Computed tomography

An enhanced or unenhanced cranial routine investigation is used in order to establish the following diagnostics:

• Ischemic or hemorrhagic strokes
• Brain tumors

In case of craniocerebral traumas:

• The evaluation of the midline displacement
• The evaluation of the perimesencephalic cisterns
• The diagnostic of the cerebral edema, brain concussion, edematous/bleeding diffuse axonal injuries, brain deceleration, post traumatic intraparenchymal hematoma, subdural/extradural hematoma (acute, subacute, chronic), intraventricular hemorrhage, subarachnoid hemorrhage
• The diagnostic of skull base trauma
• The diagnostic of the CSF fistula
• The diagnostic of cerebral hernia
• The diagnostic of fractures:
• • Single fracture
  • Multiple fractures
  • Depressed fractures
  • Complex frontal sinus fractures
  • Complex ethmoid fractures
  • Complex orbital fractures
  • Complex craniofacial fractures
• Ischemic or hemorrhagic strokes
• Brain tumors:
• • Subdural empyema
  • Brain abscess
  • Carotid-cavernous fistula
  • Hygroma
  • Regional brain atrophy

• Inflammatory or infectious pathology
• Tumor pathology: pharynx, larynx, glom, secondary determinations

• Pulmonary pathology
• Pleural pathology

Indications:

• For the diagnostic of abdominal or pelvic pathologies;
• Liver, spleen, kidneys or other organs diseases, as well as their post-traumatic injuries;
• Preoperative and postoperative interventions, such as organ transplants and gastric bypass;
• Pre- and post- radiotherapy or chemotherapy in patients with cancer (the evaluation of the response factor);
• In infections such as: appendicitis, diverticulitis, pyelonephritis, abscess, etc.
• In inflammatory processes: pancreatitis, cirrhosis, Crohn disease;
• In oncologic diseases: colon cancer, liver cancer, kidney cancer, pancreatic cancer, lymphoma, etc.
• Renal colic;
• Abdominal aortic aneurysm and other vascular diseases.

Indications:

• For the diagnostic of abdominal or pelvic pathologies;
• Liver, spleen, kidneys or other organs diseases, as well as their post-traumatic injuries;
• Preoperative and postoperative interventions, such as organ transplants and gastric bypass;
• Pre- and post- radiotherapy or chemotherapy in patients with cancer (the evaluation of the response factor);
• In infections such as: appendicitis, diverticulitis, pyelonephritis, abscess, etc.
• In inflammatory processes: pancreatitis, cirrhosis, Crohn disease;
• In oncologic diseases: colon cancer, liver cancer, kidney cancer, pancreatic cancer, lymphoma, etc.
• Renal colic;
• Abdominal aortic aneurysm and other vascular diseases.

It is the most used in order to find the post traumatic injuries of the spine.

Indications:

• Pre- and post- operative examination of the spine;
• Various tumor diseases of the spine including those invading the spine with starting point in other regions or organs;
• Vertebral metastases (prostate cancer);
• To diagnose the cause of the spinal pain, most commonly due to a herniated intervertebral disc;
• To measure the vertebral density of the osteoporotic patient (in order to predict what are the regions with higher fracture risk due to the osteoporosis) – by means of the quantitative CT;
• Malformations;
• Fractures, deformities, infections, arthritis.

The slow heart rate, the use of the 4D care-dose (the modulation of the power in the tube depending on the thickness of the examined area), the use of the modulated ECG scanning (120kV or 100 kV scanning for the patients with lower rate in the range of 60-70% of the cardiac cycle, and for the rest of the patients, the scanning with 20% of the tube power) and the limitation of the FOV to 12-14 cm enables the obtaining of the coronary CT angiography with a dose of 6-8 mS (the background natural radiation if of 2.5 mS/year for Europe).

The procedure is useful due to the details offered in case of the following:

• The investigation of the coronary arteries and the quantification of the stenosis
• The investigation of the bypasses
• The investigation of the stents
• The view of the vascular walls and the changes undergone by them during the pathological process of positive reshaping which implies the presence of the atheromatous plaque without the effect of the lumen decrease, but with an unpredictable development potential.
• The study of the atheromatous plaques, by showing the difference between the fibrous plaques and the lipid rich plaques
• The examination of the left ventricular function: ejection fraction, end systolic volume, end diastolic volume, the kinetic of the intraventricular septum and ventricular walls
• The highlighting of the pacemaker probes, cine (movie) reconstructions for the study of the ventricular walls (useful in case of ventricular walls aneurysmus)
• The investigation of congenital heart disease, heart formations and heart valve diseases
• The morphological evaluation of a complex anatomy organ
• The evaluation of coronary calcifications (Agatston calcium score), the deceleration of the heart valve calcifications and the evaluations of the small vessels
• The evaluation of the pulmonary and systemic circulation

