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Seminars in Ultrasound, CT, and MR

Gabriela Gayer, Christian Park
The abdominal wall does not comprise a distinct organ, and is often cursorily evaluated on CT. However, it is affected by many different pathological processes. These may be categorized according to their underlying etiology-trauma, infection or inflammation, iatrogenic and neoplastic process-or according to the abdominal wall layer they affect. We chose instead to group these lesions into 6 distinct categories based on their CT characteristic density: solid, infiltrative, hypervascular, fluid, fat, and bone density lesions...
April 2018: Seminars in Ultrasound, CT, and MR
Ulysses S Torres, Carlos Matsumoto, Dalila R Maia, Luis Ronan M F de Souza, Giuseppe D'Ippolito
The group of inflammatory pseudotumors (IPTs) encompasses a variety of rare neoplastic and nonneoplastic entities described to occur in almost every location in the body and whose clinical features and aggressive imaging findings (varying from infiltrative to mass-forming lesions), frequently mimic those of malignant tumors. The radiologic features of IPTs are variable and nonspecific, the imaging findings depending on the body location and involved organ. Abdominopelvic IPTs are rare and the purposes of this review, therefore, are to familiarize the radiologist with the wide spectrum of computed tomography and magnetic resonance imaging findings of IPTs in various locations throughout the abdomen and pelvis, discussing the imaging features that allow consideration of IPTs in the differential diagnosis of soft-tissue masses within the pertinent clinical setting...
April 2018: Seminars in Ultrasound, CT, and MR
Ulysses S Torres, Carlos Matsumoto, Augusto Cesar de Macedo Neto, Rogério Pedreschi Caldana, Ângela Hissae Motoyama Caiado, Dario Ariel Tiferes, Gisele Warmbrand, Laiz Laura de Godoy, Giuseppe D'Ippolito
There is a broad range of inflammatory, pseudotumoral, and benign lesions that may masquerade as pancreatic malignancies, often representing a challenge to the radiologist. Unawareness of these entities can lead to inadequate differential diagnoses or misdiagnosis, with important prognostic and therapeutic consequences. The purpose of this article is to revisit a spectrum of lesions, varying from common to exceedingly rare nonmalignant, that may mimic malignant pancreatic neoplasms on imaging, identifying relevant features that may contribute to reaching the correct diagnosis...
April 2018: Seminars in Ultrasound, CT, and MR
Adele Taibbi, Dario Picone, Massimo Midiri, Ludovico La Grutta, Tommaso Vincenzo Bartolotta
Nowadays, the most common imaging techniques allow to study focal liver lesions with high diagnostic accuracy but a relatively recent emerging field of interest is represented by diffuse liver disease. They include a variegated series of storage and metabolic pathologies (ie, iron overload disorders and steatosis) requiring a precise diagnosis not always possible at imaging due to the overlapping of findings at conventional ultrasound, CT, or MR studies. In recent years, several imaging tecniques and specific softwares have been developed, especially for ultrasound and MR imaging, in order to identify different parameters useful in the noninvasive recognition and follow-up of these diffuse processes involving the liver...
April 2018: Seminars in Ultrasound, CT, and MR
Arthur H Baghdanian, Armonde A Baghdanian, Shilpa Puppala, Michele Tana, Michael A Ohliger
Although the overall prevalence of peptic ulcer disease (PUD) has decreased in modern times, its actual incidence may be underestimated owing to the nonspecific clinical presentations patients' manifest. The potential lethal complications that can result from PUD include life-threatening abdominal hemorrhage and bowel perforation that result in significant morbidity and mortality. Computed tomography (CT) imaging historically lacks specificity in detecting PUD-related pathology in the stomach and proximal small bowel segments...
