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Current Problems in Diagnostic Radiology

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https://www.readbyqxmd.com/read/28318763/pancreatic-carcinosarcoma-a-case-report-highlighting-computed-tomography-characteristics
#1
Steven Mszyco, Leslie Teng, Joseph Annunziata, Matthew S Hartman
Primary pancreatic carcinosarcoma is a rare and malignant neoplasm arising within the pancreas. With fewer than a dozen cases ever reported, the recognition and treatment of this rare phenomenon can be difficult. We describe the case of an 85-year-old man who presented with vague right upper quadrant and epigastric abdominal pain and was found to have a pancreatic mass on ultrasound and computed tomography. The patient underwent open pancreaticoduodenectomy and was found to have pancreatic carcinosarcoma on microscopic evaluation...
January 27, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28291556/teaching-communication-skills-to-radiology-residents
#2
Jason N Itri, Sammy Yacob, Ayman Mithqal
The transition of health care in the United States from volume to value requires a systems-based approach aligning clinical services across the continuum of care. The ability to communicate effectively and resolve conflict is a critical skill within the systems-based model. Recognizing the essential role of communication in medicine, the Accreditation Council of Graduate Medical Education has designated interpersonal and communication skills a core competency for all residents regardless of specialty. Yet, communication skills are often developed through on-the-job training or not at all...
January 17, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28302329/the-high-performing-radiology-residency-a-case-study
#3
Lu Anne V Dinglasan, Mary H Scanlon
The primary goal of any radiology residency program is to train clinically competent radiologists. However, some radiology programs go above and beyond basic ACGME requirements and produce highly productive radiologists who contribute to the field in research, education and technology. At the core of such residencies are the people who comprise it, including self-motivated, personable residents and faculty who can facilitate excellence from their trainees. Indeed, radiology residencies which create unique programs in response to evolving resident interests can help foster resident-driven research, advocacy, technological innovation and early leadership...
January 14, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28284459/unexpected-presentation-of-perianal-granular-cell-tumor-in-a-young-woman
#4
Laila Rashidi, Darren Pollock, Sarah Bastawrous
Granular cell tumors originate from Schwann cells of the soft tissues and are rarely observed in the perianal region. Often, correct diagnosis can be challenging owing to nonspecific clinical symptoms and imaging characteristics, as well as its ability to mimic other malignant lesions histologically. We describe the case of a previously healthy 36-year-old woman who presents with a slow growing, painless lump in her perianal region who underwent surgical excision and was found to have a granular cell tumor on microscopic evaluation...
January 14, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28262386/resident-perspectives-of-an-interactive-case-review-following-independent-didactic-study-as-a-method-of-teaching-a-pediatric-imaging-curriculum
#5
Aleksandr Rozenberg, Sachin Dheer, Levon N Nazarian, Suzanne S Long
PURPOSE: The ABR has recently changed the format of the board examination, in which the oral examination was replaced by a computer based multiple-choice test. The purpose of this study was to determine resident's perceptions of a new conference resembling the new ABR format. METHODS: Residents were requested to review a series of didactic pediatric imaging presentations prior to attending case conference. During conference, unknown cases reflecting the subject matter from the didactic presentations were presented along with multiple-choice questions...
January 14, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28215521/orbital-imaging-manifestations-of-neurocutaneous-syndromes-revisited
#6
REVIEW
Abanti Das, Sanjay Sharma
Neurocutaneous syndromes or phakomatoses represent a heterogeneous group of multisystemic disorders involving structures of ectodermal origin. Characteristic ocular manifestations are described for individual entities that are often the first clues to the underlying diagnosis. However, opaque ocular media or involvement of retrobulbar orbit limits adequate clinical evaluation. This underlines the role of imaging, especially cross-sectional imaging modalities, such as computed tomography and magnetic resonance imaging, which offer a comprehensive evaluation of orbit and its contents...
December 30, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28215519/repeatability-of-computerized-tomography-based-anthropomorphic-measurements-of-frailty-in-patients-with-pulmonary-fibrosis-undergoing-lung-transplantation
#7
Taylor McClellan, Brian C Allen, Matthew Kappus, Lubna Bhatti, Randa A Dafalla, Laurie D Snyder, Mustafa R Bashir
PURPOSE: To determine interreader and intrareader repeatability and correlations among measurements of computerized tomography-based anthropomorphic measurements in patients with pulmonary fibrosis undergoing lung transplantation. METHODS: This was an institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study of 23 randomly selected subjects (19 male and 4 female; median age = 69 years; range: 66-77 years) with idiopathic pulmonary fibrosis undergoing pulmonary transplantation, who had also undergone preoperative thoracoabdominal computerized tomography...
