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Clinical Imaging

Charles N Weber, Jason A Poff, Anna S Lev-Toaff, Marc S Levine, Hanna M Zafar
PURPOSE: To explore quantitative differences between genders in morphologic colonic metrics and determine metric reproducibility. METHODS: Quantitative colonic metrics from 20 male and 20 female CTC datasets were evaluated twice by two readers; all exams were performed after incomplete optical colonoscopy. Intra-/inter-reader reliability was measured with intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC). RESULTS: Women had overall decreased colonic volume, increased tortuosity and compactness and lower sigmoid apex height on CTC compared to men (p<0...
July 15, 2017: Clinical Imaging
Emilio Inarejos Clemente, Modupe Oyewumi, Evan Probst, Bo-Yee Ngan, Mary-Louise Greer
Distinguishing between thyroglossal duct cysts (TGDC) and dermoid cysts (DC) sonographically can be challenging. We illustrate the three sonographic features in neck masses in children recently identified as being most suggestive of TGDC (septa, irregular wall and solid elements) and their corresponding histopathology. These three variables form a proposed predictive model for TGDC as a guide to surgical intervention. Pediatric radiologists should be familiar with these key imaging features, as compared with other imaging features described in TGDC also illustrated here, which are less discriminating...
July 12, 2017: Clinical Imaging
Bhavika K Patel, Michelle E Naylor, Heidi E Kosiorek, Yania M Lopez-Alvarez, Adrian M Miller, Victor J Pizzitola, Barbara A Pockaj
OBJECTIVE: Supplement tomosynthesis-detected architectural distortions (AD) with CESM to better characterize malignant vs benign lesions. METHODS: Retrospective review CESM prior to biopsied AD. Pathology: benign, radial scar, or malignant. RESULTS: 49 lesions (45 patients). 29 invasive cancers, 1 DCIS (range, 0.4-4.7cm); 9 radial scars; 10 benign. 37 (75.5%) ADs had associated enhancement. PPV 78.4% (29/37), sensitivity 96.7% (29/30); specificity, 57...
July 12, 2017: Clinical Imaging
Peng-Gang Qiao, Zhi-Wei Zuo, Cong Han, Juan Zhou, Hong-Tao Zhang, Lian Duan, Tianyi Qian, Gong-Jie Li
PURPOSE: To characterize the changes in cortical thickness of adult patients with moyamoya disease (MMD). METHODS: 60 patients with MMD and 60 age and sex-matched healthy volunteers were recruited. Structural images were acquired by MRI. Freesurfer was used to measure cortical thickness in patients and controls, and this was compared with MRA scores and cerebrovascular accident (CVA) scores. RESULTS: Compared with controls, the average cortical thickness of both cerebral hemispheres was lower in patients than in controls and symmetrical differences were seen in the regional cortex: bilateral precentral gyri were thinner, bilateral postcentral gyri and posterior cingulate gyri were thicker, and thinning and thickening were both found in the insula...
July 11, 2017: Clinical Imaging
Jennifer Ní Mhuircheartaigh, Colm McMahon, Yu-Ching Lin, Jim Wu
PURPOSE: To identify whether there was an association between Hounsfield units of sclerotic bone lesions and diagnostic yield of biopsy. METHOD: All core needle biopsies of sclerotic bone lesion were identified from a database. Pathology reports were reviewed to determine whether the biopsy was diagnostic or non-diagnostic. RESULTS: 91 patients were included in the study group. The yield for lesions with mean HU≥500 was significantly lower than those with a mean HU≤500 (40% vs...
July 4, 2017: Clinical Imaging
Eiji Matsusue, Yoshio Fujihara, Eiken Matsuda, Yusuke Tokuyasu, Shu Nakamoto, Kazuhiko Nakamura, Toshihide Ogawa
BACKGROUND: There have been no reports about quantitative evaluations of enhancing components of parotid tumors on conventional MR imaging. PURPOSE: To evaluate the signal intensity of the enhancing components of tumors, including pleomorphic adenomas (PAs), Warthin tumors (WTs) and malignant tumors (MTs), on various MR sequences and to assess the usefulness of quantitative evaluations for differentiation among the three groups of tumors. MATERIAL AND METHODS: A total of 39 histologically proven tumors, including 15 PAs, 17 WTs and 7 MTs, were enrolled in this study...
July 4, 2017: Clinical Imaging
Audree Tadros, Brittany Arditi, Christina Weltz, Elisa Port, Laurie R Margolies, Hank Schmidt
PURPOSE: To determine the utility and rate of biopsy in women with a positive history of breast cancer screened with MRI. METHODS: Retrospective review of 491 breast MRI screening examinations in women with a personal history of breast cancer. RESULTS: In total, 107 biopsies were performed, an average of 0.09 biopsies per person year. The positive predictive value for biopsies prompted by MRI findings was 0.24 (95% C.I. 0.10-0.38). Eight of the nine subsequent cancers were initially identified on screening MRI alone...
