To investigate the macroscopic fatigue properties and the mesoscopic pore evolution characteristics of salt rock under cyclic loading,fatigue tests under different upper-limit stresses were carried out on salt rock,an...To investigate the macroscopic fatigue properties and the mesoscopic pore evolution characteristics of salt rock under cyclic loading,fatigue tests under different upper-limit stresses were carried out on salt rock,and the mesoscopic pore structures of salt rock before and after fatigue tests and under different cycle numbers were measured using CT scanning instrument.Based on the test results,the effects of the cycle number and the upper-limit stress on the evolution of cracks,pore morphology,pore number,pore volume,pore size,plane porosity,and volume porosity of salt rock were analyzed.The failure path of salt rock specimens under cyclic loading was analyzed using the distribution law of plane porosity.The damage variable of salt rock under cyclic loading was defined on basis of the variation of volume porosity with cycle number.In order to describe the fatigue deformation behavior of salt rock under cyclic loading,the nonlinear Burgers damage constitutive model was further established.The results show that the model established can better reflect the whole development process of fatigue deformation of salt rock under cyclic loading.展开更多
Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hema...Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hemangioblastoma through observation. We report the case of a 38-year-old patient referred to the radiology and Medical Imaging Department of the Marie Curie Medical Clinic in Bamako, Mali, for an orbito-cerebral CT scan in a context of bilateral eyelid edema. The examination was performed using multi-slice computed tomography (16 slices) with reconstruction in the 3 planes of space without and with the injection of an iodinated contrast agent. The CT scan was crucial in making the diagnosis of hemangioblastoma incidentally, which allowed for adequate management. The patient was operated on, and the radiological outcome was favorable, without significant cystic formation, after postoperative control and clinical signs were resolved. CT can be an interesting alternative in countries like ours despite MRI being the examination of choice in hemangioblastomas.展开更多
The geometry of joints has a significant influence on the mechanical properties of rocks.To simplify the curved joint shapes in rocks,the joint shape is usually treated as straight lines or planes in most laboratory e...The geometry of joints has a significant influence on the mechanical properties of rocks.To simplify the curved joint shapes in rocks,the joint shape is usually treated as straight lines or planes in most laboratory experiments and numerical simulations.In this study,the computerized tomography (CT) scanning and photogrammetry were employed to obtain the internal and surface joint structures of a limestone sample,respectively.To describe the joint geometry,the edge detection algorithms and a three-dimensional (3D) matrix mapping method were applied to reconstruct CT-based and photogrammetry-based jointed rock models.For comparison tests,the numerical uniaxial compression tests were conducted on an intact rock sample and a sample with a joint simplified to a plane using the parallel computing method.The results indicate that the mechanical characteristics and failure process of jointed rocks are significantly affected by the geometry of joints.The presence of joints reduces the uniaxial compressive strength (UCS),elastic modulus,and released acoustic emission (AE) energy of rocks by 37%–67%,21%–24%,and 52%–90%,respectively.Compared to the simplified joint sample,the proposed photogrammetry-based numerical model makes the most of the limited geometry information of joints.The UCS,accumulative released AE energy,and elastic modulus of the photogrammetry-based sample were found to be very close to those of the CT-based sample.The UCS value of the simplified joint sample (i.e.38.5 MPa) is much lower than that of the CT-based sample (i.e.72.3 MPa).Additionally,the accumulative released AE energy observed in the simplified joint sample is 3.899 times lower than that observed in the CT-based sample.CT scanning provides a reliable means to visualize the joints in rocks,which can be used to verify the reliability of photogrammetry techniques.The application of the photogrammetry-based sample enables detailed analysis for estimating the mechanical properties of jointed rocks.展开更多
Objective: To evaluate the lung CT scan as a possible predictive diagnostic method for COVID-19 in the Cameroonian context. Methods: We designed a cross sectional study. Suspected cases of COVID-19 during the first wa...Objective: To evaluate the lung CT scan as a possible predictive diagnostic method for COVID-19 in the Cameroonian context. Methods: We designed a cross sectional study. Suspected cases of COVID-19 during the first wave at the national social insurance fund (NSIF) hospital were screened with both COVID-19 with lung CT scan and a PCR test. Univariate analysis was performed for sample description and multivariate analysis to assess the correlation between positive results for the PCR and other parameters. We estimated the optimum threshold of sensitivity/specificity, and area under curve using the empirical method and package. Results: A total of 62 suspected COVID-19 cases were recorded, predominantly males (Sex Ratio = 2.2) with a median age of 58.5 (IQR = 19.7). Among our 62 patients, 29 (46.8%) were confirmed COVID-19 cases with positive PCR results. All the patients had a thorax CT scan with a median impairment of 40% (IQR = 20%). The optimum threshold estimate for CT scan for COVID-19 infection diagnosis was 60% (95% CI = 25% - 80%). Overall, the sensitivity and specificity estimates were 0.30 (95% CI = 0.15 - 0.49) and 0.87 (95% CI = 0.70 - 0.96), respectively, leading to an Area Under Curve (AUC) estimate of 0.59 (95% CI = 0.46, 0.71). Conclusion: In this setting, lung CT scan was neither sensitive nor specific to predict COVID-19 disease.展开更多
