Gastric leak following sleeve gastrectomy (SG) is a rare but significant cause of morbidity and mortality. A high clinical index of suspicion is the most sensitive approach to detect gastric leaks. Computed tomography (CT) is the gold standard diagnostic technique, although it might not be performed due to unavailability, and the inability to image superobese patients due to limited CT gantry space. Early detection and management are critical for attaining a better prognosis. The following pictorial review discusses the various plain X-ray radiographic findings that indicate a gastric leak. These findings may be overlooked, however, they remain valuable in patients with clinically suspected gastric leaks. This pictorial review illustrates the spectrum of findings related to post-SG gastric leak encountered in plain X-ray radiography.
{"title":"Plain X-ray findings of post sleeve gastrectomy gastric leak","authors":"Sultan R. Alharbi","doi":"10.25259/JCIS_6_2022","DOIUrl":"https://doi.org/10.25259/JCIS_6_2022","url":null,"abstract":"Gastric leak following sleeve gastrectomy (SG) is a rare but significant cause of morbidity and mortality. A high clinical index of suspicion is the most sensitive approach to detect gastric leaks. Computed tomography (CT) is the gold standard diagnostic technique, although it might not be performed due to unavailability, and the inability to image superobese patients due to limited CT gantry space. Early detection and management are critical for attaining a better prognosis. The following pictorial review discusses the various plain X-ray radiographic findings that indicate a gastric leak. These findings may be overlooked, however, they remain valuable in patients with clinically suspected gastric leaks. This pictorial review illustrates the spectrum of findings related to post-SG gastric leak encountered in plain X-ray radiography.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"164 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77485168","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}
H. Hindi, G. Dongmo, Alyssa Goodwin, S. Jones, Kristian Loveridge
Deep venous thrombosis (DVT) is a subtype of venous thromboembolism. Lower extremity DVT affects about 1-2% of hospitalized patients. If not managed properly, these thrombi can embolize, causing further complications. Thrombosis risk factors include vascular endothelial injury, venous stasis, and hypercoagulability states. This triad is also known as Virchow’s triad. Although clinical features of lower extremity DVT are nonspecific and many patients are asymptomatic, physicians should maintain a high index of suspicion in patients presenting with leg swelling, pain, warmth, and erythema. Several diagnostic approaches for suspected first DVT have been proposed, and management depends on multiple factors such as location, duration of symptoms, cause of the thrombosis, and recurrence rate.
{"title":"Imaging findings and interventional management of deep venous thrombosis","authors":"H. Hindi, G. Dongmo, Alyssa Goodwin, S. Jones, Kristian Loveridge","doi":"10.25259/JCIS_221_2021","DOIUrl":"https://doi.org/10.25259/JCIS_221_2021","url":null,"abstract":"Deep venous thrombosis (DVT) is a subtype of venous thromboembolism. Lower extremity DVT affects about 1-2% of hospitalized patients. If not managed properly, these thrombi can embolize, causing further complications. Thrombosis risk factors include vascular endothelial injury, venous stasis, and hypercoagulability states. This triad is also known as Virchow’s triad. Although clinical features of lower extremity DVT are nonspecific and many patients are asymptomatic, physicians should maintain a high index of suspicion in patients presenting with leg swelling, pain, warmth, and erythema. Several diagnostic approaches for suspected first DVT have been proposed, and management depends on multiple factors such as location, duration of symptoms, cause of the thrombosis, and recurrence rate.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"67 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91141494","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}
Intractable or drug-resistant seizures in pediatric patients are often secondary to cortical malformations, hamartomas, or mass lesions. Various subtypes of intracerebral hamartomas, associated with seizure disorders, have been described. In this report, we describe a subtype of intracerebral hamartoma associated with intractable epilepsy in a 10-year-old patient. Initial MR imaging demonstrated a mildly expansile, T2/FLAIR hyperintense, T1 isointense, nonenhancing lesion with blurring of the gray-white junction in the left amygdala. Surgical resection was performed, and pathology confirmed oligodendroglial hamartoma. Patient’s seizures recurred after a two-year interval with imaging demonstrating a similar lesion in the right amygdala which in retrospect was also seen on multiple imaging studies. This case report demonstrates the importance of recognizing oligodendroglial hamartomas as a cause of intractable seizures given the imaging findings, distinguishing it from ganglioglioma, dysembryoplastic neuroepithelial tumor, and oligodendroglioma, and the importance of closely looking/searching for contralateral lesions, which has important therapeutic and prognostic implications.
