Biondetti Pr

CT appearance of generalized von recklinghausen neurofibromatosis

Two cases of von Recklinghausen neurofibromatosis (VRN) with thoracic and abdominal involvement are described. Computed tomography demonstrated the typical lesions of this disease: meningoceles, neurofibromas, and skeletal alterations. In both cases lesion morphology and location were similar and characteristic, in particular in the pelvic region. Computed tomography findings in generalized VRN are sufficiently characteristic to be considered diagnostic for this disease.

Role of transjugular liver biopsy in the diagnostic and therapeutic management of patients with severe liver disease

Purpose. This study sought to assess the diagnostic yield, the impact on treatment and the safety of transjugular liver biopsyMaterials and methods. We reviewed the medical records of 72 patients with severely impaired liver function who underwent transjugular biopsy at our department. Contraindications to percutaneous liver biopsy included thrombocytopenia, severe coagulopathy, marked ascites or a combination of the above. Patients were divided into four groups based on the clinically suspected cause of liver disease. Group 1 included 44 patients (58%) with acute abnormalities of liver function, whereas groups 2, 3 and 4 included patients with chronic abnormalities suspected to be due to infectious cirrhosis (12 patients, 16%), alcoholic cirrhosis (seven patients, 9%) and cirrhosis of unknown origin (13 patients, 17%), respectively. A Quick-Core (Cook, ProAct Ltd., State College, Pennsylvania, USA) needle allowing automated tissue sampling was used for all biopsiesResults. Biopsy specimens were diagnostic in 69 out of 72 patients (91%). Biopsy findings influenced treatment in 34 out of 69 patients (49%). The most significant results were obtained in group 1, where the histological diagnosis differed from clinical suspicion in 25/39 patients. There was only one major complication and four minor complications. The major complication was an arteriovenous and arteriobiliary fistula with haemorrhage and anaemia, which was successfully embolised by the same team of interventional radiologistsConclusions. Transjugular liver biopsy proved to be a safe procedure that provided important information for the clinical and therapeutic management of patients in whom treatment would have been either empirical or unfeasibleRiassuntoObiettivo. Valutare l’efficacia diagnostica, l’impatto sul trattamento terapeutico e la sicurezza della biopsia epatica transgiugulareMateriali e metodi. Abbiamo revisionato le cartelle cliniche di 72 pazienti con severa alterazione della funzionalità epatica che sono stati sottoposti a biopsia transgiugulare presso il nostro Dipartimento. I pazienti sono stati suddivisi in 4 gruppi, in base al sospetto clinico dell’origine della malattia epatica. Il gruppo 1 includeva 44 pazienti (58%) con un’alterazione acuta della funzionalità epatica, mentre i gruppi 2, 3, 4 includevano pazienti in cui l’alterazione era cronica e in cui il sospetto clinico era rispettivamente di cirrosi di tipo infettivo (12 pazienti, 16%), alcolico (7 pazienti, 9%) e di origine sconosciuta (13 pazienti, 17%). Per la biopsia è stato utilizzato un ago Quick Core (Cook, ProAct Ltd., State College, Pennsylvania, USA), che permette il prelievo in modo automaticoRisultati. Materiale bioptico diagnostico è stato ottenuto in 69 pazienti su 72 (91%). I dati forniti dalla biopsia hanno permesso un cambiamento terapeutico in 34 su 69 soggetti (49%). I risultati più significativi sono stati ottenuti nel gruppo 1 dove in 25 casi su 39 pazienti si è ottenuta una diagnosi diversa da quella sospettata. Abbiamo avuto una sola complicanza maggiore, risolta dallo stesso gruppo di radiologi interventisti e 4 complicanza minoriConclusioni. La biopsia epatica per via transgiugulare permette di ottenere importanti dati relativi al trattamento clinico e terapeutico di pazienti nei quali la terapia sarebbe altrimenti empirica o non proponibile, con una bassa incidenza di complicanze

