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Practical approach to linear endoscopic ultrasound examination of the gallbladder. 胆囊线性内窥镜超声波检查实用方法。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-28 DOI: 10.4329/wjr.v16.i6.184
Hussein Hassan Okasha, Eyad Gadour, Hassan Atalla, Omar AbdAllah AbdEl-Hameed, Reem Ezzat, Ahmed Elsayed Alzamzamy, Elsayed Ghoneem, Rasha Ahmad Matar, Zeinab Hassan, Bogdan Miutescu, Ayman Qawasmi, Katarzyna M Pawlak, Ahmed Elmeligui

The gallbladder (GB) is a susceptible organ, prone to various pathologies that can be identified using different imaging techniques. Transabdominal ultrasound (TUS) is typically the initial diagnostic method due to its numerous well-established advantages. However, in cases of uncertainty or when a definitive diagnosis cannot be established, computed tomography (CT) or magnetic resonance imaging may be employed to provide more detailed information. Nevertheless, CT scans may sometimes offer inadequate spatial resolution, which can limit the differentiation of GB lesions, particularly when smaller yet clinically relevant abnormalities are involved. Conversely, endoscopic ultrasound (EUS) provides higher frequency compared to TUS, superior spatial resolution, and the option for contrast-enhanced harmonic imaging, enabling a more comprehensive examination. Thus, EUS can serve as a supplementary tool when conventional imaging methods are insufficient. This review will describe the standard EUS examination of the GB, focusing on its endosonographic characteristics in various GB pathologies.

胆囊(GB)是一个易感器官,容易发生各种病变,可通过不同的成像技术进行识别。经腹超声(TUS)因其众多公认的优点,通常是最初的诊断方法。不过,在不确定或无法确定诊断的情况下,可采用计算机断层扫描(CT)或磁共振成像来提供更详细的信息。不过,CT 扫描有时可能无法提供足够的空间分辨率,从而限制了对 GB 病变的区分,尤其是涉及较小但与临床相关的异常时。相反,与 TUS 相比,内窥镜超声(EUS)的频率更高,空间分辨率更高,并可进行对比度增强谐波成像,从而实现更全面的检查。因此,EUS 可作为常规成像方法不足时的辅助工具。本综述将介绍标准的胃肠道超声检查,重点是各种胃肠道病变的内镜特征。
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引用次数: 0
Navigating nephrotoxic waters: A comprehensive overview of contrast-induced acute kidney injury prevention. 在肾毒性水域中航行:造影剂诱发急性肾损伤预防综合概述。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-28 DOI: 10.4329/wjr.v16.i6.168
Panagiotis Theofilis, Rigas Kalaitzidis

Contrast-induced acute kidney injury (CI-AKI) is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality. Its pathophysiology, although not well-established, revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney. Critically ill patients, as well as those with pre-existing renal disease and cardiovascular comorbidities, are more susceptible to CI-AKI. Despite the continuous research in the field of CI-AKI prevention, clinical practice is based mostly on periprocedural hydration. In this review, all the investigated methods of prevention are presented, with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.

造影剂诱发的急性肾损伤(CI-AKI)是诊断和治疗过程中血管内使用造影剂导致急性肾损伤的第三大主要原因,会导致住院时间延长、短期和长期死亡率上升。尽管其病理生理学尚未得到很好的证实,但它是围绕髓质缺氧和物质对肾脏的直接毒性而产生的。重症患者以及原有肾脏疾病和心血管并发症的患者更容易发生 CI-AKI。尽管在 CI-AKI 预防领域的研究仍在继续,但临床实践主要基于围手术期水化。本综述介绍了所有研究过的预防方法,重点是有关 RenalGuard 和造影剂清除系统在预防高危人群 CI-AKI 方面潜力的最新证据。
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引用次数: 0
Imaging features and management of focal liver lesions. 肝脏局灶性病变的成像特征和处理方法。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-28 DOI: 10.4329/wjr.v16.i6.139
Gökhan Kahraman, Kemal Murat Haberal, Osman Nuri Dilek