Due to the reservoir heterogeneity and the stress shadow effect, multiple hydraulic fractures within one fracturing segment cannot be initiated simultaneously and propagate evenly, which will cause a low effectiveness...Due to the reservoir heterogeneity and the stress shadow effect, multiple hydraulic fractures within one fracturing segment cannot be initiated simultaneously and propagate evenly, which will cause a low effectiveness of reservoir stimulation. Temporary plugging and diverting fracturing(TPDF) is considered to be a potential uniform-stimulation method for creating multiple fractures simultaneously in the oilfield. However, the multi-fracture propagation morphology during TPDF is not clear now. The purpose of this study is to quantitatively investigate the multi-fracture propagation morphology during TPDF through true tri-axial fracturing experiments and CT scanning. Critical parameters such as fracture spacing, number of perforation clusters, the viscosity of fracturing fluid, and the in-situ stress have been investigated. The fracture geometry before and after diversion have been quantitively analyzed based on the two-dimensional CT slices and three-dimensional reconstruction method. The main conclusions are as follows:(1) When injecting the high viscosity fluid or perforating at the location with low in-situ stress, multiple hydraulic fractures would simultaneously propagate. Otherwise, only one hydraulic fracture was created during the initial fracturing stage(IFS) for most tests.(2) The perforation cluster effectiveness(PCE) has increased from 26.62% during the IFS to 88.86% after using diverters.(3) The diverted fracture volume has no apparent correlation with the pressure peak and peak frequency during the diversion fracturing stage(DFS) but is positively correlated with water-work.(4) Four types of plugging behavior in shale could be controlled by adjusting the diverter recipe and diverter injection time, and the plugging behavior includes plugging the natural fracture in the wellbore, plugging the previous hydraulic fractures, plugging the fracture tip and plugging the bedding.展开更多
Objective: The aim of our study was to investigate the feature of minimal fat renal angiomyolipoma with sufficient blood supply using CT scans and improve the diagnosis accuracy required to differentiate it from clea...Objective: The aim of our study was to investigate the feature of minimal fat renal angiomyolipoma with sufficient blood supply using CT scans and improve the diagnosis accuracy required to differentiate it from clear cell renal carcinoma. Methods: Retrospective analysis of 24 cases of post-surgery confirmed angiomyolipoma with sufficient blood supply (total of 25 tumors) in our hospital that were used for a pathological comparison study. Results: Among the 24 patients diagnosed with angiomyolipoma, nobody had bloody urine, Of the 96 patients diagnosed with clear cell renal cancer, 14 had bloody urine (14.6%). In our studied group, the size of angiomyolipomas with sufficient blood supply was between 1.5 cm× 2.0 cm to 8.0 cm× 10.0 cm. During CT scan analysis, twenty tumors had similar density, and five of them had higher density. Only one tumor had a few dots of calcification (4%). Adipose tissue was not visible in 9 tumors, while 16 tumors had visible dots of adipose tissue, as visualized by CT scan. Intensive scanning indicated that all of the tumors showed a strong enhancement in the renal corticomedullary phase. Twenty tumors had significant heterogeneous enhancement in the early phase, while another set of five cases had homogenous prolonged enhancement. Nineteen patients had surgery to remove the angiomyolipomas, while six patients had single side kidney removal due to misdiagnosis for renal cancer in cases where the tumor severely compromised the renal parenchyma and sinus. All 25 cases were classified as renal angiomyolipoma by pathological analysis. Within the 96 cases of clear cell renal cancer, 64 tumors had relatively low density, 29 tumors had equal density, and 3 cases had relatively higher density. Fourteen of the tumors had calcification (14.6%), and none of them had visualized adipose tissue. Enhanced CT scans indicated that 69 cases of renal cancer showed significant enhancement in the renal corticomedu^ary phase, which had the abnormal pattern of "fast-in-and-fast-out". Additionally, 27 cases had slow and prolonged enhancement. Conclusion: Similar to clear cell renal carcinomas, angiomyolipomas with sufficient blood supply also appear to exhibit abnormal enhancement with a pattern of"fast-in-and-fast-out" during the early phase, which is easily misdiagnosed as renal cancer. It is difficult to differentiate them merely through CT scans; the key to differentiating them is to identify the adipose tissue within the tumor. Therefore, it is helpful to use thin-layer CT scans to locate the adipose tissue.展开更多
<strong>Background:</strong> Diabetes mellitus is a chronic disease where there is an increased blood sugar level in the body which is either caused due to inability of the pancreas to secrete insulin or t...<strong>Background:</strong> Diabetes mellitus is a chronic disease where there is an increased blood sugar level in the body which is either caused due to inability of the pancreas to secrete insulin or the body’s inability to utilize it. The prevalence of diabetes mellitus is growing rapidly worldwide. Statistics show that in the year 2014, there were a total of 422 million cases of DM. Diabetes mellitus is a major cause of heart attacks, kidney failure, blindness and leg amputations. Diabetic foot ulcers are quite common and are estimated to affect nearly 15% of all diabetic patients during their lifetime. In long standing diabetic patients with chronic non-healing ulcers, bony changes or deformities are not uncommon. These bony changes can be identified using CT scans. <strong>Materials and Methods:</strong> An observational study was conducted on a total of 40 patients with chronic non-healing ulcer attending the surgery outpatient department of Saveetha Medical College, Chennai, Tamilnadu. The CT-scans of their foot were observed for deformities or bony changes. <strong>Results:</strong> Out of 40 patients, 67.5% were males and 32.5% were females. A maximum number of subjects fell under the age group of 51 - 60 years. The most common site of the ulcer was found to be in the plantar surface of big toe (53%). Among the 40 patients, 33 of them were found to have bony abnormalities on the CT scan of foot and no apparent changes were seen in the rest. Bone erosions (35%), osteopenic changes (22.5%), Charcot’s joint (2.5%), osteophyte formation (12.5) and reduced joint space (10%) were the predominant changes observed on the CT scans of the study population.展开更多
Stroke represents the 2<sup>nd</sup> cause of mortality and 1<sup>st</sup> cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the ...Stroke represents the 2<sup>nd</sup> cause of mortality and 1<sup>st</sup> cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. <b>Objective: </b>To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. <b>Materials and Methods: </b>This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan.<b> Results: </b>655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. <b>Conclusion: </b>CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management.展开更多
