Journal of Clinical Imaging Science最新文献

We report a case of a 73-year-old woman presenting with intracranial and extracranial meningioma with perineural spread crossing the foramen rotundum and pterygopalatine fossa, primarily along the maxillary nerve. She visited our hospital with the chief complaint of the left cheek swelling. Subsequent magnetic resonance imaging revealed a well-demarcated mass containing intracranial (cavernous sinus, Meckel's cave, and middle cranial fossa) and extracranial components (pterygopalatine fossa, orbit, nasal cavity, ethmoid and sphenoid sinuses, infratemporal fossa, and buccal space) through the foramen rotundum. A biopsy specimen was obtained from the cheek mass, and the histopathological diagnosis was meningothelial meningioma.

Point-of-care ultrasound (POCUS) has emerged as a cost-effective diagnostic tool that significantly augments physical examinations. Positioned as an extension of traditional examination methods, particularly appealing to the upcoming generation of clinicians, it holds promise in potentially replacing the stethoscope in various medical assessments and procedures. The University of Rochester is deploying 2500 POCUS machines, enhancing compliance for image storage and documentation. Halfway through our 4-year deployment plan, we will discuss our governance structure, educational initiatives, and credentialing strategies. While POCUS adoption has seen organic growth over the past decade, our aim is to implement a comprehensive strategy ensuring adherence to established protocols for image storage and documentation. At present, we have successfully deployed 789 probes, with integration across 64 departments or divisions into our IT platform. Notably, this implementation has resulted in a remarkable 116% increase in hospital charges, underscoring the tangible impact of POCUS integration. However, achieving compliance and education among established providers has proven to be challenging.

Facet joint septic arthritis is a rare; yet, severe spinal infection often misdiagnosed due to its non-specific clinical presentation and radiological mimickers. This case series illustrates various clinical presentations, imaging features, and outcomes of patients with facet joint septic arthritis. We demonstrate different disease stages to aid clinicians and radiologists in recognizing this condition. Key diagnostic pitfalls are also discussed to enhance diagnostic accuracy in clinical practice.

Radiofrequency (RF) interference artifact is a common type of magnetic resonance imaging (MRI) artifacts caused by the presence of unwanted RF field inside the scanner room. The artifact has the appearance of parallel bright lines or bands that resemble zippers, which can mimic pathology, obstruct the viewing of underlining tissues, and lower image signal-to-noise ratio, affecting the diagnostic evaluation of the image and sometimes even rendering it non-diagnostic. Due to the presence of multiple possible sources of RF interference in MRI and potential nonrelated MRI artifacts that resemble RF interference artifact, it may be difficult to effectively and timely resolve the artifact problem. The objective of this paper is to provide a review of RF interference in MRI and to offer guidance in the prompt and correct identification of the associated image artifacts as well as efficient approaches to resolve and prevent RF interference problems. This article should serve as a useful educational reference to magnetic resonance (MR) technologists and radiologists in dealing with MR image artifacts that may be caused by RF interference.

This study aims to provide a comprehensive understanding of primary hepatic angiosarcoma, a rare and aggressive malignancy, focusing on its diagnostic challenges and unique imaging characteristics. The objective is to delineate the distinctive features of angiosarcoma through computed tomography and magnetic resonance imaging modalities, contributing to improved diagnostic precision and adding valuable insights to the scientific literature. We present the case of a 25-year-old male with primary hepatic angiosarcoma, emphasizing the challenges in distinguishing it from other vascular tumors.

Objectives: This study assesses the perceptions and attitudes of Chinese radiologists concerning the application of artificial intelligence (AI) in the diagnosis of lung nodules.

Material and methods: An anonymous questionnaire, consisting of 26 questions addressing the usability of AI systems and comprehensive evaluation of AI technology, was distributed to all radiologists affiliated with Beijing Anzhen Hospital and Beijing Tsinghua Changgung Hospital. The data collection was conducted between July 19, and 21, 2023.

Results: Of the 90 respondents, the majority favored the AI system's convenience and usability, reflected in "good" system usability scale (SUS) scores (Mean ± standard deviation [SD]: 74.3 ± 11.9). General usability was similarly well-received (Mean ± SD: 76.0 ± 11.5), while learnability was rated as "acceptable" (Mean ± SD: 67.5 ± 26.4). Most radiologists noted increased work efficiency (Mean Likert scale score: 4.6 ± 0.6) and diagnostic accuracy (Mean Likert scale score: 4.2 ± 0.8) with the AI system. Views on AI's future impact on radiology careers varied (Mean ± SD: 3.2 ± 1.4), with a consensus that AI is unlikely to replace radiologists entirely in the foreseeable future (Mean ± SD: 2.5 ± 1.1).

Conclusion: Radiologists at two leading Beijing hospitals generally perceive the AI-assisted lung nodule diagnostic system positively, citing its user-friendliness and effectiveness. However, the system's learnability requires enhancement. While AI is seen as beneficial for work efficiency and diagnostic accuracy, its long-term career implications remain a topic of debate.

Objectives: The objectives of this study were to contribute to the limited existing knowledge about subtalar dislocations, analyze the computed tomography (CT) findings and advantages over radiography, and report the rate and potential risk factors of post-traumatic peri-talar osteoarthritis (OA).

Material and methods: A total of 23 cases of traumatic subtalar dislocation during a 15-year period at three regional hospitals were retrospectively reviewed.