Single-versus multidetector-row CT: comparison of sedation rates, conventional angiograms and motion artefacts in young children following liver transplantation

Purpose.The aim of this study was to determine whether the use of multidetector computed tomography (MDCT) is associated with decreased sedation, frequency of motion artefacts and conventional angiograms compared with single-detector CT (SDCT).Materials and methods.CT examinations performed in young children between January 1993 and June 2005 were reviewed retrospectively. Prior to September 2000, SDCT was used; after that period, MDCT was used. The examinations obtained during these two periods were compared for the frequency of sedation, motion artefacts, and conventional angiograms. Statistical comparison between the two groups was determined by using the χ2 test.Results.A total of 126 infants and children younger than 6 years of age underwent 134 CT examinations. Eighty-eight were obtained with a SDCT (65%) (group 1) and 46 with a MDCT (35%) (group 2). Sedation was required in 31/88 (35%) CT examinations in group 1 and in 6/46 (13%) in group 2. Conventional angiography was performed in 20/88 (22%) cases in group 1 and in 6/46 (13%) in group 2. Motion artefacts were present in 8/88 (9%) CT examinations in group 1 and in 4/46 (8%) in group 2. There was significant statistical difference with regard to sedation and angiography rates between the two groups (p<0.001) whereas there was no significant difference with regard to motion artefacts (p>1).Conclusions.MDCT can reduce the need for sedation and conventional angiography in children after liver transplantation. There is no effect on patient motion artefacts.

Intestinal interposition: the prevalence and clinical relevance of non-hepatodiaphragmatic conditions (non-Chilaiditi forms) documented by CT and review of the literature.

PurposeThis study was done to assess the prevalence and clinical impact of non-hepatodiaphragmatic interpositions in a sample of adult patients undergoing computed tomography (CT) for a variety of medical reasons.Materials and methodsFrom November 2008 to April 2009, two observers jointly examined the cases of intestinal interposition in 4,338 adults undergoing CT investigations. This study sought to identify not only hepatodiaphragmatic intestinal interpositions, defined as Chilaiditi, but also other forms of intestinal interposition, which we termed non-Chilaiditi. The latter were divided into five different classes on the basis of their anatomical relationships: splenorenal, retrogastric, hepatocaval, retrosplenic, and retrorenal. Moreover, a questionnaire investigating the clinical symptoms reported to be associated with Chilaiditi syndrome was given to patients exhibiting any form of intestinal interposition and to a control sample. Finally, clinical data related to the three groups were compared.ResultsOf the 4,338 patients examined, 130 (3%) were found to have intestinal interposition, for a total of 143 forms: 90 Chilaiditi and 53 non-Chilaiditi. Of the latter, 30 were splenorenal, 12 retrogastric, five hepatocaval, four retrosplenic and two retrorenal. Statistical analysis showed that the Chilaiditi group suffered most symptoms (24.4%), followed by the non-Chilaiditi group (18.9%) and control cases (10.8%). Our results were validated using the χ2 test of significance.ConclusionsThe number of non-Chilaiditi cases amounted to just over half the number of Chilaiditi cases, with the splenorenal form being by far the most frequent. Statistical analysis showed that patients with non-Chilaiditi forms of intestinal interposition had more symptoms than did controls.RiassuntoObiettivoScopo del nostro lavoro è stato valutare la prevalenza e l’impatto clinico delle forme di interposizione intestinale non epatodiaframmatiche in una popolazione adulta studiata con tomografia computerizzata (TC) per differenti indicazioni medico-chirurgiche.Materiali e metodiDa novembre 2008 ad aprile 2009, due autori hanno valutato insieme i casi di interposizione intestinale su 4338 pazienti adulti sottoposti a indagini TC. In tale studio, sono state evidenziate sia interposizioni di tipo epatodiaframmatico, che sono state definite Chilaiditi come da letteratura, sia altri tipi di interposizione definite secondo i diversi rapporti anatomici: splenorenale, retrogastrica, epatocavale, retrosplenica e retrorenale, che sono state raggruppate sotto il termine non-Chilaiditi. È stato successivamente sottoposto ai pazienti dei due gruppi e ad un gruppo controllo un questionario relativo ai disturbi clinici associati più frequentemente alla sindrome di Chilaiditi. Sono stati quindi comparati i dati clinici relativi ai tre gruppi.RisultatiSu 4338 pazienti sono stati osservati 130 (3%) pazienti con interposizione colica per un totale di 143 manifestazioni, 90 Chilaiditi e 53 non-Chilaiditi: 30 interposizioni di tipo splenorenale, 12 di tipo retrogastrico, 5 epatocavale, 4 retrosplenico e 2 retrorenale. L’analisi statistica ha evidenziato che le forme di Chilaiditi producono una maggiore sintomatologia (24,4%), seguite dalle forme non-Chilaiditi (18,9%) e infine dai casi controllo (10,8%). Tale analisi è stata validata dal test di significatività χ2.ConclusioniLe forme non-Chilaiditi hanno rappresentato più della metà delle forme Chilaiditi, con la manifestazione splenorenale di gran lunga la più frequente. Abbiamo inoltre evidenziato che anche le forme non-Chilaiditi sono statisticamente più sintomatiche dei casi controllo.

