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A Reflection of Our Role as Radiologists in India's Current Landscape of Infectious Diseases. 反思我们作为放射科医生在印度当前传染病形势下的角色。
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-23 eCollection Date: 2024-10-01 DOI: 10.1055/s-0044-1788890
Anuradha Chandramohan
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引用次数: 0
Delayed Presentation of Baffle Obstruction in an Adult Post-Mustard Repair of Transposition: Computed Tomography Demonstration. 一名经马氏管横隔修补术后的成人延迟出现挡板阻塞:计算机断层扫描演示。
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-18 eCollection Date: 2024-10-01 DOI: 10.1055/s-0044-1787685
Debanjan Nandi, Amarinder Singh Malhi, Manish Shaw, Sanjeev Kumar

Atrial switch surgery is performed in patients with transposition of the great arteries. One of the complications of this surgery is obstruction of the baffle created. We describe the computed tomography findings of one such case where there was delayed presentation of recurrent Mustard baffle obstruction in addition to pulmonary venous drainage obstruction in an adult previously operated on for intra-atrial repair of transposition of the great arteries.

心房转换手术适用于大动脉转位患者。这种手术的并发症之一是造成挡板阻塞。我们描述了一个此类病例的计算机断层扫描结果,在该病例中,一名曾接受过大动脉转位房内修复手术的成人除了肺静脉引流受阻外,还延迟出现了复发性芥末挡板阻塞。
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引用次数: 0
Unraveling the Veil: Deflux Injection Masquerading as Calculus at the Vesicoureteric Junction. 揭开面纱:膀胱输尿管交界处伪装成结石的脱流注射。
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-18 eCollection Date: 2024-10-01 DOI: 10.1055/s-0044-1787779
Josh K Dasan, Antony Augustine, J Chandra Singh, Anuradha Chandramohan
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引用次数: 0
Total Anomalous Pulmonary Venous Connection with Rare Direct Right Atrial Drainage and Unprecedented Array of Coexistent Multisystem Variations. 伴有罕见的右心房直接引流和前所未有的多系统并存变异的全肺静脉连接异常。
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-18 eCollection Date: 2024-10-01 DOI: 10.1055/s-0044-1787684
Arun Sharma, Dollphy Garg, Shivali Arya, Sanjeev Hanumantacharya Naganur, Manphool Singhal

Total anomalous pulmonary venous connection (TAPVC) is anomalous drainage of all pulmonary veins into systemic circulation. The intracardiac type typically entails the drainage of all the pulmonary veins into the right atrium, via the coronary sinus. The connection of the pulmonary veins directly into the right atrium is exceptionally rare and has been primarily reported with right atrial isomerism. Herein, we presented a remarkable case of TAPVC in a 10-year-old male child, distinguished by an unconventional drainage of all the pulmonary veins directly into the right atrium, with normal coronary sinus and absent right atrial isomerism. Intriguingly, computed tomography imaging revealed a combination of incredibly rare coexistent pulmonary, vascular, and skeletal anomalies. These anomalies included absence of pulmonary fissures in the right lung, presence of left circumflex aortic arch with bovine branching pattern, bilateral cervical ribs, and C7 vertebral fusion anomalies. To our knowledge, this unique combination of coexistent anomalies has not been previously reported in scientific literature in the background of rare drainage pattern of TAPVC.

全肺静脉连接异常(TAPVC)是指所有肺静脉均异常排入体循环。心内型通常是所有肺静脉经冠状窦排入右心房。肺静脉直接与右心房相连的情况非常罕见,主要与右心房异位症有关。在此,我们介绍了一例罕见的 10 岁男童 TAPVC 病例,其特点是所有肺静脉均以非常规方式直接排入右心房,冠状动脉窦正常,无右心房异位。耐人寻味的是,计算机断层扫描成像显示出令人难以置信的罕见的肺部、血管和骨骼并存异常。这些畸形包括右肺无肺裂、左侧环状主动脉弓存在牛状分支模式、双侧颈肋骨和 C7 椎体融合异常。据我们所知,在 TAPVC 罕见引流模式的背景下,这种独特的并存异常组合以前从未在科学文献中报道过。
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引用次数: 0
CSF Flow Dynamics-Is There a Need for Normative Imaging Data? 脑脊液流动动态--是否需要规范成像数据?
