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Clinical Imaging

Mougnyan Cox, Brian Curtis, Manisha Patel, Victor Babatunde, Adam E Flanders
OBJECTIVE: Multi-sequence sagittal magnetic resonance imaging (MRI) of the entire spine is performed in patients with known single level spondylodiscitis. Our objective is to determine the frequency of multifocal infection. METHODS: After IRB approval, a retrospective five-year review of all patients with spondylodiscitis was performed. RESULTS: MRI identified 82 patients with single-level infection. All 82 had entire spine imaging performed within 72 h of admission, showing additional non-continuous sites of infection in 19 patients (23%)...
February 13, 2018: Clinical Imaging
Arunark Kolipaka, Peter A Wassenaar, Sangmin Cha, Wael M Marashdeh, Xiaokui Mo, Prateek Kalra, Bradley Gans, Brian Raterman, Eric Bourekas
This study determines the reproducibility of magnetic resonance elastography (MRE) derived brain stiffness in normal volunteers and compares it against pseudotumor patients before and after lumbar puncture (LP). MRE was performed on 10 normal volunteers for reproducibility and 14 pseudotumor patients before and after LP. During LP, opening and closing cerebrospinal fluid (CSF) pressures were recorded before and after removal of CSF and correlated to brain stiffness. Stiffness reproducibility was observed (r > 0...
February 11, 2018: Clinical Imaging
Abdulrahman Abdullah Albatly, Adnan Taleb Alsamarah, Abdulrahman Alhawas, Patrick Veit-Haibach, Alfred Buck, Paul Stolzmann, Irene A Burger, Spyros S Kollias, Martin W Huellner
PURPOSE: To investigate 18 F-fluoro-ethyl-tyrosine positron emission tomography (FET-PET) imaging characteristics of adult brainstem glioma (BSG). MATERIALS AND METHODS: FET-PET imaging and progression-free survival (PFS) of 16 adult patients with BSG was analyzed (9 high-grade gliomas, 7 low-grade gliomas). SUV max , TBR, and time activity curves of FET-PET were calculated. RESULTS: Progressive gliomas had higher SUV max (3.57 ± 1.47 vs...
February 8, 2018: Clinical Imaging
Giuseppe Corrias, Serena Monti, Natally Horvat, Laura Tang, Olca Basturk, Luca Saba, Lorenzo Mannelli
BACKGROUND: Gastroenteropancreatic neuroendocrine tumors (NETs) are rare entities arising from neuroendocrine cells in the gastroenteric tract and pancreas. The purpose of this article is to present four cases of gastroenteropancreatic NETs that featured a challenging diagnosis. CASE PRESENTATION: We report a case series of four NETs, each with different features. All NETs were suspected based on clinical and biochemical data. The workup of the abnormalities was performed with CT, PET or MRI...
February 8, 2018: Clinical Imaging
Hussein Nasser, Michael King, Henrietta Kotlus Rosenberg, Ally Rosen, Eric Wilck, William L Simpson
The canal of Nuck is the female equivalent of the processus vaginalis in the male but is less well known than its male counterpart. It is a rare entity not commonly encountered by radiologists, particularly in the adult population. Knowledge of the embryology and anatomy of the canal of Nuck is essential for identification of the various pathologic conditions that may occur in this location. Moreover, radiologists should be familiar with this entity to compose an appropriate and thorough differential diagnosis of a labial mass/swelling...
February 7, 2018: Clinical Imaging
Arie Franco, Apeksha Chaturvedi
Physeal injuries occurring secondary to neonatal birth-related trauma are rare entities. Most reported cases of physeal injury involve the distal humerus with only a few published case reports of proximal femoral involvement. So far, we have found only one reported case of neonatal distal femoral epiphysiolysis following Caesarean section. We hereby report a unique case of distal femoral physeal injury with at least partial epiphyseal separation following an uneventful, spontaneous vaginal delivery. Given the uneventful delivery and no known prenatal risk factors, the imaging findings were initially not recognized as being secondary to birth-related injury...
February 7, 2018: Clinical Imaging
Jeeyoung Min, Hee Sun Park, Young Jun Kim, Mi Hye Yu, Sung Il Jung, Hae Jeong Jeon
PURPOSE: To evaluate modified Dixon MRI techniques in hepatic fat estimation and to assess the effect of cirrhosis. METHODS: 235 patients who underwent liver MRI were included. Correlation between modified Dixon techniques with MRS was assessed. Accuracy of MR techniques in hepatic fat estimation was calculated, and the result was compared between patients with/without liver cirrhosis. RESULTS: Correlation between modified Dixon and MRS was better in group without liver cirrhosis, and accuracy of modified Dixon method was higher in group without liver cirrhosis...
