A. Rezaeian, M. Ostovari, M. Hoseini-Ghahfarokhi, Hashem Khanbabaei
Purpose Diffusion-weighted imaging as a noninvasive functional modality plays a valuable role in the evaluation of prostate cancer. However, there is still no agreement on the number and range of b-values to be used. Therefore, the purpose of this study is to investigate the influence of b-value choice on the diagnostic performance of apparent diffusion coefficient (ADC) values for prostate cancer detection. Material and methods Fifty-nine consecutive patients with abnormal digital rectal examination findings and raised serum prostate-specific antigen were chosen for magnetic resonance imaging of the prostate before systematic 12-core trans-rectal ultrasound-guided prostate biopsies. ADC values for each ROI were calculated from different b-value combinations (0-1600 s/mm2) by a monoexponential model. Mann-Whitney and the paired-sample t-test were used to compare the mean ADC values for malignant lesions and noncancerous tissues. ROC curve analysis was used to evaluate the diagnostic performance of ADC values in distinguishing prostate cancer from normal-tissue ROIs. Results The differences between mean ADC values of malignant lesions and contralateral healthy tissues were significant for all the pairs of b-value combinations. The pair of b-values 50 and 1200 provided the highest AUC (0.94), with a sensitivity of 90.2%, a specificity of 92.6%, and an accuracy of 91.2% at an ADC cut-off of 1.23 × 10-3 mm2/s. Conclusions Our study showed that using a 1.5-Tesla MRI scanner the diagnostic performance of ADC values estimated from the b-value pair 50 and 1200 s/mm2 was highest. However, some other b-value pairs provided statically comparable diagnostic performance.
{"title":"Diffusion-weighted magnetic resonance imaging at 1.5 T for peripheral zone prostate cancer: the influence of the b-value combination on the diagnostic performance of apparent diffusion coefficient","authors":"A. Rezaeian, M. Ostovari, M. Hoseini-Ghahfarokhi, Hashem Khanbabaei","doi":"10.5114/pjr.2022.115715","DOIUrl":"https://doi.org/10.5114/pjr.2022.115715","url":null,"abstract":"Purpose Diffusion-weighted imaging as a noninvasive functional modality plays a valuable role in the evaluation of prostate cancer. However, there is still no agreement on the number and range of b-values to be used. Therefore, the purpose of this study is to investigate the influence of b-value choice on the diagnostic performance of apparent diffusion coefficient (ADC) values for prostate cancer detection. Material and methods Fifty-nine consecutive patients with abnormal digital rectal examination findings and raised serum prostate-specific antigen were chosen for magnetic resonance imaging of the prostate before systematic 12-core trans-rectal ultrasound-guided prostate biopsies. ADC values for each ROI were calculated from different b-value combinations (0-1600 s/mm2) by a monoexponential model. Mann-Whitney and the paired-sample t-test were used to compare the mean ADC values for malignant lesions and noncancerous tissues. ROC curve analysis was used to evaluate the diagnostic performance of ADC values in distinguishing prostate cancer from normal-tissue ROIs. Results The differences between mean ADC values of malignant lesions and contralateral healthy tissues were significant for all the pairs of b-value combinations. The pair of b-values 50 and 1200 provided the highest AUC (0.94), with a sensitivity of 90.2%, a specificity of 92.6%, and an accuracy of 91.2% at an ADC cut-off of 1.23 × 10-3 mm2/s. Conclusions Our study showed that using a 1.5-Tesla MRI scanner the diagnostic performance of ADC values estimated from the b-value pair 50 and 1200 s/mm2 was highest. However, some other b-value pairs provided statically comparable diagnostic performance.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e215 - e219"},"PeriodicalIF":0.0,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43643828","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}
Purpose To evaluate the prevalence and significance of incidental non-cardiac findings (NCFs) on cardiac magnetic resonance imaging (MRI). We also aimed to assess the unreported rate and clinical significance of NCFs in official radiological reports. Material and methods Consecutive cardiac MRI examinations of 400 patients were retrospectively analysed and MR images reviewed by 2 observers blinded to official radiology reports. NCFs were classified as insignificant, significant, and major. In patients with significant and major findings, NCFs were classified as previously known or unknown, based on clinical archive. Moreover, we investigated the clinical follow-up results of patients with major NCF. Results Of 400 patients, 137 patients (34.3%) had a total of 175 NCFs. Fifty-nine NCFs were considered significant, and 23 were major. Patients with NCFs were significantly older than those without (p < 0.0001). Of 82 significant and major NCFs, 25 were previously unknown. In total, 18 significant and 4 major NCFs were unreported in official MRI reports. The unreported major NCFs were portal vein thrombosis, pulmonary nodule, pulmonary embolism, and liver nodule. The most common unreported findings were pulmonary artery-aorta dilatation and hiatal hernia. No statistical difference was found between official MRI reports and second consensus reading for the detection of major NCFs (p = 0.082). Conclusions The frequency of significant and major NCFs increases with age. Although no statistical difference was found between official MRI reports and second consensus reading for the detection of major NCFs, extra-cardiac findings should be carefully investigated during assessment.
