Background:Acute pulmonary embolism is one of the most common cardiovascular diseases. Computer-aided technique is widely used in chest imaging, especially for assessing pulmonary embolism. The reliability and quantitative analyses of computer-aided technique are necessary. This study aimed to evaluate the reliability of geometrybased computer-aided detection and quantification for emboli morphology and severity of acute pulmonary embolism. Material/Methods:Thirty patients suspected of acute pulmonary embolism were analyzed by both manual and computer-aided interpretation of vascular obstruction index and computer-aided measurements of emboli quantitative parameters. The reliability of Qanadli and Mastora scores was analyzed using computer-aided and manual interpretation. Results:The time costs of manual and computer-aided interpretation were statistically different (374.90±150.16 versus 121.07±51.76, P<0.001). The difference between the computer-aided and manual interpretation of Qanadli score was 1.83±2.19, and 96.7% (29 out of 30) of the measurements were within 95% confidence interval (intraclass correlation coefficient, ICC=0.998). The difference between the computer-aided and manual interpretation of Mastora score was 1.46±1.62, and 96.7% (29 out of 30) of the measurements were within 95% confidence interval (ICC=0.997). The emboli quantitative parameters were moderately correlated with the Qanadli and Mastora scores (all P<0.001). Conclusions:Computer-aided technique could reduce the time costs, improve the and reliability of vascular obstruction index and provided additional quantitative parameters for disease assessment.
A 13-year-old girl was referred to our hospital with a history of chest tightness and shortness of breath after activity for 1 year.Systolic murmurs were audible on auscultation of the left sternal border second intercostal. Electrocardiography indicated a normal sinus rhythm. Transthoracic echocardiography (TTE) revealed a large cavity connected to the lateral wall of the right atrium (RA).The apical four-chamber view revealed this large cavity, measuring 33 × 38 mm and communicating with the RA via a broad neck, the diameter of which was 20 mm (Figure 1A, arrow). The anatomical position and structure of the tricuspid valve (TV) were normal. The right ventricle (RV) and TV annular were moderately compressed by the abnormal cavity, whereas tricuspid regurgitation was mild.No thrombus was observed within the abnormal chamber. Color Doppler flow imaging (CDFI) showed free bi-directional flow between the RA and large cavity ( Figure 1B-C, arrow). In addition, a 10-mm atrial septal defect (ASD) was noted, through which a leftto-right shunt signal was detected on CDFI. Other cardiac parameters were within the normal ranges. Thus, the patient was diagnosed
OBJECTIVE: To investigate feasibility of the quantitative parameters of dual-energy computed tomography (DECT) to assess therapy response in advanced non-small cell lung cancer (NSCLC) compared with the traditional enhanced CT parameters based on the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. METHODS: Forty-five patients with unresectable locally advanced NSCLC who underwent DECT before and after chemotherapy or concurrent chemoradiotherapy (cCRT) were prospectively enrolled. By comparing baseline studies with follow-up, patients were divided into two groups according to RECIST guidelines as follows: disease control (DC, including partial response and stable disease) and progressive disease (PD). The diameter (D), attenuation, iodine concentration and normalized iodine concentration of arterial and venous phases (ICA, ICv, NICA, NICv) and the percentage of these changes pre- and post-therapy were measured and calculated. The Pearson correlation was used to analyze correlation between various quantitative parameters. The receiver operating characteristic (ROC) curves were used to evaluate accuracy of therapy response prediction. RESULTS: The change percentages of Attenuation (Δ-Attenuation-A and Δ-Attenuation-V), IC (ΔICA and ΔICV) and NIC (ΔNICA and ΔNICV) pre- and post-therapy correlate with the change percentage of D (ΔD). Among these, ΔICA strongly correlates with Δ D (r = 0.793, P < 0.001). The areas under ROC curves generated using Δ-Attenuation-A, ΔICA, and ΔNICA are 0.796, 0.900, and 0.880 with the corresponding cutoff value of 9.096, −15.692, and −4.7569, respectively, which are significantly different (P < 0.001). CONCLUSIONS: The quantitative parameters of DECT iodine map, especially iodine concentration, in arterial phase provides a new quantitative image marker to predict therapy response of patients diagnosed with advanced NSCLC.
Coronary artery fistula (CAF) is a congenital disease in which a communication forms between one or more coronary arteries and a cardiac chamber or great vessel. We describe an infrequent case of right coronary artery (RCA) fistula into the right ventricle (RV) complicated by infective endocarditis in a child. The patient received echocardiography and contrast‐enhanced multidetector computed tomography (MDCT). Surgical treatment was performed after management of the infection. Unfortunately, a residual fistula formed after surgery. However, interestingly, the residual fistula spontaneously resolved at one year after surgery. He is now in good condition and totally asymptomatic.
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