Background: There are no recommendations for the use of standardised CT reports in oncology in our country. The aim of this study was to evaluate CT reports of pancreatic tumors in the city of Ouagadougou. Materials a...Background: There are no recommendations for the use of standardised CT reports in oncology in our country. The aim of this study was to evaluate CT reports of pancreatic tumors in the city of Ouagadougou. Materials and Methods: Descriptive, multicenter, cross-sectional study conducted from 1<sup>st</sup> January 2013 to 31 December 2021. It concerned CT scan reports from five public and private imaging centers in the city of Ouagadougou. During the study period, 41 reports of pancreatic tumors were collected. We evaluated the reports using the standardized model developed by the Society of Abdominal Radiology and the American Pancreatic Association as a reference. Results: CT scan reports were not standardised. The writing style was free. Concerning the lesion, the aspect of the tumor at the pancreatic time was the item with the least information (24.4%). The status of the superior mesenteric artery was mentioned in 17%, the celiac trunk and the portal trunk in 12.2% of cases and 9.7% for the superior mesenteric vein. No report noted the appearance of the common hepatic artery. The status of the lymph nodes, liver and peritoneal cavity was mentioned in all reports. The exact location of the lymph nodes was not specified. The analysis of the reports classified them into two groups: potentially resectable tumours in the absence of secondary locations in 31.7% of cases and locally advanced tumours or presence of metastases in 68.3% of cases. Conclusion: The CT reports were not standardized. The items allowing evaluating the loco-regional extension of the tumor were the least specified. This may suggest the high rate of potentially resectable tumours in our study.展开更多
This paper is a study on texture analysis of Computer Tomography (CT) liver images using orthogonal moment features. Orthogonal moments are used as image feature representation in many applications like invariant patt...This paper is a study on texture analysis of Computer Tomography (CT) liver images using orthogonal moment features. Orthogonal moments are used as image feature representation in many applications like invariant pattern recognition of images. Orthogonal moments are proposed here for the diagnosis of any abnormalities on the CT images. The objective of the proposed work is to carry out the comparative study of the performance of orthogonal moments like Zernike, Racah and Legendre moments for the detection of abnormal tissue on CT liver images. The Region of Interest (ROI) based segmentation and watershed segmentation are applied to the input image and the features are extracted with the orthogonal moments and analyses are made with the combination of orthogonal moment with segmentation that provides better accuracy while detecting the tumor. This computational model is tested with many inputs and the performance of the orthogonal moments with segmentation for the texture analysis of CT scan images is computed and compared.展开更多
Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was ca...Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was carried out for evaluation of the deformity degree and morphology classification of chest wall malformation,展开更多
Background: Computed tomography (CT) and bronchoscopy have been shown to improve the detection rates of peripheral and central lung cancers (LC), respectively. However, the performance of the combination of CT and bro...Background: Computed tomography (CT) and bronchoscopy have been shown to improve the detection rates of peripheral and central lung cancers (LC), respectively. However, the performance of the combination of CT and bronchoscopy in detecting LC, in high-risk patients, is not clear. Patients & Methods: This prospective study included 205 high-risk patients with a history of at least 2 of the following risk factors: (1) heavy smoking;(2) aero-digestive cancer;(3) pulmonary asbestosis or;(4) chronic obstructive pulmonary disease. Patients were offered chest X-ray, sputum cytology, conventional white-light followed by autofluorescence beonchoscopy (WL/AFB) and low-dose spiral CT both at baseline and follow-up visits. Results: Seven patients (3.4%) were diagnosed with LC or carcinoma in-situ (CIS) at baseline: CT evaluation detected 5 LC/CIS, while WL/AFB evaluation also identified 5 LC/CIS, 2 of which were not detected on CT. Six (85%) of these baseline lesions were early stage (0/IA). The relative-sensitivity of CT with WL/ AFB was 40% better than CT alone. On four year follow-up, 20 patients (9.8%) were diagnosed with an LC/CIS. CT with WL/AFB detected 19 cases (95%), whereas CT alone detected 15 cases (75%). Conclusion: Bimodality surveillance with spiral CT and WL/AFB can improve the detection of early stage LCs among high-risk展开更多
Chest investigation is common in hospital practice. Chest X-ray is readily available and usually the first chest investigation. Thoracic CT scan constitutes an alternative and complimentary chest investigation. It is ...Chest investigation is common in hospital practice. Chest X-ray is readily available and usually the first chest investigation. Thoracic CT scan constitutes an alternative and complimentary chest investigation. It is currently the most efficient investigation for the chest and its contents. Objectives: To evaluate the relevance of chest CT Scan requests in two university teaching hospitals in Cameroon. Material and Methods: We conducted a cross-sectional, retrospective and descriptive study at the Radiology and imaging units of the Yaounde Central Hospital and the Yaounde University Teaching Hospital Centre. Included in our study were files of patients who had a chest CT scan investigation during three years. Results: We had a study population of 323 subjects. The age interval was 23 months to 91 years old. Pulmonologist were the most prescribers with 27.2%. We had 80% conformity of indications with French Society of Radiology (FSR) standards. 50 over of 323 indications were not recommended by the FSR. Conclusion: There is a conformity rate of 80% between indications and the FSR recommendations.展开更多
Computer Automated Tomography has been shown to be a valuable tool in production research because it provides a non-destructive method to identify and evaluate the internal structural characteristics of reservoir rock...Computer Automated Tomography has been shown to be a valuable tool in production research because it provides a non-destructive method to identify and evaluate the internal structural characteristics of reservoir rock. In CT scan, Hounsfield Unit (HU) is proportional to the degree of X-ray attenuation by the tissue. The aim of the present study was to introduce the method to estimate porosity which is one of physical parameters of reservoir rock though HU data. In this study, an Image J software was used to extract Hounsfield Unit data and calibrate by standard material’s density. This method provides the ability of using CT Scanner in advanced reservoir characterization and flow test experiments.展开更多
Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital ...Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM), of Cotonou in Benin from November 1st to December 31st. A review of CT scans skull was done for the subjects aged at least 16 years old. Anatomic variants of the sphenoid sinuses and adjacent structures have been investigated. Results: 225 CT scans of skull were analyzed. The sellar type was the most common type of pneumatization of sphenoid sinuses (74.7%). Pneumatization of anterior clinoid processes of greater and lesser wings of the sphenoid and of pterygoid processes was observed in 7.1%;4.6%;3.3% and 7.3%;respectively. Protrusion of carotid canals and optic canals, maxillary and vidian nerves were observed in 48.3%;13.1%;18% and 9.5%;respectively. Conclusion: Risky anatomic variants of the sphenoid sinuses and adjacent structures are also described by CT-scan among Beninese. Before any surgery and to avoid bad outcome, a precise approach of these risky anatomic variants must be carried out by using CT-scan.展开更多