December 29, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28237007/extreme-pareto-the-one-thing
#8
EDITORIAL
P Bhargava
No abstract text is available yet for this article.
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28104316/creating-and-sustaining-a-successful-fellowship-program-challenges-and-solutions
#9
Keith D Herr, Tarek N Hanna, Bharti Khurana, Jamlik-Omari Johnson, Aaron D Sodickson
Subspecialty expertise and fellowship training are two of the most desirable attributes in new radiology hires and, not surprisingly, the vast majority of diagnostic radiologists entering the job market today have had fellowship training. Fellowship training imparts not only expertise beyond that which is attainable during residency, but also a unique opportunity for professional maturation. In this article, we offer guidance in planning, building and sustaining a successful fellowship. The key steps in this process include strategic planning, development of a curriculum that can be customized to meet the educational goals of any individual fellow, professional development and trainee preparation for the marketplace, and approaches to ensure program longevity and success through local, regional and national fellow recruitment efforts...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28062089/structured-reporting-of-magnetic-resonance-enterography-for-pediatric-crohn-s-disease-effect-on-key-feature-reporting-and-subjective-assessment-of-disease-by-referring-physicians
#10
Benjamin Wildman-Tobriner, Brian C Allen, Joseph T Davis, Chad M Miller, Gary R Schooler, Nancy M McGreal, Reinaldo Quevedo, Julie K Thacker, Tracy A Jaffe
PURPOSE: To objectively compare the content of structured reports (SR) vs nonstructured reports (NSR) for magnetic resonance enterography (MRE) of pediatric patients with Crohn's disease, and to evaluate referring clinicians' subjective assessment of reports. METHODS: This institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study included 25 pediatric subjects (15 male, 10 female; mean age = 14 years [range: 9-18 years]) with Crohn's disease imaged with MRE...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28040296/behavioral-interviewing-integrating-acgme-competency-based-questions-into-the-radiology-resident-selection-process
#11
Tatum A McArthur, Jonathan A Flug, Nicole Restauri
The practice of radiology is continually evolving with external pressures increasing the involvement of the radiologist as an integrated member of the multidisciplinary care delivery team and not just image interpreters working in isolation. Radiologists need to be comfortable interacting directly with patients and practicing "patient and family-centered care" and "value-based medicine." Despite this evolving role of the radiologist, medical training and the residency selection process have not significantly adapted to accommodate these new demands...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27823820/daily-readiness-huddles-in-radiology-improving-communication-coordination-and-problem-solving-reliability
#12
Lane F Donnelly
Deploying an intentional daily management process is a key part to create high-reliability culture. Key components described in the literature for a successfully daily management process include leadership standard work, visual controls, daily accountability processes, and the discipline to stick to the process over the long term. We believe that the institution of a daily readiness huddle has helped us better coordinate and communicate as a department and improved our ability to deliver imaging services on a daily basis...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27475832/the-multiple-faces-of-nervous-system-lymphoma-atypical-magnetic-resonance-imaging-features-and-contribution-of-the-advanced-imaging
#13
REVIEW
María Del Mar Jiménez de la Peña, Lidia Gómez Vicente, Raquel Cano Alonso, Silvia Fuertes Cabero, Antonio Maldonado Suárez, Vicente Martínez de Vega
Primary central nervous system lymphoma (PCNSL) is an uncommon variant of extranodal non-Hodgkin lymphoma, which involves the brain, leptomeninges, eyes, or spinal cord without evidence of systemic disease. In addition to a detailed history and physical examination, the evaluation of patients suspected of having a PCNSL should include a contrast-enhanced magnetic resonance imaging. Occassionaly, PCNSL shows peculiarities on magnetic resonance imaging, which delay the diagnosis and thus the start of treatment...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27338308/incidental-suspicious-regional-lymph-nodes-on-breast-sonography-is-sampling-necessary
#14
Sean D Raj, Ahmed M Amer, Naveen Garg, Savitri Krishnamurthy, Kenneth R Hess, Young Mi Park, Tanya Moseley, Gary J Whitman
Suspicious regional lymph nodes may be incidentally identified on breast ultrasound examinations in patients who present for sonographic evaluation without a known or a suspected breast malignancy, and there is a paucity of data on whether biopsy should be performed. This study aims to characterize incidental sonographically detected suspicious regional lymph nodes and determine whether tissue sampling or follow-up imaging is required. A total of 40,773 consecutive breast ultrasounds were reviewed. Overall, 7 women with nonpalpable, incidental, suspicious axillary or supraclavicular lymph nodes in an otherwise unremarkable breast and without history of malignancy or systemic disease were identified...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27289137/breast-density-reporting-laws-and-supplemental-screening-a-survey-of-referring-providers-experiences-and-understanding
