Computed Tomography News & Stories

A cinematic VRT image shows that the LAD and the Cx originate separately off the left coronary sinus, with normal courses, without a common LM. The origin and the course of the RCA are normal.

Anomalous left coronary origins as well as a small incidental atrial septal defect

A 70-year-old female patient, suffering from hypertension, came to the hospital complaining of increasing chest discomfort suspicious of angina. Coronary CT angiography was requested and performed on a dual source CT, a SOMATOM Pro.Pulse, to rule out obstructive coronary disease.

Clinical Results

A cinematic VRT image shows a three-dimensional view of the coronary arteries. The stents and the calcified plaques are highlighted. The axial images used were reconstructed at 0.2 mm with a kernel of Bv72.

Multiple coronary stents with in-stent re-stenosis and a high-risk plaque

A 76-year-old male patient, with a history of coronary stenting, was presented to the hospital, complaining of palpitations and chest tightness. An ECG-triggered sequential ultra-high resolution CCTA with a dual source photon-counting detector (PCD) CT, NAEOTOM Alpha^®, was performed to assess the coronary arteries and the patency of the stents.

Clinical Results

A cinematic VRT image shows an overview of three patent bypass grafts – a LIMA graft anastomosed to the distal LAD and two SVG anastomosed to the D1 and the IM of the LAD.

Triple coronary artery bypass grafts and stents

A 46-year-old male patient, with a history of CABG and coronary stenting, presented himself to the hospital due to atypical chest pain. A CT scan was requested to evaluate the patency of the grafts, the anastomoses and the stents. A UHR coronary CT angiography was performed on a dual-source photon-counting detector CT, NAEOTOM Alpha®.

Clinical Results

A cinematic VRT image shows three dimensional views of the two small lesions in the left ureteropelvic junction and in the middle ureter.

Two small non-invasive papillary urothelial carcinomas in the left renal pelvis and ureter

A 76-year-old male patient suffered from repeated episodes of renal colic associated with hematuria. Two native CT scans to detect renal calculi were negative. Urine cytology analysis to detect urothelial cancer also resulted negatively. A contrast enhanced CT scan was performed with a photon-counting CT, NAEOTOM Alpha®, for further assessment.

Clinical Results

A cinematic volume rendering image shows two small hyper-dense areas in the distal part of the LAAC device, adjacent to the inner and outer surface, suggesting fabric leaks.

Multi-vessel coronary stents and high-risk plaques

A 48-year-old male patient, suffering from a Non-ST-Elevation Myocardial Infarction, underwent percutaneous coronary intervention with multi-vessel coronary stent implantations two years ago. This unexpected incident had profoundly affected his life, causing substantial stress, and even panic attacks leading to several emergency department visits.

Clinical Results

A cinematic volume rendered image shows the position of the 6 cryoprobes in three dimensions.

Cryoablation of an adrenal metastasis under CT guidance

An 85-year-old male patient, suffering from bronchial carcinoma, was diagnosed with a left adrenal mass. It was progressive in size, despite prior radiotherapy, therefore being highly suggestive of a metastasis. The patient was admitted for cryoablation.

Clinical Results

A cinematic volume rendering image shows two small hyper-dense areas in the distal part of the LAAC device, adjacent to the inner and outer surface, suggesting fabric leaks.

Pulmonary vein radiofrequency catheter ablation and left atrium appendage closure

A 71-year-old female patient, suffering from paroxysmal atrial fibrillation, had undergone an uneventful transcatheter pulmonary vein radiofrequency catheter ablation in all 4 pulmonary veins along with left atrium appendage closure. 58 days later, a contrast-enhanced ECG-triggered cardiac CT was performed as a follow-up evaluation.

Clinical Results

$Sagittal MPR images show a fracture cleft that is partially obscured by metal artifacts on the polychromatic image, and is however clearly visible on VMI images reconstructed at 120 keV. No sign of osseous consolidation is evident.$

Pseudarthrosis revision of a comminuted tibia fracture – consolidated?

A 46-year-old male patient underwent pseudarthrosis revision due to a comminuted tibia fracture. 6 weeks later, a follow-up CT examination was scheduled to evaluate the status of osseous healing. A scan in ultra-high resolution mode with spectral shaping (tin filtration) was performed on a photon-counting CT, NAEOTOM Alpha®.

