Background: Considering the importance of using more appropriate imaging technique for accurate diagnosis of PULMONARYthromboembolism (PTE) with less side effects, we aimed to evaluate the quality of PULMONARY 64-multidetector COMPUTEDTOMOGRAPHIC (MDCT) ANGIOGRAPHY in pregnant and postpartum women with suspected PTE in Isfahan. Materials and Methods: In this descriptive study, radiological findings of pregnant and postpartum women with suspected PTE who underwent PULMONARY64-MDCT ANGIOGRAPHY were evaluated. Prevalence of PTE in pregnant and postpartum women, mean of PULMONARY arteries densityfor right and left PULMONARY arteries, and their lobar and segmental branches, diagnostic quality of the PULMONARY arteries density andtheir scoring, frequency of diagnostic and nondiagnostic images, mean of radiation dose and mean of bolus time, and the correlationbetween the quality of the vascular density with the peak density of the PULMONARY artery were determined.Results: In this study, 44 pregnant and postpartum women with suspected PTE were selected. The overall prevalence of PTE was 9.1% (4.44). PTE wasdiagnosed in 1 (3.7%) pregnant and 3 (17.5%) postpartum women (P=0.14). Mean density of PULMONARY trunk was 278.81 ± 108.16Hounsfield unit (HU) and 308.41 ± 59.30 HU in pregnant and postpartum women, respectively. Mean of bolus timing, kilovoltagepeak (kVp), tube current, and dose length product (DLP) were 12.53 ± 2.36 s, 105.22 ± 45.71 milliamperage (MA), 382.9 ± 173.5MA, and 317.98 ± 78.92 mGy/cm, respectively. The rate of nondiagnostic images was 4.5%.Conclusion: Our findings indicatedthat PULMONARY 64-MDCT ANGIOGRAPHY is an appropriate imaging method for diagnosing PTE in pregnant and postpartum womenwith suspected PTE. It seems that, using fast CT systems (64-MDCT), in accordance with high flow rate, high contrast mediumconcentration and low kVp could explain the obtained appropriate quality of images more efficiently than COMPUTED TOMOGRAPHICPULMONARY ANGIOGRAPHY ((CTPA)).

Background: COMPUTED tomography PULMONARY ANGIOGRAPHY ((CTPA)) is an imaging technique widely used in the diagnosis of acute PULMONARY thromboembolism (PTE). Despite its disadvantages and potential risks, the overuse of (CTPA) has been a growing concern over the past decades. Objectives: The objective of this study was to investigate the rate of avoidable overuse of (CTPA) in patients with suspected PTE and to identify factors contributing to this overuse. The study aimed to highlight the importance of proper training for physicians in using validated diagnostic algorithms to minimize the overuse of (CTPA) and improve patient outcomes. Methods: In a cross-sectional study conducted between April 2016 and March 2019 at Shariati Hospital at Tehran University of Medical Sciences (TUMS), 1058 patients underwent (CTPA) due to suspected PTE. Wells scores were calculated retrospectively for all patients. The study defined avoidable overuse of (CTPA) as an imaging request without prior D-dimer testing or ignoring a negative D-dimer result in patients with low clinical pre-test probability. Results: Two hundred and seventy-three patients were excluded from the study due to unavailable documentation or pregnancy. Among the included 785 patients, 139 (17.7%) revealed PTE on (CTPA). Based on the Wells scores, 480 patients were identified as the “PTE-unlikely” group. In this group, 299 patients (62.3%) underwent (CTPA) directly despite recommendations to order a D-dimer test first. Of these patients, 281 (94%) cases showed negative results. Moreover, (CTPA) was performed inappropriately in 52 “PTE-unlikely” cases despite negative D-dimer serum levels, and only one patient was diagnosed with PTE. Conclusions: The study revealed that 44.7% of the (CTPA) requests for patients with suspected PTE were avoidable, indicating the need for better adherence to current diagnostic guidelines to reduce unnecessary radiologic investigations and improve patient care.

