654 results on '"Multidetector Computed Tomography"'
Search Results
2. Which vendor is most cited in the hepatic imaging literature?
- Author
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Rezvani Habibabadi R, Huntley JH, Jalilianhasanpour R, and Yousem DM
- Subjects
- Humans, Liver diagnostic imaging, Ultrasonography, United States, Diagnostic Imaging, Radiology
- Abstract
Purpose: When deciding among imaging equipment vendors, one may use a vendor's prevalence in peer-reviewed publications as a measure of their research and development. We sought to determine which vendors, countries, and journals were dominant in hepatic imaging literature of 2018 with respect to magnetic resonance (MR), computed tomography (CT), and ultrasound (US)., Methods: We recorded and analyzed the modality (MR, CT, US), journal, vendor, and authors' country for all original hepatic imaging articles published in 2018 in 29 imaging journals., Results: Of 197 MR articles, investigators used Siemens in 98 (50%), General Electric (GE) in 65 (33%), and Philips in 63 (32%). Of 115 CT articles, investigators mentioned Siemens in 55 (48%), GE in 45 (39%), Philips in 25 (22%) and other vendors in 27 (24%). Of 68 ultrasound articles, Siemens dominated with 27 (40%), versus GE with 19 (28%), Philips with 11 (16%), and other vendors with 42 (62%). We found a significant difference in vendor usage for MR, CT, and all modalities (p < .01). The plurality of articles was written in the United States (73 [23%]) with South Korea (56 [17%]) and China (56 [17%]) following. European Radiology published the most hepatic articles. For American journals, we found a significant difference in MR (p = .02) and CT (p < .01) vendor usage, whereas non-American journals nearly reached significance in MR (p = .06) and CT (p = .06) vendor usage., Conclusion: Siemens was the most cited vendor in hepatic imaging literature for all modalities. American institutions and non-American journals published the most hepatic imaging articles., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
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3. Adult obstructive sleep apnoea: Pathogenesis, importance, diagnosis and imaging.
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Whyte A and Gibson D
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- Adult, Humans, Polysomnography methods, Sleep Apnea, Obstructive diagnostic imaging, Diagnostic Imaging methods, Respiratory System diagnostic imaging, Sleep Apnea, Obstructive diagnosis, Sleep Apnea, Obstructive pathology
- Abstract
Obstructive sleep apnoea (OSA) is a serious worldwide health problem. Moderate-to-severe OSA has been found in up to 50% of men and 25% of women in the middle-aged population. It results in a fourfold increase in all causes of mortality. The prevalence of OSA is underestimated, partly due to absence of symptoms but also lack of knowledge amongst the population at large as well as sectors of the medical profession. Imaging, performed predominantly by clinicians and research scientists, has been integral to evaluating the anatomical basis of OSA. Increased nasal resistance and a narrowed and elongated oropharynx lead to increased collapsibility of the upper airway, predisposing to airway collapse and apnoea during sleep when there is reduction in tone of the pharyngeal dilator muscles. Unfortunately, a significantly narrowed upper airway is usually ignored by radiologists: it is not part of their reporting 'check-list'. The imaging findings in the upper airway that are strongly associated with OSA and its sequelae in various organ systems are discussed. Imaging can strongly suggest OSA; the diagnosis requires a polysomnogram for confirmation. Treatment of moderate-to-severe disease is primarily with positive airway pressure applied by a nasal or oral mask which splints the upper airway. Although highly effective, compliance is limited and other treatment modalities are increasingly being utilized., (© 2019 The Royal Australian and New Zealand College of Radiologists.)
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- 2020
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4. [Imaging Diagnosis and Interventional Radiology for Thoracic Surgery].
- Author
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Takase K
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- Contrast Media, Cryosurgery methods, Diagnostic Imaging trends, Electrocardiography, Embolization, Therapeutic methods, Humans, Lymphography methods, Multidetector Computed Tomography, Radiofrequency Ablation methods, Radiology, Interventional, Thoracic Duct, Tomography, X-Ray Computed, Diagnostic Imaging methods, Thoracic Surgery methods
- Abstract
Recent introduction of multidetector-row computed tomography(MDCT) with more than 64 scanners enabled high-speed scanning in wide range of the body. Electrocardiogram (ECG) gated scanning and 4-dimensional imaging provides precise evaluation of cardiac and vascular diseases. Fine vascular structures such as the artery of Adamkiewicz can be visualized due to improved spatial and temporal resolution of CT and magnetic resonance imaging(MRI). Interventional radiology also plays important roles in combination with surgical treatment. Complicated vascular embolization before and after surgery can be performed more safely using current microcatheters with increased flexibility and trackability and various kinds of detachable coils. Chylothorax also come to be treated by interventional radiology. Transnodal lymphography can visualize lymphatic leak followed by thoracic duct embolization. Radiofrequency ablation and cryoablation for thoracic tumors, which is usually performed by real-time CT fluoroscopy, is expected to be officially approved. Newly developed techniques will further improve thoracic imaging diagnosis. Dual energy CT technology and new reconstruction technique can decrease the radiation dose without deteriorating image quality. Iodine imaging by dual energy CT can visualize vascular perfusion. Four-dimensional flow image of MRI can image vascular flow-dynamics without using contrast material.
- Published
- 2018
5. The Pivotal Role of Imaging in TAVR Procedures.
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Bleakley C and Monaghan MJ
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- Aortic Valve diagnostic imaging, Aortic Valve pathology, Coronary Angiography, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Humans, Multidetector Computed Tomography, Prosthesis Design, Prosthesis Fitting methods, Aortic Valve Stenosis surgery, Diagnostic Imaging methods, Transcatheter Aortic Valve Replacement methods
- Abstract
Purpose of Review: Transcatheter aortic valve replacement (TAVR) is underpinned by an array of imaging techniques designed to not only select an appropriately sized implant but also to identify potential obstacles to procedural success. This review presents currently important aspects of TAVR imaging, describing the salient features of each modality as well as recent developments in the field., Recent Findings: The latest data on TAVR outcomes reflects the increasing experience of operators and the significant role of pre-procedural imaging. Debate continues as to which modality sizes the aortic annulus most accurately, 3D transoesophageal echocardiography (TEE) or MDCT, as well as to whether the merits of real-time peri-procedural 3D imaging guidance outweigh the possible adverse consequences of general anaesthesia which is requisite for intraprocedural 3D TEE. TAVR is now largely based on pre-acquired roadmaps of the truncal vasculature and intense pre-procedural planning. TEE and Multi-detector computed tomography (MDCT) have been shown to perform similarly in annulus sizing. However, given the complexity of many TAVR patients and the importance of identifying the most suitable pathway to the valve as well as any potentially confounding other structural or functional heart disease, both modalities remain relevant in current TAVR.
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- 2018
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6. Performance of imaging studies in patients with suspected appendicitis after stratification with adult appendicitis score.
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Sammalkorpi HE, Leppäniemi A, Lantto E, and Mentula P
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- Adolescent, Adult, Appendicitis surgery, Colon surgery, Diagnostic Imaging methods, Female, Humans, Male, Middle Aged, Probability, Prospective Studies, Severity of Illness Index, Appendicitis classification, Appendicitis diagnosis, Diagnostic Imaging standards
- Abstract
Background: Diagnostic scoring is used to stratify patients with suspected appendicitis into three groups: high, intermediate, and low probability of appendicitis. The stratification can be used for selective imaging to avoid the harms of radiation without compromising diagnostic accuracy. The aim was to study how stratification by Adult Appendicitis Score affects diagnostic performance of imaging studies., Methods: Analysis of 822 patients who underwent diagnostic imaging for suspected appendicitis was made. Adult Appendicitis Score was used to stratify patients into groups of high, intermediate, and low probability of appendicitis. Diagnostic performance of computed tomography (CT) and ultrasound (US) was compared between these patient groups., Results: After scoring, pre-test probability of appendicitis ranged from 9-16% in low probability group to 75-79% in high probability group in patients who underwent US or CT. Post-test probability of appendicitis after positive CT was 99, 91, and 75% in high probability, intermediate probability and low probability groups, respectively, p < 0.001. After positive US the respective probabilities were 95, 91 and 42%, p < 0.001., Conclusion: Diagnostic imaging has limited value in patients with low probability of appendicitis according to Adult Appendicitis Score.
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- 2017
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7. Current and future perspectives in imaging of venous thromboembolism.
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Dronkers CE, Klok FA, and Huisman MV
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- Adult, Aged, Algorithms, Angiography, Animals, Cerebral Veins pathology, Diagnostic Imaging trends, Disease Models, Animal, Female, Humans, Lung diagnostic imaging, Magnetic Resonance Imaging, Male, Middle Aged, Positron-Emission Tomography, Reproducibility of Results, Splanchnic Circulation, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed, Diagnostic Imaging methods, Venous Thromboembolism diagnostic imaging, Venous Thrombosis diagnostic imaging
- Abstract
Several thrombus imaging techniques for the diagnosis of venous thromboembolism (VTE) are available. The most prevalent forms of VTE are deep vein thrombosis of the lower extremities and pulmonary embolism. However, VTE may also occur at unusual sites such as deep veins of the upper extremity and the splanchnic and cerebral veins. Currently, the imaging techniques most widely used in clinical practice are compression ultrasonography and computed tomography (CT) pulmonary angiography. Moreover, single-photon emission CT, CT venography, positron emission tomography, and different magnetic resonance imaging (MRI) techniques, including magnetic resonance direct thrombus imaging, have been evaluated in clinical studies. This review provides an overview of the technique, diagnostic accuracy and potential pitfalls of these established and emerging imaging modalities for the different sites of venous thromboembolism., (© 2016 International Society on Thrombosis and Haemostasis.)
