Assessment of Bone Mineral Density in Male Patients with Chronic Obstructive Pulmonary Disease by DXA and Quantitative Computed Tomography

The purpose of this study is to identify the prevalence of osteoporosis in male patients with chronic obstructive pulmonary disease (COPD) by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and to compare the diagnostic abilities of the above methods. Thirty-seven male patients with established COPD were examined with DXA and standard QCT in lumbar spine, including L1, L2, and L3 vertebrae. T-scores and bone mineral density values were calculated by DXA and QCT method, respectively. Comparative assessment of the findings was performed and statistical analysis was applied. QCT measurements found more COPD patients with impaired bone mineral density compared to DXA, namely, 13 (35.1%) versus 12 (32.4%) patients with osteopenia and 16 (43.2%) versus 9 (16.2%) patients with osteoporosis (p=0.04). More vertebrae were found with osteoporosis by QCT compared to DXA (p=0.03). The prevalence of osteoporosis among male patients with COPD is increased and DXA may underestimate this risk. QCT measurements have an improved discriminating ability to identify low BMD compared to DXA measurements because QCT is able to overcome diagnostic pitfalls including aortic calcifications and degenerative spinal osteophytes

Acute occlusion of the celiac axis and its branches with perforation of gastric fundus and splenic infarction, findings on spiral computed tomography: a case report

We present the contrast-enhanced spiral CT findings in a case of acute celiac artery occlusion with gastric perforation and total splenic infarction. Spiral CT depicted thrombus in the celiac axis and its branches, stenosis of the superior mesenteric artery, splenic infarction and lack of enhancement of the gastric wall with a large necrotic gap. Spiral CT enabled prompt diagnosis and therapy in this rare condition in a patient with suspicion of acute mesenteric ischemia

Incidental Non-Cardiac Findings of a Coronary Angiography with a 128-Slice Multi-Detector CT Scanner: Should We Only Concentrate on the Heart?

Objective: To evaluate the spectrum, prevalence, and significance of incidental non-cardiac findings (INCF) in patients referred for a non-invasive coronary angiography using a 128-slice multi-detector CT (MDCT). Materials and Methods: The study subjects included 1,044 patients; 774 males (mean age, 59.9 years) and 270 females (mean age, 63 years), referred for a coronary CT angiography on a 128-slice MDCT scanner. The scans were acquired from the level of the carina to just below the diaphragm. To evaluate INCFs, images were reconstructed with a large field of view (> 300 mm) covering the entire thorax. Images were reviewed in the axial, coronal, and sagittal planes, using the mediastinal, lung, and bone windows. The INCFs were classified as severe, indeterminate, and mild, based on their clinical importance, and as thoracic or abdominal based on their locations. Results: Incidental non-cardiac findings were detected in 56% of patients (588 of 1,044), including 435 males (mean age, 65.6 years) and 153 females (mean age, 67.9 years). A total of 729 INCFs were observed: 459 (63%) mild (58% thoracic, 43% abdominal), 96 (13%) indeterminate (95% thoracic, 5% abdominal), and 174 (24%) severe (87% thoracic, 13% abdominal). The prevalence of severe INCFs was 15%. Two severe INCFs were histologically verified as lung cancers. Conclusion: The 128-slice MDCT coronary angiography, in addition to cardiac imaging, can provide important information on the pathology of the chest and upper abdomen. The presence of severe INCFs is not rare, especially in the thorax. Therefore, all organs in the scan should be thoroughly evaluated in daily clinical practice

RADIOLOGICAL FINDINGS OF THE ATLANTO-OCCIPITAL AREA IN PATIENTS WITH CHRONIC POLYARTHRITIS: PLAIN X-RAY FILMS, COMPUTER-TOMOGRAPHY, MAGNETIC-RESONANCE

