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Current Problems in Diagnostic Radiology

Hina Arif-Tiwari, Christian O Twiss, Frank C Lin, Joel T Funk, Srinivasan Vedantham, Diego R Martin, Bobby T Kalb
PURPOSE: To evaluate the utility of a defecography phase (DP) sequence in dynamic pelvic floor MRI (DPMRI), in comparison to DPMRI utilizing only non-defecography Valsalva maneuvers (VM). MATERIALS AND METHODS: Inclusion criteria identified 237 female patients with symptoms and/or physical exam findings of pelvic floor prolapse. All DPMRI exams were obtained following insertion of ultrasound gel into the rectum and vagina. Steady-state free-precession sequences in sagittal plane were acquired in the resting state, followed by dynamic cine acquisitions during VM and DP...
August 23, 2018: Current Problems in Diagnostic Radiology
Wonsuk Kim, Jack A Porrino, Kenneth A Hood, Tyson S Chadaz, Andrea S Klauser, Mihra S Taljanovic
We provide a comprehensive review of the clinical presentation, imaging evaluation, classification, and management of adolescent idiopathic and adult degenerative scoliosis.
August 23, 2018: Current Problems in Diagnostic Radiology
Bridgette E McCabe, Clinton A Veselis, Igor Goykhman, John Hochhold, Daniel Eisenberg, Hongju Son
Nonthrombotic pulmonary embolism (NTPE) is less well understood and is encountered less frequently than pulmonary embolism from venous thrombosis. NTPE results from embolization of nonthrombotic material to the pulmonary vasculature originating from many different cell types as well as nonbiologic or foreign materials. For many radiologists NTPE is a challenging diagnosis, presenting nonspecific or unusual imaging findings in the setting of few or unusual clinical signs. The aim of this paper is to review the pathophysiology of diverse causes of NTPE, which should aid radiologists to better understand and, more importantly, diagnose these infrequent events...
August 17, 2018: Current Problems in Diagnostic Radiology
Caitlin Hardy, Joshua P Hazelton, Ron Gefen
PURPOSE: Fractures of the thoracolumbar spine account for up to 90% of spinal fractures, and are associated with significant disability. The advantage of acquiring dedicated spine CT imaging in addition to visceral CT studies of the chest, abdomen and pelvis for detection of spinal fractures has not been definitively established. This retrospective study seeks to determine the contribution of dedicated spine CT in the acute clinical setting. METHODS: Patients who were diagnosed with fractures of the thoracic or lumbar spine at our institution between January 1, 2010 and June 30, 2014 were identified...
August 13, 2018: Current Problems in Diagnostic Radiology
Usha R Lalchandani, Vaibhav Sahai, Katherine Hersberger, Isaac R Francis, Ashish P Wasnik
Response Evaluation Criteria in Solid Tumors (RECIST), including version 1.0 and 1.1, has been universally accepted as the standard response assessment criteria for conventional chemotherapies. Increasing use of immunotherapy led to the need and development of immune-related RECIST. Imaging plays a crucial role in response assessment for solid tumors in guiding patient management as well as in clinical trials. Familiarity to different response criteria will help radiologists to optimally identify, select, and measure tumor lesions per the criteria and assess response to therapy...
August 2, 2018: Current Problems in Diagnostic Radiology
Timothy B Morgan, Don N Nguyen, Cassie D Tran, Rishi K Maheshwary, Timothy J Mickus
A Morgagni hernia is a congenital diaphragmatic hernia (CDH)-incomplete formation of the diaphragm. Though congenital diaphragmatic hernias (CDHs) are a common class of birth defect, the majority are diagnosed either prenatally or shortly after birth since these patients can present with cardiopulmonary failure due to pulmonary hypoplasia or pulmonary hypertension.1 However, the Morgagni type of CDH predisposes it to go undetected well into adulthood. We describe the case of a 63-year-old male who presented to the emergency room with epigastric pain and emesis...