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- 2016
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8. The value of imaging in subclinical coronary artery disease.
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Zimarino M, Prati F, Marano R, Angeramo F, Pescetelli I, Gatto L, Marco V, Bruno I, and De Caterina R
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- Asymptomatic Diseases, Coronary Angiography methods, Coronary Artery Disease complications, Coronary Artery Disease therapy, Disease Progression, Humans, Magnetic Resonance Angiography, Multidetector Computed Tomography, Positron-Emission Tomography, Predictive Value of Tests, Prognosis, Reproducibility of Results, Rupture, Spontaneous, Spectroscopy, Near-Infrared, Tomography, Emission-Computed, Single-Photon, Tomography, Optical Coherence, Ultrasonography, Interventional, Coronary Artery Disease diagnostic imaging, Coronary Vessels diagnostic imaging, Diagnostic Imaging methods, Plaque, Atherosclerotic
- Abstract
Although the treatment of acute coronary syndromes (ACS) has advanced considerably, the ability to detect, predict, and prevent complications of atherosclerotic plaques, considered the main cause of ACS, remains elusive. Several imaging tools have therefore been developed to characterize morphological determinants of plaque vulnerability, defined as the propensity or probability of plaques to complicate with coronary thrombosis, able to predict patients at risk. By utilizing both intravascular and noninvasive imaging tools, indeed prospective longitudinal studies have recently provided considerable knowledge, increasing our understanding of determinants of plaque formation, progression, and instabilization. In the present review we aim at 1) critically analyzing the incremental utility of imaging tools over currently available "traditional" methods of risk stratification; 2) documenting the capacity of such modalities to monitor atherosclerosis progression and regression according to lifestyle modifications and targeted therapy; and 3) evaluating the potential clinical relevance of advanced imaging, testing whether detection of such lesions may guide therapeutic decisions and changes in treatment strategy. The current understanding of modes of progression of atherosclerotic vascular disease and the appropriate use of available diagnostic tools may already now gauge the selection of patients to be enrolled in primary and secondary prevention studies. Appropriate trials should now, however, evaluate the cost-effectiveness of an aggressive search of vulnerable plaques, favoring implementation of such diagnostic tools in daily practice., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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9. Volume and morphology of left atrial appendage as determinants of stroke subtype in patients with atrial fibrillation.
- Author
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Jeong WK, Choi JH, Son JP, Lee S, Lee MJ, Choe YH, and Bang OY
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- Aged, Atrial Fibrillation complications, Atrial Fibrillation physiopathology, Brain Ischemia diagnosis, Brain Ischemia physiopathology, Cerebrovascular Circulation, Electrocardiography, Female, Follow-Up Studies, Humans, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Cine, Male, Multidetector Computed Tomography, Prospective Studies, Reproducibility of Results, Atrial Appendage diagnostic imaging, Atrial Fibrillation diagnosis, Brain diagnostic imaging, Brain Ischemia etiology, Cardiac Volume, Diagnostic Imaging methods
- Abstract
Background: Atrial fibrillation (AF) is a leading cause of stroke, but not all cases of stroke in patients with AF are due to AF., Objective: The purpose of this study was to determine whether morphometric or volumetric parameters of left atrial appendage (LAA) would be related to the development of cardioembolism in subjects with AF., Methods: A total of 433 consecutive patients with acute ischemic stroke underwent multidetector cardiac computed tomography (MDCT). Of these patients, 88 with AF were divided into cardioembolic stroke (CES; n = 57) and non-CES (n = 31) groups, and 95 age- and sex-matched patients with non-CES without AF served as controls. Clinical factors, echocardiographic findings, and MDCT parameters were evaluated., Results: Brain infarct volume, LAA orifice diameter, and LAA volume were larger in patients with CES with AF than in those with non-CES with AF (P<.05 in all cases), but no difference was observed between patients with non-CES with AF and those with non-CES without AF. MDCT and echocardiographic parameters of left atrial (LA) dysfunction were different depending on the presence of AF but not between patients with CES with AF vs non-CES with AF. After adjusting for covariates, LAA orifice diameter (odds ratio 1.19, 95% confidence interval 1.06-1.33, P = .004) and LAA volume (odds ratio 12.20, 95% confidence interval 2.58-57.79, P = .002) were independently associated with CES with AF, as was infarct volume., Conclusion: In patients with AF, LAA orifice diameter and LAA volume, but not left atrial dysfunction, were determinants of CES and were useful for stratifying noncardioembolic risk in patients with AF., (Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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10. Evaluating Patients with Left Upper Quadrant Pain.
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Ecanow JS and Gore RM
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- Abdomen, Acute diagnosis, Abdomen, Acute etiology, Abdominal Pain etiology, Contrast Media, Diagnosis, Differential, Gastrointestinal Diseases complications, Gastrointestinal Tract diagnostic imaging, Gastrointestinal Tract pathology, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Radiographic Image Enhancement, Spleen diagnostic imaging, Spleen pathology, Splenic Diseases complications, Ultrasonography, Abdominal Pain diagnosis, Diagnostic Imaging methods, Gastrointestinal Diseases diagnosis, Splenic Diseases diagnosis
- Abstract
Imaging plays a major role in the evaluation of patients who present to the emergency department with acute left upper quadrant (LUQ) pain. Multidetector computed tomography is currently the primary modality used for imaging these patients. The peritoneal reflections, subperitoneal compartment, and peritoneal spaces of the LUQ are key anatomic features in understanding the imaging appearance of acute diseases in this area. Diseases of the stomach, spleen, pancreas, and splenic flexure are encountered in patients with acute LUQ pain. Optimization of the imaging protocol is vital for accurate diagnosis and characterization of these diseases in the acute setting., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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11. Congenital double intrahepatic portosystemic shunt: Imaging findings and endovascular closure.
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Paolantonio G, Pietrobattista A, Candusso M, Monti L, de Ville de Goyet J, Torre G, and Rollo M
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- Angiography, Digital Subtraction, Humans, Infant, Male, Multidetector Computed Tomography, Portal Vein diagnostic imaging, Portal Vein physiopathology, Portography, Predictive Value of Tests, Treatment Outcome, Ultrasonography, Doppler, Color, Vascular Malformations physiopathology, Diagnostic Imaging methods, Embolization, Therapeutic, Endovascular Procedures, Liver Circulation, Portal Vein abnormalities, Vascular Malformations diagnosis, Vascular Malformations therapy
- Published
- 2015
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12. Modern imaging techniques for preoperative detection of distant metastases in gastric cancer.
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Kwee RM and Kwee TC
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- Endoscopy, Humans, Incidence, Laparoscopy, Lymphatic Metastasis, Magnetic Resonance Imaging, Multidetector Computed Tomography, Neoplasm Metastasis, Neoplasm Staging, Positron-Emission Tomography, Radionuclide Imaging, Tomography, X-Ray Computed, Ultrasonography, Diagnostic Imaging methods, Stomach Neoplasms diagnostic imaging, Stomach Neoplasms pathology
- Abstract
A substantial portion of patients with newly diagnosed gastric cancer has distant metastases (M1 disease). These patients have a very poor prognosis and it is generally accepted that they should be treated with noncurative intent. Because it dramatically changes prognosis and treatment plans, it is very important to diagnose distant metastases. In this article, the definition, pathways, incidence and sites of distant metastases in gastric cancer are described. Subsequently, the current performance of imaging in detecting distant metastases in newly diagnosed gastric cancer is outlined and future prospects are discussed.
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- 2015
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13. Sharp penetrating wounds: spectrum of imaging findings and legal aspects in the emergency setting.
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Reginelli A, Pinto A, Russo A, Fontanella G, Rossi C, Del Prete A, Zappia M, D'Andrea A, Guglielmi G, and Brunese L
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- Humans, Multidetector Computed Tomography, Wounds, Stab diagnosis, Diagnostic Imaging, Wounds, Penetrating diagnosis
- Abstract
The main cause of severe civilian trauma is not the same all over the world; while in Europe the majority of cases are due to blunt traumatic injury, in the United States, penetrating gunshot wounds are the most common. Penetrating wounds can be classified into two different entities: gunshot wounds, or more technically ballistic traumas, and sharp penetrating traumas, also identifiable with non-ballistic traumas. Sharp penetrating injuries are mainly caused by sharp pointed objects such as spears, nails, daggers, knives, and arrows. The type of injuries caused by sharp pointed objects depends on the nature and shape of the weapon, the amount of energy in the weapon or implement when it strikes the body, whether it is inflicted upon a moving or a still body, and the nature of the tissue injured. In the assessment of hemodynamically stable patients with sharp penetrating wounds, the main imaging procedure is Multidetector Computed Tomography (MDCT), especially used in complicated cases of penetrating injuries with an important impact on the final therapeutic choice. The diagnostic approach has been changed by MDCT due to its technical improvements, in particular, faster data acquiring and upgraded image reconstructions.
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- 2015
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14. The tricuspid valve and the right heart: anatomical, pathological and imaging specifications.
