Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000066
Sanjib K. Das, IpsitaAcharya, JayashreeMohanty, Sasmita Swain
Pancreatic pseudocyst is a well-defined collection of fluid rich in pancreatic enzymes which occurs as a complication of pancreatitis. They are mostly located in the head and body of the pancreas while few are found in extra-pancreatic locations like mediastinum, liver, pelvis, pleura and spleen. However intrahepatic pseudocyst is a rare complication of pancreatitis with only 34 such cases being reported in English literature till the year 2009. Around 1 in 100 cases of pancreatic pseudocyst show extension into spleen.
{"title":"A rare case of chronic calcificpancreatitis with intrahepatic andsplenic pseudocysts","authors":"Sanjib K. Das, IpsitaAcharya, JayashreeMohanty, Sasmita Swain","doi":"10.14303/IMAGING-MEDICINE.1000066","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000066","url":null,"abstract":"Pancreatic pseudocyst is a well-defined collection of fluid rich in pancreatic enzymes which occurs as a complication of pancreatitis. They are mostly located in the head and body of the pancreas while few are found in extra-pancreatic locations like mediastinum, liver, pelvis, pleura and spleen. However intrahepatic pseudocyst is a rare complication of pancreatitis with only 34 such cases being reported in English literature till the year 2009. Around 1 in 100 cases of pancreatic pseudocyst show extension into spleen.","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"10 1","pages":"85-87"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79205244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/Imaging-Medicine.1000053
S. deSilva
Cecal volvulus is a rare cause of acute abdominal pain and intestinal obstruction, which if left untreated can lead to sepsis and death. Its clinical presentation is highly variable ranging from intermittent relenting abdominal pain, to severe acute pain associated with sepsis and bowel strangulation. This is a report of a 59 year old man who presented with nonspecific signs of an intestinal obstruction. CT demonstrated a cecal volvulus, which was not suspected by the clinical team. The objective of this report is to discuss the radiological findings critical to the urgent diagnosis and treatment of this rare but life-threatening condition.
{"title":"Cecal volvulus case report","authors":"S. deSilva","doi":"10.14303/Imaging-Medicine.1000053","DOIUrl":"https://doi.org/10.14303/Imaging-Medicine.1000053","url":null,"abstract":"Cecal volvulus is a rare cause of acute abdominal pain and intestinal obstruction, which if left untreated can lead to sepsis and death. Its clinical presentation is highly variable ranging from intermittent relenting abdominal pain, to severe acute pain associated with sepsis and bowel strangulation. This is a report of a 59 year old man who presented with nonspecific signs of an intestinal obstruction. CT demonstrated a cecal volvulus, which was not suspected by the clinical team. The objective of this report is to discuss the radiological findings critical to the urgent diagnosis and treatment of this rare but life-threatening condition.","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"11240 1","pages":"31-32"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83383387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000061
Dhafer M Alahmari, Samantha K. Barton, R. Galinsky, I. Nitsos, Anzari Atik, Michael Farrell, JamesTodd Pearson Graeme R Polglase
Objective: Inflammation and mechanical ventilation contribute additively to white matter injury in the preterm infant. We examined whether in vivo diffusion tensor imaging (DTI) indices correlate with immunohistochemical analyses of brain inflammation and injury caused by injurious ventilation at birth, in the presence or absence of intrauterine inflammation. Methods: Twin-bearing ewes received an ultrasound guided injection of lipopolysaccharide (LPS; n=11) or saline (n=12) 7 days prior to delivery at ~125 days gestation. Immediately after delivery, lambs received either an injurious (LPS+INJ; n=5 and INJ; n=6) or protective (LPS+PROT; n=6 and PROT; n=5) ventilation strategy for 90 min, after which DTI was assessed. Following imaging, neuronal density (NeuN antibody) in the thalamus (Th) and myelin density (myelin basic protein, MBP) in the internal capsule (IC) and periventricular white matter (PVWM) were assessed. Results: LPS exposure significantly increased axial diffusivity (P=0.01) and decreased myelin density in the IC (P=0.02) compared to saline groups. Moreover, there was a strong inverse correlation between fractional anisotropy values and myelin density in PVWM (P=0.01), and a trend in the IC (P=0.07) in all lambs. Injurious ventilation tended to reduce radial and mean diffusivity in the Th (P=0.07 and P=0.08). Conclusion: DTI was able to detect microstructural changes associated with a reduction in myelination due to inflammation in the short term. However, DTI indices were not sensitive enough to consistently detect the microstructural changes induced by injurious ventilation immediately after birth.