July 3, 2017: Clinical Imaging
Salvatore Rudilosso, Luis San Román, Jordi Blasco, María Hernández-Pérez, Xabier Urra, Ángel Chamorro
PURPOSE: To assess the reliability of the Fazekas score on brain CT in acute stroke patients. METHODS: Two raters evaluated the Fazekas score in 157 CT scans from consecutive patients with acute stroke. RESULTS: The Fazekas scores on brain CT scans showed consistent (weighted κ, 0.73) and moderate (weighted κ, 0.56) interobserver agreement for periventricular and deep white matter areas, respectively. Intraobserver reliability was substantial for both areas (weighted κ, 0...
July 3, 2017: Clinical Imaging
Randy Yeh, Ahmed Mohammed, Aleksandr Margolin, Peter Schlossberg, Rama S Ayyala
Hypertension is rare in the pediatric population, however renal artery stenosis (RAS) is an important cause that can be difficult to diagnose. Doppler ultrasound is the first line imaging modality, with computed tomography and magnetic resonance imaging as adjunct modalities, all with variable sensitivity for RAS. The gold standard for evaluation of RAS is invasive selective catheter angiography. We present a unique multimodality case of abnormal radiotracer uptake in the renal parenchyma on 123-Iodine metaiodobenzylguanidine ((123)I MIBG) scan in a patient with unilateral RAS...
July 3, 2017: Clinical Imaging
Chao Chen, Qinqin Kang, Bing Xu, Hairuo Guo, Qiang Wei, Tiegong Wang, Hui Ye, Xinhuai Wu
PURPOSE: To compare the utility of tumor size and CT perfusion parameters for differentiation of low- and high-grade clear cell renal cell carcinoma (RCC). MATERIALS AND METHODS: Tumor size, Equivalent blood volume (Equiv BV), permeability surface-area product (PS), blood flow (BF), and Fuhrman pathological grading of clear cell RCC were retrospectively analyzed. RESULTS: High-grade clear cell RCC had significantly higher tumor size and lower PS than low grade...
July 3, 2017: Clinical Imaging
Kie Shimizu, Tomohiro Namimoto, Masataka Nakagawa, Kosuke Morita, Seitaro Oda, Takeshi Nakaura, Daisuke Utsunomiya, Yasuyuki Yamashita
PURPOSE: To compare automated six-point Dixon (6-p-Dixon) MRI comparing with dual-echo chemical-shift-imaging (CSI) and CT for hepatic fat fraction in phantoms and clinical study. MATERIALS AND METHODS: Phantoms and fifty-nine patients were examined both MRI and CT for quantitative fat measurements. RESULTS: In phantom study, linear regression between fat concentration and 6-p-Dixon showed good agreement. In clinical study, linear regression between 6-p-Dixon and dual-echo CSI showed good agreement...
June 20, 2017: Clinical Imaging
Andrea L Magee, Brittany Z Dashevsky, Kayleen Jahangir, Kirti Kulkarni
Incidental focal FDG uptake in the breast or axilla on PET/CT performed for evaluation of extra-mammary primary disease presents a diagnostic challenge. Radiologists must consider a broad differential diagnosis, assess clinical history, and judiciously employ other imaging modalities such as mammography, ultrasound and MRI in the pursuit of findings which help narrow the differential diagnosis. Tissue sampling may be reserved for nondiagnostic imaging scenarios.
June 15, 2017: Clinical Imaging
Yong Hee Kim, Myung-Joon Kim, Hyun Joo Shin, Haesung Yoon, Mi-Jung Lee
PURPOSE: To investigate pediatric abdominal CT using a simplified split-bolus (Split group) contrast injection compared with a single bolus (Control group). METHODS: Radiation dose, image quality and diagnostic accuracy were compared. RESULTS: Split group demonstrated lower effective dose (2.46 vs. 2.85mSv, p=0.002) and noise levels in aorta, liver and portal vein (p<0.001). There was one false-negative case of portal vein obliteration in the Split group...
June 12, 2017: Clinical Imaging
Wieland Staab, Jan Menke, Christian Sohns, Susanne Wienbeck, Lukas Bauer, Johannes Tammo Kowallick, Frank Konietschke, Thorsten Derlin, Joachim Lotz, Jan Martin Sohns
PURPOSE: The purpose of this study was to analyze the prevalence of extra-mammary findings in magnetic resonance imaging (MRI). MATERIALS AND METHODS: Data from 1070 consecutive breast MRI studies was analyzed. MR-BI-RADS (Breast Imaging Reporting and Data System) was used to classify the risk category. RESULTS: According to MR-BI-RADS, 915 (85.5%) of 1070 women were classified into MR-BI-RADS categories 1-3, and 155 (14.5%) into MR-BI-RADS categories 4-5...
