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Insights Into Imaging

Valentina Virzì, Noemi Maria Giovanna Ognibene, Antonio Salvatore Sciortino, Glenda Culmone, Giuseppe Virzì
OBJECTIVES: To assess the frequency of choledocolithiasis and the role of preoperative laboratory findings, ultrasound (US) and magnetic resonance cholangio-pancreatography (MRCP) in the detection of choledocolithiasis in patients with gallbladder stones awaiting cholecystectomy. METHODS: A consecutive sample of 104 patients underwent MRCP prior to cholecystectomy. The patients were classified into different groups on the basis of the risk of choledocolithiasis...
July 5, 2018: Insights Into Imaging
Gilles Adam, Marine Ferrier, Sofia Patsoura, Raluca Gramada, Zuzana Meluchova, Vanessa Cazzola, Jean Darcourt, Christophe Cognard, Alain Viguier, Fabrice Bonneville
Acute ischaemic stroke represents the most common cause of new sudden neurological deficit, but other diseases mimicking stroke happen in about one-third of the cases. Magnetic resonance imaging (MRI) is the best technique to identify those 'stroke mimics'. In this article, we propose a diagnostic approach of those stroke mimics on MRI according to an algorithm based on diffusion-weighted imaging (DWI), which can be abnormal or normal, followed by the results of other common additional MRI sequences, such as T2 with gradient recalled echo weighted imaging (T2-GRE) and fluid-attenuated inversion recovery (FLAIR)...
June 22, 2018: Insights Into Imaging
Rikiya Yamashita, Mizuho Nishio, Richard Kinh Gian Do, Kaori Togashi
Convolutional neural network (CNN), a class of artificial neural networks that has become dominant in various computer vision tasks, is attracting interest across a variety of domains, including radiology. CNN is designed to automatically and adaptively learn spatial hierarchies of features through backpropagation by using multiple building blocks, such as convolution layers, pooling layers, and fully connected layers. This review article offers a perspective on the basic concepts of CNN and its application to various radiological tasks, and discusses its challenges and future directions in the field of radiology...
June 22, 2018: Insights Into Imaging
Walaa Alsharif, Michaela Davis, Louise Rainford, Andrea Cradock, Allison McGee
AIM: The aim was to design an app-based eLearning tool to provide radiographers with information about the physical basis of MR artefacts and practical elimination or/and minimisation strategies to optimise image quality, and to evaluate the impact of a smartphone app on radiographers' knowledge. METHODS: The study used the comparison-experimental approach (pre- and post-test). Thirty-five MR radiographers independently reviewed a prepared series of MR images (n = 25)...
June 14, 2018: Insights Into Imaging
José María García Santos, Sandra Sánchez Jiménez, Marta Tovar Pérez, Matilde Moreno Cascales, Javier Lailhacar Marty, Miguel A Fernández-Villacañas Marín
The glossopharyngeal nerve (GPN) is a rarely considered cranial nerve in imaging interpretation, mainly because clinical signs may remain unnoticed, but also due to its complex anatomy and inconspicuousness in conventional cross-sectional imaging. In this pictorial review, we aim to conduct a comprehensive review of the GPN anatomy from its origin in the central nervous system to peripheral target organs. Because the nerve cannot be visualised with conventional imaging examinations for most of its course, we will focus on the most relevant anatomical references along the entire GPN pathway, which will be divided into the brain stem, cisternal, cranial base (to which we will add the parasympathetic pathway leaving the main trunk of the GPN at the cranial base) and cervical segments...
June 13, 2018: Insights Into Imaging
Sarah Mohajeri Moghaddam, Alok A Bhatt
PURPOSE: Intramedullary spinal cord abnormalities are often challenging to diagnose. Spinal cord biopsy is a high-risk procedure with the potential to cause permanent neurological injury. Magnetic resonance imaging is the modality of choice for diagnosis and preoperative assessment of patients with spinal cord abnormalities. The radiologist's ability to narrow the differential diagnosis of spinal cord abnormalities has the potential to save patients from invasive approaches for diagnosis and also guide appropriate management...