Objectives: To assess the patients and health personnel’s level of awareness on risks related to ionizing radiation during CT scan. Materials and methods: Three questionnaires were addressed to patients, prescribing ...Objectives: To assess the patients and health personnel’s level of awareness on risks related to ionizing radiation during CT scan. Materials and methods: Three questionnaires were addressed to patients, prescribing physicians, and the medical imaging staff for three hospitals respectively. This permitted us to assess their knowledge on the benefits and risks of the required medical exam, based on the dangers of being exposed to X-rays, especially induced-radiation cancer following the amount of X-rays received during a CT scan and the possibility of not receiving radiation as tools of diagnosis. Results: 150 patients, 84 referring doctors of CT scan tests and 60 medical imaging personnel were retained. For patients, only 7.1% received information on the benefits and risks of their exams, and 34.4% believed that x-rays were harmful to their health. For the prescribers, 46.7% took into account the benefits/risk ratio before prescribing a test and only 16.7% of the referring doctors have informed the patient of the risks related to X-ray. 90% of the medical imaging staff ensures that the required test is justified, and 50% informed the patient on the risks associated with their radiation exposure, and the increased risk of developing cancer. 65% of the imaging staff could not estimate the dose that the patient will receive during the medical test. 25% mentioned the dose received during the acquisition in the patient’s exam report. Conclusion: This study confirms that the referring doctors, the patients, and the radiologists have a low knowledge concerning the risks associated with radiation exposure during a CT scan assessment. We will therefore say that patients and prescribers are not aware of the doses of radiation on CT and their possible risks, even though there is a risk of developing cancer.展开更多
Medical imaging has enabled major improvements in the medical care of the patient. However, some of these tests have the disadvantage of using ionizing radiation at low doses. Although the CT scan is a powerful diagno...Medical imaging has enabled major improvements in the medical care of the patient. However, some of these tests have the disadvantage of using ionizing radiation at low doses. Although the CT scan is a powerful diagnostic tool, it remains a highly radiant imaging modality. In addition, the risk of radiation-induced cancer associated with low X-ray doses is established by the American Phase 2 study BEIR VII, and preventive measures require a good level of knowledge on radioprotection by imaging test prescribers. In our study, we evaluated the knowledge of CT scan prescribers in Senegal regarding patient radioprotection. These prescribers consisted of physicians and surgeons without distinction of specialty. Our objective was to have the required data for optimizing CT prescriptions in compliance with the principles of radioprotection. Our work focused on a descriptive analytical study of 107 doctors who prescribed CT scan in public health institutions in Senegal. Our results revealed poor knowledge of doctors prescribing CT scan on induced radio risks, even though the majority of them stated that they took those risks into account. Our data were not isolated, they were applicable to similar studies conducted outside Senegal. In summary, our study led on the one hand to recommendations on initial and continuing training and on the other hand on organizational and regulatory considerations.展开更多
A retrospective study for 98 patient suspected to bone scan at department of radiology take place, to find out which imaging modality is more sensitive between computed tomography (CT) and bone scan;age group of patie...A retrospective study for 98 patient suspected to bone scan at department of radiology take place, to find out which imaging modality is more sensitive between computed tomography (CT) and bone scan;age group of patient was from 1 year to 90 year, the highest Site of Metastases for both Bone scan & CT was at vertebra with 31%, and the positive finding was also 31% for bone scan, while for CT the highest Site of Metastases was at forearm with 34%, and the sensitivity for CT was 44%, and 56% for bone scan. The study recommends that patients with bone metastases are kindly recommended to bone scan investigation rather than CT scan.展开更多
Purpose:Abdominal CT scan using oral and intravenous(IV)contrast is helpful in the diagnosis of intra-abdominal injuries.However,the use of oral and IV contrast delays the process of diagnosis and increases the risk o...Purpose:Abdominal CT scan using oral and intravenous(IV)contrast is helpful in the diagnosis of intra-abdominal injuries.However,the use of oral and IV contrast delays the process of diagnosis and increases the risk of aspiration.It has also been shown that CT scan with IV contrast alone is as helpful as CT scan with oral and IV contrast and rectal CT scan in detecting abdominal injuries.Therefore,the present study aims to prospectively compare the diagnostic value of CT scan with oral and IV contrast versus CT scan with IV contrast alone in the diagnosis of blunt abdominal trauma(BAT).Methods:Altogether 123 BAT patients,60(48.8%)women and 63(51.2%)men with the mean age of(40.4±18.7)years who referred to the emergency department of Imam Khomeini Educational and Medical Center in Sari,Iran(a tertiary trauma center in north of Iran)from November 2014 to March 2017 and underwent abdominal CT scans+laparotomy were investigated.Those with penetrating trauma or hemodynamically unstable patients were excluded.The participants were randomly allocated to two groups:abdominal CT scan with oral and IV contrast(n=63)and CT scan with IV contrast alone(n=60).No statistically significant difference was found between two groups regarding the hemodynamic parameters,age,gender,injury mechanisms(all p>0.05).The results of CT scan were compared with that of laparotomy results.The collected data were recorded in SPSS version 22.0 for Windows.Quantitative data were presented as mean and SD.Results:The sensitivity and specificity of CT scan using oral and IV contrast in the diagnosis of BAT were estimated at 96.48(95%CI:90.73-99.92)and 92.67(95% CI:89.65-94.88),respectively;while CT scan with IV contrast alone achieved a comparable sensitivity and specificity of 96.6(95% CI:87.45-99),42 and 92.84(95% CI:89.88-95.00),respectively.Conclusion:CT scan with IV contrast alone can be used to assess visceral injuries in BAT patients with normal hemodynamics to avoid diagnostic delay.展开更多
基金supported by the National Natural Science Foundation of China(No.52178354).
