scholarly journals Heterotopic pancreas: the added value of endoscopic ultrasound with Computed Tomography for diagnosis

2020 ◽  
Author(s):  
Jae Yong Park ◽  
Eun Sun Lee ◽  
Hye Won Hwang ◽  
Hyung Jeong Park ◽  
Beom Jin Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endoscopic Ultrasound ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Heterotopic Pancreas ◽  
Added Value ◽  
Abdominal Ct ◽  
Irregular Margin ◽  
Blinded Manner ◽  
Oval Shape

Aims: To investigate the added value of endoscopic ultrasound (EUS) with computed tomography (CT) in distinguishing heterotopic pancreas (HP) from other pathologies, when gastroduodenal subepithelial tumors (SETs) are suspected on an upper endoscopic examination.Material and methods: We retrospectively included 54 consecutive patients with gastroduodenal SETs who had undergone both abdominal CT and EUS within a 3-month interval. All EUS, endoscopy, and CT images were reviewed and evaluated in a blinded manner by an endoscopist and a radiologist, respectively. Univariate and multivariate analyses were performed to identify EUS/CT findings related to HP. Diagnostic performance of CT only and CT combined with EUS was compared for distinguishing HP from other SETs.Results: We included patients with HP (n=17; pathologically confirmed, n=6), gastrointestinal stromal tumor (GIST, n=24), and other pathologies (n=13). Multivariate logistic regression analyses revealed that irregular margin, origin from submucosal layer, internal microcystic-tubular structure, and oval shape were independent factors in diagnosing HP by EUS, whereas a micro-lobulating contour was the only significantly independent factor in CT. In assessments of diagnostic performance, CT combined with EUS showed significantly superior diagnostic performance in comparison with CT only (area under the curve, 0.961 vs. 0.833, p=0.028) in the consensus interpretation of an endoscopist and a radiologist.Conclusions: CT combined with EUS with a comprehensive and complementary interpretation showed significant added value compared to CT only in diagnosing gastroduodenal HP

Added value of delayed computed tomography angiography in primary intracranial hemorrhage and hematoma size for predicting spot sign

2017 ◽  
Vol 59 (4) ◽  
pp. 485-490 ◽  
Author(s):  
Te Chang Wu ◽  
Tai Yuan Chen ◽  
Yow Ling Shiue ◽  
Jeon Hor Chen ◽  
Tsyh-Jyi Hsieh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Computed Tomography Angiography ◽  
Area Under The Curve ◽  
Predictive Performance ◽  
Added Value ◽  
Hematoma Expansion ◽  
Contrast Extravasation ◽  
Spot Sign

Background The computed tomography angiography (CTA) spot sign represents active contrast extravasation within acute primary intracerebral hemorrhage (ICH) and is an independent predictor of hematoma expansion (HE) and poor clinical outcomes. The spot sign could be detected on first-pass CTA (fpCTA) or delayed CTA (dCTA). Purpose To investigate the additional benefits of dCTA spot sign in primary ICH and hematoma size for predicting spot sign. Material and Methods This is a retrospective study of 100 patients who underwent non-contrast CT (NCCT) and CTA within 24 h of onset of primary ICH. The presence of spot sign on fpCTA or dCTA, and hematoma size on NCCT were recorded. The spot sign on fpCTA or dCTA for predicting significant HE, in-hospital mortality, and poor clinical outcomes (mRS ≥ 4) are calculated. The hematoma size for prediction of CTA spot sign was also analyzed. Results Only the spot sign on dCTA could predict high risk of significant HE and poor clinical outcomes as on fpCTA ( P < 0.05). With dCTA, there is increased sensitivity and negative predictive value (NPV) for predicting significant HE, in-hospital mortality, and poor clinical outcomes. The XY value (product of the two maximum perpendicular axial dimensions) is the best predictor (area under the curve [AUC] = 0.82) for predicting spot sign on fpCTA or dCTA in the absence of intraventricular and subarachnoid hemorrhage. Conclusion This study clarifies that dCTA imaging could improve predictive performance of CTA in primary ICH. Furthermore, the XY value is the best predictor for CTA spot sign.

scholarly journals Double Contrast-enhanced Ultrasound for the Preoperative Gross Classification of Gastric Cancer: a Comparison With Multidetector Computed Tomography

