N. Kunimatsu, A. Kunimatsu, Y. Uchida, I. Mori, Shigeru Kiryu
Objectives To investigate the application of apparent diffusion coefficient (ADC) histogram analysis in differentiating between benign and malignant breast lesions detected as non-mass enhancement on MRI. Materials and Methods A retrospective study was conducted for 25 malignant and 26 benign breast lesions showing non-mass enhancement on breast MRI. An experienced radiologist without prior knowledge of the pathological results drew a region of interest (ROI) outlining the periphery of each lesion on the ADC map. A histogram was then made for each lesion. Following a univariate analysis of 18 summary statistics values, we conducted statistical discrimination after hierarchical clustering using Ward’s method. A comparison between the malignant and the benign groups was made using multiple logistic regression analysis and the Mann-Whitney U test. A P -value of less than 0.05 was considered statistically significant. Results Univariate analysis for the 18 summary statistics values showed the malignant group had greater entropy (P < 0.001) and lower uniformity (P < 0.001). While there was no significant difference in mean and skewness values, the malignant group tended to show a lower mean (P = 0.090) and a higher skewness (P = 0.065). Hierarchical clustering of the 18 summary statistics values identified four values (10th percentile, entropy, skewness, and uniformity) of which the 10th percentile values were significantly lower for the malignant group (P = 0.035). Conclusions Whole-lesion ADC histogram analysis may be useful for differentiating malignant from benign lesions which show non-mass enhancement on breast MRI.
{"title":"Whole-lesion histogram analysis of apparent diffusion coefficient for the assessment of non-mass enhancement lesions on breast MRI","authors":"N. Kunimatsu, A. Kunimatsu, Y. Uchida, I. Mori, Shigeru Kiryu","doi":"10.25259/JCIS_201_2021","DOIUrl":"https://doi.org/10.25259/JCIS_201_2021","url":null,"abstract":"Objectives To investigate the application of apparent diffusion coefficient (ADC) histogram analysis in differentiating between benign and malignant breast lesions detected as non-mass enhancement on MRI. Materials and Methods A retrospective study was conducted for 25 malignant and 26 benign breast lesions showing non-mass enhancement on breast MRI. An experienced radiologist without prior knowledge of the pathological results drew a region of interest (ROI) outlining the periphery of each lesion on the ADC map. A histogram was then made for each lesion. Following a univariate analysis of 18 summary statistics values, we conducted statistical discrimination after hierarchical clustering using Ward’s method. A comparison between the malignant and the benign groups was made using multiple logistic regression analysis and the Mann-Whitney U test. A P -value of less than 0.05 was considered statistically significant. Results Univariate analysis for the 18 summary statistics values showed the malignant group had greater entropy (P < 0.001) and lower uniformity (P < 0.001). While there was no significant difference in mean and skewness values, the malignant group tended to show a lower mean (P = 0.090) and a higher skewness (P = 0.065). Hierarchical clustering of the 18 summary statistics values identified four values (10th percentile, entropy, skewness, and uniformity) of which the 10th percentile values were significantly lower for the malignant group (P = 0.035). Conclusions Whole-lesion ADC histogram analysis may be useful for differentiating malignant from benign lesions which show non-mass enhancement on breast MRI.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"1 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80163520","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}
Yi Lam Priscilla Chan, Chun Hung Kevin Yu, W. Chong, K. Y. Kwok, Allen Li
Diffuse cystic lung disease represents a diverse group of uncommon disorders that has been increasingly diagnosed due to the increasing use of computed tomography. It poses a frequent diagnostic challenge to radiologists due to the similar clinical and radiological features these diseases share. This pictorial review includes selected cases from the Hospital Authority New Territories West Cluster (NTWC) in Hong Kong from the past 3 years. It will illustrate the spectrum of diffuse cystic lung diseases, including some rarer entities in our locality, and identify the pertinent differentiating imaging features on CT. A flowchart to summarize these features is provided at the end to aid in diagnosis.