文摘To investigate the macroscopic fatigue properties and the mesoscopic pore evolution characteristics of salt rock under cyclic loading,fatigue tests under different upper-limit stresses were carried out on salt rock,and the mesoscopic pore structures of salt rock before and after fatigue tests and under different cycle numbers were measured using CT scanning instrument.Based on the test results,the effects of the cycle number and the upper-limit stress on the evolution of cracks,pore morphology,pore number,pore volume,pore size,plane porosity,and volume porosity of salt rock were analyzed.The failure path of salt rock specimens under cyclic loading was analyzed using the distribution law of plane porosity.The damage variable of salt rock under cyclic loading was defined on basis of the variation of volume porosity with cycle number.In order to describe the fatigue deformation behavior of salt rock under cyclic loading,the nonlinear Burgers damage constitutive model was further established.The results show that the model established can better reflect the whole development process of fatigue deformation of salt rock under cyclic loading.
文摘Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hemangioblastoma through observation. We report the case of a 38-year-old patient referred to the radiology and Medical Imaging Department of the Marie Curie Medical Clinic in Bamako, Mali, for an orbito-cerebral CT scan in a context of bilateral eyelid edema. The examination was performed using multi-slice computed tomography (16 slices) with reconstruction in the 3 planes of space without and with the injection of an iodinated contrast agent. The CT scan was crucial in making the diagnosis of hemangioblastoma incidentally, which allowed for adequate management. The patient was operated on, and the radiological outcome was favorable, without significant cystic formation, after postoperative control and clinical signs were resolved. CT can be an interesting alternative in countries like ours despite MRI being the examination of choice in hemangioblastomas.
基金supported by the National Natural Science Foundation of China(Grant Nos.42277150,41977219)Henan Provincial Science and Technology Research Project(Grant No.222102320271).
文摘The geometry of joints has a significant influence on the mechanical properties of rocks.To simplify the curved joint shapes in rocks,the joint shape is usually treated as straight lines or planes in most laboratory experiments and numerical simulations.In this study,the computerized tomography (CT) scanning and photogrammetry were employed to obtain the internal and surface joint structures of a limestone sample,respectively.To describe the joint geometry,the edge detection algorithms and a three-dimensional (3D) matrix mapping method were applied to reconstruct CT-based and photogrammetry-based jointed rock models.For comparison tests,the numerical uniaxial compression tests were conducted on an intact rock sample and a sample with a joint simplified to a plane using the parallel computing method.The results indicate that the mechanical characteristics and failure process of jointed rocks are significantly affected by the geometry of joints.The presence of joints reduces the uniaxial compressive strength (UCS),elastic modulus,and released acoustic emission (AE) energy of rocks by 37%–67%,21%–24%,and 52%–90%,respectively.Compared to the simplified joint sample,the proposed photogrammetry-based numerical model makes the most of the limited geometry information of joints.The UCS,accumulative released AE energy,and elastic modulus of the photogrammetry-based sample were found to be very close to those of the CT-based sample.The UCS value of the simplified joint sample (i.e.38.5 MPa) is much lower than that of the CT-based sample (i.e.72.3 MPa).Additionally,the accumulative released AE energy observed in the simplified joint sample is 3.899 times lower than that observed in the CT-based sample.CT scanning provides a reliable means to visualize the joints in rocks,which can be used to verify the reliability of photogrammetry techniques.The application of the photogrammetry-based sample enables detailed analysis for estimating the mechanical properties of jointed rocks.
文摘Objective: To evaluate the lung CT scan as a possible predictive diagnostic method for COVID-19 in the Cameroonian context. Methods: We designed a cross sectional study. Suspected cases of COVID-19 during the first wave at the national social insurance fund (NSIF) hospital were screened with both COVID-19 with lung CT scan and a PCR test. Univariate analysis was performed for sample description and multivariate analysis to assess the correlation between positive results for the PCR and other parameters. We estimated the optimum threshold of sensitivity/specificity, and area under curve using the empirical method and package. Results: A total of 62 suspected COVID-19 cases were recorded, predominantly males (Sex Ratio = 2.2) with a median age of 58.5 (IQR = 19.7). Among our 62 patients, 29 (46.8%) were confirmed COVID-19 cases with positive PCR results. All the patients had a thorax CT scan with a median impairment of 40% (IQR = 20%). The optimum threshold estimate for CT scan for COVID-19 infection diagnosis was 60% (95% CI = 25% - 80%). Overall, the sensitivity and specificity estimates were 0.30 (95% CI = 0.15 - 0.49) and 0.87 (95% CI = 0.70 - 0.96), respectively, leading to an Area Under Curve (AUC) estimate of 0.59 (95% CI = 0.46, 0.71). Conclusion: In this setting, lung CT scan was neither sensitive nor specific to predict COVID-19 disease.