Notably, the number of incidentally detected focal liver lesions (FLLs) has increased dramatically in recent years due to the increased use of radiological imaging. The diagnosis of FLLs can be made through a well-documented medical history, physical examination, laboratory tests, and appropriate imaging methods. Although benign FLLs are more common than malignant ones in adults, even in patients with primary malignancy, accurate diagnosis of incidental FLLs is of utmost clinical significance. In clinical practice, FLLs are frequently evaluated non-invasively using ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Although US is a cost-effective and widely used imaging method, its diagnostic specificity and sensitivity for FLL characterization are limited. FLLs are primarily characterized by obtaining enhancement patterns through dynamic contrast-enhanced CT and MRI. MRI is a problem-solving method with high specificity and sensitivity, commonly used for the evaluation of FLLs that cannot be characterized by US or CT. Recent technical advancements in MRI, along with the use of hepatobiliary-specific MRI contrast agents, have significantly improved the success of FLL characterization and reduced unnecessary biopsies. The American College of Radiology (ACR) appropriateness criteria are evidence-based recommendations intended to assist clinicians in selecting the optimal imaging or treatment option for their patients. ACR Appropriateness Criteria Liver Lesion-Initial Characterization guideline provides recommendations for the imaging methods that should be used for the characterization of incidentally detected FLLs in various clinical scenarios. The American College of Gastroenterology (ACG) Clinical Guideline offers evidence-based recommendations for both the diagnosis and management of FLL. American Association for the Study of Liver Diseases (AASLD) Practice Guidance provides an approach to the diagnosis and management of patients with hepatocellular carcinoma. In this article, FLLs are reviewed with a comprehensive analysis of ACR Appropriateness Criteria, ACG Clinical Guideline, AASLD Practice Guidance, and current medical literature from peer-reviewed journals. The article includes a discussion of imaging methods used for the assessment of FLL, current recommended imaging techniques, innovations in liver imaging, contrast agents, imaging features of common nonmetastatic benign and malignant FLL, as well as current management recommendations.

值得注意的是,近年来,由于放射成像技术的应用日益广泛,偶然发现的局灶性肝损伤(FLLs)数量急剧增加。FLL的诊断可通过翔实的病史、体格检查、实验室检查和适当的影像学方法来完成。虽然在成人中良性 FLL 比恶性 FLL 更为常见,但即使在原发性恶性肿瘤患者中,准确诊断偶然出现的 FLL 也具有极其重要的临床意义。在临床实践中,经常使用超声波(US)、计算机断层扫描(CT)和磁共振成像(MRI)对 FLL 进行无创评估。尽管 US 是一种成本效益高且应用广泛的成像方法,但其对 FLL 特征描述的诊断特异性和灵敏度却很有限。FLL 的特征主要是通过动态对比增强 CT 和 MRI 获得增强模式。核磁共振成像是一种解决问题的方法,具有高特异性和高灵敏度,常用于评估 US 或 CT 无法定性的 FLL。核磁共振成像的最新技术进步以及肝胆特异性核磁共振成像造影剂的使用,大大提高了FLL特征描述的成功率,并减少了不必要的活检。美国放射学会(ACR)适宜性标准是以证据为基础的建议,旨在帮助临床医生为患者选择最佳的成像或治疗方案。ACR 适当性标准肝脏病变-初始特征描述指南为在各种临床情况下偶然发现的 FLL 特征描述所应使用的成像方法提供了建议。美国胃肠病学院 (ACG) 临床指南为 FLL 的诊断和管理提供了循证建议。美国肝病研究协会(AASLD)实践指南提供了肝细胞癌患者的诊断和管理方法。本文通过全面分析 ACR 适宜性标准、ACG 临床指南、AASLD 实践指南以及同行评审期刊中的最新医学文献,对 FLL 进行了综述。文章讨论了用于评估FLL的成像方法、当前推荐的成像技术、肝脏成像的创新、造影剂、常见非转移性良性和恶性FLL的成像特征以及当前的管理建议。
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引用次数: 0
Predicting distant metastasis in nasopharyngeal carcinoma using gradient boosting tree model based on detailed magnetic resonance imaging reports. 利用基于详细磁共振成像报告的梯度增强树模型预测鼻咽癌的远处转移
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-28 DOI: 10.4329/wjr.v16.i6.203
Yu-Liang Zhu, Xin-Lei Deng, Xu-Cheng Zhang, Li Tian, Chun-Yan Cui, Feng Lei, Gui-Qiong Xu, Hao-Jiang Li, Li-Zhi Liu, Hua-Li Ma