{"title":"Pictorial review of computed tomography features of diffuse cystic lung disease","authors":"Yi Lam Priscilla Chan, Chun Hung Kevin Yu, W. Chong, K. Y. Kwok, Allen Li","doi":"10.25259/JCIS_210_2021","DOIUrl":"https://doi.org/10.25259/JCIS_210_2021","url":null,"abstract":"Diffuse cystic lung disease represents a diverse group of uncommon disorders that has been increasingly diagnosed due to the increasing use of computed tomography. It poses a frequent diagnostic challenge to radiologists due to the similar clinical and radiological features these diseases share. This pictorial review includes selected cases from the Hospital Authority New Territories West Cluster (NTWC) in Hong Kong from the past 3 years. It will illustrate the spectrum of diffuse cystic lung diseases, including some rarer entities in our locality, and identify the pertinent differentiating imaging features on CT. A flowchart to summarize these features is provided at the end to aid in diagnosis.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"62 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86129814","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}
We report two cases of peripartum ruptured ovarian artery aneurysms (OAA). One patient was treated through endovascular embolization and the other with percutaneous thrombin injection. Multiple additional unruptured OAAs were incidentally discovered in each patient. We describe the pathophysiologic basis for OAA rupture, approaches to treatment, and suggest management strategies for incidentally discovered ovarian aneurysms.
{"title":"Peripartum hemorrhage: Two cases of ruptured ovarian artery aneurysms with additional multifocal intact aneurysms","authors":"T. Arleo, G. Peters, N. Kokabi, B. Majdalany","doi":"10.25259/JCIS_145_2021","DOIUrl":"https://doi.org/10.25259/JCIS_145_2021","url":null,"abstract":"We report two cases of peripartum ruptured ovarian artery aneurysms (OAA). One patient was treated through endovascular embolization and the other with percutaneous thrombin injection. Multiple additional unruptured OAAs were incidentally discovered in each patient. We describe the pathophysiologic basis for OAA rupture, approaches to treatment, and suggest management strategies for incidentally discovered ovarian aneurysms.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"62 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84662344","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}
HIV is a multisystem disease process that can affect the cardiovascular system resulting in vasculopathy. As highly active anti-retroviral therapy has allowed patients to live longer with the disease, vascular complications such as aneurysms, occlusive disease, spontaneous arteriovenous fistulae, and arterial dissections have been described. The pathogenesis of vascular-related complications in HIV is poorly understood but is thought to involve an interplay between viral-induced inflammation, vascular smooth muscle changes, endothelial alterations, and circulating blood factors. The most well-described management strategies for symptomatic aneurysm-related complications are surgical in nature, with mostly anecdotal reports of endovascular intervention. We present a case of a 24-year-old male who was found to have findings consistent with HIV vasculopathy on angiography after presenting with acute GI hemorrhage secondary to left gastric artery bleeding. Our patient was managed with endovascular embolization. Although studies have shown promise regarding the endovascular management of HIV-related aneurysmal complications in the short term, more research is needed to evaluate the long-term success of these interventions.
{"title":"Endovascular management of HIV vasculopathy","authors":"Jack B. Newcomer, Emad A. Chishti, D. Raissi","doi":"10.25259/JCIS_226_2021","DOIUrl":"https://doi.org/10.25259/JCIS_226_2021","url":null,"abstract":"HIV is a multisystem disease process that can affect the cardiovascular system resulting in vasculopathy. As highly active anti-retroviral therapy has allowed patients to live longer with the disease, vascular complications such as aneurysms, occlusive disease, spontaneous arteriovenous fistulae, and arterial dissections have been described. The pathogenesis of vascular-related complications in HIV is poorly understood but is thought to involve an interplay between viral-induced inflammation, vascular smooth muscle changes, endothelial alterations, and circulating blood factors. The most well-described management strategies for symptomatic aneurysm-related complications are surgical in nature, with mostly anecdotal reports of endovascular intervention. We present a case of a 24-year-old male who was found to have findings consistent with HIV vasculopathy on angiography after presenting with acute GI hemorrhage secondary to left gastric artery bleeding. Our patient was managed with endovascular embolization. Although studies have shown promise regarding the endovascular management of HIV-related aneurysmal complications in the short term, more research is needed to evaluate the long-term success of these interventions.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"68 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79965425","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}
Alban Wei Shern Leong, J. Langdon, Vivek Malhotra, U. Mandalia
Melorheostosis is a rare bone dysplasia of unknown etiology with an incidence of 0.9 cases per million. It typically affects the upper or lower limbs and can cause severe deformity and functional impairment. Diagnosis is radiological and is often described as a “flowing candle wax” appearance on the radiograph. Treatment is individualized depending on the site and severity of symptoms. We report a rare case of spinal melorheostosis. We demonstrate the imaging features of melorheostosis on CT and MRI. We discuss the classification, genetics, and management of this condition.