Intestinal interposition: the prevalence and clinical relevance of non-hepatodiaphragmatic conditions (non-Chilaiditi forms) documented by CT and review of the literature@@@Interposizione intestinale: prevalenza e impatto clinico delle condizioni non epatodiaframmatiche (non-Chilaiditi) documentate con TC e revisione della letteratura

PurposeThis study was done to assess the prevalence and clinical impact of non-hepatodiaphragmatic interpositions in a sample of adult patients undergoing computed tomography (CT) for a variety of medical reasons.Materials and methodsFrom November 2008 to April 2009, two observers jointly examined the cases of intestinal interposition in 4,338 adults undergoing CT investigations. This study sought to identify not only hepatodiaphragmatic intestinal interpositions, defined as Chilaiditi, but also other forms of intestinal interposition, which we termed non-Chilaiditi. The latter were divided into five different classes on the basis of their anatomical relationships: splenorenal, retrogastric, hepatocaval, retrosplenic, and retrorenal. Moreover, a questionnaire investigating the clinical symptoms reported to be associated with Chilaiditi syndrome was given to patients exhibiting any form of intestinal interposition and to a control sample. Finally, clinical data related to the three groups were compared.ResultsOf the 4,338 patients examined, 130 (3%) were found to have intestinal interposition, for a total of 143 forms: 90 Chilaiditi and 53 non-Chilaiditi. Of the latter, 30 were splenorenal, 12 retrogastric, five hepatocaval, four retrosplenic and two retrorenal. Statistical analysis showed that the Chilaiditi group suffered most symptoms (24.4%), followed by the non-Chilaiditi group (18.9%) and control cases (10.8%). Our results were validated using the χ2 test of significance.ConclusionsThe number of non-Chilaiditi cases amounted to just over half the number of Chilaiditi cases, with the splenorenal form being by far the most frequent. Statistical analysis showed that patients with non-Chilaiditi forms of intestinal interposition had more symptoms than did controls.RiassuntoObiettivoScopo del nostro lavoro è stato valutare la prevalenza e l’impatto clinico delle forme di interposizione intestinale non epatodiaframmatiche in una popolazione adulta studiata con tomografia computerizzata (TC) per differenti indicazioni medico-chirurgiche.Materiali e metodiDa novembre 2008 ad aprile 2009, due autori hanno valutato insieme i casi di interposizione intestinale su 4338 pazienti adulti sottoposti a indagini TC. In tale studio, sono state evidenziate sia interposizioni di tipo epatodiaframmatico, che sono state definite Chilaiditi come da letteratura, sia altri tipi di interposizione definite secondo i diversi rapporti anatomici: splenorenale, retrogastrica, epatocavale, retrosplenica e retrorenale, che sono state raggruppate sotto il termine non-Chilaiditi. È stato successivamente sottoposto ai pazienti dei due gruppi e ad un gruppo controllo un questionario relativo ai disturbi clinici associati più frequentemente alla sindrome di Chilaiditi. Sono stati quindi comparati i dati clinici relativi ai tre gruppi.RisultatiSu 4338 pazienti sono stati osservati 130 (3%) pazienti con interposizione colica per un totale di 143 manifestazioni, 90 Chilaiditi e 53 non-Chilaiditi: 30 interposizioni di tipo splenorenale, 12 di tipo retrogastrico, 5 epatocavale, 4 retrosplenico e 2 retrorenale. L’analisi statistica ha evidenziato che le forme di Chilaiditi producono una maggiore sintomatologia (24,4%), seguite dalle forme non-Chilaiditi (18,9%) e infine dai casi controllo (10,8%). Tale analisi è stata validata dal test di significatività χ2.ConclusioniLe forme non-Chilaiditi hanno rappresentato più della metà delle forme Chilaiditi, con la manifestazione splenorenale di gran lunga la più frequente. Abbiamo inoltre evidenziato che anche le forme non-Chilaiditi sono statisticamente più sintomatiche dei casi controllo.

