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Current Problems in Diagnostic Radiology

Scott Parker, Megan Saettele, Matthew Morgan, Matthew Stein, Nicole Winkler
INTRODUCTION: Extensive physiologic changes occur in the breasts during pregnancy and lactation. Additionally, several specific benign lesions are also common in pregnant and lactating patients. These changes and lesions have characteristic imaging appearances and findings. OBJECTIVE: This article provides an image-rich educational review of typical and atypical benign imaging findings in pregnant and lactating patients. The discussion also includes basic imaging protocol considerations and explores management options...
December 27, 2016: Current Problems in Diagnostic Radiology
Lena Naffaa, Tejaswini Deshmukh, Shanthan Tumu, Chris Johnson, Kevin P Boyd, Arthur B Meyers
: Identifying the etiology of acute pelvic pain in girls is often clinically challenging. Particularly in young girls, it is often difficult to determine if acute pelvic symptoms are originating from a gynecologic source or from a genitourinary or gastrointestinal etiology based on the child's clinical examination alone. Therefore, imaging plays a key role in establishing a diagnosis and in directing medical and surgical treatment. Pediatric gynecologic conditions, which can present acutely with pain or mass or both include ovarian torsion, hematometrocolpos, pelvic inflammatory disease, inguinal hernias containing an ovary or the uterus or both, adnexal cysts, pregnancy, vaginal foreign bodies, and ovarian vein thrombosis...
December 21, 2016: Current Problems in Diagnostic Radiology
Keith D Herr, Tarek N Hanna, Bharti Khurana, Jamlik-Omari Johnson, Aaron Sodickson
No abstract text is available yet for this article.
December 21, 2016: Current Problems in Diagnostic Radiology
Suraj H Rambhia, Catherine A D'Agostino, Ali Noor, Robert Villani, Jason J Naidich, John S Pellerito
Thoracic ultrasound is used at the bedside in emergency and critical care settings. Advantages of ultrasound include rapid real-time, low-cost, diagnostic information that can direct patient care without the use of ionizing radiation. We describe methods on how to perform lung ultrasound, with the intent to educate the radiologist who might otherwise be relatively unfamiliar with thoracic sonography. We describe and depict the normal sonographic appearance of lung anatomy. We also show the sonographic appearance of a wide range of lung and pleural pathologies such as pneumonia, pneumothorax, as well as lung and pleural masses...
December 15, 2016: Current Problems in Diagnostic Radiology
Donald Dj Perry, Derek Khorsand, Michael McNeeley
In the last century, rapidly advancing technological innovations have become essential components of modern healthcare, increasing the frequency and necessity of interactions between physicians and industry. These interactions have the potential to bias objectivity and should be approached carefully. A recent JACR article by Harvey et al, highlighted 2014 CMS data, which reported that only 4% of radiologists had interactions with industry, coming in second lowest amongst all 19 reported specialties. However, when managed appropriately, physician-industry relationships can mutually benefit patients, research, payers, providers, hospitals and the medical industry...
December 15, 2016: Current Problems in Diagnostic Radiology
Hemang M Kotecha, Lacey J McIntosh, Hao S Lo, Byron Y Chen, Carolyn S Dupuis
In this article, we discuss the challenges in the diagnosis of acute abdominopelvic pain in pregnant patients, role of imaging, and advantages of MRI over other modalities. Methods consist of pictorial review. We review the differential diagnoses and illustrate the MRI findings in pregnant patients with acute abdominopelvic pain, including gastrointestinal, gynecologic, urologic, and vascular etiologies.
December 15, 2016: Current Problems in Diagnostic Radiology
Shlomit Goldberg-Stein, William R Walter, E Stephen Amis, Meir H Scheinfeld
PURPOSE: To describe the successful implementation of a structured reporting initiative in a large urban academic radiology department. METHODS: We describe our process, compromises, and top 10 lessons learned in overhauling traditional reporting practices and comprehensively implementing structured reporting at our institution. To achieve our goals, we took deliberate steps toward consensus building, undertook multistep template refinement, and achieved close collaboration with the technical staff, department coders, and hospital information technologists...
December 15, 2016: Current Problems in Diagnostic Radiology
Cameron E Gaskill, Vlad V Simianu, Jonathan Carnell, Daniel S Hippe, Puneet Bhargava, David R Flum, Giana H Davidson
PURPOSE: Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined...
December 7, 2016: Current Problems in Diagnostic Radiology
Girish S Shroff, Brett W Carter, Chitra Viswanathan, Marcelo F Benveniste, Carol C Wu, Edith M Marom, Osama R Mawlawi, Mylene T Truong
(18)F-fluorodeoxryglucose ((18)F-FDG) PET/CT imaging is routinely performed in the evaluation of patients with known or suspected thoracic malignancy. Indications for its use include staging of malignancy, assessment of response to therapy, evaluation of suspected disease recurrence, and evaluation of a solitary pulmonary nodule. In this article, we will discuss specific technical artifacts and also review potential pitfalls in the interpretation of PET/CT in thoracic malignancies including normal variations in physiologic uptake of FDG, benign conditions (such as infection, inflammation, posttreatment changes, and iatrogenic factors) that can result in increased FDG uptake, and malignancies that demonstrate scarce to no FDG uptake...
December 6, 2016: Current Problems in Diagnostic Radiology
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...
December 5, 2016: Current Problems in Diagnostic Radiology
Puneet Bhargava
No abstract text is available yet for this article.