{"title":"A case of spinal melorheostosis","authors":"Alban Wei Shern Leong, J. Langdon, Vivek Malhotra, U. Mandalia","doi":"10.25259/JCIS_202_2021","DOIUrl":"https://doi.org/10.25259/JCIS_202_2021","url":null,"abstract":"Melorheostosis is a rare bone dysplasia of unknown etiology with an incidence of 0.9 cases per million. It typically affects the upper or lower limbs and can cause severe deformity and functional impairment. Diagnosis is radiological and is often described as a “flowing candle wax” appearance on the radiograph. Treatment is individualized depending on the site and severity of symptoms. We report a rare case of spinal melorheostosis. We demonstrate the imaging features of melorheostosis on CT and MRI. We discuss the classification, genetics, and management of this condition.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"22 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80901381","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}
Elif Soya, Nur Ekenel, R. Savaş, T. Toprak, J. Bewes, Ozkan Doganay
Objectives: Computed tomography (CT) plays a complementary role in the diagnosis of the pneumonia-burden of COVID-19 disease. However, the low contrast of areas of inflammation on CT images, areas of infection are difficult to identify. The purpose of this study is to develop a post-image-processing method for quantitative analysis of COVID-19 pneumonia-related changes in CT attenuation values using a pixel-based analysis rather than more commonly used clustered focal pneumonia volumes. The COVID-19 pneumonia burden is determined by experienced radiologists in the clinic. Previous AI software was developed for the measurement of COVID-19 lesions based on the extraction of local pneumonia features. In this respect, changes in the pixel levels beyond the clusters may be overlooked by deep learning algorithms. The proposed technique focuses on the quantitative measurement of COVID-19 related pneumonia over the entire lung in pixel-by-pixel fashion rather than only clustered focal pneumonia volumes. Material and Methods: Fifty COVID-19 and 50 age-matched negative control patients were analyzed using the proposed technique and commercially available artificial intelligence (AI) software. The %pneumonia was calculated using the relative volume of parenchymal pixels within an empirically defined CT density range, excluding pulmonary airways, vessels, and fissures. One-way ANOVA analysis was used to investigate the statistical difference between lobar and whole lung %pneumonia in the negative control and COVID-19 cohorts. Results: The threshold of high-and-low CT attenuation values related to pneumonia caused by COVID-19 were found to be between ₋642.4 HU and 143 HU. The %pneumonia of the whole lung, left upper, and lower lobes were 8.1 ± 4.4%, 6.1 ± 4.5, and 11.3 ± 7.3% for the COVID-19 cohort, respectively, and statistically different (P < 0.01). Additionally, the pixel-based methods correlate well with existing AI methods and are approximately four times more sensitive to pneumonia particularly at the upper lobes compared with commercial software in COVID-19 patients (P < 0.01). Conclusion: Pixel-by-pixel analysis can accurately assess pneumonia in COVID-19 patients with CT. Pixel-based techniques produce more sensitive results than AI techniques. Using the proposed novel technique, %pneumonia could be quantitatively calculated not only in the clusters but also in the whole lung with an improved sensitivity by a factor of four compared to AI-based analysis. More significantly, pixel-by-pixel analysis was more sensitive to the upper lobe pneumonia, while AI-based analysis overlooked the upper lung pneumonia region. In the future, this technique can be used to investigate the efficiency of vaccines and drugs and post COVID-19 effects.
