Herpes simplex virus (HSV) is a rare cause of hepatitis in pregnancy and the chronically immunosuppressed, with a high propensity to progress to acute liver failure (ALF) and death. Patients typically present with a nonspecific clinical picture that often delays diagnosis and treatment, contributing to the high mortality rate. We present a case of a young female on chronic prednisone and hydroxychloroquine for systemic lupus erythematosus (SLE) who was diagnosed with HSV-2 hepatitis after presenting with right-sided chest and abdominal discomfort. Despite early clinical deterioration, prompt initiation of therapy with intravenous acyclovir and methylprednisolone led to rapid improvement.
Primary cardiac angiosarcoma (PCAS) is a malignancy seldom seen in pregnancy. A 23-year-old G1P0 Chinese female was found to have PCAS during her first trimester when she presented with tamponade physiology. The transthoracic echocardiography (TTE) results did not indicate the presence of an intracardiac lesion, and pericardial fluid cytology analysis showed no evidence of malignancy. Cardiac magnetic resonance imaging (CMRI) exhibited a right atrial mass, and tissue biopsy indicated a high-grade angiosarcoma. MRI of the abdomen was suggestive of liver metastasis. She underwent an abortion and was started on combination chemotherapy, with a reduction in both the cardiac and liver masses. In cardiac angiosarcomas, advanced imaging modalities such as MRI should be utilised when there is high clinical suspicion or in the case of pregnancy when trying to minimise foetal harm. Prognosis is poor, and a standardised treatment protocol regardless of pregnancy continues to elude the medical community.
Background
Artifacts have significantly degraded the quality of computed tomography (CT) images, to the extent of making them unusable for diagnosis. The types of artifact that could be used are as follows: (a) streaking, which is commonly due to a discrepancy in a single measurement, (b) shading, which is due to a group of channels deviating gradually from the true measurement, (c) rings, which are due to errors in individual detector calibration and (d) distortion, which is due to helical reconstruction. It is occasionally possible to avoid scanning of a bony area, by means of changing the postion of the patient. Thus, this study aimed to evaluate the common artifacts that affect image quality and the method of correction to improve image quality.
Results
The data were collected by distributing a questionnaire to the CT technologist at different hospitals about the most common type of artifacts in the CT images, source of artifacts and methods of correction. A total of 95 CT technologists responded to the questionnaire, which included 67% males and 33% females. Most of the participants (70%) were experienced CT technologists, and 61% of the participants had not done any subspecialty CT scan courses. The most common artifact used in the CT departments was motion artifact in brain CT (73%), and the best method to reduce motion artifact was patient preparation (87%).
Conclusions
The most common shown artifact in this study was motion artifact, and the common cause was the patient-based artifact. It is important to understand why objects occur and how they could be prevented or suppressed to improve image quality.
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