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-27 eCollection Date: 2024-04-01 DOI: 10.1055/s-0044-1781468
Jitender Saini, Shikha Awasthi
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引用次数: 0
Image-Guided Percutaneous Sclerotherapy for Orbital Low-Flow Malformation: Our Experience. 眼眶低流量畸形的图像引导经皮硬化疗法:我们的经验
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-02-28 eCollection Date: 2024-07-01 DOI: 10.1055/s-0044-1779689
Gautam Lokdarshi, Shwetam Kumar, Subhash Kumar, Nitu Nitu, Nripen Gaur

For a safe sclerotherapy session to be completed in the orbital low-flow malformation (namely lymphovenous malformation or venolymphatic malformation), accurate identification of the target lesion for the drug injection is crucial. Regarding the dependability and viability of the injection approach, the authors have discussed their experiences with image-guided percutaneous sclerotherapy on a few patients.

要在眼眶低流量畸形(即淋巴管畸形或静脉淋巴管畸形)中安全地完成硬化疗法,准确识别药物注射的目标病灶至关重要。关于注射方法的可靠性和可行性,作者讨论了他们对少数患者进行图像引导经皮硬化剂治疗的经验。
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引用次数: 0
Approach to Nonmass Lesions on Breast Ultrasound. 乳腺超声非肿块病变的处理方法。
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-02-23 eCollection Date: 2024-10-01 DOI: 10.1055/s-0044-1779589
Supraja Laguduva Mohan, Ekta Dhamija, Richa Gauba

Nonmass lesions in breast ultrasound (US) are areas of altered echogenicity without definite margins or mass effect. However, these lesions may show calcifications, associated architectural distortion, or shadowing just like masses. They vary in their echogenicity, distribution, ductal or nonductal appearance and the associated features that can be seen in variety of benign and malignant pathologies. With no uniform definition or classification system, there is no standardized approach in further risk categorization and management strategies of these lesions. Malignant nonmass lesions are not uncommon and few sonographic features can help in differentiating benign and malignant pathologies. US-guided tissue sampling or lesion localization can be preferred in the nonmass lesions identified on second look US after magnetic resonance imaging or mammography. This article aims to describe various imaging patterns and attempts to provide an algorithmic approach to nonmass findings on breast US.

乳腺超声(US)中的非肿块病变是指没有明确边缘或肿块效应的回声改变区域。然而,这些病变可能会像肿块一样显示钙化、相关的结构变形或阴影。它们的回声性、分布、导管或非导管外观以及相关特征各不相同,可在各种良性和恶性病变中见到。由于没有统一的定义或分类系统,对这些病变的进一步风险分类和管理策略也没有标准化的方法。恶性非肿块病变并不少见,但很少有声像图特征有助于区分良性和恶性病变。对于在磁共振成像或乳腺 X 光检查后再次进行超声检查时发现的非肿块病变,可首选在超声引导下进行组织取样或病灶定位。本文旨在描述各种成像模式,并尝试提供乳腺 US 非肿块发现的算法。
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引用次数: 0
Pretherapeutic PSMA PET-Derived Semiquantitative Parameters as Predictors of PSA Response in Patients with mCRPC Receiving [ 177 Lu]Lu-PSMA-617 Radioligand Therapy. 接受[177 Lu]Lu-PSMA-617 放射性配体治疗的 mCRPC 患者治疗前 PSMA PET 衍生的半定量参数可预测 PSA 反应。
IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-02-23 eCollection Date: 2024-10-01 DOI: 10.1055/s-0044-1779634
Dheeratama Siripongsatian, Attapon Jantarato, Chetsadaporn Promteangtrong, Anchisa Kunawudhi, Peerapon Kiatkittikul, Natphimol Boonkawin, Sukanya Yaset, Sirinsuda Somboon, Chanisa Chotipanich

