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Clinical Imaging

Yatin Chadha, Sevil K Brahme, Brady K Huang, Eric Y Chang
Calcineurin-inhibitor induced pain syndrome (CIPS) is a condition characterized by lower extremity pain in patients receiving tacrolimus or cyclosporine therapy following organ transplantation. Through two cases, we demonstrate key imaging findings in CIPS with bone scintigraphy and magnetic resonance imaging (MRI), which are those of increased scintigraphic activity and marrow edema in the lower extremities, respectively. CIPS is an important condition that has characteristic imaging findings, but is unfortunately underappreciated in the radiology literature...
October 25, 2018: Clinical Imaging
Tong Wu, Jing Li, Dongmo Wang, Xiaoping Leng, Lei Zhang, Ziyao Li, Hui Jing, Jia Kang, Jiawei Tian
PURPOSE: To identify the ultrasound and clinical features related to the different molecular subtypes of invasive breast cancer. METHODS: Sonographic and clinical data of 311 surgically confirmed breast cancer cases were retrospectively reviewed and compared based on various subtypes. RESULTS: Luminal A (LA) breast cancers were associated with a low histologic grade, spiculated margins, an echogenic rim and posterior acoustic attenuation. The human epidermal growth factor receptor 2-positive (HER2+) subtype was characterized by a high grade, indistinct and spiculated margins, enhanced posterior acoustics, calcifications, and vascularity...
October 24, 2018: Clinical Imaging
Heather I Greenwood
Breast MRI has been shown to be the most sensitive examination in the detection of breast cancer. However, given the high associated costs, its use in the screening setting has traditionally been limited to those who are at high-risk for breast cancer. Abbreviated protocol breast MRI is capable of reducing the traditional costs associated with breast MRI, while maintaining diagnostic accuracy and cancer detection, and therefore a potential future screening tool for breast cancer in a broader population of women than just those at high-risk...
October 22, 2018: Clinical Imaging
Natalia A Viña, Patricia Carrascosa, Vanesa C Mogensen, Alejandro Deviggiano, Gaston Bellia-Munzon, Marcelo Martinez-Ferro, Gaston A Rodriguez-Granillo
PURPOSE: Preoperative assessment of patients with pectus excavatum (PE) demands evaluation of malformation indexes, generally with chest computed tomography (CT). In addition, assessment of the cardiac impact of sternal depression has become a rule in high referral centers, thus requiring two independent imaging modalities and use ionizing radiation in a very young population. The objective of this study was to explore the agreement between chest CT and standard cardiac MR (CMR) for the evaluation of chest wall malformation indexes...
October 15, 2018: Clinical Imaging
Ciara O'Brien, Hong Kuan Kok, Brendan Kelly, Kanako Kumamaru, Abhilash Sahadevan, Stephen Lane, Orla Buckley
OBJECTIVES: The aim of this study was to investigate the extent of dose reduction and comparability of standard dose CT vs Ultra low dose CT in evaluating pulmonary emphysema. METHODS: Forty-nine patients with emphysema were recruited from a tertiary referral respiratory clinic. Each patient had a non-contrast Standard Dose (SD) and Ultra Low Dose (ULD) thoracic CT. The images were reconstructed using contemporary iterative reconstruction with a standard lung kernel...
October 14, 2018: Clinical Imaging
Wolfgang Freund, Frank Weber, Gero Hoepner, Reinhard Meier, Stephan Klessinger
OBJECTIVE: Angulated projections are used in radiography to show the cervical neural foramen. Imaging the coronal oblique planes in an MRI of the cervical spine should therefore improve visualization of neural foramen pathology. This has to be demonstrated. PATIENTS AND METHODS: A multi-center investigation of 40 patients with monoradiculopathy and 10 healthy controls was undertaken. T2-weighted sagittal, coronal oblique and axial slices were individually and separately examined by four readers blinded to the diagnosis...
October 13, 2018: Clinical Imaging
Feride Kural Rahatli, Fuldem Yildirim Donmez, Cagri Kesim, Kemal Murat Haberal, Hale Turnaoglu, Ahmet Muhtesem Agildere
PURPOSE: We hypothesized that unenhanced brain MRI can be used in follow up of patients with intracranial meningioma to avoid gadolinium deposition in the brain and allow measurement of meningioma dimensions from pre-contrast T2-weighted images. METHODS: Dimensions of meningiomas were measured on pre-contrast T2, post-contrast T1 weighted images. RESULTS: The sizes of meningiomas in post-contrast axial T1-weighted images were similar with that in pre-contrast axial T2-weighted images...
