Myocardial Iron Loading in Patients With Thalassemia Major in Turkey and the Potential Role of Splenectomy in Myocardial Siderosis

WOS: 000291924700022PubMed ID: 21364469Iron-induced cardiac disease is the leading cause of death in thalassemia major (TM). Splenectomy is performed in TM to reduce transfusion requirements and iron intake. Prevalence of myocardial siderosis and its relationship with splenectomy in 146 patients with TM were investigated. The patients with myocardial siderosis (T2* < 20 ms) accounted for 42% of the cohort. Splenectomized patients had a higher incidence of myocardial siderosis (48%) compared with those having intact spleen (28%) and significantly higher myocardial iron content. Higher myocardial iron content in splenectomized patients may deserve special attention for the role of spleen in iron regulation

Salvage of Suboptimal Enhancement of Pulmonary Artery in Pulmonary CT Angiography Studies: Rapid kVp Switch Dual Energy CT Experience

WOS: 000533549200015Background: Multidetector computed tomography (MDCT) angiography is considered as the gold standard imaging modality in the evaluation of acute pulmonary embolism. Optimum vascular enhancement is critical forMDCTstudies. the suboptimal opacification in pulmonary artery could be salvaged using low-energy virtual monoenergetic images (VMI) at rapid kVP switch dual energy CT. Objectives: To explore the potential improvement in pulmonary artery opacification and to assess the change in image quality parameters in VMI using fast switch kVp dual energy CT. Patients and Methods: the CT images of 877 patients who were referred with a preliminary diagnosis of pulmonary embolism were reviewed. Sixty patients with suboptimal enhancement (= 3. Fifty six studies that met these criteria were considered as salvaged. At this best energy level, quantitative parameters were compared with standard images. Results: the mean attenuation of pulmonary arteries was 169.80HUin standard images in patients with suboptimal enhancement. the attenuations of VMIs at 40, 45, 50, 55, 60, 65, and 70 keV were significantly higher than standard images (P < 0.001). Similar findings were observed with SNR and CNR. in the salvaged patients, the average increase in mean pulmonary artery attenuation was 62% (from 172.61 +/- 23.4 to 280.55 +/- 40.7), the average increase in SNR was 38% (from 12.1 +/- 5.3 to 16.7 +/- 7.1) and the average increase in CNR was 48% (9.2 +/- 4.3 to 13.7 +/- 6) (P < 0.001). Conclusions: Low keV VMI reconstructions significantly increase pulmonary artery attenuation, CNR and SNR compared to standard image reconstructions. Suboptimal CT studies could be salvaged using low keV VMIs

Cardiac metastasis of osteosarcoma

WOS: 000285418300006Cardiac osteosarcoma metastasis is extremely rare and is documented in several case reports in the literature. The behaviour of osteosarcoma metastases is similar to the primary tumour. Thoracic non-enhanced computed tomography (CT) examination is beneficial in the detection of calcific cardiac metastases. In this case report, we describe a 29-year-old woman with cardiac osteosarcoma metastasis after 7 years of follow-up, compare the demographic features with previous cases and discuss the imaging findings

The novel coronavirus pneumonia (COVID-19): a pictorial review of chest CT features

WOS:000629039700005PubMed: 32815523Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China. The infection rapidly spread to more than 200 countries around the world. The clinical presentation of the disease may vary from mild illness to severe pneumonia such as acute respiratory distress syndrome (ARDS). The chest computed tomography (CT) has an important complementary role in diagnosis of the disease. The predominant CT findings of the disease are ground glass opacities and consolidations located in subpleural areas of lower lobes. Widespread ground-glass opacities, consolidation, air bronchograms, central involvement of lung parenchyma, mediastinal lymphadenopathy are more common in patients with the severe form of the disease. CT imaging also guides in differentiation of alternative diagnosis or in assessment of associated pulmonary embolism during the course of the disease. in this pictorial review we aim to review the CT features of COVID-19 pneumonia and mention the changes throughout the disease process

Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

Background: There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results: Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886-0.979, 100% sensitivity, 81% specificity). Conclusions: Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units

Bisphosphonate-Related Osteonecrosis of the Jaw Bones in a Patient with Ankylosing Spondylitis Receiving Anti-Tumor Necrosis Factor Treatment

WOS: 000299651800010Bisphosphonate-related osteonecrosis of the jaw bones is a rare, but well-recognized pathology, occurring mainly in patients receiving parenteral and high doses of bisphosphonates for the treatment of skeletal metastasis and/or hypercalcemia associated with cancer. However, to a lesser extent, this complication may also occur in patients receiving oral bisphosphonates for the treatment of osteoporosis. In this article, we present a 58-year-old female patient with ankylosing spondylitis (AS) who developed mandible osteonecrosis following long-term oral alendronate treatment for osteoporosis. Dental tooth extraction possibly triggered the occurrence of mandible osteonecrosis in this patient. This patient is notable for receiving concomitant anti-tumor necrosis factor (anti-TNF) treatment. To our knowledge, occurrence of bisphosphonate-related jaw osteonecrosis in a patient with AS receiving concomitant anti-TNF treatment has not been reported previously in the literature

MRI assessment of pituitary Iron accumulation by using pituitary-R2 in beta-thalassemia patients

WOS: 000432868300016PubMed ID: 28882060Background: Patients with thalassemia major (TM) require repeated blood transfusions, which leads to accumulation of iron in a wide variety of tissues. Accumulation of iron in the pituitary gland can lead to irreversible hypogonadotropic hypogonadism (HH) in this group of patients. Purpose: To investigate the reliability of pituitary-R.2 as a marker to estimate the extent of pituitary iron load by comparing the pituitary magnetic resonance imaging (MRI) findings with hepatic iron load and serum ferritin levels. Material and Methods: A total of 38 beta-TM patients were classified into HH (group A, n = 18) and non-HH (group B, n = 17) groups. A third group, group C, consisted of 17 healthy participants. Each participant underwent 1.5-T MRI examinations. Pituitary gland heights (PGH), pituitary-R2 values, and liver-R2 values were measured by using multi-echo spin-echo sequences. Results: Pituitary-R2 values were significantly higher in group A compared with group B Rho < 0.05). A positive correlation was detected between the pituitary-R2 values and serum ferritin levels in TM patients Rho < 0. 01) A threshold value of 14.1 Hz for pituitary-R2 was found to give a high specificity and sensitivity in distinguishing the TM patients with HH from those with normal pituitary functions. PGH measurements were significantly lower in group A compared with group B Rho < 0.05). Conclusion: MRI-assessed pituitary-R2 seems to be a reliable marker for differentiating the TM patients with normal pituitary function from those with secondary hypogonadism due to iron toxicity