Anh, N. Duc
The performance of preoperative embolization on a spinal tumor can be a useful adjunctive procedure that minimizes blood loss and complications, particularly for both metastatic and non-metastatic hypervascular tumors. We discuss two cases of hypervascular spinal tumors that were successfully treated with preoperative embolization and surgery. The first patient was an 18-year-old man who presented with cervical and shoulder pain for two months without paralysis or weakness. Magnetic resonance imaging revealed a tumor located in the D2 posterior vertebral arch that extended into the spinal canal and compressed the spinal cord. The second patient was a 68-year-old man with back pain that radiated to the legs for ten days. Magnetic resonance imaging revealed a mass in the L4 vertebral body. Both patients received tumor embolization and surgery. After surgery, neither patient experienced any major complications. Histological examination revealed osteoblastoma in the first patient and plasmacytoma in the second patient.
{"title":"Preoperative embolization of hypervascular spinal tumors: Two case reports","authors":"Nguyen Thai Binh, T. Hoa, Lê Tuấn Linh, T. My, Phạm Quỳnh Anh, N. Duc","doi":"10.25259/JCIS_20_2022","DOIUrl":"https://doi.org/10.25259/JCIS_20_2022","url":null,"abstract":"The performance of preoperative embolization on a spinal tumor can be a useful adjunctive procedure that minimizes blood loss and complications, particularly for both metastatic and non-metastatic hypervascular tumors. We discuss two cases of hypervascular spinal tumors that were successfully treated with preoperative embolization and surgery. The first patient was an 18-year-old man who presented with cervical and shoulder pain for two months without paralysis or weakness. Magnetic resonance imaging revealed a tumor located in the D2 posterior vertebral arch that extended into the spinal canal and compressed the spinal cord. The second patient was a 68-year-old man with back pain that radiated to the legs for ten days. Magnetic resonance imaging revealed a mass in the L4 vertebral body. Both patients received tumor embolization and surgery. After surgery, neither patient experienced any major complications. Histological examination revealed osteoblastoma in the first patient and plasmacytoma in the second patient.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"231 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86199065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Pai, Joanna Pearly Ti, L. Tan, Thye Sin Ho, C. Tham, Y. Sitoh
In acute ischemic stroke (AIS), large vessel occlusion (LVO) and the status of pial collaterals are important factors in decision-making for further treatment such as endovascular therapy. Multiphasic CT Angiogram (mCTA) is the mainstay of AIS imaging, allowing detection of LVO, evaluation of intracranial arterial dynamics, and quantification of pial collaterals. However, thorough mCTA evaluation entails scrutiny of multiple image datasets, individually and then simultaneously, which can be time-consuming, causing a potential delay in treatment. ColorViz (FastStroke, GE Healthcare, Milwaukee, Wisconsin) is a novel CT application which combines mCTA information into a single color-coded dataset for quick, unequivocal evaluation of pial collaterals. In our practice, ColorViz is both time-saving and increases the diagnostic accuracy of LVO and pial collaterals as well as medium vessel, multivessel and posterior circulation occlusions. In this article, we discuss the practical aspects of ColorViz in patients presenting with AIS.
