Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: 04/19/18

Πέμπτη 19 Απριλίου 2018

REPLY: [LETTERS]

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Altered White Matter Microstructure in the Corpus Callosum and Its Cerebral Interhemispheric Tracts in Adolescent Idiopathic Scoliosis: Diffusion Tensor Imaging Analysis [PEDIATRICS]

BACKGROUND AND PURPOSE:

Neural system was one of the important contributors to the etiopathogenesis of adolescent idiopathic scoliosis; additionally, the morphology of corpus callosum interconnecting both hemispheres of the brain was found to be altered morphologically. Our aim was to evaluate and compare the microstructural changes of the corpus callosum and its interhemispheric white matter fiber tracts interconnecting both cerebral hemispheres in patients with adolescent idiopathic scoliosis and matched controls using diffusion tensor imaging.

MATERIALS AND METHODS:

Brain DTI was performed in 69 patients with adolescent idiopathic scoliosis (female, right thoracic/thoracolumbar curve) and 40 age-matched controls without adolescent idiopathic scoliosis (female). 2D and 3D segmentation of the corpus callosum were performed using a region-growing method, and the corpus callosum was further divided into 6 regions, including the rostrum, genu, anterior and posterior midbodies, isthmus, and splenium. The laterality index was calculated to quantify the asymmetry of the corpus callosum. Interhemispheric fiber tractography were performed using the Brodmann atlas.

RESULTS:

2D ROI analysis revealed reduced fractional anisotropy in the genu and splenium (P = .075 and P = .024, respectively). Consistently reduced fractional anisotropy on the left sides of the genu and splenium was also found in 3D ROI analysis (P = .03 and P = .012, respectively). The laterality index analysis revealed a pseudo-right lateralization of the corpus callosum in adolescent idiopathic scoliosis. Interhemispheric fibers via the splenium interconnecting Brodmann 3, 1, and 2; Brodmann 17; and Brodmann 18 (corresponding to the primary somatosensory cortex and primary and secondary visual cortices) were also found to have reduced fractional anisotropy (P ≤ .05).

CONCLUSIONS:

Reduced fractional anisotropy was found in the genu and splenium of the corpus callosum and corresponding interhemispheric fiber tracts interconnecting the somatosensory and visual cortices via the splenium. Our results are suggestive of altered white matter microstructure within the brain of those with adolescent idiopathic scoliosis, which could be related to abnormal brain maturation during adolescence in adolescent idiopathic scoliosis and could possibly explain the previously documented somatosensory function impairment and visuo-oculomotor dysfunction in this condition.

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Value of Quantitative Collateral Scoring on CT Angiography in Patients with Acute Ischemic Stroke [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship.

MATERIALS AND METHODS:

From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance of both hemispheres and was compared with the visual collateral score. Primary outcomes were 90-day mRS score and follow-up infarct volume. The relation with outcome and the association with treatment effect were estimated. The influence of the CTA acquisition phase on the relation of collateral scores with outcome was determined.

RESULTS:

A total of 442 patients were included. The quantitative collateral score strongly correlated with the visual collateral score ( = 0.75) and was an independent predictor of mRS (adjusted odds ratio = 0.81; 95% CI, .77–.86) and follow-up infarct volume (exponent β = 0.88; P < .001) per 10% increase. The quantitative collateral score showed areas under the curve of 0.71 and 0.69 for predicting functional independence (mRS 0–2) and follow-up infarct volume of >90 mL, respectively. We found significant interaction of the quantitative collateral score with the endovascular therapy effect in unadjusted analysis on the full ordinal mRS scale (P = .048) and on functional independence (P = .049). Modification of the quantitative collateral score by acquisition phase on outcome was significant (mRS: P = .004; follow-up infarct volume: P < .001) in adjusted analysis.

CONCLUSIONS:

Automated quantitative collateral scoring in patients with acute ischemic stroke is a reliable and user-independent measure of the collateral capacity on baseline CTA and has the potential to augment the triage of patients with acute stroke for endovascular therapy.

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Volumetric Brain MRI Study in Fetuses with Congenital Heart Disease [PEDIATRICS]

BACKGROUND AND PURPOSE:

It is well-established that a high prevalence of infants with congenital heart defects surviving to childhood have neurodevelopmental abnormalities. The etiology is not clear. In this study, we aimed to find prenatal neuroanatomic changes in fetuses with congenital heart disease to better understand the pathophysiology behind these sequelae.

