clinical application of helical ct scan in husm edu publish-mma kareem
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MMA Kareem-EduPublish(c)-21.05.2005
CLINICAL APPLICATION OF HELICAL CT SCAN
IN HUSM
Abdul Kareem,USM, KB, Malaysia Riaz ahmed
MMA Kareem-EduPublish(c)-21.05.2005
MMA Kareem-EduPublish(c)-21.05.2005
HELICAL / SPIRAL CT
•Path of the X-rays can be described as a spiral or helix, hence the name helical or spiral CT
•The resultant continuous data set can be reconstructed at various intervals to generate overlapping sections
MMA Kareem-EduPublish(c)-21.05.2005
MMA Kareem-EduPublish(c)-21.05.2005
CT FLUROSCOPY
MMA Kareem-EduPublish(c)-21.05.2005
MMA Kareem-EduPublish(c)-21.05.2005
3- D RECONSTRUCTION
MMA Kareem-EduPublish(c)-21.05.2005
SPIRAL CT spiral CT has replaced conventional CT by
providing three fundamental advantages:
(a) reduced or eliminated motion artefacts caused by respiration or other sources of patient movement,
(b) imaging during the optimal window of
contrast enhancement for maximal image contrast,
(c) the ability to reconstruct axial images at arbitrary intervals
MMA Kareem-EduPublish(c)-21.05.2005
Objective
To highlight the role of helical CT in clinical application by referring 5 different clinical entities in HUSM.
MMA Kareem-EduPublish(c)-21.05.2005
Case-1: subarachnoid hge
58y/o man developed. sudden headache, nausea & vomiting. gradually reduced conscious level, a/w loss of consciousness for 10min
Neck stiffness, Muscle power 4/5 bilaterally
BP 150/70; HR 60/min CT scan: subarachnoid
haemorrhage
What to do next?
MMA Kareem-EduPublish(c)-21.05.2005
Urgent cerebral angio
on the left ICA not able to be cannulated
on the right, only the right MCA was opacified ACA was not opacified. ? spasm
What to do next?
MMA Kareem-EduPublish(c)-21.05.2005
CT angiography
Anterior communicating artery aneurysm detected
Right ACA - arise from the left ICA
same day
MMA Kareem-EduPublish(c)-21.05.2005
Surgery on 07/11/02- confirmed
Findings – saccular aneurysm arising from junction of A1 – A2 on the left side
Right ACA derives from left ICA
MMA Kareem-EduPublish(c)-21.05.2005
In HUSM,
multislice CT scanner is only available since middle of 2001
CTA is in the protocol for diagnosing intracranial aneurysm especially when DSA is negative or insufficient
use of CT angiography is now extended including evaluation abdominal and peripheral vasculature
MMA Kareem-EduPublish(c)-21.05.2005
MMA Kareem-EduPublish(c)-21.05.2005
Case-2:
12 Acute stroke patients had normal plain CT scan. Perfusion CT done. 7 had ischemic changes. 3 patients had normal perfusion CT
MMA Kareem-EduPublish(c)-21.05.2005
.shows extensive left hemispheric and right frontal ischemia
due to occlusion of left internal carotid artery occlusion.
Conventional CT is normal. CT perfusion image
Patient had left hemispheric syndrome since 1 hour
MMA Kareem-EduPublish(c)-21.05.2005
CT-Orbit
MMA Kareem-EduPublish(c)-21.05.2005
Case-3: Intraocular FB
MMA Kareem-EduPublish(c)-21.05.2005
Case-4 Nasopharyngeal tumor
MMA Kareem-EduPublish(c)-21.05.2005
MMA Kareem-EduPublish(c)-21.05.2005
CASE-5: BROCHIECTASIS
Bronchocele
Distended mucous filled airway produce opacity which point to the hilum, well defined and band-like
MMA Kareem-EduPublish(c)-21.05.2005
MMA Kareem-EduPublish(c)-21.05.2005