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1.

Objectives

To evaluate accuracy of computed tomography angiography (CTA) in evaluation of post traumatic renal vascular injury.

Patients and methods

38 patients were presented with post traumatic intermittent or persistent hematuria. Renal CTA and digital subtraction angiography (DSA) were done for all patients.

Results

CTA demonstrated pseudoaneurysm (PA) in 30 patients (78.9%) and no vascular lesions in 8 patient (21.1%). CTA had 86.11% sensitivity and 50% specificity in detection of post traumatic renal pseudoaneurysms, CTA missed diagnosis of renal arteriovenous fistula (RAVF) in 10 patients which discovered later by DSA.

Conclusion

CTA with MIP as non invasive technique widely replaced renal DSA in detection of posttraumatic renal pseudoaneurysm. Renal DSA is still best modality in detection of RAVF and also has the upper hand in planning of selective renal artery embolization for the management of persistent or delayed hemorrhage from renal vessels.  相似文献   

2.

Objective

A comparative study of manual and automated post processing software tools to measure CT parameters before Transcatheter Aortic Valve Implantation (TAVI).

Patients and methods

51 patients were included; all admitted to the Cardiology Department with clinically established severe aortic stenosis, in whom TAVI was the treatment of choice. All patients underwent CT angiography (CTA) pre-TAVI. The CT images were post processed and the needed CT parameters were calculated using both manual and automated methods. The results were compared for statistical analysis.

Results

Only 43 patients completed the study, with mean age 65?years old. The automated software provided accurate almost similar results as the manual method, especially for aortic annulus area and aortic circumference measurements (p-value?=?1 and 0.548) and was accepted for left and right coronary artery ostium height (p-value?=?0.191 and 0.635).However, there was a statistically significant difference for the minor diameter axis and mean annular diameter (p-value?=?0.001 and 0.021).

Conclusion

The automated software introduced rapid, accurate and reliable measurements for the aortic annulus in cases prepared for TAVI and can be used as a standard method. Also, it can be performed by junior staff with avoidable human errors.  相似文献   

3.

Aim of work

To assess the role of color Doppler ultrasonography and multidetector computed tomography angiography (MDCTA) in diagnosis of uterine arteriovenous malformations (AVMs).

Methodology

Twenty patients were referred to the radiodiagnosis and imaging department, faculty of medicine, Tanta University from obstetric and gynecology department. All patients were suspected clinically to have uterine arteriovenous malformations. All were subjected to history taking regarding clinical state, laboratory investigation and color Doppler ultrasonography and multidetector computed tomography angiography of the pelvis.

Results

Color Doppler ultrasound sensitivity was 100% in detecting a uterine hypervascular lesion and highly suggesting the diagnosis of uterine AVM and the sensitivity of MDCT angiography was 100% in diagnosing and evaluating uterine AVM.

Conclusion

Doppler US can strongly suggest the presence of AVM but patient should undergo CT angiography for definitive diagnosis and possible embolization, as CTA helps in providing valuable cross sectional anatomical details about the lesion, its extent and its surroundings.  相似文献   

4.

Aim of the work

The aim of this retrospective study is to highlight the MDCT features of portal biliopathy (PB).

Patients

This study included 32 patients with extra-hepatic portal vein obstruction (EHPVO) and biliary dilatation. Their age ranged from 27 to 63?years, including 21 males and 11 females.

Methods

The included patients had records of complete clinical examination and laboratory data, including bilirubin levels. All patients were examined by multiphase MDCT study with good portal phase.

Results

Extra-hepatic biliary dilatation without intra-hepatic dilatation seen in 5 patients (type I), intra-hepatic dilatation without extra-hepatic dilatation seen in 12 (type II) patients, unilateral intra-hepatic predominant with extra-hepatic dilatation (type IIIA) seen in 7 patients (4 right sided predominance and 3 left sided predominance). Both extra and bilateral intra-hepatic dilatation in 8 patients (type IIIB).

Conclusion

MDCT is an excellent technique for the diagnosis of portal biliopathy reducing errors in diagnosis.  相似文献   

5.

