Densitometric and geometric measurement of the proximal femur in elderly women with and without osteoporotic vertebral fractures by volumetric quantitative multi-slice CT.

There is a lack of research on volumetric multi-slice CT (MSCT) application in hip densitometric assessment and geometric measures in elderly women with osteoporotic vertebral fractures. A total of 237 elderly women were divided into three groups based on BMD values of the lumbar spine (AP-SPINE) and/or the femoral neck (NECK) by dual energy X-ray absorptiometry (DXA): osteoporosis with (OP_FX, 53 cases) or without vertebral fracture (OP_NONFX, 94 cases), or normal BMD (CONTROL, 90 cases). Volumetric BMD of trabecular bone (TRAB), integral bone (INTGL) and cortical bone (CORT) with neck axis length (NAL) and minimum cross-section area (mCSA) measures of the left femoral neck were calculated, respectively, by using OsteoCAD software based on MSCT scans of the abdominal-pelvic region of all participants, then the index of femoral neck strength (FNSI) was estimated. The values of TRAB, CORT and INTGL of OP_FX were significantly lower than those of OP_NONFX, with the decrease in 6.8-21.8%, as well as being lower than those in CONTROL, whereas no significant differences in the values of AP-SPINE and NECK were found between OP_FX and OP_NONFX. No significant difference of the value of mCSA was found among these three groups. The NAL value of OP_NONFX was larger than that of CONTROL. FNSI of femoral neck in OP_FX (0.42 ± 0.15 g(2)/cm(4)) was significantly lower than OP_NONFX (0.50 ± 0.14 g(2)/cm(4)) (p < 0.05). vQCT measurement seemed to be more effective than DXA in evaluating hip densitometric changes and discriminating osteoporotic elderly subjects with fractured vertebrae from the non-fractured in a group of Chinese women.

Cavernous transformation of portal vein: 16-slice CT portography and correlation with surgical procedure of orthotopic liver transplantation.

OBJECTIVE: To evaluate 16-slice CT portography technique and appearances of cavernous transformation of portal vein (CTPV) and the correlation with surgical procedure of orthotopic liver transplantation (OLT). MATERIAL AND METHODS: Twenty-four patients with CTPV underwent triphase scanning using a 16-slice CT scanner. Twenty-one of the 24 patients were OLT candidates. After plain scan, enhanced CT scan was performed. The parameters were as follows: thickness of 2.5 mm, reconstruction interval of 1.3 mm, flow rate of 3-4 mL/s, contrast agent of 100 mL, delayed time of 20, 50, and 70 s, respectively. Imaging reformation, including MIP, VR, and SSD, were performed by one radiologist. Two radiologists assessed the thrombosis location and degree, collateral vessels, and superior mesenteric vein (SMV) or splenic vein (SV). The details of collateral vessels, thrombosis location were graded and recorded. One score was partial thrombosis of the main PV; 2 score, complete thrombosis of the main PV; 3 score, complete thrombosis of the main PV plus thrombosis of proximal SV or SMV, and the normal diameter of remaining veins; 4 score, complete thrombosis of the main PV plus thrombosis of more than a half of SV or SMV, and thin diameter of remaining veins; 5 score, complete nonvisualization of the main PV, one or both of SV and SMV, and thin diameter of remaining veins. Thirteen patients thereafter underwent OLT. Operation record was reviewed case by case. RESULTS: All cases obtained MIP images, 16 patients got VR images, and five cases had SSD images. These images can display thrombosis location, degree, and collateral vessels. All patients had hepatopetal collateral vessels. Eleven of the 21 OLT candidates had 1 score, two patients 2 score, four patients 3 score, one patient 4 score, and three patients had 5 score. Fourteen of the 21 candidates were performed end-to-end anastomosis between the donor's and recipient's portal veins, in which 11 patients had 1 score, two patients had 2 score, and two patients 3 score. Both patients with 3 score had normal SV; end-to-end anastomoses were performed between the donor portal vein and recipient SV. Two patients are waiting for donors. OLT was canceled or changed in the six patients with 4 score or 5 score. Correlation coefficient between the score of portal vein and surgical decision was 0.813 (P-value less than 0.001, nonparametric correlation). CONCLUSIONS: Using 16-slice CT portography can noninvasively diagnose CTPV. The appearances of CTPV on the 16-slice CT portography can provide helpful information for surgeons to make an accurate preoperative decision. MIP is the optimal technique for displaying CTPV.