Intracranial calcifications, particularly within the falx cerebri, serve as crucial diagnostic markers ranging from benign accumulations to signs of severe pathologies. The falx cerebri, a dural fold that separates the cerebral hemispheres, presents challenges in visualization due to its low contrast in standard imaging techniques. Recent advancements in artificial intelligence (AI), particularly in machine learning and deep learning, have significantly transformed radiological diagnostics. This study aims to explore the application of AI in the segmentation and detection of falx cerebri calcifications using Cone-Beam Computed Tomography (CBCT) images through a comprehensive literature review and a detailed case report. The case report presents a 59-year-old patient diagnosed with falx cerebri calcifications whose CBCT images were analyzed using a cloud-based AI platform, demonstrating effectiveness in segmenting these calcifications, although challenges persist in distinguishing these from other cranial structures. A specific search strategy was employed to search electronic databases, yielding four studies exploring AI-based segmentation of the falx cerebri. The review detailed various AI models and their accuracy across different imaging modalities in identifying and segmenting falx cerebri calcifications, also highlighting the gap in publications in this area. In conclusion, further research is needed to improve AI-driven methods for accurately identifying and measuring intracranial calcifications. Advancing AI applications in radiology, particularly for detecting falx cerebri calcifications, could significantly enhance diagnostic precision, support disease monitoring, and inform treatment planning.
- Klíčová slova
- Cone-Beam Computed Tomography, algorithms, diagnosis, dura mater,
- MeSH
- dura mater diagnostické zobrazování MeSH
- kalcinóza * diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- počítačová tomografie s kuželovým svazkem * metody MeSH
- umělá inteligence * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The aim of the thesis is to present the case of a patient in whom bilateral calcification of the hydrophilic intraocular lens (IOL) Lentis M+ LS-313 MF30 (Oculentis) has developed. Due to the negative effect on visual functions, explantation and replacement of the artificial lens was necessary in both eyes. Case Report: An overview of the available literature summarized the diagnostics, current examination methods and possibilities of the surgical solution of calcification of the bifocal hydrophilic lens Lentis M+ LS-313 MF30 (Oculentis). The specific solution is described in a case report of a patient in whom calcification of both lenses developed 6 years after implantation of the IOL. In 2015, the patient underwent uncomplicated cataract surgery of both eyes with the implantation of an artificial intraocular lens into the capsule. In September 2021, an 82-year-old man was examined at our outpatient clinic for deterioration of visual acuity and changes in the material of the artificial IOL which were perceptible during a clinical examination, on the recommendation of a local ophthalmologist. Blurred vision predominated. A diagnosis of intraocular lens opacification was confirmed and documented using a Scheimpflug camera (OCULUS Pentacam HR) and anterior OCT (Avanti RTVue XR Optovue,). The patient was indicated for explantation and replacement of the opacified intraocular lens in the left and subsequently in the right eye- The same type of IOL was used for reimplantation with good functional results. Conclusion: Since 2010, multifocal lens implantation has been on an upward trend worldwide. This type of MF IOL has also been used in thousands of implantations. A number of other explantations can be expected in the coming years. The optimal solution is the correct replacement of the calcified IOL with the same construction made of safer hydrophobic material.
- Klíčová slova
- CBS, Calcification, Pentacam, anterior segment OCT, chronic kidney disease, hydrophilic acrylic lens, opacification,
- MeSH
- implantace nitrooční čočky škodlivé účinky MeSH
- kalcinóza chirurgie diagnostické zobrazování MeSH
- lidé MeSH
- melanom * radioterapie MeSH
- nádory choroidey radioterapie diagnóza MeSH
- nádory uvey radioterapie MeSH
- nitrooční čočky škodlivé účinky MeSH
- radiační poranění etiologie diagnóza chirurgie MeSH
- radiochirurgie * škodlivé účinky MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The article presents the case of a rare, free moving, completely benign intra-abdominal formation called "giant peritoneal loose body". In our case, an expansion of the left hypogastrium with central calcification, in intimate contact with intestinal loops, of rather benign etiology, reminiscent of a mesenteric calcifying fibrous tumor, was accidentally detected on CT angiography. A possible neoplastic process was suspected, and therefore PET/CT was completed, showing that the expansion had moved to the right hypogastrium, and the radiologist evaluated the finding as a possible teratoma not originating from an intestinal loop. Due to the still indeterminate nature of the expansion, an exploratory laparotomy was performed with the discovery of a loose ovoid mass without any vascular supply and unrelated to other structures, which was extracted and sent for histological examination. The result was surprising. According to the pathologist, it was a rare, completely benign intra-abdominal lesion called the "giant peritoneal loose body". This pseudotumor should be considered as a differential diagnosis whenever we accidentally detect an asymptomatic, freely moving intra-abdominal lesion with central necrosis or calcification, in order to avoid unnecessary surgery, because according to available information, only symptomatic ones should be surgically removed.
