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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
Bradley Mattson, Kal Dulaimy
With several different imaging options available, it is not surprising that health care providers are unsure which imaging study is most appropriate for evaluating patients who present to the emergency department with abdominal pain. The American College of Radiology, currently, has appropriateness criteria for patients presenting with right upper, right lower, and left lower quadrant pain, and there are different variants for each of these quadrants. Clinicians should be aware of the American College of Radiology appropriateness criteria and, whenever possible, should be using criteria as guide to help them order the most appropriate imaging study...
August 2017: Seminars in Ultrasound, CT, and MR
Abdulmalik Dredar, Prem Thanaratnam, Kaiser Hussain, Seth Andrews, Edward Mtui, Tara Catanzano
Acute abdominal pain is a common presenting complaint in the emergency department. Increasingly, computed tomography is utilized for evaluating these patients. Radiologists are therefore expected to be familiar with the pertinent clinical and radiologic information related to acute bowel pathology. This primer will review the need-to-know and latest updates related to computed tomography evaluation of acute bowel pathology.
August 2017: Seminars in Ultrasound, CT, and MR
Jed Hollingsworth, Mae Mae Mirabelli
The purpose of this article is to provide the reader, a seasoned radiologist, a budding resident, or a curious practitioner, the background necessary to accurately and swiftly interpret a head computed tomography in the emergency setting. At the very least, being able to generate a reasonable differential diagnosis is the aim and will be accomplished by describing not only features of classic neurologic emergencies but also the possible traps to which one may fall prey. Images will be used to illustrate cases, and the reader will be instructed when other imaging modalities may be required to clarify diagnoses...
August 2017: Seminars in Ultrasound, CT, and MR
Kimberly Weatherspoon, Wayne Gilbertie, Tara Catanzano
In the setting of blunt trauma, the rapid assessment of internal injuries is essential to prevent potentially fatal outcomes. Computed tomography is a useful diagnostic tool for both screening and diagnosis. In addition to trauma, acute chest syndromes often warrant emergent computed tomographic angiography, looking for etiologies such as aortic aneurysms or complications of aortic aneurysms, or both, pulmonary emboli, as well as other acute vascular process like aortic dissection and Takayasu aortitis. With continued improvements in diagnostic imaging, computed tomographic angiography of the chest, abdominal and pelvis proves to be an effective modality to image the aorta and other major vascular structures...
August 2017: Seminars in Ultrasound, CT, and MR
Nikhil Madhuripan, Parthiv Mehta, Sara E Smolinski, Njogu Njuguna
Computed tomography angiography (CTA) of the extremities offers a noninvasive, rapid means of evaluation of the extremities in vascular emergencies. CTA is now the first-line investigation for this purpose, offering high sensitivity and specificity in diagnosis. The learning objectives of this review article include reviewing normal arterial anatomy and variants of the upper and lower extremity, illustrating CTA findings in traumatic vascular injuries, and exploring the range of vascular pathologies that may cause acute ischemic symptoms in the extremities...
August 2017: Seminars in Ultrasound, CT, and MR
Nikhil Madhuripan, Oliver David Atar, Richard Zheng, Mary Tenenbaum
Computed tomography angiography (CTA) offers a rapid means of evaluating the vasculature of the head and neck in patients presenting with acute onset of neurologic symptoms and blunt trauma to the head and neck. CTA is noninvasive, easy to acquire, and offers excellent detail in identifying site and nature of the lesion. The learning objectives of this article are to review normal anatomy and variants, recognize CTA appearance of vascular pathologies, describe typical parameters used for acquiring the study, and recognize common pitfalls...
August 2017: Seminars in Ultrasound, CT, and MR
Kimberly Weatherspoon, Stanley Polansky, Tara Catanzano
Male pelvic emergencies are uncommon, and symptoms typically include scrotal pain, scrotal enlargement, or a palpable scrotal mass or all of these. Ultrasound is often the first-line modality for evaluation of male pelvic emergencies, which may be stratified into vascular, infectious, or traumatic causes. Entities such as testicular torsion, Fournier gangrene, and testicular dislocation are surgical emergencies and should not be missed or misdiagnosed, as this may cause a significant delay in urgently necessary treatment...
August 2017: Seminars in Ultrasound, CT, and MR
Daniel P Thut, Michael S Morrow, Christopher C Moore
Pelvic pain is a common complaint in female patients who present to the emergency department. Although encountered frequently, the path to a definitive diagnosis is not always a straightforward one, and imaging offers a valuable tool to aid in this diagnostic challenge. Radiologists must be familiar with the most common etiologies of female pelvic pain in the emergency setting, their imaging characteristics, and the best way to further evaluate challenging clinical presentations. This allows the radiologist to serve as a valuable asset to the treating physician, aiding in accurate diagnosis, and in guiding the course of treatment, all while ensuring the "Image Wisely" principle...
August 2017: Seminars in Ultrasound, CT, and MR
Tara M Catanzano
No abstract text is available yet for this article.
August 2017: Seminars in Ultrasound, CT, and MR
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