Results: All 23 cases were closed dislocations. Successful close reduction was performed in 17 patients (73.9%) and 6 patients (26.1%) required open reduction and internal fixation. Twenty patients (87%) had associated foot and ankle fractures. Fractures of calcaneal medial tubercle were the most common (75%), followed by talar head (30%), sinus tarsi (25%), and medial malleolus (25%). The radiograph's sensitivity for identifying fractures was 48.1%. The mean follow-up period is 30 months. Symptomatic OA affected 8 patients (36.4%). No post-trauatic talar avascular necrosis was noted. Fractures were present in all of those patients with post-traumatic OA (100%). Three out of five patients who sustained high-energy mechanism injury developed radiographic OA (66.7%). Three out of six patients (50%) treated with open reduction and internal fixation also developed radiographic OA.

Conclusion: Subtalar dislocation remains a rare injury. It is strongly associated with foot and ankle fractures. Fractures of the calcaneal medial tubercle were the most common. The risk of post-traumatic symptomatic peritalar OA is high. CT is useful in detecting occult fractures and injured bony subregions. We postulated potential risk factors of post-traumatic OA (fracture, high-energy mechanism of injury, open reduction, and internal fixation); however, this requires further study.

Objectives: The initial drug-eluting bead (DEB)-transarterial chemoembolization (TACE) are often performed after multiple sessions of transarterial infusion chemotherapy (TAI) or conventional TACE. The purpose of our study was to evaluate the factors associated with the occurrence of vascular lake phenomenon (VLP) during DEB-TACE, considering the previous interventional treatments.

Material and methods: Forty-nine initial DEB-TACE procedures in 49 patients between November 2010 and April 2024 were included in this retrospective study. VLP was defined as a localized pooling of contrast agents within the tumor in the venous phase of digital subtraction angiography. The laboratory data, pre-treatment imaging findings such as the maximum tumor diameter (≥3 cm or <3 cm) and the presence of enhancing capsule obtained from computed tomography or magnetic resonance imaging, size of DEBs, and loading drugs, the total number of previous interventional treatments were recorded and compared between VLP occurrence and VLP non-occurrence groups. The multivariate logistic regression analysis was performed to explore the association of factors in predicting VLP occurrence.

Results: VLP was observed in 16 patients (32.65%) out of 49 patients. The maximum tumor diameter (≥3 cm) and the presence of the enhancing capsule were significantly higher, and the total number of previous interventional treatments was significantly smaller in the VLP occurrence group than in the VLP non-occurrence group (P = 0.0006, 0.0007, and 0.0003). In multivariate analysis, the maximum tumor diameter, the presence of the enhancing capsule, and the total number of previous interventional treatments were significantly associated with the occurrence of VLP (P = 0.0048, 0.0093, and 0.047).

Conclusion: Our study confirmed that the reported risk factor, the maximum tumor diameter, and the enhancing capsule were significantly related to the occurrence of VLP in DEB-TACE. Further, the occurrence of VLP might be carefully considered when the number of previous interventional treatments is small.

Many chiropractors use radiological imaging, particularly X-rays, to locate and diagnose the cause of their patients' pain. However, this approach is fundamentally flawed because X-rays provide anatomical information but not functional insights. Pain, tissue damage, and injury do not always correlate directly with X-ray appearances. Given the high incidence of abnormalities found in X-rays of asymptomatic patients, the diagnostic validity of X-rays can be questioned, especially when used in isolation of the patient's history and/or a proper clinical assessment. One may posit that their application promotes overdiagnosis, and unvalidated treatment of X-ray findings (such as changes in postural curvature), which may mislead patients into believing these changes are directly responsible for their pain. A substantial amount of research has shown that there is no association between pain and reversed cervical curves. X-ray accuracy can vary due to several factors, including patient positioning, physical and morphological changes, interreliability among doctors, and other influences such as stress, pain, and emotional state. Over the past two decades, medical boards and health associations worldwide have made significant efforts to communicate better when imaging is necessary, focusing on reducing radiographic imaging. This review describes concerns about the frequent, almost routine use of spinal X-rays in primary care for spine-related pain in the absence of red-flag clinical signs.

We present a case involving a 60-year-old male with multifocal hepatocellular carcinoma (HCC), emphasizing the critical need for vigilant post-procedural monitoring following the interruption of drug-eluting beads transarterial chemoembolization (DEB-TACE) due to an allergic reaction. The patient, who had a history of various treatments for HCC, underwent DEB-TACE. During the procedure, he experienced an anaphylactic shock, presumably due to an allergy to the treatment components (iodinated contrast agent), resulting in the procedure's discontinuation. Initially stable, the patient was later found to have intra-abdominal bleeding, a complication associated with the vascular lake phenomenon (VLP), detected on post-procedural imaging. Re-embolization using gelatin particles was performed to address the VLP. It remains unclear whether the shock experienced during the DEB-TACE procedure was due to the allergic reaction or the rupture of the VLP. This case underscores the complexities in managing DEB-TACE, the necessity of careful monitoring for VLP, and the challenges in diagnosing and managing allergic reactions during such procedures. In conclusion, it is crucial to consider that VLP can occur at any time during or after DEB-TACE. Assessing the presence of VLP using digital subtraction angiography before the termination of the procedure is essential. However, when an allergy to the iodinated contrast agent is suspected, as in this case, careful follow-up with abdominal ultrasound and computed tomography might be necessary to assess the presence of intra-abdominal hemorrhage associated with VLP.