基金the National Natural Science Foundation of China fund (Project number: 52174045 and No. 52104011)Research Foundation of China University of Petroleum-Beijing at Karamay (No. XQZX20210001)PetroChina Innovation Foundation (2020D50070207)。
文摘Due to the reservoir heterogeneity and the stress shadow effect, multiple hydraulic fractures within one fracturing segment cannot be initiated simultaneously and propagate evenly, which will cause a low effectiveness of reservoir stimulation. Temporary plugging and diverting fracturing(TPDF) is considered to be a potential uniform-stimulation method for creating multiple fractures simultaneously in the oilfield. However, the multi-fracture propagation morphology during TPDF is not clear now. The purpose of this study is to quantitatively investigate the multi-fracture propagation morphology during TPDF through true tri-axial fracturing experiments and CT scanning. Critical parameters such as fracture spacing, number of perforation clusters, the viscosity of fracturing fluid, and the in-situ stress have been investigated. The fracture geometry before and after diversion have been quantitively analyzed based on the two-dimensional CT slices and three-dimensional reconstruction method. The main conclusions are as follows:(1) When injecting the high viscosity fluid or perforating at the location with low in-situ stress, multiple hydraulic fractures would simultaneously propagate. Otherwise, only one hydraulic fracture was created during the initial fracturing stage(IFS) for most tests.(2) The perforation cluster effectiveness(PCE) has increased from 26.62% during the IFS to 88.86% after using diverters.(3) The diverted fracture volume has no apparent correlation with the pressure peak and peak frequency during the diversion fracturing stage(DFS) but is positively correlated with water-work.(4) Four types of plugging behavior in shale could be controlled by adjusting the diverter recipe and diverter injection time, and the plugging behavior includes plugging the natural fracture in the wellbore, plugging the previous hydraulic fractures, plugging the fracture tip and plugging the bedding.
基金Supported by a grant from Science and Technology Bureau of Guang-zhou, China (No.2004Z3-E0481)
文摘Objective: The aim of our study was to investigate the feature of minimal fat renal angiomyolipoma with sufficient blood supply using CT scans and improve the diagnosis accuracy required to differentiate it from clear cell renal carcinoma. Methods: Retrospective analysis of 24 cases of post-surgery confirmed angiomyolipoma with sufficient blood supply (total of 25 tumors) in our hospital that were used for a pathological comparison study. Results: Among the 24 patients diagnosed with angiomyolipoma, nobody had bloody urine, Of the 96 patients diagnosed with clear cell renal cancer, 14 had bloody urine (14.6%). In our studied group, the size of angiomyolipomas with sufficient blood supply was between 1.5 cm× 2.0 cm to 8.0 cm× 10.0 cm. During CT scan analysis, twenty tumors had similar density, and five of them had higher density. Only one tumor had a few dots of calcification (4%). Adipose tissue was not visible in 9 tumors, while 16 tumors had visible dots of adipose tissue, as visualized by CT scan. Intensive scanning indicated that all of the tumors showed a strong enhancement in the renal corticomedullary phase. Twenty tumors had significant heterogeneous enhancement in the early phase, while another set of five cases had homogenous prolonged enhancement. Nineteen patients had surgery to remove the angiomyolipomas, while six patients had single side kidney removal due to misdiagnosis for renal cancer in cases where the tumor severely compromised the renal parenchyma and sinus. All 25 cases were classified as renal angiomyolipoma by pathological analysis. Within the 96 cases of clear cell renal cancer, 64 tumors had relatively low density, 29 tumors had equal density, and 3 cases had relatively higher density. Fourteen of the tumors had calcification (14.6%), and none of them had visualized adipose tissue. Enhanced CT scans indicated that 69 cases of renal cancer showed significant enhancement in the renal corticomedu^ary phase, which had the abnormal pattern of "fast-in-and-fast-out". Additionally, 27 cases had slow and prolonged enhancement. Conclusion: Similar to clear cell renal carcinomas, angiomyolipomas with sufficient blood supply also appear to exhibit abnormal enhancement with a pattern of"fast-in-and-fast-out" during the early phase, which is easily misdiagnosed as renal cancer. It is difficult to differentiate them merely through CT scans; the key to differentiating them is to identify the adipose tissue within the tumor. Therefore, it is helpful to use thin-layer CT scans to locate the adipose tissue.
文摘<strong>Background:</strong> Diabetes mellitus is a chronic disease where there is an increased blood sugar level in the body which is either caused due to inability of the pancreas to secrete insulin or the body’s inability to utilize it. The prevalence of diabetes mellitus is growing rapidly worldwide. Statistics show that in the year 2014, there were a total of 422 million cases of DM. Diabetes mellitus is a major cause of heart attacks, kidney failure, blindness and leg amputations. Diabetic foot ulcers are quite common and are estimated to affect nearly 15% of all diabetic patients during their lifetime. In long standing diabetic patients with chronic non-healing ulcers, bony changes or deformities are not uncommon. These bony changes can be identified using CT scans. <strong>Materials and Methods:</strong> An observational study was conducted on a total of 40 patients with chronic non-healing ulcer attending the surgery outpatient department of Saveetha Medical College, Chennai, Tamilnadu. The CT-scans of their foot were observed for deformities or bony changes. <strong>Results:</strong> Out of 40 patients, 67.5% were males and 32.5% were females. A maximum number of subjects fell under the age group of 51 - 60 years. The most common site of the ulcer was found to be in the plantar surface of big toe (53%). Among the 40 patients, 33 of them were found to have bony abnormalities on the CT scan of foot and no apparent changes were seen in the rest. Bone erosions (35%), osteopenic changes (22.5%), Charcot’s joint (2.5%), osteophyte formation (12.5) and reduced joint space (10%) were the predominant changes observed on the CT scans of the study population.