July 31, 2018: Current Problems in Diagnostic Radiology
Daniel Lee Md, Jason Rafferty Bs, Beth Zigmund Md
BACKGROUND: A large number of chest radiography studies in our department include extra images due to incompletely imaged anatomy (eg, extra frontal view to include a truncated costophrenic angle). Negative impacts include: increased radiologist review time due to disruption of search pattern and the need to review additional films in slightly different obliquities, additional radiation exposure, and increased technologist time expenditure. PURPOSE: To determine the chest radiograph repeat rate, collaborate with technologists on a process to decrease the frequency, and incorporate the process into our quality control program...
July 29, 2018: Current Problems in Diagnostic Radiology
Guillermo P Sangster, David H Ballard, Miguel Nazar, Richard Tsai, Maren Donato, Horacio B D'Agostino
A broad spectrum of pathology affects the rectum, anus, and perineum and understanding of its relevant anatomy is important in accurate reporting, particularly in rectal cancer. In this pictorial essay, correlative imaging, endoscopic, pathologic, and operative images are presented to illustrate normal anorectal anatomy and neoplastic conditions that affect the anus and rectum. A particular case-based focus is given to rectal adenocarcinoma with pelvic MR and surgical histopathology. Additionally, carcinoid tumor, gastrointestinal stromal tumor, condylomata acuminata, squamous cell carcinoma, melanoma, and metastatic disease about the rectum and anus are reviewed...
July 29, 2018: Current Problems in Diagnostic Radiology
David H Ballard, Guillermo P Sangster, Richard Tsai, Sana Naeem, Miguel Nazar, Horacio B D'Agostino
A broad spectrum of pathology affects the rectum, anus, and perineum, and multiple imaging modalities are complementary to physical examination for assessment and treatment planning. In this pictorial essay, correlative imaging, endoscopic, pathologic, and operative images are presented for a range of rectal, perirectal, and perineal disease processes, including infectious/inflammatory, traumatic, congenital/developmental, vascular, and miscellaneous conditions. Key anatomic and surgical concepts are discussed, including radiological information pertinent for surgical planning, and current operative approaches of these anatomic spaces to assist radiologists in comprehensive reporting for gastroenterologists and surgeons...
July 29, 2018: Current Problems in Diagnostic Radiology
Payam Sajedi, Noriko Salamon, Jason Hostetter, Stellios Karnezis, Arvind Vijayasarathi
Preparing residents for the on-call experience in Radiology is one of the most important aspects of education within a training program. Traditionally, this preparation has occurred via a combination of case conferences and didactic lectures by program faculty, daily teaching at the workstation, and precall assessments. Recently, a blended curricular model referred to as the flipped classroom has generated a lot of attention within the realm of graduate medical education. We applied this technique to resident precall education in the subspecialty of Neuroradiology, and surveyed the participants about their perceptions of the course...
July 29, 2018: Current Problems in Diagnostic Radiology
Allyson L Chesebro, Anna F Rives, Kitt Shaffer
The male breast is susceptible to a variety of benign and malignant processes, many of which clinically present as a palpable finding, focal pain, or breast enlargement. Gynecomastia is the most common abnormality in the male breast and must be distinguished from malignancy. Imaging of the symptomatic male breast begins with a diagnostic mammogram in a patient ≥25 years and targeted ultrasound in a patient <25 years. If the breast finding is incompletely imaged or occult at mammography, targeted ultrasound must be performed...
July 29, 2018: Current Problems in Diagnostic Radiology
Julia E Goldberg, Andrew B Rosenkrantz
OBJECTIVE: To use Twitter to characterize public perspectives regarding artificial intelligence (AI) and radiology. METHODS AND MATERIALS: Twitter was searched for all tweets containing the terms "artificial intelligence" and "radiology" from November 2016 to October 2017. Users posting the tweets, tweet content, and linked websites were categorized. RESULTS: Six hundred and five tweets were identified. These were from 407 unique users (most commonly industry-related individuals [22...