April 2018: Seminars in Ultrasound, CT, and MR
Ulysses S Torres, Camila D F M Fortes, Priscila S Salvadori, Dario A Tiferes, Giuseppe D Ippolito
Pneumatosis of the alimentary tract may occur from the esophagus to rectum as a result of a wide spectrum of conditions that range from benign to life-threatening. Although distinguishing between these 2 groups is of paramount importance for an appropriate clinical management, it still remains a challenge for the radiologist in the daily practice. In the light of the current literature, we provide in the present article a comprehensive review focusing on the clinical, laboratory, and radiological findings that most consistently may allow such a differentiation...
April 2018: Seminars in Ultrasound, CT, and MR
Francesca Iacobellis, Alessandra Perillo, Isabella Iadevito, Michela Tanga, Luigia Romano, Roberto Grassi, Refky Nicola, Mariano Scaglione
Oncologic emergencies can be either the result of the primary tumor, its metastasis, a paraneoplastic syndrome or reaction to the chemotherapy. Imaging plays a crucial role in ensuring a prompt diagnosis as well as assisting in the therapeutic management. In this article, we discuss the common thoracic and abdominal oncological emergencies that may be encountered in an emergency department.
April 2018: Seminars in Ultrasound, CT, and MR
Yoan K Kagoma, Gabriela Gayer
Internal hernia in the postoperative laparoscopic Roux-en-Y patient is a diagnosis associated with significant morbidity and risk of death. The radiologist plays an instrumental role in workup of this patient group; however, the imaging assessment of these patients is not straightforward given their complex postsurgical anatomy. Multiple radiologic signs of internal hernia have been studied in the literature. This review article presents these signs with representative cases as well as a summary of their diagnostic accuracy...
April 2018: Seminars in Ultrasound, CT, and MR
Kunal Kothari, John J Hines
The kidneys are paired intra-abdominal organs which provide essential functions and maintain homeostasis throughout the human body. Numerous disease processes affect the kidneys and cause acute renal dysfunction or other potentially catastrophic complications. These conditions can be broadly categorized into obstructive, infectious, hemorrhagic, traumatic, and vascular diseases. Imaging plays a vital role in the work-up and diagnosis of acute and emergent renal conditions. Evaluation of emergent renal conditions with a focus on CT imaging is discussed...
April 2018: Seminars in Ultrasound, CT, and MR
Gabriela Gayer
No abstract text is available yet for this article.
April 2018: Seminars in Ultrasound, CT, and MR
Richard G Barr
There is a large body of published material that supports the use of elastography, both strain and shear wave, for characterization of breast lesions. To a lesser extent, elastography can be used in the detection of breast abnormalities. This article reviews the principles of elastography regarding breast imaging, reviews the techniques to perform both strain and shear wave elastography, and reviews the literature and discusses how elastography can be used to improve the characterization of breast lesions to allow for decrease in the number of short-term follow-up examinations and benign biopsies...
February 2018: Seminars in Ultrasound, CT, and MR
Sughra Raza, Sona A Chikarmane, Eva C Gombos, Dianne Georgian-Smith, Elisabeth P Frost
Breast cancer is an increasing challenge in developed and limited resource areas of the world. Early detection of breast cancer offers the best chance for optimal care and best outcomes. A critical step in early detection is to obtain efficient and accurate tissue diagnoses. Although image-guided core needle breast biopsies are usually straightforward for experienced breast imagers, there are some not uncommon scenarios that present particular challenges. In this review article we will discuss these difficult situations and offer our tried and true methods to ensure safe and successful biopsies, while using stereotactic, ultrasound, and MRI guidance...
February 2018: Seminars in Ultrasound, CT, and MR
Bhavika K Patel, M B I Lobbes, John Lewin
Contrast-enhanced spectral mammography (CESM) provides low-energy 2D mammographic images comparable to standard digital mammography and a post-contrast recombined image to assess tumor neovascularity similar to magnetic resonance imaging (MRI). The utilization of CESM in the United States is currently low but could increase rapidly given many potential indications for clinical use. This article discusses historical background and literature review of indications and diagnostic accuracy of CESM to date. CESM is a growing technique for breast cancer detection and diagnosis that has levels of sensitivity and specificity on par with contrast-enhanced breast MRI...
