Definitive diagnosis of Craniosynostosis (CS) with computed tomography (CT) is readily available, however, exposure to ionizing radiation is often a hard stop for parents and practitioners. Lowering head CT radiation exposure helps mitigate risks and improves diagnostic utilization. The purpose of the study is to quantify radiation exposure from head CT in patients with CS using a ‘new’ (ultra-low dose) protocol; compare prior standard CT protocol; summarize published reports on cumulative radiation doses from pediatric head CT scans utilizing other low-dose protocols. A retrospective study was conducted on patients undergoing surgical correction of CS, aged less than 2 years, between August 2014 and February 2022. Cumulative effective dose (CED) in mSv was calculated, descriptive statistics were performed, and mean ± SD was reported. A literature search was conducted describing cumulative radiation exposure from head CT in pediatric patients and analyzed for ionizing radiation measurements. Forty-four patients met inclusion criteria: 17 females and 27 males. Patients who obtained head CT using the ‘New’ protocol resulted in lower CED exposure of 0.32 mSv ± 0.07 compared to the prior standard protocol at 5.25 mSv ± 2.79 (p < 0.0001). Five studies specifically investigated the reduction of ionizing radiation from CT scans in patients with CS via the utilization of low-dose CT protocols. These studies displayed overall CED values ranging from 0.015 mSv to 0.77 mSv. Our new CT protocol resulted in 94% reduction of ionizing radiation. Ultra-low dose CT protocols provide similar diagnostic data without loss of bone differentiation in CS and can be easily incorporated into the workflow of a children’s hospital.
The integration of medical images is the process of registering and fusing them to obtain a greater amount of diagnostic information. In this work an analysis is performed for the integration of images obtained through computed axial tomography and magnetic resonance imaging, for which a tool was developed in the Matlab program, where the registration is implemented through equivalent features; in addition, the pairs of images are compared by several fusion rules, with a view to identify the best algorithm in which the resulting fused image contains the most information from the original representations.
Gout is an arthritis characterized by the deposition of sodium monoacid crystals in the synovial membrane, articular cartilage, and periarticular tissues that leads to an inflamatory process. In most cases, the diagnosis is established by clinical criteria and analysis of the synovial fluid for MSU crystals. However, gout may manifest in atypical ways and make diagnosis difficult. In these situations, imaging studies play a fundamental role in helping to confirm the diagnosis or even exclude other differential diagnoses. Conventional radiography is still the most commonly used method in the follow-up of these patients, but it is a very insensitive test, because it only detects late changes. In recent years, advances in imaging methods have emerged in relation to gout. Ultrasound has proven to be a highly accurate test in the diagnosis of gout, identifying MSU deposits in articular cartilage and periarticular tissues, and detecting and characterizing tophi, tendinopathies, and tophi enthesopathies. Computed tomography is an excellent exam for the detection of bone erosions and evaluation of spinal involvement. Dual-energy computed tomography, a new method that provides information on the chemical composition of tissues, allows identification of MSU deposits with high accuracy. MRI can be useful in the evaluation of deep tissues not accessible by ultrasound. In addition to diagnosis, with the emergence of drugs that aim to reduce the tophaceous burden, imaging examinations become a useful tool in the follow-up treatment of gout patients.
Introduction: Given the heterogeneous nature and inherent complexity of forensic medical expertise, the expert (medical professional or related areas) must make the best use of the technical and technological tools at his disposal. Imaging, referring to the set of techniques that allow obtaining images of the human body for clinical or scientific purposes, in any of its techniques, is a powerful support tool for establishing facts or technical evidence in the legal field. Objective: To analyze the use of magnetic resonance and computed tomography in postmortem diagnosis. Methodology: information was searched in the databases PubMed, Science Direct, Springer Journal and in the search engine Google Scholar, using the terms “X-Ray Computed Tomography”, “Magnetic Resonance Spectroscopy”, “Autopsy” and “Forensic Medicine” published in the period 2008–2015. Results: MRI is useful for the detailed study of soft tissues and organs, while computed tomography allows the identification of fractures, calcifications, implants and trauma. Conclusions: In the reports found in the literature search, regarding the use of nuclear magnetic resonance and computed tomography in postmortem cases, named by the genesis of the trauma, correlation was found between the use of imaging and the correct expert diagnosis at autopsy.
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