MATERIALS AND METHODS:

A retrospective study of 46 fetal brain MR imaging scans was performed at a tertiary medical center during a 4-year period. Clinical data were collected from electronic medical charts. Volumes of the supratentorial brain, right hemisphere, left hemisphere, and cerebellum were measured using a semiautomated method and were compared with the normal growth percentiles.

RESULTS:

We found that cerebellar volume and the cerebellar-supratentorial volume ratio were significantly lower among fetuses with congenital heart disease. Supratentorial and hemisphere volumes showed no difference between groups. This difference was not observed in fetuses with septation defects.

CONCLUSIONS:

Fetuses with congenital heart disease have smaller cerebellar volumes than healthy fetuses. Additional research is needed to assess this finding as a radiologic marker for long-term outcome.

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Sequential Apparent Diffusion Coefficient for Assessment of Tumor Progression in Patients with Low-Grade Glioma [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Early and accurate identification of tumor progression in patients with low-grade gliomas is challenging. We aimed to assess the role of quantitative ADC analysis in the sequential follow-up of patients with low-grade gliomas as a potential imaging marker of tumor stability or progression.

MATERIALS AND METHODS:

In this retrospective study, patients with a diagnosis of low-grade glioma with at least 12 months of imaging follow-up were retrospectively reviewed. Two neuroradiologists independently reviewed sequential MR imaging in each patient to determine tumor progression using the Response Assessment in Neuro-Oncology criteria. Normalized mean ADC (ADC_mean) and 10th percentile ADC (ADC₁₀) values from FLAIR hyperintense tumor volume were calculated for each MR image and compared between patients with stable disease versus tumor progression using univariate analysis. The interval change of ADC values between sequential scans was used to differentiate stable disease from progression using the Fisher exact test.

RESULTS:

Twenty-eight of 69 patients who were evaluated met our inclusion criteria. Fifteen patients were classified as stable versus 13 patients as having progression based on consensus reads of MRIs and the Response Assessment in Neuro-Oncology criteria. The interval change of ADC values showed greater concordance with ultimate lesion disposition than quantitative ADC values at a single time point. The interval change in ADC₁₀ matched the expected pattern in 12/13 patients with tumor progression (overall diagnostic accuracy of 86%, P <.001). On average, the ADC₁₀ interval change predicted progression 8 months before conventional MR imaging.

CONCLUSIONS:

The interval change of ADC₁₀ values can be used to identify progression versus stability of low-grade gliomas with a diagnostic accuracy of 86% and before apparent radiologic progression on conventional MR imaging.

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Neuroimaging in Dengue Seropositive Cases [LETTERS]

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Noninvasive Assessment of Hemodynamic Stress Distribution after Indirect Revascularization for Pediatric Moyamoya Vasculopathy [PEDIATRICS]

BACKGROUND AND PURPOSE:

Indirect revascularization surgery is an effective treatment in children with Moyamoya vasculopathy. In the present study, we hypothesized that DSC-PWI may reliably assess the evolution of CBF-related parameters after revascularization surgery, monitoring the outcome of surgical pediatric patients with Moyamoya vasculopathy. Thus, we aimed to evaluate differences in DSC-PWI parameters, including the hemodynamic stress distribution, in surgical and nonsurgical children with Moyamoya vasculopathy and to correlate them with long-term postoperative outcome.

MATERIALS AND METHODS:

Pre- and postoperative DSC parameters of 28 patients (16 females; mean age, 5.5 ± 4.8 years) treated with indirect revascularization were compared with those obtained at 2 time points in 10 nonsurgical patients (6 females; mean age, 6.9 ± 4.7 years). We calculated 4 normalized CBF-related parameters and their percentage variance: mean normalized CBF of the MCA territory, mean normalized CBF of the proximal MCA territory, mean normalized CBF of cortical the MCA territory, and hemodynamic stress distribution. The relationship between perfusion parameters and postoperative outcomes (poor, fair, good, excellent) was explored using 1-way analysis of covariance (P < .05).