June 12, 2018: Insights Into Imaging
J-B Coty, C Nedelcu, S Yahya, V Dupont, C Rougé-Maillart, M Verschoore, C Ridereau Zins, C Aubé
Currently, post-mortem computed tomography (PMCT) has become an accessible and contemporary tool for forensic investigations. In the case of burn victims, it provides specific semiologies requiring a prudent understanding to differentiate between the normal post-mortem changes from heat-related changes. The aim of this pictorial essay is to provide to the radiologist the keys to establish complete and focused reports in cases of PMCT of burn victims. Thus, the radiologist must discern all the contextual divergences with the forensic history, and must be able to report all the relevant elements to answer to the forensic pathologist the following questions: Are there tomographic features that could help to identify the victim? Is there evidence of remains of biological fluids in liquid form available for toxicological analysis and DNA sampling? Is there another obvious cause of death than heat-related lesions, especially metallic foreign bodies of ballistic origin? Finally, what are the characteristic burn-related injuries seen on the corpse that should be sought during the autopsy? TEACHING POINTS: • CT is highly useful to find features permitting the identification of a severely burned body...
June 7, 2018: Insights Into Imaging
Véronique Freire, Thomas P Moser, Marianne Lepage-Saucier
Musculoskeletal calcifications are frequent on radiographs and sometimes problematic. The goal of this article is to help radiologists to make the correct diagnosis when faced with an extraosseous musculoskeletal calcification. One should first differentiate a calcification from an ossification or a foreign body and then locate the calcification correctly. Each location has a specific short differential diagnosis, with minimal further investigation necessary. Intra-tendon calcifications are most frequently associated with hydroxyapatite deposition disease (HADD)...
June 7, 2018: Insights Into Imaging
Aurélie D'Hondt, Marie Cassart, Raymond De Maubeuge, Gustavo Soto Ares, Jacques Rommens, E Fred Avni
Postmortem fetal magnetic resonance imaging (PMFMRI) is increasingly used thanks to its good overall concordance with histology paralleling the rising incidence of parental refusal of autopsy. The technique could become a routine clinical examination but it needs to be standardized and conducted by trained radiologists. Such radiologists should be aware of not only the (congenital and acquired) anomalies that can involve the fetus, but also of the "physiological" postmortem changes. In this article, we intend to focus on the contribution of PMFMRI based on the existing literature and on our own experience, as we presently perform the technique routinely in our clinical practice...
June 4, 2018: Insights Into Imaging
M I Vargas, B M A Delattre, J Boto, J Gariani, A Dhouib, A Fitsiori, J L Dietemann
In this article, we illustrate the main advanced magnetic resonance imaging (MRI) techniques used for imaging of the spine and spinal cord in children and adults. This work focuses on daily clinical practice and aims to address the most common questions and needs of radiologists. We will also provide tips to solve common problems with which we were confronted. The main clinical indications for each MR technique, possible pitfalls and the challenges faced in spine imaging because of anatomical and physical constraints will be discussed...
June 1, 2018: Insights Into Imaging
Annelotte Vos, Guido Kranenburg, Pim A de Jong, Willem P T M Mali, Wim Van Hecke, Ronald L A W Bleys, Ivana Isgum, Aryan Vink, Wilko Spiering
OBJECTIVES: Pseudoxanthoma elasticum (PXE) is a rare genetic disorder, characterised by elastic fibre degeneration and calcifications in multiple organ systems. Computed tomography (CT) imaging is a potential method to monitor disease progression in PXE patients; however, this method has not been validated. The aim of this study was to correlate histological and computed tomographic findings in PXE patients to investigate the ability of CT scanning to detect these alterations. METHODS: Post mortem total body CT scans were obtained from two PXE patients (a 69-year-old male and 77-year-old female)...
June 1, 2018: Insights Into Imaging
Marta Drake-Pérez, Jose Boto, Aikaterini Fitsiori, Karl Lovblad, Maria Isabel Vargas
Diffusion-weighted imaging (DWI) has revolutionised stroke imaging since its introduction in the mid-1980s, and it has also become a pillar of current neuroimaging. Diffusion abnormalities represent alterations in the random movement of water molecules in tissues, revealing their microarchitecture, and occur in many neurological conditions. DWI provides useful information, increasing the sensitivity of MRI as a diagnostic tool, narrowing the differential diagnosis, providing prognostic information, aiding in treatment planning and evaluating response to treatment...
May 30, 2018: Insights Into Imaging
Kristina Samarzija, Petar Milosevic, Zoran Jurjevic, Emilija Erdeljac
OBJECTIVES: To compare the estimation of carotid artery stenosis by computed tomography angiography (CTA) based on cross-sectional area versus the smallest diameter measurement, and test the accuracy of both CTA measurements using color Doppler ultrasonography (CDUS) as a reference method. METHODS: For 113 carotid arteries with stenosis ≥50% we analysed the differences in the estimated stenosis level between both CTA methods and CDUS using the Bland-Altman approach...