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van Rosendael PJ, Delgado V, and Bax JJ
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- Echocardiography, Doppler, Heart Valve Prosthesis, Humans, Multidetector Computed Tomography, Patient Selection, Predictive Value of Tests, Prosthesis Design, Severity of Illness Index, Treatment Outcome, Tricuspid Valve Insufficiency physiopathology, Ventricular Function, Right, Ventricular Remodeling, Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Cardiac Catheterization methods, Cardiac Valve Annuloplasty adverse effects, Cardiac Valve Annuloplasty instrumentation, Cardiac Valve Annuloplasty methods, Diagnostic Imaging methods, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation instrumentation, Heart Valve Prosthesis Implantation methods, Heart Ventricles physiopathology, Mitral Valve physiopathology, Tricuspid Valve Insufficiency diagnosis, Tricuspid Valve Insufficiency therapy
- Abstract
Transcatheter tricuspid valve repair/replacement is an emerging therapy for patients with symptomatic severe tricuspid regurgitation who are deemed inoperable. Accurate knowledge of the anatomy of the tricuspid valve and right ventricle is key to developing transcatheter techniques. In addition, it is important to understand the mechanistic concept of transcatheter tricuspid valve repair/replacement in order to select the patients who may benefit from it. The severity and mechanism of tricuspid regurgitation, right ventricular function, dimensions of the caval veins and the course of the right coronary artery in relation to the atrioventricular groove are important aspects to be evaluated before embarking on these procedures. The present article reviews current advances in transcatheter approaches for significant tricuspid regurgitation and the role of imaging modalities to characterise the anatomy of the tricuspid valve and right ventricle as well as the underlying pathophysiology of tricuspid regurgitation.
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- 2015
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15. Follow-up Imaging After Liver Transplantation Should Take Into Consideration Primary Hepatocellular Carcinoma Characteristics.
- Author
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Dioguardi Burgio M, Ronot M, Fuks D, Dondero F, Cauchy F, Gaujoux S, Dokmak S, Paradis V, Durand F, Belghiti J, and Vilgrain V
- Subjects
- Adult, Carcinoma, Hepatocellular etiology, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Cell Differentiation, Disease Progression, Disease-Free Survival, Humans, Kaplan-Meier Estimate, Liver Cirrhosis complications, Liver Cirrhosis mortality, Liver Cirrhosis pathology, Liver Neoplasms etiology, Liver Neoplasms mortality, Liver Neoplasms pathology, Magnetic Resonance Imaging, Male, Middle Aged, Multidetector Computed Tomography, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Predictive Value of Tests, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Carcinoma, Hepatocellular surgery, Diagnostic Imaging methods, Liver Cirrhosis surgery, Liver Neoplasms surgery, Liver Transplantation adverse effects, Liver Transplantation mortality
- Abstract
Background: Tumor recurrence occurs in almost 10% after liver transplantation (LT) for early stage hepatocellular carcinoma (HCC). Evidence-based recommendation regarding these techniques and their schedule remains unclear. The aim was to analyze the imaging characteristics of HCC recurrence after LT according to the initial primary tumor characteristics to provide relevant evidence regarding their role., Methods: Among 336 cirrhotic patients undergoing LT between 2000 and 2011, 25 (7.4%) experienced HCC recurrence. Their pre-LT characteristics, long-term outcome and imaging characteristics of recurrences were retrospectively analyzed., Results: All patients were men and median age at the time of recurrence was 54 (41-64) years. Before LT, 13 (52%) patients had HCC outside the Milan criteria. Median time to HCC recurrence was 13.8 months (1-75) after LT and 8 patients (32%) experienced recurrence longer than 24 months after LT. The most frequently involved organs were the lungs (n = 13, 52%) and the bones (n = 9, 36%). Recurrent HCC involved more than 1 organ in 11 patients (44%). Recurrences were limited to the liver in 1 patient (4%), exclusively extrahepatic in 18 patients (72%), and were both intra and extrahepatic in 6 patients (24%). Delay of recurrence was shorter in the presence of microvascular invasion (17 vs 28 months), but this was not significant (P = 0.208). Poorly differentiated tumors showed a trend toward decreased recurrence-free survival (8 vs 28 months, P = 0.075)., Conclusions: Both pattern and delay of HCC recurrence support performing regular whole-body imaging initially every 6 to 12 months and continuing beyond 2 years after LT for HCC, especially in patients with pejorative pathological features of the primary tumor that could influence HCC recurrence pattern.
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- 2015
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16. Imaging of systemic vasculitis in childhood.
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Soliman M, Laxer R, Manson D, Yeung R, and Doria AS
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- Angiography, Blood Vessels pathology, Child, Diagnosis, Differential, Humans, Magnetic Resonance Angiography, Multidetector Computed Tomography, Positron-Emission Tomography, Radionuclide Angiography, Diagnostic Imaging methods, Systemic Vasculitis diagnosis
- Abstract
The term "systemic vasculitis" encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults. In 2006, the European League Against Rheumatism (EULAR) and the Pediatric Rheumatology European Society (PReS) proposed a classification system for childhood vasculitis adopting the system devised in the Chapel Hill Consensus Conference in 1993, which categorizes vasculitides according to the predominant size of the involved blood vessels into small, medium and large vessel diseases. Currently, medical imaging has a pivotal role in the diagnosis of vasculitis given recent developments in the imaging of blood vessels. For example, early diagnosis of coronary artery aneurysms, a serious complication of Kawasaki disease, is now possible by magnetic resonance imaging (MRI) of the heart and multidetector computed tomography (MDCT); positron emission tomography/CT (PET/CT) helps to assess active vascular inflammation in Takayasu arteritis. Our review offers a unique approach using the integration of the proposed classification criteria for common systemic childhood vasculitides with their most frequent imaging findings, along with differential diagnoses and an algorithm for diagnosis based on common findings. It should help radiologists and clinicians reach an early diagnosis, therefore facilitating the ultimate goal of proper management of affected children.
- Published
- 2015
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17. Cumulative radiation dose and radiation risk from medical imaging in patients subjected to endovascular aortic aneurysm repair.
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Brambilla M, Cerini P, Lizio D, Vigna L, Carriero A, and Fossaceca R
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- Bone Marrow radiation effects, Colon radiation effects, Female, Follow-Up Studies, Humans, Liver radiation effects, Lung radiation effects, Male, Multidetector Computed Tomography, Radiology, Interventional, Radiometry, Stomach radiation effects, Tomography, X-Ray Computed, Aortic Aneurysm diagnostic imaging, Aortic Aneurysm surgery, Diagnostic Imaging adverse effects, Endovascular Procedures, Radiation Dosage
- Abstract
Purpose: This study was undertaken to quantify the cumulative effective dose (CED) of radiation and the dose to relevant organs in endovascular aortic repair (EVAR) patients, to assess radiation risks and to evaluate the clinical usefulness of multi-detector computed tomography (MDCT) follow-up., Materials and Methods: The radiation exposures were obtained from 71 consecutive EVAR patients with a follow-up duration ≥1 year. Dose calculations were performed on an individual basis and expressed as effective doses and organ doses. Radiation risk was expressed as risk of exposure-induced death (%), using the biological effects of ionising radiation model. Two radiologists independently assessed the images for abdominal aortic aneurysm expansion without endoleaks, thrombotic occlusion, endoleaks and device migration. They first reviewed arterial imaging alone and subsequently added non-contrast and delayed phases to determine the overall performance., Results: The median total CED and annual CED were 224 and 104 mSv per patient-year. The median cumulative organ doses were 191, 205, 230, 269 and 271 mSv for lung, bone marrow, liver, colon and stomach, respectively. The average risk of exposure-induced death was 0.8 % (i.e., odds 1 in 130). All the findings related to EVAR outcome and leading to a change in patient management were visible during the arterial phase of the MDCT angiography. Omission of the unenhanced scan and the venous phase of the MDCT angiography would have led to a significant reduction of about 60 % of the associated MDCT radiation exposure in a single patient., Conclusions: EVAR patients received high radiation doses and the excess cancer risk attributable to radiation exposure is not negligible. The unenhanced scan and the venous phase of the MDCT angiography could have been omitted without compromising the utility of the examination and with a significant reduction of doses and associated risks.
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- 2015
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18. Optimizing imaging for aortic repair.
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Törnqvist P, Dias NV, and Resch T
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- Aortic Aneurysm, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal surgery, Aortography, Blood Vessel Prosthesis Implantation, Contrast Media, Endovascular Procedures, Humans, Imaging, Three-Dimensional, Magnetic Resonance Angiography, Multidetector Computed Tomography, Predictive Value of Tests, Radiographic Image Interpretation, Computer-Assisted, Treatment Outcome, Ultrasonography, Aorta, Abdominal diagnostic imaging, Aorta, Abdominal surgery, Aortic Aneurysm, Abdominal diagnosis, Diagnostic Imaging methods
- Abstract
Imaging is an integral part of an aortic program. Careful preoperative planning is essential to successful evaluation and treatment of aortic pathology. Computed tomography angiography (CTA) is the dominant modality for such preoperative planning. The use of a dedicated workstation for 3D postprocessing is very favorable and is considered mandatory when treating complex aortic pathology. Intraoperative imaging during aortic repair still depends heavily on standard fluoroscopy and angiography. However, the introduction of image fusion has the potential to reduce the use of both contrast and radiation, for the benefit of both patients and operators. Using cross-sectional imaging intraoperatively also has the potential to reduce the need for early imaging follow-up and to reduce the technical failures of endovascular aneurysm repair (EVAR). Imaging follow-up after EVAR has changed dramatically since the introduction of minimally invasive aortic repair. CTA remains the gold standard but a significant shift towards ultrasound surveillance has occurred. With the introduction of newer generation EVAR devices, results have improved and a trend towards less rigorous follow-up is expected.
- Published
- 2015
19. [Noninvasive Methods of Detection of Vulnerable Atherosclerotic Plaques in Coronary Arteries].