Objectives

To assess the clinical utility of PET-CT in assessment of thoracic involvement in lymphoma patients prior to, during and after finishing treatment and comparing it to contrast enhanced CT (CECT).

Patients and methods

PET-CT was performed for 30 patients with lymphoma. Thoracic nodal and extranodal involvement was assessed and compared to contrast enhanced CT.

Results

Comparison of CECT and PET-CT in staging and assessment of treatment response reveals significant statistical difference (P?=?.0001 & .04 respectively). CECT shows sensitivity?=?83.3% and specificity?=?75% in evaluation of patients after finishing chemotherapy.

Conclusion

PET-CT plays an important role in staging, detection of response to treatment and restaging of lymphoma after finishing chemotherapy.  相似文献   

6.

Purpose

to evaluate the role of three dimentional power doppler ultrasonography (3D PDUS) of the uteroplacental circulation in early pregnancy as a screening tool for prediction of preeclampsia.

Patients and methods

50 pregnant women who came to do routine ultrasound scan between 11 and 13.6?weeks of pregnancy during the period from February 2016 to April 2016. Placental volume and vascularization indices were obtained, and vascular index (VI), flow index (FI), blood vessels and blood flow index (VFI) were calculated by three-dimensional Doppler histogram.

Results

Of the included 50 pregnant women, 22% developed preeclampsia and 78% did not develop preeclampsia. The placental blood flow perfusion in patients with pre-eclampsia had a lower VI, FI and VFI compared to non preeclamptic women with highly significant statistical difference (P?<?0.001)

Conclusion

3D PDUS can be used as an effective screening tool to predict preeclampsia in early pregnancy.  相似文献   

7.

Aim

To compare 3D steady-state free-precession (SSFP) non-contrast magnetic resonance angiography (NC-MRA) with contrast-enhanced MRA (CE-MRA) for quantitative and qualitative analysis of thoracic arteries in pediatric patients with congenital heart disease.

Methodology

Forty patients with thoracic vascular anomalies (22 boys & 18 girls) ranging in age between 6?months and 14?years (mean age 4.58?±?4.5) were included in this prospective study. Measurements of the thoracic arteries were taken by 3D SSFP NC-MRA & CE-MRA. Image quality was assessed using a four-point score. Pearson's and Spearman's Correlation Coefficients were calculated for correlation analysis while Student's t and Mann-Whitney U tests were used for comparative analysis, Bland-Altman plots were employed to demonstrate the level of agreement between the 2 techniques.

Results

Measurements from NC-CMRA images were comparable to those from CE-MRA. All measures highly correlated (r?>?0.9), 3D SSFP NC-MRA exhibited a significantly higher image quality score than contrast- enhanced MRA, the mean difference was significantly lower than that of the 3D SSFP; (p-value <0.0001).

Conclusion

NC-MRA produced similar and comparable measurements of the thoracic arteries with superior image quality when compared to contrast- enhanced MRA in pediatric congenital heart defects.  相似文献   

8.

Aim of the work

To evaluate the role of diffusion weighted imaging (DWI) in the planning for CT guided biopsy of lung and mediastinal lesions.

Subjects and methods

This cross sectional study included 23 patients with mean age was 42.7?years came with clinical and imaging suspicion of chest malignancy, referred for CT guided transthoracic biopsy. DWI and apparent diffusion coefficient (ADC) were evaluated for all patients to choose the area of maximum restriction.

Results

The study showed that with DWI guidance; all the biopsy specimens were diagnostic and provide adequate material for analysis.

Conclusion

DWI and measurement of ADC value has a very helpful role in the pre-procedural planning of transthoracic biopsies.  相似文献   

9.

Objective

We evaluated multidetector computed tomography (MDCT) accuracy for the prediction of the optimal prosthetic aortic valve deployment angle in trans-catheter aortic valve implantation (TAVI) with the different variables.

