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CT Airway2

Sep 7, 2006

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Axial contrast-enhanced CT scan in a 28-year-old premenopausal woman shows an incidentally detected solid-appearing left ovarian lesion (solid arrow) anterior to the uterus (U), associated with trace ascites in the right adnexa and cul de sac (dashed arrows). At pathologic analysis, this was shown to be ovarian dysgerminoma. Two readers misdiagnosed this lesion, one as a leiomyoma and one as an ovarian fibroma.
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Clinicians, beware: CT diagnostic accuracy varies by adnexal lesion type
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Images from two representative cases. (A-C) Images in an 82-year-old man with a calcified plaque in the proximal segment of the left anterior descending artery. (A, B) Curved planar reconstruction images from CCTA with (A) hybrid iterative reconstruction (HIR) and (B) super-resolution deep learning reconstruction (SR-DLR) show that the measured PDS was 66% for the HIR image and 42% for the SR-DLR image. (C) Quantitative analysis of the invasive coronary angiography (ICA) image (reference standard) revealed a PDS of 34% (arrow). (D-F) Images in a 37-year-old woman with a noncalcified plaque in the middle segment of the left circumflex artery. (D, E) Curved planar reconstruction images from CCTA with (D) HIR and (E) SR-DLR show that the measured PDS was 47% for the HIR image and 80% for the SR-DLR image. (F) Quantitative analysis of the ICA image revealed a PDS of 72% (arrow). Blue, red, and yellow lines in A, B, D, and E represent the proximal reference point, stenosed lesion, and distal reference point, respectively, and the insets show the corresponding cross-sectional images.
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Subgroup analysis based on lesion size on PCCT images. The red outlined areas highlight the magnified images of lesions. (A-C) PCCT images in a 62-year-old woman with a body mass index (BMI) of 23.6, calculated as weight in kilograms divided by height in meters squared, who was diagnosed with adenocarcinoma. A lesion with a long diameter of 25 mm was identified in the right lower lobe on axial images acquired during the venous phase. For lesions less than or equal to 30 mm, decreasing section thickness improved boundary sharpness and contrast between the necrotic area and enhanced tissue, with optimal visualization at 0.4 mm. (D-F) PCCT images in a 66-year-old man with a BMI of 24.2 who was diagnosed with adenocarcinoma, revealing a lesion with a long diameter of 52 mm in the right lower lobe. For lesions greater than 30 mm, a section thickness of 1 mm demonstrated better contrast and clarity at the boundary of the necrotic area compared with 0.4 mm. This observation supported the selection of an appropriate section thickness for accurate quantification of necrotic regions within the lesion.
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