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Tagieva NR, Shakhnovich RM, and Veselova TN
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- Acute Coronary Syndrome etiology, Humans, Multidetector Computed Tomography, Plaque, Atherosclerotic complications, Positron-Emission Tomography, Tomography, Emission-Computed, Single-Photon, Acute Coronary Syndrome diagnosis, Diagnostic Imaging methods, Plaque, Atherosclerotic diagnosis
- Abstract
In most cases direct cause of acute coronary syndrome and sudden death is an intracoronary thrombus formed on a surface of unstable atherosclerotic plaque (UAP). The following are main characteristics of UAP: active inflammation; large lipid rich nucleus occupying a40% of plaque volume; thin (< 65 mm) fibrous cap; erosions of intima over plaque; tear of plaque cap; superficially located calcium nodules; intraplaque hemorrhage. Visualization of UAP in coronary arteries is a very important direction in diagnostics. During recent years both invasive and noninvasive methods of detection of UAP have been actively developed. In this review we present main noninvasive techniques used for detection of UAP: multislice computed tomography, magnetic resonance tomography, positron emission tomography and single-photon emission computed tomography. In the review we have covered main advantages and limitations of each invasive method of UAP detection and delineated perspectives of development of this direction.
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- 2015
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20. Diagnostic imaging of hepatic lesions in adults.
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Lamba R, Fananapazir G, Corwin MT, and Khatri VP
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- Carcinoma, Hepatocellular pathology, Cystadenocarcinoma diagnosis, Cystadenoma diagnosis, Focal Nodular Hyperplasia diagnosis, Hemangioendothelioma, Epithelioid diagnosis, Humans, Liver Abscess diagnosis, Liver Neoplasms pathology, Liver Neoplasms secondary, Magnetic Resonance Imaging, Multidetector Computed Tomography, Radionuclide Imaging, Sarcoma diagnosis, Ultrasonography, Bile Duct Neoplasms diagnosis, Bile Ducts, Intrahepatic, Carcinoma, Hepatocellular diagnosis, Cholangiocarcinoma diagnosis, Diagnostic Imaging methods, Liver Neoplasms diagnosis
- Abstract
Multiphase contrast-enhanced magnetic resonance imaging (MRI) is the current modality of choice for characterization of liver masses incidentally detected on imaging. Contrast-enhanced computed tomography (CT) performed in the portal phase is the mainstay for the screening of liver metastases. Characterization of a liver mass by CT and MRI primarily relies on the dynamic contrast-enhancement characteristics of the mass in multiple phases. Noninvasive MRI and CT imaging characteristics of benign and malignant liver masses, coupled with relevant clinical information, allow reliable characterization of most liver lesions. Some cases may have nonspecific or overlapping features that may present a diagnostic dilemma., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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21. Paleoimaging: a review of applications and challenges.
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Beckett RG
- Subjects
- Diagnostic Imaging history, Endoscopy, Forensic Anthropology history, History, 20th Century, History, 21st Century, Humans, Image Interpretation, Computer-Assisted, Imaging, Three-Dimensional, Multidetector Computed Tomography, Multimodal Imaging, Photography, Predictive Value of Tests, Diagnostic Imaging methods, Forensic Anthropology methods, Mummies diagnostic imaging, Mummies history, Mummies pathology
- Abstract
This paper reviews the contributions and current practices of paleoimaging modalities as applied to the bioarchaeological research setting. The paper provides a brief historical perspective regarding imaging approaches in this unique context and a description of various modalities including photography, 3D surface scanning, aerial imaging, LiDAR, GPR, portable radiography, endoscopy, X-ray fluorescence, and advanced medical imaging. The paper presents a review of issues and applications of paleoimaging with an emphasis on specific research questions. A description of the limitations and challenges for paleoimaging within the bioarchaeological construct follows and offers support for the multimodal approach to paleoimaging. Interpretation of imaging data by consensus including paleoimagers, medical scientists and bioarchaeologists is addressed. The paper concludes with a look to the future of paleoimaging from an applications and standards development perspective.
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- 2014
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22. Evaluation of bend relief disconnection in patients supported by a HeartMate II left ventricular assist device.
- Author
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Waller AH, Dunne R, Stewart GC, Ghosh N, Gosev I, Rybicki FJ, Blankstein R, Couper GS, and Steigner M
- Subjects
- Humans, Prosthesis Design, Prosthesis Failure, Diagnostic Imaging trends, Heart Failure surgery, Heart Ventricles surgery, Heart-Assist Devices, Postoperative Complications diagnosis
- Published
- 2014
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23. Update on imaging of Peutz-Jeghers syndrome.
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Tomas C, Soyer P, Dohan A, Dray X, Boudiaf M, and Hoeffel C
- Subjects
- Adult, Biopsy, Endoscopy, Gastrointestinal, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multidetector Computed Tomography, Peutz-Jeghers Syndrome diagnostic imaging, Peutz-Jeghers Syndrome pathology, Peutz-Jeghers Syndrome surgery, Predictive Value of Tests, Young Adult, Diagnostic Imaging methods, Intestine, Small diagnostic imaging, Intestine, Small pathology, Intestine, Small surgery, Peutz-Jeghers Syndrome diagnosis
- Abstract
Peutz-Jeghers syndrome (PJS) is a rare, autosomal dominant disease linked to a mutation of the STK 11 gene and is characterized by the development of benign hamartomatous polyps in the gastrointestinal tract in association with a hyperpigmentation on the lips and oral mucosa. Patients affected by PJS have an increased risk of developing gastrointestinal and extra-digestive cancer. Malignancy most commonly occurs in the small-bowel. Extra-intestinal malignancies are mostly breast cancer and gynecological tumors or, to a lesser extent, pancreatic cancer. These polyps are also at risk of acute gastrointestinal bleeding, intussusception and bowel obstruction. Recent guidelines recommend regular small-bowel surveillance to reduce these risks associated with PJS. Small-bowel surveillance allows for the detection of large polyps and the further referral of selected PJS patients for endoscopic enteroscopy or surgery. Video capsule endoscopy, double balloon pushed enteroscopy, multidetector computed tomography and magnetic resonance enteroclysis or enterography, all of which are relatively new techniques, have an important role in the management of patients suffering from PJS. This review illustrates the pathological, clinical and imaging features of small-bowel abnormalities as well as the role and performance of the most recent imaging modalities for the detection and follow-up of PJS patients.
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- 2014
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24. Imaging findings in a distinct lethal inherited arteriopathy syndrome associated with a novel mutation in the FBLN4 gene.
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Rajeshkannan R, kulkarni C, Kappanayil M, Nampoothiri S, Malfait F, De Paepe A, and Moorthy S
- Subjects
- Angiography, Child, Child, Preschool, DNA Mutational Analysis, Extracellular Matrix Proteins metabolism, Female, Humans, Infant, Infant, Newborn, Magnetic Resonance Angiography, Male, Multidetector Computed Tomography, Reproducibility of Results, Syndrome, Vascular Calcification genetics, Vascular Calcification metabolism, Arteries pathology, DNA genetics, Diagnostic Imaging methods, Extracellular Matrix Proteins genetics, Mutation, Vascular Calcification diagnosis
- Abstract
Objectives: We present the imaging findings of a newly identified lethal arteriopathy associated with a novel mutation in the gene encoding fibulin-4, occurring in a distinct community from southern India., Material and Methods: A total of 31 children from a distinct population subgroup who presented with characteristic arterial dilatation and tortuosity were studied. All children except one belonged to unrelated families from an ethno-religious group (Muslim) from the northern coastal belt of southern India. CT angiography was performed in 30 children and contrast MRA in one., Results: Impressive dilatation and elongation of ascending aorta, arch, descending aorta and main pulmonary arteries with characteristic narrowing of aortic isthmus were seen in all patients. Stenosis of arch branches, abdominal visceral branches and pulmonary artery branches was observed in 21 (68%), 23 (62.5%) and 20 (65%) patients respectively. Genetic studies revealed an identical mutation in exon 7 of the FBLN4 gene. On follow-up, 27 of them had died before the age of 3 years and only two children were alive after the age of 4 years., Conclusions: FBLN4-associated vasculopathy is a highly lethal disease characterized by severe aneurysmal dilatation of thoracic aorta, its branches and pulmonary arteries with stenoses at typical locations., Key Points: • Homozygous mutations in exon 7 of the FBLN4 gene can produce lethal vasculopathy. • Fibulin-4 is a critical determinant in human elastogenesis. • Imaging findings can give a clue to underlying connective tissue disorders.
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- 2014
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25. Bronchopleural fistula and the role of contemporary imaging.
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Gaur P, Dunne R, Colson YL, and Gill RR
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- Bronchial Fistula etiology, Bronchial Fistula surgery, Bronchoscopy, Humans, Multidetector Computed Tomography, Pleural Diseases etiology, Pleural Diseases surgery, Predictive Value of Tests, Prognosis, Radionuclide Imaging, Reoperation, Risk Factors, Bronchial Fistula diagnosis, Diagnostic Imaging methods, Pleural Diseases diagnosis, Pneumonectomy adverse effects
- Abstract
One of the most morbid postoperative complications after a lobectomy or a pneumonectomy is a bronchopleural fistula (BPF). The diagnosis and identification of BPF may be challenging, often requiring repeat imaging and invasive tests, including bronchoscopy, thoracoscopic exploration, or even open exploration. The purpose of this article is to review the types and presentations of BPF and to describe the role of noninvasive imaging for diagnosis and surgical treatment planning. We focused on multidetector computed tomography and advanced postprocessing applications such as multiplanar reconstructions, virtual bronchoscopy, and volume rendering images, including minimum-intensity and maximum-intensity projections. Both multidetector computed tomography and nuclear scintigraphy are reliable noninvasive imaging modalities that can be used expeditiously in an outpatient setting and may prove to be a more cost-effective strategy to identify the fistula as well as conduct postoperative surveillance. These modalities can be used for accurate and efficient testing for earlier diagnosis and treatment planning, thereby significantly improving patient outcome. Additional advanced postprocessing techniques using already acquired imaging data can provide complementary information that is both visually accessible and anatomically meaningful for the surgeon. Better understanding of the potential uses and benefits of these techniques will eventually improve the diagnostic accuracy, optimize preoperative planning, and facilitate follow-up for patients with BPF with improved patient outcomes., (Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.)
