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11 pages, 491 KiB

Open AccessArticle

Anatomical Variations and Morphometry of Carotid Sinus: A Computed Tomography Study

by Noor Fazaldad, Srinivasa Rao Sirasanagandla, Anwar Al-Shuaili, Sreenivasulu Reddy Mogali, Ramya Chandrasekaran, Humoud Al Dhuhli and Eiman Al-Ajmi

Tomography 2025, 11(4), 45; https://doi.org/10.3390/tomography11040045 - 7 Apr 2025

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Abstract

Background: The radiological evaluation of the carotid sinus (CS) anatomy and its morphometry is essentially important for various surgical procedures involving the carotid bifurcation and the CS itself. Despite its tremendous clinical significance, studies dealing with the CS anatomy are seldom reported. Hence, [...] Read more.

Background: The radiological evaluation of the carotid sinus (CS) anatomy and its morphometry is essentially important for various surgical procedures involving the carotid bifurcation and the CS itself. Despite its tremendous clinical significance, studies dealing with the CS anatomy are seldom reported. Hence, the present study aimed to evaluate the frequencies of the CS positional variants and their morphometry and correlate them with age and body mass index (BMI). Methods: In this retrospective cross-sectional study, a total of 754 disease-free carotid arteries were examined using computed tomography angiography scans to determine the CS positional variations (such as types I to III) and its morphometry, including the CS diameter and length. Additionally, the association between these parameters and factors such as sex, age, and body mass index were explored using appropriate statistical tests. The inter-rater agreement of the collected dataset was evaluated using Cohen’s Kappa. Results: The CS type I was observed in 87.67% of the cases, and type II and type III were observed at lower frequencies with 9.02% and 3.32%, respectively. There were statistically significant (p < 0.001) differences observed in the mean diameter and length of the sinus between the sex and the type I CS variations. However, there was no significant and strong correlation between the age and BMI factors with sinus length and sinus diameter. The kappa values for inter-rater agreement ranged from 0.77 to 0.99 for all parameters. Conclusions: In type I, the CS length and carotid vessel’s diameter is significantly different between the sexes. However, age and BMI do not affect the CS anatomy in radiologically disease-free carotid arteries. Knowledge of the CS variant anatomy is clinically significant as it influences the patients’ surgical and physiological outcomes. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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11 pages, 1876 KiB

Open AccessEditor’s ChoiceArticle

Biliary Leak after Pediatric Liver Transplantation Treated by Percutaneous Transhepatic Biliary Drainage—A Case Series

by Michael Doppler, Christin Fürnstahl, Simone Hammer, Michael Melter, Niklas Verloh, Hans Jürgen Schlitt and Wibke Uller

Tomography 2023, 9(5), 1965-1975; https://doi.org/10.3390/tomography9050153 - 19 Oct 2023

Cited by 1 | Viewed by 2498

Abstract

Background: Biliary leaks are a severe complication after pediatric liver transplantation (pLT), and successful management is challenging. Objectives: The aim of this case series was to assess the outcome of percutaneous transhepatic biliary drainage (PTBD) in children with bile leaks following pLT. The [...] Read more.

Background: Biliary leaks are a severe complication after pediatric liver transplantation (pLT), and successful management is challenging. Objectives: The aim of this case series was to assess the outcome of percutaneous transhepatic biliary drainage (PTBD) in children with bile leaks following pLT. The necessity of additional percutaneous bilioma drainage and laboratory changes during therapy and follow-up was documented. Material and Methods: All children who underwent PTBD for biliary leak following pLT were included in this consecutive retrospective single-center study and analyzed regarding site of leak, management of additional bilioma, treatment response, and patient and transplant survival. The courses of inflammation, cholestasis parameters, and liver enzymes were retrospectively reviewed. Results: Ten children underwent PTBD treatment for biliary leak after pLT. Seven patients presented with leakage at the hepaticojejunostomy, two with leakage at the choledocho-choledochostomy and one with a bile leak because of an overlooked segmental bile duct. In terms of the mean, the PTBD treatment started 40.3 ± 31.7 days after pLT. The mean duration of PTBD treatment was 109.7 ± 103.6 days. Additional percutaneous bilioma drainage was required in eight cases. Bile leak treatment was successful in all cases, and no complications occurred. The patient and transplant survival rate was 100%. CRP serum level, leukocyte count, gamma-glutamyl transferase (GGT), and total and direct bilirubin level decreased significantly during treatment with a very strong effect size. Additionally, the gamma-glutamyl transferase level showed a statistically significant reduction during follow-up. Conclusions: PTBD is a very successful strategy for bile leak therapy after pLT. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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23 pages, 4182 KiB

