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Duplex kidney is a urinary tract anomaly commonly associated with a wide range of primary and secondary parenchymal structural abnormalities. We present a unique comparison of US and MRI findings with histopathology following partial resection of duplex kidneys due to nephropathy. We examined a group of 21 children with duplex kidneys who were qualified for heminephrectomy (24 kidney units (KU)). All patients underwent US and MRI prior to the surgery. The imaging results were compared with histopathologic findings. In 21/24 KU, dysplastic changes were found on histopathology, including all with obstructive nephropathy and 7/10 specimens with refluxing uropathy. The loss of corticomedullary differentiation on US and increased signal on T2-weighted images (T2WI) on MRI were the imaging findings that best correlated with fibrosis. In children with megaureter, there were no statistical differences in histopathological findings between primary megaureter, megaureter with ureterocele, and megaureter with ectopia (p > 0.05). The extent of dysplasia of the affected pole correlated negatively with residual function in MRI. Kidney dysplasia and inflammation in the kidney with obstructive nephropathy are the most important histopathologic findings of this study. US is a valuable screening tool, and MRI enables morphologic and functional assessments of the nephropathy in duplex kidneys.

Background: Computed tomography (CT) contributes significantly to the collective dose from medical sources, raising concerns about potential health risks. However, existing radiation dose estimation tools, such as volume computed tomography dose index (CTDIvol), dose-length product (DLP), effective dose (ED), and size-specific dose estimate (SSDE), have limitations in accurately reflecting patient exposure. This study introduces a new parameter, size-specific dose-length product (DLPss), aiming to enhance the precision of radiation dose estimation in real-life scenarios. Methods: A retrospective analysis of 134 chest CT studies was conducted. Relationships between CTDIvol and anthropometric parameters were examined, and SSDE was calculated based on effective diameter. Additionally, the novel parameter, DLPss, was introduced, considering scan length and cross-sectional dimensions. Results: Analysis reveals variations in scan length, effective diameter, and CTDIvol between genders. Strong correlations were observed between CTDIvol and effective diameter, particularly in men. The average CTDIvol for the entire group was 7.83 ± 2.92 mGy, with statistically significant differences between women (7.38 ± 3.23 mGy) and men (8.30 ± 2.49 mGy). SSDE values showed significant gender differences, with men exhibiting higher values. The average SSDE values for women and men were 9.15 ± 2.5 mGy and 9.6 ± 2.09 mGy, respectively, with a statistically significant difference (p = 0.03). The newly introduced DLPss values ranged around 343.90 ± 81.66 mGy·cm for the entire group, with statistically significant differences between women (323.53 ± 78.69 mGy·cm) and men (364.89 ± 79.87 mGy·cm) (p < 0.05), providing a comprehensive assessment of total radiation dose. Conclusion: The study highlights the need for accurate radiation dose estimation, emphasizing the impact of CT examination parameters on dose variability. The proposed DLPss parameter offers a promising approach to enhancing precision in assessing radiation risk during CT scans. Further research is warranted to explore additional parameters for a comprehensive understanding of radiation exposure and to optimize imaging protocols for patient safety.

Failure of the blood-brain barrier (BBB) is a critical event in the development and progression of diseases such as acute ischemic stroke, chronic ischemia or small vessels disease that affect the central nervous system. It is not known whether BBB breakdown in subjects with chronic carotid artery stenosis can be restrained with postoperative recovery of cerebral perfusion. The aim of the study was to assess the short-term effect of internal carotid artery stenting on basic perfusion parameters and permeability surface area-product (PS) in such a population. Forty subjects (23 males) with stenosis of >70% within a single internal carotid artery and neurological symptoms who underwent a carotid artery stenting procedure were investigated. Differences in the following computed tomography perfusion (CTP) parameters were compared before and after surgery: global cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP) and PS. PS acquired by CTP is used to measure the permeability of the BBB to contrast material. In all baseline cases, the CBF and CBV values were low, while MTT and TTP were high on both the ipsi- and contralateral sides compared to reference values. PS was approximately twice the normal value. CBF was higher (+6.14%), while MTT was lower (−9.34%) on the contralateral than on the ipsilateral side. All perfusion parameters improved after stenting on both the ipsilateral (CBF +22.66%; CBV +18.98%; MTT −16.09%, TTP −7.62%) and contralateral (CBF +22.27%, CBV +19.72%, MTT −14.65%, TTP −7.46%) sides. PS decreased by almost half: ipsilateral −48.11%, contralateral −45.19%. The decline in BBB permeability was symmetrical on the ipsi- and contralateral sides to the stenosis. Augmented BBB permeability can be controlled by surgical intervention in humans.