- Published
- 2014
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26. Using advanced noninvasive imaging techniques to probe the links between regional coronary artery endothelial dysfunction and atherosclerosis.
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Iantorno M and Weiss RG
- Subjects
- Animals, Coronary Artery Disease metabolism, Coronary Artery Disease physiopathology, Coronary Vessels metabolism, Endothelium, Vascular metabolism, Humans, Magnetic Resonance Angiography, Multidetector Computed Tomography, Positron-Emission Tomography, Predictive Value of Tests, Coronary Artery Disease diagnosis, Coronary Vessels physiopathology, Diagnostic Imaging methods, Endothelium, Vascular physiopathology
- Abstract
Cardiovascular disease remains the number one cause of death in the US annually. The development in recent years of imaging strategies that can identify coronary endothelial dysfunction noninvasively provides new information about the early presence and local spatial heterogeneity of endothelial function in patients with, and those at risk for, coronary artery disease. In this article, we will briefly review the mechanisms relating endothelial function and atherosclerosis, contemporary imaging strategies now able to quantify coronary endothelial function noninvasively, and recent insights on human coronary endothelial function., (© 2013 Elsevier Inc. All rights reserved.)
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- 2014
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27. Identifying the high-risk carotid plaque.
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Naylor AR
- Subjects
- Biomarkers blood, Carotid Arteries diagnostic imaging, Carotid Arteries physiopathology, Carotid Stenosis blood, Carotid Stenosis complications, Carotid Stenosis pathology, Carotid Stenosis physiopathology, Carotid Stenosis therapy, Humans, Magnetic Resonance Angiography, Multidetector Computed Tomography, Multimodal Imaging, Patient Selection, Positron-Emission Tomography, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, Rupture, Spontaneous, Stroke etiology, Stroke pathology, Stroke physiopathology, Time Factors, Ultrasonography, Doppler, Transcranial, Ultrasonography, Interventional, Carotid Arteries pathology, Carotid Stenosis diagnosis, Diagnostic Imaging methods, Plaque, Atherosclerotic, Stroke diagnosis
- Abstract
With the benefit of hindsight, most symptomatic (67%) and most asymptomatic patients (88%) who were treated medically in the randomized trials were never destined to suffer a stroke. As a consequence of a growing awareness that only a relative minority of patients actually benefit from surgery or stenting, there has been much debate about how contemporary imaging and serum biomarkers might be used to identify the patient with the "high-risk for stroke" plaque in whom to target surgery or stenting in the future. This is particularly important for patients with asymptomatic carotid disease in whom 95% of carotid surgical procedures are ultimately unnecessary. Even if the procedural risk could be reduced to zero, 93% of all interventions would still prove to be unnecessary. This paper reviews the rationale underlying the need to identify "high-risk for stroke" patients in whom to target invasive therapies. It reviews the pathophysiology of the unstable carotid plaque and how such a lesion might be identified using contemporary imaging modalities and serum biomarkers.
- Published
- 2014
28. Cardiothoracic imaging in the pregnant patient.
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Litmanovich DE, Tack D, Lee KS, Shahrzad M, and Bankier AA
- Subjects
- Algorithms, Contrast Media, Female, Fetus radiation effects, Heart Diseases diagnostic imaging, Humans, Lactation, Magnetic Resonance Imaging, Multidetector Computed Tomography, Noise, Patient Safety, Pregnancy, Pregnancy Complications diagnostic imaging, Pulmonary Embolism diagnosis, Radiation Dosage, Radiation Protection, Thoracic Diseases diagnostic imaging, Tomography, X-Ray Computed, Cardiac Imaging Techniques, Diagnostic Imaging adverse effects, Heart Diseases diagnosis, Pregnancy Complications diagnosis, Thoracic Diseases diagnosis
- Abstract
Cardiovascular imaging during pregnancy poses a unique challenge to clinicians in differentiating between physiological changes mimicking pathology and true pathologic conditions, as well as for radiologists in terms of image quality. This review article will focus on 3 goals: first, to familiarize radiologists with safety issues related to imaging pregnant women using computed tomography and magnetic resonance imaging; second, to review the current, evidence-based recommendations for radiology topics unique and common to pregnant and lactating patients; and third, to provide practical algorithms to minimize risk and increase safety for both the pregnant woman and the fetus.
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- 2014
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29. Nonurgent aortic disease: clinical-radiological diagnosis of aortitis.
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Cabero Moyano J, Andreu Magarolas M, Castañer González E, Gallardo Cistaré X, and Belmonte Castan E
- Subjects
- Aortitis diagnostic imaging, Humans, Radiography, Aortitis diagnosis, Diagnostic Imaging
- Abstract
Aortitis is a pathological term designating inflammation of the aortic wall, regardless of its cause. The clinical presentation of aortitis is nonspecific and variable. Symptoms include abdominal pain, fever, and weight loss; acute phase reactants may also be elevated. Aortitis can be caused by a wide spectrum of entities, including from infectious processes to autoimmune diseases (Takayasu arteritis and giant cell arteritis are among the most common of these causing aortitis), and the prognosis and treatment of these entities vary widely. Various imaging techniques can be used to evaluate the lumen and wall of the aorta (such as multidetector computed tomography, magnetic resonance imaging, angiography, or PET-CT). This review focuses on the most common diseases that cause aortitis and on the clinical and radiological findings that are most useful for diagnosing and treating this condition appropriately., (Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.)
- Published
- 2013
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30. [Lung infarction - a diagnostic challenge in the oncologic patient?].
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Hinrichs J, Bengel F, Wacker F, and Vogel-Claussen J
- Subjects
- Cardiac-Gated Imaging Techniques, Contrast Media, Diagnosis, Differential, Fluorodeoxyglucose F18, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Multidetector Computed Tomography, Multimodal Imaging methods, Prognosis, Pulmonary Embolism diagnosis, Diagnostic Imaging, Pulmonary Infarction diagnosis
- Published
- 2013
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- View/download PDF
31. Imaging techniques in chronic thromboembolic pulmonary hypertension.
- Author
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Giannouli E and Maycher B
- Subjects
- Angiography, Endarterectomy, Humans, Hypertension, Pulmonary surgery, Magnetic Resonance Imaging, Multidetector Computed Tomography, Perfusion Imaging, Pulmonary Embolism surgery, Diagnostic Imaging methods, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary etiology, Pulmonary Embolism complications, Pulmonary Embolism diagnosis
- Abstract
Purpose of Review: Chronic thromboembolic pulmonary hypertension (CTEPH) can affect up to 4-5% of patients with acute pulmonary embolism. It is likely an underdiagnosed entity. Misdiagnosis is common because patients often present with nonspecific symptoms of pulmonary hypertension. Early diagnosis may help improve the outcome, as CTEPH is potentially curable with pulmonary thromboendarterectomy (PEA). Imaging is central to an accurate diagnosis, and for assessing correctly the technical feasibility of PEA. This review examines the findings of various imaging techniques in CTEPH and their contribution in the diagnostic and therapeutic evaluation of the disease., Recent Findings: Ventilation-perfusion scintigraphy remains a sensitive method for excluding CTEPH. Multidetector computed tomography angiography (MDCTA) depicts directly changes of CTEPH, provides a surgical 'road map', and should be used for the diagnostic assessment of all suitable patients with pulmonary arterial hypertension. In many centers, the role of conventional pulmonary angiography is gradually being replaced by cross-sectional methods. MRI has a role in preoperative and postoperative assessment of right ventricular function and can depict vascular abnormalities up to segmental level., Summary: MDCTA in combination with MRI represent the main techniques for the diagnosis and management of CTEPH. Newer techniques such as dual spectrum computed tomography may further improve preoperative and postoperative assessment of CTEPH patients.
- Published
- 2013
- Full Text
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32. Management of vascular access in transcatheter aortic valve replacement: part 1: basic anatomy, imaging, sheaths, wires, and access routes.
- Author
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Toggweiler S, Leipsic J, Binder RK, Freeman M, Barbanti M, Heijmen RH, Wood DA, and Webb JG
- Subjects
- Aortic Valve Stenosis diagnosis, Cardiac Catheters, Equipment Design, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation instrumentation, Humans, Patient Selection, Predictive Value of Tests, Risk Factors, Severity of Illness Index, Treatment Outcome, Vascular Access Devices, Aortic Valve Stenosis therapy, Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Catheterization, Peripheral adverse effects, Catheterization, Peripheral instrumentation, Diagnostic Imaging methods, Heart Valve Prosthesis Implantation methods
- Abstract
Transcatheter aortic valve implantation (TAVI) has emerged as a new therapy for patients with severe aortic stenosis who are inoperable or at very high risk of open heart surgery. Vascular complications are a potential limitation of TAVI and have been associated with bleeding, transfusions, and mortality. Transfemoral TAVI can be considered the least invasive approach and is therefore the most widely used access for TAVI. With the current 18-F to 24-F sheaths, the majority of patients can be treated via the transfemoral route. Initially, open surgical access was routinely used to introduce the large sheaths and catheters. Subsequently, percutaneous techniques have emerged as the new standard, resulting in a less invasive, fully percutaneous procedure. Stiff wires allow insertion of the sheath and delivery of the device without causing trauma to the artery. Given the high burden of vascular disease in TAVI candidates, increasing the effectiveness of pre-procedural screening is key. This often begins with conventional angiography, but computed tomography allows visualization of the artery in 3 dimensions, thereby overcoming some of the limitations of conventional angiography. Approximately one third of patients do not have adequate anatomy to allow safe transfemoral access. In such patients, alternative access routes such as the transapical, transaxillary, or direct aortic access are preferred. These alternative routes all have specific advantages and disadvantages., (Copyright © 2013. Published by Elsevier Inc.)