Interposizione intestinale: prevalenza e impatto clinico delle condizioni non epatodiaframmatiche (non-Chilaiditi) documentate con TC e revisione della letteratura

PurposeThis study was done to assess the prevalence and clinical impact of non-hepatodiaphragmatic interpositions in a sample of adult patients undergoing computed tomography (CT) for a variety of medical reasons.Materials and methodsFrom November 2008 to April 2009, two observers jointly examined the cases of intestinal interposition in 4,338 adults undergoing CT investigations. This study sought to identify not only hepatodiaphragmatic intestinal interpositions, defined as Chilaiditi, but also other forms of intestinal interposition, which we termed non-Chilaiditi. The latter were divided into five different classes on the basis of their anatomical relationships: splenorenal, retrogastric, hepatocaval, retrosplenic, and retrorenal. Moreover, a questionnaire investigating the clinical symptoms reported to be associated with Chilaiditi syndrome was given to patients exhibiting any form of intestinal interposition and to a control sample. Finally, clinical data related to the three groups were compared.ResultsOf the 4,338 patients examined, 130 (3%) were found to have intestinal interposition, for a total of 143 forms: 90 Chilaiditi and 53 non-Chilaiditi. Of the latter, 30 were splenorenal, 12 retrogastric, five hepatocaval, four retrosplenic and two retrorenal. Statistical analysis showed that the Chilaiditi group suffered most symptoms (24.4%), followed by the non-Chilaiditi group (18.9%) and control cases (10.8%). Our results were validated using the χ2 test of significance.ConclusionsThe number of non-Chilaiditi cases amounted to just over half the number of Chilaiditi cases, with the splenorenal form being by far the most frequent. Statistical analysis showed that patients with non-Chilaiditi forms of intestinal interposition had more symptoms than did controls.RiassuntoObiettivoScopo del nostro lavoro è stato valutare la prevalenza e l’impatto clinico delle forme di interposizione intestinale non epatodiaframmatiche in una popolazione adulta studiata con tomografia computerizzata (TC) per differenti indicazioni medico-chirurgiche.Materiali e metodiDa novembre 2008 ad aprile 2009, due autori hanno valutato insieme i casi di interposizione intestinale su 4338 pazienti adulti sottoposti a indagini TC. In tale studio, sono state evidenziate sia interposizioni di tipo epatodiaframmatico, che sono state definite Chilaiditi come da letteratura, sia altri tipi di interposizione definite secondo i diversi rapporti anatomici: splenorenale, retrogastrica, epatocavale, retrosplenica e retrorenale, che sono state raggruppate sotto il termine non-Chilaiditi. È stato successivamente sottoposto ai pazienti dei due gruppi e ad un gruppo controllo un questionario relativo ai disturbi clinici associati più frequentemente alla sindrome di Chilaiditi. Sono stati quindi comparati i dati clinici relativi ai tre gruppi.RisultatiSu 4338 pazienti sono stati osservati 130 (3%) pazienti con interposizione colica per un totale di 143 manifestazioni, 90 Chilaiditi e 53 non-Chilaiditi: 30 interposizioni di tipo splenorenale, 12 di tipo retrogastrico, 5 epatocavale, 4 retrosplenico e 2 retrorenale. L’analisi statistica ha evidenziato che le forme di Chilaiditi producono una maggiore sintomatologia (24,4%), seguite dalle forme non-Chilaiditi (18,9%) e infine dai casi controllo (10,8%). Tale analisi è stata validata dal test di significatività χ2.ConclusioniLe forme non-Chilaiditi hanno rappresentato più della metà delle forme Chilaiditi, con la manifestazione splenorenale di gran lunga la più frequente. Abbiamo inoltre evidenziato che anche le forme non-Chilaiditi sono statisticamente più sintomatiche dei casi controllo.

