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Diagnostic and Therapeutic Difficulties in Retroperitoneal AbscessTunuguntla, Anuradha, Raza, Rafi, Hudgins, Larry 01 November 2004 (has links)
Abscesses developing within the retroperitoneal spaces are complicated and serious infections. These abscesses present insidiously, leading to considerable mortality and morbidity. A high clinical suspicion can help diagnose and treat this potentially fatal illness. Computed axial tomography is the best diagnostic modality for retroperitoneal abscess. Computed tomographic scan is useful, not only for diagnosing the retroperitoneal abscess, but can be used for therapeutic drainage of abscesses in high-surgical-risk patients. We present an illustrative case of retroperitoneal abscess and discuss the pathogenesis of retroperitoneal abscess, diagnosis, and treatment.
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Is 3-Tesla Gd-EOB-DTPA-enhanced MRI with diffusion-weighted imaging superior to 64-slice contrast-enhanced CT for the diagnosis of hepatocellular carcinoma?Maiwald, Bettina, Lobsien, Donald, Kahn, Thomas, Stumpp, Patrick 11 November 2014 (has links) (PDF)
Objectives: To compare 64-slice contrast-enhanced computed tomography (CT) with 3-Tesla magnetic resonance imaging (MRI) using Gd-EOB-DTPA for the diagnosis of hepatocellular carcinoma (HCC) and evaluate the utility of diffusion-weighted imaging (DWI) in this setting. Methods: 3-phase-liver-CT was performed in fifty patients (42 male, 8 female) with suspected or proven HCC. The patients were subjected to a 3-Tesla-MRI-examination with Gd-EOB-DTPA and diffusion weighted imaging (DWI) at b-values of 0, 50 and 400 s/mm2. The apparent diffusion coefficient (ADC)-value was determined for each lesion detected in DWI. The histopathological report after resection or biopsy of a lesion served as the gold standard, and a surrogate of follow-up or complementary imaging techniques in combination with clinical and paraclinical parameters was used in unresected lesions. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values were evaluated for each technique. Results: MRI detected slightly more lesions that were considered suspicious for HCC per patient compared to CT (2.7 versus 2.3, respectively). ADC-measurements in HCC showed notably heterogeneous values with a median of 1.2±0.5×10−3 mm2/s (range from 0.07±0.1 to 3.0±0.1×10−3 mm2/s). MRI showed similar diagnostic accuracy, sensitivity, and positive and negative predictive values compared to CT (AUC 0.837, sensitivity 92%, PPV 80% and NPV 90% for MRI vs. AUC 0.798, sensitivity 85%, PPV 79% and NPV 82% for CT; not significant). Specificity was 75% for both techniques. Conclusions: Our study did not show a statistically significant difference in detection in detection of HCC between MRI and CT. Gd-EOB-DTPA-enhanced MRI tended to detect more lesions per patient compared to contrast-enhanced CT; therefore, we would recommend this modality as the first-choice imaging method for the detection of HCC and therapeutic decisions. However, contrast-enhanced CT was not inferior in our study, so that it can be a useful image modality for follow-up examinations.
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Is 3-Tesla Gd-EOB-DTPA-enhanced MRI with diffusion-weighted imaging superior to 64-slice contrast-enhanced CT for the diagnosis of hepatocellular carcinoma?Maiwald, Bettina, Lobsien, Donald, Kahn, Thomas, Stumpp, Patrick January 2014 (has links)
Objectives: To compare 64-slice contrast-enhanced computed tomography (CT) with 3-Tesla magnetic resonance imaging (MRI) using Gd-EOB-DTPA for the diagnosis of hepatocellular carcinoma (HCC) and evaluate the utility of diffusion-weighted imaging (DWI) in this setting. Methods: 3-phase-liver-CT was performed in fifty patients (42 male, 8 female) with suspected or proven HCC. The patients were subjected to a 3-Tesla-MRI-examination with Gd-EOB-DTPA and diffusion weighted imaging (DWI) at b-values of 0, 50 and 400 s/mm2. The apparent diffusion coefficient (ADC)-value was determined for each lesion detected in DWI. The histopathological report after resection or biopsy of a lesion served as the gold standard, and a surrogate of follow-up or complementary imaging techniques in combination with clinical and paraclinical parameters was used in unresected lesions. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values were evaluated for each technique. Results: MRI detected slightly more lesions that were considered suspicious for HCC per patient compared to CT (2.7 versus 2.3, respectively). ADC-measurements in HCC showed notably heterogeneous values with a median of 1.2±0.5×10−3 mm2/s (range from 0.07±0.1 to 3.0±0.1×10−3 mm2/s). MRI showed similar diagnostic accuracy, sensitivity, and positive and negative predictive values compared to CT (AUC 0.837, sensitivity 92%, PPV 80% and NPV 90% for MRI vs. AUC 0.798, sensitivity 85%, PPV 79% and NPV 82% for CT; not significant). Specificity was 75% for both techniques. Conclusions: Our study did not show a statistically significant difference in detection in detection of HCC between MRI and CT. Gd-EOB-DTPA-enhanced MRI tended to detect more lesions per patient compared to contrast-enhanced CT; therefore, we would recommend this modality as the first-choice imaging method for the detection of HCC and therapeutic decisions. However, contrast-enhanced CT was not inferior in our study, so that it can be a useful image modality for follow-up examinations.
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Performance Evaluation Of Fan-beam And Cone-beam Reconstruction Algorithms With No Backprojection Weight On Truncated Data ProblemsSumith, K 07 1900 (has links) (PDF)
This work focuses on using the linear prediction based projection completion for the fan-beam and cone-beam reconstruction algorithm with no backprojection weight. The truncated data problems are addressed in the computed tomography research. However, the image reconstruction from truncated data perfectly has not been achieved yet and only approximately accurate solutions have been obtained. Thus research in this area continues to strive to obtain close result to the perfect. Linear prediction techniques are adopted for truncation completion in this work, because previous research on the truncated data problems also have shown that this technique works well compared to some other techniques like polynomial fitting and iterative based methods. The Linear prediction technique is a model based technique. The autoregressive (AR) and moving average (MA) are the two important models along with autoregressive moving average (ARMA) model. The AR model is used in this work because of the simplicity it provides in calculating the prediction coefficients. The order of the model is chosen based on the partial autocorrelation function of the projection data proved in the previous researches that have been carried out in this area of interest. The truncated projection completion using linear prediction and windowed linear prediction show that reasonably accurate reconstruction is achieved. The windowed linear prediction provide better estimate of the missing data, the reason for this is mentioned in the literature and is restated for the reader’s convenience in this work.
The advantages associated with the fan-beam reconstruction algorithms with no backprojection weights compared to the fan-beam reconstruction algorithm with backprojection weights motivated us to use the fan-beam reconstruction algorithm with no backprojection weight for reconstructing the truncation completed projection data. The results obtained are compared with the previous work which used conventional fan-beam reconstruction algorithms with backprojection weight. The intensity plots and the noise performance results show improvements resulting from using the fan-beam reconstruction algorithm with no backprojection weight. The work is also extended to the Feldkamp, Davis, and Kress (FDK) reconstruction algorithm with no backprojection weight for the helical scanning geometry and the results obtained are compared with the FDK reconstruction algorithm with backprojection weight for the helical scanning geometry.
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