Objective  [ 177 Lu]Lu-prostate-specific membrane antigen (PSMA)-617 radioligand therapy (RLT) shows promise for metastatic castration-resistant prostate cancer (mCRPC) patients with positive PSMA positron emission tomography (PET) imaging. Identifying high-risk patients is crucial. We evaluated pretherapeutic PSMA PET-derived parameters to predict prostate-specific antigen (PSA) response in patients undergoing [ 177 Lu]Lu-PSMA-617 RLT. Materials and Methods  We conducted a retrospective analysis among 27 patients (mean age: 71.0 ± 9.5 years; range: 52-85 years) who underwent PSMA PET/computed tomography (CT) and subsequent [ 177 Lu]Lu-PSMA-617 RLT between March 2019 and January 2023. After excluding patients with liver metastases, the number of patients left for analysis was 21 (14 responders and 7 nonresponders). Tumors were semiautomatically delineated with calculation of total tumor volume (PSMA-TV), lesion uptake (PSMA-TLU = PSMA-TV * standardized uptake value [SUV]mean), and lesion quotient (PSMA-TLQ = PSMA-TV/SUVmean) for each patient. Semiquantitative parameters were analyzed only in patients with mCRPC and no liver metastasis. Results  In total, 17/27 patients (62.96%) had a decline in PSA levels; 15/27 patients (55.56%) experienced a decline of > 50%. Pretherapeutic PSMA PET/CT results revealed significant differences in PSMA-TV ( p  = 0.003), PSMA-TLU ( p  = 0.013), and PSMA-TLQ ( p  = 0.011) between responders and nonresponders. SUVmax was significantly correlated to the best percentage change in PSA response after 177 Lu-PSMA-617 treatment ( r  = -0.79, p  = 0.006). No association was observed between PSMA-TV ( p  = 0.367), PSMA-TLU ( p  = 0.128), and PSMA-TLQ ( p  = 0.556), with the best percentage change in PSA response after 177 Lu-PSMA-617 therapy. Conclusion  Pretherapeutic PSMA PET-derived PSMA-TV, PSMA-TLU, and PSMA-TLQ were significant negative predictors of PSA response in patients with mCRPC and no liver metastasis receiving [ 177 Lu]Lu-PSMA-617 RLT.

目的[177 Lu]Lu-前列腺特异性膜抗原(PSMA)-617放射性配体疗法(RLT)有望用于PSMA正电子发射断层扫描(PET)成像呈阳性的转移性阉割耐药前列腺癌(mCRPC)患者。识别高危患者至关重要。我们评估了接受[177 Lu]Lu-PSMA-617 RLT治疗患者的治疗前PSMA PET衍生参数,以预测前列腺特异性抗原(PSA)反应。材料与方法 我们对2019年3月至2023年1月期间接受PSMA PET/计算机断层扫描(CT)和随后接受[177 Lu]Lu-PSMA-617 RLT的27名患者(平均年龄:71.0 ± 9.5岁;范围:52-85岁)进行了回顾性分析。排除肝转移患者后,剩下的分析患者为 21 人(14 人应答,7 人未应答)。通过计算每位患者的肿瘤总体积(PSMA-TV)、病灶摄取率(PSMA-TLU = PSMA-TV * 标准化摄取值 [SUV] 平均值)和病灶商数(PSMA-TLQ = PSMA-TV/SUVmean ),对肿瘤进行半自动划分。半定量参数仅对mCRPC且无肝转移的患者进行分析。结果 共有 17/27 例患者(62.96%)的 PSA 水平有所下降;其中 15/27 例患者(55.56%)的下降幅度大于 50%。治疗前 PSMA PET/CT 结果显示,PSMA-TV(p = 0.003)、PSMA-TLU(p = 0.013)和 PSMA-TLQ (p = 0.011)在有反应者和无反应者之间存在显著差异。SUVmax与177 Lu-PSMA-617治疗后PSA反应的最佳百分比变化有明显相关性(r = -0.79,p = 0.006)。PSMA-TV ( p = 0.367)、PSMA-TLU ( p = 0.128) 和 PSMA-TLQ ( p = 0.556) 与 177 Lu-PSMA-617 治疗后 PSA 反应的最佳百分比变化之间没有关联。结论 治疗前 PSMA PET 衍生的 PSMA-TV、PSMA-TLU 和 PSMA-TLQ 是接受[177 Lu]Lu-PSMA-617 RLT 治疗的无肝转移 mCRPC 患者 PSA 反应的显著负向预测因子。
{"title":"Pretherapeutic PSMA PET-Derived Semiquantitative Parameters as Predictors of PSA Response in Patients with mCRPC Receiving [ <sup>177</sup> Lu]Lu-PSMA-617 Radioligand Therapy.","authors":"Dheeratama Siripongsatian, Attapon Jantarato, Chetsadaporn Promteangtrong, Anchisa Kunawudhi, Peerapon Kiatkittikul, Natphimol Boonkawin, Sukanya Yaset, Sirinsuda Somboon, Chanisa Chotipanich","doi":"10.1055/s-0044-1779634","DOIUrl":"https://doi.org/10.1055/s-0044-1779634","url":null,"abstract":"<p><p><b>Objective</b>  [ <sup>177</sup> Lu]Lu-prostate-specific membrane antigen (PSMA)-617 radioligand therapy (RLT) shows promise for metastatic castration-resistant prostate cancer (mCRPC) patients with positive PSMA positron emission tomography (PET) imaging. Identifying high-risk patients is crucial. We evaluated pretherapeutic