Background: Development of distant metastasis (DM) is a major concern during treatment of nasopharyngeal carcinoma (NPC). However, studies have demonstrated improved distant control and survival in patients with advanced NPC with the addition of chemotherapy to concomitant chemoradiotherapy. Therefore, precise prediction of metastasis in patients with NPC is crucial.

Aim: To develop a predictive model for metastasis in NPC using detailed magnetic resonance imaging (MRI) reports.

Methods: This retrospective study included 792 patients with non-distant metastatic NPC. A total of 469 imaging variables were obtained from detailed MRI reports. Data were stratified and randomly split into training (50%) and testing sets. Gradient boosting tree (GBT) models were built and used to select variables for predicting DM. A full model comprising all variables and a reduced model with the top-five variables were built. Model performance was assessed by area under the curve (AUC).

Results: Among the 792 patients, 94 developed DM during follow-up. The number of metastatic cervical nodes (30.9%), tumor invasion in the posterior half of the nasal cavity (9.7%), two sides of the pharyngeal recess (6.2%), tubal torus (3.3%), and single side of the parapharyngeal space (2.7%) were the top-five contributors for predicting DM, based on their relative importance in GBT models. The testing AUC of the full model was 0.75 (95% confidence interval [CI]: 0.69-0.82). The testing AUC of the reduced model was 0.75 (95%CI: 0.68-0.82). For the whole dataset, the full (AUC = 0.76, 95%CI: 0.72-0.82) and reduced models (AUC = 0.76, 95%CI: 0.71-0.81) outperformed the tumor node-staging system (AUC = 0.67, 95%CI: 0.61-0.73).

Conclusion: The GBT model outperformed the tumor node-staging system in predicting metastasis in NPC. The number of metastatic cervical nodes was identified as the principal contributing variable.

背景:远处转移(DM)的发生是鼻咽癌(NPC)治疗过程中的一个主要问题。然而,有研究表明,在化疗的同时加用化疗放疗可改善晚期鼻咽癌患者的远处转移控制和生存率。因此,准确预测鼻咽癌患者的转移至关重要。目的:利用详细的磁共振成像(MRI)报告建立鼻咽癌转移预测模型:这项回顾性研究纳入了792例非远处转移性鼻咽癌患者。从详细的磁共振成像报告中获得了总共 469 个成像变量。数据被分层并随机分成训练集(50%)和测试集。建立梯度提升树(GBT)模型,用于选择预测 DM 的变量。建立了一个包含所有变量的完整模型和一个包含前五个变量的简化模型。通过曲线下面积(AUC)评估模型性能:结果:在792名患者中,有94人在随访期间发生了DM。根据其在GBT模型中的相对重要性,转移性颈结节数量(30.9%)、鼻腔后半部肿瘤侵犯(9.7%)、两侧咽凹(6.2%)、输卵管环(3.3%)和单侧咽旁间隙(2.7%)是预测DM的前五大因素。完整模型的测试AUC为0.75(95%置信区间[CI]:0.69-0.82)。简化模型的测试 AUC 为 0.75(95% 置信区间:0.68-0.82)。就整个数据集而言,完整模型(AUC = 0.76,95%CI:0.72-0.82)和简化模型(AUC = 0.76,95%CI:0.71-0.81)的表现优于肿瘤结节分期系统(AUC = 0.67,95%CI:0.61-0.73):结论:在预测鼻咽癌转移方面,GBT模型优于肿瘤结节分期系统。结论:在预测鼻咽癌转移方面,GBT 模型优于肿瘤结节分期系统。
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引用次数: 0
Multisystemic recurrent Langerhans cell histiocytosis misdiagnosed with chronic inflammation at the first diagnosis: A case report. 初诊时被误诊为慢性炎症的多系统复发性朗格汉斯细胞组织细胞增生症:病例报告。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-28 DOI: 10.4329/wjr.v16.i6.232
Zhan-Rong Zhang, Feng Chen, Hui-Juan Chen

