A case is presented of an 83-year-old female patient with a strong suspicion of active bleeding, but no diagnostic contrast blush could be seen on the original computed tomography (CT) scan. Teaching point: When performing CT angiography in veno-arterial extracorporeal membrane oxygenation (VA-ECMO), it is important to understand the altered haemodynamics, as flow-related artefacts such as the vascular watershed phenomenon can obscure bleeding.
{"title":"Invisible Active Bleeding Due to the Watershed Phenomenon","authors":"Miloud Dewilde, Birgitt Janssens","doi":"10.5334/jbsr.3604","DOIUrl":"https://doi.org/10.5334/jbsr.3604","url":null,"abstract":"A case is presented of an 83-year-old female patient with a strong suspicion of active bleeding, but no diagnostic contrast blush could be seen on the original computed tomography (CT) scan. Teaching point: When performing CT angiography in veno-arterial extracorporeal membrane oxygenation (VA-ECMO), it is important to understand the altered haemodynamics, as flow-related artefacts such as the vascular watershed phenomenon can obscure bleeding.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"88 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141106192","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}
Teaching point: Myositis ossificans is a do not touch lesion of which the radiological findings can be misleading in the early stages due to possible features mimicking a malignant process.
{"title":"Myositis Ossificans: A Mimicker of an Intramuscular Tumour","authors":"Bjorn Valgaeren, Ione Limantoro","doi":"10.5334/jbsr.3531","DOIUrl":"https://doi.org/10.5334/jbsr.3531","url":null,"abstract":"Teaching point: Myositis ossificans is a do not touch lesion of which the radiological findings can be misleading in the early stages due to possible features mimicking a malignant process.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"376 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139839358","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}
Teaching point: Lentiform fork sign is a rare finding on MRI of the brain, found in patients with metabolic acidosis, in a critically ill patient with low consciousness and renal failure, this sign can correspond to uremic encephalopathy.
{"title":"Low Consciousness in a Patient with Pancolitis","authors":"A. Nikoghosyan, Julie Lambert","doi":"10.5334/jbsr.3265","DOIUrl":"https://doi.org/10.5334/jbsr.3265","url":null,"abstract":"Teaching point: Lentiform fork sign is a rare finding on MRI of the brain, found in patients with metabolic acidosis, in a critically ill patient with low consciousness and renal failure, this sign can correspond to uremic encephalopathy.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"64 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837678","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}
Teaching point: Both xanthogranulomatous and emphysematous pyelonephritis are severe renal inflammatory disorders, occurring simultaneously in extremely rare cases.
教学要点：黄原细胞瘤性肾盂肾炎和气肿性肾盂肾炎都是严重的肾脏炎症，同时发生的病例极为罕见。
{"title":"Xanthogranulomatous and Emphysematous Pyelonephritis: Two Rare Entities Occurring in One Kidney","authors":"Vincent Alberts, Felix Delbare, B. Leenknegt","doi":"10.5334/jbsr.3424","DOIUrl":"https://doi.org/10.5334/jbsr.3424","url":null,"abstract":"Teaching point: Both xanthogranulomatous and emphysematous pyelonephritis are severe renal inflammatory disorders, occurring simultaneously in extremely rare cases.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"432 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139839528","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}
A case is reported of a 46-year-old woman referred to a magnetic resonance imaging (MRI) for menometrorrhagia. MRI revealed a mass lesion lateral to the uterus fundus, suspicious of an ovarian granulosa cell tumor. Extensive surgery was performed. Histological examination revealed a polypoid endometriosis lesion arising from the Douglas pouch. Teaching point: Polypoid endometriosis is a rare benign entity with a challenging differential diagnosis from malignancy. Specific MRI features can contribute to the diagnosis and thus avoid excessive surgical resection.
{"title":"A Rare Presentation of Polypoid Endometriosis of the Douglas Pouch: Case Report","authors":"Emilie Demondion, Yves Borghesi, Nathalie Trouillet","doi":"10.5334/jbsr.3420","DOIUrl":"https://doi.org/10.5334/jbsr.3420","url":null,"abstract":"A case is reported of a 46-year-old woman referred to a magnetic resonance imaging (MRI) for menometrorrhagia. MRI revealed a mass lesion lateral to the uterus fundus, suspicious of an ovarian granulosa cell tumor. Extensive surgery was performed. Histological examination revealed a polypoid endometriosis lesion arising from the Douglas pouch. Teaching point: Polypoid endometriosis is a rare benign entity with a challenging differential diagnosis from malignancy. Specific MRI features can contribute to the diagnosis and thus avoid excessive surgical resection.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"708 ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139841145","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}
Bénédicte Verbrugge, Adelard De Backer, Koenraad Nieboer
Teaching point: Ingestion of a foreign body is a rare cause of a colovesical fistula.
