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Acta gastroenterologica Latinoamericana 12/2012; 42(4):268, 351-2.
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ABSTRACT: To study the value of virtual hysterosalpingography (VHSG) in the diagnosis of bicornuate vs. septate uterus.
Retrospective study of all cases with bicornuate or septate uterus that had VHSG during the last 3 years at our center.
Private fertility center and radiology institute with university affiliations.
A total of 47 patients (from more than 1,000 studies) with bicornuate uterus (n = 15) or septate uterus (n = 32) were analyzed to determine the ability of VHSG to distinguish both entities.
Virtual hysterosalpingography was performed in patients with bicornuate or septate uterus.
Procedure length, discomfort, amount of radiation, and ability to outline the uterine fundus.
We were able to clearly distinguish bicornuate from septate uterus. In all patients who underwent septoplasty the VHSG diagnosis of septate uterus was confirmed. Virtual hysterosalpingography was well tolerated by all patients; scanning took 5 seconds per patient, and the average radiation was very low (0.9 ± 0.7 mSv).
Virtual hysterosalpingography seems to be a valuable tool in the diagnosis of common uterine anomalies.
Fertility and sterility 09/2011; 96(5):1190-2. · 3.97 Impact Factor
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Acta gastroenterologica Latinoamericana 12/2010; 40(4):311, 378.
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ABSTRACT: To assess the feasibility of gadolinium-enhanced 64-slice cardiac CT (CCT) for the diagnosis of obstructive coronary artery disease.
Comparative prospective study.
Outpatient Imaging Diagnostic Centre, Diagnóstico Maipú, Buenos Aires, Argentina.
Twenty patients with suspected coronary artery disease.
Gadolinium-enhanced 64-slice CCT was performed before invasive coronary angiography (ICA).
The feasibility of gadolinium-enhanced 64-slice CCT for detection of obstructive coronary artery disease (>50% diameter reduction) was evaluated, using ICA as the 'gold standard'. Mean lumen attenuation, non-calcified and calcified plaques densities were correlated between gadolinium-enhanced CCT studies and iodine-enhanced CCT studies of a control group. Renal function was strictly monitored.
Gadolinium-enhanced CCT demonstrated adequate visualisation of 283/289 coronary segments that were evaluable by ICA, 31 of which had >50% luminal stenosis. In per-segment analysis, gadolinium-enhanced CCT showed a sensitivity of 90.3%, specificity of 96.8%, positive predictive value of 77.8% and negative predictive value of 98.8%. The agreement of coronary stenosis between multidetector CT (MDCT) and ICA was 94.1% (272/289). The mean lumen attenuation, non-calcified and calcified plaques densities in gadolinium-enhanced CCT studies were 140.1 Hounsfield units (HU), 51.1 HU and 523.6 HU, whereas in iodine-enhanced CCT studies the values were 354.1 HU, 101.0 HU and 778.5 HU, respectively (p < 0.001).
Gadolinium-enhanced CCT is a feasible alternative for patients with severe contraindications to iodinated contrast agents referred for MDCT coronary angiography.
Heart (British Cardiac Society) 10/2010; 96(19):1543-9. · 4.22 Impact Factor
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ABSTRACT: With the advent of multidetector computed tomography (MDCT), a whole new spectrum of diagnostic imaging techniques and procedures appears. Virtual hysterosalpingography (VHSG) is a novel non-invasive modality for assessing the uterus and female reproductive system that combines hysterosalpingography technique with MDCT technologies. Nowadays, 64-row VHSG offers an excellent diagnostic performance, in concordance with the development of new reproductive interventions and the need of accurate diagnostic procedures. In this article, we review the VHSG technique and describe normal and pathologic findings.
Abdominal Imaging 05/2010; 36(1):1-14. · 1.73 Impact Factor
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ABSTRACT: To determine the usefulness of perspective-filet view for polypoid lesions in paediatric patients in comparison with conventional virtual colonoscopy (VC) analysis and optical colonoscopy.
Sixty-one patients (mean age 5 years old) with a previous episode of rectal bleeding were studied using a 16 slices CT scanner. All patients underwent a colonic preparation. Two acquisitions were done in supine and prone positions with slices of 2mm thickness; increment 1mm, 30-50mA; 90-120kV. In a workstation an experienced radiologist reviewed images twice. The first read was done using the conventional virtual colonoscopy technique with the evaluation of two-dimensional (2D), three-dimensional (3D) and endoscopical images. Later, in a second session, perspective-filet view was used. It shows a 360 degrees unrolled visualization of the inner colon. The presence, size and location of the lesions were determined. A record of the reading time was made.