- Published
- 2013
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33. Gastric carcinoma: imaging diagnosis, staging and assessment of treatment response.
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Hallinan JT and Venkatesh SK
- Subjects
- Adenocarcinoma epidemiology, Adenocarcinoma pathology, Adenocarcinoma therapy, Endosonography, Gastroscopy, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging methods, Positron-Emission Tomography, Stomach Neoplasms epidemiology, Stomach Neoplasms pathology, Stomach Neoplasms therapy, Treatment Outcome, Adenocarcinoma diagnosis, Diagnostic Imaging methods, Stomach Neoplasms diagnosis
- Abstract
Gastric carcinoma (GC) is one of the most common causes of cancer-related death worldwide. Surgical resection is the only cure available and is dependent on the GC stage at presentation, which incorporates depth of tumor invasion, extent of lymph node and distant metastases. Accurate preoperative staging is therefore essential for optimal surgical management with consideration of preoperative and/or postoperative chemotherapy. Multidetector computed tomography (MDCT) with its ability to assess tumor depth, nodal disease and metastases is the preferred technique for staging GC. Endoscopic ultrasonography is more accurate for assessing the depth of wall invasion in early cancer, but is limited in the assessment of advanced local or stenotic cancer and detection of distant metastases. Magnetic resonance imaging (MRI), although useful for staging, is not proven to be effective. Positron emission tomography (PET) is most useful for detecting and characterizing distant metastases. Both MDCT and PET are useful for assessment of treatment response following preoperative chemotherapy and for detection of recurrence after surgical resection. This review article discusses the usefulness of imaging modalities for detecting, staging and assessing treatment response for GC and the potential role of newer applications including CT volumetry, virtual gastroscopy and perfusion CT in the management of GC.
- Published
- 2013
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34. Detection and imaging of cardiac allograft vasculopathy.
- Author
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Pollack A, Nazif T, Mancini D, and Weisz G
- Subjects
- Coronary Angiography, Coronary Artery Disease etiology, Humans, Multidetector Computed Tomography, Predictive Value of Tests, Prognosis, Ultrasonography, Interventional, Coronary Artery Disease diagnosis, Diagnostic Imaging methods, Heart Transplantation adverse effects
- Abstract
Cardiac allograft vasculopathy (CAV) is an important cause of morbidity and mortality among cardiac transplant recipients. CAV occurs in approximately 30% of patients by 5 years and 50% by 10 years, and is a major cause of graft loss and death. Early detection of CAV is important because it may allow alterations in medical therapy before progression to the stage that revascularization is required. This has led to routine screening for CAV in transplant recipients, traditionally by invasive coronary angiography (ICA). Recent advances in imaging technology, specifically intravascular ultrasound, now also permit detection of subangiographic CAV. Noninvasive stress testing and multislice coronary computed tomography angiography have been investigated as noninvasive alternatives to routine ICA. However, currently available noninvasive tests remain limited with respect to their sensitivity and specificity for CAV. Given the multiple available diagnostic modalities, no consensus definition for the classification of CAV has been widely accepted, although new guidelines that rely heavily on ICA have recently been published by the International Society of Heart and Lung Transplantation. This review summarizes imaging modalities that are utilized in the diagnosis and surveillance of CAV and explores newer imaging techniques that may play a future role., (Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
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35. Coronary artery aneurysms after sirolimus-eluting stent implantation: multimodality imaging evaluation.
- Author
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Fujino Y, Attizzani GF, Nakamura S, Costa MA, and Bezerra HG
- Subjects
- Coronary Aneurysm etiology, Coronary Angiography, Female, Humans, Middle Aged, Multidetector Computed Tomography, Predictive Value of Tests, Tomography, Optical Coherence, Ultrasonography, Interventional, Cardiovascular Agents administration & dosage, Coronary Aneurysm diagnosis, Coronary Artery Disease therapy, Diagnostic Imaging methods, Drug-Eluting Stents, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention instrumentation, Sirolimus administration & dosage
- Published
- 2013
- Full Text
- View/download PDF
36. Multimodality noninvasive cardiac imaging established the diagnosis of aneurysms of Vieussens' arterial ring.
- Author
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Deng B, Wei Y, and Nie R
- Subjects
- Aged, Cardiac Surgical Procedures, Coronary Aneurysm surgery, Coronary Angiography, Coronary Vessel Anomalies surgery, Echocardiography, Doppler, Color, Female, Humans, Multidetector Computed Tomography, Multimodal Imaging, Predictive Value of Tests, Coronary Aneurysm diagnosis, Coronary Vessel Anomalies diagnosis, Diagnostic Imaging methods
- Abstract
Noninvasive cardiac imagines are rapidly evolving in recent years. In this patient with Vieussens' arterial ring aneurysm, multimodality noninvasive cardiac imaging provided sufficient information for diagnosis and surgical decision making. This report no only provides unique information leading to better understanding on aneurysms of Vieussens' arterial ring, but also highlights the important role of multimodality noninvasive cardiac imagines in the diagnosis and management of certain cardiac emergencies.
- Published
- 2013
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37. Challenges in diagnosing mesenteric ischemia.
- Author
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van den Heijkant TC, Aerts BA, Teijink JA, Buurman WA, and Luyer MD
- Subjects
- Biomarkers metabolism, Early Diagnosis, Fatty Acid-Binding Proteins metabolism, Glutathione Transferase metabolism, Humans, Ischemia etiology, Ischemia metabolism, Isoenzymes metabolism, Magnetic Resonance Imaging, Mesenteric Ischemia, Mesenteric Vascular Occlusion etiology, Mesenteric Vascular Occlusion metabolism, Multidetector Computed Tomography, Predictive Value of Tests, Prognosis, Risk Factors, Vascular Diseases etiology, Vascular Diseases metabolism, Diagnostic Imaging methods, Ischemia diagnosis, Mesenteric Vascular Occlusion diagnosis, Vascular Diseases diagnosis
- Abstract
Early identification of acute mesenteric ischemia (AMI) is challenging. The wide variability in clinical presentation challenges providers to make an early accurate diagnosis. Despite major diagnostic and treatment advances over the past decades, mortality remains high. Arterial embolus and superior mesenteric artery thrombosis are common causes of AMI. Non-occlusive causes are less common, but vasculitis may be important, especially in younger people. Because of the unclear clinical presentation and non-specific laboratory findings, low clinical suspicion may lead to loss of valuable time. During this diagnostic delay, progression of ischemia to transmural bowel infarction with peritonitis and septicemia may further worsen patient outcomes. Several diagnostic modalities are used to assess possible AMI. Multi-detector row computed tomographic angiography is the current gold standard. Although computed tomographic angiography leads to an accurate diagnosis in many cases, early detection is a persistent problem. Because early diagnosis is vital to commence treatment, new diagnostic strategies are needed. A non-invasive simple biochemical test would be ideal to increase clinical suspicion of AMI and would improve patient selection for radiographic evaluation. Thus, AMI could be diagnosed earlier with follow-up computed tomographic angiography or high spatial magnetic resonance imaging. Experimental in vitro and in vivo studies show promise for alpha glutathione S transferase and intestinal fatty acid binding protein as markers for AMI. Future research must confirm the clinical utility of these biochemical markers in the diagnosis of mesenteric ischemia.
- Published
- 2013
- Full Text
- View/download PDF
38. Imaging of valvular heart disease.
- Author
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Pibarot P, Larose É, and Dumesnil J
- Subjects
- Cardiac Imaging Techniques methods, Coronary Angiography, Echocardiography, Doppler, Echocardiography, Stress, Echocardiography, Three-Dimensional, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases therapy, Heart Ventricles diagnostic imaging, Heart Ventricles pathology, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Practice Guidelines as Topic, Predictive Value of Tests, Sensitivity and Specificity, Diagnostic Imaging methods, Heart Valve Diseases diagnosis
- Abstract
Imaging plays a fundamental role in the current diagnosis and treatment of valvular heart disease (VHD) and in the preclinical and clinical research aiming at the development of novel pharmacologic or interventional therapies. Doppler echocardiography remains the primary imaging technique for the clinical management of VHD. However, the multifaceted and complex nature of VHD and the rapid development of transcatheter valve therapies has led to a spectacular increase in the use of multimodality imaging in the past decade. The purpose of this article is to review the current and emerging roles of the different imaging modalities in the diagnosis and treatment of VHD and to present the new directions for future research and clinical applications., (Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
