Positron emission tomography detected thyroid incidentaloma

We describe the case of a 48-year-old woman who presented with a thyroid lesion incidentally detected on positron emission tomography/computed tomography for a suspicious lung lesion. Subsequent clinical examination and investigations revealed a 3cm nodule in the left lower pole of the thyroid. Fine needle aspiration was indeterminate for malignancy. A left hemithyroidectomy was performed and histology confirmed a benign thyroid adenoma with an incidental micropapillary carcinoma. The literature regarding the best management for thyroid incidentalomas remains uncertain and, as such, each patient must be managed on an individual basis.     

螺旋CT在原发性肝癌诊断中的应用价值研究

目的:研究螺旋CT在原发性肝癌临床诊断中的应用价值.方法:采用双排螺旋CT对382例疑似原发性肝癌患者进行检测,同时采用彩色多普勒进行检查,比较两种诊断方法在原发性肝癌诊断中的敏感性与特异性.结果:382例受检者中确诊原发性肝癌219例,排除163例.其中彩色多普勒确诊157例,排除104例,灵敏度为0.717,特异度为0.638;螺旋CT确诊212例,排除131例,灵敏度为0.968,特异度为0.804.螺旋CT AUC为0.942,彩色多普勒AUC值为0.831,螺旋CT诊断价值优于彩色多普勒,差异具有统计学意义(P<0.05).结论:螺旋CT可满足原发性肝癌的诊断,临床应用安全可靠.     

Not just quantity: Gluteus maximus muscle characteristics in able-bodied and SCI individuals – Implications for tissue viability

Study aimSome individuals with spinal cord injury (SCI) remain pressure ulcer (PU) free whilst others experience a recurring cycle of tissue breakdown. Detailed analysis of gluteal muscle characteristics may provide insights to local tissue viability variability. The study hypothesis was that SCI individuals have altered muscle composition compared to able-bodied (AB).MaterialsTen AB and ten SCI received a supine pelvic CT scan, with contrast.MethodsCross-sectional area (CSA) and overall muscle volume were derived using image analysis. Gluteal muscle tissue type was classified at the S2/S3 sacral vertebrae midpoint, the superior greater trochanters margin (GT) and the inferior ischial tuberosities margin (IT) using the linear transformation Hounsfield Unit scale.ResultsSCI gluteal CSA was less than for AB throughout the muscle, with the greatest relative atrophy at the IT (48%). Average AB gluteal volume was nearly double SCI. Eight SCI had over 20% infiltrative adipose tissue, three with over 50%. SCI gluteal CSA and intramuscular fat infiltration were significantly negatively correlated (p < 0.05). SCI IT axial slices showed less lean muscle and higher intramuscular fat infiltration than more proximally (p < 0.05).ConclusionSCI gluteal muscle characteristics were indicative of impaired tissue viability. SCI disuse muscle atrophy was anticipated; the analytic approach further indicated that intramuscular atrophy was not uniform. SCI muscle composition showed increased proportions of both low density muscle and adipose tissue. CT scan with contrast is effective for gluteal muscle characterization. This assessment technique may contribute to determination of personalized risk for PU development and other secondary complications.     

Dietary fiber and flavan-3-ols in shortbread biscuits enriched with barley flours co-products

The coarse fraction obtained by air classification of barley flour, rich in dietary fiber and flavan-3-ols, was utilized to develop functional biscuits. The flavan-3-ol content, antioxidant activity and oxidative stability of biscuits were measured during storage under retail conditions for 1 year. The replacement of 60% (w/w) refined wheat flour with barley coarse fraction increased the ash, fiber and flavan-3-ol contents significantly. Biscuit samples enriched with barley coarse fraction had a significantly higher amount of fiber compared with the control sample (six times higher). The β-glucan content in enriched samples was 15 times higher than control samples. The flavan-3-ol loss in biscuits after baking was about 67%. The initial content of flavan-3-ols increased from 0.6 to 4.3 mg/100 g in biscuits formulated with barley coarse fraction and showed improved antioxidant properties. Lipid oxidation increased during the shelf-life; the enriched biscuit showed the higher lipid oxidation status, but the level reached during the shelf-life was lower than the limit of acceptance reported for bakery products and, for this reason, does not compromise the safety.     

Use of flat panel DynaCT myelography to locate the site of CSF leak

Spontaneous intracranial hypotension is often treated conservatively or with epidural blood patch. Patients who are resistant to these treatments require accurate imaging localisation of the site of cerebrospinal fluid (CSF) leak for surgical repair. We describe two patients where MRI, CT myelography and MRI gadolinium myelography showed evidence of a large volume of epidural CSF, but failed to identify the pressure site of leak. Subsequently, DynaCT (Siemens, Erlangen, Germany) accurately identified the site with confidence in both cases, confirmed at surgery. This technique of using a flat panel detector‐based, angiographic system to produce high quality, high‐contrast multiplanar CT images for detecting the source of rapid CSF leak is detailed.     

