Journal of the Belgian Society of Radiology最新文献

Objectives: The objective of the present study was to determine the morphologic features and measurements of the normal thymus on contrast-enhanced multi-detector computed tomography (MDCT) in subjects from the newborn period up to 18 years of age.

Materials and methods: The MDCT scans obtained from 464 children with a mean age ± SD of 8.43 ± 5.60 years were retrospectively re-evaluated. The shape, margins, side predominance, density, and measurements of the thymic gland were defined for each age group.

Results: A triangular thymic shape with a middle location and straight lateral contours were the most frequently seen morphologic features in children. The mean anteroposterior and transverse diameter of the thymus was 17.32 ± 4.58 and 29.99 ± 11.42 mm, respectively. The mean values for the width and thickness were 20.66 ± 5.36 and 15.15 ± 6.76 mm for the right thymic lobe, respectively; and 26.14 ± 7.85 and 14.91 ± 5.51 mm for the left, respectively. The transverse diameter of the thymus and thymic lobe dimensions decreased significantly with age, however, the anteroposterior diameter of the thymus was not significantly associated with age. Girls had higher mean thymic attenuation values compared to boys, however, this gender difference was not statistically significant (63.8 ± 22.4 HU vs. 60.1 ± 25.3, p = 0.164).

Conclusion: Our study provides a better understanding of the normal thymic appearances in children that can aid in accurate diagnosis and avoid unnecessary, costly, and invasive interventions.

Objectives: To (i) identify the prevalence of dental disease, (ii) identify the proportion of sinusitis cases that could be considered odontogenic in origin and, (iii) audit the rate of diagnosis of incidental dental disease and odontogenic sinusitis in radiology reports on CT scans covering the maxillary teeth and sinuses.

Materials and methods: Images and reports of CT studies performed in our institution that covered the paranasal sinuses and maxilla were retrospectively audited for documentation of findings pertaining to maxillary sinusitis and maxillary dental disease. Trauma cases, edentulous and pediatric patients and patients without maxillary sinusitis or dental disease were excluded. The etiologies of maxillary sinusitis was defined as likely odontogenic, indeterminate and rhinogenic sinusitis. Only molar and pre-molar tooth disease were considered as these are most commonly in direct contact with the floor of the maxillary sinus.

Results: One-hundred sixty CT studies were reviewed. The prevalence of dental caries and periapical lucency was 80.6% and 15.0%, respectively. The cause of sinusitis was determined to be likely odontogenic in 30.0%, rhinogenic in 33.1% and of indeterminate origin in 36.9%. The rate of reporting dental findings or raising the suspicion of odontogenic sinusitis was 8.5% (n = 14).

Conclusions: Under-reporting of dental disease and odontogenic sinusitis is common. Early recognition results in higher chances of salvaging the diseased tooth, preventing complications and providing appropriate treatment. An urgent and collective effort by the radiological fraternity is warranted to recognize the significance of reporting of dental pathologies, even in CT scans done for other indications.

Objectives: We aim to contribute to the assessment of the screening performance in Flanders (Belgium) and to identify valuable mammograms for subsequent studies and training.

Materials and methods: Initially negative prior screening mammograms (sMx) of 210 women with confirmed breast cancer detected by the Flemish screening programme between 2011-2013 were reviewed by a highly experienced radiologist. The review of the prior sMx was performed in three steps: 1) only prior mammograms available; 2) with index sMx (=subsequent positive sMx) present; 3) with index sMx and clinical information present.

Results: The radiological review yielded 94 (45%) mammograms 'without suspicious lesions', 77 (37%) 'with minimal signs in at least one breast', and 39 (19%) 'with clearly visible tumours'. In univariate analyses, the reclassification of prior sMx was significantly associated with the date of the prior sMx, the need for a third reader for arbitration, image quality and the detector system used (computed radiography versus direct readout digital radiography), and it was not associated with the interval between screening rounds, age at prior sMx, breast density, or tumour characteristics (

Conclusion: This retrospective review reclassified 19% of the sMx as clearly visible tumours. With this, the Flemish screening programme performs in accordance with similar studies. The sMx reviewed in this study, form a valuable set of mammograms for training and further research.

Aim: To evaluate the contribution of medical imaging request forms as trigger tools to detect patient adverse event (AE) occurring during hospitalization.

Material and methods: This is a retrospective study in a single institution. Between January and June 2019, the hospital information system (HIS) was fetched for request forms of radiological examinations performed for inpatients >48 hours after the admission date. The investigated request forms were: Doppler ultrasound of the upper limbs, Doppler ultrasound of the lower limbs, and the repetition of three consecutive requests of chest radiographs within 24 hrs, to detect upper or lower limb venous thrombosis, or AEs related to the respiratory system, respectively. Patients' medical charts and radiological examinations were evaluated to document the presence or absence of an AE. The frequencies of AEs in the three groups of trigger tools were compared to corresponding control groups, matched according to age, sex and length of stay.