THE RADIOLOGICAL FINDINGS ON C-T AND M.R.I. FILMS OF THE ATLANTO - OCCIPITAL AREA OF 55 PATIENTS WITH CONFIRMED CHRONIC POLYARTHRITIS ARE PRESENTED. AFTER A DETAILED ANALYSIS OF THE ANATOMY AND THE RADIOLOGICAL ANATOMY OF THE AREA THE ADVANTAGES OF EACH METHOD ARE DISCUSSED SEPARATELY AND IN COMPARISON TO THE OTHERS. PLAIN X-RAY FILMS, CLASSIC TOMOGRAPHY INCLUDED, HAD THE BEST RESULTS REGARDING THE VISUALISATION PERIOSTEAL REACTIONS AND BONE ERROSION. ALSO, THEY DEFINEBETTER THE ATLANTO-AXIAL DISTANCE, ESPECIALLY IN FUNCTIONAL STUDIES. CT VISUALISES WELL THE BONES' REACTION AS WELL AS THE SOFT TISSUE CHANGES. IT IS SUPERIOR IN THE DIFFERENTIAL DIAGNOSIS BETWEEN FLUID COLLECTION AND SOLID LESIONS. M.R.I. VISUALISES MORE OFTEN AND MORE CLEARLY THE SOFT TISSUE CHANGES ESPECIALLY THE COMPRESSION OF THE SUBARACHOIDAL SPACE AND THE SPINAL CORD. IT CAN ALSO DIFFERENTIATE INFLAMMATORY FROM NON-INFLAMMATORY CHANGES, IN MORE CASES THAN CT DOES. IT IS HOWEVER INTERIOR IN VISUALISING BONE REACTIONS.ΕΚΤΙΘΕΝΤΑΙ ΤΑ ΕΥΡΗΜΑΤΑ ΤΩΝ ΚΛΑΣΣΙΚΩΝ ΑΚΤΙΝΟΓΡΑΦΙΩΝ ΤΗΣ ΑΞΟΝΙΚΗΣ ΤΟΜΟΓΡΑΦΙΑΣ ΚΑΙΤΟΥ ΜΑΓΝΗΤΙΚΟΥ ΣΥΝΤΟΝΙΣΜΟΥ ΣΤΗΝ ΙΝΙΑΚΟ-ΑΥΧΕΝΙΚΗ ΠΕΡΙΟΧΗ ΣΕ 55 ΑΣΘΕΝΕΙΣ ΜΕ ΔΙΑΠΙΣΤΩΜΕΝΗ ΧΡΟΝΙΑ ΠΟΛΥΑΡΘΡΙΤΙΔΑ. ΜΕΤΑ ΑΠΟ ΛΕΠΤΟΜΕΡΗ ΑΝΑΛΥΣΗ ΤΗΣ ΑΝΑΤΟΜΙΑΣ ΚΑΙ ΤΗΣΑΚΤΙΝΟΑΝΑΤΟΜΙΑΣ ΤΗΣ ΠΕΡΙΟΧΗΣ ΣΥΖΗΤΑΤΑΙ Η ΑΞΙΑ ΤΗΣ ΚΑΘΕ ΜΕΘΟΔΟΥ ΧΩΡΙΣΤΑ ΚΑΙ ΣΕ ΣΥΓΚΡΙΣΗ ΠΡΟΣ ΤΙΣ ΑΛΛΕΣ. ΟΙ ΑΠΛΕΣ ΑΚΤΙΝΟΓΡΑΦΙΕΣ ΣΥΜΠΕΡΙΛΑΜΒΑΝΟΜΕΝΗΣ ΚΑΙ ΤΗΣ ΚΛΑΣΣΙΚΗΣ ΤΟΜΟΓΡΑΦΙΑΣ ΕΦΕΡΑΝ ΤΑ ΚΑΛΥΤΕΡΑ ΑΠΟΤΕΛΕΣΜΑΤΑ ΟΣΟΝ ΑΦΟΡΑ ΤΗΝ ΑΠΕΙΚΟΝΙΣΗ ΠΕΡΙΟΣΤΙΚΩΝ ΑΛΛΟΙΩΣΕΩΝ ΚΑΙ ΔΙΑΒΡΩΣΕΩΝ ΤΩΝ ΟΣΤΩΝ. ΕΠΙΣΗΣ ΑΝΑΔΕΙΚΝΥΕΙ ΚΑΛΥΤΕΡΑ ΤΗΝ ΑΤΛΑΝΤΟ-ΟΔΟΝΤΙΚΗ ΑΠΟΣΤΑΣΗ, ΙΔΙΑΙΤΕΡΑ ΔΕ ΣΤΙΣ ΔΥΝΑΜΙΚΕΣ ΛΗΨΕΙΣ . Η ΑΞΟΝΙΚΗ ΤΟΜΟΓΡΑΦΙΑ ΑΠΕΙΚΟΝΙΖΕΙ ΚΑΤΑ ΤΟΣΟ ΤΙΣ ΟΣΤΙΚΕΣ, ΟΣΟ ΚΑΙ ΤΙΣ ΑΛΛΟΙΩΣΕΙΣ ΤΩΝ ΜΑΛΑΚΩΝ ΜΟΡΙΩΝ: ΥΠΕΡΕΧΕΙ ΔΕ ΣΤΗΝ ΔΙΑΦΟΡΟΠΟΙΗΣΗ ΜΕΤΑΞΥ ΣΥΛΛΟΓΗΣ ΥΓΡΩΝ ΚΑΙ ΣΥΜΠΑΓΩΝ ΜΟΡΦΩΜΑΤΩΝ. Ο ΜΣ ΑΠΕΙΚΟΝΙΖΕΙ ΣΥΧΝΟΤΕΡΑ ΚΑΙ ΜΕ ΜΕΓΑΛΥΤΕΡΗ ΕΥΚΡΙΝΕΙΑ ΤΙΣ ΑΛΛΟΙΩΣΕΙΣ ΤΩΝ ΜΑΛΑΚΩΝ ΜΟΡΙΩΝ, ΙΔΙΑΙΤΕΡΑ ΔΕ ΤΗΝ ΣΥΜΠΙΕΣΗ ΤΟΥ ΥΠΑΡΑΧΝΟΕΙΔΟΥΣ ΧΩΡΟΥ ΚΑΙ ΤΟΥ ΝΩΤΙΑΙΟΥ ΜΥΕΛΟΥ. ΕΠΙΣΗΣ ΜΠΟΡΕΙ ΝΑ ΔΙΑΧΩΡΙΣΕΙ ΦΛΕΓΜΟΝΩΔΕΙΣ ΑΠΟ ΜΗ ΦΛΕΓΜΟΝΩΔΕΙΣ ΑΛΛΟΙΩΣΕΙΣ, ΣΕ ΠΕΡΙΣΣΟΤΕΡΕΣ ΠΕΡΙΠΤΩΣΕΙΣ ΑΠ'ΟΤΙ Η ΑΤ. ΥΣΤΕΡΕΙ ΟΜΩΣ ΣΤΗΝ ΑΠΕΙΚΟΝΙΣΗ ΤΩΝΟΣΤΙΚΩΝ ΑΛΛΟΙΩΣΕΩΝ