{"title":"Bilateral oligodendroglial hamartomas: A rare cause of drug-resistant epilepsy in a pediatric patient","authors":"Havisha Munjal, D. Mistry, J. Almast, S. Ellika","doi":"10.25259/JCIS_197_2021","DOIUrl":"https://doi.org/10.25259/JCIS_197_2021","url":null,"abstract":"Intractable or drug-resistant seizures in pediatric patients are often secondary to cortical malformations, hamartomas, or mass lesions. Various subtypes of intracerebral hamartomas, associated with seizure disorders, have been described. In this report, we describe a subtype of intracerebral hamartoma associated with intractable epilepsy in a 10-year-old patient. Initial MR imaging demonstrated a mildly expansile, T2/FLAIR hyperintense, T1 isointense, nonenhancing lesion with blurring of the gray-white junction in the left amygdala. Surgical resection was performed, and pathology confirmed oligodendroglial hamartoma. Patient’s seizures recurred after a two-year interval with imaging demonstrating a similar lesion in the right amygdala which in retrospect was also seen on multiple imaging studies. This case report demonstrates the importance of recognizing oligodendroglial hamartomas as a cause of intractable seizures given the imaging findings, distinguishing it from ganglioglioma, dysembryoplastic neuroepithelial tumor, and oligodendroglioma, and the importance of closely looking/searching for contralateral lesions, which has important therapeutic and prognostic implications.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"106 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79123650","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}
Manpreet Manoj, Leeba Mathew, S. Natarajan, Shweta Yellapurkar, S. Shetty, Ceena Denny, S. Dahal
Objective The shape of the condyle, coronoid, and the intervening sigmoid notch is unique due to attachments and direction of pull of temporalis muscle, different chewing habits, hormones, etc. So morphometric variation of these mandibular landmarks can be used in individual identification. Material And Methods The study was carried out on 500 panoramic view images. Visual tracing assisted assessment of thousand sides (left and right) was done. Sexual dimorphism of left and right mandibular ramus parts (sigmoid notch bordered by coronoid and condylar process). The shape of coronoid process, condyle, and sigmoid notch were interpreted. Results The most prevalent shape of sigmoid notch was wide variant (41.2%), condyle was convex type (50%) and coronoid was round (53.4%). Condyle and coronoid showed asymmetry between right and left with p-value 0.001 and 0.019, respectively. This study has illustrated that triangular-shaped coronoid was more in females (p-value 0.012). Conclusion Sexual dimorphism is observed in the shape of the mandible due to masticatory activity at the point of insertion of temporalis muscle, biting force, hormones, and various genetic reasons. The results have exemplified that the morphometric variation of condyle, coronoid and sigmoid notch can be used as a tool for personal identification.
{"title":"Morphometric anlaysis of mandibular coronoid, condyle and sigmoid shape using panoromic view for personal identification in south Indian population","authors":"Manpreet Manoj, Leeba Mathew, S. Natarajan, Shweta Yellapurkar, S. Shetty, Ceena Denny, S. Dahal","doi":"10.25259/JCIS_27_2022","DOIUrl":"https://doi.org/10.25259/JCIS_27_2022","url":null,"abstract":"Objective The shape of the condyle, coronoid, and the intervening sigmoid notch is unique due to attachments and direction of pull of temporalis muscle, different chewing habits, hormones, etc. So morphometric variation of these mandibular landmarks can be used in individual identification. Material And Methods The study was carried out on 500 panoramic view images. Visual tracing assisted assessment of thousand sides (left and right) was done. Sexual dimorphism of left and right mandibular ramus parts (sigmoid notch bordered by coronoid and condylar process). The shape of coronoid process, condyle, and sigmoid notch were interpreted. Results The most prevalent shape of sigmoid notch was wide variant (41.2%), condyle was convex type (50%) and coronoid was round (53.4%). Condyle and coronoid showed asymmetry between right and left with p-value 0.001 and 0.019, respectively. This study has illustrated that triangular-shaped coronoid was more in females (p-value 0.012). Conclusion Sexual dimorphism is observed in the shape of the mandible due to masticatory activity at the point of insertion of temporalis muscle, biting force, hormones, and various genetic reasons. The results have exemplified that the morphometric variation of condyle, coronoid and sigmoid notch can be used as a tool for personal identification.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"47 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78848716","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}
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}
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