Pub Date : 2023-02-01DOI: 10.1053/j.sult.2022.10.004
Gopal R. Vijayaraghavan , Connie Ge , Amanda Lee , John G. Roubil , Dina H. Kandil , Kate H. Dinh , Srinivasan Vedantham
Breast-conserving surgery or lumpectomy requires localization of the lesion prior to surgery, which is traditionally accomplished by imaging-guided wire localization. Over the last decade, alternatives to wire localization have emerged. This work reviews the literature on one such wireless technology, SaviScout radar (SSR) system, and shares our experience with using this technology for presurgical tumor localization. The SSR surgical guidance system is non-radioactive. The radiologist implants a reflector device in the breast under mammography or ultrasound guidance at any time prior to surgery. The placement of this reflector can be confirmed from the cadence of a handheld percutaneous probe of a handpiece and console system. Results from several studies show that the surgical outcomes from SSR and wire-localization are similar. SSR provides operational advantages as the scheduling for reflector placement by radiologists is decoupled from surgery, but at an increased cost compared to wire-localization.
{"title":"Savi-Scout Radar Localization: Transitioning From the Traditional Wire Localization to Wireless Technology for Surgical Guidance at Lumpectomies","authors":"Gopal R. Vijayaraghavan , Connie Ge , Amanda Lee , John G. Roubil , Dina H. Kandil , Kate H. Dinh , Srinivasan Vedantham","doi":"10.1053/j.sult.2022.10.004","DOIUrl":"10.1053/j.sult.2022.10.004","url":null,"abstract":"<div><p>Breast-conserving surgery or lumpectomy<span><span> requires localization of the lesion prior to surgery, which is traditionally accomplished by imaging-guided wire localization. Over the last decade, alternatives to wire localization have emerged. This work reviews the literature on one such wireless technology, SaviScout radar (SSR) system, and shares our experience with using this technology for presurgical tumor localization. The SSR surgical guidance system is non-radioactive. The radiologist implants a reflector device in the breast under </span>mammography or ultrasound guidance at any time prior to surgery. The placement of this reflector can be confirmed from the cadence of a handheld percutaneous probe of a handpiece and console system. Results from several studies show that the surgical outcomes from SSR and wire-localization are similar. SSR provides operational advantages as the scheduling for reflector placement by radiologists is decoupled from surgery, but at an increased cost compared to wire-localization.</span></p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10727480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-01DOI: 10.1053/j.sult.2022.10.003
Eren D. Yeh MD , Leah H. Portnow MD
Iodine-125 (I-125) labelled radioactive seeds were the first published wireless pre-operative image-guided breast localization technique. Radioseeds offer benefit to radiologists as a relatively intuitive procedure with precise mammographic or sonographic-guided localization and improved patient experience. Localization and surgical dates can be uncoupled, which facilitates efficient scheduling for radiologists and surgeons. Surgeons can better tailor their surgery with intra-operative localization using a special probe to detect the emitted gamma energy. Due to radioactivity, implementation of a radioseed program requires compliance with the National Regulatory Commission and therefore multidisciplinary involvement. Seeds have a high placement success rate, and comparable surgical success and re-excision rate to wires.