目的:计算机断层扫描(CT)在COVID-19肺炎负担诊断中发挥补充作用。然而，CT图像上炎症区域对比度低，感染区域难以识别。本研究的目的是开发一种图像后处理方法，使用基于像素的分析来定量分析COVID-19肺炎相关CT衰减值的变化，而不是更常用的聚集性局灶性肺炎体积。COVID-19肺炎负担由临床经验丰富的放射科医生确定。以前的AI软件是基于局部肺炎特征的提取来测量COVID-19病变。在这方面，深度学习算法可能会忽略集群之外像素水平的变化。所提出的技术侧重于以逐像素的方式定量测量整个肺部的COVID-19相关肺炎，而不仅仅是聚集性局灶性肺炎体积。材料与方法:采用提出的技术和市售人工智能(AI)软件对50例COVID-19患者和50例年龄匹配的阴性对照患者进行分析。肺炎的百分比是根据经验定义的CT密度范围内的实质像素的相对体积计算的，不包括肺气道、血管和裂隙。采用单因素方差分析(One-way ANOVA)分析阴性对照组和COVID-19队列大叶性肺炎和全肺性肺炎的统计学差异。结果:与COVID-19肺炎相关的CT高低衰减值阈值在24.642.4 HU ~ 14.3hu之间。肺炎组全肺、左上肺叶、左下肺叶肺炎%分别为8.1±4.4%、6.1±4.5%、11.3±7.3%，差异有统计学意义(P < 0.01)。此外，基于像素的方法与现有的人工智能方法具有良好的相关性，并且与商业软件相比，对COVID-19患者的肺炎(特别是上肺叶)的敏感性约为四倍(P < 0.01)。结论:逐像素分析可准确评估COVID-19患者的肺炎。基于像素的技术比人工智能技术产生更敏感的结果。使用提出的新技术，不仅可以在群集中定量计算肺炎，而且可以在整个肺中定量计算，与基于人工智能的分析相比，灵敏度提高了四倍。更重要的是，逐像素分析对上肺肺炎更敏感，而基于人工智能的分析忽略了上肺肺炎区域。未来，该技术可用于研究疫苗和药物的效率以及COVID-19后的效果。
{"title":"Pixel-based analysis of pulmonary changes on CT lung images due to COVID-19 pneumonia","authors":"Elif Soya, Nur Ekenel, R. Savaş, T. Toprak, J. Bewes, Ozkan Doganay","doi":"10.25259/JCIS_172_2021","DOIUrl":"https://doi.org/10.25259/JCIS_172_2021","url":null,"abstract":"Objectives: Computed tomography (CT) plays a complementary role in the diagnosis of the pneumonia-burden of COVID-19 disease. However, the low contrast of areas of inflammation on CT images, areas of infection are difficult to identify. The purpose of this study is to develop a post-image-processing method for quantitative analysis of COVID-19 pneumonia-related changes in CT attenuation values using a pixel-based analysis rather than more commonly used clustered focal pneumonia volumes. The COVID-19 pneumonia burden is determined by experienced radiologists in the clinic. Previous AI software was developed for the measurement of COVID-19 lesions based on the extraction of local pneumonia features. In this respect, changes in the pixel levels beyond the clusters may be overlooked by deep learning algorithms. The proposed technique focuses on the quantitative measurement of COVID-19 related pneumonia over the entire lung in pixel-by-pixel fashion rather than only clustered focal pneumonia volumes. Material and Methods: Fifty COVID-19 and 50 age-matched negative control patients were analyzed using the proposed technique and commercially available artificial intelligence (AI) software. The %pneumonia was calculated using the relative volume of parenchymal pixels within an empirically defined CT density range, excluding pulmonary airways, vessels, and fissures. One-way ANOVA analysis was used to investigate the statistical difference between lobar and whole lung %pneumonia in the negative control and COVID-19 cohorts. Results: The threshold of high-and-low CT attenuation values related to pneumonia caused by COVID-19 were found to be between ₋642.4 HU and 143 HU. The %pneumonia of the whole lung, left upper, and lower lobes were 8.1 ± 4.4%, 6.1 ± 4.5, and 11.3 ± 7.3% for the COVID-19 cohort, respectively, and statistically different (P < 0.01). Additionally, the pixel-based methods correlate well with existing AI methods and are approximately four times more sensitive to pneumonia particularly at the upper lobes compared with commercial software in COVID-19 patients (P < 0.01). Conclusion: Pixel-by-pixel analysis can accurately assess pneumonia in COVID-19 patients with CT. Pixel-based techniques produce more sensitive results than AI techniques. Using the proposed novel technique, %pneumonia could be quantitatively calculated not only in the clusters but also in the whole lung with an improved sensitivity by a factor of four compared to AI-based analysis. More significantly, pixel-by-pixel analysis was more sensitive to the upper lobe pneumonia, while AI-based analysis overlooked the upper lung pneumonia region. In the future, this technique can be used to investigate the efficiency of vaccines and drugs and post COVID-19 effects.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91304196","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}
