Coronary artery calcium score on low-dose computed tomography for lung cancer screening

AIM: To evaluate the feasibility of coronary artery calcium score(CACS) on low-dose non-gated chest CT(ngCCT).METHODS: Sixty consecutive individuals(30 males; 73 ± 7 years) scheduled for risk stratification by means of unenhanced ECG-triggered cardiac computed to-mography(gCCT) underwent additional unenhanced ngCCT. All CT scans were performed on a 64-slice CT scanner(Somatom Sensation 64 Cardiac, Siemens, Germany). CACS was calculated using conventional methods/scores(Volume, Mass, Agatston) as previ-ously described in literature. The CACS value obtained were compared. The Mayo Clinic classification was used to stratify cardiovascular risk based on Agatston CACS. Differences and correlations between the two methods were compared. A P-value < 0.05 was considered sig-nificant.RESULTS: Mean CACS values were significantly higher for gCCT as compared to ngCCT(Volume: 418 ± 747 vs 332 ± 597; Mass: 89 ± 151 vs 78 ± 141; Agatston: 481 ± 854 vs 428 ± 776; P < 0.05). The correlation between the two values was always very high(Volume: r = 0.95; Mass: r = 0.97; Agatston: r = 0.98). Of the 6 patients with 0 Agatston score on gCCT, 2(33%) showed an Agatston score > 0 in the ngCCT. Of the 3 patients with 1-10 Agatston score on gCCT, 1(33%) showed an Agatston score of 0 in the ngCCT. Overall, 23(38%) patients were reclassified in a different car-diovascular risk category, mostly(18/23; 78%) shifting to a lower risk in the ngCCT. The estimated radiation dose was significantly higher for gCCT(DLP 115.8 ± 50.7 vs 83.8 ± 16.3; Effective dose 1.6 ± 0.7 mSv vs 1.2 ± 0.2 mSv; P < 0.01).CONCLUSION: CACS assessment is feasible on ngCCT; the variability of CACS values and the associated re-stratification of patients in cardiovascular risk groups should be taken into account.

Retrolaminar migration as a complication of intraocular silicone oil injection detected on unenhanced CT

AIM:To describe the clinical and radiologic features of retrolaminar migration silicone oil(SiO)and observe the dynamic position of ventricular oil accumulation in supine and prone.METHODS:For this retrospective study,29 patients who had a history of SiO injection treatment and underwent unenhanced head computed tomography(CT)were included from January 2019 to October 2022.The patients were divided into migration-positive and negative groups.Clinical history and CT features were compared using Whitney U and Fisher’s exact tests.The dynamic position of SiO was observed within the ventricular system in supine and prone.CT images were visually assessed for SiO migration along the retrolaminar involving pathways for vision(optic nerve,chiasm,and tract)and ventricular system.RESULTS:Intraocular SiO migration was found in 5 of the 29 patients(17.24%),with SiO at the optic nerve head(n=1),optic nerve(n=4),optic chiasm(n=1),optic tract(n=1),and within lateral ventricles(n=1).The time interval between SiO injection and CT examination of migration-positive cases was significantly higher than that of migration-negative patients(22.8±16.5mo vs 13.1±2.6mo,P<0.001).The hyperdense lesion located in the frontal horns of the right lateral ventricle migrated to the fourth ventricle when changing the position from supine to prone.CONCLUSION:Although SiO retrolaminar migration is unusual,the clinician and radiologist should be aware of migration routes.The supine combined with prone examination is the first-choice method to confirm the presence of SiO in the ventricular system.