MSCTA对下肢动脉硬化闭塞症的应用价值

目的通过比较各种MSCTA后处理技术,探讨MSCTA对下肢动脉硬化闭塞症诊断的应用价值。方法对73例下肢动脉硬化闭塞症患者MSCTA检查结果进行MIP、MPR、CPR、VR重组,对比动脉清晰度、管壁钙化、支架显示、病变狭窄段及下肢动脉栓子的检出。对成像方法及临床诊断优选方案进行探讨。结果各种后处理技术均可以清晰显示血管轮廓及血管壁的钙化情况及支架的情况。对于动脉狭窄的显示,MPR、2mmMIP显示最佳。对于动脉栓子的检出,2mmMIP图像具有较大的优势。结论多种后处理方法综合运用,可以显示狭窄病变部位、范围、程度,闭塞远端血管充盈情况,管壁钙化及栓子的情况,术后腔内支架的情况,为临床诊断治疗提供重要信息。     

Initial HRCT findings of novel influenza A (H1N1) infection

Please cite this paper as: Yuan et al. (2012) Initial HRCT findings of novel influenza A (H1N1) infection. Influenza and Other Respiratory Viruses 6(601), e114–e119. Objectives The aim of our study was to describe the presentation and illustrate the imaging features of chest high‐resolution computed tomography (HRCT) of patients with novel influenza A (H1N1) virus infection. Methods Data were collected from 163 hospitalized patients between November 2009 and March 2011, who fulfilled the clinical criteria for H1N1 influenza infection and underwent HRCT examinations within 24 hours of admission. Results Abnormal findings were observed in 40·5% of the patients. The patients with positive imaging findings were significantly older than patients with normal HRCT findings (P = 0·02). The most common finding was ground‐glass opacity (GGO) (n = 35). Interlobular septal thickening (n = 31) and centrilobular nodules (n = 30) were the second most frequent findings. Other common findings were consolidation, reticulation, and linear shadow. The most common imaging finding for lung involvement was GGO with a patchy pattern. Pulmonary involvement of the disease may be extensive and variable, but the total volume of affected lung was mostly <1 lobe. Conclusion The baseline HRCT may be valuable and suggestive even for non‐severe H1N1 infections. When a severe case or a evolution is suspected, chest CT could be essential both for determining the precise extent of parenchymal damage and for monitoring its evolution.     

CT Radiation Dose Optimization and Estimation: an Update for Radiologists

In keeping with the increasing utilization of CT examinations, the greater concern about radiation hazards from examinations has been addressed. In this regard, CT radiation dose optimization has been given a great deal of attention by radiologists, referring physicians, technologists, and physicists. Dose-saving strategies are continuously evolving in terms of imaging techniques as well as dose management. Consequently, regular updates of this issue are necessary especially for radiologists who play a pivotal role in this activity. This review article will provide an update on how we can optimize CT dose in order to maximize the benefit-to-risk ratio of this clinically useful diagnostic imaging method.     

CT图像后处理技术结合磁共振成像在老年踝关节骨折分型诊断和预后评估中的应用

目的分析CT图像后处理技术结合MRI检查在老年踝关节骨折分型诊断和预后评估中的应用。方法回顾性分析68例的老年踝关节骨折患者临床资料,分别对患者进行CT及MRI检查,分析患者骨折位置与区域、骨折分型和分度情况,关节韧带经CT图像后处理的显示结果,利用CT图像后处理与MRI技术评估患者术后并发症及预后。结果患者的骨折位置中,发生在左踝与右踝的比例无统计学差异(P>0.05)。而在骨折区域上,发生在内踝与外踝的比例明显高于发生于后踝的比例(P<0.05);患者的骨折分型之间并无明显差异(P>0.05),但骨折分度为Ⅰ度、Ⅱ度及Ⅲ度的比例均明显高于Ⅳ度者(P<0.05);CT图像后处理技术对于不同分型骨折患者关节韧带的显示率无统计学差异(P>0.05);50例需手术治疗的患者中,经CT图像后处理与MRI技术评估发现,并发症预后为优的比例为50.00%(25/50),良为36.00%(18/50),差为14.00%(7/50)。预估患者术后发生创伤性关节炎的比例为8.00%(4/50),与随访6个月后的实际发生率4.00%(2/50)相比无统计学差异(P>0.05)。结论 CT图像后处理结合MRI技术对老年踝关节骨折患者进行分型诊断和预后评估效果较好,准确率较高。