Abstract: In the elderly, the chest without evident pathology is characterized by findings that occupy a sort of "no man's land" between the normal and the pathologic. Aging results in physiologic modifications that must be recognized so as not to be interpreted erroneously as pathologies. On the other hand, the elderly tend to become ill more frequently and multipathologies are more frequent. Image diagnostics is a key element in the clarification of often blurry clinical pictures, which may make early diagnosis possible, a great advantage to timely treatment. In this sense, knowledge of heart/lung interactions makes it possible to obtain, from the onset, radiologic and clinical signs of the two physiopathologic models prevalent in the elderly, the "cardiac lung" and the "pulmonary heart."
Abstract: PURPOSE: To evaluate the influence of slice thickness, reconstruction algorithm and tube current (mA) on the performance of a software package in determining the volume of solid pulmonary nodules on multidetector-row computed tomography (MDCT). MATERIALS AND METHODS: A chest phantom containing artificial solid nodules with known volume was imaged with two MDCT scans at 100 and 40 mAs (200 mA and 80 mA, 0.5-s rotation time), respectively. Data were reconstructed with slice thicknesses of 1.25 and 2.5 mm and five different algorithms. The volumes of three nodules (juxtavascular, intraparenchymal, juxtapleural) were calculated using three-dimensional (3D) volumetric software. Differences between estimated and real volume were reported for each nodule and reconstruction set. RESULTS: The software segmented all nodules on 1.25-mm-thick reconstructions, independently from the mAs. It did not segment the juxtapleural nodule on 2.5-mm-thick reconstructions at 40 mAs. Mean values of the differences, which better approximated the real volume of the nodules, were obtained with high-spatial-resolution algorithms on both 100 and 40 mAs images at 1.25-mm slice thickness. CONCLUSIONS: Slice thickness, reconstruction algorithm and tube current can affect the 3D volume measurement of solid nodules. The best performance of the software, on both 100 and 40 mAs images, was observed with a slice thickness of 1.25 mm and high-spatial-resolution algorithms.
Abstract: Lung cancer is the main cause of death from malignancies due to the high prevalence and adverse prognosis when diagnosis is established in symptomatic patients. With early diagnosis, survival is far better; this led to perform some trials of screening in subjects at high risk with chest X-ray since 1970 but outcomes were contrasting. The technological evolution with the introduction of spiral CT and low dose techniques in the last decade led to a new interest in lung cancer screening. Numerous trials were performed and several diagnostic algorithms based on the dimensional and densitometric analysis of CT-evidenced nodules were designed. In spite of the encouraging outcome achieved so far, the high rate of false positives, the high costs and the use of ionizing radiation advise caution at least until a decreased mortality rate from lung cancer is evidenced.
Abstract: The case of a 39-year-old male patient with symptoms of persistent abdominal pain and melena, affected by Henoch-Schönlein purpura, is reported. Abdominal CT was requested. The examination was justified by the fact that symptoms could be correlated with other pathological conditions (volvulus, neoplasms, Chron's disease, etc.) which had to be excluded. For optimum study of the abdominal wall, correct preparation and the use of oral contrast agents were required. From the analysis of CT findings, in particular loop thickening with stratified density, the increased density of mesenteric fat and the presence of fluid among loops led to the radiological diagnosis of intestinal involvement in Henoch-Schönlein purpura. Other imaging procedures (double contrast enema, sonography, Doppler US, MRI) now used in the study of intestinal loops, are examined.
Abstract: At present, conventional radiology is being slowly but inexorably replaced by digital radiology. While storage phosphors introduced approximately twenty years ago are now routinely used, flat panel systems are increasingly popular. There are two types of flat panels: those with direct X-ray conversion to electric charge and those where there is initial X photon conversion to visible light from optical amorphous silicon photodiode coupling for conversion to electric charge. The charge is therefore amplified and digital signal conversion is obtained with an analog-to-digital converter. One of the main advantages of Computed Radiography is the separation of image acquisition processing and display. Acquisition systems of digital images with image processing techniques allow the operator to adapt the image characteristics to the clinical requirements. Contrast value and image brightness can be changed soon after acquisition to optimize visualization before printing or transfer to the workstation for postprocessing. Image processing can be interactive, directly on the system consolle. To digital data various processing algorithms can be applied as high spatial frequency enhancement through the construction of the shadow mask. The new digital systems have improved the quality of conventional radiological images as compared to the screen-film and storage phosphor systems with shorter times of procedures and lower exposure dose to patients, while the diagnostic potentialities of the acquired image are enhanced.
Abstract: Ureteropelvic junction disease is very frequent in pediatric age. Diagnosis is usually established on sonography; in most cases it is prenatal and confirmed at birth. On sonography, hydronephrosis and the site of obstruction is identified with morphofunctional information on renal parenchyma. In the past, urography was the reference examination for ureteropelvic junction disease, but its use is limited in pediatrics especially in prenatal study for radioprotection as well as for the limited glomerular filtration of neonatal kidney. CT and MRI as second level examinations do not find many indications, while angioscintigraphy is largely used to acquire functional data and, in combination with sonography, is basic for diagnosis as well as in follow-up of operated patients.
