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Seminars in Ultrasound, CT, and MR

Gabriela Gayer
Thoracoliths are rare benign intrapleural loose bodies, often containing calcification, that are mobile in the pleural cavity. The presence of these intrapleural nodules is referred to as thoracolithiasis. The exact etiology of thoracoliths is unknown, but they presumably result from a prior episode of mediastinal (epipericardial) fat necrosis. Thoracoliths are usually asymptomatic and incidentally encountered on computed tomography. However, they sometimes pose diagnostic challenges, as a thoracolith may be located within a pleural fissure, and is then indistinguishable from a pulmonary nodule...
December 2017: Seminars in Ultrasound, CT, and MR
Gabriela Gayer
Necrosis of the fat adjacent to the heart, referred to as pericardial fat necrosis, epipericardial fat necrosis, and mediastinal fat necrosis, is a rare, self-limited condition. It presents as a sudden onset of severe chest pain that mimics symptoms of pulmonary embolism and acute coronary syndrome. Computed tomography (CT) findings are quite typical and consist of a round- or oval-shaped mass-like lesion containing soft tissue and fat density components in the cardiophrenic space. Lack of familiarity with this condition has led in the past to surgical interventions to remove the mass-like mediastinal fat necrosis...
December 2017: Seminars in Ultrasound, CT, and MR
Girish S Shroff, Daniel Ocazionez, Bindu Akkanti, Daniel Vargas, Alheli Garza, Pushpender Gupta, Jayeshkumar A Patel, Manish K Patel, Igor D Gregoric
Heart failure is becoming increasingly prevalent, and more patients are being treated with left ventricular assist devices (LVADs), either as a bridge to transplant or as destination therapy. The use of continuous-flow LVADs is on the rise. LVAD therapy is associated with several classes of complications, including bleeding, thrombosis, and infection. CT imaging can be used effectively to diagnose LVAD complications, including mediastinal hematomas and pericardial, abdominal wall, and retroperitoneal hemorrhage, inflow and outflow graft and aortic thrombi, and driveline and pump pocket infections...
December 2017: Seminars in Ultrasound, CT, and MR
Sonia L Betancourt Cuellar, Lior Heller, Diana P Palacio, Wayne L Hofstetter, Edith M Marom
Improvements in surgical technique over the last decade enable surgeons to perform extensive resection and reconstruction in patients presenting with tumors involving the soft tissue or bony structures of the chest wall. The type of surgical resection and its size, depend on the type of tumor resected and its location. In addition to providing a better esthetic result, the reconstruction restores support and functionality of the thoracic cage. The approach to chest wall repair includes primary closure or reconstruction by using transposition flaps, free flaps, prosthetic material, or a mixture of a flap and prosthetic material...
December 2017: Seminars in Ultrasound, CT, and MR
Girish S Shroff, Marcelo F Benveniste, Brett W Carter, Patricia M de Groot, Carol C Wu, Chitra Viswanathan, Bradley S Sabloff, Mylene T Truong
Pulmonary and pleural metastases are routinely identified on thoracic computed tomography. Pulmonary metastases are the most common pulmonary neoplasms and commonly originate from primary malignancies of the lung, breast, colon, pancreas, stomach, skin (ie, melanoma), head and neck, and kidney. Metastatic disease to the lungs may occur via 3 routes of spread: hematogenous, lymphatic, and endobronchial. Pleural metastases most commonly originate from primary malignancies of the lung and breast. Mechanisms of pleural metastatic involvement include hematogenous spread, direct invasion from a neighboring tumor, and retrograde lymphatic spread from the mediastinum...
December 2017: Seminars in Ultrasound, CT, and MR
Daniel Ocazionez, Girish S Shroff, Daniel Vargas, Demetrius Dicks, Abhishek Chaturvedi, Arun C Nachiappan, Horacio Murillo, Ameya Baxi, Carlos S Restrepo
Intrathoracic paragangliomas are uncommon and only represent 1%-2% of paragangliomas. They are most commonly found in mediastinal compartments (aortopulmonary window or posterior mediastinum). Computed tomography, magnetic resonance, and specific nuclear medicine radiotracers are routinely used to characterize these lesions and help exclude other more common conditions. Selective angiography is currently used for preoperative embolization and mapping of the vascular supply before surgical resection, rather than for diagnostic purposes alone...