Background: Langerhans cell histiocytosis (LCH) is characterized by diabetes insipidus and is an uncommon occurrence. Pathological biopsies still have a certain degree of diagnostic probability. We present a case in which LCH initially affected the pituitary gland. This resulted in a misdiagnosis of chronic inflammation upon pathological examination.

Case summary: A 25-year-old female exhibited symptoms of diabetes insipidus. Magnetic resonance imaging revealed an enhanced foci in the pituitary gland. After surgical resection of the pituitary lesion, the pathological diagnosis was chronic inflammation. However, the patient later experienced bone destruction in the skull and lower limb bones. After the lower limb bone lesion was compared with the initial pituitary lesion, the final diagnosis was modified to LCH. The patient was treated with multiple chemotherapy courses. However, the patient's condition gradually worsened, and she eventually passed away at home.

Conclusion: LCH should be considered when patients exhibit diabetes insipidus and absence of high signal intensity in the pituitary gland on sagittal T1-weighted image and abnormal enhancement in the pituitary region.

背景:朗格汉斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)以糖尿病性尿崩症为特征,并不常见。病理活检仍有一定的诊断可能性。我们介绍了一例 LCH 最初累及垂体的病例。病例摘要:一名 25 岁女性表现出糖尿病症状。磁共振成像显示垂体有强化灶。手术切除垂体病灶后,病理诊断为慢性炎症。然而,患者的颅骨和下肢骨后来出现了骨质破坏。将下肢骨病变与最初的垂体病变进行比较后,最终诊断改为 LCH。患者接受了多个疗程的化疗。然而,患者的病情逐渐恶化,最终在家中去世:结论:当患者出现糖尿病性尿崩症,矢状面T1加权图像上垂体无高信号强度,垂体区域异常强化时,应考虑LCH。
{"title":"Multisystemic recurrent Langerhans cell histiocytosis misdiagnosed with chronic inflammation at the first diagnosis: A case report.","authors":"Zhan-Rong Zhang, Feng Chen, Hui-Juan Chen","doi":"10.4329/wjr.v16.i6.232","DOIUrl":"10.4329/wjr.v16.i6.232","url":null,"abstract":"<p><strong>Background: </strong>Langerhans cell histiocytosis (LCH) is characterized by diabetes insipidus and is an uncommon occurrence. Pathological biopsies still have a certain degree of diagnostic probability. We present a case in which LCH initially affected the pituitary gland. This resulted in a misdiagnosis of chronic inflammation upon pathological examination.</p><p><strong>Case summary: </strong>A 25-year-old female exhibited symptoms of diabetes insipidus. Magnetic resonance imaging revealed an enhanced foci in the pituitary gland. After surgical resection of the pituitary lesion, the pathological diagnosis was chronic inflammation. However, the patient later experienced bone destruction in the skull and lower limb bones. After the lower limb bone lesion was compared with the initial pituitary lesion, the final diagnosis was modified to LCH. The patient was treated with multiple chemotherapy courses. However, the patient's condition gradually worsened, and she eventually passed away at home.</p><p><strong>Conclusion: </strong>LCH should be considered when patients exhibit diabetes insipidus and absence of high signal intensity in the pituitary gland on sagittal T1-weighted image and abnormal enhancement in the pituitary region.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 6","pages":"232-240"},"PeriodicalIF":1.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564633","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}
引用次数: 0
Prediction of hepatic artery occlusion after liver transplantation by ultrasound characteristics and clinical risk factors. 通过超声波特征和临床风险因素预测肝移植后肝动脉闭塞。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-28 DOI: 10.4329/wjr.v16.i6.196
Yu-Ting Lai, Yi Chen, Tai-Shi Fang, Zhi-Yan Li, Ning-Bo Zhao

Background: Hepatic artery occlusion (HAO) after liver transplantation (LT) is a devastating complication, resulting in early graft loss and reduced overall survival. Ultrasound is an established assessment method for HAO in patients following LT, especially those with complex hepatic artery reconstruction.