在急性缺血性脑卒中(AIS)中，大血管闭塞(LVO)和顶侧络的状况是决定是否进行血管内治疗等进一步治疗的重要因素。多相CT血管造影(mCTA)是AIS成像的主要手段，可以检测LVO，评估颅内动脉动力学，量化颅底侧支。然而，彻底的mCTA评估需要对多个图像数据集进行单独和同时的审查，这可能会耗费大量时间，导致潜在的治疗延迟。ColorViz (FastStroke, GE Healthcare, Milwaukee, Wisconsin)是一种新型的CT应用程序，它将mCTA信息合并到一个单一颜色编码的数据集中，用于快速，明确地评估抵押品。在我们的实践中，ColorViz既节省了时间，又提高了LVO和头侧支以及中血管、多血管和后循环闭塞的诊断准确性。在这篇文章中，我们讨论了ColorViz在AIS患者中的实际应用。
{"title":"Practice enhancements with FastStroke ColorViz analysis in acute ischemic stroke","authors":"V. Pai, Joanna Pearly Ti, L. Tan, Thye Sin Ho, C. Tham, Y. Sitoh","doi":"10.25259/JCIS_30_2022","DOIUrl":"https://doi.org/10.25259/JCIS_30_2022","url":null,"abstract":"In acute ischemic stroke (AIS), large vessel occlusion (LVO) and the status of pial collaterals are important factors in decision-making for further treatment such as endovascular therapy. Multiphasic CT Angiogram (mCTA) is the mainstay of AIS imaging, allowing detection of LVO, evaluation of intracranial arterial dynamics, and quantification of pial collaterals. However, thorough mCTA evaluation entails scrutiny of multiple image datasets, individually and then simultaneously, which can be time-consuming, causing a potential delay in treatment. ColorViz (FastStroke, GE Healthcare, Milwaukee, Wisconsin) is a novel CT application which combines mCTA information into a single color-coded dataset for quick, unequivocal evaluation of pial collaterals. In our practice, ColorViz is both time-saving and increases the diagnostic accuracy of LVO and pial collaterals as well as medium vessel, multivessel and posterior circulation occlusions. In this article, we discuss the practical aspects of ColorViz in patients presenting with AIS.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"4 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90335431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives This study aimed to find out the association of CT severity score with demographic and clinical characteristics as well as mortality in the patients who were confirmed to have COVID-19 disease in the second wave. Material and Methods This retrospective study included collection and assessment of the demographic, clinical, laboratory data, and mortality of the patients, suspected with COVID-19 infection who underwent chest HRCT scan during March to April 2021. The findings of the chest HRCT were retrieved manually from the Medical Records section. Determination of the severity was done by the scoring system that involved the visual evaluation of the affected lobes. Results CT severity score was mild, moderate, and severe in 21.94%, 41.60%, and 30.48% patients, respectively. Mortality rate was 5.70%. Age of the patients with mild, moderate, and severe CT severity score was significantly more than those with normal severity score (50 vs. 50 vs. 50 vs. 31, P=0.0009). When compared to patients with normal score, those with mild, moderate, and severe CT severity score had significantly higher dyspnoea (10.39% vs. 67.81% vs. 97.20% vs. 0%), significantly more cases with diabetes mellitus (16.88% vs. 25.34% vs. 31.78% vs. 9.52%, P=0.044), hypertension (27.27% vs. 21.23% vs. 32.71% vs. 4.76%, P=0.026), and obesity (6.49% vs. 8.90% vs. 23.36% vs. 0%, P=0.0005). Total leucocyte counts, absolute neutrophil counts, creatinine, serum glutamic pyruvic transaminase (SGPT), lactate dehydrogenase (LDH), ferritin, and D-dimer were deranged in significantly more patients of severe score (53.27%, 62.62%, 60.75%, 85.05%, 90.65%, 97.20%, and 95.35%, respectively). Interleukin-6 (IL-6) and C-reactive protein were deranged in significantly more patients with moderate disease (98.18% and 98.63%, respectively). Increasing severity scores were associated with increased mortality (mild vs. moderate vs. severe: 1.30% vs. 1.37 vs. 15.89%, P<.0001). Oxygen saturation (SpO2) was significantly lowest in severe score followed by moderate, mild and normal scores (87 vs. 90 vs. 96 vs. 97, P<.0001). Duration of non-rebreather mask (NRBM), noninvasive ventilation (NIV), high-flow nasal cannula (HFNC), Venture/face mask, and intubation was also associated with increasing severity scores (P<0.0001). Conclusion CT scans play an important role in guiding physicians with their management plans and can serve as a predictor of disease severity and outcomes.