K. Premnath, Ahmed Tarek Saleh, M. Elsakhawy, Meric Kutlay, S. Jacob
Pseudoaneurysm with arteriovenous fistula is a rare presentation of penetrating trauma, occurs when trauma involves major blood vessels, and is traditionally treated surgically. Recently, these are more commonly treated using endovascular techniques which include stent graft placement and parent artery occlusion. In this case report, we present a case of femoral artery pseudoaneurysm and arteriovenous fistula with severe size difference between the arterial segments proximal and distal to the fistula site, treated successfully by using the upside-down gore excluder limb technique.
{"title":"Stent graft for a longstanding femoral artery pseudoaneurysm with arteriovenous fistula– A case report of the first infra-inguinal application of the upside-down gore excluder limb technique","authors":"K. Premnath, Ahmed Tarek Saleh, M. Elsakhawy, Meric Kutlay, S. Jacob","doi":"10.25259/JCIS_110_2021","DOIUrl":"https://doi.org/10.25259/JCIS_110_2021","url":null,"abstract":"Pseudoaneurysm with arteriovenous fistula is a rare presentation of penetrating trauma, occurs when trauma involves major blood vessels, and is traditionally treated surgically. Recently, these are more commonly treated using endovascular techniques which include stent graft placement and parent artery occlusion. In this case report, we present a case of femoral artery pseudoaneurysm and arteriovenous fistula with severe size difference between the arterial segments proximal and distal to the fistula site, treated successfully by using the upside-down gore excluder limb technique.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"2 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87623438","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}
R. Mattay, Lane Miner, A. Copelan, K. Davtyan, J. Schmitt, E. Church, A. Mamourian
Objectives: While hemorrhage arising from ruptured arteriovenous malformations (AVMs) is usually evident on multidetector non-contrast computed tomography (NCCT), unruptured AVMs can be below the limits of detection. We performed a retrospective review of NCCT of patients with a proven diagnosis of unruptured AVM to determine if advances in CT technology have made them more apparent and what features predict their detection. Material and Methods: Twenty-five NCCTs met inclusion criteria of having angiography or MR proven AVM without hemorrhage, prior surgery, or other CNS disease. Demographic variables, clinical symptoms at presentation, abnormal CT imaging findings, attenuation of the superior sagittal sinus (SSS), and Spetzler-Martin grade of each AVM were recorded. We examined the relationship between AVM detection and SSS attenuation through Kruskal–Wallis test. Exploratory serial logistic principal components analysis was performed including demographics, symptoms, and CT features in the multivariate model. Results: About 80% of the NCCTs showed an abnormality while 20% were normal. All those with an identifiable abnormality showed hyperdensity (80%). Logistic regression models indicate that clustered associations between several CT features, primarily calcifications, hyperdensity, and vascular prominence significantly predicted Spetzler-Martin grade (likelihood ratio 7.7, P = 0.006). SSS attenuation was significantly lower in subjects with occult AVMs when compared to those with CT abnormalities (median 47 vs. 55 HU, P < 0.04). Conclusion: Abnormal hyperdensity was evident in all detectable cases (80%) and multiple CT features were predictive of a higher Spetzler-Martin AVM grade. Moreover, SSS attenuation less than 50 HU was significantly correlated with a false-negative NCCT.