{"title":"Transitioning From the Traditional Wire Localization to the Wireless Technology for Surgical Guidance at Lumpectomies: Part A. Radioseed Localization","authors":"Eren D. Yeh MD , Leah H. Portnow MD","doi":"10.1053/j.sult.2022.10.003","DOIUrl":"10.1053/j.sult.2022.10.003","url":null,"abstract":"<div><p>Iodine-125 (I-125) labelled radioactive seeds were the first published wireless pre-operative image-guided breast localization technique. Radioseeds offer benefit to radiologists as a relatively intuitive procedure with precise mammographic or sonographic-guided localization and improved patient experience. Localization and surgical dates can be uncoupled, which facilitates efficient scheduling for radiologists and surgeons. Surgeons can better tailor their surgery with intra-operative localization using a special probe to detect the emitted gamma energy. Due to radioactivity, implementation of a radioseed program requires compliance with the National Regulatory Commission and therefore multidisciplinary involvement. Seeds have a high placement success rate, and comparable surgical success and re-excision rate to wires.</p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10727482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-01DOI: 10.1053/j.sult.2022.11.004
Gopal R. Vijayaraghavan , Isabelle M. Guembou BSc, MBA , Srinivasan Vedantham MSc, PhD
There are several steps involved in a breast cancer diagnosis, starting from the initial abnormal screening mammogram. Each step from the additional imaging to a biopsy provokes anxiety. Timely attention to these appointments will not only help allay anxiety but also provide better care. While breast facilities routinely audit their performance, currently timeliness is not one of the audit parameters. The role of timeliness as a robust quality tool is gaining attention. In this study, we review the timeline of care at our facility over a 1-year period (October 2021- September 2022) and compare them with those reported by National Quality Measures for Breast Centers (NQMBC). Race, ethnicity, location, and type of facility affect the outcome of care and contribute to delays in providing care. In this manuscript, we outline some of the major factors. Societal guidelines outlining some metrics for timeliness may be a useful first step.
{"title":"The Current State of Timeliness in the Breast Cancer Diagnosis Journey: Abnormal Screening to Biopsy","authors":"Gopal R. Vijayaraghavan , Isabelle M. Guembou BSc, MBA , Srinivasan Vedantham MSc, PhD","doi":"10.1053/j.sult.2022.11.004","DOIUrl":"10.1053/j.sult.2022.11.004","url":null,"abstract":"<div><p><span>There are several steps involved in a breast cancer diagnosis, starting from the initial abnormal screening mammogram. Each step from the additional imaging to a biopsy provokes anxiety. Timely attention to these appointments will not only help allay anxiety but also provide better care. While breast facilities routinely </span>audit their performance, currently timeliness is not one of the audit parameters. The role of timeliness as a robust quality tool is gaining attention. In this study, we review the timeline of care at our facility over a 1-year period (October 2021- September 2022) and compare them with those reported by National Quality Measures for Breast Centers (NQMBC). Race, ethnicity, location, and type of facility affect the outcome of care and contribute to delays in providing care. In this manuscript, we outline some of the major factors. Societal guidelines outlining some metrics for timeliness may be a useful first step.</p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10727478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1053/j.sult.2022.06.001
Anu E. Obaro , Paul McCoubrie , David Burling , Andrew A. Plumb
The value of computed tomographic colonography (CTC) as a sensitive diagnostic investigation for colorectal cancer is well established. However, there is lack of consensus in the best way to achieve expertise in interpreting these studies. In this review we discuss the value of CTC training, accreditation and performance monitoring; the qualities of good CTC interpretation training, and specific training cases with associated learning points.
{"title":"Training in Computed Tomographic Colonography Interpretation: Recommendations for Best Practice","authors":"Anu E. Obaro , Paul McCoubrie , David Burling , Andrew A. Plumb","doi":"10.1053/j.sult.2022.06.001","DOIUrl":"10.1053/j.sult.2022.06.001","url":null,"abstract":"The value of computed tomographic colonography (CTC) as a sensitive diagnostic investigation for colorectal cancer is well established. However, there is lack of consensus in the best way to achieve expertise in interpreting these studies. In this review we discuss the value of CTC training, accreditation and performance monitoring; the qualities of good CTC interpretation training, and specific training cases with associated learning points.","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887217122000592/pdfft?md5=d0be488c71d73ac0befab7d9cb89d036&pid=1-s2.0-S0887217122000592-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40558482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1053/j.sult.2022.06.005
Paulo Donato , João Facas , Filipe Caseiro Alves
Hepatic vascular pathology comprises a spectrum of diseases with specific imaging features that have portal hypertension as a common denominator. The imaging features of the main pathologies are described, such as portal thrombosis, Budd-Chiari syndrome, hereditary hemorrhagic telangiectasia, portosystemic shunts and congenital vascular malformations. Endovascular intervention techniques are listed according to the indication for each hepatic vascular pathology and emphasis is placed on the ability to shape disease progression in order to prevent related morbidity and mortality.