教学要点：摄入异物是结肠瘘的罕见病因。
{"title":"Colovesical Fistula as a Late Complication of Ingestion of a Foreign Body","authors":"Bénédicte Verbrugge, Adelard De Backer, Koenraad Nieboer","doi":"10.5334/jbsr.3426","DOIUrl":"https://doi.org/10.5334/jbsr.3426","url":null,"abstract":"Teaching point: Ingestion of a foreign body is a rare cause of a colovesical fistula.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"447 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139860096","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}
Tophaceous gout can rarely present in the middle ear as a mass-like lesion, causing conductive hearing loss. Noncontrast high-resolution computed tomography (HRCT) of the temporal bone plays a significant role in the diagnosis. Awareness of this condition among radiologists is important since it presents a distinctive appearance on HRCT. We present a case of tophaceous gout of the middle ear diagnosed with photon-counting computed tomography (PCCT). Teaching point: The presence of a partially calcified mass with a semolina-like appearance within the middle ear is highly suggestive of tophaceous gout, even in the presence of normal serum uric acid levels.
{"title":"Tophaceous Gout of the Middle Ear","authors":"Joren Waumans, Christian Desloovere, J. Devos","doi":"10.5334/jbsr.3421","DOIUrl":"https://doi.org/10.5334/jbsr.3421","url":null,"abstract":"Tophaceous gout can rarely present in the middle ear as a mass-like lesion, causing conductive hearing loss. Noncontrast high-resolution computed tomography (HRCT) of the temporal bone plays a significant role in the diagnosis. Awareness of this condition among radiologists is important since it presents a distinctive appearance on HRCT. We present a case of tophaceous gout of the middle ear diagnosed with photon-counting computed tomography (PCCT). Teaching point: The presence of a partially calcified mass with a semolina-like appearance within the middle ear is highly suggestive of tophaceous gout, even in the presence of normal serum uric acid levels.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"50 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139864938","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}
Laura Haddad, Hanna Saleme, Nigel Howarth, Denis Tack
Objective: Reject analysis is usually performed in digital radiography (DR) for quality assurance. Data for computed tomography (CT) rejects remains sparse. The aim of this study is to help provide a straightforward benchmark for reject analysis of both DR and CT. Materials and methods: This retrospective observational study included 107,277 DR and 20,659 CT during 18 months in a tertiary care center. Rejected acquisitions were retrieved by Dose Archiving and Communication System (DACS). The DR and CT reject analysis included reject rates, reasons for rejection and supplementary radiation dose associated with these rejects. Results: 8,904 rejected DR and 514 rejected CT were retrieved. The DR reject rate was 8.3% whereas the CT reject rate was 2.5%. The cumulative effective dose (ED) of DR rejects was 377.3 mSv while the cumulative ED of CT rejects was 1267.4 mSv. The major reason for rejects was positioning for both DR (61%) and CT (44%). Conclusion: This study helps constitute a simple reproducible method to analyze both DR and CT rejects simultaneously. Although CT rejects are less often monitored than DR rejects, the radiation dose associated with CT rejects is much higher, which emphasizes the need to systematically monitor both DR and CT rejects. Investigating the reasons and the most frequently rejected examinations gives an opportunity for improvement of imaging techniques in cooperation with technologists.
目的：剔除分析通常在数字放射摄影（DR）中进行，以保证质量。计算机断层扫描（CT）剔除的数据仍然很少。本研究旨在为 DR 和 CT 的剔除分析提供一个简单明了的基准。材料和方法：这项回顾性观察研究包括一家三级医疗中心 18 个月内的 107,277 例 DR 和 20,659 例 CT。通过剂量存档和通信系统（DACS）检索了拒收数据。DR 和 CT 剔除分析包括剔除率、剔除原因以及与这些剔除相关的补充辐射剂量。结果：共检索到 8904 份拒收的 DR 和 514 份拒收的 CT。DR 拒收率为 8.3%，而 CT 拒收率为 2.5%。DR剔除的累积有效剂量（ED）为377.3 mSv，CT剔除的累积有效剂量（ED）为1267.4 mSv。DR（61%）和 CT（44%）被拒的主要原因都是定位。结论：这项研究有助于建立一种可同时分析 DR 和 CT 排斥的简单、可重复的方法。虽然 CT 排异的监测频率低于 DR 排异，但与 CT 排异相关的辐射剂量要高得多，这就强调了系统监测 DR 和 CT 排异的必要性。调查被拒检查的原因和最常被拒检查的项目，为与技术人员合作改进成像技术提供了机会。
