Indian Journal of Radiology and Imaging最新文献

Background  The information-seeking behavior of the radiology residents on call has undergone modernization in the recent times given the advent of easy to access, reliable online resources, and robust artificial intelligence chatbots such as Chat Generative Pre-Trained Transformer (ChatGPT). Purpose  The aim of this study was to conduct a baseline analysis among the residents to understand the best way to meet information needs in the future, spread awareness about the existing resources, and narrow down to the most preferred online resource. Methods and Materials  A prospective, descriptive study was performed using an online survey instrument and was conducted among radiology residents in India. They were questioned on their demographics, frequency of on call, fatigue experienced on call, and preferred information resources and reasons for choosing them. Results  A total of 286 residents participated in the survey. All residents had used the Internet radiology resources during on-call duties. The most preferred resource material was Radiopaedia followed by Radiology Assistant. IMAIOS e-Anatomy was the most preferred anatomy resource. There was significant ( p  < 0.05) difference in relation to the use of closed edit peer-reviewed literature among the two batches with it being used almost exclusively by third year residents. In the artificial intelligence-aided ChatGPT section, 61.8% had used the software at least once while being on call, of them 57.6% responded that the information was inaccurate, 67.2% responded that the information was insufficient to aid in diagnosis, 100% felt that the lack of images in the software made it an unlikely resource that would be used by them in the future, and 85.8% agreed that they would use it for providing reporting templates in the future. In the suggestions for upcoming versions, 100% responded that images should be included in the description provide by the chatbot, and 74.5% felt that references for the information being provided should be included as it reaffirms the reliability of the information. Conclusions  Presently, we find that Radiopaedia met most of the requirements as an ideal online radiology resource according to the residents. In the present-day scenario, ChatGPT is not considered as an important on-call radiology education resource first because it lacks images which is quintessential for a budding radiologist, and second, it does not have any reference or proof for the information that it is providing. However, it may be of help to nonmedical professionals who need to understand radiology in layman's terms and to radiologists for patient report preparation and research writing.

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon condition, which can result either from a primary genetic abnormality affecting children or secondary to various conditions like malignancy or infection predominantly in adults. HLH is associated with immune dysregulation, resulting in an uncontrolled overproduction and infiltration of lymphocytes and histiocytes. The infiltration predominantly involves liver, spleen, lymph nodes, and central nervous system. Neuroimaging features on magnetic resonance imaging are highly nonspecific and variable. The most typical findings include periventricular white matter hyperintensities and diffuse atrophy. Ring or nodular enhancing or nonenhancing focal parenchymal lesions may be seen. Here, we present three pediatric cases of primary HLH with a wide spectrum of imaging findings involving cerebral and cerebellar cortex, white matter, deep gray matter, and brain stem. The findings in these patients range from small nonenhancing hemorrhagic lesions and enhancing small lesions to ill-defined mass with mass effect and midline shift. Lesions in deep gray matter including thalamus, basal ganglia, and also brain stem in HLH are rarely described in literature. Early diagnosis of HLH and timely management can improve the course of the disease.

Renovascular hypertension (RVH) contributes close to one-fourth of the secondary etiologies of hypertension in children and a delay in diagnosis can result in adverse clinical outcomes. RVH in children is clinically silent with elevations in blood pressure measurements sometimes as its sole manifestation. Only a high index of suspicion by the clinician can prompt its detection. Despite the availability of other imaging modalities like ultrasound, computed tomography, and magnetic resonance imaging, digital subtraction angiography is still considered the gold standard to make a diagnosis of RVH. Angioplasty is considered the treatment of choice in appropriately selected patients. In this article, we shall focus on the various imaging findings, and management of RVH in children, which requires a multidisciplinary approach with a special focus on the role of interventional radiology.

Background  High-grade gliomas (HGGs) are the most prevalent primary malignancy of the central nervous system. The tumor results in vasogenic and infiltrative edema . Exact anatomical differentiation of these edemas is so important for surgical planning. Multimodal imaging could be used to differentiate the edema type. Purpose  The aim of this study was to investigate the role of multimodal imaging in the differentiation of vasogenic edema from infiltrative edema in patients with HGG (grade III and grade IV). Data Sources  A search on PubMed, EMBASE, Scopus, and ISI Web of Science Core Collection up to June 2022 using terms related to (a) multimodal imaging AND (b) HGG AND (c) edema. (PROSPERO registration number: CRD42022336131) Study Selection  Two reviewers screened the articles and independently extracted the data. We included original articles assessing the role of multimodal imaging in differentiating vasogenic from infiltrative edema in patients with HGG. Six high-quality articles remained for the narrative synthesis. Data Synthesis  Dynamic susceptibility contrast imaging showed that relative cerebral blood volume and relative cerebral blood flow were higher in the infiltrative edema component than in the vasogenic edema component. Diffusion tensor imaging revealed a dispute on fractional anisotropy. The apparent diffusion coefficient was comparable between the two edematous components. Magnetic resonance spectroscopy exhibited an increment in choline/creatinine ratio and choline/N-acetyl aspartate ratio in the infiltrative edema component. Limitations  Strict study selection, low sample size of relevant published studies, and heterogeneity in endpoint variables were the major drawbacks. Conclusions  Multimodal imaging, including dynamic susceptibility contrast and magnetic resonance spectroscopy, might help differentiate between vasogenic and infiltrative edema.

Intracranial granulomas are a major cause of seizures in India, the most common etiologies being neurocysticercosis and tuberculosis. However, other pathologies including rare low-grade tumors may mimic these granulomas on imaging. In this article, we presented the case of a young woman patient with drug-resistant epilepsy. On imaging, there was a small calcified lesion in the brain parenchyma. In view of concordant electroclinical and imaging data on presurgical evaluation, the lesion was excised and the patient was seizure free. On histopathological evaluation, it was found to be a polymorphous low-grade neuroepithelial tumor of the young (PLNTY) - a rare, recently reported entity that can mimic an intracranial granuloma on imaging.

Coronary involvement in Kawasaki disease is not uncommon; however, giant coronary aneurysm exceeding 50 mm is extremely rare. In this article, we presented a case of giant coronary aneurysm involving right coronary artery with associated asymptomatic myocardial ischemia as evident by multimodality imaging.