{"title":"Hepatic Vascular Disorders: From Diagnosis to Interventional Radiology","authors":"Paulo Donato , João Facas , Filipe Caseiro Alves","doi":"10.1053/j.sult.2022.06.005","DOIUrl":"10.1053/j.sult.2022.06.005","url":null,"abstract":"<div><p><span>Hepatic vascular pathology comprises a spectrum of diseases with specific imaging features that have portal hypertension as a common denominator. The imaging features of the main pathologies are described, such as </span>portal thrombosis<span><span><span>, Budd-Chiari syndrome, hereditary hemorrhagic telangiectasia, </span>portosystemic shunts and congenital </span>vascular malformations<span>. Endovascular intervention techniques are listed according to the indication for each hepatic vascular pathology and emphasis is placed on the ability to shape disease progression in order to prevent related morbidity and mortality.</span></span></p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40462538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1053/j.sult.2022.06.006
Eduardo Medeiros de Araújo , Ulysses S. Torres , Hanna Dalla Pria , Lucas Rios Torres , Maria Helena Naves Inacio Pedroso , Douglas Jorge Racy , Giuseppe D'Ippolito
Although the liver may present a range of congenital anomalies, often involving shape irregularities or the number of lobules, less common variations include the presence of accessory liver lobes (ALL), consisting of a supernumerary lobe of normal hepatic parenchyma in continuity with the liver. This paper reviews the embryology, frequency, anatomy, and types of ALL. Furthermore, we describe computed tomography and magnetic resonance imaging findings in a range of such cases, including those simulating disease or presenting with complications. Knowledge about ALL may facilitate imaging interpretation of such alterations, avoiding inappropriate additional work-up and unnecessary interventions.
{"title":"Anatomy and Imaging of Accessory Liver Lobes: What Radiologists Should Know","authors":"Eduardo Medeiros de Araújo , Ulysses S. Torres , Hanna Dalla Pria , Lucas Rios Torres , Maria Helena Naves Inacio Pedroso , Douglas Jorge Racy , Giuseppe D'Ippolito","doi":"10.1053/j.sult.2022.06.006","DOIUrl":"10.1053/j.sult.2022.06.006","url":null,"abstract":"<div><p><span><span>Although the liver may present a range of congenital anomalies<span>, often involving shape irregularities or the number of lobules, less common variations include the presence of accessory liver lobes (ALL), consisting of a supernumerary lobe of normal hepatic parenchyma in continuity with the liver. This paper reviews the embryology, frequency, </span></span>anatomy, and types of ALL. Furthermore, we describe </span>computed tomography<span> and magnetic resonance imaging findings in a range of such cases, including those simulating disease or presenting with complications. Knowledge about ALL may facilitate imaging interpretation of such alterations, avoiding inappropriate additional work-up and unnecessary interventions.</span></p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40570030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1053/j.sult.2022.06.002
Anu E. Obaro , Paul McCoubrie , David Burling , Andrew A. Plumb
International guidance recommends that readers be specifically trained before embarking on independent interpretation of CT colonography (CTC) examinations. Systematic comparison of both international training requirements and the effectiveness of CTC training is lacking in the published literature. Therefore, we identified available international training standards for CTC and performed a review of studies published in the last 20 years to assess the impact of CTC interpretation training on reader diagnostic accuracy. A wide variation in training requirements was observed. Studies of the effectiveness of CTC reader training were heterogenous in methodology, with large variation in sample size and the type of training administered. Although training in CTC interpretation improves reader sensitivity overall, it has varying impact on specificity. Consensus agreement on the best way to train and assess readers in CTC interpretation may lead to lasting improvements in reader performance.