At per patient evaluation the conventional virtual colonoscopy analysis obtained a sensitivity of 86% and a specificity of 98%. The perspective-filet view obtained a sensitivity of 91% and a specificity of 99%. In the evaluation on a per lesion basis the conventional analysis had a sensitivity of 81% and a specificity of 88%. Perspective-filet view, had a sensitivity of 82% and specificity of 90%. The average total reading time using conventional colonoscopy technique was 18+/-3min, versus 4+/-1min using the perspective-filet view.
Virtual colon dissection with perspective-filet view is more time-efficient than conventional virtual colonoscopy evaluation with correct correlation in results.
European journal of radiology 05/2009; 74(1):189-94. · 2.65 Impact Factor
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Journal of cardiovascular computed tomography 02/2009; 3(2):112-3.
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ABSTRACT: Double right coronary artery (RCA) arising from two separated ostia in the right sinus of Valsalva is an extremely rare coronary artery variation. We report a case of double RCA detected by multidetector-row computed tomography (MDCT). MDCT allows three-dimensional comprehension of the coronary artery anatomy and it is extremely useful to identify coronary artery anomalies.
International journal of cardiology 01/2009; 139(3):e33-5. · 7.08 Impact Factor
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ABSTRACT: Computed tomographic angiography (CTA) has gained wide clinical acceptance as a powerful diagnostic tool in the non-invasive evaluation of vascular disorders and has became the method of choice for the assessment of aortic pathology. In addition, recent advances in computed tomography (CT) technology improve the image quality and diagnostic performance of the procedure in the abdominal vascular system. In this paper, we briefly review the CTA technique and describe the main applications of abdominal CTA.
Abdominal Imaging 09/2008; 34(1):81-93. · 1.73 Impact Factor
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ABSTRACT: The improvement in spatial, temporal, and contrast resolutions with the newest multidetector computed tomographic (MDCT) scanners opens the opportunity to explore other applications of the virtual endoscopy technique besides the colon and stomach evaluation. As a non-invasive technique, virtual esophagoscopy represents an alternative to conventional endoscopy for the assessment of esophageal stenosis. The procedure and diagnostic performance are reviewed. Findings of this modality are illustrated.
Abdominal Imaging 09/2008; 34(1):19-25. · 1.73 Impact Factor
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ABSTRACT: To illustrate the large variety of pathologies found on 64-row computed tomographic (CT) virtual hysterosalpingography (CT-VHSG) in the evaluation of the female reproductive tract in infertile patients.
We prospectively evaluated CT datasets from 209 patients with diagnosis of infertility. CT-VHSG was performed with a 64-row CT scanner using 64 x 0.625 mm(2) collimation and 0.9 mm slice thickness. A total volume of 20 mL of an iodine contrast dilution was injected into the uterine cavity. The duration of the CT scan and the grade of patient discomfort of the procedure were documented. Images were analyzed on a workstation. The CT-VHSG exams were divided in studies with normal or pathological findings; pathologies were classified according to their locations (cervical, uterine, and fallopian tube pathology).
No complications occurred during the procedure. The mean scan time was 3.4 +/- 0.4 s; the mean patient effective dose was 2.58 +/- 0.75 mSv. In relation to the patient's discomfort evaluation, 55.5% of the patients referred no discomfort during the procedure. Cervical pathology was found in 100/209 patients, uterine pathology in 93/209 patients, and fallopian tubes pathology in 37/209 patients.
A 64-row CT-VHSG provides a reliable, non-invasive alternative diagnostic technique in the infertility workup algorithm.
Abdominal Imaging 09/2008; 34(1):121-33. · 1.73 Impact Factor
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ABSTRACT: To evaluate the potential clinical value of 64-row multislice computed tomography hysterosalpingography (MSCT-H) in the evaluation of female patients with a diagnosis of infertility and compare it with the use of standard X-ray hysterosalpingography (HSG).
Comparative prospective study.
Outpatient Imaging Diagnostic Centre, Diagnóstico Maipú, Buenos Aires, Argentina, and a university-affiliated fertility institute (Centro de Estudios en Ginecología y Reproducción, Buenos Aires, Argentina).
Twenty-two female patients with a diagnosis of infertility.
Sixty-four-row MSCT-H and conventional X-ray HSG.
Diagnostic accuracy of MSCT-H for the evaluation of cervical, uterine, and tubal pathology.
We found that 64-row MSCT-H was useful in identifying female reproductive tract abnormalities, showing in the per patient analysis a sensitivity of 100% and a specificity of 85.71%. This new procedure can be performed without a tenaculum, making it well tolerated. Clinical complications did not occur in any of the patients participating in the study.
Sixty-four-row MSCT-H is a valuable alternative diagnostic technique in the infertility workup algorithm for the evaluation of the female reproductive tract.
Fertility and sterility 02/2008; 90(5):1953-8. · 3.97 Impact Factor
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ABSTRACT: To compare the efficacy of multidetector CT virtual hysterosalpingography (MDCT-VH) with conventional X-ray hysterosalpingography (HSG) in the evaluation of patients with diagnosis of infertility.