{"title":"Correlation between diffusion tensor imaging and histological brain injury in ventilated preterm lambs","authors":"Dhafer M Alahmari, Samantha K. Barton, R. Galinsky, I. Nitsos, Anzari Atik, Michael Farrell, JamesTodd Pearson Graeme R Polglase","doi":"10.14303/IMAGING-MEDICINE.1000061","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000061","url":null,"abstract":"Objective: Inflammation and mechanical ventilation contribute additively to white matter injury in the preterm infant. We examined whether in vivo diffusion tensor imaging (DTI) indices correlate with immunohistochemical analyses of brain inflammation and injury caused by injurious ventilation at birth, in the presence or absence of intrauterine inflammation. Methods: Twin-bearing ewes received an ultrasound guided injection of lipopolysaccharide (LPS; n=11) or saline (n=12) 7 days prior to delivery at ~125 days gestation. Immediately after delivery, lambs received either an injurious (LPS+INJ; n=5 and INJ; n=6) or protective (LPS+PROT; n=6 and PROT; n=5) ventilation strategy for 90 min, after which DTI was assessed. Following imaging, neuronal density (NeuN antibody) in the thalamus (Th) and myelin density (myelin basic protein, MBP) in the internal capsule (IC) and periventricular white matter (PVWM) were assessed. Results: LPS exposure significantly increased axial diffusivity (P=0.01) and decreased myelin density in the IC (P=0.02) compared to saline groups. Moreover, there was a strong inverse correlation between fractional anisotropy values and myelin density in PVWM (P=0.01), and a trend in the IC (P=0.07) in all lambs. Injurious ventilation tended to reduce radial and mean diffusivity in the Th (P=0.07 and P=0.08). Conclusion: DTI was able to detect microstructural changes associated with a reduction in myelination due to inflammation in the short term. However, DTI indices were not sensitive enough to consistently detect the microstructural changes induced by injurious ventilation immediately after birth.","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"38 1","pages":"67-76"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74388208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000064
A. Tobias, Anjali Agrawal ArjunKalyanpur
Background and objective: Serum D-dimer assay is an inexpensive laboratory test with a high negative predictive value, obviating the need for computed tomographic pulmonary angiography (CTPA) in patients with low clinical probability of thromboembolic disease. It has been recommended that CTPA may be performed only in patients with positive D-dimer assays and clinical suspicion of PTE (pulmonary thromboembolism), to curb unnecessary imaging and health care costs. We wanted to reassess the validity of this recommendation by looking into the D-dimer results in patients with positive PTE on CTPA. Methods: All patient records with positive PTE diagnosis on CTPA and having relevant laboratory data during one calendar year (January 01 to December 31, 2009) were selected. Serum D-dimer values of >500 ng/ml was considered abnormal. The D-dimer results among the patients who had the test performed were tabulated based on age and sex along with those without D-dimer assay in the same groups and correlated with their percentage distribution. Results: Out of a total of 98 positive PTE cases on CTPA, only 26 patients (26.5%) had a serum D-dimer assay done prior to CTPA. Of these, 20 (76.9%) had elevated values and 6 cases (23.1%) had a negative test. Negative D-dimer results varied with patient age, being highest in the 21-40 years age group. Conclusion: Overall, there seems to be more preferred use of CTPA and underutilization of serum D-dimer assay in clinical practice for suspected PTE. Secondly, negative D-dimer assay should not be used to triage patients with a high clinical index of suspicion for PTE.