{"title":"The prevalence and clinical significance of incidental non-cardiac findings on cardiac magnetic resonance imaging and unreported rates of these findings in official radiology reports","authors":"F. Ufuk, H. G. Yavas, E. Sağtaş, I. Kilic","doi":"10.5114/pjr.2022.115713","DOIUrl":"https://doi.org/10.5114/pjr.2022.115713","url":null,"abstract":"Purpose To evaluate the prevalence and significance of incidental non-cardiac findings (NCFs) on cardiac magnetic resonance imaging (MRI). We also aimed to assess the unreported rate and clinical significance of NCFs in official radiological reports. Material and methods Consecutive cardiac MRI examinations of 400 patients were retrospectively analysed and MR images reviewed by 2 observers blinded to official radiology reports. NCFs were classified as insignificant, significant, and major. In patients with significant and major findings, NCFs were classified as previously known or unknown, based on clinical archive. Moreover, we investigated the clinical follow-up results of patients with major NCF. Results Of 400 patients, 137 patients (34.3%) had a total of 175 NCFs. Fifty-nine NCFs were considered significant, and 23 were major. Patients with NCFs were significantly older than those without (p < 0.0001). Of 82 significant and major NCFs, 25 were previously unknown. In total, 18 significant and 4 major NCFs were unreported in official MRI reports. The unreported major NCFs were portal vein thrombosis, pulmonary nodule, pulmonary embolism, and liver nodule. The most common unreported findings were pulmonary artery-aorta dilatation and hiatal hernia. No statistical difference was found between official MRI reports and second consensus reading for the detection of major NCFs (p = 0.082). Conclusions The frequency of significant and major NCFs increases with age. Although no statistical difference was found between official MRI reports and second consensus reading for the detection of major NCFs, extra-cardiac findings should be carefully investigated during assessment.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e207 - e214"},"PeriodicalIF":0.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46918147","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}
Purpose To ascertain the role of optic nerve sheath diameter (ONSD) in the evaluation of cerebral venous sinus thrombosis (CVST). Material and methods A retrospective study with convenient sampling was done during the period November 2018 to January 2020. Forty-one patients across all age groups with magnetic resonance venography (MRV) diagnosis of CVST and 82 gender-matched controls were included in the study. ONSD was measured on axial T2-weighted magnetic resonance images. CVST was identified on axial TOF-MRV including the stage, degree, and location. Intraparenchymal infarction and haemorrhage were also noted with their stage and size. The distribution of values for ONSD was tested for equality of variances using independent samples t-test. A cut-off value for ONSD was derived using ROC analysis. Results The mean difference between ONSD of cases and controls was 0.84 mm (95% CI: 0.61-1.06) and was statistically significant at p < 0.001. Mean ONSD in cases was 5.33 ± 0.66, and in the control group it was 4.49 ± 0.31. The cut-off value for ONSD was taken as 4.57 mm, derived using the ROC analysis (AUC was 0.876 suggesting good diagnostic accuracy). ONSD showed a sensitivity of 87% and a negative predictive value of 89% in predicting CVST. However, we found no statistical significance between ONSD in patients with acute or chronic thrombosis or in those with neuroparenchymal complications. Conclusions ONSD is a valid triage tool with high sensitivity and negative predictive value, and it can be used in the evaluation of CVST.
{"title":"Optic nerve sheath diameter and its implications in the evaluation of cerebral venous sinus thrombosis","authors":"S. Das, S. Jindal, Vikram Patil, Sachin T.","doi":"10.5114/pjr.2022.115706","DOIUrl":"https://doi.org/10.5114/pjr.2022.115706","url":null,"abstract":"Purpose To ascertain the role of optic nerve sheath diameter (ONSD) in the evaluation of cerebral venous sinus thrombosis (CVST). Material and methods A retrospective study with convenient sampling was done during the period November 2018 to January 2020. Forty-one patients across all age groups with magnetic resonance venography (MRV) diagnosis of CVST and 82 gender-matched controls were included in the study. ONSD was measured on axial T2-weighted magnetic resonance images. CVST was identified on axial TOF-MRV including the stage, degree, and location. Intraparenchymal infarction and haemorrhage were also noted with their stage and size. The distribution of values for ONSD was tested for equality of variances using independent samples t-test. A cut-off value for ONSD was derived using ROC analysis. Results The mean difference between ONSD of cases and controls was 0.84 mm (95% CI: 0.61-1.06) and was statistically significant at p < 0.001. Mean ONSD in cases was 5.33 ± 0.66, and in the control group it was 4.49 ± 0.31. The cut-off value for ONSD was taken as 4.57 mm, derived using the ROC analysis (AUC was 0.876 suggesting good diagnostic accuracy). ONSD showed a sensitivity of 87% and a negative predictive value of 89% in predicting CVST. However, we found no statistical significance between ONSD in patients with acute or chronic thrombosis or in those with neuroparenchymal complications. Conclusions ONSD is a valid triage tool with high sensitivity and negative predictive value, and it can be used in the evaluation of CVST.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e202 - e206"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46570491","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}