December 2017: Seminars in Ultrasound, CT, and MR
Sonia L Betancourt Cuellar, Diana P Palacio, Marcelo F Benveniste, Brett W Carter, Wayne L Hofstetter, Edith M Marom
Squamous cell carcinoma and adenocarcinoma represent approximately 98% of esophageal malignant tumors. During the last 30 years, the incidence of adenocarcinoma has increased in Western countries (including the USA) where adenocarcinoma currently represents more than 60% of esophageal malignancies, although, worldwide, squamous cell carcinoma continues to be the predominant histologic type. Integrated positron emission tomography or computed tomography with 2-[fluorine18] fluro-2-deoxy-d-glucose is used in many institutions routinely as a tool in the initial staging and then repeated after therapy for the assessment of response to neoadjuvant therapy and detection of recurrent disease in patients with esophageal carcinoma...
December 2017: Seminars in Ultrasound, CT, and MR
Erika G Odisio, Edith M Marom, Girish S Shroff, Carol C Wu, Ana Paula A Benveniste, Mylene T Truong, Marcelo F Benveniste
Malignant pleural mesothelioma is the most common primary neoplasm of the pleura. Imaging evaluation is essential in diagnosis, staging, and assessment of treatment response in malignant pleural mesothelioma. Computed tomography is the most commonly used modality for tumor staging. Assessment of tumor extension and lymph node involvement is essential in imaging evaluation as locally advanced tumors are amenable to resection. Knowledge of the full imaging spectrum of this rare disease, differential diagnosis, staging classification, and the current guidelines for diagnostic evaluation and follow-up are essential in accurate interpretation to optimize patient management...
December 2017: Seminars in Ultrasound, CT, and MR
Gabriela Gayer
No abstract text is available yet for this article.
December 2017: Seminars in Ultrasound, CT, and MR
Seyed Ali Nabavizadeh, Sanjeev Chawla, Mohit Agarwal, Suyash Mohan
Conventional imaging modalities are limited in the evaluation of lymph nodes as they predominantly rely on size and morphology, which have suboptimal sensitivity and specificity for malignancy. In this review we will explore the role of "on the horizon" advanced imaging modalities that can look beyond the size and morphologic features of a cervical lymph node and explore its molecular nature and can aid in personalizing therapy rather than use the "one-size-fits-all" approach.
October 2017: Seminars in Ultrasound, CT, and MR
Amir A Borhani, Sara E Monaco
Image-guided percutaneous biopsy of cervical lymph nodes is a minimally invasive method performed for the characterization of abnormal lymph nodes, staging, and for the detection of regional tumor recurrence. When performed with proper technique and by a skilled proceduralist, this technique offers a very high diagnostic yield and can potentially save the patient from more invasive procedures. Its diagnostic role in different disease processes and the variations in technique as well as its potential risks and pitfalls will be discussed in this article...
October 2017: Seminars in Ultrasound, CT, and MR
Mohit Agarwal, Seyed Ali Nabavizadeh, Suyash Mohan
Cervical lymphadenopathy is a common indication for imaging evaluation of the neck. Besides metastatic squamous cell carcinoma of the head and neck, cervical lymphadenopathy can be due to many causes, with simple reactive lymphadenopathy on one end of the spectrum and malignant lymphadenopathy due to a distant infraclavicular primary, on the other end. A systematic approach to the cause of cervical lymphadenopathy, which includes pattern of lymph node enlargement, lymph node characteristics, systemic symptoms, and extranodal abnormalities, can be very useful in arriving at the correct diagnosis...
October 2017: Seminars in Ultrasound, CT, and MR
Ramanujam Prativadi, Nirvikar Dahiya, Aya Kamaya, Shweta Bhatt
With approximately 800 lymph nodes in the body, and more than one-third found within the head and neck, lymph nodes are a common site for neck pathology. Differentiation between benign and malignant lymph nodes is critical in accurate prognosis; similarly, treatment hinges on accurate identification of the etiology of the pathologic process. Key gray-scale and color Doppler ultrasound criteria can help accurately distinguish between benign and malignant lymph nodes.