{"title":"Effectiveness of Training in CT Colonography Interpretation: Review of Current Literature","authors":"Anu E. Obaro , Paul McCoubrie , David Burling , Andrew A. Plumb","doi":"10.1053/j.sult.2022.06.002","DOIUrl":"10.1053/j.sult.2022.06.002","url":null,"abstract":"<div><p>International guidance recommends that readers be specifically trained before embarking on independent interpretation of CT colonography (CTC) examinations. Systematic comparison of both international training requirements and the effectiveness of CTC training is lacking in the published literature. Therefore, we identified available international training standards for CTC and performed a review of studies published in the last 20 years to assess the impact of CTC interpretation training on reader diagnostic accuracy. A wide variation in training requirements was observed. Studies of the effectiveness of CTC reader training were heterogenous in methodology, with large variation in sample size and the type of training administered. Although training in CTC interpretation improves reader sensitivity overall, it has varying impact on specificity. Consensus agreement on the best way to train and assess readers in CTC interpretation may lead to lasting improvements in reader performance.</p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887217122000609/pdfft?md5=d122bbfc94a19a66b87e860f75b3a7c4&pid=1-s2.0-S0887217122000609-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40547624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1053/j.sult.2022.06.008
Isabella Hana Bertuol Kinoshita , Ulysses S. Torres , Lilian Aguiar Pupo Zanini , Maria Fernanda Pinto , Julia de Castro Vieira Veloso , Glaucio Rodrigo Silva de Siqueira , Giuseppe D'Ippolito
Fibropolycystic liver disease is a continuum of disorders that result from insults to the ductal plate at different stages of development and are often associated with each other. Caroli's syndrome, polycystic liver disease, biliary hamartomas, and congenital hepatic fibrosis are included in this complex spectrum that also shows frequent association with renal anomalies, such as polycystic kidney disease and medullary sponge kidney. Choledochal cysts are a controversial point in this topic since they have long been considered part of this spectrum due to morphological similarities, but studies have shown different pathogenesis. This article's purpose is to review these abnormalities through a multimodality radiological perspective offering correlation with its key embryological aspects. Knowing these numerous anomalies and their possible associations may ease an accurate diagnosis and prompt management.
{"title":"The Ductal Plate From the Inside Out: An Illustrated Review of Fibropolycystic Liver Disease","authors":"Isabella Hana Bertuol Kinoshita , Ulysses S. Torres , Lilian Aguiar Pupo Zanini , Maria Fernanda Pinto , Julia de Castro Vieira Veloso , Glaucio Rodrigo Silva de Siqueira , Giuseppe D'Ippolito","doi":"10.1053/j.sult.2022.06.008","DOIUrl":"10.1053/j.sult.2022.06.008","url":null,"abstract":"<div><p><span><span>Fibropolycystic liver disease is a continuum of disorders that result from insults to the ductal plate at different stages of development and are often associated with each other. Caroli's syndrome, </span>polycystic liver disease<span>, biliary hamartomas<span><span><span>, and congenital hepatic fibrosis<span> are included in this complex spectrum that also shows frequent association with renal anomalies, such as </span></span>polycystic kidney disease and </span>medullary sponge kidney. </span></span></span>Choledochal cysts are a controversial point in this topic since they have long been considered part of this spectrum due to morphological similarities, but studies have shown different pathogenesis. This article's purpose is to review these abnormalities through a multimodality radiological perspective offering correlation with its key embryological aspects. Knowing these numerous anomalies and their possible associations may ease an accurate diagnosis and prompt management.</p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40547637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1053/j.sult.2022.06.004
Ulysses S. Torres , Angela H.M. Caiado , Dario A. Tiferes , Elisa A.S. Bretas , Serli K.N. Ueda , Luciana P. Chamié , Marina S. Fong , Lorenna L.C. Silva , Ana Carolina Ottaiano , Giuseppe D'Ippolito
A wide range of conditions involving the cecum may be found in patients undergoing imaging work-up for conditions as various as right lower pain, diarrhea, fever, and weight loss. The cecum may be the only area of involvement by a particular disease. However, it may also be affected by a more diffuse process of the gastrointestinal tract or even as part of systemic diseases. Imaging provides an excellent evaluation of the cecal region and its surrounding planes, with an impactful clinical application in multiple scenarios. While typical features in many situations allow establishing a confident diagnosis, there are also challenging entities with overlapping features, making it critical for the radiologist awareness of the whole gamut of these conditions, as well as the ability to correlate imaging findings with other clinical data. Additional challenges to the imaging evaluation include anatomical variations of the cecal position and the absence of proper colonic distention in some cases. This article aims to revisit the spectrum of cross-sectional imaging features of common and uncommon pathologies involving the cecum, ranging from inflammatory and infectious to vascular and neoplastic ones.
