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Related Concept Videos

Computed Tomography01:10

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
Imaging Studies I: CT and MRI01:14

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Introduction: MRI and CT scans are crucial advancements in medical imaging techniques, playing a vital role in diagnosing conditions related to the gastrointestinal (GI) system. Each scan serves distinct purposes, targets specific areas, and requires unique nursing duties.
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Computed tomography celiac trunk topography relating to celiac plexus block.

Ian Y Yang1, Saeed Oraee, Carlos Viejo

  • 1Department of Anesthesiology and Pain Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Grand Concourse, Bronx, NY 10457, USA. iyangmd@yahoo.com

Regional Anesthesia and Pain Medicine
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Celiac plexus blocks using the celiac trunk landmark risk vital organ injury due to anatomical variations. Pre-procedural computed tomography (CT) imaging is recommended for safe needle placement during celiac plexus blocks.

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Area of Science:

  • Radiology
  • Anatomy
  • Pain Management

Background:

  • The celiac plexus, a key autonomic network, is targeted for pain management via blocks using the celiac trunk as a landmark.
  • Needle placement techniques, particularly the
  • walking-off
  • method, may lead to inadvertent puncture of adjacent organs due to anatomical variability.

Purpose of the Study:

  • To investigate the topography of the celiac trunk and surrounding structures using computed tomography (CT) imaging.
  • To assess the risk of vital organ traversal during simulated celiac plexus block needle placement.

Main Methods:

  • Review of 200 computed tomography (CT) images to analyze celiac trunk emergence, aortic location, and vertebral anatomy.
  • Simulation of needle trajectories using the
  • walking-off
  • technique at fixed distances from the midline (L-9s and L-4.5s).
  • Identification and analysis of vital organs traversed by simulated needle paths.

Main Results:

  • Significant variability in celiac trunk emergence levels (T11-L1) and its relationship with the aorta and vertebrae.
  • High rates of simulated needle trajectories traversing vital organs: 88% and 96% for L-9s (right and left), and 64% and 88% for L-4.5s (right and left), respectively.
  • Demonstrated frequent overlap between simulated needle paths and organs such as the liver, spleen, pancreas, and kidneys.

Conclusions:

  • Anatomical variations of the celiac trunk and surrounding structures are common.
  • Standardized needle insertion techniques for celiac plexus blocks carry a significant risk of injuring adjacent vital organs.
  • Individualized pre-procedural CT imaging and simulated needle placement are crucial for optimizing safety and efficacy in celiac plexus blocks.