#15
Santo Maimone, Michelle D McDonough, Stephanie L Hines
Dense breast parenchyma obscures breast lesions on mammography and is an independent risk factor for development of breast cancer. Many states have approved laws requiring patient notification of dense breast tissue. Supplemental screening modalities are available however their utilization and efficacy are quite variable. Our aim was to survey primary care providers in an effort to gauge awareness of and familiarity with dense breast legislation and supplemental screening. A multisite survey was administered via e-mail to all Mayo Clinic staff physicians, residents and fellows, as well as nurse practitioners and physician assistants in the departments of Internal Medicine, Family Medicine, and Obstetrics and Gynecology...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27234338/poem-procedure-what-the-radiologist-needs-to-know-for-this-new-surgical-intervention-for-achalasia
#16
Brian Williams, Jonathan Kass, Rishi Maheshwary, Krishna Gurram, Matthew Hartman
Achalasia is a debilitating condition resulting from the failure of appropriate lower esophageal sphincter relaxation. Traditionally, the treatment of choice for achalasia has been a Heller myotomy, performed either via laparotomy or laparoscopically. The latter method has gained wide popularity in its documented lower postoperative morbidity. Recently, however, a new technique has been developed that can be performed by both thoracic surgeons and endoscopists-Per-Oral Endoscopic Myotomy. This procedure offers an alternative to invasive surgery and provides excellent outcomes with minimal recovery time...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27207823/congenital-and-acquired-disorders-of-ureteral-course
#17
REVIEW
David C Reisner, Megan T Elgethun, Matthew T Heller, Paul R Klepchick, Matthew S Hartman
A wide variety of entities can alter the course of the ureter in the abdomen and pelvis. These include conditions both intrinsic and extrinsic to the ureter leading to a number of different ureteral abnormalities including thickening, displacement, dilatation, etc. An understanding of ureteral pathology, as with any organ, first requires understanding of the normal anatomic appearance. The ureter can be evaluated in a number of ways, including radiographs, such as intravenous pyelogram and retrograde pyelogram, as well as computed tomography or magnetic resonance urography...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/27017404/avoiding-pitfalls-maximizing-success-at-image-guided-breast-interventions-a-pictorial-review
#18
REVIEW
Eren D Yeh, Elisabeth P Frost, Sughra Raza, Robyn L Birdwell, Catherine S Giess
Imaging and image-guided interventions have become increasingly important in the workup and treatment of breast lesions in the past 2 decades. Radiologists should be aware of potential pitfalls during the workup, the procedure itself, and in the postprocedure follow-up. In this pictorial review, we illustrate challenges related to technique and interpretation related to breast interventions, and suggest ways to maximize success.
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/26949063/pseudoangiomatous-stromal-hyperplasia-of-the-breast-multimodality-review-with-pathologic-correlation
#19
REVIEW
Sean D Raj, Vivek G Sahani, Beatriz E Adrada, Marion E Scoggins, Constance T Albarracin, Piyanoot Woodtichartpreecha, Flavia E Posleman Monetto, Gary J Whitman
Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast condition. PASH is thought to be hormonally responsive, and it is usually identified in premenopausal and perimenopausal women. PASH may also be seen in postmenopausal woman on hormone replacement therapy (HRT). Approximately 53% of patients with PASH present with abnormalities on screening mammography, and 44% of patients with PASH present with palpable abnormalities. On imaging studies, PASH appears similar to fibroadenomas. On mammography, PASH is usually seen as a noncalcified, circumscribed mass...
March 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/26949062/upper-extremity-runoff-pearls-and-pitfalls-in-computed-tomography-angiography-and-magnetic-resonance-angiography
#20
REVIEW
Prashant Nagpal, Vinod Maller, Gunjan Garg, Sandeep Hedgire, Ashish Khandelwal, Sanjeeva Kalva, Michael L Steigner, Sachin S Saboo
Upper extremity vasculature can be affected by various traumatic and nontraumatic pathologies; however, the evaluation of these arteries can be challenging for the radiologists as well as for the clinicians. After an accurate history and clinical examination, imaging plays a vital role in the diagnosis and treatment planning of these patients. Depending on the urgency and the indication, upper extremity arteries may be evaluated by ultrasonography with color Doppler, computed tomography (CT), magnetic resonance imaging (MRI), or digital subtraction angiography...
March 2017: Current Problems in Diagnostic Radiology
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