RESULTS:

A significant decrease of the mean normalized CBF of the proximal MCA territory and hemodynamic stress distribution and an increase of the mean normalized CBF of the cortical MCA territory were observed after revascularization surgery (P < .001). No variations were observed in nonsurgical children. Postoperative hemodynamic stress distribution and its percentage change were significantly different in outcome groups (P < .001).

CONCLUSIONS:

DSC-PWI indices show postoperative hemodynamic changes that correlate with clinical outcome after revascularization surgery in children with Moyamoya disease.

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Comparison of 3T Intracranial Vessel Wall MRI Sequences [EXTRACRANIAL VASCULAR]

BACKGROUND AND PURPOSE:

Intracranial vessel wall MR imaging plays an increasing role in diagnosing intracranial vascular diseases. For a complete assessment, pre- and postcontrast sequences are required, and including other sequences, these result in a long scan duration. Ideally, the scan time of the vessel wall sequence should be reduced. The purpose of this study was to evaluate different intracranial vessel wall sequence variants to reduce scan duration, provided an acceptable image quality can be maintained.

MATERIALS AND METHODS:

Starting from the vessel wall sequence that we use clinically (6:42 minutes), 6 scan variants were tested (scan duration ranging between 4:39 and 8:24 minutes), creating various trade-offs among spatial resolution, SNR, and contrast-to-noise ratio. In total, 15 subjects were scanned on a 3T MR imaging scanner: In 5 subjects, all 7 variants were performed precontrast-only, and in 10 other subjects, the fastest variant (4:39 minutes) and our clinically used variant (6:42 minutes) were performed pre- and postcontrast.

RESULTS:

The fastest variant (4:39 minutes) had higher or comparable SNRs/contrast-to-noise ratios of the intracranial vessel walls compared with the reference sequence (6:42 minutes). Qualitative assessment showed that the contrast-to-noise ratio was most suppressed in the fastest variant of 4:39 minutes and the variant of 6:42 minutes pre- and postcontrast. SNRs/contrast-to-noise ratios of the fastest variant were all, except one, higher compared with the variant of 6:42 minutes (P < .008). Furthermore, the fastest variant (4:39 minutes) detected all vessel wall lesions identified on the 6:42-minute variant.

CONCLUSIONS:

A 30% faster vessel wall sequence was developed with high SNRs/contrast-to-noise ratios that resulted in good visibility of the intracranial vessel wall.

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Pancreatic Adenocarcinoma Staging in the Era of Preoperative Chemotherapy and Radiation Therapy.

Pancreatic Adenocarcinoma Staging in the Era of Preoperative Chemotherapy and Radiation Therapy.

Radiology. 2018 May;287(2):374-390

Authors: Zins M, Matos C, Cassinotto C

Abstract
Pancreatic ductal adenocarcinoma (PDA) remains among the most challenging malignancies to treat. At diagnosis, the tumor often already extends beyond the confines of the pancreas, spreading to an extent such that primary surgery with curative intent is very rarely feasible. Considerable momentum is now being given to a treatment strategy involving neoadjuvant chemotherapy or chemotherapy and radiation therapy in patients with nonmetastatic PDA. The main advantage of this strategy is better selection of patients likely to benefit from curative-intent surgery through the achievement of negative resection margins. Patients with rapidly progressive disease are identified and are spared ineffective surgery with its attendant morbidity. Neoadjuvant therapy can downstage tumors classified as locally advanced at initial imaging studies to resectable tumors. However, the imaging study evaluation of the response to neoadjuvant therapy is extremely complex. Thus, the diagnostic performance of imaging studies is not sufficient to ensure the accurate selection of patients in whom negative-margin resection is likely to be achieved. More specifically, standard criteria for predicting vascular invasion, based on the amount of tumor-vessel contact, are not valid after neoadjuvant therapy. ©RSNA, 2018.

PMID: 29668413 [PubMed - in process]

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Deep Learning or Fundamental Descriptors?

Deep Learning or Fundamental Descriptors?

Radiology. 2018 May;287(2):728-729

Authors: Kopans DB

PMID: 29668415 [PubMed - in process]

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68Ga Prostate-specific Membrane Antigen PET/CT for Primary Diagnosis of Prostate Cancer: Complementary or Alternative to Multiparametric MR Imaging.

68Ga Prostate-specific Membrane Antigen PET/CT for Primary Diagnosis of Prostate Cancer: Complementary or Alternative to Multiparametric MR Imaging.