Clinical Results

A cVRT image of the right foot show an irregular and narrowed subtalar joint involving both middle and posterior subtalar facet, which are deformed. There are no signs of bony bridging, confirming the diagnosis of a non-osseous talocalcaneal coalition. Additionally, a talar beak can be seen at the superior aspect of the talus head. Note that the input images for cVRT creation are reconstructed at 0.2 mm, with a very sharp kernel of Br84u and an image matrix of 1024 × 1024.

Non-osseous subtalar coalition

A 22-year-old female patient, suffering from tarsal coalition, was scheduled for surgery. CT was performed to evaluate the size, location and extent of the coalition for preoperative workup. An ultra-high resolution scan mode was performed on a photon-counting CT, NAEOTOM Alpha®.

Clinical Results

Three-dimensional Cinematic Rendering images highlight the calcified plaques in the proximal LAD and RCA. Note that the images used for the rendering are reconstructed at 0.2 mm with a sharp kernel of Bv64.

A case of hemiparesis and dysarthria after stenting of the left internal carotid artery

A 67-year-old male patient underwent a left internal carotid artery stent angioplasty. Following a successful procedure, he developed right hemiparesis and dysarthria. Dual Energy brain CT without i.v. contrast was performed to rule out a suspected subarachnoid bleeding.

Clinical Results

MPR images show a small lung nodule centrally captured by an 18G biopsy needle.

Percutaneous lung biopsy of a small metastatic nodule under CT guidance

A 61-year-old male patient, suffering from a renal cell carcinoma (RCC), underwent a CT examination for staging. A small lung nodule was detected, suspicious of a metastasis. The patient was admitted for a biopsy of the lesion under CT guidance.

Clinical Results

Three-dimensional Cinematic Rendering images highlight the calcified plaques in the proximal LAD and RCA. Note that the images used for the rendering are reconstructed at 0.2 mm with a sharp kernel of Bv64.

Extensive coronary calcifications with high-risk plaques

A 64-year-old male patient, complaining of atypical chest discomfort during exercise and palpitations at rest, presented himself to the hospital. A coronary CT angiography was performed on a Dual Source photon-counting CT, NAEOTOM Alpha®, using a Quantum HD cardiac mode to rule out exercise-induced coronary insufficiency.

Clinical Results

cVRT images show a diffusely dilated RCA with an ARCAPA at an angulation of less than 45 degrees and a proximal trajectory towards the right atrioventricular groove making a sharp turn. The LM, LAD, and Cx were also diffusely dilated, with normal origins and courses. Collaterals between the RCA and the LAD are seen.

Síndrome de ARCAPA - un hallazgo incidental en un adulto

Acude a la consulta de cardiología una paciente de sexo femenino, de 70 años, con dolor intermitente en la región dorsal interescapular, ocasionalmente asociado a disnea, desde hace un año. Su historial médico incluía un cáncer de mama ductal infiltrante hace 7 años y un melanoma en la mano derecha hace 2 años, ambos habían sido tratados quirúrgicamente.

Clinical Results

$cVRT images reconstructed parallel to the screw, show lucency on the tip of the screw and in various parts around the screw, confirming screw loosening. Metal artifact reduction surrounding the screw is remarkable, and the trabecular bone structure surrounding the fracture can be appreciated. The fracture in the scaphoid is still largely visible, with a sclerotically bordered fracture line.$

Lesión FOOSH con fijación con tornillo del escafoides

Un paciente masculino de 20 años con lesión de FOOSH fue sometido a una fijación con tornillos de escafoides y posteriormente a una cirugía de revisión por pseudoartrosis de la fractura. Una TC de seguimiento mostró una estructura ósea poco clara alrededor del tornillo con presencia de artefactos metálicos. Se realizó una evaluación adicional utilizando un modo de exploración UHR en una TC con conteo de fotones.

Clinical Results

A cVRT image shows a three-dimensional overview (7 lesions in green) and a clip from the cholecystectomy.

Multiple gastrinomas

A 37-year-old female patient, complaining of chronic epigastric pain, had had a cholecystectomy as treatment but the pain persisted. She was referred to CT to investigate a suspected Zollinger Ellison Syndrome. A multiphase dynamic CT scanning of the upper abdomen was performed, with thin slice reconstruction to capture all potential lesions.

Clinical Results