Aim: To investigate the ultrasound characteristics and analyze the risk factors associated with HAO in patients after LT.

Methods: We retrospectively analyzed the ultrasound characteristics and the clinic risk factors associated with HAO in 400 adult LT patients who were enrolled and treated at the Third People's Hospital of Shenzhen between November 2016 and July 2022. Fourteen patients diagnosed with acute HAO (A-HAO) by surgery and fifteen diagnosed with chronic HAO (C-HAO) were included. A control group of 33 patients without HAO complications during the same period were randomly selected using a random number table. All patients underwent an ultrasonography examination. Parameters including resistance index (RI), peak systolic velocity (PSV), and portal vein velocity (PVV) were compared across the groups. Additionally, basic clinical data were collected for all patients, including gender, age, primary diagnosis, D-dimer concentration, total operation time, cold ischemia time, hot ischemia time, intraoperative blood loss and transfusion, intraoperative urine volume, infusion, model for end-stage liver disease (MELD) score, and whether complex hepatic artery reconstructions were performed. Furthermore, risk factors influencing HAO formation after LT were analyzed.

Results: Compared to the non-HAO group, PVV and RI were higher in the A-HAO group, while PSV was lower. Conversely, both PSV and RI were lower in the C-HAO group compared to the non-HAO group. The proportion of patients undergoing complex hepatic artery reconstructions and the gamma-glutamyltransferase (GGT) level before occlusion were significantly higher in the A-HAO group compared to the non-HAO group. However, there were no distinct differences between the two groups in D-dimer, MELD score, pre-occlusion alanine transaminase and aspartate transaminase levels, or intraoperative conditions.

Conclusion: Ultrasound features of the hepatic artery before occlusion are significantly associated with postoperative HAO development. Additionally, complex hepatic artery reconstructions, defined as revascularization of the graft requiring additional anastomosis between donor hepatic arteries, constitute a risk factor for A-HAO. Besides, abnormal pre-occlusion GGT elevation is an important biochemical indicator. Therefore, ultrasound examination serves as an important tool for screening HAO, especially in patients with the identified risk factors.

