{"title":"Acute respiratory distress syndrome caused by demulsifier poisoning: A case report.","authors":"Kai-Ying Yang, Zhi-Xin Cui","doi":"10.4329/wjr.v16.i11.689","DOIUrl":"10.4329/wjr.v16.i11.689","url":null,"abstract":"<p><strong>Background: </strong>This case report emphasizes the potential pulmonary toxicity of demulsifier gas, which is a widely used chemical. To our knowledge, this is the first documented instance of acute respiratory distress syndrome (ARDS) induced by inhalation of demulsifier gas. This report underscores the need for increased workplace safety and awareness regarding health risks associated with demulsifiers, particularly in industrial settings. Timely diagnosis and management of ARDS are crucial for improving patient outcomes, thus making this report significant for clinical practice and occupational health literature.</p><p><strong>Case summary: </strong>We present a rare case of acute demulsifier poisoning leading to ARDS in a previously healthy 69-year-old man. He presented with chest discomfort, shortness of breath, and dyspnea following a 30-minute exposure to demulsifier fumes in a poorly ventilated area. Chest computed tomography revealed bilateral diffuse infiltrative shadows. Based on his exposure history and clinical findings, a diagnosis of ARDS due to demulsifier poisoning was confirmed. The patient required high-flow oxygen and intravenous norepinephrine upon admission and was subsequently intubated for mechanical ventilation. Following timely and effective multidisciplinary treatment interventions including emergency care, intensive care, and respiratory medicine, he achieved positive outcomes and was ultimately discharged.</p><p><strong>Conclusion: </strong>This case underscores the critical importance of recognizing chemical exposure risks and their potential to cause severe respiratory complications.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"689-695"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Yuan, Ying-Jie Zhang, Wu Wen, Xiao-Cong Liu, Feng-Lin Chen, Ye Yang
{"title":"Afferent loop syndrome of a patient with recurrent fever: A case report.","authors":"Jing Yuan, Ying-Jie Zhang, Wu Wen, Xiao-Cong Liu, Feng-Lin Chen, Ye Yang","doi":"10.4329/wjr.v16.i11.678","DOIUrl":"10.4329/wjr.v16.i11.678","url":null,"abstract":"<p><strong>Background: </strong>Afferent loop syndrome (ALS) is a rare complication, Aoki <i>et al</i> reported that the incidence of distal gastrectomy in Billroth-II is 0.3%-1.0%. The clinical manifestations of ALS are atypical, which can manifest as severe abdominal pain, vomiting, obstructive jaundice, malnutrition, <i>etc.</i></p><p><strong>Case summary: </strong>The patient was a 58-year-old man who complained of recurrent high fever for more than 1 week. Laboratory tests showed an increase in neutrophil ratio, procalcitonin, C-reactive protein, and abnormal liver function. Enhanced computed tomography scan of the abdomen showed small intestinal obstruction between the anastomosis of the gastrojejunum, bile duct, and pancreaticoduodenum. Gastroscopy revealed significant narrowing of the lumen 15 cm from the anastomosis into the afferent loop. After performing balloon dilation and placement of the nutrition tube, the patient did not experience further fever.</p><p><strong>Conclusion: </strong>ALS is relatively rare after pancreaticoduodenectomy, and the treatment depends on the nature of the obstructive lesion. The traditional treatment method is surgery, and in recent years, endoscopy has provided a new treatment method for ALS.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"678-682"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Right-to-left shunt detection <i>via</i> synchronized contrast transcranial Doppler combined with contrast transthoracic echocardiography: A preliminary study.","authors":"Man-Juan Yao, Ying-Ying Zhao, Shui-Ping Deng, Hua-Hua Xiong, Jing Wang, Li-Jie Ren, Li-Ming Cao","doi":"10.4329/wjr.v16.i11.657","DOIUrl":"10.4329/wjr.v16.i11.657","url":null,"abstract":"<p><strong>Background: </strong>Patent foramen ovale (PFO)-related right-to-left shunts (RLSs) have been implicated in cryptogenic stroke and migraine, with larger shunts posing a higher risk. When used individually to detect RLS, contrast transcranial Doppler (cTCD) and contrast transthoracic echocardiography (cTTE) may yield false-negative results. Further, the literature exposes gaps regarding the understanding of the limitations of cTCD and cTTE, presents conflicting recommendations on their exclusive use, and highlights inefficiencies associated with nonsynchronous testing.