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Chest anatomy

Steven P Rowe, Stefan L Zimmerman, Pamela T Johnson, Elliot K Fishman
Kawasaki's disease (KD) is a vasculitis that predominantly affects children and can lead to the development of coronary artery aneurysms. These aneurysms can subsequently thrombose and occlude, which may lead to chest pain and other signs and symptoms of acute coronary syndrome in young patients. Coronary CT angiography, including 3D visualization techniques, is a common modality used in the follow-up of KD patients. In this series of three patients, we present the typical coronary artery imaging findings that can appear in these patients, with an emphasis on the use of the novel 3D technique of cinematic rendering (CR)...
February 27, 2018: Emergency Radiology
David Borrego, Erin M Lowe, Cari M Kitahara, Choonsik Lee
A PC Program for X ray Monte Carlo (PCXMC) has been used to calculate organ doses in patient dosimetry and for the exposure assessment in epidemiological studies of ra- diogenic health related risks. This study compared the dosimetry from using the built-in stylized phantoms in the PCXMC to that of a newer hybrid phantom library with improved anatomical realism. We simulated chest and abdominal x ray projections for 146 unique body size computational phantoms, 77 males and 69 females, with different combinations of height (125 - 180 cm) and weight (20 - 140 kg) using the built-in stylized phantoms in the PCXMC version 2...
February 21, 2018: Physics in Medicine and Biology
Tomasz Gołębiowski, Mariusz Kusztal, Krzysztof Letachowicz, Jerzy Garcarek, Tomasz Porażko, Jan Penar, Magdalena Krajewska, Wacław Weyde, Marian Klinger
Tunneling of the cuffed catheter for hemodialysis is an important part of insertion procedure with faulty techniques being the cause of catheter dysfunctions. We retrospectively analyzed 737 double-lumen cuffed catheter procedures between 2008 and 2015 in patients aged 60 ± 15years, requiring renal replacement therapy. Complications of tunneling included kinking, bleeding and other problems. In 20 of 737 (2.7%) procedures, the catheter kinked, which was observed in 7.7% of silicone and 0.6% of polyurethane catheters...
February 20, 2018: Scientific Reports
Mostafa Elguindy, Rod Stables, Zoe Nicholas, Ian Kemp, Nick Curzen
BACKGROUND: Investigation of anginal chest pain has traditionally involved either assessment of the coronary anatomy by angiography or noninvasive testing for reversible ischemia. Invasive pressure wire assessment at the time of angiography offers information on both anatomy and physiology. Fractional flow reserve-guided percutaneous coronary intervention is associated with lower resource utilization and improved clinical outcome compared with angiographic guidance alone. However, the value of routine fractional flow reserve of all major coronary vessels at the time of diagnostic angiography has not been established in a randomized trial despite persuasive observational data...
February 2018: Circulation. Cardiovascular Quality and Outcomes
Alexandra Wipf, Martin Christmann, Susanne Navarini-Meury, Hitendu Dave, Daniel Quandt, Walter Knirsch, Oliver Kretschmar
OBJECTIVES: Purpose of this study is to evaluate the clinical significance of major aortopulmonary collateral arteries (MAPCAs) during the early postoperative course after arterial switch operation (ASO) in d-transposition of the great arteries (dTGA). METHODS: Clinical data of 98 patients with simple dTGA between January 2007 and December 2016 at the University Children's Hospital Zurich, Switzerland were analyzed retrospectively. RESULTS: 37 from 98 patients (38%) required cardiac catheterization (CC) due to an early complicated postoperative course or difficult coronary transfer due to special coronary anatomy...
February 2, 2018: International Journal of Cardiology
Nara S Higano, Alister J Bates, Jean A Tkach, Robert J Fleck, Foong Y Lim, Jason C Woods, Paul S Kingma
Esophageal atresia (EA) is a relatively uncommon congenital anomaly, often observed in conjunction with tracheoesophageal fistula (TEF). Surgical repair in neonates typically takes place with little information about the pre-existing EA/TEF structure because there are currently no acceptable tools for evaluating EA/TEF anatomy prior to repair; chest x-ray radiograph does not identify malformation sub-type or gap length, while x-ray computed tomography (CT) demonstrate an unacceptably high exposure to ionizing radiation...
