Misty mesentery: a pictorial review of multidetector-row CT findings
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Multidetector computed tomography
Multidetector computed tomography
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There are several anomalies of the pulmonary vessels. Clinicians need to be well informed about anatomy, particularly before video-assisted thoracic surgery, to prevent fatal complications.We report the case of an 80-year-old woman who was suspected of having lung cancer in the right lower lobe. The patient was accordingly scheduled for surgery. Three-dimension multidetector computed tomography (3D-MDCT) showed an extremely rare anomaly in which A4 + 5 ran between V2 and V1 + 3. We scheduled a non-anatomical wedge resection of the lesion and performed rapid pathological diagnosis during surgery. Because adenocarcinoma was diagnosed, we performed right lower lobectomy using video-assisted thoracic surgery. Station 11i lymph node rigidly adhered to the main pulmonary artery, V2, and intermedius bronchus. Thus, the surgery was shifted to middle and lower lobectomy.To the best of our knowledge, this type of anomaly has not been reported yet. Pulmonary vessels can be accurately identified using 3D-MDCT; thus, a rare anatomy can be identified, and information can be shared across the surgical team simulating familiarity with this rare anatomy.Using 3D-MDCT, we could accurately divide A4 + 5 and safely perform the surgery.
Multidetector computed tomography
Anomaly (physics)
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BACKGROUNDAnastomosis of the testicular vein with the superior mesenteric vein rarely causes severe gastrointestinal bleeding.To date, there have been few studies describing its appearance on medical imaging.Here, we present multidetector computed tomography three-dimensional and multiplanar reconstruction (MPR) images of a typical digital subtraction angiography showing proven ectopic bleeding and provide the first review of the image performance. CASE SUMMARYA 68-year-old man who had been rushed to the hospital with a four-day history of melena and fainting underwent multiple esophagogastroduodenoscopy procedures that failed to identify the source of bleeding.We used MPR combined with three-dimensional reconstruction images, and found that the testicular vein had anastomosed with the superior mesenteric vein, and they clustered together in the jejunal vessel wall, which caused severe gastrointestinal bleeding.Digital subtraction angiography confirmed the location of bleeding.After transfusion and embolization therapy, the patient's condition improved. CONCLUSIONComputed tomography-MPR combined with three-dimensional images offers significant value in the localization and qualitative assessment of rare gastrointestinal hemorrhage.The features of multiphase spiral scanning can improve the accuracy of the diagnosis.
Multidetector computed tomography
Gastrointestinal bleeding
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Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases. Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch. In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch.
Multidetector computed tomography
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Aims To retrospectively evaluate the correlation between multidetector‐row computed tomography findings of acute appendicitis and the pathological status of acute appendicitis, and evaluate the capability of multidetector‐row computed tomography to predict the pathological status of acute appendicitis in children. Methods The presence of a distended appendix (>6 mm in transverse diameter) was used as a primary sign to indicate the presence of appendiceal inflammation. The presence of appendiceal wall thickening (>1 mm) and enhanced appendiceal wall continuity were also used as predictive findings to reflect the degree of progression of acute appendicitis on multidetector‐row computed tomography findings. The findings of each individual case were classified into four grades. The final pathological diagnosis was classified into four groups: normal findings, only mucosal inflammation, inflammation with intramural spreading, and gangrenous. The relationship between the pathological grades and computed tomography grades was analyzed using S pearman's rank correlation test. Results Four of six cases in Grade 0 reflected normal appendiceal findings (66.7%) and 3 of 5 cases in Grade I reflected only mucosal inflammation status (60.0%). Forty‐four of 51 cases in Grade II reflected intramural inflammation status (86.3%), and 40 of 57 cases in Grade III reflected gangrenous status (70.2%). The multidetector‐row computed tomography grade was significantly correlated to the pathological grade with Spearman's rank correlation coefficient of 0.689 ( P < 0.001). Conclusions There was a close relationship between the multidetector‐row computed tomography imaging findings and the pathological findings. This preoperative information is extremely useful for decision‐making in the treatment strategy for acute appendicitis in children.
Multidetector computed tomography
Rank correlation
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Multidetector computed tomography
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大網裂孔ヘルニアは稀な疾患であり，特徴的な臨床所見を呈しないため術前診断が困難である．近年，画像診断の進歩により術前に診断しえた報告も増えている．今回われわれはmultidetector CT（以下MD-CT）により大網裂孔ヘルニアと術前診断し緊急手術を施行した症例を経験したので報告する．症例は30歳の男性，嘔吐，右下腹痛を主訴に来院した．右下腹部に圧痛あるが，反跳痛や筋性防御は認めなかった．MD-CTによって再構築した画像所見では横行結腸より腹側に脱出した拡張腸管とヘルニア門，腸間膜の収束像を認めた．大網裂孔ヘルニアを疑い同日緊急手術を行った．手術は腹腔鏡下に開始し循環不全に陥った腸管を同定し，臍上部より４cmの切開創から大網に生じた直径約３cmのヘルニア門に約30cmに渡る小腸が嵌頓していることを確認した．ヘルニア門を切開し開大すると血流の改善を認めたため，腸管切除は不要と判断し手術を終了した．患者は術後12日目に軽快退院した．
Multidetector computed tomography
Abdominal computed tomography
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Background: Gastric cancer is the third most common cause of cancer-related death in the world.Currently, multislice computed tomography (MSCT) is a valuable tool for detection, staging, surveillance, and post-treatment evaluation of gastric neoplasm.Objective: The aim of this work is to clarify the role of multidetector CT in diagnosis and preoperative staging of gastric carcinoma.Patients and methods: The present study was conducted between October 2017 and June 2019 on 60 patients (26 males and 34 females) with age ranged from 28 to 73 years with mean age of 53 years.The patients were complaining of symptoms of gastric cancer or as a follow-up study for gastric cancer, referred to the CT Unit in Tanta University Hospital, Tanta Oncology Center and Health Insurance Hospital from the Oncology Department.Results: In our study we found that there was a significant relationship between pathological and CT staging by using MPR.CT with MPR was specific and accurate in diagnosis of all stages of gastric cancer with specificity ranged between (95-100%) and accuracy ranged between (94.5-97.5%).However, it showed lowest sensitivity in diagnosis of stage 1 of gastric cancer.On the other hand, it showed highest sensitivity (97.5%) in diagnosis of stage IV.Conclusion: MSCT is a valuable tool for detection, staging, surveillance, and post-treatment evaluation of gastric neoplasm.
Multidetector computed tomography
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Poster: RANZCR-AOCR 2012 / R-0073 / Analysis of Frontal Sinus Disease and the Relationships to the Nearby Structures: A Multidetector Computed Tomography Study by: J. K. Han, I. Y. Kim, H. C. Shin, H. H. Kim, S. S. Jo
Multidetector computed tomography
Frontal sinus
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Inaba, Kenji; Branco, Bernardino C.; Menaker, Jay; Scalea, Thomas M.; Crane, Sean; DuBose, Joseph J.; Tung, Lily; Reddy, Sravanthi; Demetriades, Demetrios
Multidetector computed tomography
Neck injury
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