Open AccessArticle

Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients

by Roberto Minici, Michele Mercurio, Giuseppe Guzzardi, Massimo Venturini, Federico Fontana, Luca Brunese, Pasquale Guerriero, Raffaele Serra, Filippo Piacentino, Marco Spinetta, Lorenzo Zappia, Davide Costa, Andrea Coppola, MGJR Research Team, Olimpio Galasso and Domenico Laganà

Tomography 2023, 9(5), 1660-1682; https://doi.org/10.3390/tomography9050133 - 1 Sep 2023

Cited by 4 | Viewed by 2670

Abstract

Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of [...] Read more.

Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs. hemodynamic instability. Methods: In our multicenter retrospective investigation, we analyzed data from consecutive patients who underwent, from January 2020 to May 2023, angioembolization for traumatic pelvic arterial injury. Results: In total, 116 angioembolizations were performed. Gelatin sponges (56.9%) and coils (25.9%) were the most widely used embolic agents. The technical and clinical success rates were 100% and 91.4%, respectively. No statistically significant differences were observed between the two groups in terms of technical success, clinical success, procedure-related complication rate, or 30-day bleeding-related mortality. Conclusions: Angioembolization is an effective and safe option for the management of traumatic pelvic arterial lesions even in hemodynamically unstable patients, despite technical variations such as greater use of prophylactic angioembolization. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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9 pages, 10431 KiB

Open AccessCommunication

Significance of Postprocedural Contrast Medium Injection after CT-Guided Abscess Drainage

by Holger Goessmann, Stephan Schleder, Christian Stroszczynski and Andreas G. Schreyer

Tomography 2023, 9(4), 1434-1442; https://doi.org/10.3390/tomography9040114 - 27 Jul 2023

Cited by 1 | Viewed by 1802

Abstract

The aim was to evaluate the additive clinical value of an additional post-procedural control-scan after CT-guided percutaneous abscess drainage (PAD) placement with contrast medium (CM) via the newly placed drain. All CT-guided PADs during a 33-month period were retrospectively analyzed. We analyzed two [...] Read more.

The aim was to evaluate the additive clinical value of an additional post-procedural control-scan after CT-guided percutaneous abscess drainage (PAD) placement with contrast medium (CM) via the newly placed drain. All CT-guided PADs during a 33-month period were retrospectively analyzed. We analyzed two subgroups, containing patients with and without surgery before intervention. Additionally, radiological records were reevaluated, concerning severe inflammatory response syndrome (SIRS) during the intervention. A total of 499 drainages were placed under CT-guidance in 352 patients. A total of 197 drainages were flushed with CM directly after the intervention, and 51 (26%) showed an additional significant finding. An immediate change of therapy was found in 19 cases (9%). The subgroup that underwent surgery (120 CM-drainages; 32 (27%) additional findings; 13 (11%) immediate changes of therapy) showed no statistically significant difference compared to the subgroup without surgery (77 CM-drainages; 19 (25%) additional findings; 5 (6%) immediate changes of therapy). SIRS occurred in 2 of the 197 flushed drainages (1%) after CM application. An additional scan with CM injection via the newly placed drain revealed clinically significant additional information in almost 26% of the drainages reviewed in this study. In 9% of the cases this information led to an immediate change of therapy. Risks for SIRS are low. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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12 pages, 3836 KiB

Open AccessArticle

Different Ultrasound Shear Wave Elastography Techniques as Novel Imaging-Based Approaches for Quantitative Evaluation of Hepatic Steatosis—Preliminary Findings

by Natascha Platz Batista da Silva, Gregor Scharf, Lukas Lürken, Niklas Verloh, Stephan Schleder, Christian Stroszczynski, Ernst Michael Jung and Michael Haimerl

