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Tracking Wall Characteristics of Necrotic Pancreatic Fluid Collections in Acute Pancreatitis on Serial Contrast-Enhanced Computed Tomography 连续对比增强计算机断层扫描显示急性胰腺炎坏死性胰液集聚的胰壁特征
Pub Date : 2024-05-03 DOI: 10.1055/s-0044-1785683
Harsimran Bhatia, Joseph Johnson, Pallavi T., Pankaj Gupta, Ajay Gulati, J. Shah, A. Singh, V. Jearth, J. Samanta, H. Mandavdhare, Vishal Sharma, S. Sinha, U. Dutta, Rakesh Kocchar
Background Encapsulated pancreatic fluid collection (PFC) is a requisite for endoscopic drainage procedures. The 4-week threshold for defining walled-off necrosis does not capture the dynamic process of encapsulation. We aim to investigate the changes in the wall characteristics of PFC in acute necrotizing pancreatitis (ANP) by comparing baseline contrast-enhanced computed tomography (CECT) with follow-up CT scans. Methods This retrospective study comprised consecutive patients with ANP who underwent a baseline CECT within first 2 weeks and follow-up CECT in the third to fifth weeks of illness. Presence, extent, and encapsulation thickness (defined as enhancing wall around the collection) on baseline CECT were compared with follow-up CT (done in the third–fifth weeks of illness). Results Thirty patients (19 males and 11 females; mean age 41.5 ± 13.5 years) were included in the study. The mean time to first CECT was 10 ± 3.6 days. There were 58 collections. The most common site was the lesser sac (n = 29), followed by the left pararenal space (n = 15). At baseline CT, 52 (89.7%) collections had varying degree of encapsulation (15.3%, complete encapsulation). Complete encapsulation was seen in 52 and 82.6% collections in third and fourth week, respectively. All collections in fifth week and beyond were encapsulated. The wall was thicker on follow-up CECT scans (p < 0.01). The mean wall thickness was not significantly associated with the degree of encapsulation (p = 0.417). There was no significant association between the site and degree of encapsulation (p = 0.546). Conclusion Encapsulation is dynamic and collections may get “walled off” before 4 weeks. Walled-off collections should be defined based on imaging rather than a fixed 4-week revised Atlanta classification threshold.
背景包裹性胰液收集(PFC)是内镜引流手术的必要条件。定义贴壁坏死的 4 周阈值并不能捕捉到包裹的动态过程。我们旨在通过对比基线对比增强计算机断层扫描(CECT)和随访 CT 扫描,研究急性坏死性胰腺炎(ANP)中 PFC 壁特征的变化。方法 这项回顾性研究包括连续接受基线 CECT 扫描的 ANP 患者,他们在发病后两周内接受了基线 CECT 扫描,并在发病后第三至第五周接受了随访 CECT 扫描。将基线 CECT 与随访 CT(病程第三至第五周时进行)的存在、范围和包膜厚度(定义为增厚的集合体周围壁)进行比较。结果 研究共纳入 30 名患者(19 名男性,11 名女性;平均年龄为 41.5 ± 13.5 岁)。首次 CECT 的平均时间为 10 ± 3.6 天。共有 58 例采集。最常见的部位是小囊(29 例),其次是左肾旁间隙(15 例)。在基线 CT 上,52 个(89.7%)集合体有不同程度的包膜(15.3% 为完全包膜)。在第 3 周和第 4 周,分别有 52 个和 82.6% 的集合体出现完全包裹。第五周及以后的所有积液均被包裹。随访的 CECT 扫描结果显示管壁变厚(P < 0.01)。平均壁厚与包裹程度无明显关系(p = 0.417)。包膜部位与包膜程度无明显关联(p = 0.546)。结论 包膜是动态的,集合体可能会在 4 周前被 "包壁"。应根据影像学而不是固定的 4 周修订版亚特兰大分类阈值来定义 "壁关闭 "集合。
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引用次数: 0
Imaging of Benign Biliary Tract Disease 良性胆道疾病的影像学检查
Pub Date : 2024-05-03 DOI: 10.1055/s-0044-1786038
S. Ghuman, T. Buxi, Kinshuk Jain, K. Rawat, A. Yadav, S. Sud
This review article discusses the most common benign biliary disorders and the various radiological findings on multiple modalities. A broad spectrum of diseases including various congenital disorders, infective and parasitic etiologies, immunological pathologies such as primary sclerosing cholangitis, and immunoglobulin G4-related sclerosing cholangitis are discussed along with obstructive diseases and ischemic cholangitis.The article emphasized the imaging differential diagnosis of the above lesions as well as clinical correlates those that are most relevant to radiologists. The article briefly touched upon management and intervention where relevant.