Ruolo della biopsia epatica per via transgiugulare nella diagnosi e gestione terapeutica dei pazienti con epatopatia grave

Purpose. This study sought to assess the diagnostic yield, the impact on treatment and the safety of transjugular liver biopsyMaterials and methods. We reviewed the medical records of 72 patients with severely impaired liver function who underwent transjugular biopsy at our department. Contraindications to percutaneous liver biopsy included thrombocytopenia, severe coagulopathy, marked ascites or a combination of the above. Patients were divided into four groups based on the clinically suspected cause of liver disease. Group 1 included 44 patients (58%) with acute abnormalities of liver function, whereas groups 2, 3 and 4 included patients with chronic abnormalities suspected to be due to infectious cirrhosis (12 patients, 16%), alcoholic cirrhosis (seven patients, 9%) and cirrhosis of unknown origin (13 patients, 17%), respectively. A Quick-Core (Cook, ProAct Ltd., State College, Pennsylvania, USA) needle allowing automated tissue sampling was used for all biopsiesResults. Biopsy specimens were diagnostic in 69 out of 72 patients (91%). Biopsy findings influenced treatment in 34 out of 69 patients (49%). The most significant results were obtained in group 1, where the histological diagnosis differed from clinical suspicion in 25/39 patients. There was only one major complication and four minor complications. The major complication was an arteriovenous and arteriobiliary fistula with haemorrhage and anaemia, which was successfully embolised by the same team of interventional radiologistsConclusions. Transjugular liver biopsy proved to be a safe procedure that provided important information for the clinical and therapeutic management of patients in whom treatment would have been either empirical or unfeasibleRiassuntoObiettivo. Valutare l’efficacia diagnostica, l’impatto sul trattamento terapeutico e la sicurezza della biopsia epatica transgiugulareMateriali e metodi. Abbiamo revisionato le cartelle cliniche di 72 pazienti con severa alterazione della funzionalità epatica che sono stati sottoposti a biopsia transgiugulare presso il nostro Dipartimento. I pazienti sono stati suddivisi in 4 gruppi, in base al sospetto clinico dell’origine della malattia epatica. Il gruppo 1 includeva 44 pazienti (58%) con un’alterazione acuta della funzionalità epatica, mentre i gruppi 2, 3, 4 includevano pazienti in cui l’alterazione era cronica e in cui il sospetto clinico era rispettivamente di cirrosi di tipo infettivo (12 pazienti, 16%), alcolico (7 pazienti, 9%) e di origine sconosciuta (13 pazienti, 17%). Per la biopsia è stato utilizzato un ago Quick Core (Cook, ProAct Ltd., State College, Pennsylvania, USA), che permette il prelievo in modo automaticoRisultati. Materiale bioptico diagnostico è stato ottenuto in 69 pazienti su 72 (91%). I dati forniti dalla biopsia hanno permesso un cambiamento terapeutico in 34 su 69 soggetti (49%). I risultati più significativi sono stati ottenuti nel gruppo 1 dove in 25 casi su 39 pazienti si è ottenuta una diagnosi diversa da quella sospettata. Abbiamo avuto una sola complicanza maggiore, risolta dallo stesso gruppo di radiologi interventisti e 4 complicanza minoriConclusioni. La biopsia epatica per via transgiugulare permette di ottenere importanti dati relativi al trattamento clinico e terapeutico di pazienti nei quali la terapia sarebbe altrimenti empirica o non proponibile, con una bassa incidenza di complicanze