背景:肝移植(LT)后肝动脉闭塞(HAO)是一种破坏性并发症,会导致早期移植物损失和总体存活率降低。目的:研究肝移植术后患者的超声特征并分析与 HAO 相关的风险因素:我们回顾性分析了2016年11月至2022年7月期间在深圳市第三人民医院入院并接受治疗的400名成年LT患者的超声特征以及与HAO相关的临床风险因素。其中14名患者经手术确诊为急性HAO(A-HAO),15名患者确诊为慢性HAO(C-HAO)。使用随机数字表随机抽取 33 名同期无 HAO 并发症的患者作为对照组。所有患者均接受了超声波检查。对各组患者的阻力指数(RI)、收缩峰值速度(PSV)和门静脉速度(PVV)等参数进行比较。此外,还收集了所有患者的基本临床数据,包括性别、年龄、主要诊断、D-二聚体浓度、总手术时间、冷缺血时间、热缺血时间、术中失血量和输血量、术中尿量、输液量、终末期肝病模型(MELD)评分以及是否进行了复杂肝动脉重建。此外,还分析了影响LT术后HAO形成的风险因素:结果:与非HAO组相比,A-HAO组的PVV和RI较高,而PSV较低。相反,与非HAO组相比,C-HAO组的PSV和RI均较低。与非HAO 组相比,A-HAO 组接受复杂肝动脉重建术的患者比例和闭塞前的γ-谷氨酰转移酶(GGT)水平明显更高。然而,两组患者在D-二聚体、MELD评分、闭塞前丙氨酸转氨酶和天门冬氨酸转氨酶水平以及术中情况方面没有明显差异:结论:肝动脉闭塞前的超声特征与术后HAO的发生密切相关。此外,复杂的肝动脉重建,即需要在供体肝动脉之间进行额外吻合的移植物血管再造,也是 A-HAO 的一个危险因素。此外,闭塞前 GGT 异常升高也是一个重要的生化指标。因此,超声波检查是筛查 HAO 的重要工具,尤其是对存在上述风险因素的患者。
{"title":"Prediction of hepatic artery occlusion after liver transplantation by ultrasound characteristics and clinical risk factors.","authors":"Yu-Ting Lai, Yi Chen, Tai-Shi Fang, Zhi-Yan Li, Ning-Bo Zhao","doi":"10.4329/wjr.v16.i6.196","DOIUrl":"10.4329/wjr.v16.i6.196","url":null,"abstract":"<p><strong>Background: </strong>Hepatic artery occlusion (HAO) after liver transplantation (LT) is a devastating complication, resulting in early graft loss and reduced overall survival. Ultrasound is an established assessment method for HAO in patients following LT, especially those with complex hepatic artery reconstruction.</p><p><strong>Aim: </strong>To investigate the ultrasound characteristics and analyze the risk factors associated with HAO in patients after LT.</p><p><strong>Methods: </strong>We retrospectively analyzed the ultrasound characteristics and the clinic risk factors associated with HAO in 400 adult LT patients who were enrolled and treated at the Third People's Hospital of Shenzhen between November 2016 and July 2022. Fourteen patients diagnosed with acute HAO (A-HAO) by surgery and fifteen diagnosed with chronic HAO (C-HAO) were included. A control group of 33 patients without HAO complications during the same period were randomly selected using a random number table. All patients underwent an ultrasonography examination. Parameters including resistance index (RI), peak systolic velocity (PSV), and portal vein velocity (PVV) were compared across the groups. Additionally, basic clinical data were collected for all patients, including gender, age, primary diagnosis, D-dimer concentration, total operation time, cold ischemia time, hot ischemia time, intraoperative blood loss and transfusion, intraoperative urine volume, infusion, model for end-stage liver disease (MELD) score, and whether complex hepatic artery reconstructions were performed. Furthermore, risk factors influencing HAO formation after LT were analyzed.</p><p><strong>Results: </strong>Compared to the non-HAO group, PVV and RI were higher in the A-HAO group, while PSV was lower. Conversely, both PSV and RI were lower in the C-HAO group compared to the non-HAO group. The proportion of patients undergoing complex hepatic artery reconstructions and the gamma-glutamyltransferase (GGT) level before occlusion were significantly higher in the A-HAO group compared to the non-HAO group. However, there were no distinct differences between the two groups in D-dimer, MELD score, pre-occlusion alanine transaminase and aspartate transaminase levels, or intraoperative conditions.</p><p><strong>Conclusion: </strong>Ultrasound features of the hepatic artery before occlusion are significantly associated with postoperative HAO development. Additionally, complex hepatic artery reconstructions, defined as revascularization of the graft requiring additional anastomosis between donor hepatic arteries, constitute a risk factor for A-HAO. Besides, abnormal pre-occlusion GGT elevation is an important biochemical indicator. Therefore, ultrasound examination serves as an important tool for screening HAO, especially in patients with the identified risk factors.</p>","PeriodicalId":23819,"journal":{"name":"World journal of radiology","volume":"16 6","pages":"196-202"},"PeriodicalIF":1.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564537","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}
引用次数: 0
Interdepartmental miscommunication regarding radiology: Addressing chronic challenges and exploring solutions. 放射科部门间沟通不畅:应对长期挑战,探索解决方案。
IF 2.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-05-28 DOI: 10.4329/wjr.v16.i5.109
Nikolaos-Achilleas Arkoudis, Emmanouil Karofylakis, Ornella Moschovaki-Zeiger, Spyridon Prountzos, Evgenia Efthymiou, George Samonis, Christos Koutserimpas

Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care. Interdepartmental miscommunication poses a significant challenge to healthcare systems, potentially undermining the quality of healthcare services provided. In the same manner, communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes. This article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical practice. Practical solutions are explored and proposed, which should be tailored to the specific needs and issues that each individual institution may face.