这篇综述文章讨论了最常见的良性胆道疾病以及多种模式下的各种放射学发现。文章讨论的疾病范围广泛,包括各种先天性疾病、感染和寄生虫病因、免疫性病变(如原发性硬化性胆管炎和免疫球蛋白 G4 相关硬化性胆管炎)以及梗阻性疾病和缺血性胆管炎。文章强调了上述病变的影像学鉴别诊断以及与放射科医生最相关的临床相关性。文章简要介绍了相关的管理和干预措施。
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引用次数: 0
Comment on: ChatGPT: Chasing the Storm in Radiology Training and Education 评论ChatGPT:追逐放射学培训与教育的风暴
Pub Date : 2024-05-03 DOI: 10.1055/s-0044-1786722
Pradosh Kumar Sarangi, Suvrankar Datta, Himel Mondal
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引用次数: 0
Magnetic Resonance Imaging Safety Board for India 印度磁共振成像安全委员会
Pub Date : 2024-05-03 DOI: 10.1055/s-0044-1785682
R. M. Choorakuttil, Hrishikesh Kale, Bejoy Thomas
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引用次数: 0
An Unusual Case of Calcific Periarthritis Causing Carpal Tunnel Syndrome and Its Management with Ultrasound-Guided Barbotage 钙化性关节周围炎引发腕管综合征的罕见病例及其超声引导下的 Barbotage 治疗方法
Pub Date : 2024-03-25 DOI: 10.1055/s-0043-1778650
S. Ariyaratne, J. Babhulkar, Ashish Babhulkar, K. Iyengar, R. Botchu
Hydroxyapatite crystal deposition disease (HADD) is a common disorder resulting from the deposition of calcium hydroxyapatite crystals in various soft tissues, typically in periarticular distribution, including tendons, tendon sheaths, joint capsules, ligaments, bursae, periarticular soft tissues, and occasionally within the joints. The more commonly known subtypes of HADD are calcific tendinopathy and calcific periarthritis. Carpal tunnel syndrome (CTS) can be rarely caused by calcific deposits within the carpal tunnel in the setting of HADD-related calcific periarthritis. Imaging, particularly ultrasound and radiographs, is crucial in distinguishing this entity from the conventional form of CTS that tends to be idiopathic. We describe a rare presentation of CTS secondary to calcific periarthritis in a 45-year-old patient, with imaging demonstrating mass-like calcification within the carpal tunnel, with typical features of those seen with HADD. The patient was treated with ultrasound-guided barbotage, with significant clinical improvement. The case highlights a lesser-known cause of CTS as well as a presentation of HADD, and the role of ultrasound-guided barbotage, a minimally invasive procedure, as a viable first-line management option as an alternative to surgery.
羟基磷灰石晶体沉积病(HADD)是一种常见疾病,是由于羟基磷灰石钙晶体沉积在各种软组织中而引起的,通常分布在关节周围,包括肌腱、腱鞘、关节囊、韧带、滑囊、关节周围软组织,偶尔也发生在关节内。HADD 较为常见的亚型是钙化性肌腱病和钙化性关节周围炎。在 HADD 相关钙化性关节周围炎的情况下,腕管内的钙化沉积物极少会导致腕管综合征(CTS)。影像学检查,尤其是超声波和X光检查,是将这种病症与倾向于特发性的传统形式的 CTS 区分开来的关键。我们描述了一名 45 岁患者因钙化性关节周围炎继发 CTS 的罕见病例,其影像学表现为腕管内肿块样钙化,具有 HADD 的典型特征。患者接受了超声引导下的钩刺治疗,临床症状明显改善。该病例强调了一种鲜为人知的 CTS 病因以及 HADD 的表现形式,并强调了超声引导下钩刺术这种微创手术的作用,它是一种替代手术的可行的一线治疗方案。
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引用次数: 0
Response Generated by Large Language Models Depends on the Structure of the Prompt 大语言模型生成的反应取决于提示的结构
Pub Date : 2024-03-25 DOI: 10.1055/s-0044-1782165
Pradosh Kumar Sarangi, Himel Mondal
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引用次数: 0
Letter to Editor Regarding “Assessing the Capability of ChatGPT, Google Bard, and Microsoft Bing in Solving Radiology Case Vignettes” 致编辑的信,内容涉及 "评估 ChatGPT、Google Bard 和 Microsoft Bing 解决放射学病例小故事的能力
Pub Date : 2024-03-25 DOI: 10.1055/s-0044-1782164
Yasin Celal Gunes, Turay Cesur
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引用次数: 0
Determining the Normal Glenoid Version in the Indian Population 确定印度人口中的正常盂成形体
Pub Date : 2024-01-31 DOI: 10.1055/s-0044-1778725
Ashwini Sankhe Sonve, Anagha R. Joshi, Pareekshith R Rai, Yash Achhapalia
Background Glenoid version refers to the angle subtended by the glenoid with the scapula. On average, it is 0 ± 10 degrees with a slight propensity toward retroversion. Numerous factors such the dominance(handedness), gender, ethnicity, and pathology are known to affect version. Version has important consequences on the biomechanics of the shoulder joint and is altered in those with arthritis and shoulder joint instability. Aim Our study aimed to determine the normal range of glenoid version in the population. Further, we aim to assess the relationship between gender and version. Settings and Design We conducted a retrospective