Methods

Sixty-six patients underwent contrast-enhanced MDCT before TAVI. From the three-dimensional aortic root reconstructions, we get the appropriate perpendicular aortic valve projection at which the bases of the aortic valve cusps were on a straight line. The predicted angles by MDCT were compared to the perpendicular fluoroscopic angles of the prosthetic valve. The degree of MDCT accuracy was defined as accurate, suitable or inaccurate according to the difference between the predicted angles and the perpendicular prosthetic valve projections. The degree of aortic cusp calcification, annular ellipticity, the type of aortic valve (to be tricuspid or bicuspid), were compared in patients with accurate, suitable and inaccurate prediction. The radiation exposure and volume of the used contrast agent were also considered in the comparison.

Results

MDCT prediction was accurate in 84.8% of cases, suitable in 9.1% and inaccurate in 6.1% of cases. There was a significant association between MDCT accuracy and the valve type with higher rates of accurate prediction with tricuspid aortic valves than bicuspid valves (93.1% versus 25%, respectively). The mean number of aortograms and the volume of contrast agent used for TAVI procedure were significantly less in patients with accurate CT prediction (p < 0.001).

Conclusion

MDCT allows accurate prediction of the proper deployment angle for TAVI. Bicuspid aortic valve is significantly associated with fewer rates of accurate prediction.  相似文献   

10.

Objectives

To evaluate the efficacy and safety of percutaneous cholecystostomy (PC) in management of acute cholecystitis in elderly patients.

Methods

Retrospective study of elderly patients (age?≥?60?years) undergoing Ultrasound-guided PC for acute cholecystitis, over a period of two years. Patients were reviewed for demographic features, co-morbidity, resolution of symptoms and outcome and complications.

Results

Seventeen patients (11 women, 6 men; mean age, 66?±?7?years) underwent PC for acute cholecystitis. PC was technically successful in all patients and showed positive clinical response within 72?h in 15 patients (88.2%). Complications of PC tube placement occurred in 2 (11.8%) of 17 patients, including bile leakage around the skin in 1 patient ,tube dislodgment in another one and were treated effectively with drain replacement.

Conclusion

Percutaneous cholecystostomy is a safe, effective and technically achievable procedure for treating elderly high-risk patients who present with acute cholecystitis.  相似文献   

11.

Objectives

To assess the role of 320 MDCT angiography in the evaluation of extra cardiac, vascular anomalies of great arteries and compare its results with transthoracic echocardiography and its impact on treatment planning.

Materials and methods

This study included 39 patients, their age ranged from 16?days to 13?years. All of these patients underwent echocardiography and CTA examination using 320-MDCT. The images were analyzed using reconstruction techniques including MPR, cMPR, MinIP and VR techniques, the results were compared with surgical/catheter angiographic data.

Results

MDCT was superior to echocardiography in diagnosis of great arteries anomalies (aortic and pulmonary). We found excellent agreement between 320-MDCT and surgery/catheter angiography with k?=?1.000 sensitivity, specificity, PPV, NPV, accuracy for aortic anomalies were 100%, 100%, 100%, 100%, 100% and 82.05%, 100%, 100%, 56.25% and 85.42% for MDCT and echocardiography respectively, and that of pulmonary anomalies were 100%, 100%, 100%, 100%, 100% and 84.62%, 100%, 100%, 92.86% and 94.87% for MDCT and echocardiography respectively.

Conclusion

The main advantage added by 320-MDCT to transthoracic echocardiograpy was excellent delineation of the great arteries anomalies with suitable operative/catheteric decision without the need for the invasive diagnostic catheter angiography to the patients.  相似文献   

12.

Aim

Assessment of the clinical benefit of [18F]-FDG PET/CT examinations in restaging of patients with non Hodgkin lymphoma (NHL) in Egypt.

Patients, methods

This study was performed on 45 patients with NHL. PET-CT and CECT were analyzed after end of chemotherapy regimen, using 12?months follow-up as standard of reference.

Results

Follow-up of patients with NHL after 12?months of treatment revealed significant differences between staging by CT versus PET/CT (P?=?0.0001). Disease was upstaged by PET/CT in 36% (mostly in stages I and II) and downstaged in only 2% of patients. Agreement between PET-CT & CECT were usually in stage III and IV. Evaluation showed a sensitivity of 77% for CT alone, 95% for FDG-PET-CT.