{"title":"Evaluating patients with pulmonarythromboembolism: a retrospective studyon the utilization of serum D-dimer assayand CT angiography","authors":"A. Tobias, Anjali Agrawal ArjunKalyanpur","doi":"10.14303/IMAGING-MEDICINE.1000064","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000064","url":null,"abstract":"Background and objective: Serum D-dimer assay is an inexpensive laboratory test with a high negative predictive value, obviating the need for computed tomographic pulmonary angiography (CTPA) in patients with low clinical probability of thromboembolic disease. It has been recommended that CTPA may be performed only in patients with positive D-dimer assays and clinical suspicion of PTE (pulmonary thromboembolism), to curb unnecessary imaging and health care costs. We wanted to reassess the validity of this recommendation by looking into the D-dimer results in patients with positive PTE on CTPA. Methods: All patient records with positive PTE diagnosis on CTPA and having relevant laboratory data during one calendar year (January 01 to December 31, 2009) were selected. Serum D-dimer values of >500 ng/ml was considered abnormal. The D-dimer results among the patients who had the test performed were tabulated based on age and sex along with those without D-dimer assay in the same groups and correlated with their percentage distribution. Results: Out of a total of 98 positive PTE cases on CTPA, only 26 patients (26.5%) had a serum D-dimer assay done prior to CTPA. Of these, 20 (76.9%) had elevated values and 6 cases (23.1%) had a negative test. Negative D-dimer results varied with patient age, being highest in the 21-40 years age group. Conclusion: Overall, there seems to be more preferred use of CTPA and underutilization of serum D-dimer assay in clinical practice for suspected PTE. Secondly, negative D-dimer assay should not be used to triage patients with a high clinical index of suspicion for PTE.","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"21 1","pages":"81-84"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82702493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000080
L. Leão, T. Mussi, F. Yamauchi, R. Baroni
More than half of patients over the age of 50 years old may have at least one incidental renal lesion detected on imaging studies, such as ultrasonography, computed tomography or magnetic resonance imaging. Although the majority can be easily detected and correctly characterized, misdiagnoses may occur and are often related to methods limitations, inadequate imaging protocols and misinterpretation. This pictorial essay addresses recommendations on how to recognize benign and malignant renal processes that can be potentially missed or mischaracterized on imaging studies.
{"title":"How (not) to misdiagnose focal renal lesions: lessons learned?","authors":"L. Leão, T. Mussi, F. Yamauchi, R. Baroni","doi":"10.14303/IMAGING-MEDICINE.1000080","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000080","url":null,"abstract":"More than half of patients over the age of 50 years old may have at least one incidental renal lesion detected on imaging studies, such as ultrasonography, computed tomography or magnetic resonance imaging. Although the majority can be easily detected and correctly characterized, misdiagnoses may occur and are often related to methods limitations, inadequate imaging protocols and misinterpretation. This pictorial essay addresses recommendations on how to recognize benign and malignant renal processes that can be potentially missed or mischaracterized on imaging studies.","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"16 1","pages":"161-169"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87130361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000086
C. Francisco, S. João, B. Rita, M. Carlos, Leal de Faria Joao Abecasis Nuno
Objective: NAC’s blood supply may convey essential information for surgery planning. This study’s aim was to evaluate breast blood supply using MRI and to compare it between oncological and non-oncological subjects. The risk factors for NAC necrosis in nipple sparing mastectomy were analyzed. Methods: Breast MRI exams in one month at a single institution were evaluated. The considered inclusion criteria focused on patients with: ductal carcinoma in situ, invasive carcinoma (IC) or high-risk screening (HRS) without previous breast surgery. Subtraction reconstructions from dynamic acquisitions obtained at 60 s post-contrast administration were used. Results: 166 breasts were evaluated (12 pre op DCIS; 42 HRS; 112 pre op IC) - 71% of the NAC’s had a dominant blood supply. Tumors were localized in the upper outer quadrant (UOQ) in 46% of cases. In the NAC vascularization analysis, there was a tendency for a higher number of vessels vascularizing the NAC in the IC group (p=0.056) and there was a difference in the quadrant analysis mainly at the UOQ that had a dominant blood supply in 18% of the IC group and only 2% in the HRS (p=0.048). 16 patients performed NSM, three had NAC necrosis. The number of vessels supplying the NAC was the only factor with correlation with this outcome (p=0.01). There was not a single NAC with a dominant blood vessel from the lower outer quadrant (LOQ). Conclusion: Using MRI to pre-operatively evaluate breast blood supply is feasible without adding extra MRI time or contrast. 71% had dominant supply to the NAC, so every effort should be made to preserve it. The LOQ appears to be an optimal site for skin incisions. There is an asymmetry between cancer and HRS breasts mainly at the NAC’s level with neovascularization of that area. Patients with a single vessel supplying the NAC are at improved risk for necrosis.