CT angiography types:

• Cerebral CT angiography
• Cervical CT angiography
• Thorax CT angiography
• Abdomen CT angiography
• Pelvis CT angiography
• Upper limb CT angiography
• Peripheral CT angiography

• bone subtraction cerebral angiography (NeuroDSA) – for the diagnostic of the arteriovenous malformations and aneurysms
• carotid arteries angiography – emphasizing and quantification of the stenoses and details of the atheromatous plaque
• thoracic aorta angiography – to diagnose aneurysms, dissections, coarctation
• large pulmonary vessels in order to emphasize pulmonary embolism
• abdominal aorta and large arterial trunks angiography
• renal artery angiography
• upper or lower limbs angiography

Virtual colonoscopy or CT colonography is the imaging investigation procedure of the colon. This is a minimally invasive method that does not require anesthesia and consists in blowing air in the colon by means of a transrectal small cannula. In order to accurately identify the injuries, the colon must be prepared before the investigation by an appropriate diet and laxatives administration.

The indications of the method are the following:

• Polyp detection/asymptomatic patients screening;
• Detection of tumor formations;
• Colon visualization after an incomplete optical colonoscopy;
• Evaluation of the colon in elderly patients with chronic diseases in which cases the anesthesia is contraindicated;
• Postoperative monitoring of the colon.

Furthermore, this investigation offers further information in what concerns the extracolonic injuries of the abdominopelvic organs.

The virtual bronchoscopy enables the navigation through the bronchial tract and the detection of the stenosis injuries, of the bronchial polyps and the precise localization of the injury.

LungCARE – an acquisition dedicated to the detection and evaluation of the pulmonary nodular injuries (volume, size of the 3 axes, medium densities, histograms) and their time tracking.

Dental CT is a special program to examine the mandible and maxilla by processing the information obtained following the CT scanning of the maxilla and mandible with sections of 1 mm thickness, parallel to the alveolar ridge or to the dental plan, by providing images in 3 plans (axial, coronal and sagittal plan). The coronal sections and the oblique sagittal sections obtained enable the view of the bone topography and the mandibular canal, the mental foramen, incisive canal and maxillary sinuses.

The obtained images are transferred on the workstation in order to perform the multiplanar reconstructions. The reconstructions for the mandible and maxilla are performed separately.

Dental CT is the election method in case of preoperative examination of the candidates in case of dental implant, due to the fact that the method enables the evaluation of the bone quality and quantity, the measuring of the thickness and height of the alveolar ridge and the accurate identification of the associated pathology.

The method is extremely useful due to the multiplanar reconstructions in the diagnostic of the inflammatory, endodontic, and periodontal diseases, of the tumors and cysts. Furthermore, the CT dental method is very useful for the postoperative monitoring of the maxilla and mandible.

• for traumas discovered during the thorax, sternum and thoracic spine scanning, including patients with osteosynthesis material (cage, screw plates)

• by highlighting the ureters and bladder path (virtual cistoscopy)

Entero CT is a method used to examine the small intestine.

This method is primarily used in the evaluation of Crohn disease (the activity of Crohn disease, the number of intestinal loops involved in the inflammatory process, the length of the inflammatory process, fistulas, adenopathies.Furthermore, the Entero CT – has an important role in detecting other pathologies such as: Meckel diverticulum, gastrointestinal stromal tumors, intestinal lymphoma, neuroendocrine tumors of the gastrointestinal tract, adenocarcinoma of the small intestine, rotation and fixation abnormalities of the gastrointestinal tract and small intestine intussusception caused by polyps.

Entero CT enables the visualization of the following: bone involvement (i.e. sacroiliac) that may be the cause of some inflammatory intestinal diseases, as well as the origin of a bleeding.

These images allow you to undergo coronal and sagittal reconstructions, the surgeons using them as maps.

All this information is reliable, reproducible and simple for the field of the surgeries.

• Useful in stroke and for the evaluation of the tumor formations

• For the tumor formations and mediastinal and pulmonary parenchymal adenopathies

• Parenchymal organs perfusion study in order to highlight the vascularization of tumor formations (flow, volume, ALP-arterial liver perfusion, PVP-portal venous liver perfusion, HPI-hepatic perfusion index)

• including in patients with osteosynthesis materials in which cases the fracture of the osteosynthesis material can be detected
• the existence of special trauma protocols that allow the scanning of 5 segments within no more than 2 minutes as of the patient’s introduction in the medical device

• The existence of pediatric protocols, that beside CARE DOSE (the program intending to modulate the radiation dose depending on the scanned area), use low kilovoltage and milliamperage.