October 2017: Seminars in Ultrasound, CT, and MR
Daniel Thomas Ginat, Anca M Avram
Determining the extent of disease is necessary for guiding the management of thyroid carcinomas. Diagnostic imaging, including ultrasound, computed tomography, magnetic resonance imaging, and nuclear medicine scans, plays an essential role in staging and restaging of thyroid carcinomas. This article reviews the approaches and imaging findings for evaluating the primary tumor, regional lymph node metastases, and distant metastases. In addition, potential pitfalls are discussed and depicted.
October 2017: Seminars in Ultrasound, CT, and MR
Hrishikesh Kale, Tanya J Rath
Head and neck squamous cell carcinoma is an important cause of cancer morbidity worldwide and has been stratified into human papillomavirus-related and human papillomavirus-unrelated subgroups that affect prognosis and now staging. Conventional anatomical imaging methods are suboptimal for the detection of regional and distant metastases that are important prognosticators associated with poor outcomes. Functional imaging with (F18)-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) is a useful tool in the management of head and neck squamous cell carcinoma, providing complementary physiological and anatomical information...
October 2017: Seminars in Ultrasound, CT, and MR
Hillary R Kelly, Hugh D Curtin
The presence of cervical lymph node metastases is a major prognostic factor in squamous cell carcinoma of the head and neck. The presence of a solitary ipsilateral metastatic lymph node reduces expected survival by almost 50%, and the presence of regional metastatic nodes at the time of presentation is the strongest predictor of recurrence or the development of distant metastases or both. Therefore, accurate identification of metastatic cervical lymph nodes is essential for staging and treatment planning. Pretreatment imaging is important for identifying clinically occult pathologic nodes as well as delineating nodal size and morphologic characteristics used in staging...
October 2017: Seminars in Ultrasound, CT, and MR
Matthew H Kulzer, Barton F Branstetter
The anatomy of the neck is complex, with many critical structures crowded together in a relatively small cross-sectional area. Many structures in the neck also have similar soft tissue density or signal that further complicates interpretation for the radiologist, who relies on tissue differences to create contrast resolution and distinguish structures. Head and neck cancer incidence exceeds 550,000 cases per year worldwide, with diagnosis, treatment, and prognosis relying highly on a thorough knowledge of this compact space...
October 2017: Seminars in Ultrasound, CT, and MR
Tanya J Rath
No abstract text is available yet for this article.
October 2017: Seminars in Ultrasound, CT, and MR
Parthiv Mehta, Micheal Morrow, Joshua Russell, Nikhil Madhuripan, Michael Habeeb
Musculoskeletal trauma and infections are commonly encountered in the emergency department. Magnetic resonance imaging (MRI) is rarely employed in true emergencies and most musculoskeletal studies can be deferred to the outpatient setting. This article seeks to address the urgent conditions in which MRI can play a role in diagnosis, management, and treatment. This article outlines MRI's role in the evaluation of posterolateral corner injuries and other soft-tissue pathologies such as rhabdomyolysis, diabetic myonecrosis, septic arthritis, cellulitis, necrotizing fasciitis, and compartment syndrome...
August 2017: Seminars in Ultrasound, CT, and MR
Joseph M Rozell, Shan Li
The use of magnetic resonance imaging (MRI) for the diagnosis of emergent life-threatening neurologic conditions and what are considered "do not miss" pathologies has dramatically increased over the past 10 years due to its increasing importance in the emergency department. Although computed tomography is likely to remain the more significantly used imaging modality due to lower cost and faster speeds, continuing technological advances in MRI have made its use more mainstream. Knowledge of specific clinical signs and symptoms as well as the technical limitations of MRI should help to guide emergency department clinicians with both the recognition and the appropriate use of emergent MRI...
August 2017: Seminars in Ultrasound, CT, and MR
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