</p><p><strong>Aim: </strong>To investigate the accuracy of multimodal ultrasound to improve diagnostic efficiency in detecting PFO-related RLSs.</p><p><strong>Methods: </strong>We prospectively enrolled four patients with cryptogenic stroke (<i>n</i> = 1), migraine (<i>n</i> = 2), and unexplained dizziness (<i>n</i> = 1) who underwent synchronized cTCD combined with cTTE. The participants were monitored and followed-up for 24 months.</p><p><strong>Results: </strong>cTTE identified moderate and large RLSs in patients with recurrent cryptogenic stroke and migraines, whereas cTCD revealed only small RLSs. Moderate and large RLS were confirmed on combined cTTE and cTCD. After excluding other causes, both patients underwent PFO occlusion. At 21- and 24-month follow-up examinations, neither stroke nor migraine had recurred. cTTE revealed a small RLS in a third patient with unexplained dizziness and a fourth patient with migraines; however, simultaneous cTCD detected a large RLS. These patients did not undergo interventional occlusion, and dizziness and headache recurred at the 17- and 24-month follow-up examinations.</p><p><strong>Conclusion: </strong>Using cTTE or cTCD may underestimate RLS, impairing risk assessments. Combining synchronized cTCD with cTTE could enhance testing accuracy and support better diagnostic and therapeutic decisions.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"657-667"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xing-Yan Le, Jin-Rui Zhang, Jun-Bang Feng, Chuan-Ming Li
{"title":"Optimizing clinical decision-making for ruptured intracranial aneurysms: Current applications and future directions of computed tomography angiography.","authors":"Xing-Yan Le, Jin-Rui Zhang, Jun-Bang Feng, Chuan-Ming Li","doi":"10.4329/wjr.v16.i11.700","DOIUrl":"10.4329/wjr.v16.i11.700","url":null,"abstract":"<p><p>Ruptured intracranial aneurysms (RIAs) are a leading cause of subarachnoid haemorrhage (SAH) and are associated with a poor prognosis and high mortality rate. Computed tomography angiography (CTA) is the preferred imaging modality for the diagnosis of RIAs, as it is considered to be a fast, economical, and less invasive method. In this letter, regarding an original study presented by Elmokadem <i>et al</i>, we present our insights and discuss how CTA can better assist in clinical decision-making for patients with RIAs complicated by SAH.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"700-702"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pancreatic volume change using three dimensional-computed tomography volumetry and its relationships with diabetes on long-term follow-up in autoimmune pancreatitis.","authors":"Ryuichi Shimada, Yasunari Yamada, Kazuhisa Okamoto, Kazunari Murakami, Mitsuteru Motomura, Hajime Takaki, Kengo Fukuzawa, Yoshiki Asayama","doi":"10.4329/wjr.v16.i11.644","DOIUrl":"10.4329/wjr.v16.i11.644","url":null,"abstract":"<p><strong>Background: </strong>Several studies found that early pancreatic atrophy detected by computed tomography (CT) within 6 months was associated with a high incidence of diabetes in patients with type-1 autoimmune pancreatitis (AIP) receiving steroid therapy; however, no long-term follow-up studies have been performed.</p><p><strong>Aim: </strong>To investigate pancreatic volume (PV) changes using three dimensional (3D)-CT volumetry and their relationship with IgG4 and diabetes in patients with AIP.</p><p><strong>Methods: </strong>This retrospective study included 33 patients with type-1 AIP receiving steroid therapy. Patients were divided into diffuse (D-type) and mass-forming type (M-type) AIP. PV was determined by semi-automated 3D-CT volumetry, and changes between initial and follow-up values were calculated. The relationship between PV and serum IgG4 levels was analyzed by Spearman's rank correlation. The PV atrophy ratio compared with the presumed normal PV at the time of last follow-up CT and its relationship with diabetes were investigated.