Role of transjugular liver biopsy in the diagnostic and therapeutic management of patients with severe liver disease@@@Ruolo della biopsia epatica per via transgiugulare nella diagnosi e gestione terapeutica dei pazienti con epatopatia grave

Purpose. This study sought to assess the diagnostic yield, the impact on treatment and the safety of transjugular liver biopsyMaterials and methods. We reviewed the medical records of 72 patients with severely impaired liver function who underwent transjugular biopsy at our department. Contraindications to percutaneous liver biopsy included thrombocytopenia, severe coagulopathy, marked ascites or a combination of the above. Patients were divided into four groups based on the clinically suspected cause of liver disease. Group 1 included 44 patients (58%) with acute abnormalities of liver function, whereas groups 2, 3 and 4 included patients with chronic abnormalities suspected to be due to infectious cirrhosis (12 patients, 16%), alcoholic cirrhosis (seven patients, 9%) and cirrhosis of unknown origin (13 patients, 17%), respectively. A Quick-Core (Cook, ProAct Ltd., State College, Pennsylvania, USA) needle allowing automated tissue sampling was used for all biopsiesResults. Biopsy specimens were diagnostic in 69 out of 72 patients (91%). Biopsy findings influenced treatment in 34 out of 69 patients (49%). The most significant results were obtained in group 1, where the histological diagnosis differed from clinical suspicion in 25/39 patients. There was only one major complication and four minor complications. The major complication was an arteriovenous and arteriobiliary fistula with haemorrhage and anaemia, which was successfully embolised by the same team of interventional radiologistsConclusions. Transjugular liver biopsy proved to be a safe procedure that provided important information for the clinical and therapeutic management of patients in whom treatment would have been either empirical or unfeasibleRiassuntoObiettivo. Valutare l’efficacia diagnostica, l’impatto sul trattamento terapeutico e la sicurezza della biopsia epatica transgiugulareMateriali e metodi. Abbiamo revisionato le cartelle cliniche di 72 pazienti con severa alterazione della funzionalità epatica che sono stati sottoposti a biopsia transgiugulare presso il nostro Dipartimento. I pazienti sono stati suddivisi in 4 gruppi, in base al sospetto clinico dell’origine della malattia epatica. Il gruppo 1 includeva 44 pazienti (58%) con un’alterazione acuta della funzionalità epatica, mentre i gruppi 2, 3, 4 includevano pazienti in cui l’alterazione era cronica e in cui il sospetto clinico era rispettivamente di cirrosi di tipo infettivo (12 pazienti, 16%), alcolico (7 pazienti, 9%) e di origine sconosciuta (13 pazienti, 17%). Per la biopsia è stato utilizzato un ago Quick Core (Cook, ProAct Ltd., State College, Pennsylvania, USA), che permette il prelievo in modo automaticoRisultati. Materiale bioptico diagnostico è stato ottenuto in 69 pazienti su 72 (91%). I dati forniti dalla biopsia hanno permesso un cambiamento terapeutico in 34 su 69 soggetti (49%). I risultati più significativi sono stati ottenuti nel gruppo 1 dove in 25 casi su 39 pazienti si è ottenuta una diagnosi diversa da quella sospettata. Abbiamo avuto una sola complicanza maggiore, risolta dallo stesso gruppo di radiologi interventisti e 4 complicanza minoriConclusioni. La biopsia epatica per via transgiugulare permette di ottenere importanti dati relativi al trattamento clinico e terapeutico di pazienti nei quali la terapia sarebbe altrimenti empirica o non proponibile, con una bassa incidenza di complicanze