October 13, 2018: Clinical Imaging
Mayumi Takeuchi, Kenji Matsuzaki, Masafumi Harada
PURPOSE: High intensity intra-tumoral hemorrhagic necrosis on T1-weighted images is a suggestive finding for uterine sarcomas, however, the reported prevalence varies. The purpose of this study is to evaluate the capability of susceptibility-weighted MR sequences (SWS) for the diagnosis of uterine sarcomas. MATERIALS AND METHODS: MR imaging of surgically proven 10 uterine sarcomas and 24 benign leiomyomas were retrospectively evaluated for the presence of high intensity areas on T1-weighted images and signal voids on SWS (T2 star-weighted angiography: SWAN)...
October 13, 2018: Clinical Imaging
Dao Chen Lin, Kun Yu Wu, Fang Ju Sun, Chun Chao Huang, Tung Hsin Wu, Shin Lin Shih, Pei Shan Tsai
PURPOSE: Biliary atresia is a life-threatening disease that needs early diagnosis and management. Recently, MRI images have been used for the diagnosis of biliary atresia with improved accuracy of diagnosis when other imaging modalities such as ultrasonography are equivocal. This study aimed to evaluate the juxta-hilar extrahepatic biliary tree using MRI images to determine a quantitative value for diagnosing biliary atresia. MATERIALS AND METHODS: This retrospective study was approved by the Ethical Committee at Mackey Memorial Hospital (IRB Number: 15MMHIS149e)...
October 12, 2018: Clinical Imaging
Michaela Cellina, Giancarlo Oliva, Andrea Menozzi, Massimo Soresina, Carlo Martinenghi, Daniele Gibelli
Lymphedema (LE) is a chronic disabling disease, characterized by the accumulation of macromolecules and liquids in the interstitial space. Patients affected by LE should undergo appropriate imaging to confirm the diagnosis, to evaluate characteristics and the severity of LE and to allow for correct management and treatment plan. However, there is no consensus regarding the best imaging technique to study this disorder. We want to propose an overview of the studies published on Non-contrast Magnetic Resonance Lymphangiography, a relatively new technique for the diagnosis, assessment and management of lymphedema...
October 12, 2018: Clinical Imaging
Arun Sharma, Niraj Nirmal Pandey, Sanjeev Kumar
Coronary artery fistulas are rare cardiac conditions which constitute a subgroup of anomalies of the coronary arteries. Though majority are asymptomatic, they may be associated with high prevalence of late symptoms and complications. Accurate identification of the fistulas, their hemodynamic significance and associated conditions generally influence management strategies. Dual source computed tomographic evaluation is valuable in delineating its precise morphology with identification and characterization of associated anomalies, thereby assisting in mapping the ideal treatment option...
October 8, 2018: Clinical Imaging
Roka Namoto Matsubayashi, Hiromi Iwasaki, Nobutaka Iwakuma, Seiya Momosaki
Tumors originating from the nipple-areolar complex of the breast are rare. We herein report the case of a patient with metachronous bilateral areolar methotrexate (MTX)-associated lymphoma. The patient was a 67-year-old woman who presented with a rapidly enlarging tumor in the areolar region of her left breast. She had a long history of rheumatoid arthritis and had taken MTX for many years. On ultrasonography, the tumor showed well-demarcated margins and hyper-vascularity. On magnetic resonance imaging, the tumor showed a homogeneous low-to-moderate signal intensity that was similar to that of the nipple on both T1- and T2-weighted imaging; the diffusion was significantly reduced on diffusion-weighted images...
October 6, 2018: Clinical Imaging
Suehyb G Alkhatib, Marc S Levine
We describe a patient who developed an intractable leak from the gastric sleeve after laparoscopic sleeve gastrectomy, resulting in the development of a gastrobronchial fistula. Affected individuals typically have a persistent leak from the gastric sleeve with recurrent subphrenic abscesses, and when a gastrobronchial fistula develops, these patients may present with paroxysms of coughing immediately after ingestion of solids or liquids. In the appropriate clinical setting, a barium study not only may show the leak, but also directly visualize the gastrobronchial fistula...