Radiology. 2018 May;287(2):725-726

Authors: Lopci E, Guazzoni G, Lazzeri M

PMID: 29668418 [PubMed - in process]

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Case 257.

Case 257.

Radiology. 2018 May;287(2):715-718

Authors: Bednarova I, Frellesen C, Roman A, Vogl TJ

PMID: 29668417 [PubMed - in process]

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Andrew Joseph Dwyer, MD.

Andrew Joseph Dwyer, MD.

Radiology. 2018 May;287(2):730

Authors: Dunnick NR

PMID: 29668416 [PubMed - in process]

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Can T1 Mapping Be Used to Differentiate between Acute and Chronic Myocardial Infarctions?

Can T1 Mapping Be Used to Differentiate between Acute and Chronic Myocardial Infarctions?

Radiology. 2018 May;287(2):726-727

Authors: Tessa C, Casolo G, Meglio JD, Diciotti S, Vignali C, Giannelli M

PMID: 29668414 [PubMed - in process]

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On Quality Metrics and Quantitative Imaging.

On Quality Metrics and Quantitative Imaging.

Radiology. 2018 May;287(2):367-372

Authors: Abramson RG

PMID: 29668412 [PubMed - in process]

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Molecularly Targeted MR Imaging Agent in Liver Fibrosis: High Sensitivity and Low Gadolinium Mean High Translational Potential.

Molecularly Targeted MR Imaging Agent in Liver Fibrosis: High Sensitivity and Low Gadolinium Mean High Translational Potential.

Radiology. 2018 May;287(2):590-591

Authors: Pomper MG, Lee S

PMID: 29668411 [PubMed - in process]

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Case 253: Thrombosed Umbilical Venous Varix in an Infant.

Case 253: Thrombosed Umbilical Venous Varix in an Infant.

Radiology. 2018 May;287(2):719-724

Authors: Sandberg JK, Hulett-Bowling R, Khanna G

Abstract
History A 3-month-old previously healthy girl presented to an outside institution with a 4-day history of low-grade fever, irritability, and a tender "knot" in the upper abdomen. Ultrasonography (US) was performed at an outside hospital. US images were not available for review; however, they showed a mass in the left hepatic lobe, per the outside report, and the patient was referred to our institution for further evaluation. Her parents reported a normal full-term pregnancy, with regular prenatal care and normal prenatal US findings. The baby was born after an uncomplicated gestation. She was delivered at term via an uncomplicated cesarean section due to a maternal history of cesarean section. The perinatal course was uncomplicated, and there was no history of umbilical catheterization, per the parents. On arrival at our institution, the patient had a temperature of 38.2°C. All other vital signs were normal. Palpation revealed a tender and firm mass in the periumbilical region; otherwise, physical examination findings were normal. Results of laboratory work-up were normal, except for elevated white blood cell count (26 600/mm3 [26.6 × 109/L]; normal, 6000-17 500/mm3 [6-17.5 × 109/L]). The patient underwent US followed by intravenous contrast material-enhanced (10 mL ioversol, Optiray 320; Medtronic, Santa Rosa, Calif) computed tomography (CT) on the same day.

PMID: 29668410 [PubMed - in process]

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Progressive Reduction in Gray Matter in Patients with Schizophrenia Assessed with MR Imaging by Using Causal Network Analysis.

Progressive Reduction in Gray Matter in Patients with Schizophrenia Assessed with MR Imaging by Using Causal Network Analysis.

Radiology. 2018 May;287(2):729

Authors: Jiang Y, Luo C, Li X, Duan M, He H, Chen X, Yang H, Gong J, Chang X, Woelfer M, Biswal BB, Yao D

PMID: 29668409 [PubMed - in process]

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Can Optoacoustic Imaging Safely Reduce Benign Breast Biopsies?

Can Optoacoustic Imaging Safely Reduce Benign Breast Biopsies?

Radiology. 2018 May;287(2):413-415

Authors: Berg WA

PMID: 29668408 [PubMed - in process]

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Radiology in 2018: Are You Working with AI or Being Replaced by AI?

Radiology in 2018: Are You Working with AI or Being Replaced by AI?

Radiology. 2018 May;287(2):365-366

Authors: Bluemke DA

PMID: 29668407 [PubMed - in process]

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Diagnosis of Attention Deficit Hyperactivity Disorder by Using MR Imaging and Radiomics: A Potential Tool for Clinicians.