{"title":"The Cecum Revisited: A Multimodality Imaging Case-based Review of Common and Uncommon Cecal Diseases","authors":"Ulysses S. Torres , Angela H.M. Caiado , Dario A. Tiferes , Elisa A.S. Bretas , Serli K.N. Ueda , Luciana P. Chamié , Marina S. Fong , Lorenna L.C. Silva , Ana Carolina Ottaiano , Giuseppe D'Ippolito","doi":"10.1053/j.sult.2022.06.004","DOIUrl":"10.1053/j.sult.2022.06.004","url":null,"abstract":"<div><p>A wide range of conditions involving the cecum may be found in patients<span><span> undergoing imaging work-up for conditions as various as right lower pain, diarrhea, fever, and weight loss. The cecum may be the only area of involvement by a particular disease. However, it may also be affected by a more diffuse process of the </span>gastrointestinal tract<span> or even as part of systemic diseases<span>. Imaging provides an excellent evaluation of the cecal region and its surrounding planes, with an impactful clinical application in multiple scenarios. While typical features in many situations allow establishing a confident diagnosis, there are also challenging entities with overlapping features, making it critical for the radiologist awareness of the whole gamut of these conditions, as well as the ability to correlate imaging findings with other clinical data. Additional challenges to the imaging evaluation include anatomical variations of the cecal position and the absence of proper colonic distention in some cases. This article aims to revisit the spectrum of cross-sectional imaging features of common and uncommon pathologies involving the cecum, ranging from inflammatory and infectious to vascular and neoplastic ones.</span></span></span></p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40570474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1053/j.sult.2022.06.007
Hanna Dalla Pria , Ulysses S. Torres , Silvana C. Faria , Fernanda G. Velloni , Angela H.M. Caiado , Dario A. Tiferes , Giuseppe D'Ippolito
Sclerosing cholangitis comprises a group of conditions that lead to chronic cholestatic disease of the bile ducts, characterized by inflammation, fibrosis, and segmental strictures of the intrahepatic and/or extrahepatic ducts, and can be classified as primary sclerosing cholangitis or secondary sclerosing cholangitis. In this review, we follow a logical step-by-step appraisal of the clinical and radiological findings of the main secondary sclerosing cholangitis groups, finally arriving at the exclusion diagnosis, which is primary sclerosing cholangitis. At the end, a practical guide is provided, aiming to facilitate the radiological approach to this complex group of diseases.
{"title":"Practical Guide for Radiological Diagnosis of Primary and Secondary Sclerosing Cholangitis","authors":"Hanna Dalla Pria , Ulysses S. Torres , Silvana C. Faria , Fernanda G. Velloni , Angela H.M. Caiado , Dario A. Tiferes , Giuseppe D'Ippolito","doi":"10.1053/j.sult.2022.06.007","DOIUrl":"10.1053/j.sult.2022.06.007","url":null,"abstract":"<div><p>Sclerosing cholangitis<span> comprises a group of conditions that lead to chronic cholestatic disease of the bile ducts<span><span>, characterized by inflammation, fibrosis, and segmental strictures of the intrahepatic and/or extrahepatic ducts, and can be classified as </span>primary sclerosing cholangitis<span> or secondary sclerosing cholangitis. In this review, we follow a logical step-by-step appraisal of the clinical and radiological findings of the main secondary sclerosing cholangitis groups, finally arriving at the exclusion diagnosis, which is primary sclerosing cholangitis. At the end, a practical guide is provided, aiming to facilitate the radiological approach to this complex group of diseases.</span></span></span></p></div>","PeriodicalId":49541,"journal":{"name":"Seminars in Ultrasound Ct and Mri","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40458426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}