Background and Objective: Since accurate and quick clinical and paraclinical diagnostic methods are not available, in some cases diagnosis of active PULMONARY tuberculosis occurs after considerable time from the onset of disease. This study was designed to determine the diagnostic value of High Resolution COMPUTED TOMOGRAPHIC (HRCT) scan in active PULMONARY tuberculosis, in Gorgan, Golestan province, North of Iran.Materials and Methods: This diagnostic screening study was carried out on 135 (79 male and 56 female) hospitalized patients suspected with active PULMONARY tuberculosis, and HRCT was used in their course of treatment as recommendation of their clinician. The patients were chosen from 5th Azar hosptial during 2009-10. Also it should be mentioned that patients were selected on avaliabity bases, and they were examined by smear, and sputum culture. The patients with negative smear and culture were set up as true healthy group (64 subjects). The lung or small nuddles in HRCT was considered as proper position of lung involvument in active lung PULMONARY. The HRCT findings between the case group (71 subjects) and healthy group were compared. According to HRCT findings, the sensitivity and specifity were determined for each patient. Data were analyzed using SPSS-16 and Chi-Square test.Results: In this study, sensitivity, specificity, positive predictive value and negative predictive value of HRCT in active PULMONARY tuberculosis were equal to 97.2%, 71.9%, 79.3% and 95.8% respectively. Involvement of upper and middle lobe of the right lung and upper lobe of the left lung were significantly higher than the control group (P<0.05).Conclusion: This study showed that HRCT has high sensitivity and specificity in diagnosis of active PULMONARY tuberculosis and can be used as a quick diagnostic way in active PULMONARY tuberculosis, especially in patients with strong clinical suspicion and negative smear.

Background/Objective: Multislice COMPUTED TOMOGRAPHIC (MSCT) ANGIOGRAPHY is a rapid and minimally invasive method for the detection of intracranial aneurysms. The purpose of this study was to compare MSCT ANGIOGRAPHY with digital subtraction ANGIOGRAPHY (DSA) in the diagnosis of cerebral aneurysms. Patients and Methods: In this cross sectional study we evaluated 111 consecutive patients [42(37.8%) male and 69(62.2%) female], who were admitted under clinical symptoms and signs, suggestive of harboring an intracranial aneurysm by using a four detector MSCT ANGIOGRAPHY. Then we compared results of MSCT ANGIOGRAPHY with DSA results as a gold standard method. DSA was performed by bilateral selective common carotid artery injections and either unilateral or bilateral vertebral artery injections, as necessary. MSCT ANGIOGRAPHY images were interpreted by one radiologist and DSA was performed by another radiologist who was blinded to the interpretation of the MSCT angiograms. Results: The mean±SD age of the patients was 49.1±13.6 years (range: 12-84 years). We performed MSCT in 111 and DSA in 85 patients. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratio (LR) of MSCT ANGIOGRAPHY, when compared with DSA as the gold standard, were 100%, 90%, 87.5%, 100%, 10 and 0, respectively.Conclusion: MSCT ANGIOGRAPHY seems to be an accurate and non-invasive imaging modality in the diagnosis of intracranial aneurysms.

Background: There is a lack of evidence on the link between mitral annular calcification (MAC) and coronary atherosclerotic diseases. The present investigation was undertaken to detect the clinical and prognostic value of MAC in coronary atherosclerotic diseases in patients who underwent coronary COMPUTED TOMOGRAPHIC (CT) ANGIOGRAPHY. Materials and Methods: Two hundred and five individuals with MAC and without it (n = 85 and 120, respectively) were included in the present cross? sectional study. Coronary artery disease? reporting and data system (CAD? RADS) at coronary CT ANGIOGRAPHY was used to define the severity of coronary atherosclerotic diseases. Patients were classified into no or non? significant CAD (CAD? RADS 0–2) and significant CAD (CAD? RADS 3–5) according to the severity of coronary atherosclerotic diseases. The association of MAC with two mentioned groups (no or non? significant CAD and significant CAD) was assessed using the Chi? squared test and logistic regression in crude and adjusted models. Results: Patients with MAC were significantly older (69. 34 ± 8. 20 vs. 60. 64 ± 11. 42, P < 0. 001), had lower glomerular infiltration rate (69. 67 ± 20. 92 vs. 78. 00 ± 20. 23, P = 0. 005), and higher coronary artery calcification score (352. 87 ± 495. 85 vs. 200. 55 ± 426. 13, P = 0. 05) in comparison to those without MAC. However, the significant difference between the two groups regarding coronary artery alcification score disappeared after adjustment for confounders (P = 0. 14). In addition, a statistically significant positive link between MAC and significant CAD was observed (odds ratio [OR] [95% confidence interval (CI)]: 1. 96 [1. 04–3. 71], P = 0. 04). Nevertheless, the association became statistically insignificant after adjustment for confounders (OR [95% CI]: 1. 60 [0. 78–3. 28], P = 0. 2). Conclusion: The findings of the study revealed that MAC has no independent prognostic value in coronary atherosclerotic diseases evaluated by coronary CT ANGIOGRAPHY.

