We assessed with computed tomography (CT) densitometry the prevalence of emphysema in 266 (175 men and 91 women; mean age 64 ± 4 years) smokers and former smokers enrolled in the ITALUNG trial of ...lung cancer screening with low-dose thin-slice CT. Whole-lung volume and the relative area at −950 Hounsfield units (RA
950
) and mean lung attenuation (MLA) in 1 of every 10 slices (mean, 24 slices per subject) were measured. Lung volume, MLA and RA950 significantly correlated each other and with age. Average RA950 >6.8% qualifying for emphysema was present in 71 (26.6%) of 266 subjects, with a higher prevalence in men than in women (30.3% vs 19.8%; p = 0.003). Only in smokers was a weak (r = 0.18; p = 0.05) correlation between RA950 and packs/year observed. In multiple regression analysis, the variability of RA950 (R2 = 0.24) or MLA (R2 = 0.34) was significantly, but weakly explained by age, lung volume and packs/year. Other factors besides smoking may also have a significant role in the etiopathogenesis of pulmonary emphysema.
Moreno did not accept the psychotherapeutic approach of the time: as a medical student, he attended a lecture by Sigmund Freud in 1912; when Freud approached him, asking his occupation, he replied, ...‘Well, Dr Freud, I start where you leave off. … ...he was appointed an adjunct professor in the Department of Sociology at New York University (1951–1966) and special lecturer at various universities in North America, continuing his studies until his death in 1974. ...he believed that the complexity of the human psyche could not be represented by static images, but it required the action of the theatre, which allowed the individual to become aware of their condition and to critically observe it through fiction.
We compared whole-lung densitometry with visual evaluation of pulmonary emphysema. Thirty patients with chronic obstructive pulmonary disease underwent multi-detector CT (150 mAs and 0.75 ...collimation) with double reconstruction: thick (5-mm) slices with smooth filter for whole-lung densitometry and thin (1 mm) slices with sharp filter for visual assessment (one of every ten slices). Densitometry and visual assessment were performed by three operators each, and the time required for assessment, the inter-observer agreement and the correlation with the results of the diffusion capacity of carbon monoxide (DL
CO
) in the same patients were computed. The average time for densitometry (8.49 ± 0.13 min) was significantly longer (p < 0.0001) than that for visual evaluation (5.14 ± 0.11 min). However, the inter-operator agreement ranged between “moderate” to “almost perfect” for densitometry (kappa range 0.58–0.87) and “slight” for visual (kappa = 0.20) assessment. The correlation coefficients of DL
CO
with relative area at −960 and −970 Hounsfield units (HU) (both r = −0.66) and of the first percentile point of lung density (r = 0.66) were slightly stronger than that of the visual score (r = −0.62). Densitometry should be preferred to visual assessment because it enables a more reproducible evaluation of the extent of pulmonary emphysema, which can be carried out on the entire lung in a reasonable amount of time.
Nodule growth as observed in computed tomography (CT) scans acquired at different times is the primary feature to malignancy of indeterminate small lung nodules. In this paper, we propose the ...estimation of nodule size through a scale-space representation which needs no segmentation and has high intra- and inter-operator reproducibility. Lung nodules usually appear in CT images as blob-like patterns and can be analyzed in the scale-space by Laplacian of Gaussian ( LoG ) kernels. For each nodular pattern the LoG scale-space signature was computed and the related characteristic scale adopted as measurement of nodule size. Both in vitro and in vivo validation of LoG characteristic scale were carried out. In vitro validation was done by 40 nondeformable phantoms and 10 deformable phantoms. A close relationship between the characteristic scale and the equivalent diameter, i.e., the diameter of the sphere having the same volume of nodules, (Pearson correlation coefficient was 0.99) and, for nodules undergoing little deformations (obtained at constant volume), small variability of the characteristic scale was observed. The in vivo validation was performed on low and standard-dose CT scans collected from the ITALUNG screening trial (86 nodules) and from the LIDC public data set (89 solid nodules and 40 part-solid nodules or ground-glass opacities). The Pearson correlation coefficient between characteristic scale and equivalent diameter was 0.83-0.93 for ITALUNG and 0.68-0.83 for LIDC data set. Intra- and inter-operator reproducibility of characteristic scale was excellent: on a set of 40 lung nodules of ITALUNG data, two radiologists produced identical results in repeated measurements. The scan-rescan variability of the characteristic scale was also investigated on 86 two-year-stable solid lung nodules (each one observed, on average, in four CT scans) identified in the ITALUNG screening trial: a coefficient of repeatability of about 0.9 mm was observed. Experimental evidence supports the clinical use of the LoG characteristic scale to measure nodule size in CT imaging.