- Klíčová slova
- abdominal stalactite, boiled egg, epiploic appendices, giant peritoneal loose body,
- MeSH
- kalcinóza * diagnostické zobrazování chirurgie patologie MeSH
- laparotomie MeSH
- lidé MeSH
- nemoci peritonea * diagnostické zobrazování chirurgie MeSH
- PET/CT MeSH
- počítačová rentgenová tomografie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
INTRODUCTION: Chronic calcified/ossified subdural hematoma is a rare diagnosis. The incidence of chronic calcified subdural hematoma is 0.3-2.7% of all chronic subdural hematomas. Surgical treatment is indicated in most cases, but there is still some controversy. MATERIALS AND METHODS: We present a case report of 81-year-old woman with calcified chronic subdural hematoma. Patient underwent an osteoplastic left craniotomy, evacuation of chronic subdural mass with careful dissection andsuccessful removal of inner and outer membrane. Postoperative CT scan showed removal of subdural hematoma, decrease of left shift of median line and good brain re-expansion. Postoperative period was without any serious complications. RESULTS: Subdural hematoma was successfully removed, resulting in a good recovery with complete resolution of patients symptoms. From our experience, we highly recommend surgical treatment in cases of chronic symptomatic calcified subdural hematomas.
- Klíčová slova
- calcified, ossified, subdural hematoma, surgical treatment,
- MeSH
- chronický subdurální hematom diagnostické zobrazování chirurgie MeSH
- kalcinóza diagnostické zobrazování chirurgie MeSH
- kraniotomie MeSH
- lidé MeSH
- počítačová rentgenová tomografie MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
We report a very rare case of Streptococcus canis native infective endocarditis in a 73-year-old woman living in close contact with her dog. Her echocardiography showed large calcifications in the mitral annulus, massive regurgitation below the posterior leaflet, and adjacent vegetation. Blood culture was positive for Streptococcus Lancefield group G. A coronary artery bypass and mitral valve replacement had to be done. Streptococcus canis was detected in a heart valve using a broad range PCR followed by 16S rRNA and confirmed by tuf gene sequencing, while tissue culture remained negative. The patient was not bitten by her dog nor did she have comorbidities or skin ulcers. She fully recovered.
- Klíčová slova
- PCR, Streptococcus canis, infective endocarditis, sequencing,
- MeSH
- bakteriální endokarditida diagnóza mikrobiologie patologie chirurgie MeSH
- DNA bakterií chemie genetika MeSH
- echokardiografie MeSH
- elongační faktor Tu genetika MeSH
- fylogeneze MeSH
- kalcinóza diagnostické zobrazování MeSH
- koronární bypass MeSH
- krev mikrobiologie MeSH
- lidé MeSH
- mitrální chlopeň diagnostické zobrazování patologie chirurgie MeSH
- polymerázová řetězová reakce MeSH
- ribozomální DNA chemie genetika MeSH
- RNA ribozomální 16S genetika MeSH
- sekvenční analýza DNA MeSH
- senioři MeSH
- shluková analýza MeSH
- Streptococcus klasifikace izolace a purifikace MeSH
- streptokokové infekce diagnóza mikrobiologie patologie chirurgie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- DNA bakterií MeSH
- elongační faktor Tu MeSH
- ribozomální DNA MeSH
- RNA ribozomální 16S MeSH
