Combined CT venography with dual-slice scanning is an accurate method to diagnose deep venous thrombosis that may reveal additional imaging findings in some patients with possible pulmonary embolism.
Our objective was to evaluate the image quality of a 16-slice CT system with a rotation time of 375 ms in the assessment of coronary arteries. One hundred patients underwent iodine-enhanced CT coronary angiography within a single breath hold. Images were reconstructed in diastole, 300, 350, 400, 450, 500 and 550 ms prior to the onset of the next R-wave using absolute reverse retrospective ECG gating. The 15 coronary segments of the AHA classification were consensually reviewed by two radiologists. On the whole, best quality imaging was obtained with reconstruction intervals of -350 ms and -400 ms in high percentages of each segment (P<0.0001). Only 6.2% of the arteries with a diameter greater than or equal to 1.5 mm were not assessable because of extensive calcifications (3.9%), cardiac motion artifacts (1.9%), lack of enhancement (0.2%) and stent artifacts (0.3%). In patients with a heart rate above 70 beats per minute, the percentage of assessable segments decreased to 88%, while at a lower heart rate it increased to 95%. In 61% of the patients, all segments were assessable. In conclusion, this generation of CT technique may allow visualization of coronary arteries with a low percentage of non-assessable segments.
A 40-year-old white man with a 3-year history of mild to severe right thigh and knee pain was referred for radiographic investigation. Radiographs show a fusiform, bilaterally symmetrical enlargement of the diaphyses and metaphyses of the long bones (femur, tibia, fibula, radius and ulna). A narrowed medullary cavity is illustrated on CT scan of the femur. All bones show periosteal and endosteal bone formation. There is no history of familial involvement, trauma, infection or systemic illness. Blood chemistry could not point out any abnormality. Radiographic findings and clinical history suggest the diagnosis of Camurati-Engelmann disease, also known as progressive diaphyseal dysplasia (PDD). This case is of interest because of its rare metaphyseal involvement, mild form and sporadic presentation.
The purpose of our study was to derive from the anatomical literature an easy-to-use map of the brain areas supplied by the anterior choroidal artery (AChA) and to assess the correspondence between damage within the putative AChA areas and clinical symptoms. A thorough review of the literature led to the recognition of 16 anatomical areas which could be delineated on routine diffusion-weighted MR images. A database of 138 consecutive ischemic stroke patients examined with MRI less than 6 h after symptoms onset was thereafter processed in a retrospective way. Patients presenting with at least one damaged AChA area were selected so as to assess the prevalence of AChA infarction and the clinical correlates of the condition. Fifteen patients (11%) had at least one damaged AChA area. Only two of them had "pure" AChA-restricted infarction. Contralateral hemiparesis and contralateral hemianesthesia were best predicted by lesions within the tail of the caudate nucleus with a sensitivity of 87% and 83%, respectively. Homonymous hemianopsia best correlated with lesions within the posterior limb of the internal capsule and within the retrolenticular part of the internal capsule, with a sensitivity of 100% and a specificity of 70% for both areas. We concluded that the clinical-radiological correlations did not match the neurophysiological standards, thereby highlighting the limitation of this study, which involved a cohort of acute stroke patients recruited from clinical practice and investigated the clinical impact of these brain lesions, even when documented with the most sensitive imaging modality.
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