PSMA PET-derived parameters to predict prostate-specific antigen (PSA) response in patients undergoing [ <sup>177</sup> Lu]Lu-PSMA-617 RLT. <b>Materials and Methods</b>  We conducted a retrospective analysis among 27 patients (mean age: 71.0 ± 9.5 years; range: 52-85 years) who underwent PSMA PET/computed tomography (CT) and subsequent [ <sup>177</sup> Lu]Lu-PSMA-617 RLT between March 2019 and January 2023. After excluding patients with liver metastases, the number of patients left for analysis was 21 (14 responders and 7 nonresponders). Tumors were semiautomatically delineated with calculation of total tumor volume (PSMA-TV), lesion uptake (PSMA-TLU = PSMA-TV * standardized uptake value [SUV]mean), and lesion quotient (PSMA-TLQ = PSMA-TV/SUVmean) for each patient. Semiquantitative parameters were analyzed only in patients with mCRPC and no liver metastasis. <b>Results</b>  In total, 17/27 patients (62.96%) had a decline in PSA levels; 15/27 patients (55.56%) experienced a decline of > 50%. Pretherapeutic PSMA PET/CT results revealed significant differences in PSMA-TV ( <i>p</i>  = 0.003), PSMA-TLU ( <i>p</i>  = 0.013), and PSMA-TLQ ( <i>p</i>  = 0.011) between responders and nonresponders. SUVmax was significantly correlated to the best percentage change in PSA response after <sup>177</sup> Lu-PSMA-617 treatment ( <i>r</i>  = -0.79, <i>p</i>  = 0.006). No association was observed between PSMA-TV ( <i>p</i>  = 0.367), PSMA-TLU ( <i>p</i>  = 0.128), and PSMA-TLQ ( <i>p</i>  = 0.556), with the best percentage change in PSA response after <sup>177</sup> Lu-PSMA-617 therapy. <b>Conclusion</b>  Pretherapeutic PSMA PET-derived PSMA-TV, PSMA-TLU, and PSMA-TLQ were significant negative predictors of PSA response in patients with mCRPC and no liver metastasis receiving [ <sup>177</sup> Lu]Lu-PSMA-617 RLT.</p>","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"34 4","pages":"579-587"},"PeriodicalIF":0.9,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332165","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
Assessing the Capability of ChatGPT, Google Bard, and Microsoft Bing in Solving Radiology Case Vignettes 评估 ChatGPT、Google Bard 和 Microsoft Bing 解决放射病例小故事的能力
IF 0.6 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-29 DOI: 10.1055/s-0043-1777746
Pradosh Kumar Sarangi, Ravi Kant Narayan, S. Mohakud, Aditi Vats, Debabrata Sahani, Himel Mondal
Abstract Background  The field of radiology relies on accurate interpretation of medical images for effective diagnosis and patient care. Recent advancements in artificial intelligence (AI) and natural language processing have sparked interest in exploring the potential of AI models in assisting radiologists. However, limited research has been conducted to assess the performance of AI models in radiology case interpretation, particularly in comparison to human experts. Objective  This study aimed to evaluate the performance of ChatGPT, Google Bard, and Bing in solving radiology case vignettes (Fellowship of the Royal College of Radiologists 2A [FRCR2A] examination style questions) by comparing their responses to those provided by two radiology residents. Methods  A total of 120 multiple-choice questions based on radiology case vignettes were formulated according to the pattern of FRCR2A examination. The questions were presented to ChatGPT, Google Bard, and Bing. Two residents wrote the examination with the same questions in 3 hours. The responses generated by the AI models