文摘Stroke represents the 2<sup>nd</sup> cause of mortality and 1<sup>st</sup> cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. <b>Objective: </b>To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. <b>Materials and Methods: </b>This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan.<b> Results: </b>655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. <b>Conclusion: </b>CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management.
文摘Background: There are no recommendations for the use of standardised CT reports in oncology in our country. The aim of this study was to evaluate CT reports of pancreatic tumors in the city of Ouagadougou. Materials and Methods: Descriptive, multicenter, cross-sectional study conducted from 1<sup>st</sup> January 2013 to 31 December 2021. It concerned CT scan reports from five public and private imaging centers in the city of Ouagadougou. During the study period, 41 reports of pancreatic tumors were collected. We evaluated the reports using the standardized model developed by the Society of Abdominal Radiology and the American Pancreatic Association as a reference. Results: CT scan reports were not standardised. The writing style was free. Concerning the lesion, the aspect of the tumor at the pancreatic time was the item with the least information (24.4%). The status of the superior mesenteric artery was mentioned in 17%, the celiac trunk and the portal trunk in 12.2% of cases and 9.7% for the superior mesenteric vein. No report noted the appearance of the common hepatic artery. The status of the lymph nodes, liver and peritoneal cavity was mentioned in all reports. The exact location of the lymph nodes was not specified. The analysis of the reports classified them into two groups: potentially resectable tumours in the absence of secondary locations in 31.7% of cases and locally advanced tumours or presence of metastases in 68.3% of cases. Conclusion: The CT reports were not standardized. The items allowing evaluating the loco-regional extension of the tumor were the least specified. This may suggest the high rate of potentially resectable tumours in our study.
文摘This paper is a study on texture analysis of Computer Tomography (CT) liver images using orthogonal moment features. Orthogonal moments are used as image feature representation in many applications like invariant pattern recognition of images. Orthogonal moments are proposed here for the diagnosis of any abnormalities on the CT images. The objective of the proposed work is to carry out the comparative study of the performance of orthogonal moments like Zernike, Racah and Legendre moments for the detection of abnormal tissue on CT liver images. The Region of Interest (ROI) based segmentation and watershed segmentation are applied to the input image and the features are extracted with the orthogonal moments and analyses are made with the combination of orthogonal moment with segmentation that provides better accuracy while detecting the tumor. This computational model is tested with many inputs and the performance of the orthogonal moments with segmentation for the texture analysis of CT scan images is computed and compared.
文摘Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was carried out for evaluation of the deformity degree and morphology classification of chest wall malformation,
文摘Background: Computed tomography (CT) and bronchoscopy have been shown to improve the detection rates of peripheral and central lung cancers (LC), respectively. However, the performance of the combination of CT and bronchoscopy in detecting LC, in high-risk patients, is not clear. Patients & Methods: This prospective study included 205 high-risk patients with a history of at least 2 of the following risk factors: (1) heavy smoking;(2) aero-digestive cancer;(3) pulmonary asbestosis or;(4) chronic obstructive pulmonary disease. Patients were offered chest X-ray, sputum cytology, conventional white-light followed by autofluorescence beonchoscopy (WL/AFB) and low-dose spiral CT both at baseline and follow-up visits. Results: Seven patients (3.4%) were diagnosed with LC or carcinoma in-situ (CIS) at baseline: CT evaluation detected 5 LC/CIS, while WL/AFB evaluation also identified 5 LC/CIS, 2 of which were not detected on CT. Six (85%) of these baseline lesions were early stage (0/IA). The relative-sensitivity of CT with WL/ AFB was 40% better than CT alone. On four year follow-up, 20 patients (9.8%) were diagnosed with an LC/CIS. CT with WL/AFB detected 19 cases (95%), whereas CT alone detected 15 cases (75%). Conclusion: Bimodality surveillance with spiral CT and WL/AFB can improve the detection of early stage LCs among high-risk
文摘Chest investigation is common in hospital practice. Chest X-ray is readily available and usually the first chest investigation. Thoracic CT scan constitutes an alternative and complimentary chest investigation. It is currently the most efficient investigation for the chest and its contents. Objectives: To evaluate the relevance of chest CT Scan requests in two university teaching hospitals in Cameroon. Material and Methods: We conducted a cross-sectional, retrospective and descriptive study at the Radiology and imaging units of the Yaounde Central Hospital and the Yaounde University Teaching Hospital Centre. Included in our study were files of patients who had a chest CT scan investigation during three years. Results: We had a study population of 323 subjects. The age interval was 23 months to 91 years old. Pulmonologist were the most prescribers with 27.2%. We had 80% conformity of indications with French Society of Radiology (FSR) standards. 50 over of 323 indications were not recommended by the FSR. Conclusion: There is a conformity rate of 80% between indications and the FSR recommendations.
文摘Computer Automated Tomography has been shown to be a valuable tool in production research because it provides a non-destructive method to identify and evaluate the internal structural characteristics of reservoir rock. In CT scan, Hounsfield Unit (HU) is proportional to the degree of X-ray attenuation by the tissue. The aim of the present study was to introduce the method to estimate porosity which is one of physical parameters of reservoir rock though HU data. In this study, an Image J software was used to extract Hounsfield Unit data and calibrate by standard material’s density. This method provides the ability of using CT Scanner in advanced reservoir characterization and flow test experiments.