Sixty patients with diagnosis of infertility scheduled to perform a HSG, were evaluated with 16-row (n=50) and 64-row (n=10) MDCT-VH. In 35 patients the examination was performed without a tenaculum. The HSGs were carried out using standard technique. The HSG and MDCT-VH findings were compared. The duration for both examinations and patient discomfort were documented. The sensitivity and specificity of MDCT-VH for the detection of uterine pathology and tubal obstruction were calculated using the exact binomial method. Agreement between the two methods was assessed by the Cohen's kappa method (k).
The mean duration for MDCT-VH (16 and 64-rows) was 5+/-3 min, whereas for HSG was 28+/-3. The MDCT-VH without a tenaculum was the procedure with less patient discomfort. Sensitivity, specificity and inter-method agreement for the detection of uterine pathology were 100%, 92% and k=0.92 for 16-row MDCT-VH and 100%, 100% and k=1 for 64-row MDCT-VH, respectively. Sensitivity and specificity for detection of tubal obstruction were 80% and 80% for 16-row MDCT-VH and 100% and 100% for 64-row MDCT-VH, respectively; inter-method agreement for the visualization of the tubes was k=0.54 for 16-row MDCT-VH and k=1 for 64-row MDCT-VH.
This study demonstrated the feasibility of evaluating the female reproductive system by MDCT-VH. 64-Row MDCT-VH could be an alternative diagnostic technique in the infertility workup algorithm. A larger study is in progress to validate these encouraging results.
European Journal of Radiology 10/2007; 67(3):531-5. · 2.61 Impact Factor
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ABSTRACT: Multidetector computed tomography (MDCT) has been proposed as a noninvasive method for the diagnosis of obstructive coronary artery disease (CAD). In patients with high risk of iodinated contrast adverse effects such as acute allergic-type reactions, the use of gadolinium could be an alternative.
We sought to evaluate the feasibility of gadolinium-enhanced MDCT for the diagnosis of obstructive CAD.
Twenty patients (mean age, 61 years; range, 50-73 years) referred for X-ray coronary angiography were studied by both gadolinium and iodine-enhanced 16-row MDCT coronary angiography. The degree of enhancement and the accuracy for detection of obstructive CAD (>50% diameter reduction) were evaluated with X-ray coronary angiography as the standard. Renal nephrotoxicity was strictly monitored.
Gadolinium- and iodine-enhanced MDCT showed adequate visualization of the coronary arteries in 310 of the 312 coronary artery segments that were available by X-ray angiography, respectively. The average density of the coronary arteries in both iodine and gadolinium CT scans was 253.65 Hounsfield unit (HU) and 135.20 HU, respectively. In a per-coronary segment analysis, gadolinium- and iodine-enhanced MDCT showed sensitivities of 89% vs 84%, specificities of 96% vs 95%, and negative predictive values of 97% vs 96%, respectively. In a per-patient analysis, both gadolinium- and iodine-enhanced MDCT showed sensitivities of 92.85% vs specificities of 83.33%. Intermethod agreement between gadolinium- and iodine-enhanced MDCT (kappa) was 0.95 (P < 0.0001).
Our preliminary results indicate lower attenuation with gadolinium but similar diagnostic accuracy for the detection of obstructive CAD when compared with iodine-enhanced MDCT. Therefore, gadolinium is a feasible alternative contrast agent for patients with iodine contrast allergy referred for MDCT coronary angiography.
Journal of cardiovascular computed tomography 10/2007; 1(2):86-94.
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ABSTRACT: To show our experience and results in Virtual Colonoscopy (VC).
Five hundred patients with personal or familial history of colorectal carcinoma and/or adenomas, or any kind of coloproctologic symptoms were studied. VCs were practiced using a helical CT scanner (300 patients) and a multislice CT scanner (200 patients) a few hours after Conventional Colonoscopy (CC), considered the gold standard. The patients were evaluated in a prospective blind study, to determine sensitivity and specificity of VC. Findings were classified as: 1) normal studies; 2) studies with pathological findings. This one was subdivided into: 2a) Lesions below 5 mm., 2b) Lesions between 5-9 mm., 2c) Lesions above 9 mm.
VC detected 253 normal studies whereas CC only detected 233. The sensitivity and specificity for each subgroup were: 2a) 87.8% and 86.9%; 2b) 95.6% and 91.4%; 2c) 100.0% and 100.0% respectively.
VC is a feasible and useful method for evaluating the entire colon. It is well tolerated, it has no complications and a high sensitivity and specificity for elevated lesions, especially the ones above or equal to 5 mm.
Acta gastroenterologica Latinoamericana 02/2003; 33(3):145-9.