were collected and compared to the answer keys and explanation of the answers was rated by the two radiologists. A cutoff of 60% was set as the passing score. Results  The two residents (63.33 and 57.5%) outperformed the three AI models: Bard (44.17%), Bing (53.33%), and ChatGPT (45%), but only one resident passed the examination. The response patterns among the five respondents were significantly different ( p  = 0.0117). In addition, the agreement among the generative AI models was significant (intraclass correlation coefficient [ICC] = 0.628), but there was no agreement between the residents (Kappa = –0.376). The explanation of generative AI models in support of answer was 44.72% accurate. Conclusion  Humans exhibited superior accuracy compared to the AI models, showcasing a stronger comprehension of the subject matter. All three AI models included in the study could not achieve the minimum percentage needed to pass an FRCR2A examination. However, generative AI models showed significant agreement in their answers where the residents exhibited low agreement, highlighting a lack of consistency in their responses.
摘要 背景 放射学领域依赖对医学影像的准确解读来进行有效的诊断和病人护理。人工智能(AI)和自然语言处理领域的最新进展激发了人们探索人工智能模型在协助放射科医生方面潜力的兴趣。然而,对人工智能模型在放射学病例解读中的表现进行评估的研究还很有限,尤其是与人类专家进行比较时。目的 本研究旨在评估 ChatGPT、Google Bard 和 Bing 在解决放射学病例小故事(英国皇家放射医师学会 2A [FRCR2A] 考试风格的问题)时的表现,将它们的回答与两名放射学住院医师提供的回答进行比较。方法 按照 FRCR2A 考试的模式,根据放射科病例小故事编制了 120 道选择题。这些问题分别呈现在 ChatGPT、Google Bard 和 Bing 上。两名住院医师在 3 小时内完成了相同问题的考试。两位放射科医生收集了人工智能模型生成的答案,并将其与答案密钥和答案解释进行了比较和评分。合格分数线设定为 60%。结果 两名住院医师(63.33% 和 57.5%)的成绩优于三种人工智能模型:Bard(44.17%)、Bing(53.33%)和 ChatGPT(45%),但只有一名住院医师通过了考试。五位受访者的回答模式存在显著差异 ( p = 0.0117)。此外,生成式人工智能模型之间的一致性非常明显(类内相关系数 [ICC] = 0.628),但住院医师之间没有一致性(Kappa = -0.376)。生成式人工智能模型支持答案的解释准确率为 44.72%。结论 与人工智能模型相比,人类表现出更高的准确性,对主题的理解能力也更强。研究中的三种人工智能模型都无法达到通过 FRCR2A 考试所需的最低百分比。不过,生成式人工智能模型在回答问题时表现出明显的一致性,而住院医生则表现出较低的一致性,这凸显出他们的回答缺乏一致性。
{"title":"Assessing the Capability of ChatGPT, Google Bard, and Microsoft Bing in Solving Radiology Case Vignettes","authors":"Pradosh Kumar Sarangi, Ravi Kant Narayan, S. Mohakud, Aditi Vats, Debabrata Sahani, Himel Mondal","doi":"10.1055/s-0043-1777746","DOIUrl":"https://doi.org/10.1055/s-0043-1777746","url":null,"abstract":"Abstract Background  The field of radiology relies on accurate interpretation of medical images for effective diagnosis and patient care. Recent advancements in artificial intelligence (AI) and natural language processing have sparked interest in exploring the potential of AI models in assisting radiologists. However, limited research has been conducted to assess the performance of AI models in radiology case interpretation, particularly in comparison to human experts. Objective  This study aimed to evaluate the performance of ChatGPT, Google Bard, and Bing in solving radiology case vignettes (Fellowship of the Royal College of Radiologists 2A [FRCR2A] examination style questions) by comparing their responses to those provided by two radiology residents. Methods  A total of 120 multiple-choice questions based on radiology case vignettes were formulated according to the pattern of FRCR2A examination. The questions were presented to ChatGPT, Google Bard, and Bing. Two residents wrote the examination with the same questions in 3 hours. The responses generated by the AI models were collected and compared to the answer keys and explanation of the answers was rated by the two radiologists. A cutoff of 60% was set as the passing score. Results  