Background: PULMONARY embolism (PE) is one of the major causes of maternal mortality; however, its diagnosis based on clinical presentation is a significant challenge; therefore, imaging is required. This study aims to determine the nondiagnostic rate of PE in pregnant women who initially undergone COMPUTED TOMOGRAPHIC PULMONARY ANGIOGRAPHY ((CTPA)) or perfusion scan. Materials and Methods: In this cross‑ sectional study, all pregnant or 6‑ week postpartum women with clinical suspicion of PE were evaluated and underwent (CTPA) or perfusion scan between March 2017 and June 2019. The nondiagnostic rate of each method was defined as the outcome of this study. Results: One hundred and eighty‑ two women with a clinical suspicion of PE were included, among which the initial imaging method was (CTPA) in 122 (67. 03%) and perfusion scan in 60 (32. 97%) women. The nondiagnostic imaging for (CTPA) was significantly lower than the perfusion scan (9 cases (7. 4%) versus 25 cases (41. 7%), respectively). Logistic regression assessment revealed a statistical outcome by controlling the confounders including gestational trimester at diagnosis, hypertension, ejection fraction, and tachycardia (odds ratio 15. 911, 95% confidence interval: 5. 177– 48. 897, P < 0. 001). Conclusion: Based on the current study, (CTPA) is superior to perfusion scans to diagnose PE among pregnant or postpartum women with normal chest X‑ ray suspicion for PE.

Introduction: PULMONARY embolism (PE) is a common lethal disease that itsclinical symptoms may be seen in many other diseases. COMPUTED tomographyPULMONARY ANGIOGRAPHY ((CTPA)) is a valuable diagnostic modality for detection ofPE. In addition, it can accurately detect the other diseases with clinical symptomssimilar to PE. The aim of this study is to evaluate the frequency of PE and nonembolicdisease with similar clinical symptoms including PULMONARY, pleural, mediastinal, and cardiovascular diseases that have been detected by (CTPA) and todescribe the importance of reporting these CT findings.Materials and Methods: In this cross‐sectional study, we evaluated the medicalrecords of (CTPA) in 300 patients of suspected PE between March 2012 andFebruary 2013 in Imam Reza Hospital and Ghaem Hospital in Mashhad Universityof Medical Sciences, Mashhad, Iran. Demographic information and the results of(CTPA) of these patients were re‐evaluated. One radiologist reviewed all of the(CTPA) and the results have been analyzed by SPSS‐16 software.Results: In this study, PE was detected in 18.7% of patients. Multiple incidentalimaging findings were diagnosed as follow: PULMONARY consolidation (33.2%), pleural effusion (48.7%), PULMONARY nodules (10%), PULMONARY masses (1.3%), pneumothorax (4.7%), mediastinal mass and lymphadenopathy (9.3%), aorticcalcification (42%), coronary arteries calcification (27.3%), mitral valvecalcification (2 %), cardiomegaly (30.7%), and the evidences of right ventriculardysfunction (6.7%).Conclusion: A group of disease can cause the clinical symptoms similar to that ofPE. Among them, PULMONARY consolidation and pleural effusion have much higherfrequency than PE. In addition, (CTPA) can show pathologic findings in the patientsthat need follow‐up. It is important to detect and report these imaging findingsbecause some of them may change the treatment and prognosis of patient who aresuspected to have PE.

Background: Conventional ANGIOGRAPHY, generally referred to as intra-arterial digital subtraction ANGIOGRAPHY, still remains the gold standard reference method for the diagnosis of intracranial aneurysms, helical COMPUTED tomography ANGIOGRAPHY (CTA) is a new non-invasive volumetric imaging method.Objectives: This study was conducted to screen patients presenting with subarachnoid hemorrhage by CTA before conventional digital subtraction ANGIOGRAPHY (DSA) and subsequently comparing the results for various aneurysm projections.Patients and Methods: In a prospective study, 99 consecutive patients with an initial diagnosis of subarachnoid hemorrhage were screened for aneurysms with CTA followed by conventional DSA. There were 17 cases with negative angiograms in whom repeat angiograms, three months later were negative for 15 cases, while two cases were found to bear aneurysm on the repeat examination. Eighty two patients had at least one proven aneurysm on initial DSA and two on the repeat angiogram. Out of 84 patients, five underwent endovascular treatment and 79 patients who underwent surgical clipping were considered for projection evaluation.Results: Sensitivity of CTA was 98.78% (95% confidence interval (CI), 93.4-99.7%), while the specificity was 100% (95% CI, 81.57-100%) and the kappa coefficient of agreement between CTA and DSA was 96.5%. The most significant discrepancies with DSA findings were for visualizing the projection of inferior and posterior projecting proximal anterior circulation aneurysms.Conclusions: Helical CTA was in good concordance with DSA for screening of cerebral aneurysms; however, for exact visualization of the aneurysm neck and its projection, especially if it is inferior or posterior, DSA remains the gold standard.