Indian Journal of Radiology and Imaging最新文献

Radiation protection is at a crossroads in the era of digital imaging. Although radiographic modalities have made tremendous leaps in diagnostic sensitivity, they have, in turn, added new challenges in guaranteeing proper protection against radiation. Inconsistencies in exposure protocols, lack of health worker awareness, and differing utilization of dose optimization aids still undermine the dictums of justification and ALARA (As Low As Reasonably Achievable). This commentary calls upon the radiology and medical imaging community to embrace a concerted approach to radiation safety, based on international standards and informed by strong education, technology, and policy infrastructures. Such concerted practice has the potential to harmonize safety culture across health care systems and enable imaging professionals to reduce patient and occupational exposure without diminishing diagnostic effectiveness.

Background: Remote magnetic resonance (MR) scanning has emerged as a solution for supporting radiographers from a distance during complex MR imaging examinations.

Materials and methods: A demonstration of a commercially available remote MR scanning technology was delivered during a radiography conference. An electronic survey was conducted to investigate the perceived ease of use (PEoU), perceived usefulness (PU), attitude toward technology (ATT), and behavioral intention to use the technology (BI). The responses were analyzed using the IBM Statistical Package for Social Sciences (SPSS). Thirty-five responses were collected.

Results: PEoU and PU received high scores, indicating that respondents found the technology easy to use and useful. ATT and BI received lower scores, suggesting some hesitation in the adoption of the technology.

Conclusion: This was an early evaluation of the acceptance of remote MR scanning technology in Greece. Further research is necessary to fill the research gap in remote MR scanning, enabling future researchers to generate more reliable conclusions.

Radicular back pain is defined as low back pain radiating into the lower extremities in a dermatomal pattern caused by compression or irritation of the nerve root. Fluoroscopy is an excellent tool for the management of lower limb radiculopathies that are secondary to discogenic pathologies not responding to the conservative trial. Transforaminal epidural steroid injection technique is a minimally invasive intervention for radiculopathies, which can easily be done in a day care setting, and it should be considered before surgery; however, precision and expertise is required.

Oculomotor synkinesis or aberrant regeneration of cranial nerve III (CN III) typically results from trauma, aneurysm, or mass lesions. We present a rare case report with CN III palsy and synkinesis secondary to a meningocele in the left oculomotor cistern, causing mass effect on the oculomotor nerve. Imaging suggested underlying idiopathic intracranial hypertension (IIH) as a potential etiology. While mass lesions or trauma are common causes of oculomotor synkinesis, an association with meningocele has not been previously reported. This case highlights the importance of considering IIH-related meningoceles in unexplained CN III palsies.

Computed tomography-guided lung biopsy is a common procedure performed to obtain adequate tissue not just for diagnosis but also for molecular typing. Hemothorax is a rare yet serious complication of percutaneous lung biopsies with reported incidence of 0.092%. This is most commonly due to the injury to the intercostal artery or internal mammary artery. However, bleeding due to pulmonary artery involvement is rare and we report one such case which was managed by percutaneous glue embolization.

Noncompaction cardiomyopathy (NCC) is a rare congenital cardiomyopathy caused by the arrest of endomyocardial morphogenesis, leading to prominent trabeculations and deep intertrabecular recesses. Emerging evidence suggests that noncompaction may also occur secondary to other myocardial pathologies or have a genetic basis. A 59-year-old male with no coronary risk factors presented with 1-year history of chest pain, palpitations, orthopnea, and fatigue. Clinical examination revealed atrial fibrillation, normal pulmonary findings, and no peripheral edema. Echocardiography showed inferior wall hypokinesia, grade I diastolic dysfunction, with ejection fraction of 48%. Cardiac magnetic resonance imaging (MRI) confirmed excessive myocardial trabeculations with reduced biventricular function. Petersen, Stacey, and Jacquier criteria established the diagnosis of biventricular noncompaction (BVNC), a rare form of NCC. The patient was managed with standard heart failure therapy. BVNC, while rare, poses diagnostic challenges and carries significant morbidity due to heart failure and arrhythmias. This case describes the importance of MRI for accurate diagnosis and tailored management in BVNC.

Background: Differentiation between pediatric Wilms tumor and neuroblastoma may be difficult when solely based on conventional computed tomography (CT) features, especially in large tumors.

Objective: This article analyzes the role of CT-based texture analysis (CTTA) in differentiating (1) pediatric Wilms tumor and neuroblastoma and (2) between histological and MYCN amplified subtypes of neuroblastoma.

Materials and methods: Treatment-naive cases of pediatric (< 18 years) renal/pararenal tumors who underwent a single-phase contrast-enhanced CT of chest, abdomen, and pelvis for staging and preoperative evaluation purposes were enrolled. CT images were processed with texture analysis software for first-order texture features. Calculated parameters included mean, variance, skewness, and kurtosis. Grayscale features were also analyzed among the tumor groups and subgroups. Mann-Whitney U and Fisher's exact tests were used for statistical analysis. A p -value of < 0.05 was considered significant.

Observations and results: A total of 37 lesions (22 neuroblastoma, 15 Wilms) were evaluated. With respect to grayscale features, neuroblastoma tumors exhibited calcifications in greater frequency with a higher propensity for nodal and visceral metastasis. Significant differences were observed when comparing variance of the two tumor groups with neuroblastoma showing higher intralesional variance values than Wilms tumor. Undifferentiated subtype of neuroblastoma demonstrated higher intralesional variance than other two subtypes combined; MYCN amplified tumors showed higher intralesional mean value than unamplified tumors ( p  < 0.05 for both). The various neuroblastoma subgroups did not significantly differ when considering the grayscale parameters.

Conclusion: CTTA has a potential role in allowing differentiation between neuroblastoma and Wilms tumor. It may additionally allow differentiation among various histological subtypes of neuroblastoma and detection of MYCN amplified neuroblastoma.