PURPOSE: Transurethral ultrasound therapy is an investigational treatment modality which could potentially be used for the localized treatment of prostate cancer. One of the limiting factors of this therapy is prostatic calcifications. These attenuate and reflect ultrasound and thus reduce the efficacy of the heating. The aim of this study is to investigate how prostatic calcifications affect therapeutic efficacy, and to identify the best sonication strategy when calcifications are present. METHODS: Realistic computational models were used on clinical patient data in order to simulate different therapeutic situations with naturally occurring calcifications as well as artificial calcifications of different sizes (1-10 mm) and distances (5-15 mm). Furthermore, different sonication strategies were tested in order to deliver therapy to the untreated tissue regions behind the calcifications. RESULTS: The presence of calcifications in front of the ultrasound field was found to increase the peak pressure by 100% on average while the maximum temperature only rose by 9% during a 20-s sonication. Losses in ultrasound energy were due to the relatively large acoustic impedance mismatch between the prostate tissue and the calcifications (1.63 vs 3.20 MRayl) and high attenuation coefficient (0.78 vs 2.64 dB/MHz1.1 /cm), which together left untreated tissue regions behind the calcifications. In addition, elevated temperatures were seen in the region between the transducer and the calcifications. Lower sonication frequencies (1-4 MHz) were not able to penetrate through the calcifications effectively, but longer sonication durations (20-60 s) with selective transducer elements were effective in treating the tissue regions behind the calcifications. CONCLUSIONS: Prostatic calcifications limit the reach of therapeutic ultrasound treatment due to reflections and attenuation. The tissue regions behind the calcifications can possibly be treated using longer sonication durations combined with proper transducer element selection. However, caution should be taken with calcifications located close to sensitive organs such as the urethra, bladder neck, or rectal wall.
- Klíčová slova
- calcification, efficacy, heating, prostate cancer, therapeutic ultrasound,
- MeSH
- kalcinóza diagnostické zobrazování terapie MeSH
- lidé MeSH
- počítačová rentgenová tomografie MeSH
- prostata * diagnostické zobrazování MeSH
- ultrazvuková terapie * MeSH
- uretra * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Mucopolysaccharidosis type IVB (MPS IVB) is a very rare lysosomal storage disorder characterized by skeletal dysplasia, hearing disorder, and cardiac valvular disease. Herein, we report an extremely rare manifestation of MPS IVB in a 60-year-old female patient who underwent a successful aortic valve replacement. The patient presented with mild coarse facial features, short stature, mild dyspnea, sternal protrusion, mild lumbar hyperlordosis, and waddling gait owing to bilateral femoral head necroses and bilateral arthrosis of the knees. The patient also suffered from dyspnea, NYHA II-III. Echocardiography revealed severe stenosis of a calcified aortic valve (AVA 0.67 cm2, AVAi 0.45 cm2/m2, PG max/mean 130/80 mmHg), left ventricular hypertrophy with predominant septal thickening (18 mm) and mild left ventricle outflow tract obstruction at rest, mild mitral valve regurgitation, and dilated ascending aorta (36 mm, 26.5 mm/m2). Dyspnea resolved after septal myectomy and replacement of the aortic valve with bioprosthesis. Excretion levels and spectrum of glycosaminoglycans (GAGs) in urine were normal in the patient. We confirmed the diagnosis of MPS IVB by identifying decreased beta-galactosidase activity in isolated leukocytes (6 nmol/h/mg; controls 95-272) and by molecular genetic analyses (c.438_440delTCT and c.817_818TG>CT mutations in the GLB1 gene). Primary lysosomal storage of glycosaminoglycans was detected in fibroblasts of the aortic valve. Additional pathologies included valvular fibrosis, calcification, neovascularization, and mild chronic inflammation. In conclusion, the diagnosis of MPS IVB should be considered in older patients with cardiac valvular disease and progressive skeletal abnormality even if urinary excretion levels of GAGs are normal.
