1.Limited Evaluation of Image Quality Produced by a Portable Head CT Scanner
Ariz Chong Abdullah ; Johari Siregar Adnan ; Noor Azman A. Rahman ; Ravikant Palur
Malaysian Journal of Medical Sciences 2017;24(1):104-112
Introduction: Computed tomography (CT) is the preferred diagnostic toolkit for head and
brain imaging of head injury. A recent development is the invention of a portable CT scanner that
can be beneficial from a clinical point of view.
Aim: To compare the quality of CT brain images produced by a fixed CT scanner and a
portable CT scanner (CereTom).
Methods: This work was a single-centre retrospective study of CT brain images from
112 neurosurgical patients. Hounsfield units (HUs) of the images from CereTom were measured
for air, water and bone. Three assessors independently evaluated the images from the fixed
CT scanner and CereTom. Streak artefacts, visualisation of lesions and grey–white matter
differentiation were evaluated at three different levels (centrum semiovale, basal ganglia and
middle cerebellar peduncles). Each evaluation was scored 1 (poor), 2 (average) or 3 (good) and
summed up to form an ordinal reading of 3 to 9.
Results: HUs for air, water and bone from CereTom were within the recommended
value by the American College of Radiology (ACR). Streak artefact evaluation scores for the fixed
CT scanner was 8.54 versus 7.46 (Z = -5.67) for CereTom at the centrum semiovale, 8.38 (SD =
1.12) versus 7.32 (SD = 1.63) at the basal ganglia and 8.21 (SD = 1.30) versus 6.97 (SD = 2.77) at
the middle cerebellar peduncles. Grey–white matter differentiation showed scores of 8.27 (SD =
1.04) versus 7.21 (SD = 1.41) at the centrum semiovale, 8.26 (SD = 1.07) versus 7.00 (SD = 1.47) at
the basal ganglia and 8.38 (SD = 1.11) versus 6.74 (SD = 1.55) at the middle cerebellar peduncles.
Visualisation of lesions showed scores of 8.86 versus 8.21 (Z = -4.24) at the centrum semiovale,
8.93 versus 8.18 (Z = -5.32) at the basal ganglia and 8.79 versus 8.06 (Z = -4.93) at the middle
cerebellar peduncles. All results were significant with P-value < 0.01.
Conclusions: Results of the study showed a significant difference in image quality
produced by the fixed CT scanner and CereTom, with the latter being more inferior than the
former. However, HUs of the images produced by CereTom do fulfil the recommendation of the
ACR.
2.A Rare Case of Neurenteric Cyst of Spinal Cord with Thoracic Vertebra Fusion Successfully Managed with Spinal Cyst Excision and Posterior Instrumentation Surgery
Tan Jih Huei ; Henry Tan Chor Lip ; Chan Chee Kong ; Ariz Chong B. Abdullah@Chong Chee Yong ; Noor Azman Bin A. Rahman
Malaysian Journal of Medicine and Health Sciences 2020;16(No.2):348-350
The incidence of neurenteric cyst (NC) is rare amongst spine tumors. It is most often asymptomatic but may present with sensory and motor symptoms. When associated with thoracic vertebra fusion it is not reported before, this complicates the placement of pedicle screw during posterior instrumentation. Herein, we report a case of thoracic spinal neurenteric cyst in a 40-year-old man that presents with chronic back pain, left lower limb weakness and numbness. Elective excision of NC over T6-T7 with laminectomy and multilevel posterior instrumentation was successfully performed with significant improvement of the symptoms. Neurenteric cyst is a rare spinal cord lesion which may cause permanent neurological sequalae. Complete surgical excision with spine fixation in this case provides good long-term outcome.