Multidetector computed tomography (CT) in evaluation of congenital cyanotic heart diseases

Background: The aim of the study is to emphasize the role of 128 MSCT angiography in the diagnosis of congenital cyanotic heart diseases. Material/Methods: This study included sixty patients and was conducted from December 2014 to July 2016 in the Multidetector CT unit of Zagazig University hospitals. All images included axial, MPR, MIP, and VRT and were interpreted in one session. Pulmonary veins were assessed for PAPVR or TAPVR, PDA, cardiac apex and heart chambers, interatrial or interventricular septal defects, pericardium, and site and size of the great veins (IVC and SVC). Results: This study included 60 patients. Thirty-four were boys (56.7%), and 26 were girls (43.3%). The age ranged from nine months to five years, and the mean age was 34.5 months. We found the following anomalies: tetralogy of Fallot (15 patients, 25%), tricuspid atresia (12 patients, 20%), Ebstein's anomaly (4 patients, 6.5%), pulmonic atresia or stenosis (7 patients, 11.5%), truncus arteriosus (6 patients, 10%), TGA (10 patients, 17%), and TAPVR (6 patients, 10%). Conclusions: MDCT proved to be an important modality for decision-making in patients with congenital cyanotic heart diseases

Acute chest pain of coronary origin in patients without diabetes : how multidetector computed tomography (MDCT) angiography helps in diagnosis

Background: To assess the diagnostic value of MDCT coronary angiography for evaluation of acute chest pain of coronary origin in non-diabetic patients. Material/Methods: In 22 patients without DM, we assessed coronary arteries with multidetector CT angiography and invasive conventional angiography. Results: CT coronary angiography revealed positive coronary artery disease findings in 16 patients; LAD was affected in 16 (72.3%), RCA in 14 (63.3%), and LCX in 8 (36.4%) cases. The proximal part of LAD was the most commonly affected coronary artery (14 cases, 63.3%) in the studied patients who underwent MSCT coronary angiography. As regards the calcium score, 4 patients (18%) had low calcium scores, 6 cases (27%) had moderate calcium scores, and 12 cases (55%) had high calcium scores. There were 6 patients with positive findings of coronary artery disease detected on MDCT coronary angiography that were not mirrored by conventional angiography. Conclusions: MDCT angiography of the coronaries is a good and rapid method for evaluation of the coronary anatomy and for early detection and grading of coronary lesions in non-diabetic patients

Variability in sphenoid sinus pneumatization and its impact upon reduction of complications following sellar region surgeries

Background: The rapid evolution of transsphenoidal endoscopic surgical intervention and surgeries of skull base and sellar regions is accompanied by multiple complications. Objective: To determine different types of extension of sphenoid sinus pneumatization detected by CT and MRI and their impact upon different approaches and complications of sellar region surgeries. Subjects and methods: The pre-operative CT and MRI images of 182 patients with surgical intervention for peri-sellar region pathologies were retrospectively evaluated for patterns of sphenoid pneumatization. Post surgical complications were recorded and analyzed. Results: The overall rate of complications was 88 affecting 62 patients (34%), and 120 patients (66%) were free of complications. Different types of pneumatization were detected on CT and MRI images, conchal in 3 cases (1.6%), presellar 23 cases (12.6%) and 156 cases (85.7%) showing sellar pneumatization. Sellar pattern was reclassified into 6 types. Single inter sphenoid septum was seen in 109 patients, accessory septum was found in 13 patients and 10 patients have multiple sphenoid septation. 24 patients (13.2%) show absent septum. Conclusion: Pre-intervention assessment of sphenoid sinus pneumatization is mandatory in approaching the sella and skull base structures either via the nose or open skull base surgery to avoid injury of the nearby structures and reduce the possibility of CSF leakage

Role of multislice CT and magnetic resonance cholangiography in preoperative evaluation of potential donor in living related liver transplantation

Purpose: The aim of this study was to evaluate the role of multislice CT (MSCT) and magnetic resonance cholangiography (MRC) in evaluation of potential donors in living related liver transplantation. Patients and methods: Twenty-five potential donors included in our study. All potential donors underwent 1st step medical examination and laboratory investigations to enter the 2nd step investigations with MSCT for calculation of the hepatic parenchymal CT density, reconstruction of hepatic vascular anatomy and CT volumetry. Magnetic Resonance cholangiography (MRC) and intra-operative cholangiography (IOC) were done on only 23 patients for biliary tree assessment. Results: Of the 25 patients evaluated by MSCT, 23 patients (92%) were accepted. Two patients (8%) were excluded from surgery because of anatomical criteria, regarding portal vein variants based on CT findings. One showed right anterior portal vein arising from left portal vein and the other showed trifurcation of the main portal vein. Conclusion: Multislice CT is a valuable tool in the evaluation of potential living liver donors that provides complete information on the hepatic vascular anatomy, the liver parenchyma, and volumetric measurements. MRC with a 3.0-T MR system demonstrates the preoperative biliary evaluation very well with a high accuracy rate