Application of Radiomics and Decision Support Systems for Breast MR Differential Diagnosis

Over the years, MR systems have evolved from imaging modalities to advanced computational systems producing a variety of numerical parameters that can be used for the noninvasive preoperative assessment of breast pathology. Furthermore, the combination with state-of-the-art image analysis methods provides a plethora of quantifiable imaging features, termed radiomics that increases diagnostic accuracy towards individualized therapy planning. More importantly, radiomics can now be complemented by the emerging deep learning techniques for further process automation and correlation with other clinical data which facilitate the monitoring of treatment response, as well as the prediction of patient’s outcome, by means of unravelling of the complex underlying pathophysiological mechanisms which are reflected in tissue phenotype. The scope of this review is to provide applications and limitations of radiomics towards the development of clinical decision support systems for breast cancer diagnosis and prognosis

Body Composition in Adult Patients with Thalassemia Major

Objective. To assess body composition in adult male and female patients with thalassemia major by dual-energy X-ray absorptiometry (DXA) and to compare the findings with a group of healthy age-matched controls. Methods. Our study group included sixty-two patients (27 males, mean age 36 years, and 35 females, mean age 36.4 years) and fifteen age-matched healthy controls. All patients had an established diagnosis of thalassemia major and followed a regular blood transfusion scheme since childhood and chelation treatment. Fat, lean, and bone mineral density (BMD) were assessed with dual-energy X-ray absorptiometry. Ferritin levels and body mass index of all patients and controls were also recorded. Student t-test and Wilcoxon test were performed and statistical significance was set at p<0.05. Results. BMD and whole body lean mass are lower in both male and female adult patients compared with controls (p<0.01 in both groups), whereas whole body fat mass was found to have no statistically significant difference compared to controls. Regional trunk fat around the abdomen was found to be lower in male patients compared to controls (p=0.02). Conclusion. Severe bone loss and diminished lean mass are expected in adult male and female patients with thalassemia major. Fat changes seem to affect mainly male patients

Noninvasive histologic grading of solid astrocytomas using proton magnetic resonance spectroscopy

Background: Proton magnetic resonance spectroscopy (1H MRS) constitutes a promising modality to assess intracranial pathology. We present our experience using this method in grading solid brain astrocytomas. Material and Methods: Using a 1.5-Tesla MRI unit, 71 patients with the radiographic diagnosis of astrocytoma were examined. Water-suppressed single-voxel 1H MRS was employed in all of our patients. The concentrations of choline (Cho), N-acetyl-aspartate (NAA), phosphocreatine-creatine (Pcr-Cr), myo-inositol (MI), lactate (Lac), lipids (Lip) as well as the metabolite ratios of Cho/Pcr-Cr, NAA/PCr-Cr and NAA/Cho were calculated. An appropriate surgical biopsy was performed. Standard pathology examination was employed in a double-blinded fashion. Results: An increased concentration of Cho and decreased concentrations of Pcr-Cr and NAA were detected. The concentrations of Lac, Lip and MI varied inconsistently, even among tumors of the same histologic grade. The Cho/Pcr-Cr ratio was calculated. This ratio was found to be 2.15 ± 0.26 in 27 patients with astrocytomas grade I and II, 2.78 ± 0.09 in 18 patients with grade III, and 5.40 ± 0.16 in 26 patients with grade IV. Discussion: The increased concentration of Cho is due to the increased cellularity and a relatively increased number of membranous structures in highly malignant tumors. In abnormal anaerobic metabolic tumor states there is relatively less phosphorylization of creatine. By using the Cho/Pcr-Cr ratio the concomitant effects of structural and metabolic alteration can thereby be emphasized for diagnostic advantage. Conclusion: The Cho/ Pcr-Cr is a very important and statistically significant marker (p = 0.043) determining the degree of intracranial astrocytoma malignancy. Copyright © 2004 S. Karger AG, Basel