October 6, 2018: Clinical Imaging
Victoria L Mango, Donna D'Alessio, Elizabeth A Morris, Richard Ha, Blanca Bernard-Davila, Maxine S Jochelson
OBJECTIVE: Prior to stereotactic breast biopsy, some radiologists obtain a mammogram image with an overlying alphanumeric grid to mark the skin overlying the target. Our purpose is to determine if this grid image affects stereotactic biopsy efficiency and accuracy, including total images obtained, procedure time and need for retargeting. MATERIALS AND METHODS: IRB approved, HIPAA compliant retrospective review of prone stereotactic biopsy cases targeting calcifications 9/1/2015 to 9/1/2016 was performed...
October 6, 2018: Clinical Imaging
Abhishek Chaturvedi, Prabhakar Rajiah, Apeksha Chaturvedi
Acquired diaphragmatic defects occur secondary to trauma, infection, surgery or neoplasm. These defects can lead to abnormal thoraco-abdominal fistulous communications also. Examples of surgically created diaphragmatic defects are omental, colonic interposition and vascular grafts. Regardless of etiology, these transdiaphragmatic communications provide a direct path for spread of pathology between the abdomen and thorax. If left untreated and unrecognized, these fistulae portend a high morbidity and mortality...
October 6, 2018: Clinical Imaging
Tien C Nguyen, Yoshiaki Ohyama, Ayako Taketomi-Takahashi, Huong T Nguyen, Akio Sugimoto, Makito Sato, Hisako Sumiyoshi, Tetsuya Nakamura, Masahiko Kurabayashi, Yoshito Tsushima
PURPOSE: To evaluate the correlation between cardiac functional parameters and image quality in coronary computed tomography angiography (CCTA). MATERIAL AND METHODS: Sixty-six patients who underwent both CCTA and echocardiography were included. The coronary artery attenuation values and contrast-to-noise ratios (CNR) were measured in the proximal right coronary arteries (RCA) and left main (LM) trunk. Then, the averages of the mean values derived from RCA and LM were calculated...
October 6, 2018: Clinical Imaging
Bryce Harmon, Michael Wells, David Park, Jing Gao
The purpose of this review is to summarize main pathophysiology of neuromuscular and movement disorders, present published evidence of ultrasound elastography in the assessment of common neuromuscular and movement disorders, and discuss what role ultrasound elastography modality can play in respect to neuromuscular and movement disorders.
October 6, 2018: Clinical Imaging
Anand K Narayan, Delia M Keating, Elizabeth A Morris, Victoria L Mango
INTRODUCTION: The majority of recalls from screening mammography do not result in biopsy recommendation. The purpose of this study was to evaluate if calcifications recalled from screening mammography are more likely to result in biopsy recommendations than other findings. METHODS: IRB-approved electronic medical record search was performed to obtain a random sample of screening mammograms assigned BI-RADS 0 assessment during 2014-2015. Primary reason for recall was classified as mass, asymmetry, focal asymmetry, calcifications, or distortion...
October 5, 2018: Clinical Imaging
Garrett Smith, Stephanie K Bell, John T Sladky, Peter B Kang, Mehmet S Albayram
Spinal muscular atrophies are rare genetic disorders most often caused by homozygous deletion mutations in SMN1 that lead to progressive neurodegeneration of anterior horn cells. Ventral spinal root atrophy is a consistent pathological finding in post-mortem examinations of patients who suffered from various subtypes of spinal muscular atrophy; however, corresponding radiographic findings have not been previously reported. We present a patient with hypotonia and weakness who was found to have ventral spinal root atrophy in the lumbosacral region on MRI and was subsequently diagnosed with spinal muscular atrophy...
October 5, 2018: Clinical Imaging
Stefano Palmucci, Luca Mammino, Daniele Carmelo Caltabiano, Valeria Costanzo, Pietro Valerio Foti, Letizia Antonella Mauro, Renato Farina, Maria Elena Profitta, Nunziata Sinagra, Giovanni Carlo Ettorre, Massimiliano Veroux, Antonio Basile
OBJECTIVES: To evaluate the effects of diuretic stimulation on Diffusion Weighted Imaging (DWI) and Diffusion Tensor Imaging (DTI) techniques in transplanted kidneys. METHODS: 33 transplanted kidney recipients underwent DWI and DTI sequences before and after furosemide. Cortical and medullary Apparent Diffusion Coefficient (ADC) and Fractional Anisotropy (FA) values were calculated in transplanted kidneys. Patients were divided into two groups according to their estimated glomerular rate filtration (Group A ≥ 60 ml/min and Group B < 60 ml/min)...
October 5, 2018: Clinical Imaging
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