</p><p><strong>Results: </strong>There were 16 D-type and 17 M-type patients with long-term follow-up (mean, 95.8 months). The regression curve of mean relative PV change reduced exponentially and rapidly during the first 25 months and then more slowly in both groups. The overall cumulative pancreas re-enlargement rates at 1, 3, 5, 7 and 10 years were 6.1%, 12.2%, 29.2%, 47.5% and 55.0%, respectively. There was a moderate-to-very strong positive correlation (<i>ρ</i> ≥ 0.4) between PV and serum IgG4 levels in nine (9/13, 69.2%) patients. All 33 patients showed pancreatic atrophy (mean 59.3%) after long-term follow-up. Patients with D-type AIP had a significantly higher atrophy rate and higher incidence of diabetes than M-type patients (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>PV change initially reduced exponentially and then more slowly and is considered an important factor associated with diabetes. Serum IgG4 levels were positively correlated with PV during follow-up.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"644-656"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yao Zhao, Di Gao, Yan-Bing Liu, Jing-Jing Xue, Xiang Lu, Jing-Jing Dong, Yan Zhang, Jia Zeng
{"title":"Spectra of intracranial diseases in Chinese military pilots (cadets) unqualified for transfer to pilot modified high performance aircraft.","authors":"Yao Zhao, Di Gao, Yan-Bing Liu, Jing-Jing Xue, Xiang Lu, Jing-Jing Dong, Yan Zhang, Jia Zeng","doi":"10.4329/wjr.v16.i11.638","DOIUrl":"10.4329/wjr.v16.i11.638","url":null,"abstract":"<p><strong>Background: </strong>With very high mortality and disability rates, cerebrovascular diseases and intracranial tumors severely threaten the health and fighting strength of flying personnel, requiring great concern and intensive screening in clinic, early warning in an early and accurate manner and early intervention of diseases possibly resulting in inflight incapacitation are key emphases of aeromedical support in clinic.</p><p><strong>Aim: </strong>To probe into the spectra of intracranial diseases, flight factors and medical imaging characteristics of military pilots (cadets) in the physical examination for transfer to pilot modified high performance aircraft, thus rendering theoretical references for clinical aeromedical support of pilots.</p><p><strong>Methods: </strong>A total of 554 military pilots (cadets) undergoing physical examination for transfer to pilot modified high performance aircraft from December 2020 to April 2024 in a military medical center were enrolled in this study. Then, a retrospective study was carried out on intracranial disease spectra and head magnetic resonance imaging (MRI) data of 36 pilots (cadets) who were unqualified for transfer to pilot modified high performance aircraft. Besides, a descriptive statistical analysis was conducted on the clinical data, age, fighter type and head MRI data of such pilots (cadets).</p><p><strong>Results: </strong>Abnormal head images were found in 36 out of 554 pilots (cadets) participating in the physical examination for transfer to pilot modified high performance aircraft, including arachnoid cyst in 17 (3.1%) military pilots (cadets), suspected very small aneurysm in 11 (2.0%), cavernous hemangioma in 4 (0.7%), vascular malformation in 2 (0.4%), and pituitary tumor in 3 (0.5%, one of which developed cavernous hemangioma simultaneously). Among the 17 pilots (cadets) with arachnoid cyst, 4 were identified as unqualified for transfer to pilot modified high performance aircraft because the marginal brain tissues were compressed by the cyst > 6 cm in length and diameter. The 11 pilots (cadets) with suspected very small aneurysms identified by 3.0T MRI consisted of 6 diagnosed with conus arteriosus by digital subtraction angiography and qualified for transfer to pilot modified high performance aircraft, and 5 identified as very small intracranial aneurysms with diameter < 3 mm and unqualified for transfer to pilot modified high performance aircraft. No symptoms and signs were observed in the 4 military pilots (cadets) with cavernous hemangioma, and the results of MRI revealed bleeding. The 1 of the 4 had the lesion located in pons and developed Rathke cyst in pituitary gland at the same time, and unqualified for transfer to pilot modified high performance aircraft. The 2 of the 4 were unqualified for flying, and 2 transferred to air combat service division. The 2 pilots (cadets) with vascular malformation were identified as unqualified for transfer to pilot modified high