RESUMEN
PURPOSE: The purpose of this study was to compare multidetector-row computed tomography (MDCT) leaflet restriction measurements with fluoroscopy measurements in commonly used mechanical prosthetic heart valves (PHVs). METHODS: Four mechanical PHVs (ON-X, Carbomedics, St. Jude, and Medtronic Hall) were imaged in a pulsatile model using fluoroscopy and 64-detector-row computed tomography. Five image acquisitions of each PHV without (1) and with (4) restricted leaflet closure were made. Three observers measured closure angles on fluoroscopy and MDCT. Data were analyzed using intraclass correlation coefficient (ICC) and Bland-Altman plots. RESULTS: Interobserver agreement was high in restricted and non-restricted leaflets on both modalities (ICCs >0.995). MDCT and fluoroscopy showed high agreements (ICCs >0.989). Median MDCT closure angle measurements differed at most -2 to +2 degrees from fluoroscopy in the restricted and -1 to +2 degrees in the non-restricted leaflets. CONCLUSIONS: MDCT allows measurement of leaflet motion with a maximal median discrepancy of 2 degrees. Both MDCT and fluoroscopy detect restricted leaflet closure with great accuracy.
Asunto(s)
Fluoroscopía/métodos , Prótesis Valvulares Cardíacas , Válvulas Cardíacas/diagnóstico por imagen , Válvulas Cardíacas/cirugía , Tomografía Computarizada Multidetector/métodos , Fantasmas de Imagen , Análisis de Falla de Equipo/métodos , Fluoroscopía/instrumentación , Humanos , Tomografía Computarizada Multidetector/instrumentación , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
A 14-year-old boy had arm pain after a traumatic event. An X-ray showed a supracondylar process of the humerus, which is a coincidental finding but sometimes has clinical consequences. It may compress the median nerve or brachial artery, leading to symptoms. Resection can give complete relieve of symptoms.
Asunto(s)
Arteria Braquial , Húmero/anomalías , Húmero/diagnóstico por imagen , Nervio Mediano , Síndromes de Compresión Nerviosa/etiología , Adolescente , Humanos , Masculino , Síndromes de Compresión Nerviosa/diagnóstico por imagen , Síndromes de Compresión Nerviosa/cirugía , RadiografíaRESUMEN
Myelofibrosis and gallbladder carcinoma are both very rare diseases. This case report describes a patient with a history of myelofibrosis and colorectal carcinoma who was diagnosed with colorectal liver metastases. Surgery was performed to remove the metastases, and on site, the gallbladder was removed because of involvement in one of the liver lesions. After pathological examination, a primary gallbladder carcinoma and myelofibrosis were found in addition to the liver metastases. The combination of diseases was not likely to be interconnected but rather an unlucky course of events for the patient.