Conclusion

FDG PET-CT significantly improved sensitivity and specificity in restaging of NHL and therefore should be used routinely in follow up of patients with lymphoma.  相似文献   

13.

Objectives

To assess the technical success and short term clinical efficacy of trans-catheter ovarian vein coiling in the treatment of symptomatic pelvic congestion syndrome in women.

Methods

This study included 10 female patients having pelvic venous congestion treated by coiling and were followed up for 3?months between February 2016 and April 2017 at Ain Shams University hospital, Cairo, Egypt. Symptomatology of pelvic congestion syndrome that was documented either by transvaginal Doppler and/or by MRI with no response to conservative treatment.

Results

Symptoms successfully disappeared in 8 patients out of 10. Partial relief of symptoms in one patient that was then disappeared after another session. Only one patient showed no improvement.

Conclusion

Our study demonstrates high efficacy of ovarian vein coiling as a new technique in the treatment of symptomatic female patients with pelvic congestion syndrome.  相似文献   

14.

Purpose

To highlight the relationship between coraco-humeral distance and subscapularis tendon tear.

Material and methods

Sixty-two shoulder MRI studies were examined. Twenty-two patients had partial or complete tear of subscapularis tendon and forty shoulder as a control group. Axial and oblique sagittal MR images were examined to measure the coraco-humeral distance followed by statistical analysis to correlate the distance with tendon tear.

Results

A cut-off value of 8.25?mm for the coraco-humeral distance gave a sensitivity of 77.5% and specificity of 72.7% for subscapularis tendon tear.

Conclusion

There is a well-known relationship between the coraco-humeral distance and the subscapularis tendon tear and its meticulous assessment in subjects with pain in the anterior shoulder region increases the diagnosis of subcoracoid impingement.  相似文献   

15.

Aim of the work

The aim of this study was to assess the rule of delayed T1 post contrast sequence in detection of active lesions in multiple sclerosis patients by comparing the early and delayed T1 post contrast images.

Materials

This was a prospective study and included 30 known multiple sclerosis patients with clinically suspected activity referred form neurology department to radiology department for MRI examination.

Methods

All patients were subjected to the followings: –?Conventional routine MRI of the brain using 1.5?T machine. –?T1 delayed post contrast sequence (about 10?min after contrast injection).

Results

The included MS cases showed 162 lesions of variable distribution as 113 lesions were supratentorial while 49 lesions were infratentorial. Among 162 lesions in the current cases 58 lesions showed post contrast enhancement while the remaining 104 lesions were non enhancing. From the total of enhancing lesions (58), 16 lesions showed early enhancement while 42 lesions showed delayed enhancement.

Conclusion

Delayed T1 post contrast is an important sequence for detection of active MS plaques as it increases the sensitivity of MRI.  相似文献   

16.

Objective

The aim of this study was to assess the accuracy of ultrasound elastography as a recent imaging technique in diagnosis of CTS and evaluation of its severity in patients suffering clinically compared to the results of the gold standard electrophysiological tests.

Materials and methods

This was a prospective cross sectional study included 100 patients clinically diagnosed as having unilateral idiopathic CTS (90% of the dominant hand), referred to radiology department from physical medicine department at Alexandria main university hospital from June 2015 till May 2016 after being evaluated electrophysiologically for correlation with the data of the ultrasound and ultrasound elastography of the median nerve. A control group of 100 patients with no wrist or hand complain were included in the study.

Results

As diagnosed electrophysiologically, there were 44 (44%), 35 (35%) and 21 (21%) patients with mild, moderate and severe degree of CTS respectively. The mean cross sectional area of the median nerve among the studied cases was 12.19?±?1.59?mm2 while the mean strain ratio of the median nerve by ultrasound elastography was 2.20 (1.0–5.0).

Conclusion

In addition to electrophysiological study, ultrasound and ultrasound elastography are valuable tools for the diagnosis and classification of CTS.  相似文献   

17.

Objectives

To assess the efficacy of radiofrequency ablation of Morton's neuroma (MN) as a substitute to surgery, in patients not responding to conservative treatment.