Single-versus multidetector-row CT: comparison of sedation rates, conventional angiograms and motion artefacts in young children following liver transplantation@@@TC a singolo detettore versus TC a detettore multiplo: confronto fra sedazione, angiografie convenzionali ed artefatti da movimento, nei pazienti pediatrici dopo trapianto epatico

Purpose.The aim of this study was to determine whether the use of multidetector computed tomography (MDCT) is associated with decreased sedation, frequency of motion artefacts and conventional angiograms compared with single-detector CT (SDCT).Materials and methods.CT examinations performed in young children between January 1993 and June 2005 were reviewed retrospectively. Prior to September 2000, SDCT was used; after that period, MDCT was used. The examinations obtained during these two periods were compared for the frequency of sedation, motion artefacts, and conventional angiograms. Statistical comparison between the two groups was determined by using the χ2 test.Results.A total of 126 infants and children younger than 6 years of age underwent 134 CT examinations. Eighty-eight were obtained with a SDCT (65%) (group 1) and 46 with a MDCT (35%) (group 2). Sedation was required in 31/88 (35%) CT examinations in group 1 and in 6/46 (13%) in group 2. Conventional angiography was performed in 20/88 (22%) cases in group 1 and in 6/46 (13%) in group 2. Motion artefacts were present in 8/88 (9%) CT examinations in group 1 and in 4/46 (8%) in group 2. There was significant statistical difference with regard to sedation and angiography rates between the two groups (p<0.001) whereas there was no significant difference with regard to motion artefacts (p>1).Conclusions.MDCT can reduce the need for sedation and conventional angiography in children after liver transplantation. There is no effect on patient motion artefacts.

TC a singolo detettore versus TC a detettore multiplo: Confronto fra sedazione, angiografie convenzionali ed artefatti da movimento, nei pazienti pediatrici dopo trapianto epatico

Purpose.The aim of this study was to determine whether the use of multidetector computed tomography (MDCT) is associated with decreased sedation, frequency of motion artefacts and conventional angiograms compared with single-detector CT (SDCT).Materials and methods.CT examinations performed in young children between January 1993 and June 2005 were reviewed retrospectively. Prior to September 2000, SDCT was used; after that period, MDCT was used. The examinations obtained during these two periods were compared for the frequency of sedation, motion artefacts, and conventional angiograms. Statistical comparison between the two groups was determined by using the χ2 test.Results.A total of 126 infants and children younger than 6 years of age underwent 134 CT examinations. Eighty-eight were obtained with a SDCT (65%) (group 1) and 46 with a MDCT (35%) (group 2). Sedation was required in 31/88 (35%) CT examinations in group 1 and in 6/46 (13%) in group 2. Conventional angiography was performed in 20/88 (22%) cases in group 1 and in 6/46 (13%) in group 2. Motion artefacts were present in 8/88 (9%) CT examinations in group 1 and in 4/46 (8%) in group 2. There was significant statistical difference with regard to sedation and angiography rates between the two groups (p<0.001) whereas there was no significant difference with regard to motion artefacts (p>1).Conclusions.MDCT can reduce the need for sedation and conventional angiography in children after liver transplantation. There is no effect on patient motion artefacts.