Diagnosis of Attention Deficit Hyperactivity Disorder by Using MR Imaging and Radiomics: A Potential Tool for Clinicians.

Radiology. 2018 May;287(2):631-632

Authors: Port JD

PMID: 29668406 [PubMed - in process]

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Radiofrequency Ablation versus Resection for Small Hepatocellular Carcinoma: Are Randomized Controlled Trials Still Needed?

Radiofrequency Ablation versus Resection for Small Hepatocellular Carcinoma: Are Randomized Controlled Trials Still Needed?

Radiology. 2018 May;287(2):473-475

Authors: Crocetti L

PMID: 29668405 [PubMed - in process]

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Andrew Joseph Dwyer.

Andrew Joseph Dwyer.

Radiology. 2018 Apr 17;:184009

Authors: Choyke PL, Jones EC, Kim L

PMID: 29668356 [PubMed - as supplied by publisher]

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Rectal cancer MRI: protocols, signs and future perspectives radiologists should consider in everyday clinical practice

Abstract

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.

Teaching Points

• MRI protocol for rectal cancer staging and re-staging.

• MRI findings that radiologists should consider for reports during everyday clinical activity.

• Perspectives regarding the development of latest technologies.

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Hydatidosis: Preparation and evaluation of radiolabeled antigens and antibodies.

https:--linkinghub.elsevier.com-ihub-ima

Hydatidosis: Preparation and evaluation of radiolabeled antigens and antibodies.

Exp Parasitol. 2018 Apr;187:67-74

Authors: Hadj Rabia S, Benmoussa F, Benzaid A, Baz A

Abstract
The present preliminary study intends to evaluate the in vitro use of hydatid antigen and their antibodies once labeled with iodine 125(I125) and characterized from viewpoint of radiochemical purity and immunoreactivity. Radiolabelled molecules gave satisfactory purity of 94% and 96%-98%, for hydatid antigen and IgG respectively. As regards, the specific activity of these latter, varied between 4.79 and 5.97 μCi/μg. The specificity test of radiolabelled IgG against the hydatid membranes showed a significant recognition that increased proportionally according to the contact surface. Likewise this immunoreactivity test performed with a simple binding assay, using human hydatid fluid antigen (HHF-Ag), previously fixed on a solid phase, gave satisfactory fixation rate of the order of 356 ± 48.08cpm, 2539 ± 550.12cpm and 6558 ± 712.76cpm for the concentrations of 0.1 μg/ml, 2 μg/ml and 25 μg/ml respectively. Statistical study of 88 sera, carried out with radiolabelled antigen (125I-HHF-Ag) in competitive radioimmunoassay test (CRIA) showed highly significant difference (p < 0.0001) in the binding capacity of antigens from patients sera with hydatid disease (65.63 ± 9.12) compared to the negative sera (19.25 ± 14.84). No cross reaction was observed using sera from patients with toxoplasmosis (33, 07 ± 13, 07) and the difference was highly significant (p < 0.0001) compared to E granulosus infected patient sera. Furthermore, this test seemed to be sensitive since among the 43 sera tested, only 37 (86%) were found to be positive by passive hemagglutination (HAP), while the totality (100%) responded positively by CRIA. Our findings are encouraging, suggesting that these radiolabeled molecules could be useful for advancing toward new diagnostic and therapeutic modalities.

PMID: 29499179 [PubMed - indexed for MEDLINE]

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Contrast opacification difference of mural artery and the transluminal attenuation gradient on coronary computed tomography angiography for detection of systolic compression of myocardial bridge.

Contrast opacification difference of mural artery and the transluminal attenuation gradient on coronary computed tomography angiography for detection of systolic compression of myocardial bridge.