Results: Among a total of 2798 hospital admissions during the study period, there were 74 files triggered by the three types of radiological request forms. There were 6/24 AE (25%) related to upper limb venous thrombosis, 4/33 (12.1%) AE related to lower limb venous thrombosis, and 6/17 (35.3%) AE related to the respiratory system. For all the trigger tools, the frequency of AE in the study groups was significantly higher than that in the control groups.

Conclusion: Medical imaging requests could be used as potential trigger tools to detect adverse events related to hospital stay.

Objectives: To compare the effectiveness of individual multiparametric prostate MRI (mpMRI) sequences-T2W, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), and dynamic contrast-enhanced (DCE)-in assessing prostate cancer (PCa) index lesion volume using whole-mount pathology as the ground-truth; to assess the impact of an endorectal coil (ERC) on the measurements.

Materials and methods: We retrospectively enrolled 72 PCa patients who underwent 3T mpMRI with (n = 39) or without (n = 33) an ERC. A pathologist drew the index lesion borders on whole-mount pathology using planimetry (whole-mount_vol). A radiologist drew the borders of the index lesion on each mpMRI sequence-T2W_vol, DWI_vol, ADC_vol, and DCE_vol. Additionally, we calculated the maximum index lesion volume for each patient (maxMRI_vol). The correlation and differences between mpMRI and whole-mount pathology in measuring the index lesion volume and the impact of an ERC were investigated.

Results: The median T2W_vol, DWI_vol, ADC_vol, DCE_vol, and maxMRI_vol were 0.68 cm³, 0.97 cm³, 0.98 cm³, 0.82 cm³, and 1.13 cm³. There were good positive correlations between whole-mount_vol and mpMRI sequences. However, all mpMRI-derived volumes underestimated the median whole-mount_vol volume of 1.97 cm³ (P ≤ 0.001), with T2W_vol having the largest volumetric underestimation while DWI_vol and ADC_vol having the smallest. The mean relative index lesion volume underestimations of maxMRI_vol were 39.16% ± 32.58% and 7.65% ± 51.91% with and without an ERC (P = 0.002).

Conclusion: T2W_vol, DWI_vol, ADC_vol, DCE_vol, and maxMRI_vol substantially underestimate PCa index lesion volume compared with whole-mount pathology, with T2W_vol having the largest volume underestimation. Additionally, using an ERC exacerbates the volume underestimation.

Painless solid testicular masses on ultrasonography are commonly malignant. However, if the lesion is well demarcated, rounded, and hypoechoic with alternating hyperechoic and hypoechoic layers, and no internal vascular flow, the possibility of an epidermoid cyst should be considered. Epidermoid cysts are uncommon benign testicular lesions and are extremely rare in the intrascrotal extratesticular region. Including these cysts in the differential diagnosis may allow the urologist to perform testis-sparing surgery. Teaching Point: The possibility of an epidermoid cyst should be considered when a scrotal mass shows an 'onion ring' appearance on sonography and no vascularity on Doppler.

Teaching Point: Although Behçet disease is a multisystemic and chronic vasculitis, it can be superimposed with a variety of acute vasculitis.

Teaching Point: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is an underrecognized and misdiagnosed cause of multiple lung nodules in combination with mosaic attenuation.

Objective: This work aimed to investigate the correlation between body mass index (BMI) and computed tomography angiography (CTA) in the vascular positioning of anterolateral thigh perforator flap (ALT) and to discuss the influence of CTA on the vascular positioning of the ALT by taking BMI as a variable.

Methods: A total of 117 patients who admitted to our hospital (Wuxi Ninth People's Hospital) from January 2017 to May 2019, hospitalized due to limb injury and needed ALT transplantation were collected in this work. According to the BMI, the patients were divided into group A (BMI < 18.5) with 18 cases, group B (18.5 ≤ BMI < 24) with 56 cases, and group C (BMI ≥ 24) with 43 cases. CTA was used to locate the perforator vessels in anterolateral thigh (ALT) flap of the three groups. All surgical and CTA data were collected.

Results: There was a significant positive correlation between BMI and CTA positioning (P < 0.05).

Conclusion: The larger the BMI, the more accurate the CTA positioning. When the BMI was not less than 18.5, CTA positioning should be the most accurate.

Teaching Point: Intravertebral venous collateral formation can occur in thoracic venous obstruction syndrome and mimic metastatic bone lesions on contrast-enhanced imaging: vanishing bone metastases.