To investigate the utility of diffusion-weighted (DW) imaging in distinguishing bland thrombus fr... more To investigate the utility of diffusion-weighted (DW) imaging in distinguishing bland thrombus from neoplastic thrombus in the portal vein in patients with hepatocellular carcinoma (HCC). In this retrospective institutional review board-approved HIPAA-complaint study, the imaging results in 25 patients (16 men [average age, 62.3 years; range, 35-75 years] and nine women [average age, 58.4 years; range, 32-69 years]; overall average age, 60.1 years; range, 32-75 years) with HCC and portal vein thrombosis who were examined with both contrast material-enhanced computed tomography (CT) and 1.5-T magnetic resonance (MR) imaging were reviewed. Axial echo-planar two-dimensional DW imaging was performed by using b values of 50, 400, and 800 sec/mm(2). A thrombus was considered neoplastic if it expanded the vessel or enhanced on the dynamic CT and MR images; otherwise it was considered bland. The signal intensity (SI) of the thrombus and HCC lesions in the same patients was compared on DW images. The results were evaluated by using the Fisher exact test. The apparent diffusion coefficients (ADCs) of HCC and thrombus were used to compute the ratio of the ADC of the thrombus to the ADC of the tumor. On DW images, 15 of 19 neoplastic thrombi demonstrated same SI and four showed lower SI than the primary HCC. Each of the six bland thrombi had lower SI than the primary HCC (P < .001). The mean ADC of HCC and thrombus in the neoplastic thrombus group was 0.87 x 10(-3) mm(2)/sec and 0.88 x 10(-3) mm(2)/sec, respectively (P = .45). The ADC of the bland thrombus was 2.89 x 10(-3) mm(2)/sec, significantly higher than the ADC of the HCC (1.0 x 10(-3) mm(2)/sec, P < .0003). The ratio of the ADC of the thrombus to the ADC of the tumor in the bland thrombus group was 2.9 compared with 0.998 in the neoplastic group (P = .0003). DW imaging enables discrimination between bland and neoplastic portal vein thrombi when the ratio of the ADC of the thrombus to the ADC of HCC was lower than 2 and when the thrombi showed similar SI as the primary HCC when qualitative analysis was performed.
... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for Pow... more ... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for PowerPoint, which adds a large number of useful batch ... to resort to more complex and expensive image editing software packages, such as Adobe Photoshop (Adobe Systems, San Jose, Calif ...
... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for Pow... more ... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for PowerPoint, which adds a large number of useful batch ... to resort to more complex and expensive image editing software packages, such as Adobe Photoshop (Adobe Systems, San Jose, Calif ...
Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren, 2009
Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits n... more Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits noninvasive diagnosis of congenital and acquired cardiac pathologies and has thus become increasingly important in the last years. Several studies investigated the incidence and relevance of incidental extracardiac structures within the lungs, mediastinum, chest wall, and abdomen with gated coronary CT. This resulted in the general acceptance of the review of extracardiac structures as a routine component of coronary CT interpretation. On the other hand radiologists tend to neglect pericardial and cardiac pathologies in non-gated chest CT, which is primarily performed for the evaluation of the respiratory system or for tumor staging. Since the introduction of multi-detector spiral CT technology, the incidental detection of cardiac and pericardial findings has become possible using non-gated chest CT. This article reviews the imaging appearances and differential diagnostic considerations of incidental cardiac entities that may be encountered in non-gated chest CT.