The two residents (63.33 and 57.5%) outperformed the three AI models: Bard (44.17%), Bing (53.33%), and ChatGPT (45%), but only one resident passed the examination. The response patterns among the five respondents were significantly different ( p  = 0.0117). In addition, the agreement among the generative AI models was significant (intraclass correlation coefficient [ICC] = 0.628), but there was no agreement between the residents (Kappa = –0.376). The explanation of generative AI models in support of answer was 44.72% accurate. Conclusion  Humans exhibited superior accuracy compared to the AI models, showcasing a stronger comprehension of the subject matter. All three AI models included in the study could not achieve the minimum percentage needed to pass an FRCR2A examination. However, generative AI models showed significant agreement in their answers where the residents exhibited low agreement, highlighting a lack of consistency in their responses.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":" 33","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139143939","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}
引用次数: 0
Bedside Ultrasound-Guided Percutaneous Cholecystostomy in Critically Ill Patients—Outcomes in 51 Patients 重症患者的床旁超声引导经皮胆囊造口术--51 例患者的成果
IF 0.6 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-12-28 DOI: 10.1055/s-0043-1777744
Rozil Gandhi, K. Gala, Mohd Shariq, Aditi Gandhi, Manish Gandhi, Amit Shah
Abstract Purpose  The aim of this study was to report technical and clinical success of bedside ultrasound-guided percutaneous cholecystostomy (PC) tube placement in intensive care unit (ICU). Materials and Methods  This is a retrospective study of 51 patients (36 males:15 females, mean age: 67 years) who underwent ultrasound-guided PC from May 2015 to January 2020. The indication for cholecystostomy tube placement, comorbidities, imaging finding, technical success, clinical success, timing of surgery post-cholecystostomy tube placement, indwelling catheter time, complications, and follow-up were recorded. Results  Indications for cholecystostomy tube placement were acute calculous cholecystitis ( n  = 43; 84.3%), perforated cholecystitis ( n  = 5; 9.8%), and emphysematous cholecystitis ( n  = 3; 5.9%). Most of the patients had multiple comorbidities; these were diabetes mellitus, hypertension, cardiovascular disease, chronic renal disease, underlying malignancy, and multisystem disease with sepsis. All patients had undergone PC through transhepatic approach under ultrasound guidance in ICU. Technical success rate of the procedure was 100%. Clinical success rate was 92.1% (47/51) and among these 44/51 (86.2%) patients underwent definitive elective cholecystectomy, 3/51 (5.9%) patients had elective tube removal. Three of fifty-one (5.9%) patients did not improve; among these two underwent emergency surgery, while there was 1/51 (1.9%) mortality due to ongoing sepsis and multiorgan dysfunction. There were no procedure-related mortalities or procedure-related major complications. One patient had bile leak due to multiple attempts for cholecystostomy placement. Mean tube indwelling time was 13 days (range: 3–45 days). Conclusion  Ultrasound-guided PC can be safely performed in ICU in critically ill patients unfit for surgery with high technical and clinical success rates. Early laparoscopic cholecystectomy should be preferred after stabilization of clinical condition following cholecystostomy.