39. Imaging investigations in infective endocarditis: current approach and perspectives.
- Author
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Thuny F, Gaubert JY, Jacquier A, Tessonnier L, Cammilleri S, Raoult D, and Habib G
- Subjects
- Echocardiography, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Multimodal Imaging, Positron-Emission Tomography, Predictive Value of Tests, Prognosis, Tomography, X-Ray Computed, Diagnostic Imaging methods, Endocarditis diagnosis
- Abstract
Infective endocarditis is a serious disease that needs rapid diagnosis and accurate risk stratification to offer the best therapeutic strategy. Echocardiography plays a key role in the management of the disease but may be limited in some clinical situations. Moreover, this method is insensitive for very early detection of the infection and assessment of therapeutic response because it does not provide imaging at the molecular and cellular levels. Recently, several novel morphological, molecular and hybrid imaging modalities have been investigated in infective endocarditis and offer new perspectives for better management of the disease., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
40. Questions and answers: what can be said by diagnostic imaging in neuroendocrine tumors?
- Author
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Cuccurullo V, Faggiano A, Scialpi M, Cascini GL, Piunno A, Catalano O, Colao A, and Mansi L
- Subjects
- Fluorine Radioisotopes, Fluorodeoxyglucose F18, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Multimodal Imaging, Neoplasm Proteins analysis, Neuroendocrine Tumors chemistry, Neuroendocrine Tumors diagnostic imaging, Neuroendocrine Tumors epidemiology, Nuclear Medicine Department, Hospital, Oligopeptides, Positron-Emission Tomography, Radiopharmaceuticals, Receptors, Somatostatin analysis, Sensitivity and Specificity, Somatostatin analogs & derivatives, Tomography, X-Ray Computed, Ultrasonography, Diagnostic Imaging, Neuroendocrine Tumors diagnosis
- Abstract
The neuroendocrine tumors (NET) of the gastro-entero-pancreatic area (GEP) represent a heterogeneous group of malignancies from the histologic, clinico-laboratoristic (functioning and non-functioning variants), and therapeutic point of view. It is an issue becoming more frequent for the diagnostic imager, being radiologist as well as nuclear physician. Imaging (together with biopsy) plays a key role in the diagnostic assessment and staging (including grading and prognostic definition), in evaluating response to treatment, and in follow-up of GEP-NET. Multislice computed tomography (MSCT), octreoscan and PET-CT are the most widely diffuse and accurate imaging modalities employed in this setting. Other methods, such as Magnetic Resonance and Endoscopic Ultrasound, may also play a significant role.
- Published
- 2012
41. [Gastroenteric diseases in the third millennium: a rational approach to optimal imaging technique and patient selection].
- Author
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Cuccurullo V, Cioce F, Sica A, Iasiello F, Capasso R, Gatta G, and Rubini G
- Subjects
- Gastrointestinal Diseases diagnostic imaging, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Ultrasonography, Diagnostic Imaging, Gastrointestinal Diseases diagnosis, Patient Selection
- Abstract
In the last twenty years, the study of gastroenteric disorders underwent a radical change as a result of rapid advances in diagnostic imaging, with the introduction of more sophisticated and better performing techniques. Although this evolution has significantly contributed to improve diagnostic accuracy, also allowing assessment of different areas of the gastroenteric tract that could not be well evaluated in the past, clinicians may feel confused about deciding the most appropriate diagnostic approach according to lesion type and site. The aim of this paper is to provide an overview of available imaging techniques to guide the diagnostic approach to gastroenteric diseases.
- Published
- 2012
- Full Text
- View/download PDF
42. The role of multi-modality imaging for sinus of Valsalva aneurysms.
- Author
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Hoey ET, Gulati GS, Singh S, Watkin RW, Nazir S, Ganeshan A, Rafique A, and Sivananthan MU
- Subjects
- Aortic Aneurysm diagnostic imaging, Aortic Aneurysm pathology, Echocardiography, Doppler, Color, Echocardiography, Transesophageal, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Predictive Value of Tests, Prognosis, Aortic Aneurysm diagnosis, Diagnostic Imaging methods, Sinus of Valsalva diagnostic imaging, Sinus of Valsalva pathology
- Abstract
Sinus of Valsalva aneurysms (SVAs) are uncommon but important entities. They are most often congenital in origin, resulting from incomplete fusion of the aortic media to the aortic valve annulus. Less frequently, they may be acquired, usually secondary to infective endocarditis. Unruptured aneurysms may be clinically silent and diagnosed incidentally, but can also produce symptoms as a consequence of mass effect on related structures. Rupture may present with sudden hemodynamic collapse but can have a more insidious onset depending upon the site and size of the perforation. Early diagnosis is imperative and can usually be made reliably by transthoracic echocardiography. However, transesophageal echocardiography may sometimes be required for confirmation. Cardiovascular magnetic resonance imaging (CMRI) and multi-detector computed tomography are being increasingly utilized for evaluation of SVAs and can offer valuable complimentary information. CMRI in particular enables a comprehensive assessment of anatomy, function and flow in a single sitting. Surgical repair forms the mainstay of treatment for both ruptured and unruptured aneurysms and has low complication rates. This article provides an overview of the pathological and clinical aspects of SVAs and discusses in detail the role of advanced imaging modalities in their evaluation.
- Published
- 2012
- Full Text
- View/download PDF
43. Peritoneal and retroperitoneal anatomy and its relevance for cross-sectional imaging.
- Author
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Tirkes T, Sandrasegaran K, Patel AA, Hollar MA, Tejada JG, Tann M, Akisik FM, and Lappas JC
- Subjects
- Abdominal Cavity diagnostic imaging, Abdominal Cavity embryology, Adult, Aged, Ascites diagnostic imaging, Ascites pathology, Female, Humans, Ligaments diagnostic imaging, Magnetic Resonance Imaging methods, Male, Mesentery anatomy & histology, Mesentery diagnostic imaging, Mesentery embryology, Middle Aged, Multidetector Computed Tomography, Peritoneal Cavity diagnostic imaging, Peritoneum diagnostic imaging, Peritoneum pathology, Peritonitis diagnostic imaging, Retroperitoneal Space diagnostic imaging, Retroperitoneal Space pathology, Tomography, X-Ray Computed methods, Ultrasonography, Viscera diagnostic imaging, Viscera pathology, Diagnostic Imaging methods, Peritoneum anatomy & histology, Retroperitoneal Space anatomy & histology
- Abstract
It is difficult to identify normal peritoneal folds and ligaments at imaging. However, infectious, inflammatory, neoplastic, and traumatic processes frequently involve the peritoneal cavity and its reflections; thus, it is important to identify the affected peritoneal ligaments and spaces. Knowledge of these structures is important for accurate reporting and helps elucidate the sites of involvement to the surgeon. The potential peritoneal spaces; the peritoneal reflections that form the peritoneal ligaments, mesenteries, and omenta; and the natural flow of peritoneal fluid determine the route of spread of intraperitoneal fluid and disease processes within the abdominal cavity. The peritoneal ligaments, mesenteries, and omenta also serve as boundaries for disease processes and as conduits for the spread of disease., (© RSNA, 2012.)
- Published
- 2012
- Full Text
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44. [Radiological evaluation of intraductal papillary mucinous neoplasm].
- Author
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Brambs HJ and Juchems M
- Subjects
- Carcinoma, Pancreatic Ductal pathology, Carcinoma, Pancreatic Ductal surgery, Cell Transformation, Neoplastic pathology, Cholangiopancreatography, Magnetic Resonance, Diagnosis, Differential, Endosonography, Humans, Magnetic Resonance Imaging, Multidetector Computed Tomography, Pancreas pathology, Pancreas surgery, Pancreatic Cyst diagnosis, Pancreatic Cyst pathology, Pancreatic Cyst surgery, Pancreatic Neoplasms pathology, Pancreatic Neoplasms surgery, Prognosis, Sensitivity and Specificity, Tomography, X-Ray Computed, Carcinoma, Pancreatic Ductal diagnosis, Diagnostic Imaging, Image Interpretation, Computer-Assisted, Pancreatic Neoplasms diagnosis
- Abstract
The intraductal papillary mucinous neoplasm (IPMN) is the most frequent cystic neoplasm of the pancreas. Due to the widespread use of cross-sectional imaging IPMN is being incidentally recognized with increasing frequency. The most common type is branch- duct IPMN which occurs multifocally in about 20-30%. Patients with IPMN may present with symptoms resembling chronic pancreatitis and episodes of acute pancreatitis are increasingly being reported which usually have a mild course. The most important diagnostic technique is contrast-enhanced multidetector computed tomography (MDCT), which most frequently allows the differentiation from other cystic lesions and enables the attribution to branch duct or main duct IPMN. Magnetic resonance imaging (MRI) in combination with magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound are superior in depicting the fine architecture of cystic tumors. Particularly for evaluation of malignant transformation and extent of malignant disease, high resolution imaging is essential. Whereas main duct IPMN is an indication for resection therapy for small and asymptomatic branch duct IPMN periodic surveillance at 6-12 month intervals is recommended.
- Published
- 2012
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45. [Imaging in the emergency room].
- Author
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Kloth JK, Kauczor HU, and Hosch W
- Subjects
- Algorithms, Cooperative Behavior, Germany, Hemoperitoneum classification, Hemoperitoneum diagnosis, Hemoperitoneum mortality, Hemoperitoneum therapy, Hospital Mortality, Hospitals, University, Humans, Interdisciplinary Communication, Multidetector Computed Tomography, Multiple Trauma classification, Multiple Trauma mortality, Multiple Trauma therapy, Prognosis, Referral and Consultation, Risk Factors, Ultrasonography, Whole Body Imaging, Diagnostic Imaging, Emergency Service, Hospital, Multiple Trauma diagnosis
- Abstract
In order to reduce mortality in severely injured patients, a rapid radiologic diagnosis is essential. Sonography plays a role only as a focused assessment with sonography for trauma (FAST) to clarify free intraperitoneal fluid immediately on admittance. Today, whole-body multislice helical computed tomography (CT) has become increasingly important as a diagnostic tool. Based on the results of the CT scan, patients can be referred for laparotomy or safely classified for "wait and see" treatment. Although the reduction in injury-related mortality would outweigh the risk of radiation dose, the indiscriminate use of CT for patients with minor injuries is not justified and must be avoided.