p","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"638-643"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Carbon ion radiation therapy in prostate cancer: The importance of dosage.","authors":"Teeradon Treechairusame, Pahnwat T Taweesedt","doi":"10.4329/wjr.v16.i11.696","DOIUrl":"10.4329/wjr.v16.i11.696","url":null,"abstract":"<p><p>In this article, we comment on the article by Ono <i>et al</i>. We focus specifically on the carbon ion radiotherapy studies and the method to calculate the dosing schedule. While photon hypofractionated radiotherapy in prostate cancer has demonstrated improvement in tumor control with reduced gastrointestinal toxicity compared to conventional radiotherapy, carbon ion radiotherapy (CIRT) offers additional physical and biological advantages. Recent findings, including those from Ono <i>et al</i>, have established new dose constraints of CIRT for prostate cancer treatment and risk factors for rectal bleeding. Due to limited data on CIRT dosing, this study underscores the need for more research to refine dose calculation methods and better understand their effects on clinical outcomes.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"696-699"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qing-Biao Zhang, Dan Liu, Jun-Bang Feng, Chun-Qi Du, Chuan-Ming Li
{"title":"Relationship between pancreatic morphological changes and diabetes in autoimmune pancreatitis: Multimodal medical imaging assessment has important potential.","authors":"Qing-Biao Zhang, Dan Liu, Jun-Bang Feng, Chun-Qi Du, Chuan-Ming Li","doi":"10.4329/wjr.v16.i11.703","DOIUrl":"10.4329/wjr.v16.i11.703","url":null,"abstract":"<p><p>Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis with clinical symptoms of obstructive jaundice and abdominal discomfort; this condition is caused by autoimmunity and marked by pancreatic fibrosis and dysfunction. Previous studies have revealed a close relationship between early pancreatic atrophy and the incidence rate of diabetes in type 1 AIP patients receiving steroid treatment. Shimada <i>et al</i> performed a long-term follow-up study and reported that the pancreatic volume (PV) of these patients initially exponentially decreased but then slowly decreased, which was considered to be an important factor related to diabetes; moreover, serum IgG4 levels were positively correlated with PV during follow-up. In this letter, regarding the original study presented by Shimada <i>et al</i>, we present our insights and discuss how multimodal medical imaging and artificial intelligence can be used to better assess the relationship between pancreatic morphological changes and diabetes in patients with AIP.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"703-707"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick W O'Regan, Antonia Harold-Barry, Alexander T O'Mahony, Claire Crowley, Stella Joyce, Niamh Moore, Owen J O'Connor, Michael T Henry, David J Ryan, Michael M Maher
{"title":"Ultra-low-dose chest computed tomography with model-based iterative reconstruction in the analysis of solid pulmonary nodules: A prospective study.","authors":"Patrick W O'Regan, Antonia Harold-Barry, Alexander T O'Mahony, Claire Crowley, Stella Joyce, Niamh Moore, Owen J O'Connor, Michael T Henry, David J Ryan, Michael M Maher","doi":"10.4329/wjr.v16.i11.668","DOIUrl":"10.4329/wjr.v16.i11.668","url":null,"abstract":"<p><strong>Background: </strong>Incidental pulmonary nodules are an increasingly common finding on computed tomography (CT) scans of the thorax due to the exponential rise in CT examinations in everyday practice. The majority of incidental pulmonary nodules are benign and correctly identifying the small number of malignant nodules is challenging. Ultra-low-dose CT (ULDCT) has been shown to be effective in diagnosis of respiratory pathology in comparison with traditional standard dose techniques. Our hypothesis was that ULDCT chest combined with model-based iterative reconstruction (MBIR) is comparable to standard dose CT (SDCT) chest in the analysis of pulmonary nodules with significant reduction in radiation dose.</p><p><strong>Aim: </strong>To prospectively compare ULDCT chest combined with MBIR with SDCT chest in the analysis of solid pulmonary nodules.