Tomography 2023, 9(2), 681-692; https://doi.org/10.3390/tomography9020054 - 16 Mar 2023

Cited by 5 | Viewed by 2476

Abstract

Background: Modern ultrasound (US) shear-wave dispersion (SWD) and attenuation imaging (ATI) can be used to quantify changes in the viscosity and signal attenuation of the liver parenchyma, which are altered in hepatic steatosis. We aimed to evaluate modern shear-wave elastography (SWE), SWD and [...] Read more.

Background: Modern ultrasound (US) shear-wave dispersion (SWD) and attenuation imaging (ATI) can be used to quantify changes in the viscosity and signal attenuation of the liver parenchyma, which are altered in hepatic steatosis. We aimed to evaluate modern shear-wave elastography (SWE), SWD and ATI for the assessment of hepatic steatosis. Methods: We retrospectively analyzed the US data of 15 patients who underwent liver USs and MRIs for the evaluation of parenchymal disease/liver lesions. The USs were performed using a multifrequency convex probe (1–8 MHz). The quantitative US measurements for the SWE (m/s/kPa), the SWD (kPa-m/s/kHz) and the ATI (dB/cm/MHz) were acquired after the mean value of five regions of interest (ROIs) was calculated. The liver MRI (3T) quantification of hepatic steatosis was performed by acquiring proton density fat fraction (PDFF) mapping sequences and placing five ROIs in artifact-free areas of the PDFF scan, measuring the fat-signal fraction. We correlated the SWE, SWD and ATI measurements to the PDFF results. Results: Three patients showed mild steatosis, one showed moderate steatosis and eleven showed no steatosis in the PDFF sequences. The calculated SWE cut-off (2.5 m/s, 20.4 kPa) value identified 3/4 of patients correctly (AUC = 0.73, p > 0.05). The SWD cut-off of 18.5 m/s/kHz, which had a significant correlation (r = 0.55, p = 0.034) with the PDFF results (AUC = 0.73), identified four patients correctly (p < 0.001). The ideal ATI (AUC = 0.53 (p < 0.05)) cut-off was 0.59 dB/cm/MHz, which showed a significantly good correlation with the PDFF results (p = 0.024). Conclusion: Hepatic steatosis can be accurately detected using all the US-elastography techniques applied in this study, although the SWD and the SWE showed to be more sensitive than the PDFF. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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10 pages, 2326 KiB

Open AccessArticle

Two-Dimensional Post-Traumatic Measurements of Orbital Floor Blowout Fractures Underestimate Defect Sizes Compared to Three-Dimensional Approaches

by Juergen Taxis, Lena Ungerboeck, Mika R. Gehrking, Constantin Motel, Matthias Wurm, Alexander W. Eckert, Gerrit Spanier, Felix Nieberle, Natascha Platz Batista da Silva, Nils Ludwig, Johannes K. Meier, Tobias Ettl, Torsten E. Reichert and Steffen Spoerl

Tomography 2023, 9(2), 579-588; https://doi.org/10.3390/tomography9020047 - 5 Mar 2023

Cited by 4 | Viewed by 2630

Abstract

Orbital floor fractures represent a common fracture type of the midface and are standardly diagnosed clinically as well as radiologically using linear measurement methods. The aim of this study was to evaluate the accuracy of diagnostic measurements of isolated orbital floor fractures based [...] Read more.