Surg Radiol Anat. 2018 Apr 17;:

Authors: Xie Y, Wang X, Xie W, Chen F, Gao S, Xu Y

Abstract
PURPOSE: Myocardial bridges (MB) have traditionally been considered a benign condition, but recent studies have demonstrated that the clinical complications can be dangerous. The transluminal attenuation gradient (TAG) obtained from coronary computed tomography angiography (CCTA) data (Retrospective ECG-triggered method) has been used in detecting significant stenosis in coronary artery caused by atherosclerosis. Contrast opacification difference (COD) was the parameters calculated as the change between attenuation of mural artery and the median attenuation of presumptive vessel segment; it was evaluated along with TAGstandardized (TAGs) and MB length for predicting MB with systolic compression (MB-SC) in patients diagnosed as MB in left anterior descending coronary artery (LAD) by CCTA or invasive coronary angiograph (ICA).
METHODS: A total of 107 MB patients were divided into three groups based on systolic compression (SC), including: Group 1 (MB without SC); Group 2 (MB with mild SC); and Group 3 (MB with significant SC). ANOVA and Kruskal-Wallis analysis indicated TAGs showed the most significant differences for MB identification.
RESULTS: This study revealed that TAGs decreasing and COD increasing were dominated in MB with significant SC.
CONCLUSIONS: COD had a higher sensitivity and a higher negative predictive value for detecting MB with significant SC than TAGs.

PMID: 29667032 [PubMed - as supplied by publisher]

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The prevalence and ossification pattern of the biphalangeal and triphalangeal lateral toes.

The prevalence and ossification pattern of the biphalangeal and triphalangeal lateral toes.

Surg Radiol Anat. 2018 Apr 17;:

Authors: Ceynowa M, Rocławski M, Pankowski R, Mazurek T

Abstract
PURPOSE: Biphalangealism of the toes is an exclusively human phenomenon. The aim of this study was to evaluate the development of the lateral toes in childhood by following the ossification pattern of the phalanges.
METHODS: Foot radiographs of 913 adults have been evaluated for biphalangealism of 3rd to 5th toe. The pediatric group, aged 6-15 years of age, was assessed for the number of ossification centers in the foot.
RESULTS: In adults, the mean prevalence of biphalangealism in the 5th toe was 41.39%, in the 4th toe was 2.15%, and in the 3rd toe was 0.48%. In children, 45% feet had four ossification centers in the 5th toe. The epiphysis center of the middle and distal phalanx was missing. In the 4th toe, four centers were present in of 2.47% of cases. Those values are similar to the prevalence of the biphalangeal toes in adult population. The remaining toes had 5 or 6 ossification centers. In the 5-center toe, the epiphysis of the middle phalanx was missing.
CONCLUSION: A missing distal phalanx epiphyseal ossification center is considered indicative of a biphalangeal toe, and the toes with 5 or 6 ossification centers are indicative of triphalangeal toes. The reason for such evolution of the lateral toes is still debated, but the differences in anatomy most likely have no impact on foot function.

PMID: 29667031 [PubMed - as supplied by publisher]

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Rare combined variations of renal, suprarenal, phrenic and accessory hepatic arteries.

Rare combined variations of renal, suprarenal, phrenic and accessory hepatic arteries.

Surg Radiol Anat. 2018 Apr 17;:

Authors: Olewnik Ł, Waśniewska A, Polguj M, Topol M

Abstract
Knowledge of the morphological variations within the abdominal cavity is significant for all medical practitioners planning surgery. This report presents the rare origin of a common trunk for the right inferior phrenic artery, and superior and inferior suprarenal artery from the right renal artery. An accessory hepatic artery was found, which served as a branch of the right inferior phrenic artery. The diameter of the common trunk was 3.95 mm, and the diameters of the inferior and superior suprarenal arteries were 1.84 and 1.36 mm, respectively. The diameter of the right inferior phrenic artery was 2.55 mm. Both the embryological background and the potential clinical significance of this morphological variation are discussed. Knowledge of this common trunk and the occurrence of the accessory right hepatic artery may be of significance in diagnostic and surgical procedures.

PMID: 29667030 [PubMed - as supplied by publisher]

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Congenital absence of the internal carotid artery with a persistent primitive trigeminal artery as a collateral pathway: a report of an anatomic variation.

Congenital absence of the internal carotid artery with a persistent primitive trigeminal artery as a collateral pathway: a report of an anatomic variation.

Surg Radiol Anat. 2018 Apr 17;:

Authors: Kim D, Baek JW, Heo YJ, Jeong HW

Abstract
Congenital absence of the internal carotid artery (ICA) is rare, and patients with such a condition are often asymptomatic throughout their lifetime, because of sufficient collateral circulation. Collateral flow is provided via various channels; however, the role of persistent embryonic vessels under conditions in which the ICA is absent or occluded is unknown. We report a rare case of congenital absence of the left ICA and describe the collateral pathway consisting of a persistent trigeminal artery.