目的:虽然破裂的动静脉畸形(AVMs)引起的出血通常在多检测器非对比计算机断层扫描(NCCT)上很明显，但未破裂的动静脉畸形可能低于检测范围。我们对确诊为未破裂AVM的患者的NCCT进行了回顾性分析，以确定CT技术的进步是否使其更加明显，以及哪些特征可以预测其检测。材料和方法:25例NCCTs符合血管造影或MR证实无出血、既往手术或其他中枢神经系统疾病的AVM纳入标准。记录人口统计学变量、首发时的临床症状、异常CT影像表现、上矢状窦(SSS)衰减以及每个AVM的Spetzler-Martin分级。我们通过Kruskal-Wallis检验检验了AVM检测与SSS衰减的关系。在多变量模型中进行探索性序列logistic主成分分析，包括人口统计学、症状和CT特征。结果:80%的ncct显示异常，20%的ncct显示正常。所有可识别异常的患者均表现为高密度(80%)。Logistic回归模型显示，几种CT特征(主要是钙化、高密度和血管突出)之间的聚类关联可显著预测Spetzler-Martin分级(似然比7.7,P = 0.006)。隐匿性avm患者的SSS衰减明显低于CT异常患者(中位47 vs 55 HU, P < 0.04)。结论:所有可检出的病例(80%)均有明显的异常高密度，多重CT表现可预测较高的Spetzler-Martin AVM分级。此外，SSS衰减小于50 HU与NCCT假阴性显著相关。
{"title":"Unruptured Arteriovenous Malformations in the Multidetector Computed Tomography Era: Frequency of Detection and Predictable Failures","authors":"R. Mattay, Lane Miner, A. Copelan, K. Davtyan, J. Schmitt, E. Church, A. Mamourian","doi":"10.25259/JCIS_200_2021","DOIUrl":"https://doi.org/10.25259/JCIS_200_2021","url":null,"abstract":"Objectives: While hemorrhage arising from ruptured arteriovenous malformations (AVMs) is usually evident on multidetector non-contrast computed tomography (NCCT), unruptured AVMs can be below the limits of detection. We performed a retrospective review of NCCT of patients with a proven diagnosis of unruptured AVM to determine if advances in CT technology have made them more apparent and what features predict their detection. Material and Methods: Twenty-five NCCTs met inclusion criteria of having angiography or MR proven AVM without hemorrhage, prior surgery, or other CNS disease. Demographic variables, clinical symptoms at presentation, abnormal CT imaging findings, attenuation of the superior sagittal sinus (SSS), and Spetzler-Martin grade of each AVM were recorded. We examined the relationship between AVM detection and SSS attenuation through Kruskal–Wallis test. Exploratory serial logistic principal components analysis was performed including demographics, symptoms, and CT features in the multivariate model. Results: About 80% of the NCCTs showed an abnormality while 20% were normal. All those with an identifiable abnormality showed hyperdensity (80%). Logistic regression models indicate that clustered associations between several CT features, primarily calcifications, hyperdensity, and vascular prominence significantly predicted Spetzler-Martin grade (likelihood ratio 7.7, P = 0.006). SSS attenuation was significantly lower in subjects with occult AVMs when compared to those with CT abnormalities (median 47 vs. 55 HU, P < 0.04). Conclusion: Abnormal hyperdensity was evident in all detectable cases (80%) and multiple CT features were predictive of a higher Spetzler-Martin AVM grade. Moreover, SSS attenuation less than 50 HU was significantly correlated with a false-negative NCCT.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"53 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90229781","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}
H. Kwok, Kwok Yan Li, R. L. Chan, C. H. Chan, Stephen Ka Hon Wong, Chiu Man Lee, L. F. Cheng, J. Ma
Lymphomas of the central nervous system (CNS) are broadly classified into primary CNS lymphoma (PCNSL) and secondary CNS lymphoma (SCNSL). PCNSL refers to lymphoma restricted to the brain, leptomeninges, spinal cord, or eyes without evidence of it outside the CNS at primary diagnosis, while SCNSL refers to secondary CNS involvement by systemic lymphoma. The brain is the most common site of involvement and intracranial CNS lymphoma has a highly variable imaging appearance and varies according to the patient’s clinical profile and immunity. This pictorial essay aims to illustrate the different facets of intracranial CNS lymphomas on neuroimaging. This enables radiologists to be familiarized with their key diagnostic features and differentiate from their differential diagnoses, leading to early diagnosis, and treatment.