Orbital floor fractures represent a common fracture type of the midface and are standardly diagnosed clinically as well as radiologically using linear measurement methods. The aim of this study was to evaluate the accuracy of diagnostic measurements of isolated orbital floor fractures based on two-dimensional (2D) and three-dimensional (3D) measurement techniques. A cohort of 177 patients was retrospectively and multi-centrically evaluated after surgical treatment of an orbital floor fracture between 2010 and 2020. In addition to 2D and 3D measurements of the fracture area, further fracture-related parameters were investigated. Calculated fracture areas using the 2D measurement technique revealed an average area of 287.59 mm², whereas the 3D measurement showed fracture areas with a significantly larger average value of 374.16 mm² (p < 0.001). On average, the 3D measurements were 1.53-fold larger compared to the 2D measurements. This was observed in 145 patients, whereas only 32 patients showed smaller values in the 3D-based approach. However, the process duration of the 3D measurement took approximately twice as long as the 2D-based procedure. Nonetheless, 3D-based measurement of orbital floor defects provides a more accurate estimation of the fracture area than the 2D-based procedure and can be helpful in determining the indication and planning the surgical procedure. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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10 pages, 1797 KiB

Open AccessArticle

Stereotactic Microwave Ablation of Hepatocellular Carcinoma: The Impact of Tumor Size and Minimal Ablative Margin on Therapeutic Success

by Antonia-Maria Pausch, Tamam Ghali, Tobias Wertheimer, Florian Zeman, Karolina Mueller, Michael Christian Doppler, Ingo Einspieler, Lukas Philipp Beyer, Stephan Schleder, Christian Stroszczynski and Lukas Luerken

Tomography 2023, 9(1), 50-59; https://doi.org/10.3390/tomography9010005 - 26 Dec 2022

Cited by 4 | Viewed by 3739

Abstract

Background: Microwave ablation (MWA) has gained relevance in the treatment of hepatic malignancies and especially in hepatocellular carcinoma (HCC), and it is an important alternative to surgery. The purpose of the study was to evaluate whether the minimal ablative margin (MAM) or the [...] Read more.

Background: Microwave ablation (MWA) has gained relevance in the treatment of hepatic malignancies and especially in hepatocellular carcinoma (HCC), and it is an important alternative to surgery. The purpose of the study was to evaluate whether the minimal ablative margin (MAM) or the initial tumor size has a greater effect on the success of stereotactic MWA of HCC regarding the time to local tumor progression (LTP) and overall survival (OS). Methods: 88 patients, who received stereotactic MWA of 127 tumor lesions with a curative intention were included in this single-center, retrospective study. The MAM was evaluated in a side-by-side comparison of pre- and post-ablative, contrast-enhanced slice imaging. A Cox proportional hazard model with a frailty term was computed to assess the influence of the MAM and the maximum tumor diameter on the time to LTP and the OS. Results: The maximum tumor diameter was identified as a significant positive predictor for LTP (hazard ratio 1.04, 95% CI 1.00–1.08, p = 0.03), but it was not a significant positive predictor for the OS (p = 0.20). The MAM did not have a significant influence on LTP-free survival (p = 0.23) and OS (p = 0.67). Conclusion: For the successful stereotactic MWA of HCC, the MAM and maximum tumor diameter might not have an influence on the OS, but the maximum tumor diameter seems to be an independent predictor of the time to LTP. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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8 pages, 437 KiB

Open AccessCommentary

Unraveling the Invisible: Topological Data Analysis as the New Frontier in Radiology’s Diagnostic Arsenal

by Yashbir Singh and Emilio Quaia

Tomography 2025, 11(1), 6; https://doi.org/10.3390/tomography11010006 - 9 Jan 2025

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Abstract

This commentary examines Topological Data Analysis (TDA) in radiology imaging, highlighting its revolutionary potential in medical image interpretation. TDA, which is grounded in mathematical topology, provides novel insights into complex, high-dimensional radiological data through persistent homology and topological features. We explore TDA’s applications [...] Read more.

This commentary examines Topological Data Analysis (TDA) in radiology imaging, highlighting its revolutionary potential in medical image interpretation. TDA, which is grounded in mathematical topology, provides novel insights into complex, high-dimensional radiological data through persistent homology and topological features. We explore TDA’s applications across medical imaging domains, including tumor characterization, cardiovascular imaging, and COVID-19 detection, where it demonstrates 15–20% improvements over traditional methods. The synergy between TDA and artificial intelligence presents promising opportunities for enhanced diagnostic accuracy. While implementation challenges exist, TDA’s ability to uncover hidden patterns positions it as a transformative tool in modern radiology. Full article

(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)

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