{"title":"Reject Analysis in Digital Radiography and Computed Tomography: A Belgian Imaging Department Case Study","authors":"Laura Haddad, Hanna Saleme, Nigel Howarth, Denis Tack","doi":"10.5334/jbsr.3259","DOIUrl":"https://doi.org/10.5334/jbsr.3259","url":null,"abstract":"Objective: Reject analysis is usually performed in digital radiography (DR) for quality assurance. Data for computed tomography (CT) rejects remains sparse. The aim of this study is to help provide a straightforward benchmark for reject analysis of both DR and CT. Materials and methods: This retrospective observational study included 107,277 DR and 20,659 CT during 18 months in a tertiary care center. Rejected acquisitions were retrieved by Dose Archiving and Communication System (DACS). The DR and CT reject analysis included reject rates, reasons for rejection and supplementary radiation dose associated with these rejects. Results: 8,904 rejected DR and 514 rejected CT were retrieved. The DR reject rate was 8.3% whereas the CT reject rate was 2.5%. The cumulative effective dose (ED) of DR rejects was 377.3 mSv while the cumulative ED of CT rejects was 1267.4 mSv. The major reason for rejects was positioning for both DR (61%) and CT (44%). Conclusion: This study helps constitute a simple reproducible method to analyze both DR and CT rejects simultaneously. Although CT rejects are less often monitored than DR rejects, the radiation dose associated with CT rejects is much higher, which emphasizes the need to systematically monitor both DR and CT rejects. Investigating the reasons and the most frequently rejected examinations gives an opportunity for improvement of imaging techniques in cooperation with technologists.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"46 22","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946435","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}
Purpose: This study aimed to evaluate the post-intervention target primary patency of drug-coated balloon angioplasty (DCBA) compared with conventional balloon angioplasty (CBA) in the treatment of the dysfunctional autogenous arteriovenous fistula (AVF) in a real-world clinical setting. Materials and Methods: This retrospective study included 24 patients with end-stage renal disease, who developed dysfunctional AVF during hemodialysis, and underwent endovascular treatment using CBA and DCBA from January 1, 2014, to June 30, 2021. The demographic data of patients and details regarding their fistula were recorded. Post-intervention target primary patency was analyzed. Results: Sixteen men and 8 women with an average age of 63.9 ± 14.2 years, who underwent 333 endovascular treatments in 57 target lesions of access were enrolled. DCBA was a protective factor for the treatment of a target lesion of dysfunctional access with an adjusted hazard ratio of 0.725 (95% confidence interval [CI]: 0.528–0.996; P = 0.047). According to the Weibull proportional hazards regression model, DCBA showed a longer post-intervention target primary patency than CBA. Conclusion: DCBA has better outcomes in terms of post-intervention target primary patency in the real-world treatment of dysfunctional autogenous AVF.
{"title":"Patency of Drug-Coated versus Conventional Balloon Angioplasty for Hemodialysis Access Stenosis","authors":"Thanawat Anukanchanavera, Keerati Hongsakul, Phurich Janjindamai, Surasit Akkakrisee, Kittipitch Bannangkoon, S. Rookkapan, Ussanee Boonsrirat, Sarayut Geater","doi":"10.5334/jbsr.3315","DOIUrl":"https://doi.org/10.5334/jbsr.3315","url":null,"abstract":"Purpose: This study aimed to evaluate the post-intervention target primary patency of drug-coated balloon angioplasty (DCBA) compared with conventional balloon angioplasty (CBA) in the treatment of the dysfunctional autogenous arteriovenous fistula (AVF) in a real-world clinical setting. Materials and Methods: This retrospective study included 24 patients with end-stage renal disease, who developed dysfunctional AVF during hemodialysis, and underwent endovascular treatment using CBA and DCBA from January 1, 2014, to June 30, 2021. The demographic data of patients and details regarding their fistula were recorded. Post-intervention target primary patency was analyzed. Results: Sixteen men and 8 women with an average age of 63.9 ± 14.2 years, who underwent 333 endovascular treatments in 57 target lesions of access were enrolled. DCBA was a protective factor for the treatment of a target lesion of dysfunctional access with an adjusted hazard ratio of 0.725 (95% confidence interval [CI]: 0.528–0.996; P = 0.047). According to the Weibull proportional hazards regression model, DCBA showed a longer post-intervention target primary patency than CBA. Conclusion: DCBA has better outcomes in terms of post-intervention target primary patency in the real-world treatment of dysfunctional autogenous AVF.","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"13 11","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138950221","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}
{"title":"Welcome Word Annual Meeting BSR 2023","authors":"P. Vanhoenacker","doi":"10.5334/jbsr.3312","DOIUrl":"https://doi.org/10.5334/jbsr.3312","url":null,"abstract":"","PeriodicalId":56282,"journal":{"name":"Journal of the Belgian Society of Radiology","volume":"16 26","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589303","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}
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