May 24, 2018: Insights Into Imaging
Cinta Sangüesa Nebot, Sara Picó Aliaga, Agustín Serrano Durbá, María José Roca
Xanthogranulomatous pyelonephritis (XPN) is an unusual and severe form of chronic inflammatory lesion of the kidney, characterised by the destruction of the renal parenchyma and the presence of multinucleated giant cells and lipid-laden macrophages, inflammatory infiltration and intensive renal fibrosis. There are a few cases in the literature which describe the disease in children. The pathomechanism of XPN is poorly understood. Renal obstruction with concomitant urinary tract infection is the most commonly associated pathological finding...
May 23, 2018: Insights Into Imaging
Antoine Iannessi, Pierre-Yves Marcy, Olivier Clatz, Anne-Sophie Bertrand, Maki Sugimoto
The digitalization of modern imaging has led radiologists to become very familiar with computers and their user interfaces (UI). New options for display and command offer expanded possibilities, but the mouse and keyboard remain the most commonly utilized, for usability reasons. In this work, we review and discuss different UI and their possible application in radiology. We consider two-dimensional and three-dimensional imaging displays in the context of interventional radiology, and discuss interest in touchscreens, kinetic sensors, eye detection, and augmented or virtual reality...
May 16, 2018: Insights Into Imaging
Salvatore Stefanelli, Pravin Mundada, Anne-Laure Rougemont, Vincent Lenoir, Paolo Scolozzi, Laura Merlini, Minerva Becker
Although rare, masses and mass-like lesions of developmental and genetic origin may affect the paediatric craniofacial skeleton. They represent a major challenge in clinical practice because they can lead to functional impairment, facial deformation and disfigurement. The most common lesions include fibrous dysplasia, dermoid cysts, vascular malformations and plexiform neurofibromas. Less common lesions include torus mandibularis and torus palatinus, cherubism, nevoid basal cell carcinoma syndrome, meningoencephalocele and nasal sinus tract...
May 15, 2018: Insights Into Imaging
Tetsuhiko Okabe, Taiki Nozaki, Noriko Aida, Jay Starkey, Mikako Enokizono, Tetsu Niwa, Atsuhiko Handa, Yuji Numaguchi, Yasuyuki Kurihara
Neurological complications of paediatric cancers are a substantial problem. Complications can be primary from central nervous system (CNS) spread or secondary from indirect or remote effects of cancer, as well as cancer treatments such as chemotherapy and radiation therapy. In this review, we present the clinical and imaging findings of rare but important neurological complications in paediatric patients with cancer. Neurological complications are classified into three phases: pre-treatment, treatment and post-remission...
May 15, 2018: Insights Into Imaging
Eija Metsälä, Nicole Richli Meystre, José A Pires Jorge, Anja Henner, Tiina Kukkes, Cláudia Sà Dos Reis
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April 25, 2018: Insights Into Imaging
Christopher Siew Wai Tang, Nishanth Sivarasan, Nyree Griffin
In the last decade, autoimmune pancreatitis has become recognised as part of a wider spectrum of IgG4-related disease, typically associated with elevated serum IgG4 levels and demonstrating a response to corticosteroid therapy. Radiologically, there is imaging overlap with other benign and neoplastic conditions. This pictorial review discusses the intra-abdominal manifestations of this disease on cross-sectional imaging before and after steroid treatment and the main radiological features which help to distinguish it from other key differentials...
April 25, 2018: Insights Into Imaging
Andrea Delli Pizzi, Raffaella Basilico, Roberta Cianci, Barbara Seccia, Mauro Timpani, Alessandra Tavoletta, Daniele Caposiena, Barbara Faricelli, Daniela Gabrielli, Massimo Caulo
Magnetic resonance imaging (MRI) allows to non-invasively evaluate rectal cancer staging and to assess the presence of "prognostic signs" such as the distance from the anorectal junction, the mesorectal fascia infiltration and the extramural vascular invasion. Moreover, MRI plays a crucial role in the assessment of treatment response after chemo-radiation therapy, especially considering the growing interest in the new conservative policy (wait and see, minimally invasive surgery). We present a practical overview regarding the state of the art of the MRI protocol, the main signs that radiologists should consider for their reports during their clinical activity and future perspectives...
April 19, 2018: Insights Into Imaging
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