目的探讨第二波新冠肺炎确诊患者CT严重程度评分与人口学特征、临床特征及死亡率的相关性。材料与方法本回顾性研究包括收集和评估2021年3月至4月期间接受胸部HRCT扫描的疑似COVID-19感染患者的人口学、临床、实验室数据和死亡率。胸部HRCT的结果是手动从“医疗记录”部分检索的。严重程度的确定是通过评分系统完成的，该评分系统包括对受影响的脑叶的视觉评估。结果CT严重程度评分为轻度的占21.94%，中度的占41.60%，重度的占30.48%。死亡率5.70%。轻、中、重度CT严重程度评分患者的年龄明显大于正常严重程度评分患者(50 vs. 50 vs. 50 vs. 31, P=0.0009)。与正常评分的患者相比，轻、中、重度CT严重程度评分的患者呼吸困难明显增加(10.39% vs. 67.81% vs. 97.20% vs. 0%)，糖尿病(16.88% vs. 25.34% vs. 31.78% vs. 9.52%， P=0.044)、高血压(27.27% vs. 21.23% vs. 32.71% vs. 4.76%， P=0.026)、肥胖(6.49% vs. 8.90% vs. 23.36% vs. 0%， P=0.0005)发生率明显增加。白细胞总计数、绝对中性粒细胞计数、肌酐、血清谷丙转氨酶(SGPT)、乳酸脱氢酶(LDH)、铁蛋白和d -二聚体紊乱在重度患者中显著高于对照组(分别为53.27%、62.62%、60.75%、85.05%、90.65%、97.20%和95.35%)。白介素-6 (IL-6)和c反应蛋白紊乱在中度疾病患者中显著增加(分别为98.18%和98.63%)。加重评分与死亡率增加相关(轻度、中度、重度:1.30%、1.37、15.89%，P< 0.0001)。重度评分的血氧饱和度(SpO2)最低，其次是中度、轻度和正常评分(87 vs. 90 vs. 96 vs. 97, P< 0.0001)。非呼吸面罩(NRBM)、无创通气(NIV)、高流量鼻插管(HFNC)、Venture/面罩和插管的持续时间也与严重程度评分增加相关(P<0.0001)。结论CT扫描对指导医生制定治疗方案具有重要作用，可作为疾病严重程度和预后的预测指标。
{"title":"A retrospective study of association of CT severity with clinical profile and outcomes of patients with COVID-19 in the second wave","authors":"Neema Agarwal, P. Jain, T. Khan, A. Raja","doi":"10.25259/JCIS_11_2022","DOIUrl":"https://doi.org/10.25259/JCIS_11_2022","url":null,"abstract":"Objectives This study aimed to find out the association of CT severity score with demographic and clinical characteristics as well as mortality in the patients who were confirmed to have COVID-19 disease in the second wave. Material and Methods This retrospective study included collection and assessment of the demographic, clinical, laboratory data, and mortality of the patients, suspected with COVID-19 infection who underwent chest HRCT scan during March to April 2021. The findings of the chest HRCT were retrieved manually from the Medical Records section. Determination of the severity was done by the scoring system that involved the visual evaluation of the affected lobes. Results CT severity score was mild, moderate, and severe in 21.94%, 41.60%, and 30.48% patients, respectively. Mortality rate was 5.70%. Age of the patients with mild, moderate, and severe CT severity score was significantly more than those with normal severity score (50 vs. 50 vs. 50 vs. 31, P=0.0009). When compared to patients with normal score, those with mild, moderate, and severe CT severity score had significantly higher dyspnoea (10.39% vs. 67.81% vs. 97.20% vs. 0%), significantly more cases with diabetes mellitus (16.88% vs. 25.34% vs. 31.78% vs. 9.52%, P=0.044), hypertension (27.27% vs. 21.23% vs. 32.71% vs. 4.76%, P=0.026), and obesity (6.49% vs. 8.90% vs. 23.36% vs. 0%, P=0.0005). Total leucocyte counts, absolute neutrophil counts, creatinine, serum glutamic pyruvic transaminase (SGPT), lactate dehydrogenase (LDH), ferritin, and D-dimer were deranged in significantly more patients of severe score (53.27%, 62.62%, 60.75%, 85.05%, 90.65%, 97.20%, and 95.35%, respectively). Interleukin-6 (IL-6) and C-reactive protein were deranged in significantly more patients with moderate disease (98.18% and 98.63%, respectively). Increasing severity scores were associated with increased mortality (mild vs. moderate vs. severe: 1.30% vs. 1.37 vs. 15.89%, P<.0001). Oxygen saturation (SpO2) was significantly lowest in severe score followed by moderate, mild and normal scores (87 vs. 90 vs. 96 vs. 97, P<.0001). Duration of non-rebreather mask (NRBM), noninvasive ventilation (NIV), high-flow nasal cannula (HFNC), Venture/face mask, and intubation was also associated with increasing severity scores (P<0.0001). Conclusion CT scans play an important role in guiding physicians with their management plans and can serve as a predictor of disease severity and outcomes.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"95 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76858803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan Mercer, Madison R. Kocher, N. Shaheen, Brian Flemming, Jeffrey Waltz
Following low anterior resection (LAR) of the colon, an image-guided assessment of the anastomosis for leak is typically performed using an enema via a rectal catheter, whether by CT or fluoroscopy. However, there is potential for poor assessment due to inappropriate catheter positioning as well as potential risk that the anastomosis becomes compromised by the balloon inflation. This article discusses the adaptation of a novel double-balloon catheter (originally designed by a member of our institution for use in pediatric intussusception reduction) for assessment of low rectal anastomoses. The goal of this technical note is to demonstrate our experience with this catheter, primarily through example cases, and explain its potential for optimizing colon distension, minimizing improper catheter placement, and potentially reducing the risk of iatrogenic anastomosis disruption.