February 7, 2018: Clinical Imaging
David H Ballard, George Patton Pennington, George P Pennington, Joe Johnson, Sanjeev Bhalla, Constantine Raptis
A case of necrotizing infection of the heart is presented. A 70-year-old woman presented with vague chest and abdominal pain. CT of the abdomen and pelvis was initially obtained, which demonstrated gas in the myocardium of the left ventricle. Subsequent chest CT, endoscopy, and abdominal surgical exploration did not reveal perforated viscus or diaphragm compromise. At median sternotomy, the inferior wall of the heart was found to be necrotic. Culture of the excised tissue grew E. coli. The patient expired shortly after surgical exploration...
February 6, 2018: Clinical Imaging
Nobuo Tomizawa, Kodai Yamamoto, Shinichi Inoh, Takeshi Nojo, Sunao Nakamura
OBJECTIVE: To compare the diagnostic performance of estimated energy loss (EEL) with diameter stenosis (DS) to estimate significant stenosis by fractional flow reserve (FFR). MATERIALS AND METHODS: One hundred twenty-five patients were included. EEL was calculated using DS, lesion length, minimal lumen area and left ventricular volume. FFR ≤ 0.80 was determined significant. RESULTS: EEL improved the accuracy from 63% (95% confidence interval (CI): 55-72%) to 83% (95% CI: 75-89%, p < 0...
February 6, 2018: Clinical Imaging
Priya K Shah, Ilana A Kafer, Gregory M Grimaldi
OBJECTIVE: The objective of this study was to determine the rate of malignancy in incidentally detected T2 hyperintense hepatic lesions at breast MRI. METHODS: Incidental hepatic lesions identified during breast MRI, for which abdominal imaging was recommended, were retrospectively analyzed. RESULTS: Of the hepatic lesions, 97.3% were benign, and 2.7% were malignant, with a significant association between indication for the breast MRI and the malignancy status of the hepatic lesion (Fisher's Exact, P < 0...
February 6, 2018: Clinical Imaging
Massimo Galia, Domenico Albano, Dario Picone, Maria Chiara Terranova, Antonino Agrusa, Giuseppe Di Buono, Annalisa Licata, Giuseppe Lo Re, Ludovico La Grutta, Massimo Midiri
PURPOSE: To compare imaging features of pancreatic metastases (PM) with those of pancreatic ductal adenocarcinomas (PDAC). METHODS: CT and MR scans of 24 patients with 54 PM and 30 patients with PDAC were reviewed to evaluate the imaging features, which were compared by using a Chi square test. RESULTS: We found a statistically significant difference between PM and PDAC based on location (P < 0.001), margins (P < 0.001), arterial enhancement (P = 0...
February 6, 2018: Clinical Imaging
Kumi Ozaki, Jun Yoshikawa, Toru Yamamoto
AIM: To investigate the prevalence and morphometric characteristics of small accessory liver lobes using computed tomography (CT) and magnetic resonance (MR) images. MATERIAL AND METHODS: The study population comprised 3269 patients (1671 men and 1598 women; mean age, 67.1 ± 15.2 years) who had undergone abdominal CT examination. Small accessory liver lobes were identified after verification of their continuity with the liver parenchyma on CT images. Their imaging characteristics were analyzed and presented...
February 6, 2018: Clinical Imaging
Tatsuya Hayashi, Kei Fukuzawa, Hidekazu Yamazaki, Takashi Konno, Tosiaki Miyati, Jun'ichi Kotoku, Hiroshi Oba, Hiroshi Kondo, Keiko Toyoda, Satoshi Saitoh
PURPOSE: To evaluate the reproducibility of proton density fat fraction (PDFF) and T2* in a fat-water phantom on three different 3 T MRI systems using 6-point DIXON methods. METHODS: A phantom which included varying fat volume percentages (true fat fraction [FF]) was scanned by three 3 T MR machines, and PDFF and T2* were measured. RESULTS: The mean difference between true FF and PDFF was small in all vendors (-2.11% to 0.41%). However, the difference ratio for T2* values was large among vendors (1...
