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