{"title":"A novel dual balloon rectal catheter for use in the postoperative assessment of low rectal anastomoses following low anterior resection","authors":"Megan Mercer, Madison R. Kocher, N. Shaheen, Brian Flemming, Jeffrey Waltz","doi":"10.25259/JCIS_220_2021","DOIUrl":"https://doi.org/10.25259/JCIS_220_2021","url":null,"abstract":"Following low anterior resection (LAR) of the colon, an image-guided assessment of the anastomosis for leak is typically performed using an enema via a rectal catheter, whether by CT or fluoroscopy. However, there is potential for poor assessment due to inappropriate catheter positioning as well as potential risk that the anastomosis becomes compromised by the balloon inflation. This article discusses the adaptation of a novel double-balloon catheter (originally designed by a member of our institution for use in pediatric intussusception reduction) for assessment of low rectal anastomoses. The goal of this technical note is to demonstrate our experience with this catheter, primarily through example cases, and explain its potential for optimizing colon distension, minimizing improper catheter placement, and potentially reducing the risk of iatrogenic anastomosis disruption.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"136 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90063614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esophageal dissection is a rare condition, characterized by disruption of the submucosa from the muscular layer of the esophageal wall. It is commonly iatrogenic in etiology and patients typically present with acute onset dysphagia, odynophagia, and retrosternal pain. The condition can be diagnosed endoscopically; however, contrast swallow studies either with CT or fluoroscopy carry less risk and are the imaging investigations of choice for this condition. Patients are managed conservatively in the majority of cases. In this case report, we present a case of chronic esophageal dissection in a 15-year-old male who had undergone endoscopic removal of a foreign body from the esophagus several years prior. We discuss the clinical features, radiological diagnosis, and management of this condition.
{"title":"Chronic esophageal dissection: Delayed diagnosis in a 15-year-old male","authors":"N. Vakharia, U. N. Sirisena, U. Mandalia","doi":"10.25259/JCIS_3_2022","DOIUrl":"https://doi.org/10.25259/JCIS_3_2022","url":null,"abstract":"Esophageal dissection is a rare condition, characterized by disruption of the submucosa from the muscular layer of the esophageal wall. It is commonly iatrogenic in etiology and patients typically present with acute onset dysphagia, odynophagia, and retrosternal pain. The condition can be diagnosed endoscopically; however, contrast swallow studies either with CT or fluoroscopy carry less risk and are the imaging investigations of choice for this condition. Patients are managed conservatively in the majority of cases. In this case report, we present a case of chronic esophageal dissection in a 15-year-old male who had undergone endoscopic removal of a foreign body from the esophagus several years prior. We discuss the clinical features, radiological diagnosis, and management of this condition.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"69 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76933042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives (1) To calculate the sensitivity and specificity of the Hounsfield Unit (HU), the HU to hematocrit (H:H) ratio, and the D-dimer level in the diagnosis of acute CVST. (2) To assess the D-dimer level’s linear relationship with the HU and the H:H ratio. Materials and Methods A single-center retrospective case-control study was conducted from 2005 to 2020. The inclusion criteria for the thrombosed and control groups were specified. A region of interest (ROI) was plotted on the respective sinuses to calculate the HU. The H:H ratio was calculated by dividing the HU value by the hematocrit value. The receiver operating characteristic curve was used to calculate the sensitivity and specificity of the HU and the H:H ratio at different cutoff values. The Pearson correlation was used to assess the linear relationship between the D-dimer level and the HU and H:H ratio. Results There were 19 patients in the thrombosed group and 28 patients in the control group. There were significant differences in the mean HU (71 ± 6.3 vs. 45 ± 4.8, P < 0.001) and the mean H:H ratio (2.11 ± 0.38 vs. 1.46 ± 0.63,P < 0.001). An optimal HU value of 56 yielded 100% sensitivity and specificity. An H:H value of 1.48 yielded a sensitivity of 100% and a specificity of 65%, an H:H ratio of 1.77 demonstrated a sensitivity of 85% and a specificity of 90%, and an H:H ratio of 1.88 yielded a sensitivity of 79% and a specificity of 93%. D-dimer levels had a 95% and 71% sensitivity and specificity, respectively. There was a significant moderately positive linear correlation between the D-dimer level and the HU (r = 0.52, P < 0.001) and the H:H ratio (r = 0.61, P < 0.001). Conclusion Unenhanced CT of the brain can be a valuable objective diagnostic tool for acute CVST diagnosis. Hounsfield blood density and its normalized ratio with hematocrit are positively correlated with D-dimer levels, which may indicate active blood coagulation in a cerebral venous sinus.