February 2, 2018: Clinical Imaging
Ashley Beecy, Bríain Ó Hartaigh, Joshua Schulman-Marcus, Khalil Anchouche, Heidi Gransar, Subhi Al'Aref, Kimberly Elmore, Fay Y Lin, James K Min, Jessica M Peña
BACKGROUND: This study examines the relationship between epicardial fat volume (EFV) and lesion-specific ischemia by fractional flow reserve (FFR). METHODS: In a study of 173 patients (63.0 ± 8.3 years) undergoing FFR, EFV was determined using cardiac computed tomography. Relationships between EFV and FFR were assessed using multivariable linear and logistic regression. RESULTS: Using multivariable linear and logistic regression, no association between EFV and FFR was observed (β [SE] = -0...
February 2, 2018: Clinical Imaging
Anilawan Smitthimedhin, Hansel J Otero
Zellweger syndrome is the most severe form of a group of autosomal recessive disorders with defective peroxisomes. We report a case of Zellweger syndrome in a newborn baby, which was first suspected by the presence of scimitar-like patella seen on skeletal survey. The subsequent brain MRI showed germinolytic cysts and polymicrogyria, which furthered the suspicion. Laboratory and genetic results confirmed the diagnosis. To date, there are a limited number of case reports of this rare disease. We emphasize skeletal findings that can lead to targeted genetic and laboratory testing and hence earlier diagnosis...
February 1, 2018: Clinical Imaging
Lindsey M Negrete, Lucy B Spalluto
Delay in diagnosis of cervical incompetence can be detrimental to the fetus. Up to 20-25% of miscarriages in the second trimester can be attributed to the incompetent cervix. Given the profound impact of cervical incompetence on obstetric outcomes, careful attention should be given to evaluation of the cervix on MRI studies in pregnant patients. We present a case of incompetent cervix diagnosed incidentally at the time of MRI performed to evaluate for acute appendicitis.
January 31, 2018: Clinical Imaging
Diana Palacio, Edith M Marom, Arlene Correa, Sonia L Betancourt-Cuellar, Wayne L Hofstetter
The imaging modalities available to evaluate anastomotic leak complicating esophagectomy include CT-Esophageal Protocol (CTEP) and esophagram. The purpose of this study was to compare the performance of these two modalities, alone or in combination, with the final diagnosis of leak established by endoscopy, surgery and/or the clinical course and evaluate management implications.
January 31, 2018: Clinical Imaging
Jun Sun, Zhaoyu Xing, Jie Chen, Tingting Zha, Yunjie Cao, Dachuan Zhang, Dexing Zeng, Wei Xing
PURPOSE: To detect fat status and differentiate histotypes of renal masses by using Dixon technique. MATERIALS AND METHODS: This study included 134 solid renal masses. Signal intensity index (SII) and fat fraction (FF) in different histotypes were compared. RESULTS: Only angiomyolipoma (AML), clear cell renal cell carcinoma (RCC), and papillary RCC were confirmed to contain fat. The FF of 16.8% can effectively differentiate AML from clear cell RCC, so did the SII of 9...
January 30, 2018: Clinical Imaging
Ali Gholamrezanezhad, Kyle Basques, Christos Kosmas
Juxtacortical or surface tumors of bone are neoplasms arising from or just outside the cortex, and are composed of different histologic types. Although the imaging appearances of these lesions have similarities to their intramedullary counterparts, their location alters their radiographic and MR characteristics, creating difficulties in diagnosis. Meanwhile, several non-neoplastic lesions, such as stress reaction/stress fracture and indolent infectious processes, compound the differential diagnosis. Neoplastic juxtacortical lesions of bone have been classified into five categories: cartilaginous, fibrous, lipomatous, osseous, and metastatic tumors...
January 27, 2018: Clinical Imaging
Sadek A Nehmeh, Jazmin Schwartz, Milan Grkovski, Ivan Yeung, Charles M Laymon, Mark Muzi, John L Humm
PURPOSE: To assess the inter-operator variability in compartment analysis (CA) of dynamic-FMISO (dyn-FMISO) PET. METHODS: Study-I: Five investigators conducted CA for 23 NSCLC dyn-FMISO tumor time-activity-curves. Study-II: Four operators performed CA for four NSCLC dyn-FMISO datasets. Repeatability of Kinetic-Rate-Constants (KRCs) was assessed. RESULTS: Study-I: Strong correlation (ICC > 0.9) and interchangeable results among operators existed for all KRCs...
January 12, 2018: Clinical Imaging
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