Methods

15 patients, who performed radiofrequency ablation (RFA) of Morton's neuroma between November 2015 and December 2016, were submitted to follow up to assess the response to therapy over a period of 6?months by assessment of pain relief through visual analogue scale (VAS) scale from 1 to 10 from least to severe pain.

Results

All of the 15 patients suffered from intense pain during their normal daily activity prior to RF ablation, pretreatment VAS average was 7.Follow up of the patients was done after 1?week, 1?month, 3?months and 6?months.After RF ablation, pain disappeared in 9 cases (60%), 3 had mild pain (20%), 2 moderate pain (13.3%) and 1 with severe pain (6.6%) and proceeded to surgery. Complete resolution of pain was encountered in the patients with mild and moderate pain with conservative or second session of RFA.

Conclusion

Radiofrequency ablation of Morton's neuroma, is an effective technique in treatment of symptomatic patient's after failure of conservative treatment and prior to surgical intervention.  相似文献   

18.

Background and objective

Laparoscopic sleeve gastrectomy become widely employed and accepted operation in between Arab population as a permanent solution for morbid obesity. There are many acute complications associated with LSG such postoperative leaks or bleeding, abscess formation, splenic infarction and portal vein thrombosis. The purpose of the study is to present how multidetector CT is beneficial as a screening investigation to detect these complications.

Methods

We retrospectively review CT images done in the first week post operative for280 patients subjected to LSG the center in the period between July 2017-December 2017 (average age 39.5?years old).

Results

the leak was suspected in 3 patients documented by a direct leak of contrast in one of them, 2 patients active bleeding was clinically suspected, but the exact site of bleeding could not be identified by CT, 15 patients had serous fluid collection, splenic infarction was noticed in 18 patients, 3 patients developed postoperative hematoma one of them become infected, anterior abdominal wall hematoma seen in 5 patients, one patient developed portal vein thrombosis.

Conclusion

CT is an important imaging tool to diagnose post LSG complications.  相似文献   

19.

Objective

To evaluate the outcome and the cost value of surgical clips use as guidance for breast cancer localization in patients prepared for neoadjuvant chemotherapy (NAC).

Methods

A prospective study of 43 patients confirmed histopathologically to have breast cancer and prepared to receive pre-operative NAC. Surgical clips were inserted via US guidance. The patients were followed up by mammography and US before surgery to evaluate the treatment response meanwhile, assessment of clips location, migration and complications. The overall cost of clips was also calculated.

Results

Only 32 patients completed the study; the mean time interval was 32?weeks?±?2?weeks between the clip insertion date and the surgery. The number of the inserted clips was 34 surgical clips. Only two cases showed positive migration yet with no evidence of other complications occurred in our study patients. The average cost of the surgical clips was 145?±?20 Egyptian pounds (average 8–9 US$).

Conclusion

Surgical clips can be used safely to replace the usual commercial markers in the localization of breast cancer before NAC. They showed effective results with no complications, don't interfere with the patients' imaging and of the significant low cost compared to the commercial ones.  相似文献   

20.

Introduction

Data assimilated for coronary arteries angiography by MDCT with retrospective (ECG) gating could be used for LV function without the need to repeat examination.

Aim of the work

Is to study left ventricular segmental motility and global function using MDCT compared to MRI.

Patients and methods

Fifty patients had cardiac MDCT and MRI studies within the same hour. LVEDV and LVESV volumes were measured. Consequently, the (EF) was calculated, for wall motion analysis, cine loops evaluated by two radiologists.

Results

Excellent correlation between MDCT and MRI for the measurement of EDV (r2?=?0.962; p?<?0.001), and ESV (r2?=?0.988; p?<?0.001). Evaluation of EF revealed a good correlation between MDCT and MRI (r2?=?0.984; p?<?0.001) all by linear regression analysis. All the cardiac segments that shows dyskinesia or akinesia showed agreement between MDCT and MRI in cine images, the only disagreement in cases of mild hypokinesia detected only by MRI.

Conclusions

High agreement between MDCT and MRI in the study of left ventricular segmental motility and global function.  相似文献   

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