European radiology
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Assessment of vascular proliferation as an important grading criterion has been employed in both the histologic and the radiologic characterization of gliomas with encouraging results. Perfusion in gliomas can be measured by dynamic contrast-enhanced magnetic resonance imaging (dMRI). The goal of this study was to develop a model for simultaneously quantifying the fractional volumes of different tissue compartments of gliomas by dMRI. ⋯ Using cerebral blood volume (CBV), dMRI grading showed a correspondence with WHO grading in 83% of the cases (20/24 gliomas WHO grades II-IV). The use of interstitial volume maps can also be helpful, for instance, in differentiating gliomas from other brain tumors. As a supplement to conventional MRI, dynamic MR techniques thus provide a useful tool for improving in vivo glioma characterization.
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The aim of this study was to compare 2D and 3D CT imaging in the pre- and postoperative evaluation of complex benign larynges-tracheal airway stenoses with rigid endoscopy, considered as the gold standard. Six patients (aged 5-72 years) with a total of nine complex laryngo-tracheal stenoses underwent non-contrast helical CT scans (slice thickness 3 mm, pitch 1.3, reconstruction interval 1.5 mm) before and after surgical resection. With prototype software, virtual endoscopy (VE) post-processing algorithms were applied to the imaging data sets. ⋯ Two-dimensional images and 3D VE of tracheal stenoses proved to be efficient and complementary to the rigid endoscopy, permitting a reliable endoluminal 3D view and evaluation of the surrounding anatomical structures. Limitations of this technique relate to the maximal spatial resolution of 1.5 mm, the lack of color, and the inability to assess the mucosa. Virtual endoscopy is for complex laryngo-tracheal stenoses an excellent complement for rigid endoscopy, remaining the method of reference, and may be indicated with complicated pathological structures.
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The aim of this study was to evaluate the appearance, extent, and distribution of parenchymal changes in the lung after acute respiratory distress syndrome (ARDS) as a function of disease severity and therapeutic procedures. High-resolution computed tomography (HRCT), clinical examination, and lung function tests were performed in 15 patients, 6-10 months after ARDS. The appearance and extent of parenchymal changes were compared with the severity of ARDS, as well as with clinical and therapeutic data. ⋯ A significant correlation was observed between the extent of lung alterations and the severity of ARDS ( p<0.01), and the duration in which patients had received mechanical ventilation either with a peak inspiratory pressure greater than 30 mmHg ( p<0.05), or with more than 70% oxygen ( p<0.01). Acute respiratory distress syndrome frequently is followed by fibrotic changes in lung parenchyma. The predominantly ventral distribution of these changes indicates that they may be caused by the ventilation regimen and the oxygen therapy rather than by the ARDS.
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Comparative Study
The value of CT diagnosis of hernia recurrence after prosthetic repair of ventral incisional hernias.
Herein we present a prospective study made to compare the diagnostic value of a physical examination and a CT scan in the detection of a hernia relapse after carrying out of a intraperitoneal hernioplasty using a non-resorbable mesh. Fifty patients operated on for intraperitoneal hernioplasty with ePTFE mesh and postoperative symptomatology were assessed within a year of the operation via a physical exploration and CT. Each of the patients was subjected to an exploratory laparoscopy for the purpose of confirming the diagnosis. ⋯ The negative predictive values were 1 and 0.95, respectively. The differences between the values of both methods held a statistical meaning (chi-square test; p < 0.05). The postoperative assessment by CT of symptomatic patients who have been operated on for an intraperitoneal hernioplasty with unabsorbable mesh facilitates carrying out a correct diagnosis in the detection or exclusion of hernial relapse.
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Case Reports
Blunt traumatic rupture of a mainstem bronchus: spiral CT demonstration of the "fallen lung" sign.
Tracheo-bronchial injuries occur in less than 1 % of blunt chest trauma patients. Indirect signs, such as pneumomediastinum, pneumothorax, and/or subcutaneous emphysema, are revealed on admission plain films and chest CT survey. In most instances, however, tracheobronchoscopy is mandatory in assessing the definite diagnosis of tracheo-bronchial lesion. Occasionally, an abnormal course of a mainstem bronchus or a "fallen lung" sign, featuring a collapsed lung in a dependent position, hanging on the hilum only by its vascular attachments, may allow for CT diagnosis of a blunt traumatic bronchial injury.