Ipsilateral reduced olfactory bulb volume in patients with unilateral nasal obstruction.

OBJECTIVES: To evaluate the effect of unilateral nasal obstruction (by nasal polyps of different histopathology) on olfactory bulb volume using MRI technique. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary university hospitals, Departments of Otolaryngology and Radiology. SUBJECTS AND METHODS: Eleven patients with a few months of complete unilateral nasal obstruction of different pathological etiologies were selected. MRI assessment of olfactory bulb volume was performed using planimetric manual contouring. The contralateral olfactory bulb was used as a comparative control for the same patient. Eleven healthy controls constituted the control group. RESULTS: Mean olfactory bulb volume ± SD of obstructed side = 14.3 ± 3.7 mm(3), mean olfactory bulb volume ± SD of nonobstructed side = 43.49 ± 10.7 mm(3). The difference between the 2 sides was significant (P = .003). The difference in olfactory bulb volume between normal subjects and nonobstructed nasal side was statistically nonsignificant (t = .9118, P = .3727), while the difference between normal subjects' olfactory bulb volume and obstructed nasal side olfactory bulb volume in our patients was extremely statistically significant (t = 9.7320, P < .0001). A strong negative correlation was found between duration of obstruction and olfactory bulb volume (R = -0.9761). CONCLUSION: This study shows that unilateral nasal obstruction may be associated with a lateralized ipsilateral difference of olfactory bulb volume.

Prediction of pulmonary embolism outcome and severity by computed tomography.

BACKGROUND: Pulmonary embolism (PE) is the third most common cause of cardiovascular death. When PE is fatal, right ventricular failure usually occurs within the first few hours, so right ventricular dysfunction (RVD) should be diagnosed rapidly to identify patients who could benefit from fibrinolytic therapy. PURPOSE: To determine whether quantification of PE with computed tomography (CT) pulmonary angiography and ventricular measurements is of value in the diagnosis of PE severity and prediction of patient outcome. MATERIAL AND METHODS: Multidetector-row CT studies of 48 hospitalized patients with proven pulmonary embolism were reviewed. Pulmonary artery (PA) obstructive index was derived for each patient on the basis of location and degree of obstruction. Ventricular measurements, including right ventricular (RV) short axis, left ventricular (LV) short axis, and RV/LV ratio, were evaluated and compared among survivors and nonsurvivors. Also, the ventricular measurements were correlated with the PA obstructive index. RV/LV ratio and related PA obstructive index were correlated to the patient outcome and hospital stay. RESULTS: Comparison of the PA obstructive index and ventricular measurements between survivors and nonsurvivors showed significant difference in PA obstructive index (P<0.001), RV short axis (P<0.001), and RV/LV ratio (P=0.03), and no significant difference was noted in LV short axis (P=0.95). Good correlation was found between PA obstructive index and LV short axis (-0.326), RV short axis (0.539), and RV/LV ratio (0.696). A significant difference was found between the PA obstructive indexes of the different categories of RV/LV ratio (P<0.001). CONCLUSION: PA obstructive index of more than 50% and RV/LV ratio >1.5 are useful diagnostic criteria for severe PE and poor patient outcome.