We present an unusual case of a delayed right ventricular perforation by a single standard-caliber implantable cardioverter-defibrillator lead, which manifested 14 days after implantation. Multidetector computed tomography could clearly display the lead perforation, and allow for identification of the associated sequelae such as pericardial effusion and planning the lead extraction strategy.
Defibrillators, Implantable ; Multidetector Computed Tomography ; Pericardial Effusion

The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for the presence of a third canal. The root canal configuration of 3-2-1 was confirmed for the mesiobuccal root using information gained from clinical, radiographic, and multi-detector computed tomography (MDCT) scan findings. This case demonstrates the need for efforts to locate extra canals in the mesiobuccal root of the maxillary molars as their internal anatomy remains a mystery.
Dental Pulp Cavity ; Molar ; Multidetector Computed Tomography

Small bowel obstruction is a relatively common clinical condition and its diagnosis is based on the clinical signs, the patient's history and the radiologic findings. For a patient with suspected small bowel obstruction, it is essential to determine the site, location and cause of obstruction for the appropriate management. Because of the poor accuracy of plain radiography, computed tomography (CT) now has an essential role to diagnose bowel obstruction. With the recent evolution of conventional CT into multi-detector computed tomography (MDCT), it is possible to obtain cross sectional images with high spatial resolution and different post-processes can be done, such as obtaining the volume rendering (VR), maximum intensity projection (MIP), or multiplanar reformatted (MPR) images from the volume data. In this article, we illustrate and discuss the utility of the multiplanar images of MDCT for diagnosing the sites, causes and complications of small bowel obstruction.
Humans ; Imaging, Three-Dimensional ; Multidetector Computed Tomography

No abstract available.
Coronary Vessels ; Multidetector Computed Tomography ; Sinus of Valsalva

No abstract available.
Angiography* ; Glomus Tumor* ; Multidetector Computed Tomography*

Multidetector-row computed tomography (MDCT) provides new opportunities and poses challenges for medical imaging to radiologists and physicians. Isotropic imaging (similar resolution in three dimensional directions) allows in-depth views of anatomy and disease. Ultra-fast scan enables whole-body volume imaging within a single breath hold and thus the reduction of contrast medium consumption. CT volume data sets can be used for threedimensional visualization of the whole body, with which the detailed and comprehensive interpretation of thoracic anatomy and specific disease location and extent is plausible. Moreover, four-dimensional CT imaging can be possible and therefore, we can observe and quantify cardiopulmonary functions without invasive procedures. The author reviews briefly the application of MDCT for the thoracic imaging.
Dataset ; Diagnostic Imaging ; Four-Dimensional Computed Tomography ; Multidetector Computed Tomography

BACKGROUND AND OBJECTIVES: The aim of this study was to assess mechanical valve function using 64-slice multidetector computed tomography (MDCT). SUBJECTS AND METHODS: In 20 patients (mean age, 50+/-12 years; male-to-female ratio, 10:10), 30 St. Jude bileaflet mechanical valves (15 aortic and 15 mitral valves) were evaluated using MDCT. We selected images vertical and parallel to the mechanical valve. The valve orifice area (OA) and valve length were determined by manual tracing and the opening and closing angles were measured using a protractor. The OA and length of the mechanical valves were compared with the manufacturer's values. RESULTS: The geometric orifice areas (GOAs) based on the manufacturer's values and the OAs determined by MDCT were 3.4+/-0.2 cm2 and 3.4+/-0.3 cm2 for the mitral valves and 2.1+/-0.3 cm2 and 2.1+/-0.4 cm2 for the aortic valves, respectively. The correlation coefficients between the OA measures were 0.433 for the mitral valves and 0.874 for the aortic valves (both p<0.001). The lengths based on the manufacturer's values and determined by MDCT were 29.3+/-1.99 mm and 29.6+/-1.65 mm for the mitral valves and 21.5+/-2.1 mm and 20.7+/-2.3 mm for the aortic valves, respectively. The correlation coefficients between the measures were 0.651 for the mitral valve and 0.846 for the aortic valve (both p<0.001). The opening and closing angles determined by MDCT were 10.9+/-0.6degrees and 131.1+/-3.2degrees for the mitral valves and 11.1+/-0.9degrees and 120.6+/-1.7degrees for the aortic valves, respectively. CONCLUSION: MDCT is an accurate modality with which to assess the function and morphology of bileaflet mechanical valves.
Aortic Valve ; Heart ; Humans ; Mitral Valve ; Multidetector Computed Tomography

In perforator flap reconstruction, vascular mapping using preoperative computed tomography (CT) angiography is widely used to confirm the existence and location of an appropriate perforator. This study proposes a rapid, accurate, and convenient method for marking the perforator location on the skin surface. For 12 patients who underwent perforator flap reconstruction between November 2011 and November 2013, metal clips were fixed on the skin surface at the anticipated perforator locations, which were decided using a handheld Doppler. CT angiography was used to compare the location between the metal clip and the actual perforator. The metal clip was moved and repositioned, if needed, on the basis of the CT images. The locations of the appropriate perforator and the metal clip, which were observed during the surgery, were then compared. In CT angiography, the mean distance between the metal clip and the perforator was 3+/-3.9 mm, and the mean distance that was measured during surgery was 0.8+/-0.8 mm. In conclusion, we report a simple, rapid, and precise technique to indicate the accurate location of the appropriate perforator on the skin surface.
Angiography* ; Humans ; Multidetector Computed Tomography ; Perforator Flap* ; Skin ; Ultrasonography, Doppler

OBJECTIVE: Percutaneous vertebroplasty (PVP) is usually carried out under three-dimensional (2D) fluoroscopic guidance. However, operative complications or bone cement distribution might be difficult to assess on the basis of only 2D radiographic projection images. We evaluated the feasibility of performing an intraoperative and postoperative examination in patients undergoing PVP by using three-dimensional (3D) reconstructive C-arm. METHODS: Standard PVP procedures were performed on 14 consecutive patients by using a Siremobil Iso-C3D and a multidetector computed tomography machine. Post-processing of acquired volumetric datasets included multiplanar reconstruction (MPR) and surface shaded display (SSD). We analyzed intraoperative and immediate postoperative evaluation of the needle trajectory and bone cement distribution. RESULTS: The male : female ratio was 2 : 12; mean age of patients, 70 (range, 77-54) years; and mean T score, -3.4. The mean operation time was 52.14 min, but the time required to perform and post-process the rotational acquisitions was 7.76 min. The detection of bone cement distribution and leakage after PVP by using MPR and SSD was possible in all patients. However, detection of the safe trajectory for needle insertion was not possible. CONCLUSION: 3D rotational image acquisition can enable intra- or post-procedural assessment of vertebroplasty procedures for the detection of bone cement distribution and leakage. However, it is difficult to assess the safe trajectory for needle insertion.
Female ; Humans ; Male ; Multidetector Computed Tomography ; Needles ; Silver Sulfadiazine ; Vertebroplasty

Traumatic thoracic aortic injury is typically fatal. However, recent improvements in pre-hospital care and diagnostic modalities have resulted in an increased number of patients with traumatic aortic injury arriving alive at the hospital. Also, the morbidity and mortality associated with endovascular repair are significantly lower than with conventional open surgery in traumatic thoracic aorta injury. We experienced two cases of successful management of traumatic thoracic aortic dissection with endovascular stents caused by traffic accidents.
Accidents, Traffic ; Aorta, Thoracic ; Aortography ; Humans ; Multidetector Computed Tomography ; Stents