Quantitative evaluation of cardiac image data obtained using multidetector row computed tomography (CT) is compromised by partial scan reconstructions, which improve the temporal resolution but significantly increase image-to-image CT number variations for a fixed region of interest compared to full reconstruction images. The feasibility of a new approach to solve this problem is assessed. An anthropomorphic cardiac phantom and an anesthetized pig were scanned on a dual-source CT scanner using both full and partial scan acquisition modes under different conditions. Additional scans were conducted with the electrocardiogram (ECG) signal being in synchrony with the gantry rotation. In the animal study, a simple x-ray detector was used to generate a signal once per gantry rotation. This signal was then used to pace the pig's heart. Phantom studies demonstrated that partial scan artifacts are strongly dependent on the rotational symmetry of angular projections, which is determined by the object shape and composition and its position with respect to the isocenter. The degree of partial scan artifacts also depends on the location of the region of interest with respect to highly attenuating materials (bones, iodine, etc.) within the object. Singlesource partial scan images (165 ms temporal resolution) were significantly less affected by partial scan artifacts compared to dual-source partial scan images (82 ms temporal resolution). When the ECG signal was in synchrony with the gantry rotation, the same cardiac phase always corresponded to the same positions of the x-ray tube(s) and, hence, the same scattering and beam hardening geometry. As a result, the range of image-to-image CT number variations for partial scan reconstruction images acquired in synchronized mode was decreased to that achieved using full a)Author to whom correspondence should be addressed. Electronic
Objectives: The chest CT findings that can distinguish patients with corona virus disease 2019 (COVID-19) from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative have not previously been described in detail. The purpose of this study was to determine the distinctions among patients with COVID-19 by comparing the imaging findings of patients with suspected confirmed COVID-19 and those of patients initially suspected to have COVID-19 who were ultimately negative for the disease. Methods: 28 isolated suspected in-patients with COVID-19 were enrolled in this retrospective study from January 22, 2020 to February 6, 2020. 12 patients were confirmed to have positive severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) RNA results, and 16 patients had negative results. The thin-section CT imaging findings and clinical and laboratory data of all the patients were evaluated. Results: There were no significant differences between the 12 confirmed COVID-19 (SARS-Cov-2-positive) patients and 16 SARS-CoV-2-negative patients in epidemiology and most of the clinical features or laboratory data. The CT images showed that the incidence of pure/mixed ground-glass opacities (GGOs) was not different between COVID-19 and SARS-CoV-2-negative patients [9/12 (75.0%) vs 10/16 (62.5%), p = 0.687], but pure/mixed GGOs in the peripheral were more common in patients with COVID-19 [11/12 (91.7%) vs 6/16 (37.5%), p = 0.006]. There were no significant differences in the number of lesions, bilateral lung involvement, large irregular/patchy opacities, rounded opacities, linear opacities, crazy-paving patterns, halo signs, interlobular septal thickening or air bronchograms. Conclusions: Although peripheral pure/mixed GGOs on CT may help distinguish patients with COVID-19 from clinically suspected but negative patients, CT cannot replace RT-PCR testing. Advances in knowledge: Peripheral pure/mixed GGOs on-chest CT findings can be helpful in distinguishing patients with COVID-19 from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative.
Objective: The purpose of this study was to evaluate the radiological and clinical findings of invasive pulmonary aspergillosis (IPA) after liver transplantation. Methods: This study included 25 consecutive liver transplant recipients with histologically confirmed IPA after liver transplantation. Radiological examinations performed for diagnosis were available in all patients. Clinical findings and changes in clinical response and radiological findings after treatment were also evaluated. Results: 3 main radiological findings were identified: nodules, 64% (16/25); masses, 36% (9/25); and consolidations in a patchy pattern, 20% (5/25). A tree-in-bud pattern was found in 12% (3/25) of patients. In 8 (32%) of 25 patients, we found a combination of 2 or more of these signs: 5 (20%) patients presented with concurrent nodules accompanied by patchy consolidations and/or tree-in-bud, and 3 (12%) patients showed masses accompanied by large consolidations. A halo sign was observed in 20 (80%) of 25 patients. Hypodense sign and cavitary lesions were encountered in 17 (68%) of 25 patients. Follow-up radiological findings after treatment showed improvement in 18 patients, no change in 4 patients and progression in 3 patients. There were three aspergillosis-associated deaths during the follow-up period. The onset time of IPA was a median of 31 days after transplantation. The most common symptom at diagnosis was fever (n=15). None of the 25 patients had leukopaenia at the time of the diagnosis of IPA. Conclusions: The most common radiological findings of IPA after liver transplantation are multiple nodules with or without halo sign, masses and consolidations, which usually appear about 1 month after transplantation.
The presence of large nodules with the halo sign is most suggestive of fungal infection after OLT. Other HRCT patterns are not helpful in distinguishing among the various types of infection seen in liver transplant recipients.
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