Undiagnosed Myocardial Tear Blocked byan Omental Plug: Potentially LifethreateningCondition

Blunt chest trauma carries a high mortality when associated with cardiac rupture. Rapid diagnosis represents a true challenge for clinicians, with CT scan examination playing a central role. We report a case of a traumatic myocardial tear, plugged by the greater omentum through a diaphragmatic rent in an hemodynamically stable patient. This condition, identified during laparoscopy, was not suspected preoperatively at both clinical examination and CT. This case illustrates that a transparietal cardiac rupture can be sealed off by surrounding structures. This phenomenon explains why CT can be unable to detect traumatic cardiac rupture, with the potential risk of a delayed fatal bleeding. This case also emphasizes the risk of using laparoscopy in traumatic diaphragm rupture repai

EPIDEMIOLOGICAL DATABASE AND THE RESULTS OF USING ORAL BAITS VACCINES IN FOXES TO CONTROL RABIES

Rabies is a viral encephalomyelitis pathology that affects all kind of warm-blooded animals. While in America the main rabies reservoir is represented by the bat, in Europe rabies in maintained in wildlife by foxes which are the main source of the disease. In Europe, due to oral vaccination campaign in foxes which takes part every year, it is believed that in some years many European countries will be free of the disease. The study presents the efficiency of the oral vaccines in foxes by comparing the number of positive rabies cases before and after the use of baits vaccines. The research is made in Bistrita-Nasaud county between 2000 and 2017 and there were tested both domestic and wild animals

Contrast enhanced ultrasonography versus MR angiography in aortocaval fistula: case report

Aortocaval fistula (ACF) is a rare, life threatening complication of abdominal aortic aneurysms. Time to diagnosis is crucial as preoperative diagnosis and early surgical intervention significantly improve the outcome. The clinical spectrum being varied, the challenge of prompt and reliable diagnosis rests on emergency radiology. While the gold standard for detecting ACF today is CT angiography (CTA), frequently complicating renal insufficiency discourages the use of iodinated contrast making MR angiography (MRA) a useful alternative. Contrast enhanced ultrasound (CEUS) provides a promising new diagnostic option allowing rapid, non invasive and bedside diagnosis, especially in hemodynamically unstable patients. We present a case of prompt diagnosis of ACF by CEUS in comparison to modern MRA, thus establishing the new potential role of CEU

Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis

The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30mAs), followed by standard CT (180mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) ≥ 18.5. In slim patients (BMI < 18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI ≥ 18.

Case-based lung image categorization and retrieval for interstitial lung diseases: clinical workflows

Purpose: Clinical workflows and user interfaces of image-based computer-aided diagnosis (CAD) for interstitial lung diseases in high-resolution computed tomography are introduced and discussed. Methods: Three use cases are implemented to assist students, radiologists, and physicians in the diagnosis workup of interstitial lung diseases. Results: In a first step, the proposed system shows a three-dimensional map of categorized lung tissue patterns with quantification of the diseases based on texture analysis of the lung parenchyma. Then, based on the proportions of abnormal and normal lung tissue as well as clinical data of the patients, retrieval of similar cases is enabled using a multimodal distance aggregating content-based image retrieval (CBIR) and text-based information search. The global system leads to a hybrid detection-CBIR-based CAD, where detection-based and CBIR-based CAD show to be complementary both on the user's side and on the algorithmic side. Conclusions: The proposed approach is in accordance with the classical workflow of clinicians searching for similar cases in textbooks and personal collections. The developed system enables objective and customizable inter-case similarity assessment, and the performance measures obtained with a leave-one-patient-out cross-validation (LOPO CV) are representative of a clinical usage of the syste

Comparative Performance Analysis of State-of-the-Art Classification Algorithms Applied to Lung Tissue Categorization

In this paper, we compare five common classifier families in their ability to categorize six lung tissue patterns in high-resolution computed tomography (HRCT) images of patients affected with interstitial lung diseases (ILD) and with healthy tissue. The evaluated classifiers are naive Bayes, k-nearest neighbor, J48 decision trees, multilayer perceptron, and support vector machines (SVM). The dataset used contains 843 regions of interest (ROI) of healthy and five pathologic lung tissue patterns identified by two radiologists at the University Hospitals of Geneva. Correlation of the feature space composed of 39 texture attributes is studied. A grid search for optimal parameters is carried out for each classifier family. Two complementary metrics are used to characterize the performances of classification. These are based on McNemar's statistical tests and global accuracy. SVM reached best values for each metric and allowed a mean correct prediction rate of 88.3% with high class-specific precision on testing sets of 423 ROI

Occult fractures of the scaphoid: the role of ultrasonography in the emergency department

Objective: To evaluate ultrasonography (US) performed by an emergency radiologist in patients with clinical suspicion of scaphoid fracture and normal radiographs. Materials and methods: Sixty-two consecutive adult patients admitted to our emergency department with clinical suspicion of scaphoid fracture and normal radiographs underwent US examination of the scaphoid prior to wrist computed tomography (CT), within 3days following wrist trauma. US examination was performed by a board-certified emergency radiologist, non-specialized in musculoskeletal imaging, using the linear probe (5-13MHz) of the standard sonographic equipment of the emergency department. The radiologist evaluate for the presence of a cortical interruption of the scaphoid along with a radio-carpal or scapho-trapezium-trapezoid effusion. A CT of the wrist (reference standard) was performed in every patient, immediately after ultrasonography. Fractures were classified into two groups according to their potential for complication: group 1 (high potential, proximal or waist), group 2 (low-potential, distal or tubercle). Results: A scaphoid fracture was demonstrated by CT in 13 (21%) patients: eight (62%) of them belonged to group 1 (three in the proximal pole, five in the waist), five (38%) to group 2 (three in the distal part, two in the tubercle). US was 92% sensitive (12/13) in demonstrating a scaphoid fracture. It was 100% sensitive (8/8) in demonstrating a fracture with a high potential of complication (group 1). Conclusions: Our data show that, in emergency settings, US can be used for the triage to CT in patients with clinical suspicion of scaphoid fracture and normal radiograph