January 2017: Current Problems in Diagnostic Radiology
Wendy Hansen, Mariam Moshiri, Angelisa Paladin, Ramit Lamba, Douglas S Katz, Puneet Bhargava
OBJECTIVE: The purpose of our study was to determine the current practice patterns of U.S. radiologists in imaging pregnant or potentially pregnant patients with acute abdominal and pelvic conditions. MATERIALS AND METHODS: After obtaining an Institutional Review Board waiver, all members of the Association of University Radiologists, the Association of Program Directors in Radiology, and the Society of Radiologists in Ultrasound were invited via e-mail to take a 23-question online survey on radiology practices and clinical scenarios about acute abdominal and pelvic imaging of pregnant patients...
January 2017: Current Problems in Diagnostic Radiology
Vibhor Wadhwa, Paul Nagy, Avneesh Chhabra, Cindy S Lee
Mentoring is an essential part of a resident's career development. It plays an important role in nurturing, and sustaining success along the career path of a young physician. Mentoring is a long-term goal that is development-driven rather than performance-driven. Although specific learning goals may be used as a basis, the focus of mentoring may also include self-confidence, self-perception, and work-life balance. A number of residency programs have implemented mentoring programs in their institutions. This article discusses the importance of mentoring, illustrates "do's and don'ts" for mentees and demonstrates how to choose the ideal mentor...
January 2017: Current Problems in Diagnostic Radiology
Shawn S Carter, Syed Ramisa Ehsan, Richard Duszak, Daniel J Lee, Fabio P Esteves, David C Brandon, Raghuveer K Halkar
OBJECTIVE: To optimize resource utilization of cholescintigraphy for suspected acute cholecystitis with a time-saving method without a loss in diagnostic accuracy. MATERIALS AND METHODS: Institutional review board approval was obtained for this retrospective study. Hepatobiliary imaging data for 81 patients with suspected acute cholecystitis were recalled for modification into 2 summed static images, using only the first and last 5 minutes of the dynamic images, thereby eliminating the middle 50 minutes of imaging data...
January 2017: Current Problems in Diagnostic Radiology
Jack Porrino, Blake Carlson, Kimia K Kani, Hyojeong Mulcahy, Alvin Wyatt, Felix S Chew
Most of the destructive joint disease necessitating arthoplasty is the result of an insidious and protracted process that occurs over the course of many years. However, there are a variety of diseases that may result in a rapid progressive deterioration of a joint. We describe both the common and less common etiologies of rapidly destructive arthropathy that one should consider, with imaging examples, and present discriminative factors when present.
January 2017: Current Problems in Diagnostic Radiology
Michael Yu, Kathryn Robinson, Cary Siegel, Christine Menias
This article provides pictorial review of complicated upper and lower genitourinary infections and their mimics. Imaging features of upper urinary tract infections including uncomplicated acute pyelonephritis, xanthogranulomatous pyelonephritis (XGPN), emphysematous pyelonephritis, perirenal abscess, and pyonephrosis are first reviewed and then followed by pictorial review of their mimics including contrast-associated nephrotoxicity, renal infarcts, malakoplakia, renal cell cancer, leukemia or lymphoma and Castleman's disease...
January 2017: Current Problems in Diagnostic Radiology
Kyungmin Shin, Kanchan Phalak, Anthony Hamame, Gary J Whitman
The Breast Imaging Reporting and Data System (BI-RADS) was first initiated in the late 1980s in order to standardize reporting, improve report organization, and to monitor outcomes for more clear, concise, and uniform communication of breast imaging findings. In the BI-RADS 5th edition, several changes and new additions have been made to the magnetic resonance imaging (MRI) lexicon, reflecting increased utilization and availability of breast MRI in clinical practice. Understanding the role and appropriate utilization of breast MRI and the BI-RADS lexicon could help with interpretation and effective communication of MRI findings as well as preparing for incorporation of more advanced imaging techniques...
January 2017: Current Problems in Diagnostic Radiology
Joseph T Azok, Michael A Bolen, Jason K Lempel, Rahul D Renapurkar
Interventional pulmonology (IP) is a relatively new field that uses endoscopy and other technologies for both the diagnosis and treatment of pulmonary and thoracic conditions. IP is a continually developing field driven by clinical need as well as technological and therapeutic innovation. Developments in IP have increased both the efficacy and breadth of procedures that may be encountered by radiologists on periprocedural and postprocedural imaging. In this article, we will describe commonly performed IP procedures, with a focus on relevant imaging implications for radiologists...
January 2017: Current Problems in Diagnostic Radiology
Bethany Milliron, Pardeep K Mittal, Juan C Camacho, Abhijit Datir, Courtney Coursey Moreno
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with most occurring in the stomach. GISTs may present with clinical symptoms (eg, gastrointestinal bleeding) or may be found incidentally at surgery, endoscopy, or imaging. At initial staging, GISTs often appear as well-circumscribed, round, solid masses. Small tumors may appear solid, whereas larger tumors may demonstrate central areas of necrosis. At follow-up imaging, decreasing tumor attenuation at computed tomographic indicates treatment response even in the setting of stable tumor size...
January 2017: Current Problems in Diagnostic Radiology
Geraldine N Abbey-Mensah, Stephen Waite, Deborah Reede, Cameron Hassani, Alan Legasto
The diaphragm is often overlooked or incompletely evaluated when interpreting chest radiographs. Alterations in the appearance of the diaphragm on chest radiographs such as elevation, contour abnormalities, adjacent lucency, and calcifications can offer clues to pulmonary and extrapulmonary pathology. Familiarity with common causes of these alterations facilitates the appropriate selection of additional imaging and leads to the diagnosis of both benign and life-threatening processes. This article reviews normal variations in the appearance of the diaphragm as well as those associated with pulmonary and extrapulmonary pathology...
January 2017: Current Problems in Diagnostic Radiology
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