医疗保健专业人员之间的有效沟通与协作对于提供高质量的病人护理至关重要。部门间的沟通不畅给医疗系统带来了巨大挑战,可能会影响医疗服务的质量。同样,转诊医生和放射科医生之间的沟通障碍也会特别影响放射科服务和患者的治疗效果。本文试图聚焦这一问题长期存在的挑战,促使读者在日常临床实践中认识到相关的潜在隐患。文章探讨并提出了切实可行的解决方案,这些方案应适合每个机构可能面临的具体需求和问题。
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引用次数: 0
Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding: A useful predictor of positive angiographic findings. 胃肠道出血时计算机断层扫描血管造影的外渗造影剂体积评估:血管造影阳性结果的有效预测指标。
IF 2.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-05-28 DOI: 10.4329/wjr.v16.i5.115
Laura Maria Cacioppa, Chiara Floridi, Alessandra Bruno, Nicolò Rossini, Tommaso Valeri, Alessandra Borgheresi, Riccardo Inchingolo, Francesco Cortese, Giacomo Novelli, Alessandro Felicioli, Mario Torresi, Pietro Boscarato, Letizia Ottaviani, Andrea Giovagnoni

Background: Gastrointestinal bleeding (GIB) is a severe and potentially life-threatening condition, especially in cases of delayed treatment. Computed tomography angiography (CTA) plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the haemorrhage.

Aim: To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic findings.

Methods: In this retrospective single-centre study, 35 patients (22 men; median age 69 years; range 16-92 years) admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were enrolled. Twenty-three (65.7%) patients underwent endoscopy before CTA. Bleeding volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated software. Bleeding rate was obtained from volume change between the two phases and standardised for unit time. Patients were divided into two groups, according to the angiographic signs and their concordance with CTA.

Results: Upper bleeding accounted for 42.9% and lower GIB for 57.1%. Mean haemoglobin value at the admission was 7.7 g/dL. A concordance between positive CTA and direct angiographic bleeding signs was found in 19 (54.3%) cases. Despite no significant differences in terms of bleeding volume in the arterial phase (0.55 mL vs 0.33 mL, P = 0.35), a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography (2.06 mL vs 0.9 mL, P = 0.02). In the latter patient group, a significant increase in bleeding rate was also detected (2.18 mL/min vs 0.19 mL/min, P = 0.02).

Conclusion: In GIB of any origin, extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

背景:胃肠道出血(GIB)是一种严重且可能危及生命的疾病,尤其是在延误治疗的情况下。计算机断层扫描血管造影术(CTA)在早期识别上消化道出血和及时治疗出血方面起着关键作用。目的:确定在 CTA 中对 GIB 外渗造影剂的体积估算是否可预测随后的血管造影阳性结果:在这项回顾性单中心研究中,纳入了 2018 年 1 月至 2022 年 2 月期间因 CTA 检测出活动性 GIB 而入院并进一步接受导管血管造影的 35 名患者(22 名男性;中位年龄 69 岁;范围 16-92 岁)。23名患者(65.7%)在CTA前接受了内镜检查。通过半自动化专用软件对动脉和静脉阶段的出血量进行评估。出血率根据两个阶段之间的出血量变化得出,并以单位时间进行标准化。根据血管造影征象及其与 CTA 的一致性,将患者分为两组:结果:上部出血占 42.9%,下部 GIB 占 57.1%。入院时的平均血红蛋白值为 7.7 g/dL。19例(54.3%)CTA阳性和直接血管造影出血征象一致。尽管动脉阶段的出血量无明显差异(0.55 mL vs 0.33 mL,P = 0.35),但在血管造影阳性的患者组中,静脉阶段的出血量增加有统计学意义(2.06 mL vs 0.9 mL,P = 0.02)。在后一组患者中,出血率也明显增加(2.18 mL/min vs 0.19 mL/min,P = 0.02):结论:对于任何原因引起的 GIB,CTA 的外渗造影剂容量分析可作为血管造影阳性的预测指标,有助于避免不必要的进一步手术。
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引用次数: 0
Assessment of the potential interactions between favipiravir and radiocontrast agents. 评估法非吡拉韦与放射性对比剂之间的潜在相互作用。
IF 2.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-05-28 DOI: 10.4329/wjr.v16.i5.128
Sonay Aydin, Ozlem Celik Aydin, Mesut Furkan Yazar, Huseyin Aydemir, Mecit Kantarci, Sureyya Barun