February 2018: Journal of Pediatric Surgery Case Reports
Jennifer T Nguyen, Kairav Vakil, Selcuk Adabag, Anders Westanmo, Richard Madlon-Kay, Areef Ishani, Santiago Garcia, Edward O McFalls
OBJECTIVES: Quality of care utilization measures for patients admitted to the hospital with an acute myocardial infarction (AMI) include length of stay (LOS) and 30-day readmission rates. Our aim was to test whether efforts resulting in reduced LOS in patients diagnosed as having AMI would result in a higher risk of readmission within 30 days of hospital discharge and whether specific interventions could be targeted to reduce readmissions. METHODS: Using data supplied by the Veterans Affairs Inpatient Evaluation Center, we analyzed both the readmissions within 30 days of an AMI and LOS and determined the timing of readmissions and associated diagnoses...
February 2018: Southern Medical Journal
Gao-Wu Yan, Jiang-Fa Deng, Anup Bhetuwal, Guo-Qing Yang, Quan-Shui Fu, Hong Chen, Na Hu, Hao Zeng, Xiao-Ping Fan, Gao-Wen Yan, Xiao-Lin Wu
RATIONALE: Even though barium sulphate aspiration during upper gastrointestinal examination is a well-known phenomenon, complication such as long-term lung injury and death may still occur. This may depend upon the concentration, amount, anatomy, or certain predisposing factors. PATIENT CONCERNS: A 47-year-old woman who had a barium swallow to screen for foreign body in esophagus. DIAGNOSES: Chest radiographs demonstrated massive barium sulphate depositions in her trachea and inferior lobe of right lung...
November 2017: Medicine (Baltimore)
Bari Dane, Ankur Doshi, Soterios Gfytopoulos, Priya Bhattacharji, Michael Recht, William Moore
OBJECTIVES AND RATIONALE: Radiology-pathology correlation is time-consuming and is not feasible in most clinical settings, with the notable exception of breast imaging. The purpose of this study was to determine if an automated radiology-pathology report pairing system could accurately match radiology and pathology reports, thus creating a feedback loop allowing for more frequent and timely radiology-pathology correlation. METHODS: An experienced radiologist created a matching matrix of radiology and pathology reports...
January 17, 2018: Academic Radiology
Oren Lev-Ran, Dan Abrahamov, Nina Baram, Menachem Matsa, Yaron Ishai, Ohad Gabai, Yael Refaely, Mahmud Abu Salah, Gideon Sahar
Background Procurement of the internal thoracic artery risks ipsilateral phrenic nerve injury and elevated hemidiaphragm. Anatomical variations increase the risk on the right side. Patients receiving left-sided in-situ right internal thoracic artery configurations appear to be at greatest risk. Methods From 2014 to 2016, 432 patients undergoing left-sided in-situ bilateral internal thoracic artery grafting were grouped according to right internal thoracic artery configuration: retroaortic via transverse sinus (77%) or ante-aortic (23%); targets were the circumflex and left anterior descending artery territories, respectively...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Justin A Smith, Vanessa P Ho, Christopher W Towe
BACKGROUND: Open reduction and internal fixation of rib fractures is recommended to decrease mortality, shorten the duration of mechanical ventilation, and lower hospital length of stay. Prosthetic titanium plates are frequently used to repair chest wall trauma, and are typically contoured to the patient's anatomy at the time of implant in the operating room. We describe the use of 3-dimensional (3D) digitally corrected rapid prototyping to generate a model of a patient's skeletal anatomy for the purposes of preoperative customization of standard titanium plates for fixation of rib fractures...
January 1, 2018: Surgical Innovation
Xi Tao, Hua Zhang, Genggeng Qin, Jianhua Ma, Qianjin Feng, Wufan Chen
Chest tomosynthesis (CTS) is a newly developed imaging technique which provides pseudo-3D volume anatomical information of thorax from limited-angle projections and contains much less of superimposed anatomy than the chest X-ray radiography. One of the relatively common problems in CTS is the patient respiratory motion during image acquisition, which negatively impacts the detectability. In this work, we propose a sin-quadratic model to analyze the respiratory motion during CTS scan, which is a real time method where the respiratory signal is generated by extracting the motion of diaphragm from projection radiographs...
January 11, 2018: Medical Engineering & Physics
Sadat Ali Edroos, Jeremy William Sayer
We present a case of a patient who presented with chest pain, and on diagnostic coronary angiography appeared to have a grossly angulated yet significant coronary stenosis. This was proven to be an artefactual appearance on further assessment with intravascular ultrasound imaging. We describe the causes and associations of coronary tortuosity with other arteriopathy, and highlight challenges in the interpretation of tortuous vessels to accurately assess luminal narrowing and suitability for coronary intervention...