PMID: 29667029 [PubMed - as supplied by publisher]

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Imaging of the sublingual and submandibular spaces

Abstract

Divided by the mylohyoid muscle, the sublingual and submandibular spaces represent a relatively small part of the oral cavity, but account for a disproportionate amount of pathological processes. These entities are traditionally separated into congenital, infectious/inflammatory, vascular and neoplastic aetiologies. This article reviews the relevant anatomy, clinical highlights and distinguishing imaging features necessary for accurate characterisation.

Teaching Points

• The mylohyoid sling is a key anatomical landmark useful in surgical planning.

• Congenital lesions and infectious/inflammatory processes constitute the majority of pathology.

• Depth of invasion is key when staging tumours in the oral cavity.

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Multidetector CT of iatrogenic and self-inflicted vascular lesions and infections at the groin

Abstract

The number and complexity of endovascular procedures performed via either arterial or venous access are steadily increasing. Albeit associated with higher morbidity compared to the radial approach, the traditional common femoral artery remains the preferred access site in a variety of cardiac, aortic, oncologic and peripheral vascular procedures. Both transarterial and venous cannulation (for electrophysiology, intravenous laser ablation and central catheterisation) at the groin may result in potentially severe vascular access site complications (VASC). Furthermore, vascular and soft-tissue groin infections may develop after untreated VASC or secondarily to non-sterile injections for recreational drug use. VASC and groin infections require rapid diagnosis and appropriate treatment to avoid further, potentially devastating harm. Whereas in the past colour Doppler ultrasound was generally used, in recent years cardiologists, vascular surgeons and interventional radiologists increasingly rely on pelvic and femoral CT angiography. Despite drawbacks of ionising radiation and the need for intravenous contrast, multidetector CT rapidly and consistently provides a panoramic, comprehensive visualisation, which is crucial for correct choice between conservative, endovascular and surgical management. This paper aims to provide radiologists with an increased familiarity with iatrogenic and self-inflicted VASC and infections at the groin by presenting examples of haematomas, active bleeding, pseudoaneurysms, arterial occlusion, arterio-venous fistula, endovenous heat-induced thrombosis, septic thrombophlebitis, soft-tissue infections at the groin, and late sequelae of venous injuries.

Teaching Points

• Complications may develop after femoral arterial or venous access for interventional procedures.

• Arterial injuries include bleeding, pseudoaneurysm, occlusion, arteriovenous fistula, dissection.

• Endovenous heat-induced thrombosis is a specific form of iatrogenic venous complication.

• Iatrogenic infections include groin cellulitis, abscesses and septic thrombophlebitis.

• CT angiography reliably triages vascular access site complications and groin infections.

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Silicosis : CXR Findings DAMS Unplugged

Here is a short DAMS Unplugged video discussing the CXR findings in silicosis.

Famous Radiology Blog https://ift.tt/1MM2hKr TeleRad Providers at https://ift.tt/1NgppuI Mail us at sales@teleradproviders.com

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Dyspnoe nach Instillationstherapie beim Harnblasenkarzinom

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PET-Basics

Zusammenfassung

Die Positronenemissionstomographie (PET) ist ein nuklearmedizinisches Verfahren, das vorwiegend in der onkologischen Diagnostik zum Einsatz kommt. In Form moderner Hybridgeräte wie PET/Computertomographie (CT) und zunehmend PET/Magnetresonanztomographie (MRT) hat es eine breite Anwendung gefunden. Es handelt sich jedoch nicht nur um eine weitere Bildtechnik, sondern eine funktionelle Methode, die neben dem Verteilungsbild des Radiopharmakons auch Methoden der quantitativen Auswertung bietet, deren Ergebnisse auch für Therapieentscheidungen herangezogen werden. Eine profunde Kenntnis der Grundlagen der PET einschließlich der Indikationsstellung, der Patientenvorbereitung und möglicher Artefakte ist für die korrekte Interpretation unabdingbar.

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Πληροφορίες

Πέμπτη 19 Απριλίου 2018

Abstract

Teaching Points

Abstract

Teaching Points

Abstract

Teaching Points

Zusammenfassung

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