Background: In cases of coronavirus disease 2019 (COVID-19), favipiravir is commonly included to the therapy regimen. Drug interactions between favipiravir and other COVID-19 therapy drugs are frequently researched. However, no research on possible drug interactions between Favipiravir and radiocontrast agents, which have become almost crucial in diagnostic processes while not being part of the treatment, has been found.

Aim: To determine potential medication interactions between Favipiravir and radiocontrast agents.

Methods: The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) test while taking the medicine. The computerized patient files of the cases included in the study, as well as the pharmacovigilance forms in the designated hospital, were evaluated for this purpose.

Results: The study included the evaluation of data from 1046 patients. The study sample's mean age was 47.23 ± 9.48 years. The mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions (P = 0.003). When evaluated with logistic regression analysis, a 1-year raises in age increases the risk of developing drug interactions by 1.63 times (P = 0.023). There was no statistically significant difference in the occurrence of medication interactions between the sexes (P = 0.090). Possible medication interactions were discovered in 42 cases (4%).

Conclusion: The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values, as well as an increase in the frequency of nausea and vomiting. The majority of drug interactions discovered were modest enough that they were not reflected in the clinic. Drug interactions become more common as people get older.

背景:在冠状病毒病2019(COVID-19)的病例中,通常会将法匹拉韦纳入治疗方案。法非拉韦与其他COVID-19治疗药物之间的药物相互作用经常被研究。目的:确定法非拉韦与放射性对比剂之间潜在的药物相互作用:研究对象包括服用法维拉韦治疗 COVID-19,并在服药期间接受造影剂增强计算机断层扫描(CT)或磁共振成像(MRI)检查的患者。为此,对纳入研究的病例的计算机化患者档案以及指定医院的药物警戒表进行了评估:研究评估了 1046 名患者的数据。研究样本的平均年龄为 47.23±9.48 岁。有药物相互作用的病例的平均年龄在统计学上明显高于无药物相互作用的病例(P = 0.003)。通过逻辑回归分析评估,年龄每增加 1 岁,发生药物相互作用的风险就会增加 1.63 倍(P = 0.023)。在发生药物相互作用方面,男女之间没有明显的统计学差异(P = 0.090)。42例患者(4%)发现了可能的药物相互作用:本研究结果表明,造影剂和法非吡韦联合使用的最显著结果是肌酐和转氨酶值升高,以及恶心和呕吐的频率增加。发现的大多数药物相互作用并不严重,因此没有在临床上反映出来。随着年龄的增长,药物相互作用变得越来越常见。
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引用次数: 0
Is it a normal phenomenon for pediatric patients to have brain leptomeningeal contrast enhancement on 3-tesla magnetic resonance imaging? 儿科患者在 3 特斯拉磁共振成像中出现脑部脑膜对比度增强是正常现象吗?
IF 2.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-05-28 DOI: 10.4329/wjr.v16.i5.136
Min Ai, Hang-Hang Zhang, Yi Guo, Jun-Bang Feng

Determining whether sevoflurane sedation in children leads to "pseudo" prominent leptomeningeal contrast enhancement (pLMCE) on 3 Tesla magnetic resonance imaging will help reduce overdiagnosis by radiologists and clarify the pathophysiological changes of pLMCE.

确定七氟醚镇静是否会导致儿童在 3 特斯拉磁共振成像中出现 "假性 "突出脑膜对比度增强(pLMCE),将有助于减少放射科医生的过度诊断,并明确 pLMCE 的病理生理变化。
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引用次数: 0
期刊
World journal of radiology
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