December 26, 2017: World Journal of Cardiology
Michael P Rogers, Sophie M Reskin, Adam Ubert, Matthew C Black, Kendra J Grubb
Acute type A aortic dissections starting at the arch pose a challenge for cardiac surgeons. Open surgical repair requires deep hypothermic circulatory arrest for arch reconstruction and is associated with significant morbidity and mortality. Hybrid aortic repair techniques, with open arch debranching and thoracic endovascular aortic repair, have been employed in high-risk cases and challenging aortic pathology. Herein, we present a case of a 33-year-old African American male with a history of open thoracoabdominal aortic reconstruction and femoral-femoral artery bypass for a type B dissection who subsequently presented with new-onset chest pain and was found to have a retrograde type A dissection of a bovine arch with multiple dissection flaps and possible contrast extravasation on chest computed tomography...
January 1, 2017: Vascular and Endovascular Surgery
Marguerite E Faure, Laurens E Swart, Marcel L Dijkshoorn, Jos A Bekkers, Marcel van Straten, Koen Nieman, Paul M Parizel, Gabriel P Krestin, Ricardo P J Budde
OBJECTIVES: Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose. METHODS: Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest...
December 12, 2017: European Radiology
Nikki L Stamp, Christopher J Merry
Coronary artery anomalies occur in an estimated 1.3% of the population. We present a case of a 52 year-old-man who had a less common anomaly of a left anterior descending artery arising from the right coronary ostium, causing ischaemia and chest pain demonstrated by perfusion scan. The usual options of management of coronary anomalies were not suitable for this anatomy and thus, we present the case of patch augmentation of the arteries.
December 9, 2017: Annals of Thoracic Surgery
Nathan C Hull, Gary R Schooler, Larry A Binkovitz, Eric E Williamson, Phillip A Araoz, Lifeng Yu, Philip M Young
Performing chest CT angiography on pediatric patients on extracorporeal membrane oxygenation (ECMO) can be challenging. Successfully performing CT angiography in these children requires substantial communication and coordination between the radiologists and clinical care providers. Additionally, the radiologist must understand the child's anatomy and disease pathophysiology, flow dynamics of the ECMO circuit, image acquisition timing, contrast injection site, and volume, rate and duration of contrast administration...
December 7, 2017: Pediatric Radiology
Steven P Rowe, Pamela T Johnson, Elliot K Fishman
BACKGROUND: Cinematic rendering (CR) a new method of 3D computed tomography (CT) volumetric visualization that produces photorealistic images. As with traditional 3D visualization methods, CR may prove to be of value in providing important information when evaluating regions of complex anatomy such as the heart. METHODS: The gated, IV contrast-enhanced chest CT angiogram data from three recent patients were evaluated with CR. Image comparision demonstrates the difference between CR and traditional volume rendering (VR), owing to a more complex lighting model that enhances surface detail and produces realistic shadows to add depth to 3D visualizations...
January 2018: Journal of Cardiovascular Computed Tomography
Joshua Warren Sappenfield, William Brit Smith, Lou Ann Cooper, David Lizdas, Drew B Gonsalves, Nikolaus Gravenstein, Samsun Lampotang, Albert R Robinson
BACKGROUND: We investigated whether visual augmentation (3D, real-time, color visualization) of a procedural simulator improved performance during training in the supraclavicular approach to the subclavian vein, not as widely known or used as its infraclavicular counterpart. METHODS: To train anesthesiology residents to access a central vein, a mixed reality simulator with emulated ultrasound imaging was created using an anatomically authentic, 3D-printed, physical mannequin based on a computed tomographic scan of an actual human...
November 30, 2017: Anesthesia and Analgesia
Zuhal Bayramoglu, Ravza Yilmaz, Emine Caliskan, Gulsah Buyuksahin, Furkan Bulut, Shamil Aliyev, Ibrahim Adaletli
INTRODUCTION: Although mild bone angulation with osseous enlargement often suggests fractures with callus formation, in some cases the diagnosis is synchondrosis. CASE REPORT: We present a rare variation of the chest wall in a 15-year-old male with a history of lymphoma. Bilateral multi-level posterior rib enlargements revealing mild (18)F-fluorodeoxyglucose uptake were detected via positron-emission tomography/computed tomography. The variations were identified as healing fractures, although the more accurate diagnosis was determined to be multi-level posterior rib synchondroses with consecutive bridgings...
November 3, 2017: Surgical and Radiologic Anatomy: SRA
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