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

The role of magnetic resonance imaging in prostate cancer staging with newer imaging techniques

Purpose: To prospectively evaluate which technique among T2 weighted images, Dynamic Contrast Enhanced (DCE) or Diffusion Weighted (DW) MRI or combination of those is best suited for prostate cancer detection and local staging. Materials & Methods: Twenty seven consecutive patients with biopsy proven adenocarcinoma of the prostate underwent MR imaging on a 1,5T scanner with a surface phased-array coil prior radical prostatectomy. Combined anatomical and functional imaging was performed with the use of T2 sequences, DCE and DW MRI. We compared the imaging results with whole mount histopathology.Results: For the multiparametric approach, significantly higher sensitivity values, ie, 53% (95% CI: 41-64.1) were obtained as compared to each modality alone or any combination of the three modalities (P 86%) were obtained for both tumor detection and local staging.Conclusion: The combination of T2, DCE and DW MRI yields higher diagnostic performance for tumor detection and local staging than any of these techniques alone or even any combination of those.Σκοπός: Να εκτιμηθεί προοπτικά ποια τεχνική μεταξύ των ακολουθιών Τ2, της δυναμικής μελέτης μετά την ενδοφλέβια χορήγηση παραμαγνητικής ουσίας, της ακολουθίας διάχυσης ή συνδυασμός 2 ή 3 εξ αυτών, γνωστός ως Πολυπαραμετρική τεχνική, είναι η καλύτερη για την ανίχνευση του καρκίνου του προστάτη και την τοπική σταδιοποίηση. Υλικό & Μέθοδος: Εικοσιεπτά διαδοχικοί ασθενείς με ιστολογικά επιβεβαιωμένο αδενοκαρκίνωμα προστάτη με διορθική βιοψία, υποβλήθηκαν σε Μαγνητική Τομογραφία προστάτη σε ΜΤ 1,5Τ με πολυπηνίο επιφανείας κυλιόμενης φάσης πριν από προγραμματισμένη προστατεκτομή. Πραγματοποιήθηκε συνδυασμένη ανατομική και λειτουργική απεικόνιση με τη χρήση ακολουθιών Τ2, δυναμικής μελέτης μετά την ενδοφλέβια χορήγηση παραμαγνητικής ουσίας και ακολουθίας διάχυσης. Έγινε σύγκριση των απεικονιστικών ευρημάτων με τα παθολογοανατομικά ευρήματα του χειρουργικού παρασκευάσματος μετά την προστατεκτομή.Αποτελέσματα: Στην Πολυπαραμετρική προσέγγιση σημειώθηκε σημαντικά μεγαλύτερο ποσοστό ευαισθησίας ίσο με 53% (95% CI: 41-64.1), συγκριτικά με κάθε τεχνική ξεχωριστά ή με κάθε συνδυασμό από τις τρεις τεχνικές (P 86%) σημειώθηκαν και την ανίχνευση του όγκου και για την τοπική σταδιοποίηση. Συμπέρασμα: Ο συνδυασμός ακολουθιών Τ2, δυναμικής μελέτης και διάχυσης αποδίδει υψηλότερη διαγνωστική επίδοση για την ανίχνευση του όγκου και την τοπική σταδιοποίηση από ότι κάθε μια από αυτές τις τεχνικές ξεχωριστά ή ακόμα και κάθε συνδυασμό δύο εξ αυτών

Solely MRI-Guided Cardiac Catheterization for Assessment of Pulmonary Hypertension in a Pregnant Lady with Undiagnosed Congenital Heart Disease

Pregnancy in women with complex congenital heart disease (CHD) can be poorly tolerated. Amongst pregnant women with CHD and pulmonary hypertension (PH), the mortality rate can be as high as 30%. Cardiac catheterization procedures for assessment of haemodynamics and pulmonary vascular resistance (PVR) are often required in this patient population for risk stratification. However, during the first few weeks of pregnancy, this should better be avoided due to the known adverse effects of the ionizing radiation to the immature fetus. In this setting, a solely MRI-guided catheterization may present as a better alternative

A three-dimensional quantification of calcified and non-calcified plaques in coronary arteries based on computed tomography coronary angiography images: Comparison with expert's annotations and virtual histology intravascular ultrasound

The detection, quantification and characterization of coronary atherosclerotic plaques has a major effect on the diagnosis and treatment of coronary artery disease (CAD). Different studies have reported and evaluated the noninvasive ability of Computed Tomography Coronary Angiography (CTCA) to identify coronary plaque features. The identification of calcified plaques (CP) and non-calcified plaques (NCP) using CTCA has been extensively studied in cardiovascular research. However, NCP detection remains a challenging problem in CTCA imaging, due to the similar intensity values of NCP compared to the perivascular tissue, which surrounds the vasculature. In this work, we present a novel methodology for the identification of the plaque burden of the coronary artery and the volumetric quantification of CP and NCP utilizing CTCA images and we compare the findings with virtual histology intravascular ultrasound (VH-IVUS) and manual expert's annotations. Bland-Altman analyses were employed to assess the agreement between the presented methodology and VH-IVUS. The assessment of the plaque volume, the lesion length and the plaque area in 18 coronary lesions indicated excellent correlation with VH-IVUS. More specifically, for the CP lesions the correlation of plaque volume, lesion length and plaque area was 0.93, 0.84 and 0.85, respectively, whereas the correlation of plaque volume, lesion length and plaque area for the NCP lesions was 0.92, 0.95 and 0.81, respectively. In addition to this, the segmentation of the lumen, CP and NCP in 1350 CTCA slices indicated that the mean value of DICE coefficient is 0.72, 0.7 and 0.62, whereas the mean HD value is 1.95, 1.74 and 1.95, for the lumen, CP and NCP, respectively