July 23, 2018: Current Problems in Diagnostic Radiology
Vilert Loving, Brian Johnston, Elizabeth Valencia, Shay Dupras, Kristi Blackhurst, Joseph Rush, Rebekah Johnson, Mariann Figuli
With the use of intravenous contrast in medical imaging, radiologists and radiology personnel will inevitably encounter adverse events at their imaging facilities. At our institution, the stress of these emergency scenarios led to disorderly and unsafe responses by the staff. We present a quality improvement project, where our team addressed these unsafe emergency responses. Through explicit role delineation and standardization, we created an effective and efficient emergency response protocol that was replicable throughout our healthcare organization...
July 23, 2018: Current Problems in Diagnostic Radiology
Leonard Riley, Nupur Verma, Tan-Lucien Mohammed, Ali Ataya
Lymphangitic carcinomatosis, the presence of tumor within the pulmonary lymphatics, occurs in the setting of malignant tumors and is associated with a poor prognosis. Here we describe a case of lymphangitic carcinomatosis in the setting of renal cell carcinoma and review the radiological manifestations of this disease.
July 23, 2018: Current Problems in Diagnostic Radiology
Neena Kapoor, Glenn Gaviola, Aijia Wang, Victor D Babatunde, Ramin Khorasani
OBJECTIVE: Trainees play an important role in the delivery of medical services in academic medical centers, yet the full extent of their contribution in radiology is unknown. The purpose of this study was to quantify trainee involvement in a single large academic radiology department. MATERIALS AND METHODS: In this Institutional Review Board-approved retrospective study performed in a tertiary care academic medical center, we identified the proportion of radiology reports with trainee involvement (by means of report co-signature) between July 2015 and June 2016...
July 21, 2018: Current Problems in Diagnostic Radiology
Girish S Shroff, Edith M Marom, Carol C Wu, Mylene T Truong, Myrna C B Godoy
Hematopoietic stem cell transplantation (HSCT) is used in the treatment of various oncologic and hematologic diseases. After HSCT, patients are immunocompromised and are at risk for a wide variety of infectious and noninfectious complications. CT is routinely used when pulmonary complications are suspected after HSCT. In this article, we review the CT appearance of pulmonary complications that occur in the post-transplantation period with special emphasis on opportunistic infections, many of which are life-threatening...
July 21, 2018: Current Problems in Diagnostic Radiology
Jonathan Kass, Amir Sherkat, Elmer Nahum, Matthew Hartman
The following case report demonstrates an unusual case of a patient with multiple intravascular iatrogenic foreign bodies. An inferior vena cava filter was identified in the abdominal aorta, and multiple hydrophilic wire fragments were found in the pulmonary circulation. After describing the management of this patient, we discuss how radiologists can best distinguish between various intravascular iatrogenic foreign bodies. Determining the type of catheter or wire within the patient can not only establish the chronicity of the finding, but can determine whether or not endovascular retrieval is recommended, and by what method...
July 21, 2018: Current Problems in Diagnostic Radiology
Carolynn M DeBenedectis, Max P Rosen
No abstract text is available yet for this article.
July 5, 2018: Current Problems in Diagnostic Radiology
Pamela J DiPiro, Sree Harsha Tirumani, Nikhil H Ramaiya
OBJECTIVE: To evaluate the perception and ease of utilization of the imaging consultation service by different types of referring clinicians and physician extenders within the breast oncology disease center at our tertiary cancer institute using a survey-based questionnaire. METHODS: An institutional review board-exempted survey was created using a freely available online survey software and questionnaire tool. The survey was sent to 83 clinicians associated with the breast oncology disease center at our tertiary cancer center through an institutional e-mail list...
June 28, 2018: Current Problems in Diagnostic Radiology
Rebecca J Mieloszyk, Joshua I Rosenbaum, Christopher S Hall, Usha Nandini Raghavan, Puneet Bhargava
No abstract text is available yet for this article.
September 2018: Current Problems in Diagnostic Radiology
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