observational study in a tertiary referral hospital with a target sample size of 200 shoulders. Methods and Materials The computed tomography images were retrospectively reviewed to determine the scapular shape and the glenoid version angle. Statistical Analysis Statistical analysis was done using SPSS v.22 software with p-value less than 0.05 considered as significant. Results The mean age of the individuals in our study was 44 years. In our study, irrespective of gender, most individuals had some degree of anteversion and males had lower degree of anteversion. Previous studies have shown that most normal individuals usually have retroverted shoulder joints. The mean glenoid version was significantly lower in the right than in the left shoulder and males had significantly lower mean glenoid version than females in both shoulders. Most individuals in our study had a flat scapular spine. Conclusion This study shows that the Indian population may have a slight propensity toward anteversion and this has an important bearing on shoulder arthroplasty. Further, this study shows that significantly lower degrees of version are found on the right side and that the degree of version is significantly lower in males. Understanding the role of glenoid version in shoulder biomechanics will go a long way in the early identification of pathology, the preoperative planning of shoulder arthroplasty, and the operative restoration of a functional shoulder joint.
背景 盂唇角度是指盂唇与肩胛骨之间的夹角。平均角度为 0 ± 10 度,有轻微的后倾倾向。许多因素,如优势(手性)、性别、种族和病理,都会影响盂成形度。肩关节内翻会对肩关节的生物力学产生重要影响,患有关节炎和肩关节不稳定的患者肩关节内翻会发生改变。研究目的 我们的研究旨在确定人群盂成形的正常范围。此外,我们还旨在评估性别与盂凸之间的关系。设置与设计 我们在一家三级转诊医院进行了一项回顾性观察研究,目标样本量为 200 个肩关节。方法和材料 回顾性检查计算机断层扫描图像,以确定肩胛骨形状和盂成形角。统计分析 使用 SPSS v.22 软件进行统计分析,P 值小于 0.05 为显著。结果 研究对象的平均年龄为 44 岁。在我们的研究中,不分性别,大多数人都有一定程度的足外翻,男性的足外翻程度较低。以往的研究表明,大多数正常人的肩关节通常是后倾的。右肩的平均盂成形度明显低于左肩,男性两肩的平均盂成形度明显低于女性。在我们的研究中,大多数人的肩胛骨脊柱是扁平的。结论 本研究表明,印度人可能有轻微的肩关节内翻倾向,这对肩关节置换术有重要影响。此外,这项研究还表明,右侧的肩关节内翻程度明显较低,男性的肩关节内翻程度也明显较低。了解盂成形在肩关节生物力学中的作用,对于早期识别病变、肩关节置换术的术前规划和肩关节功能的手术恢复都有很大帮助。
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引用次数: 0
Impact of the Timing of Percutaneous Catheter Drainage Following Endoscopic Drainage on Outcomes in Acute Necrotizing Pancreatitis 内镜引流后经皮导管引流的时机对急性坏死性胰腺炎疗效的影响
Pub Date : 2024-01-31 DOI: 10.1055/s-0044-1779303
Harsimran Bhatia, Sanya Vermani, Pankaj Gupta, Shameema Farook, Abhishek Kumar, Joseph Johnson, J. Shah, A. Singh, V. Jearth, J. Samanta, H. Mandavdhare, Vishal Sharma, S. Sinha, U. Dutta, Rakesh Kocchar
Background The role of dual-modality drainage of walled-off necrosis (WON) in patients with acute pancreatitis (AP) is established. However, there are no data on the association of clinical outcomes with the timing of percutaneous catheter drainage (PCD). We investigated the impact of the timing of PCD following endoscopic drainage of WON on clinical outcomes in AP. Materials and Methods This retrospective study comprised consecutive patients with necrotizing AP who underwent endoscopic cystogastrostomy (CG) of WON followed by PCD between September 2018 and March 2023. Based on endoscopic CG to PCD interval, patients were divided into groups (≤ and >3 days, ≤ and >1 week, ≤ and >10 days, and ≤ and >2 weeks). Baseline characteristics and indications of CG and PCD were recorded. Clinical outcomes were compared between the groups, including length of hospitalization, length of intensive care unit stay, need for surgical necrosectomy, and death during hospitalization. Results Thirty patients (mean age ± standard deviation, 35.5 ± 12.7 years) were evaluated. The mean CG to PCD interval was 11.2 ± 7.5 days. There were no significant differences in baseline characteristics and indications of CG and PCD between the groups. The mean pain to CG interval was not significantly different between the groups. Endoscopic necrosectomy was performed in a significantly greater proportion of patients undergoing CG after 10 days (p = 0.003) and after 2 weeks (p = 0.032). There were no significant differences in the complications and clinical outcomes between the groups. Conclusion The timing of PCD following endoscopic CG does not affect clinical outcomes.
