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Intestinal interposition : the prevalence and clinical relevance of non-hepatodiaphragmatic conditions (nonChilaiditi forms) documented by CT and review of the literature [Interposizione intestinale : prevalenza e impatto clinico delle condizioni non epatodiaframmatiche (non-Chilaiditi) documentate con TC e revisione della letteratura]
No full textRiassunto
Obiettivo. Scopo del nostro lavoro è stato valutare la
prevalenza e l’impatto clinico delle forme di interposizione
intestinale non epatodiaframmatiche in una popolazione
adulta studiata con tomografi a computerizzata (TC) per
differenti indicazioni medico-chirurgiche.
Materiali e metodi. Da novembre 2008 ad aprile 2009,
due autori hanno valutato insieme i casi di interposizione
intestinale su 4338 pazienti adulti sottoposti a indagini TC.
In tale studio, sono state evidenziate sia interposizioni di
tipo epatodiaframmatico, che sono state defi nite Chilaiditi
come da letteratura, sia altri tipi di interposizione defi nite
secondo i diversi rapporti anatomici: splenorenale,
retrogastrica, epatocavale, retrosplenica e retrorenale, che
sono state raggruppate sotto il termine non-Chilaiditi. È
stato successivamente sottoposto ai pazienti dei due gruppi
e ad un gruppo controllo un questionario relativo ai
disturbi clinici associati più frequentemente alla sindrome
di Chilaiditi. Sono stati quindi comparati i dati clinici
relativi ai tre gruppi.
Risultati. Su 4338 pazienti sono stati osservati 130 (3%)
pazienti con interposizione colica per un totale di 143
manifestazioni, 90 Chilaiditi e 53 non-Chilaiditi: 30
interposizioni di tipo splenorenale, 12 di tipo retrogastrico,
5 epatocavale, 4 retrosplenico e 2 retrorenale. L’analisi
statistica ha evidenziato che le forme di Chilaiditi
producono una maggiore sintomatologia (24,4%), seguite
dalle forme non-Chilaiditi (18,9%) e infi ne dai casi controllo (10,8%). Tale analisi è stata validata dal test di
signifi catività χ2.
Conclusioni. Le forme non-Chilaiditi hanno rappresentato
più della metà delle forme Chilaiditi, con la manifestazione
splenorenale di gran lunga la più frequente. Abbiamo
inoltre evidenziato che anche le forme non-Chilaiditi sono
statisticamente più sintomatiche dei casi controllo.PURPOSE:
This study was done to assess the prevalence and clinical impact of non-hepatodiaphragmatic interpositions in a sample of adult patients undergoing computed tomography (CT) for a variety of medical reasons.
MATERIALS AND METHODS:
From November 2008 to April 2009, two observers jointly examined the cases of intestinal interposition in 4,338 adults undergoing CT investigations. This study sought to identify not only hepatodiaphragmatic intestinal interpositions, defined as Chilaiditi, but also other forms of intestinal interposition, which we termed non-Chilaiditi. The latter were divided into five different classes on the basis of their anatomical relationships: splenorenal, retrogastric, hepatocaval, retrosplenic, and retrorenal. Moreover, a questionnaire investigating the clinical symptoms reported to be associated with Chilaiditi syndrome was given to patients exhibiting any form of intestinal interposition and to a control sample. Finally, clinical data related to the three groups were compared.
RESULTS:
Of the 4,338 patients examined, 130 (3%) were found to have intestinal interposition, for a total of 143 forms: 90 Chilaiditi and 53 non-Chilaiditi. Of the latter, 30 were splenorenal, 12 retrogastric, five hepatocaval, four retrosplenic and two retrorenal. Statistical analysis showed that the Chilaiditi group suffered most symptoms (24.4%), followed by the non-Chilaiditi group (18.9%) and control cases (10.8%). Our results were validated using the χ(2) test of significance.
CONCLUSIONS:
The number of non-Chilaiditi cases amounted to just over half the number of Chilaiditi cases, with the splenorenal form being by far the most frequent. Statistical analysis showed that patients with non-Chilaiditi forms of intestinal interposition had more symptoms than did controls
High Pitch Dual Source CT Pulmonary Angiography with Reduced IV Contrast Dose and Free-Breathing
No full textPURPOSE
To compare different contrast material injection protocols using free breathing high-pitch dual-source pulmonary
angiography in patients with suspected pulmonary embolism.