{"title":"MRI in pre-operative NAC vascular map","authors":"C. Francisco, S. João, B. Rita, M. Carlos, Leal de Faria Joao Abecasis Nuno","doi":"10.14303/IMAGING-MEDICINE.1000086","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000086","url":null,"abstract":"Objective: NAC’s blood supply may convey essential information for surgery planning. This study’s aim was to evaluate breast blood supply using MRI and to compare it between oncological and non-oncological subjects. The risk factors for NAC necrosis in nipple sparing mastectomy were analyzed. Methods: Breast MRI exams in one month at a single institution were evaluated. The considered inclusion criteria focused on patients with: ductal carcinoma in situ, invasive carcinoma (IC) or high-risk screening (HRS) without previous breast surgery. Subtraction reconstructions from dynamic acquisitions obtained at 60 s post-contrast administration were used. Results: 166 breasts were evaluated (12 pre op DCIS; 42 HRS; 112 pre op IC) - 71% of the NAC’s had a dominant blood supply. Tumors were localized in the upper outer quadrant (UOQ) in 46% of cases. In the NAC vascularization analysis, there was a tendency for a higher number of vessels vascularizing the NAC in the IC group (p=0.056) and there was a difference in the quadrant analysis mainly at the UOQ that had a dominant blood supply in 18% of the IC group and only 2% in the HRS (p=0.048). 16 patients performed NSM, three had NAC necrosis. The number of vessels supplying the NAC was the only factor with correlation with this outcome (p=0.01). There was not a single NAC with a dominant blood vessel from the lower outer quadrant (LOQ). Conclusion: Using MRI to pre-operatively evaluate breast blood supply is feasible without adding extra MRI time or contrast. 71% had dominant supply to the NAC, so every effort should be made to preserve it. The LOQ appears to be an optimal site for skin incisions. There is an asymmetry between cancer and HRS breasts mainly at the NAC’s level with neovascularization of that area. Patients with a single vessel supplying the NAC are at improved risk for necrosis.","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"19 1","pages":"215-222"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75004359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000046
N. Jain, R. Galhotra, Kavita Saggar Simran Sidhu
Ewings sarcoma is the second most common bone tumor after osteosarcoma in children and adolescents. Diagnosis of skeletal Ewings sarcoma is usually based on MRI and histopathological findings. But one should be aware of the ultrasonographic appearance of this tumor as this may aid in the initial diagnosis. We report a case of Ewings sarcoma of the femur in which a periosteal reaction, cortical destruction, and Power Doppler on sonography suggested a probable malignant diagnosis.
{"title":"Sonographic appearance of ewings sarcoma of femur: a case report","authors":"N. Jain, R. Galhotra, Kavita Saggar Simran Sidhu","doi":"10.14303/IMAGING-MEDICINE.1000046","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000046","url":null,"abstract":"Ewings sarcoma is the second most common bone tumor after osteosarcoma in children and adolescents. Diagnosis of skeletal Ewings sarcoma is usually based on MRI and histopathological findings. But one should be aware of the ultrasonographic appearance of this tumor as this may aid in the initial diagnosis. We report a case of Ewings sarcoma of the femur in which a periosteal reaction, cortical destruction, and Power Doppler on sonography suggested a probable malignant diagnosis.","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"2 1","pages":"13-14"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89752992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000088
Yassir Benameura, M. Nadif, I. Ghfir, L. Oukerraj, H. Guerrouj, M. Cherti, N. B. Aouad
Planar whole-body bone scan was performed in the anterior and posterior projections 3 hrs after injection of 740 MBq (20mCi) of 99mTcHMDP (99m Technetium hydroxymethylene diphosphonate). The scanning speed was at 10-15 cm/min and the image format was 1024 × 256. Single photon emission computed tomography (SPECT-CT) was additionally performed. The bone scintigraphy showed an intense cardiac uptake corresponding to a grade 3 (intense cardiac uptake with attenuated bone uptake) and
{"title":"Cardiac amyloidosis revealed by bone scintigraphy","authors":"Yassir Benameura, M. Nadif, I. Ghfir, L. Oukerraj, H. Guerrouj, M. Cherti, N. B. Aouad","doi":"10.14303/IMAGING-MEDICINE.1000088","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000088","url":null,"abstract":"Planar whole-body bone scan was performed in the anterior and posterior projections 3 hrs after injection of 740 MBq (20mCi) of 99mTcHMDP (99m Technetium hydroxymethylene diphosphonate). The scanning speed was at 10-15 cm/min and the image format was 1024 × 256. Single photon emission computed tomography (SPECT-CT) was additionally performed. The bone scintigraphy showed an intense cardiac uptake corresponding to a grade 3 (intense cardiac uptake with attenuated bone uptake) and","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"13 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90235195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.14303/IMAGING-MEDICINE.1000052
L. Phillips
{"title":"Depressed skull fracture following a baseball bat strike to the head","authors":"L. Phillips","doi":"10.14303/IMAGING-MEDICINE.1000052","DOIUrl":"https://doi.org/10.14303/IMAGING-MEDICINE.1000052","url":null,"abstract":"","PeriodicalId":13333,"journal":{"name":"Imaging in Medicine","volume":"3 1","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82746856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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