Hintergrund Ziel dieser Studie war es, die Prävalenz und klinische Bedeutung inzidenteller Herzbe... more Hintergrund Ziel dieser Studie war es, die Prävalenz und klinische Bedeutung inzidenteller Herzbefunde im nicht EKG-getriggerten Thorax-CT ohne primär kardiale Fragestellung zu evaluieren. Patienten und Methode Dreihundert nicht EKG-getriggerte Thorax-CT-Untersuchungen wurden retrospektiv bzgl. inzidenteller Herzbefunde analysiert. Die klinische Bedeutung wurde von einem Kardiologen bewertet. Ergebnisse Von 300 Patienten hatten 107 insgesamt 174 Herzbefunde: Koronarsklerose (90), Aorten-/Mitralklappenverkalkung (42), iatrogene Veränderungen (23), Perikarderguss (6), Herzvergrößerung (4), Myokardpathologien (3), Perikardverkalkungen (2), Thrombus im linken Ventrikel (2) und Myxom (1). Im radiologischen Bericht wurden 51% aller Herzbefunde beschrieben. Bei 53 der 107 Patienten mit Herzbefund waren diese klinisch nicht bekannt. Als klinisch relevant wurden die bisher unbekannten Befunde von 8 Patienten eingestuft: Perikarderguss (4), Perikardverkalkung (1), Thrombus im linken Ventrikel (1), Vorhofmyxom (1) und Herzvergrößerung (1). Schlussfolgerung Inzidentelle Herzbefunde sind im nicht EKG-getriggerten Thorax-CT häufig und können in Einzelfällen von hoher klinischer Bedeutung sein. Background The purpose of this study was to evaluate the prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT. Patients and methods Non-ECG-gated chest CT examinations of 300 patients were retrospectively analyzed for incidental cardiac findings. Subsequently, these findings were evaluated for their clinical relevance by a cardiologist. Results A total of 107 out of 300 examined patients had 174 incidental cardiac findings including coronary calcification (90), aortic/mitral valve calcification (42), iatrogenic changes (23), pericardial effusion (6), dilatation of the heart (4), myocardial changes (3), thrombus in the left ventricle (2), constrictive pericarditis (2) and atrial myxoma (1). Of the cardiac findings 51% were described in the written report and in 53 out of the 107 patients the cardiac findings were unknown. Newly detected incidental findings from 8 patients were rated as clinically significant: pericardial effusion (4), constrictive pericarditis (1), thrombus in the left ventricle (1), atrial myxoma (1) and dilatation of the heart (1). Conclusion Incidental cardiac findings are frequent in non-ECG-gated chest CT and may have a high clinical relevance.
To investigate the utility of diffusion-weighted (DW) imaging in distinguishing bland thrombus fr... more To investigate the utility of diffusion-weighted (DW) imaging in distinguishing bland thrombus from neoplastic thrombus in the portal vein in patients with hepatocellular carcinoma (HCC). In this retrospective institutional review board-approved HIPAA-complaint study, the imaging results in 25 patients (16 men [average age, 62.3 years; range, 35-75 years] and nine women [average age, 58.4 years; range, 32-69 years]; overall average age, 60.1 years; range, 32-75 years) with HCC and portal vein thrombosis who were examined with both contrast material-enhanced computed tomography (CT) and 1.5-T magnetic resonance (MR) imaging were reviewed. Axial echo-planar two-dimensional DW imaging was performed by using b values of 50, 400, and 800 sec/mm(2). A thrombus was considered neoplastic if it expanded the vessel or enhanced on the dynamic CT and MR images; otherwise it was considered bland. The signal intensity (SI) of the thrombus and HCC lesions in the same patients was compared on DW images. The results were evaluated by using the Fisher exact test. The apparent diffusion coefficients (ADCs) of HCC and thrombus were used to compute the ratio of the ADC of the thrombus to the ADC of the tumor. On DW images, 15 of 19 neoplastic thrombi demonstrated same SI and four showed lower SI than the primary HCC. Each of the six bland thrombi had lower SI than the primary HCC (P < .001). The mean ADC of HCC and thrombus in the neoplastic thrombus group was 0.87 x 10(-3) mm(2)/sec and 0.88 x 10(-3) mm(2)/sec, respectively (P = .45). The ADC of the bland thrombus was 2.89 x 10(-3) mm(2)/sec, significantly higher than the ADC of the HCC (1.0 x 10(-3) mm(2)/sec, P < .0003). The ratio of the ADC of the thrombus to the ADC of the tumor in the bland thrombus group was 2.9 compared with 0.998 in the neoplastic group (P = .0003). DW imaging enables discrimination between bland and neoplastic portal vein thrombi when the ratio of the ADC of the thrombus to the ADC of HCC was lower than 2 and when the thrombi showed similar SI as the primary HCC when qualitative analysis was performed.
... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for Pow... more ... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for PowerPoint, which adds a large number of useful batch ... to resort to more complex and expensive image editing software packages, such as Adobe Photoshop (Adobe Systems, San Jose, Calif ...
... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for Pow... more ... Another worthwhile resource on Shyam Pillai's OfficeTips Web site is the Toolbox for PowerPoint, which adds a large number of useful batch ... to resort to more complex and expensive image editing software packages, such as Adobe Photoshop (Adobe Systems, San Jose, Calif ...
Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren, 2009
Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits n... more Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits noninvasive diagnosis of congenital and acquired cardiac pathologies and has thus become increasingly important in the last years. Several studies investigated the incidence and relevance of incidental extracardiac structures within the lungs, mediastinum, chest wall, and abdomen with gated coronary CT. This resulted in the general acceptance of the review of extracardiac structures as a routine component of coronary CT interpretation. On the other hand radiologists tend to neglect pericardial and cardiac pathologies in non-gated chest CT, which is primarily performed for the evaluation of the respiratory system or for tumor staging. Since the introduction of multi-detector spiral CT technology, the incidental detection of cardiac and pericardial findings has become possible using non-gated chest CT. This article reviews the imaging appearances and differential diagnostic considerations of incidental cardiac entities that may be encountered in non-gated chest CT.
Hintergrund Ziel dieser Studie war es, die Prävalenz und klinische Bedeutung inzidenteller Herzbe... more Hintergrund Ziel dieser Studie war es, die Prävalenz und klinische Bedeutung inzidenteller Herzbefunde im nicht EKG-getriggerten Thorax-CT ohne primär kardiale Fragestellung zu evaluieren. Patienten und Methode Dreihundert nicht EKG-getriggerte Thorax-CT-Untersuchungen wurden retrospektiv bzgl. inzidenteller Herzbefunde analysiert. Die klinische Bedeutung wurde von einem Kardiologen bewertet. Ergebnisse Von 300 Patienten hatten 107 insgesamt 174 Herzbefunde: Koronarsklerose (90), Aorten-/Mitralklappenverkalkung (42), iatrogene Veränderungen (23), Perikarderguss (6), Herzvergrößerung (4), Myokardpathologien (3), Perikardverkalkungen (2), Thrombus im linken Ventrikel (2) und Myxom (1). Im radiologischen Bericht wurden 51% aller Herzbefunde beschrieben. Bei 53 der 107 Patienten mit Herzbefund waren diese klinisch nicht bekannt. Als klinisch relevant wurden die bisher unbekannten Befunde von 8 Patienten eingestuft: Perikarderguss (4), Perikardverkalkung (1), Thrombus im linken Ventrikel (1), Vorhofmyxom (1) und Herzvergrößerung (1). Schlussfolgerung Inzidentelle Herzbefunde sind im nicht EKG-getriggerten Thorax-CT häufig und können in Einzelfällen von hoher klinischer Bedeutung sein. Background The purpose of this study was to evaluate the prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT. Patients and methods Non-ECG-gated chest CT examinations of 300 patients were retrospectively analyzed for incidental cardiac findings. Subsequently, these findings were evaluated for their clinical relevance by a cardiologist. Results A total of 107 out of 300 examined patients had 174 incidental cardiac findings including coronary calcification (90), aortic/mitral valve calcification (42), iatrogenic changes (23), pericardial effusion (6), dilatation of the heart (4), myocardial changes (3), thrombus in the left ventricle (2), constrictive pericarditis (2) and atrial myxoma (1). Of the cardiac findings 51% were described in the written report and in 53 out of the 107 patients the cardiac findings were unknown. Newly detected incidental findings from 8 patients were rated as clinically significant: pericardial effusion (4), constrictive pericarditis (1), thrombus in the left ventricle (1), atrial myxoma (1) and dilatation of the heart (1). Conclusion Incidental cardiac findings are frequent in non-ECG-gated chest CT and may have a high clinical relevance.
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