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- 2011
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46. [Advances in imaging modalities of hepatocellular carcinoma].
- Author
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Imai Y, Kogita S, Igura T, Sawai Y, Ohama H, Fukuda K, Seki Y, Takamura M, Okada M, and Murakami T
- Subjects
- Contrast Media, Ferric Compounds, Gadolinium DTPA, Humans, Iron, Magnetic Resonance Imaging, Multidetector Computed Tomography, Oxides, Carcinoma, Hepatocellular diagnosis, Diagnostic Imaging methods, Liver Neoplasms diagnosis
- Published
- 2011
47. Optimizing Coronary Computed Tomography Angiography Using a Novel Deep Learning-Based Algorithm.
- Author
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Dreesen, H. J. H., Stroszczynski, C., and Lell, M. M.
- Subjects
MOTION ,SCALE analysis (Psychology) ,DIAGNOSTIC imaging ,DATA analysis ,BLOOD vessels ,COMPUTED tomography ,DESCRIPTIVE statistics ,DEEP learning ,STATISTICS ,CORONARY angiography ,MEDICAL artifacts ,DIGITAL image processing ,ALGORITHMS ,MULTIDETECTOR computed tomography - Abstract
Coronary computed tomography angiography (CCTA) is an essential part of the diagnosis of chronic coronary syndrome (CCS) in patients with low-to-intermediate pre-test probability. The minimum technical requirement is 64-row multidetector CT (64-MDCT), which is still frequently used, although it is prone to motion artifacts because of its limited temporal resolution and z-coverage. In this study, we evaluate the potential of a deep-learning-based motion correction algorithm (MCA) to eliminate these motion artifacts. 124 64-MDCT-acquired CCTA examinations with at least minor motion artifacts were included. Images were reconstructed using a conventional reconstruction algorithm (CA) and a MCA. Image quality (IQ), according to a 5-point Likert score, was evaluated per-segment, per-artery, and per-patient and was correlated with potentially disturbing factors (heart rate (HR), intra-cycle HR changes, BMI, age, and sex). Comparison was done by Wilcoxon-Signed-Rank test, and correlation by Spearman's Rho. Per-patient, insufficient IQ decreased by 5.26%, and sufficient IQ increased by 9.66% with MCA. Per-artery, insufficient IQ of the right coronary artery (RCA) decreased by 18.18%, and sufficient IQ increased by 27.27%. Per-segment, insufficient IQ in segments 1 and 2 decreased by 11.51% and 24.78%, respectively, and sufficient IQ increased by 10.62% and 18.58%, respectively. Total artifacts per-artery decreased in the RCA from 3.11 ± 1.65 to 2.26 ± 1.52. HR dependence of RCA IQ decreased to intermediate correlation in images with MCA reconstruction. The applied MCA improves the IQ of 64-MDCT-acquired images and reduces the influence of HR on IQ, increasing 64-MDCT validity in the diagnosis of CCS. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
48. Bridge bronchus and pulmonary artery sling: Case report and literature review
- Author
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Lizeth Pardo, Santiago Ardila, Meggy Bitar, Michela Moreno, and Sara Ruiz
- Subjects
Bronchi ,Pulmonary artery abnormalities ,Tracheal abnormalities ,Diagnostic imaging ,Multidetector computed tomography ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
We present the case of a 14-year-old adolescent boy with a history of poorly controlled asthma and a final diagnosis of a bridge bronchus associated with sling of the left pulmonary artery. Regarding the case report, we describe the characteristic findings in computerized tomography multidetector of the thorax, its classification, and the most relevant information about this malformation. Congenital malformations of the tracheobronchial tree may occur in the context of asymptomatic or symptomatic respiratory patients. These malformations may be associated with other vascular, tracheal, and syndromes with multiorgan involvement. Although most patients are asymptomatic, some of them will have nonspecific symptoms without a clear etiology or will be diagnosed incidentally during the diagnostic evaluation of other pathologies. It is important to know and recognize the normal anatomy and its variations, since radiology undoubtedly plays a fundamental role in the diagnosis and preoperative assessment of these malformations, which although they have low incidence, must be identified in a timely manner by the specialist in diagnostic images.
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- 2024
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49. Assessment of Arterial Involvement in Pancreatic Cancer: Utility of Reconstructed CT Images Perpendicular to Artery.
- Author
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Noda, Yoshifumi, Kobayashi, Kazuhiro, Kawaguchi, Masaya, Ando, Tomohiro, Takai, Yukiko, Suto, Taketo, Iritani, Yukako, Ishihara, Takuma, Fukada, Masahiro, Murase, Katsutoshi, Kawai, Nobuyuki, Kaga, Tetsuro, Miyoshi, Toshiharu, Hyodo, Fuminori, Kato, Hiroki, Miyazaki, Tatsuhiko, Matsuhashi, Nobuhisa, Yoshida, Kazuhiro, and Matsuo, Masayuki
- Subjects
- *
ARTERIOGRAPHY , *DIAGNOSTIC imaging , *COMPUTED tomography , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *PANCREATIC tumors , *COMPUTER-aided diagnosis , *MEDICAL records , *ACQUISITION of data , *PANCREATECTOMY , *DIGITAL image processing , *CONFIDENCE intervals , *CONTRAST media , *SPLENIC artery - Abstract
Simple Summary: The diagnostic performance and interobserver variability of the contrast-enhanced CT currently used for evaluating arterial involvement from pancreatic cancer has limitations. The purpose of this study was to investigate the utility of reconstructed CT images perpendicular to the artery for assessing arterial involvement from pancreatic cancer and to compare the interobserver variability between it and the current diagnostic imaging method. We found that reconstructed CT images perpendicular to the splenic artery were feasible and showed less interobserver variability than current diagnostic method images. The purpose of this study was to investigate the utility of reconstructed CT images perpendicular to the artery for assessing arterial involvement from pancreatic cancer and compare the interobserver variability between it and the current diagnostic imaging method. This retrospective study included patients with pancreatic cancer in the pancreatic body or tail who underwent preoperative pancreatic protocol CT and distal pancreatectomy. Five radiologists used axial and coronal CT images (current method) and perpendicular reconstructed CT images (proposed method) to determine if the degree of solid soft-tissue contact with the splenic artery was ≤180° or >180°. The generalized estimating equations were used to compare the diagnostic performance of solid soft-tissue contact >180° between the current and proposed methods. Fleiss' ĸ statistics were used to assess interobserver variability. The sensitivity and negative predictive value for diagnosing solid soft-tissue contact >180° were higher (p < 0.001 for each) and the specificity (p = 0.003) and positive predictive value (p = 0.003) were lower in the proposed method than the current method. Interobserver variability was improved in the proposed method compared with the current method (ĸ = 0.87 vs. 0.67). Reconstructed CT images perpendicular to the artery showed higher sensitivity and negative predictive value for diagnosing solid soft-tissue contact >180° than the current method and demonstrated improved interobserver variability. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
50. Image Quality and Lesion Detection of Multiplanar Reconstruction Images Using Deep Learning: Comparison with Hybrid Iterative Reconstruction.
- Author
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Hiroto Yunaga, Hidenao Miyoshi, Ryoya Ochiai, Takuro Gonda, Toshio Sakoh, Hisashi Noma, and Shinya Fujii
- Subjects
DEEP learning ,COMPUTED tomography ,IMAGE quality analysis ,DIAGNOSTIC imaging ,BONFERRONI correction - Abstract
Background: We assessed and compared the image quality of normal and pathologic structures as well as the image noise in chest computed tomography images using "adaptive statistical iterative reconstruction-V" (ASiR-V) or deep learning reconst ruction "TrueFidelity". Methods: Forty consecutive patients with suspected lung disease were evaluated. The 1.25-mm axial images and 2.0-mm coronal multiplanar images were reconstructed under the following three conditions: (i) ASiR-V, lung kernel with 60% of ASiR-V; (ii) TF-M, standard kernel, image filter (Lung) with TrueFidelity at medium strength; and (iii) TF-H, standard kernel, image filter (Lung) with TrueFidelity at high strength. Two radiologists (readers) independently evaluated the image quality of anatomic structures using a scale ranging from 1 (best) to 5 (worst). In addition, readers ranked their image preference. Objective image noise was measured using a circular region of interest in the lung parenchyma. Subjective image quality scores, total scores for normal and abnormal structures, and lesion detection were compared using Wilcoxon's signedrank test. Objective image quality was compared using Student's paired t-test and Wilcoxon's signed-rank test. The Bonferroni correction was applied to the P value, and significance was assumed only for values of P < 0.016. Results: Both readers rated TF-M and TF-H images significantly better than ASiR-V images in terms of visualization of the centrilobular region in axial images. The preference score of TF-M and TF-H images for reader 1 were better than that of ASiR-V images, and the preference score of TF-H images for reader 2 were significantly better than that of ASiR-V and TF-M images. TF-M images showed significantly lower objective image noise than ASiR-V or TF-H images. Conclusion: TrueFidelity showed better image quality, especially in the centrilobular region, than ASiR-V in subjective and objective evaluations. In addition, the image texture preference for TrueFidelity was better than that for ASiR-V. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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