The request for CT diagnostic in patients with suspected COVID-19 pneumonia has become part of the daily clinical routine. We reported a case of a 61-year-old patient with flu-like symptoms and a suspected COVID-19 pneumonia. After a negative PCR-test, a non-contrast enhanced CT was performed which revealed a suspicious hyperdensity in the left pulmonary artery and a pneumonia in the left lower lobe. A contrast enhanced CT confirmed a pulmonary embolism. An acute pulmonary embolism is a major complication and a main differential diagnosis of COVID-19. A hyperdense pulmonary artery sign (PAS) is a sensitive sign for a pulmonary embolism. Non-enhanced chest CT scans should be checked for hyperdense PAS in suspected of COVID-19 patients.
Introduction: Determining the dignity of intraductal papillary mucinous neoplasms (IPMNs) by imaging procedures is challenging. Various CT-based criteria were evaluated. Patients and Methods: Preoperative CT scans from 47 patients with IPMN were analyzed. Predefined criteria of malignancy were compared between patients with benign (bIPMN; n = 28) and malignant (mIPMN; n = 19) tumors, and a summation score was determined. Results: Preoperative carbohydrate-antigen 19-9 levels were higher in patients with mIPMN (p = 0.013). The diameter of the main pancreatic duct was greater in patients with mIPMN (p < 0.0001). More patients with mIPMN showed bile duct obstruction (p = 0.0076), solid tumor components (p = 0.0076), contrast enhancement in cystic walls (p = 0.0086), peripancreatic lymph nodes (p = 0.0076), and abrupt diameter changes of the main pancreatic duct (p = 0.0008). The CT density of the cysts was higher in mIPMN (p = 0.0063). The diagnostic accuracy of the summation score (sensitivity: 0.84, specificity: 0.96) was greater when compared to each individual CT parameter. Conclusions: The prevalence and extent of various CT-based abnormalities are greater in patients with mIPMN, but the wide overlap limits the diagnostic value of each individual parameter. A simple summation score largely enhances the diagnostic accuracy.
These findings indicate that vibrography is a promising real-time imaging method with numerous potential applications in the field of neurosurgery. Visualization of the elastic properties provides the neurosurgeon with additional data on the lesion and the boundary between the lesion and the surrounding tissue.
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