2021 ◽  
Author(s):  
Ping He ◽  
Lan Zeng ◽  
Liying Miao ◽  
Tianli Wang ◽  
Juxiang Ye ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Diagnostic Performance ◽  
Imaging Modality ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Contrast Enhanced Ultrasound ◽  
Double Contrast ◽  
Contrast Enhanced

Abstract Purpose To compare the diagnostic performance of double contrast-enhanced ultrasound (DCEUS) and multi-detector row computed tomography (MDCT) in the gross classification of gastric cancer (GC) preoperatively. Methods 54 patients with GC proved by histology were included in this study. The sensitivity and specificity of DCEUS and MDCT for gross classification were calculated and compared. The area under the curve (AUC) from a receiver operating characteristic curve analysis was used to evaluate the difference of the diagnostic performance between these two methods.Results There were no significant differences between DCEUS and MDCT in terms of AUC values for early gastric cancer (EGC) and Borrmann Ⅰ-Ⅲ (P = 0.248, 0.317, 0.717 and 0.464, respectively). However, the sensitivities of DCEUS for EGC, Borrmann Ⅰ and Borrmann Ⅲ were higher than those of MDCT (75% versus 62%; 100% versus 50%; 90% versus 73%). The specificity of DCEUS for Borrmann Ⅲ was lower than that of MDCT (50% versus 75%). The AUC value of MDCT for Borrmann Ⅳ was significantly higher than that of DCEUS (0.927 versus 0.625; P=0.001). The accuracy and specificity of DCEUS and MDCT for Borrmann Ⅳ were similar, but the sensitivity of MDCT was significantly higher than that of DCEUS (88% versus 25%).Conclusion DCEUS may be considered as a useful complementary imaging modality to MDCT for the evaluation of the gross classification of GC preoperatively.

scholarly journals Comparison of the different voxel sizes in the estimation of peri-implant fenestration defects using cone beam computed tomography: an ex vivo study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Mehmet Hakan Kurt ◽  
Nilsun Bağış ◽  
Cengiz Evli ◽  
Cemal Atakan ◽  
Kaan Orhan
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Ex Vivo ◽  
Statistical Significance ◽  
Area Under The Curve ◽  
Titanium Implant ◽  
Bone Defects ◽  
Titanium Implants ◽  
Cone Beam ◽  
Voxel Size

Abstract Background To examine the influence of voxel sizes to detect of peri-implant fenestration defects on cone beam computed tomography (CBCT) images. Materials and methods This study performed with three sheep heads both maxilla and mandible and two types of dental implant type 1 zirconium implant (Zr40) (n = 6) and type 2 titanium implant (Ti22) (n = 10). A total of 14 peri-implant fenestrations (8 buccal surfaces, 6 palatal/lingual surface) were created while 18 surfaces (8 buccal, 10 palatal/lingual) were free of fenestrations. Three observers have evaluated the images of fenestration at each site. Images obtained with 0.75 mm3, 0.100 mm3, 0.150 mm3, 0.200 mm3, and 0.400 mm3 voxel sizes. For intra- and inter-observer agreements for each voxel size, Kappa coefficients were calculated. Results Intra- and inter-observer kappa values were the highest for 0.150 mm3, and the lowest in 0.75 mm3 and 0.400 mm3 voxel sizes for all types of implants. The highest area under the curve (AUC) values were found higher for the scan mode of 0.150 mm3, whereas lower AUC values were found for the voxel size for 0.400 mm3. Titanium implants had higher AUC values than zirconium with the statistical significance for all voxel sizes (p ≤ 0.05). Conclusion A voxel size of 0.150 mm3 can be used to detect peri-implant fenestration bone defects. CBCT is the most reliable diagnostic tool for peri-implant fenestration bone defects.

Computed tomography angiography and microsurgical flaps for traumatic wounds: What is the added value?

2021 ◽  
pp. 1-9
Author(s):  
Lucas Sousa Macedo ◽  
Renato Polese Rusig ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Upper Limb ◽  
Computed Tomography Angiography ◽  
Lower Limb ◽  
High Energy ◽  
Lower Limbs ◽  
Added Value ◽  
Vascular Lesions ◽  
Limb Injuries ◽  
Significant Difference

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.

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