METHOD AND MATERIALS
Data of 50 consecutive patients refferred for CTPA for exclusion of PE were retrospectevely evaluated.All scans were
performed on a 128-channel dual-source CT scanner (Somatom Definition Flash, Germany) with a high-pitch
protocol ( pitch 3.0,100kV, 180mAs).In group 1 (n=20) contrast enhancement was achieved by injecting 1.5mLxkg of
CM followed by a saline chaser of 50cc, and in group 2 contrast enhancement was achieved by means of a dose
Iodine converter ( Bracco, italy) followed by a saline chaser of 50 cc. In all studies, Iomeron (400mg/ml) was used and
injected at 4ml/sec. Attenuation profiles in the pulmonary trunk and on segmental levels were measured to evaluate
the enhancement within the pulmonary arteries. Image quality and motion artifacts were assessed using a 3 degree
scale ( 1-non-diagnostic), (2-poor), (3-sufficient). Statiscal analysis was performed by using the Wilcoxon test.
RESULTS
The amount of CM generated by the Dose Iodine Converter for reduced IV constrat dose ranged from 30 to 55 mL. In
all patients an adequate and homogeneous contrast enhancement of more than 250 HU was achieved in the
pulmonary arteries. No statiscally significant difference between group 1 and 2 was observed (p<0.05) regarding the
attenuation of the pulmonary arteries. With regard to image quality and motion artifacts, all examinations were
classified as sufficient.
CONCLUSION
A homogeneous opacitifaction of the pulmonary arteries and sufficient image quality partially free of motion artifacts
due to breathing , can be achieved with reduced IV contrast dose in high pitch CT pulmonary angiography.
CLINICAL RELEVANCE/APPLICATION
High Pitch Dual Source CT pulmonary angiography is recommended for patients that are not able to hold their breat
Curved Multiplanar Reconstructions for the Evaluation of the Aorta in Multisystem Trauma Patients by Using Ultra- High Pitch CT
No full textPURPOSE
The purpose of our study was to investigate on the applicability of Curved Multiplanar Reconstructions (CMR) for the
evaluation of the aorta in multi-system trauma patients by using Ultra-High Pitch CT , the so called FLASH
acquisition.
METHOD AND MATERIALS
From October 2011 to February 2012, 32 patients (43-72 years old, mean age, 58 years old ) underwent 34 wholebody
CT examinations by using a SOMATOM Definition Flash (Siemens Medical Solutions , Forchheim, Germany).The
arterial phase was acquired by using bolous tracking technique, following a venous phase at 60 sec. delay from the
initiation of contrast material injection (1.3 mL/kg patient body weight at 400mgmL iodine concentration ; flow 4mL/s,
followed by a saline chaser bolous of 50 ml).Post- processing images were automatically generated by SyngoVIA
(Siemens Medical Solutions , Forchheim, Germany) workstation. Two experienced emergency radiologists analyzed
the arterial phase using Ultra High-Pitch acquisition technique. Image quality was assessed in 2D and CMR
algorithms using a 4 degree scale: 1) not diagnostic, 2) fairly diagnostic 3) good, 4) optimal. Statistical analysis was
performed by using the Wilcoxon test.
RESULTS
CMR was useful in determining the presence, extension and characterization of aortic injuries in 4 out of 12
cases(33%) not visualized in 2D images .Twenty-eight out of 32 (87.5%) of the arterial phase examinations were
classified as optimal, whereas the remaining 4 (12.5%) were classified as good. Two CT examinations were
repeated because of artifacts mimicking aortic injuries. None of the CT examinations were considered nondiagnostic.
CONCLUSION
Curved Multiplanar Reconstructions are useful in addition to 3D multiplanar reconstructions algorithms in the
evaluation of post-traumatic aortic injuries.
CLINICAL RELEVANCE/APPLICATION
CMR can demostrate eloquent areas of aortic injury and is recommended as part of post-proccesing in the study of
the aorta
CT ventilation imaging: technical backgroud and impact in acute lung injury and ARDS management
No full textCalcified spur of the thyroid cartilage
No full textWe describe an unusual laryngeal anomaly incidentally detected in an adult male patient who had suffered from chronic dysphonia since infancy with no change of voice quality over time. Laryngostroboscopy revealed a formation originating below the anterior commissure and protruding through the vocal folds, which computed tomography scan showed to be a calcified spur on the internal surface of the thyroid cartilage. The patient's clinical history of long-term dysphonia with a stable voice quality suggests that the anomaly may be congenital. To the best of our knowledge, no similar laryngeal malformations have been previously described
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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