Nodule growth as observed in computed tomography (CT) scans acquired at different times is the primary feature to malignancy of indeterminate small lung nodules. In this paper, we propose the ...estimation of nodule size through a scale-space representation which needs no segmentation and has high intra- and inter-operator reproducibility. Lung nodules usually appear in CT images as blob-like patterns and can be analyzed in the scale-space by Laplacian of Gaussian ( LoG ) kernels. For each nodular pattern the LoG scale-space signature was computed and the related characteristic scale adopted as measurement of nodule size. Both in vitro and in vivo validation of LoG characteristic scale were carried out. In vitro validation was done by 40 nondeformable phantoms and 10 deformable phantoms. A close relationship between the characteristic scale and the equivalent diameter, i.e., the diameter of the sphere having the same volume of nodules, (Pearson correlation coefficient was 0.99) and, for nodules undergoing little deformations (obtained at constant volume), small variability of the characteristic scale was observed. The in vivo validation was performed on low and standard-dose CT scans collected from the ITALUNG screening trial (86 nodules) and from the LIDC public data set (89 solid nodules and 40 part-solid nodules or ground-glass opacities). The Pearson correlation coefficient between characteristic scale and equivalent diameter was 0.83-0.93 for ITALUNG and 0.68-0.83 for LIDC data set. Intra- and inter-operator reproducibility of characteristic scale was excellent: on a set of 40 lung nodules of ITALUNG data, two radiologists produced identical results in repeated measurements. The scan-rescan variability of the characteristic scale was also investigated on 86 two-year-stable solid lung nodules (each one observed, on average, in four CT scans) identified in the ITALUNG screening trial: a coefficient of repeatability of about 0.9 mm was observed. Experimental evidence supports the clinical use of the LoG characteristic scale to measure nodule size in CT imaging.
We describe an early CT study of a rare case of blunt traumatic injury to the right submandibular salivary gland, without mandibular bone fractures, in a 30-year-old man after a car accident.
The purpose of the study is to evaluate the ability of Gd-enhancement and fat-suppressed MR imaging operating at midfield strength to characterize incidentally discovered adrenal masses. Sixty ...patients with 72 adrenal masses incidentally discovered during US or CT exams were studied with a 0.51 MR unit following clinical and laboratory evaluation. After Gd-DTPA intravenous administration a modified three-point Dixon technique was performed in all patients. This technique provided three images sets: conventional T1-weighted SE images, fat-suppressed T1-weighted images and water-suppressed T1-weighted images. Diagnosis was established by means of surgery (11 lesions), fineneedle biopsy (21 lesions) and stability on ultrasonographic follow-up for at least 1 year (range, 12–87 months) from adrenal lesion discovery (40 masses). In most of adenomas (
n = 55) an homogeneous enhancement was observed on postcontrast T1WI; however, 15 out of these lesions showed a small focal spot of high intensity in Gd-enhanced fat-suppressed images. On the contrary, malignant conditions (
n = 6) and pheochromocytoma (
n = 1), all had inhomogeneous signal intensities which were relatively higher after Gadolinium injection as compared with the liver. The fat suppression technique demonstrated areas of bright signal intensity related to high vascularity. The performance of three observers in order to differentiate malignant from benign conditions showed sensitivity, specificity, diagnostic accuracy, positive and negative predictive values of 100, 88.5, 90, 50 and 100% on the basis of gadolinium enhancement only, by utilizing the Dixon technique. In conclusion, although Gd-enhancement and fat-suppressed sequence helped correctly differentiate among the groups of incidentally discovered adrenal masses, the degree of overlap suggests that it is still difficult to characterize individual patients. However, the modified three-point Dixon technique after contrast material administration appears to be a further capability of midfield MRI in the characterization of adrenal tissue.
This paper offers a new edition of the of «Demotic graffito from Elephantine», first published by Erich of Lüddeckens in 1971. This inscription is dated to 277 BC, the month of Mechir. As in a ...flashback, the text mentions the following events: (i) the invasion of Egypt by Artaxerses III and (ii) its effects on the rise of the price of corn, (iii) the collapse of the tempie of Satet at Elephantine during the second year of the reign of Ptolemy II Philadelphos; (iv) the date and célébration of the wedding between Ptolemy II and his sister Arsinoe II (mentioned as nȝ pr-ʿȝ.w) on the 30th of Mesore 278 BC.; (v) Ptolemy's decision to reduce the price of corn; (vi) the beginning of the reconstruction of the temple of Satet, in 277 BC, the month of Tibi; (vii) the date of the inscription and the discovery of three earlier temples during the foundation works for the new building of Satet. The present edition offers significantly new readings and a new historical interpretation of the inscription.
The case of a 37 year old man with a longstanding HLA-B27 associated bilateral Achilles tendinitis without seronegative spondyloarthropathy is reported. This case suggests that heel enthesopathy may ...for a long time be the only clinical manifestation of the HLA-B27 associated disease process.
Emoperitoneo (frecce bianche) e lacerazione epatica traumatica nel VI-VII segmento (freccia nera) caratterizzata da rifornimento arterioso (Figg. 3, 4).In caso di riscontro alla MDCT (Multidetector ...Computed Tomography) di uno stravaso di mdc e.v. in fase arteriosa o di lesioni di grado maggiore (IV-V) con coinvolgimento dei vasi venosi epatici principali, essendo le lesioni di queste strutture segno indiretto di altre lesioni arteriose.Il trattamento conservativo.Sì, poiché il principale fattore predittivo della necessità di ricorrere ad un intervento chirurgico è l’instabilità emodinamica e non il grado della lesione riportata. Il riscontro alla TC di un rifornimento arterioso non cambia la strategia conservativa delle lesioni traumatiche epatiche. In tali circostanze si deve ricorrere all’embolizzazione del vaso, prima che il paziente diventi emodinamicamente instabile, senza dover intraprendere un intervento chirurgico in urgenza.
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