{"title":"Different facets of intracranial central nervous system lymphoma and its imaging mimics","authors":"H. Kwok, Kwok Yan Li, R. L. Chan, C. H. Chan, Stephen Ka Hon Wong, Chiu Man Lee, L. F. Cheng, J. Ma","doi":"10.25259/JCIS_135_2021","DOIUrl":"https://doi.org/10.25259/JCIS_135_2021","url":null,"abstract":"Lymphomas of the central nervous system (CNS) are broadly classified into primary CNS lymphoma (PCNSL) and secondary CNS lymphoma (SCNSL). PCNSL refers to lymphoma restricted to the brain, leptomeninges, spinal cord, or eyes without evidence of it outside the CNS at primary diagnosis, while SCNSL refers to secondary CNS involvement by systemic lymphoma. The brain is the most common site of involvement and intracranial CNS lymphoma has a highly variable imaging appearance and varies according to the patient’s clinical profile and immunity. This pictorial essay aims to illustrate the different facets of intracranial CNS lymphomas on neuroimaging. This enables radiologists to be familiarized with their key diagnostic features and differentiate from their differential diagnoses, leading to early diagnosis, and treatment.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"49 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74146655","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}
Joanna W Kee-Sampson, Dheeraj Reddy Gopireddy, Sai Swarupa Reddy Vulasala, Rachel Stein, Sindhu Kumar, Mayur Virarkar
Penetrating vascular injury has become the topic of interest with increased gun violence in the United States. The radiologist plays a crucial role in establishing and systemizing the signs of vascular injury such as intimal flap, dissection, pseudoaneurysm, rupture, and arteriovenous fistula. Various imaging techniques such as ultrasound Doppler, computed tomographic angiography (CTA), magnetic resonance angiography, and conventional angiography are being employed based on clinical recommendations. Of all the techniques, CTA has been shown to embrace a promising role in identifying vascular injuries with superior sensitivity, specificity, and accuracy. An acquaintance of the imaging features has been shown to improve the approach to trauma patients in clinical settings. This article details the imaging modalities and the features of the head-and-neck penetrating vascular injury.
{"title":"Role of imaging in penetrating vascular injuries of the craniocervical region.","authors":"Joanna W Kee-Sampson, Dheeraj Reddy Gopireddy, Sai Swarupa Reddy Vulasala, Rachel Stein, Sindhu Kumar, Mayur Virarkar","doi":"10.25259/JCIS_98_2022","DOIUrl":"https://doi.org/10.25259/JCIS_98_2022","url":null,"abstract":"<p><p>Penetrating vascular injury has become the topic of interest with increased gun violence in the United States. The radiologist plays a crucial role in establishing and systemizing the signs of vascular injury such as intimal flap, dissection, pseudoaneurysm, rupture, and arteriovenous fistula. Various imaging techniques such as ultrasound Doppler, computed tomographic angiography (CTA), magnetic resonance angiography, and conventional angiography are being employed based on clinical recommendations. Of all the techniques, CTA has been shown to embrace a promising role in identifying vascular injuries with superior sensitivity, specificity, and accuracy. An acquaintance of the imaging features has been shown to improve the approach to trauma patients in clinical settings. This article details the imaging modalities and the features of the head-and-neck penetrating vascular injury.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"12 ","pages":"63"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/17/JCIS-12-63.PMC9805603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10546578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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