- Klíčová slova
- Aortic valve replacement, Mucopolysaccharidosis type IVB, Progressive skeletal disease,
- MeSH
- aortální chlopeň diagnostické zobrazování patologie patofyziologie chirurgie transplantace MeSH
- aortální stenóza diagnostické zobrazování etiologie patofyziologie chirurgie MeSH
- beta-galaktosidasa genetika MeSH
- bioprotézy MeSH
- biopsie MeSH
- časové faktory MeSH
- chirurgická náhrada chlopně * přístrojové vybavení MeSH
- echokardiografie MeSH
- kalcinóza diagnostické zobrazování etiologie patofyziologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mukopolysacharidóza IV komplikace diagnóza genetika MeSH
- mutace MeSH
- mutační analýza DNA MeSH
- opožděná diagnóza MeSH
- srdeční chlopně umělé MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- beta-galaktosidasa MeSH
- GLB1 protein, human MeSH Prohlížeč
Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, classified into 2 subtypes - AIP type 1 and AIP type 2. We present a case of a 31-years-old female admitted to our institution with upper abdominal pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatoscopy (ERCP) revealed stenosis of intrapancreatic distal bile duct. Diffuse parenchymal enlargement and typical features of AIP were shown by computed tomography (CT) and endoscopic ultrasonography (EUS). The patient´s serum IgG4 was elevated at 3.8 g/l (range 0.08-1.4 g/l). She was diagnosed with AIP type 1 and treated with prednisone (initial dose of 30 mg per day, then tapered by 5 mg/day every week). The maintenance dose of 5 mg per day was continued for 6 months. Despite clinical and radiological remission, serum levels of IgG4 remained elevated. The patient experienced disease relapse 25 months after first attack. Moreover, new finding of calcifications occured in pancreas. The relapse was managed with corticosteroids and maintenance immunosupression with azathioprin was started. Literature review on risk factor of relapse, long-term immunosupressive therapy indication and optimal follow-up of AIP type 1 patients are discussed.Key words: autoimmune pancreatitis type 1 - long-term follow-up - relapse - therapy.
- MeSH
- autoimunitní nemoci diagnostické zobrazování farmakoterapie imunologie MeSH
- azathioprin terapeutické užití MeSH
- cholangiopankreatografie endoskopická retrográdní MeSH
- chronická pankreatitida diagnostické zobrazování farmakoterapie imunologie MeSH
- dospělí MeSH
- endosonografie MeSH
- glukokortikoidy terapeutické užití MeSH
- imunoglobulin G imunologie MeSH
- imunosupresiva terapeutické užití MeSH
- kalcinóza diagnostické zobrazování MeSH
- lidé MeSH
- nemoci slinivky břišní diagnostické zobrazování MeSH
- nemoci žlučových cest diagnóza MeSH
- počítačová rentgenová tomografie MeSH
- prednison terapeutické užití MeSH
- recidiva MeSH
- rizikové faktory MeSH
- stenóza MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
- Názvy látek
- azathioprin MeSH
- glukokortikoidy MeSH
- imunoglobulin G MeSH
- imunosupresiva MeSH
- prednison MeSH
The accepted definition of virtual histology intravascular ultrasound (IVUS-VH) thin-cap fibroatheroma (TCFA) is only a modest predictor of plaque rupture (PR). We sought to determine the relation between IVUS-VH findings and culprit lesions with PR using computational analysis. A total of 80 culprit lesions from 80 patients with stable angina (n = 37), unstable angina (n = 20), and myocardial infarction (n = 23) were divided into those with (n = 15) and without PR (n = 65). By use of automated computational analysis, the standard IVUS-VH TCFA criterion and 124 additional criteria were compared. The standard TCFA definition demonstrated modest ability to discriminate lesions with and without PR (sensitivity 87%, specificity 37%, PPV 0.24, and NPV 0.92). Of 124 additional IVUS-VH TCFA definitions, only 2 improved the discriminative ability even modestly. However, a positive correlation was demonstrated between cavity size and necrotic core percentage (r = 0.78, p <0.01) and a negative correlation with percentage of fibrous tissue (r = -0.81, p <0.01). In conclusion, IVUS-VH criteria were only modestly associated with PR, without significant improvement by varying IVUS-VH TCFA features, but IVUS-VH features of ruptured plaques were strongly correlated with cavity size.
- MeSH
- aterosklerotický plát diagnostické zobrazování patologie MeSH
- fibróza MeSH
- infarkt myokardu diagnostické zobrazování chirurgie MeSH
- intervenční ultrasonografie MeSH
- kalcinóza diagnostické zobrazování patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nekróza MeSH
- nemoci koronárních tepen diagnostické zobrazování chirurgie MeSH
- nestabilní angina pectoris diagnostické zobrazování chirurgie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- spontánní ruptura diagnostické zobrazování MeSH
- stabilní angina pectoris diagnostické zobrazování chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