背景 对急性胰腺炎(AP)患者的脱壁坏死(WON)进行双模式引流的作用已经确立。然而,目前还没有关于临床结果与经皮导管引流术(PCD)时机相关性的数据。我们研究了内镜引流 WON 后 PCD 的时机对 AP 临床预后的影响。材料和方法 这项回顾性研究包括在 2018 年 9 月至 2023 年 3 月间接受内镜下 WON 膀胱造口术(CG),然后进行 PCD 的坏死性 AP 连续患者。根据内镜下CG到PCD的间隔时间,将患者分为几组(≤和>3天、≤和>1周、≤和>10天、≤和>2周)。记录了CG和PCD的基线特征和适应症。比较两组患者的临床结果,包括住院时间、重症监护室住院时间、是否需要进行外科坏死切除术以及住院期间的死亡情况。结果 评估了 30 名患者(平均年龄 ± 标准差,35.5 ± 12.7 岁)。从 CG 到 PCD 的平均间隔时间为 11.2 ± 7.5 天。两组患者的基线特征、CG 和 PCD 适应症无明显差异。两组患者从疼痛到CG的平均间隔时间无明显差异。接受CG治疗的患者中,10天后(P = 0.003)和2周后(P = 0.032)进行内镜坏死切除术的比例明显更高。两组患者的并发症和临床结果无明显差异。结论 内镜 CG 术后 PCD 的时机不会影响临床效果。
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引用次数: 0
Additional Role of 3D ASL Perfusion in Skull Base Lesions 三维 ASL 灌注在颅底病变中的其他作用
Pub Date : 2024-01-27 DOI: 10.1055/s-0044-1778727
J. F. Naghath, S. Peter
Background Arterial spin labeling (ASL) perfusion imaging is widely used since its main advantage is that no intravenous contrast is needed. Given that perfusion is a crucial biological characteristic for identifying tumor lesions, the qualitative noncontrast perfusion characteristics of these lesions were examined. Aim We attempted utilizing the three-dimensional (3D) ASL technique to characterize skull base lesions and to highlight its crucial role in differentiating lesions. Methods and Material 3D ASL imaging of 20 patients with posterior skull base lesions was performed in a 3-T magnetic resonance (MR) system (Siemens Healthineers, Skyra, Erlangen, Germany). The common differential diagnoses of skull base lesions could be distinguished based on this qualitative evaluation. Results and Conclusions Glomus tumor has a strikingly increased perfusion when compared to meningiomas. The perfusion characteristics of metastasis depends on the primary tumor. Chondrosarcomas have a heterogeneously increased perfusion. Chordomas have variable perfusion, which helps in prognosticating the tumors. ASL benefits pediatric patients and in renal failure as well since it avoids the ethical ambiguity associated with contrast agents.
背景 动脉自旋标记(ASL)灌注成像的主要优点是无需静脉注射对比剂,因此被广泛应用。鉴于灌注是识别肿瘤病变的一个重要生物学特征,我们对这些病变的非对比灌注定性特征进行了研究。目的 我们尝试利用三维(3D)ASL 技术来描述颅底病变的特征,并强调其在区分病变方面的关键作用。方法和材料 在 3-T 磁共振(MR)系统(德国埃尔兰根西门子健康公司 Skyra)中对 20 例后颅底病变患者进行了三维 ASL 成像。根据这一定性评估结果,可以区分颅底病变的常见鉴别诊断。结果与结论 与脑膜瘤相比,胶质瘤的灌注明显增加。转移瘤的灌注特征取决于原发肿瘤。软骨肉瘤的灌注量呈异质性增加。脊索瘤有不同的灌注,这有助于预测肿瘤的预后。ASL 对儿科患者和肾功能衰竭患者也有好处,因为它避免了与造影剂相关的道德模糊性。
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引用次数: 0
期刊
Indian Journal of Radiology and Imaging
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