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on adult patients (<i>n</i> = 30) attending a respiratory medicine outpatient clinic in a tertiary referral university hospital for surveillance of previously detected indeterminate pulmonary nodules on SDCT chest. This study involved the acquisition of a reference SDCT chest followed immediately by an ULDCT chest. Nodule identification, nodule characterisation, nodule measurement, objective and subjective image quality and radiation dose were compared between ULDCT with MBIR and SDCT chest.</p><p><strong>Results: </strong>One hundred solid nodules were detected on ULDCT chest and 98 on SDCT chest. There was no significant difference in the characteristics of correctly identified nodules when comparing SDCT chest to ULDCT chest protocols. Signal-to-noise ratio was significantly increased in the ULDCT chest in all areas except in the paraspinal muscle at the maximum cardiac diameter level (<i>P</i> < 0.001). The mean subjective image quality score for overall diagnostic acceptability was 8.9/10. The mean dose length product, computed tomography volume dose index and effective dose for the ULDCT chest protocol were 5.592 mGy.cm, 0.16 mGy and 0.08 mSv respectively. These were significantly less than the SDCT chest protocol (<i>P</i> < 0.001) and represent a radiation dose reduction of 97.6%.</p><p><strong>Conclusion: </strong>ULDCT chest combined with MBIR is non-inferior to SDCT chest in the analysis of previously identified solid pulmonary nodules and facilitates a large reduction in radiation dose.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"668-677"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhsin Ozgun Ozturk, Mustafa Resorlu, Sonay Aydin, Kemal Bugra Memis
{"title":"Use of the vertebrae and iliac bone as references for localizing the appendix vermiformis in computed tomography.","authors":"Muhsin Ozgun Ozturk, Mustafa Resorlu, Sonay Aydin, Kemal Bugra Memis","doi":"10.4329/wjr.v16.i11.629","DOIUrl":"10.4329/wjr.v16.i11.629","url":null,"abstract":"<p><strong>Background: </strong>The appendix vermiformis is a part of the gastrointestinal tract, situated in the lower right quadrant of the abdomen. Acute appendicitis, acute inflammation of the appendix vermiformis, is the most common cause of acute abdomen requiring surgical intervention. Although computed tomography (CT) offers high diagnostic efficacy in assessing the appendix across various anatomical positions, it also involves radiation exposure. Reducing exposure factors and narrowing the field of view (FOV) are ways to decrease the radiation dose to the patient. To narrow the FOV, appendix locations within the population must be defined using metric markers.</p><p><strong>Aim: </strong>To determine the location of the appendix vermiformis on CT using the vertebrae and the right iliac bone as anatomical landmarks.</p><p><strong>Methods: </strong>This retrospective study examined 470 patients presenting with abdominal pain who underwent abdominal CT scans between January 01, 2015 and January 01, 2018. Forty-three patients were excluded due to various reasons. The most superior and inferior points and the origin of the appendix were measured separately in relation to the vertebrae and right iliac bone for localization. The population was divided into normal and acute appendicitis groups, and the relationship between appendix location and anthropometric parameters relationship was examined. <i>P</i> values below 0.05 were considered statistically significant.</p><p><strong>Results: </strong>The final analysis included 427 adult patients (206 females and 221 males) with a mean age of 42.1 ± 19.5 years. An ascending appendix course was the most common (90.4%). The appendix ranged from the L2 vertebral body level to the coccygeal vertebral level relative to the vertebrae. The appendix ranged between (-) 140.5 mm and (+) 87.4 mm relative to the right iliac bone. A negative correlation was found between patient age, height, body mass index, and the highest and lowest points of the appendix in regard to the vertebrae.</p><p><strong>Conclusion: </strong>The study's findings unveiled the locations of the appendix in the population in relation to the bony anatomical landmarks. These data can be used as the basis for future research aimed at reducing patient exposure to ionizing radiation.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 11","pages":"629-637"},"PeriodicalIF":1.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}