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Patricia Carrascosa,
R Corti,
G Sangster,
C Capuñay,
G Suinbourn,
Liliana Schenone,
A Giordano,
J Doweck,
G Menéndez,
J Valero,
O Zerbo,
J Carrascosa
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ABSTRACT: To define the role of virtual gastroscopy (VG) in the detection of elevated lesions comparing its results with conventional endoscopy (CE) as the gold standard method.
Between December 2000 and July 2001, 19 patients were evaluated. The age ranged between 41 and 72 (mean 58.8 years old). VG and CE were performed in all the patients during the same week. VG were carried out with a multislice CT scanner (Mx 8000, Marconi Medical Systems). The technical parameters used were 3 mm with slices and 1.5 mm reconstruction intervals. The acquisition time was 22 seconds. Images were sent to a workstation (MxView, Marconi Medical Systems) where they were reprocessed in three different ways: 1) Bidimensionally 2) Tridimensionally 3) Virtual Endoscopy Findings of VG were compared with CE.
VG detected 39 lesions, whereas CE detected 40 lesions. There were 39 true-positive findings, 2 true-negative findings, 0 false-positive findings and 1 false-negative findings. The Sensitivity (Se) was 97.5%; Specificity (Sp) was 100%, positive predictive value 100% and Negative predictive value 66%.
VG is a new non-invasive method with high Se and Sp in the detection of elevated lesions. The actual role of VG consist in identification of gastric lesions and possibility to diagnose gastric disease.
Acta gastroenterologica Latinoamericana 06/2002; 32(1):11-5.
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ABSTRACT: Virtual colonoscopy is used worldwide for the detection of colon polyps, but this technique has not been used much for the evaluation of inflammatory bowel diseases. The advent of multidetector-computed tomography and the use of high quality 3D and virtual images opened up the opportunity to assess these patients with this non-invasive technique. Early and late colonic changes are illustrated.
Abdominal Imaging 32(5):596-601. · 1.73 Impact Factor
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ABSTRACT: Currently accepted techniques that evaluate the uterus and female reproductive system in the infertility workup algorithm include hysterosonography, hysteroscopy and hysterosalpingography. Based on high speed multidetector computed tomography (MDCT) which can acquire high-quality volumetric data of the pelvic region in a single brief scan, MDCT virtual hysteroscopy is proposed as a developing, non-invasive alternative diagnostic procedure for the evaluation of uterine pathology and other gynecologic disorders. Findings of the technique are illustrated.
Abdominal Imaging 33(4):381-7. · 1.73 Impact Factor
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ABSTRACT: The purpose of our study was to determine the usefulness of a virtual computed tomography colon dissection visualization technique for the detection of polypoid lesions in comparison with conventional virtual colonoscopy analysis and optical colonoscopy.
Twenty-three patients were evaluated with optical colonoscopy and computed tomography colonoscopy using 16-row MDCT on the same day. CT images were analyzed by the colon dissection workup with unfolded haustra visualization and also using the conventional virtual colonoscopy technique (axial images and endoluminal views). The CT analysis was performed by an experienced radiologist using both viewing methods in a randomized order and blinded to optical colonoscopy results.
Optical colonoscopy revealed 35 colonic lesions; 15 < 5 mm, 18 between 5-9 mm and 2 > 9 mm. For conventional virtual colonoscopy analysis the overall sensitivity was 86.67%; for the colon dissection visualization technique, the overall sensitivity was 82.86%. The average reading time for conventional virtual colonoscopy was 15 +/- 3 vs. 8 +/- 2 min for the colon dissection visualization technique.
Our results showed that there is a significant reduction in the reading time using the colon dissection visualization technique without detriment to the detection rate, that is, competitive to conventional virtual colonoscopy interpretation results.
Abdominal Imaging 32(5):582-8. · 1.73 Impact Factor
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ABSTRACT: To investigate the gadolinium performance for 16-detector-row coronary computed tomography (CT) angiography.
Ethics committee approval and informed consent were obtained. Ten patients with coronary artery disease underwent digital coronary angiography and gadolinium-enhanced CT coronary angiography (Gd-CTCA) within the same week. For the Gd-CTCA, each patient received a dose of 0.3 mmol/kg of body weight of 0.5 mmol/mL gadoterate meglumine. Two readers interpreted the CT angiographies independently, and their results were matched with the digital angiography findings. The diagnostic accuracy of Gd-CTCA was calculated by the exact binomial method.
Sensitivity, specificity, and positive and negative predictive values were for observer 1: 91.67%, 98.73%, 84.62%, and 99.36%, and for observer 2: 83.33%, 98.73%, 83.33%, and 98.73%, respectively.
Preliminary results demonstrated that gadolinium chelates may be used as an alternative CT contrast media in coronary CT angiographies, without detriment to diagnosis results.
Journal of Computer Assisted Tomography 31(3):441-3. · 1.22 Impact Factor