目的(1)计算Hounsfield Unit (HU)、HU / hematocrit (H:H)比值、d -二聚体水平对急性CVST诊断的敏感性和特异性。(2)评价d -二聚体水平与HU和H:H比的线性关系。材料与方法2005 - 2020年采用单中心回顾性病例对照研究。明确了血栓形成组和对照组的纳入标准。在各自的鼻窦上绘制感兴趣区域(ROI)以计算HU。H:H比值由HU值除以红细胞压积值计算。采用受试者工作特征曲线计算不同截止值下HU和H:H比的灵敏度和特异性。采用Pearson相关性评估d -二聚体水平与HU和H:H比值之间的线性关系。结果血栓形成组19例，对照组28例。平均HU(71±6.3比45±4.8,P < 0.001)和平均H:H比(2.11±0.38比1.46±0.63,P < 0.001)差异有统计学意义。最佳HU值为56，灵敏度和特异性均为100%。当H:H值为1.48时，敏感性为100%，特异性为65%;当H:H值为1.77时，敏感性为85%，特异性为90%;当H:H值为1.88时，敏感性为79%，特异性为93%。d -二聚体水平的敏感性和特异性分别为95%和71%。d -二聚体水平与HU (r = 0.52, P < 0.001)和H:H比(r = 0.61, P < 0.001)呈显著的中正线性相关。结论CT对急性CVST的诊断是一种有价值的客观诊断工具。Hounsfield血密度及其与红细胞压积的归一化比值与d -二聚体水平呈正相关，可能提示脑静脉窦血凝活动。
{"title":"The diagnostic utility of unenhanced computed tomography of the brain and D-dimer levels in acute cerebral venous sinus thrombosis: A quantitative study","authors":"Omar A. Alharbi, K. Alahmadi","doi":"10.25259/JCIS_76_2021","DOIUrl":"https://doi.org/10.25259/JCIS_76_2021","url":null,"abstract":"Objectives (1) To calculate the sensitivity and specificity of the Hounsfield Unit (HU), the HU to hematocrit (H:H) ratio, and the D-dimer level in the diagnosis of acute CVST. (2) To assess the D-dimer level’s linear relationship with the HU and the H:H ratio. Materials and Methods A single-center retrospective case-control study was conducted from 2005 to 2020. The inclusion criteria for the thrombosed and control groups were specified. A region of interest (ROI) was plotted on the respective sinuses to calculate the HU. The H:H ratio was calculated by dividing the HU value by the hematocrit value. The receiver operating characteristic curve was used to calculate the sensitivity and specificity of the HU and the H:H ratio at different cutoff values. The Pearson correlation was used to assess the linear relationship between the D-dimer level and the HU and H:H ratio. Results There were 19 patients in the thrombosed group and 28 patients in the control group. There were significant differences in the mean HU (71 ± 6.3 vs. 45 ± 4.8, P < 0.001) and the mean H:H ratio (2.11 ± 0.38 vs. 1.46 ± 0.63,P < 0.001). An optimal HU value of 56 yielded 100% sensitivity and specificity. An H:H value of 1.48 yielded a sensitivity of 100% and a specificity of 65%, an H:H ratio of 1.77 demonstrated a sensitivity of 85% and a specificity of 90%, and an H:H ratio of 1.88 yielded a sensitivity of 79% and a specificity of 93%. D-dimer levels had a 95% and 71% sensitivity and specificity, respectively. There was a significant moderately positive linear correlation between the D-dimer level and the HU (r = 0.52, P < 0.001) and the H:H ratio (r = 0.61, P < 0.001). Conclusion Unenhanced CT of the brain can be a valuable objective diagnostic tool for acute CVST diagnosis. Hounsfield blood density and its normalized ratio with hematocrit are positively correlated with D-dimer levels, which may indicate active blood coagulation in a cerebral venous sinus.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":" 11","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72383212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Salivary lymphadenoma is an extremely rare neoplasm that is usually seen in the older patient population, arising sporadically on one side and almost exclusive to the parotid gland. Imaging and pathology findings can mimic both benign and malignant tumors, and therefore, this lesion may be misdiagnosed if not on the differential diagnosis. This article reviews the clinical presentation, as well as the pathology and imaging findings of salivary lymphadenoma in the setting of Sjogren’s syndrome.
