Multi-detector computed tomography imaging of blunt chest trauma

Background and purpose: Chest trauma is a significant cause of mortality and morbidity, especially in the younger population. The purpose of this study was to evaluate the role of multi-detector computed tomography (MDCT) in the assessment of patients with blunt chest trauma. Patients and methods: A prospective study was conducted on thirty (30) patients with blunt chest trauma (21 males and 9 females, aged from 6 to 62 years) and 29 control patients presented with any trauma other than blunt chest trauma (23 males and 6 females, aged from 10 to 68 years) at the Emergency Department, Tanta University Hospital, from January 2013 to February 2014. Cases were subjected to clinical evaluation and radiological assessment of the chest using conventional chest X-ray (CXR) and multi-detector computed tomography. Results: The most common mode of injury was motor vehicle accidents (56.7%). On MDCT scan, the frequency of chest injuries were; chest wall injuries (86.7%), pleural injuries (80%), parenchymal injuries (56.7%), mediastinal injuries (30%) and finally the dorsal spine injuries (16.7%). MDCT is more sensitive, specific, and accurate than CXR in the assessment of blunt chest trauma and management of patients. Conclusion: MDCT is the modality of choice for rapid assessment of emergency chest trauma patients, when chest X-ray was inconclusive

Cardiac MRI to evaluate right ventricular function after surgical correction of congenital heart diseases

Background: Cardiac MRI (CMR) is a noninvasive imaging technique that plays an important role during clinical follow-up of postoperative CHD patients. MRI can provide valuable information on cardiac anatomy, ventricular function, valvular function, and on the presence and location of myocardial scar tissue. Our study aimed to assess the right ventricular function after surgery in patients with congenital heart diseases & assessment of myocardial viability with particular attention to scar tissue in the ventricular myocardium aside from sites of previous surgery (e.g., ventricular septal defect and right ventricular outflow tract patches). Results: The most common encountered CHD in this study were tetralogy of Fallot &transposition of great arteries. The most common postoperative complication detected by CMR was pulmonary regurgitation particularly in repaired TOF patients. Regarding the RV volume & function, there was statically significant increase in RVEDVI &ESVI in patients with decreased RVEF with good correlation with echocardiographic results. Patients post TGA arterial switch repair showed less complications than atrial switch repair with better RV postoperative function. Most patients showed no residual shunting (QP/QS =1). Conclusion: CMR is able to effectively identify post-procedural anatomical and functional intra- and extracardiac information, thus allowing accurate diagnosis of postoperative complications in most patients