Highlights
Metastatic involvement of the diaphragm is more common than primary malignancy.
Isolated diaphragmatic metastasis is very rare.
Contrast-enhanced multidetector computed tomography provides essential information for preoperative planning.
A pathology study and surgical revision are the most informative diagnostic methods.
Purpose:to develop optimal technique of cardiac multidetector computed tomography (MDCT) before noninvasive cardiac mapping before cateter ablation of atrial fibrillation.Materials and methods.94 patients with atrial fibrillation were included in study (60 males, 34 females; mean age = 58.3 ± 10 years; mean body mass index (BMI) = 29.9 ± ± 4.8). The patients were divided into 2 groups: I – 80 patients who underwent computer tomography (CT)-protocol for noninvasive cardiac mapping with standard contrast enhancement (single-bolus protocol); II – 14 patients who underwent CT with modified contrast enhancement technique with preliminary contrast injection (prebolus). To detect thrombotic masses in the left auricle the low-dose delayed phase was performed. The analysis of individual features of pulmonary veins, left atrium and adjacent structures was performed. Contrast enhancement of heart chambers was assessed by mean attenuation and homogeneity measurement.Results and discussion.The typical anatomy of the right pulmonary veins was in 93.6% of cases; right middle pulmonary vein in 5.3%; right segmental veins in 1.1%. The typical anatomy at the left side was in 57.4% of cases; common vestibulum of the left pulmonary veins in 18.1%; common left trunk in 24.5%. Volume enlargement of the left atrium (LA) was in 96.8% of patients. In 6 cases left auricle thrombosis was suspected, low-dose delayed phase was performed. In 2 cases filling defects in left auricle persisted, thrombosis was proved by transesophageal echocardiography. With the single-bolus injection protocol the contrast enhancement of left heart chambers was best (mean attenuation of blood in LA = 296 ± 84 HU, in left ventricle (LV) = 286 ± 83 HU), but the contrast enhancement and homogeneity of the chambers were insufficient (mean attenuation of blood in right atrium (RA) = 179 ± 97 HU, in right ventricle (RV) = 176 ± 80 HU). With prebolus protocol the contrast enhancement and homogeneity of all chambers were optimal (mean attenuation of blood in LA = 259 ± 31 HU, in LV = 286 ± 83 HU, in RA = 270 ± 92 HU, in RV = 253 ± 80 HU). This allowed making more accurate epi-endocardial heart models in the noninvasive cardiac mapping and operation planning.Conclusion.MDCT with standard contrast enhancement protocol provides detailed information about anatomy and size of pulmonary veins, the left atrium volume, the presence of intracardiac masses (including thrombotic masses), the anatomy of adjacent structures. The modified contrast enhancement technique with preliminary contrast injection (prebolus) allows to receive optimal contrast enhancement of all heart chambers and to make high accurate epi-endocardial models of both the right and left sides of the heart in case of noninvasive cardiac mapping.
To investigate the dependence of textural parameters of pancreatic ductal adenocarcinoma on using standard and low-dose CT protocols.Materials and methods. The study included 52 consecutive patients with histologically confirmed pancreatic ductal adenocarcinoma who underwent contrast enhanced computed tomography using standard (120 kV) and low-dose (100 kV) scanning protocols. We compared radiomics features of the identical histological tumors in all scanning phases.Results. We calculated 53 radiomics features in all types of pancreatic ductal adenocarcinoma grade differentiation for all scanning phases. We identified that out of 53 features of texture analysis, less than half was statistically different for each scan phase (11 parameters (20.8%) for the unenhanced phase; 18 parameters (34%) for the arterial; 19 parameters (35.8%) for the venous and delayed scanning phases), in all types of tumor differentiation (GLCM_ Contrast, GLCM_Correlation, GLCM_Dissimilarity, GLRLM_SRHGE etc., p < 0.05).The diagnostic accuracy of more than 50% of the radiomics features is preserved when changing kV in the CT scan protocol.Conclusion. The use of a low-dose CT protocol doesn’t affect the diagnostic accuracy of the features of texture analysis in the preoperative assessment of the degree of differentiation of pancreatic ductal adenocarcinoma.
Purpose of research. The aim of the study is to evaluate changes in density, Agatston score, Volume and Mass scores of coronary calcium at different scanning parameters using phantom measurement.Materials and methods. 8 1-ml insulin syringes filled with potassium hydroorthophosphate solution of different densities were used in the study. The syringes were placed at regular intervals into two phantoms: type 1 phantom – container filled with water; type 2 phantom – Chest Phantom N1 “LUNGMAN”. The phantoms were scanned with a Philips Ingenuity Elite CT 128 scanner using protocols with different voltages (80, 100, 120, 140 kV), amperage (27–45, 166, 330–400 mA), and slice thickness (0.625, 1, 2.5, 3 mm).Results. Density and Agatston indexes were obtained at different scanning parameters (voltage, amperage, slice thickness) for different factors of calcification density in both phantoms. The results are presented as a table with mean density values, standard deviation (SD), Agatston score of coronary calcium, and scanning parameters.Conclusion. The study demonstrates the influence of various scanning parameters on coronary artery calcium scoring results. The obtained information can be used in practice for more accurate quantification of coronary artery calcium, regardless of the scanning parameters.
Endometriosis is a common pathological condition characterized by the presence of endometrial glands and stroma outside the uterus, most frequently in the pelvis. Despite the ability to demonstrate infiltrative growth and tendency to local recurrence and invasion, endometriosis is considered as a benign proliferative disease. An increasing incidence of extragenital endometriosis (including that in young patients) and difficulties associated with its visualization during ultrasonography lead to a delayed diagnosis, resulting in an increase in the number of cases of advanced endometriosis, which requires long-term treatment. The improvement of a screening ultrasound tomography technique and development of specific ultrasound criteria for preventive examination will ensure rapid identification of patients requiring treatment. In this retrospective study, we analyzed 57 cases of extragenital endometriosis detected during preventive examinations of women between 2014 and 2019. Each case was analyzed with the consideration of ultrasound characteristics together with clinical and gynecological data. We evaluated location, size, contours, and structure of foci. We propose a method of extended ultrasound examination in women with suspected extragenital endometriosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.