June 10, 2017: Clinical Imaging
Eric T Foo, Amie Y Lee, Kimberly M Ray, Genevieve A Woodard, Rita I Freimanis, Bonnie N Joe
PURPOSE: To review the use of diagnostic breast imaging and outcomes for symptomatic male patients. METHODS: We retrospectively evaluated 122 males who underwent diagnostic imaging for breast symptoms at our academic center. RESULTS: The majority (94%) of cases had negative or benign imaging, with gynecomastia being the most common diagnosis (78%). There were two malignancies, both of which had positive imaging. Fifteen patients underwent percutaneous biopsy, and over half (53%) were palpation-guided biopsies initiated by the referring clinician despite negative imaging...
June 9, 2017: Clinical Imaging
Sang Jin Ha, Yeonggul Jang, Byoung Kwon Lee, In-Jeong Cho, Chi Young Shim, Geu-Ru Hong, Namsik Chung, Hyuk-Jae Chang
PURPOSE: To evaluate the diagnostic performance of dual-energy computed tomography (DECT) for the assessment of myocardial viability compared with magnetic resonance imaging (MRI) in patients with chronic myocardial infarction (CMI). METHODS AND MATERIAL: Twenty-six patients were prospectively enrolled, who underwent DECT and MRI at delayed phase. The infarct volumes for DECT and MRI were measured. RESULTS: In per-segment and per-vessel analysis, DECT showed excellent diagnostic performance compared with MRI (diagnostic accuracy: 86...
June 8, 2017: Clinical Imaging
Susanne Smolka, Julius Chapiro, Wilfred Manzano, John Treilhard, Eric Reiner, Yanhong Deng, Yan Zhao, Bernd Hamm, James S Duncan, Bernhard Gebauer, MingDe Lin, Jean-François Geschwind
PURPOSE: To investigate whether bevacizumab compromises early response assessment after Transarterial Chemoembolization (TACE) in patients with hepatocellular carcinoma by 3D quantitative European Association for the Study of the Liver (qEASL) criteria in comparison to other imaging-based criteria. MATERIALS AND METHODS: Each of 14 patients receiving TACE and bevacizumab was matched with two patients receiving TACE alone. Baseline and Follow-up MRI was retrospectively analyzed regarding qEASL and other imaging-based criteria...
June 7, 2017: Clinical Imaging
Ruth P Lim, Emma Hornsey, Dinesh Ranatunga, Huming Hao, Julie Smith, Tim Spelman, Jason Chuen, Mark Goodwin
PURPOSE: To assess feasibility, image quality and measured venous caliber of non-contrast MRV (NC-MRV) of central and upper extremity veins, compared to contrast-enhanced MRV (CE-MRV) and ultrasound (US) in healthy volunteers. MATERIALS AND METHODS: 10 subjects underwent NC-MRV and CE-MRV at 1.5 T, with comparison to US. Two radiologists evaluated MRI for image quality (IQ) and venous caliber. RESULTS AND CONCLUSIONS: NC-MRV is feasible, with inferior IQ but comparable venous caliber measurements CE-MRV (mean 7...
June 6, 2017: Clinical Imaging
Michael J Hoch, Joanne Rispoli, Mary Bruno, Mervin Wauchope, Yvonne W Lui, Timothy M Shepherd
Diffusion imaging of the spine has the potential to change clinical management, but is challenging due to the small size of the cord and susceptibility artifacts from adjacent structures. Reduced field-of-view (rFOV) diffusion can improve image quality by decreasing the echo train length. Over the past 2 years, we have acquired a rFOV diffusion sequence for MRI spine protocols on most inpatients and emergency room patients. We provide selected imaging diagnoses to illustrate the utility of including diffusion spine MRI in clinical practice...
June 6, 2017: Clinical Imaging
Mark D Mamlouk, Andrew D Nicholson, Daniel L Cooke, Christopher P Hess
Magnetic resonance imaging (MRI) serves as the principal imaging modality to diagnose and plan treatment for children with cutaneous vascular anomalies. While routine MRI protocols can lead to the correct diagnosis in the majority of cases, the imaging appearances can sometimes be nonspecific or confusing, yielding more than one possible diagnosis. This review highlights specific MRI sequence recommendations and scanning tips that can optimize the imaging protocol to increase diagnostic confidence.
May 31, 2017: Clinical Imaging
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