Evaluation of risk factors and diseases associated with metabolic and atherosclerotic disorders in different abdominal fat distribution patterns assessed by CT-scan.

INTRODUCTION: Obesity is defined as an increase in body fat composition.

Evaluating the Performance of Unenhanced Computed Tomography in the Diagnosis of Pulmonary Embolism.

Background: Computed tomography pulmonary angiography (CTPA) as the gold-standard examination in the detection of pulmonary embolism (PE) is contraindicated or unavailable in certain cases. The current study aimed to assess the accuracy of unenhanced CT in the diagnosis of PE. Methods: This cohort study was conducted between October 2020 and March 2021 in Birjand, Iran, on 195 participants with clinical suspicion of PE examined with multidetector computed tomography (MDCT) scanning and CTPA. The patients were categorized into 2 groups based on the diagnosis PE in CTPA results. Imaging variables in unenhanced CT scans, including hyper/hypodense intraluminal signs, pulmonary trunk enlargements, peripheral wedge-shaped opacities, and pleural effusions, were independently reviewed by 2 radiologists and then compared between the groups. Results: There were 82 men (42.1%) and 113 women (57.9%) at a mean age ± standard deviation of 56.00±0.24 years. Based on CTPA results, PE was diagnosed in 24.1% of the study population (47/195). However, only 20 cases (42.5%) were detected by MDCT: 17 cases (85.0%) with central PE and 3 cases (15.0%) with peripheral PE. Concerning the intraluminal clot density, 12 patients (60.0%) had hyperdense signs, 3 (15.0%) had hypodense signs, and 5 (25.0%) had mixed hyper/hypodense signs. There was a significant difference between central PE and peripheral PE detected by MDCT. Intraluminal signs had the highest specificity and sensitivity (98.6% and 42.5%, area under the curve =0.734). Conclusion: Unenhanced MDCT has a remarkable performance in detecting PE, specifically central clots, and can, therefore, be considered an alternative modality when CTPA is not available or indicated.

The Prevalence of Undetected Vertebral Fracture in Patients with Back Pain by Dual-Energy X-ray Absorptiometry (DXA) of the Lateral Thoracic and Lumbar Spine.

STUDY DESIGN: This is a prospective study. PURPOSE: This study is conducted to determine the prevalence of unrecognized vertebral fracture (VF) in patients who present with back pain. OVERVIEW OF LITERATURE: VF is often unrecognized, and significantly increases the risk of further fractures. Unfortunately, the patients at a high risk for VF usually do not receive adequate therapy to reduce the fracture risk. METHODS: This is a prospective study of 344 patients who presented with back pain from April 2008 to May 2009. The patients underwent dual-energy X-ray absorptiometry (DXA) evaluation and vertebral fracture assessment from T4 to L4 using a hologic densitometer. RESULTS: Three hundred forty four of 386 patients who presented with back pain were included. Forty two patients were excluded because of a prior history of VF or the lack of written consent. Most of the patients were female (95.3%). The mean age of the patients was 58.21 ± 11.74 years. According to the World Health Organization definition (based on the T-score), 13.4% of the patients had normal lumbar spine bone mineral density (BMD). 27.9% of them were osteopenic and 58.7% were osteoporotic. The overall prevalence of VF, as established by lateral vertebral assessment, was 39% (n = 134). Moreover, 62.6% (n = 84) of the patients with VF had more than one fracture and 64.1% (n = 86) of them had Grade 2 or 3 fracture. CONCLUSIONS: We recommend performing not only DXA scanning for BMD evaluation, but also VFA by DXA in old patients with back pain.