摘要 目的 本研究旨在报告重症监护病房(ICU)床旁超声引导经皮胆囊造口术(PC)置管的技术和临床成功率。材料与方法 这是一项回顾性研究,研究对象为 2015 年 5 月至 2020 年 1 月期间接受超声引导 PC 的 51 例患者(36 例男性:15 例女性,平均年龄:67 岁)。研究记录了胆囊造口术置管指征、合并症、影像学发现、技术成功率、临床成功率、胆囊造口术置管后手术时机、留置导管时间、并发症和随访情况。结果 胆囊造口术置管的适应症为急性结石性胆囊炎(43 例;84.3%)、穿孔性胆囊炎(5 例;9.8%)和气肿性胆囊炎(3 例;5.9%)。大多数患者患有多种并发症,包括糖尿病、高血压、心血管疾病、慢性肾病、潜在的恶性肿瘤以及伴有败血症的多系统疾病。所有患者都是在重症监护室的超声引导下,通过经肝途径进行 PC 手术的。手术的技术成功率为 100%。临床成功率为 92.1%(47/51),其中 44/51 例(86.2%)患者接受了明确的择期胆囊切除术,3/51 例(5.9%)患者接受了择期胆管切除术。51例患者中有3例(5.9%)病情未见好转,其中2例患者接受了急诊手术,1/51例(1.9%)患者因持续败血症和多器官功能障碍而死亡。没有出现与手术相关的死亡或重大并发症。一名患者因多次尝试胆囊造口术而导致胆漏。平均留置导管时间为 13 天(范围:3-45 天)。结论 超声引导胆囊造口术可在重症监护室安全地为不适合手术的重症患者实施,且技术和临床成功率高。胆囊造口术后临床情况稳定后,应首选早期腹腔镜胆囊切除术。
{"title":"Bedside Ultrasound-Guided Percutaneous Cholecystostomy in Critically Ill Patients—Outcomes in 51 Patients","authors":"Rozil Gandhi, K. Gala, Mohd Shariq, Aditi Gandhi, Manish Gandhi, Amit Shah","doi":"10.1055/s-0043-1777744","DOIUrl":"https://doi.org/10.1055/s-0043-1777744","url":null,"abstract":"Abstract Purpose  The aim of this study was to report technical and clinical success of bedside ultrasound-guided percutaneous cholecystostomy (PC) tube placement in intensive care unit (ICU). Materials and Methods  This is a retrospective study of 51 patients (36 males:15 females, mean age: 67 years) who underwent ultrasound-guided PC from May 2015 to January 2020. The indication for cholecystostomy tube placement, comorbidities, imaging finding, technical success, clinical success, timing of surgery post-cholecystostomy tube placement, indwelling catheter time, complications, and follow-up were recorded. Results  Indications for cholecystostomy tube placement were acute calculous cholecystitis ( n  = 43; 84.3%), perforated cholecystitis ( n  = 5; 9.8%), and emphysematous cholecystitis ( n  = 3; 5.9%). Most of the patients had multiple comorbidities; these were diabetes mellitus, hypertension, cardiovascular disease, chronic renal disease, underlying malignancy, and multisystem disease with sepsis. All patients had undergone PC through transhepatic approach under ultrasound guidance in ICU. Technical success rate of the procedure was 100%. Clinical success rate was 92.1% (47/51) and among these 44/51 (86.2%) patients underwent definitive elective cholecystectomy, 3/51 (5.9%) patients had elective tube removal. Three of fifty-one (5.9%) patients did not improve; among these two underwent emergency surgery, while there was 1/51 (1.9%) mortality due to ongoing sepsis and multiorgan dysfunction. There were no procedure-related mortalities or procedure-related major complications. One patient had bile leak due to multiple attempts for cholecystostomy placement. Mean tube indwelling time was 13 days (range: 3–45 days). Conclusion  Ultrasound-guided PC can be safely performed in ICU in critically ill patients unfit for surgery with high technical and clinical success rates. Early laparoscopic cholecystectomy should be preferred after stabilization of clinical condition following cholecystostomy.","PeriodicalId":51597,"journal":{"name":"Indian Journal of Radiology and Imaging","volume":"325 9","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139152442","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}
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Indian Journal of Radiology and Imaging
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