February 2018: Seminars in Ultrasound, CT, and MR
Ashley I Huppe, Anita K Mehta, Rachel F Brem
Molecular breast imaging (MBI), also called breast-specific gamma imaging (BSGI), has been an integral component of our breast imaging practice for over a decade. Unlike mammography and ultrasound that are based on anatomy, MBI is a physiologic approach to breast cancer detection. MBI detects additional foci of occult breast cancer in 9.0% of women with newly diagnosed breast cancer, has a high sensitivity for detecting high-risk lesions, and detects 98% of invasive breast cancer and 91.0% of ductal carcinoma in situ...
February 2018: Seminars in Ultrasound, CT, and MR
Heather I Greenwood, Rita I Freimanis, Bianca M Carpentier, Bonnie N Joe
Breast magnetic resonance imaging (MRI) is the most sensitive imaging modality for the detection of breast cancer, and it is indicated for breast cancer screening in patients at high-risk of developing breast cancer. It is limited to this group given the high cost. In addition, breast MRI is also indicated for evaluating the extent of disease in patients with new breast cancer diagnoses, monitoring the response to neoadjuvant treatment, and evaluating implant integrity. New promising innovations in breast MRI include fast abbreviated MRI, and functional techniques including diffusion-weighted imaging and magnetic resonance spectroscopy are promising particularly as regards to treatment response...
February 2018: Seminars in Ultrasound, CT, and MR
Stamatia Destounis
Digital breast tomosynthesis is quickly becoming the standard of care in breast cancer screening and diagnosis. Since its introduction to the clinical landscape in 2011, radiologists specializing in breast disease diagnosis around the country have made the decision to adopt the technology for both screening and diagnostic applications; with adoption growing substantially in present day. Users of the technology have attested to the benefits the technology affords, both in screening and the diagnostic evaluation of patients, through peer-reviewed publications and scientific presentations in recent years...
February 2018: Seminars in Ultrasound, CT, and MR
Jaime Geisel, Madhavi Raghu, Regina Hooley
Mammography is the gold standard for breast cancer screening. However, with increasing awareness among patients and health care providers of mammography limitations especially in dense breasts, supplemental screening for breast cancer with ultrasound and magnetic resonance imaging has been expanding. The roles of both in screening need to be re-examined. This article reviews the efficacy, utility, and feasibility of ultrasound as a screening tool for the early detection of occult breast cancer.
February 2018: Seminars in Ultrasound, CT, and MR
Daniel B Kopans
The effort to reduce access to breast cancer screening has been going on for decades. As each piece of misinformation has been published, scientific responses have exposed the fallacies, but then new "alternative facts" are generated. The effort has been compared to the arcade game "Whack-a-Mole" in which one false argument is addressed only to have a new one "pop up" to replace it. This has ranged from the false claim that early detection would have no effect on breast cancer, to the fallacious idea that early detection was leading to early deaths among young women, to the more recent false suggestion that tens of thousands of breast cancers found by mammography would disappear if left undetected...
February 2018: Seminars in Ultrasound, CT, and MR
Sean D Raj, Valerie Fein-Zachary, Priscilla J Slanetz
Although dense breast tissue is a normal and routine finding on screening mammography, dense breast tissue is associated with an independent increased risk for breast cancer. It is well known that screening mammography has a decreased sensitivity for cancer detection in women with dense breasts. Over the past decade, there has been increased interest generated among patients, physicians, and legislators regarding how best to screen dense-breasted women culminating in 2009 with the passage of a breast density notification law in Connecticut...
February 2018: Seminars in Ultrasound, CT, and MR
Lorell Ruiz-Flores, Lilian O Ebuoma, Marcelo F Benveniste, Chandandeep Nagi, Tamara OrtizPerez, Ana Paula Benveniste
This report describes the clinical presentation, imaging findings, and treatment options of a case of metastatic malignant phyllodes.
February 2018: Seminars in Ultrasound, CT, and MR
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