文摘Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM), of Cotonou in Benin from November 1st to December 31st. A review of CT scans skull was done for the subjects aged at least 16 years old. Anatomic variants of the sphenoid sinuses and adjacent structures have been investigated. Results: 225 CT scans of skull were analyzed. The sellar type was the most common type of pneumatization of sphenoid sinuses (74.7%). Pneumatization of anterior clinoid processes of greater and lesser wings of the sphenoid and of pterygoid processes was observed in 7.1%;4.6%;3.3% and 7.3%;respectively. Protrusion of carotid canals and optic canals, maxillary and vidian nerves were observed in 48.3%;13.1%;18% and 9.5%;respectively. Conclusion: Risky anatomic variants of the sphenoid sinuses and adjacent structures are also described by CT-scan among Beninese. Before any surgery and to avoid bad outcome, a precise approach of these risky anatomic variants must be carried out by using CT-scan.
文摘Objectives: To assess the patients and health personnel’s level of awareness on risks related to ionizing radiation during CT scan. Materials and methods: Three questionnaires were addressed to patients, prescribing physicians, and the medical imaging staff for three hospitals respectively. This permitted us to assess their knowledge on the benefits and risks of the required medical exam, based on the dangers of being exposed to X-rays, especially induced-radiation cancer following the amount of X-rays received during a CT scan and the possibility of not receiving radiation as tools of diagnosis. Results: 150 patients, 84 referring doctors of CT scan tests and 60 medical imaging personnel were retained. For patients, only 7.1% received information on the benefits and risks of their exams, and 34.4% believed that x-rays were harmful to their health. For the prescribers, 46.7% took into account the benefits/risk ratio before prescribing a test and only 16.7% of the referring doctors have informed the patient of the risks related to X-ray. 90% of the medical imaging staff ensures that the required test is justified, and 50% informed the patient on the risks associated with their radiation exposure, and the increased risk of developing cancer. 65% of the imaging staff could not estimate the dose that the patient will receive during the medical test. 25% mentioned the dose received during the acquisition in the patient’s exam report. Conclusion: This study confirms that the referring doctors, the patients, and the radiologists have a low knowledge concerning the risks associated with radiation exposure during a CT scan assessment. We will therefore say that patients and prescribers are not aware of the doses of radiation on CT and their possible risks, even though there is a risk of developing cancer.
文摘Medical imaging has enabled major improvements in the medical care of the patient. However, some of these tests have the disadvantage of using ionizing radiation at low doses. Although the CT scan is a powerful diagnostic tool, it remains a highly radiant imaging modality. In addition, the risk of radiation-induced cancer associated with low X-ray doses is established by the American Phase 2 study BEIR VII, and preventive measures require a good level of knowledge on radioprotection by imaging test prescribers. In our study, we evaluated the knowledge of CT scan prescribers in Senegal regarding patient radioprotection. These prescribers consisted of physicians and surgeons without distinction of specialty. Our objective was to have the required data for optimizing CT prescriptions in compliance with the principles of radioprotection. Our work focused on a descriptive analytical study of 107 doctors who prescribed CT scan in public health institutions in Senegal. Our results revealed poor knowledge of doctors prescribing CT scan on induced radio risks, even though the majority of them stated that they took those risks into account. Our data were not isolated, they were applicable to similar studies conducted outside Senegal. In summary, our study led on the one hand to recommendations on initial and continuing training and on the other hand on organizational and regulatory considerations.
文摘A retrospective study for 98 patient suspected to bone scan at department of radiology take place, to find out which imaging modality is more sensitive between computed tomography (CT) and bone scan;age group of patient was from 1 year to 90 year, the highest Site of Metastases for both Bone scan & CT was at vertebra with 31%, and the positive finding was also 31% for bone scan, while for CT the highest Site of Metastases was at forearm with 34%, and the sensitivity for CT was 44%, and 56% for bone scan. The study recommends that patients with bone metastases are kindly recommended to bone scan investigation rather than CT scan.
基金The present study was based on a doctoral dissertation in the Emergency Medicine,School of Medicine,Mazandaran University of Medical Sciences,Iran(grant number 1404)。
文摘Purpose:Abdominal CT scan using oral and intravenous(IV)contrast is helpful in the diagnosis of intra-abdominal injuries.However,the use of oral and IV contrast delays the process of diagnosis and increases the risk of aspiration.It has also been shown that CT scan with IV contrast alone is as helpful as CT scan with oral and IV contrast and rectal CT scan in detecting abdominal injuries.Therefore,the present study aims to prospectively compare the diagnostic value of CT scan with oral and IV contrast versus CT scan with IV contrast alone in the diagnosis of blunt abdominal trauma(BAT).Methods:Altogether 123 BAT patients,60(48.8%)women and 63(51.2%)men with the mean age of(40.4±18.7)years who referred to the emergency department of Imam Khomeini Educational and Medical Center in Sari,Iran(a tertiary trauma center in north of Iran)from November 2014 to March 2017 and underwent abdominal CT scans+laparotomy were investigated.Those with penetrating trauma or hemodynamically unstable patients were excluded.The participants were randomly allocated to two groups:abdominal CT scan with oral and IV contrast(n=63)and CT scan with IV contrast alone(n=60).No statistically significant difference was found between two groups regarding the hemodynamic parameters,age,gender,injury mechanisms(all p>0.05).The results of CT scan were compared with that of laparotomy results.The collected data were recorded in SPSS version 22.0 for Windows.Quantitative data were presented as mean and SD.Results:The sensitivity and specificity of CT scan using oral and IV contrast in the diagnosis of BAT were estimated at 96.48(95%CI:90.73-99.92)and 92.67(95% CI:89.65-94.88),respectively;while CT scan with IV contrast alone achieved a comparable sensitivity and specificity of 96.6(95% CI:87.45-99),42 and 92.84(95% CI:89.88-95.00),respectively.Conclusion:CT scan with IV contrast alone can be used to assess visceral injuries in BAT patients with normal hemodynamics to avoid diagnostic delay.