{"title":"Parotid sebaceous lymphadenoma associated with Sjogren’s syndrome: Review of pathologic and radiologic characteristics and clinical presentation","authors":"J. Janus, Obaie Mzaik, A. Bhatt","doi":"10.25259/JCIS_14_2022","DOIUrl":"https://doi.org/10.25259/JCIS_14_2022","url":null,"abstract":"Salivary lymphadenoma is an extremely rare neoplasm that is usually seen in the older patient population, arising sporadically on one side and almost exclusive to the parotid gland. Imaging and pathology findings can mimic both benign and malignant tumors, and therefore, this lesion may be misdiagnosed if not on the differential diagnosis. This article reviews the clinical presentation, as well as the pathology and imaging findings of salivary lymphadenoma in the setting of Sjogren’s syndrome.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"44 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80709146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sir William Osler coined the term “mycotic” to identify aneurysms secondary to an infectious cause, which may not be necessarily fungal and are caused mainly by bacteria. The literature’s reported incidence of coronary artery aneurysms (CAA) is from 1.5-5%. The right coronary artery (RCA) is mainly involved, followed by the left side coronary circulation. Mycotic aneurysms are more commonly associated with infective endocarditis. More recently, coronary artery stents, particularly drug-eluting stents, are typically causing mycotic coronary aneurysms. CT angiography (CTA) has been the forefront diagnostic modality, showing both the lumen and wall of the coronary arteries. It also aids in preoperative planning. MRI is useful in diagnosing and following children with Kawasaki’s disease. Smaller mycotic coronary aneurysms may resolve with antibiotic therapy; however, aneurysms more significant than 1-2 cm diameter needs corrective surgery. Early diagnosis and appropriate management are the critical factors in the successful treatment of infective coronary artery aneurysms.
{"title":"Mycotic and non-mycotic coronary artery aneurysms—A review of the rarity","authors":"Vishal Kukkar, H. Kapoor, A. Aggarwal","doi":"10.25259/JCIS_218_2021","DOIUrl":"https://doi.org/10.25259/JCIS_218_2021","url":null,"abstract":"Sir William Osler coined the term “mycotic” to identify aneurysms secondary to an infectious cause, which may not be necessarily fungal and are caused mainly by bacteria. The literature’s reported incidence of coronary artery aneurysms (CAA) is from 1.5-5%. The right coronary artery (RCA) is mainly involved, followed by the left side coronary circulation. Mycotic aneurysms are more commonly associated with infective endocarditis. More recently, coronary artery stents, particularly drug-eluting stents, are typically causing mycotic coronary aneurysms. CT angiography (CTA) has been the forefront diagnostic modality, showing both the lumen and wall of the coronary arteries. It also aids in preoperative planning. MRI is useful in diagnosing and following children with Kawasaki’s disease. Smaller mycotic coronary aneurysms may resolve with antibiotic therapy; however, aneurysms more significant than 1-2 cm diameter needs corrective surgery. Early diagnosis and appropriate management are the critical factors in the successful treatment of infective coronary artery aneurysms.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"96 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75916658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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