Background: Head injury is one of the leading causes of morbidity and mortality throughout the world. Fall injury is the main cause of head trauma followed by road traffic accidents (RTA) and physical assault. Every victim with altered level of consciousness must be evaluated for brain injury. Radiological evaluation has undergone dramatic changes with the advent of computed tomography (CT) as it can precisely define the nature and location of the culprit lesion(s).Aims and Objective: To identify the major CT scan findings in suspected cases of Head injury.Materials and Methods: Three hundred seventeen patients of age 4 years and above, with suspected cases of head injury attending emergency department of TUTH during a period of 3 months (28 June 2012 to 28 September 2012) were included in this study. Non-contrast CT scan of head was performed in a single slice Hitachi Spiral CT scanner and 10 mm axial slices of head without any interslice gap were obtained at 15-20 degrees to the canthomeatal line. Data analysis was performed in SPSS v.21.0 software.Results: From 317 patients studied 198(62.5%) were male and 119 (37.5%) were female. Head injury was more common in male. 80(25.23%) were below 15 years of age, 221(69.73%) were between 16 to 65 years and only 16(5.04%) were above 66 years of age. The mean age was 28.57 years. In 239(75.4%) of patients the CT scan was normal. The most common cause of head injury was fall which was found in 210(66.2%) patients followed by RTA 82(25.9%) and Physical Assault 25(7.9%). Fall as a cause of head injury was more common in children and old people, with the RTA being more common in adults and adolescents. The most common positive finding in CT was contusion which was found in 32(10.1%), 25(7.9%) had SDH, 11(3.5%) of the patients had EDH, 10(3.2%) had SAH. Headache was found to be nonspecific for predicting positive CT findings.Conclusion: CT was found highly sensitive in demonstrating fractures and was considered the modality of choice when imaging suspected cases of head injury and in emergency patients due to its accuracy, reliability, safety and wide availability.Asian Journal of Medical Sciences Vol.8(2) 2017 76-81
Introduction Normal orbital dimensions are important for diagnosing orbital pathologies. Computed tomography (CT) of the orbit is an important modality offering high accuracy for precise measurements of orbit. The study was disbursed to ascertain criteria for the normative values of the various orbital dimensions using computed tomography in patients visiting Tribhuvan University Teaching Hospital, Kathmandu. MethodsOrbital volume, ocular diameter, length of the interzygomatic line (IZL), the distance of the posterior extent of the globe from the interzygomatic line, globe position, diameters of extraocular muscles (medial, lateral, superior group, and inferior rectus) and lens density were measured in each eye of 172 patients undergoing CT examination of paranasal sinuses. The correlations with age and sex were also analyzed. ResultsMean values (mean±SD) of orbital volume, ocular diameter, IZL, globe position and lens density were 24.54±2.57 cm3, 2.44±0.22 cm, 94.3±6.2 mm, 12.3±2.4 mm and 141.43±16.62 HU respectively. Mean diameters of extraocular muscles were 3.67± 0.52 mm, 3.36± 0.50 mm, 3.74±0.42 mm and 3.87±0.38 mm for medial rectus, lateral rectus, inferior rectus and the superior group respectively. There was no significant age and gender difference in most of the measurements. There was significant positive correlation of age with lens density, orbital volume and ocular diameter (p<0.05). ConclusionNormative data of different orbital measurements were obtained. The present result may help radiologists and ophthalmologists to accurately assess various orbital parameters, particularly in Nepalese populations.
Introduction: Pancreatic pathologies present a challenge for the medical imaging professionals for detection, classification and staging. Multiphasic multidetector computed tomography provides detailed visualization and definition of deeper and smaller structures and enhancement pattern of tumors during different phases. The objective of this study was to optimize the scan delay time for contrast enhanced computed tomography of pancreas after the use of bolus tracking technique. Materials and methods: Triphasic MDCT of the pancreas was performed on 109 patients after administration of 300-350 mgI/mL contrast medium injected at 3.5 mL/s. Patients were prospectively randomized into three groups with different scanning delays for the three phases (arterial, pancreatic, and venous) after bolus tracking was triggered at 100 HU of aortic contrast enhancement. Mean attenuation values of the abdominal aorta, superior mesenteric artery, pancreatic parenchyma, splenic vein, portal vein, and hepatic parenchyma were measured. Increases in attenuation values after contrast administration were assessed. Results: Mean contrast enhancement in the aorta (change in attenuation, 313–320 HU) and the superior mesenteric artery (change in attenuation, 291–302 HU) approached peak enhancement 4-7 seconds after bolus tracking was triggered. Pancreatic parenchyma became most intensely enhanced (change in attenuation, 107–110 HU) 20-25 seconds after triggering, and then the enhancement gradually decreased. Enhancement of the splenic vein and portal vein peaked at 22 seconds. Liver parenchyma reached 71 HU, 25 seconds after triggering and reached a plateau (change in attenuation, 81-76 HU) at a further scanning delay of 45–50 seconds. Conclusion: Based on the protocol used in this study, the optimum scan delay were 4-7 seconds for arterial phase, 10-22 seconds for pancreatic parenchymal phase and 40-50 seconds for the hepatic parenchymal phase; after bolus tracking triggered at 100 HU in the abdominal aorta.
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