Transcutaneous laryngeal ultrasonography (TLUS) has become a cheap, convenient, and novel method in vocal fold (VF) assessment. The gold standard method of VF examination is laryngoscopy. It requires ear, nose, and throat specialist consultation and additional equipment. Moreover, laryngoscopy causes distress to patients, and during the COVID-19 pandemic it is a high-risk, aerosol-producing procedure. The aim of the paper was to review publications on the role of TLUS in VF evaluation. Considered aspects included VF visibility, factors affecting them, and different variables measured during TLUS examination. The visibility of VFs in TLUS ranged from 72.8 to 100%. Among men it was significantly lower (17-100%) in comparison to women (83-100%). All but 2 authors concluded that TLUS is a viable tool that can be an alternative to laryngoscopy in diagnosing VFs. Obesity, age, male gender, height, calcified thyroid, and incision close to the thyroid cartilage were independent factors for inaccessible vocal folds. VF displacement velocity (VFDV) is the most objective parameter measured by Doppler, and it is proportional to the velocity of the wave causing the vibrations of the VFs. After VF paralysis, this parameter is reduced. Valsalva manoeuvre, low-frequency transducer, and different transducer positions can improve images obtained on USG. TLUS in a majority of cases can adequately assess whether the function of the VFs is intact or paresis/paralysis has occurred. It is noninvasive and rapid, it adds no extra cost, and it can be a part of the preoperative examination of the thyroid gland. TLUS can usually be a convenient alternative to laryngoscopy.
{"title":"Transcutaneous laryngeal ultrasonography in vocal fold assessment before and after thyroid surgery in light of recent studies","authors":"Sylwia Wolff, Adam Gałązka, M. Dedecjus","doi":"10.5114/pjr.2022.115154","DOIUrl":"https://doi.org/10.5114/pjr.2022.115154","url":null,"abstract":"Transcutaneous laryngeal ultrasonography (TLUS) has become a cheap, convenient, and novel method in vocal fold (VF) assessment. The gold standard method of VF examination is laryngoscopy. It requires ear, nose, and throat specialist consultation and additional equipment. Moreover, laryngoscopy causes distress to patients, and during the COVID-19 pandemic it is a high-risk, aerosol-producing procedure. The aim of the paper was to review publications on the role of TLUS in VF evaluation. Considered aspects included VF visibility, factors affecting them, and different variables measured during TLUS examination. The visibility of VFs in TLUS ranged from 72.8 to 100%. Among men it was significantly lower (17-100%) in comparison to women (83-100%). All but 2 authors concluded that TLUS is a viable tool that can be an alternative to laryngoscopy in diagnosing VFs. Obesity, age, male gender, height, calcified thyroid, and incision close to the thyroid cartilage were independent factors for inaccessible vocal folds. VF displacement velocity (VFDV) is the most objective parameter measured by Doppler, and it is proportional to the velocity of the wave causing the vibrations of the VFs. After VF paralysis, this parameter is reduced. Valsalva manoeuvre, low-frequency transducer, and different transducer positions can improve images obtained on USG. TLUS in a majority of cases can adequately assess whether the function of the VFs is intact or paresis/paralysis has occurred. It is noninvasive and rapid, it adds no extra cost, and it can be a part of the preoperative examination of the thyroid gland. TLUS can usually be a convenient alternative to laryngoscopy.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e195 - e201"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48840601","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}
Being budding gynaecoradiologist, we read the article “The relationship between hysterosalpingography findings and female infertility in a Nigerian population” authored by Adedigba et al. with great interest [1]. In the current era of highly sophisticated imaging modalities like magnetic resonance imaging, bringing out the importance of a simple conventional imaging modality like hysterosalpingography (HSG), which is easy, cheap, and fairly informative, is worth appreciating. We commend the authors for their work. However, we have made a few observations that we would like to bring to the notice of the readers of this article. The authors observed tubal block to be the predominant cause of infertility in females, with cornual block being the commonest site. As the authors themselves state, due to unsafe abortions there is higher risk of pelvic infections in their population. Pelvic inflammatory disease usually affects the ampullary region, and hence this observation is contradictory. A possible explanation for this observation is the presence of cornual spasm or excessive cornual plugging. A study by Sulak et al. also observed that two-thirds of the resected tubes for cornual block did not reveal any tubal pathology and were probably due to cornual spasm or mucous plugging [2]. Another observation that the authors made was that tubal pathology was more common than other pathologies in infertile patients. This could partly be explained by the fact that HSG is inherently less sensitive in detecting ovarian, uterine, or cervical pathologies [3]. Hence one cannot draw conclusions based on the findings of HSG, and it should be confirmed with a cheap and simple investigation like transvaginal ultrasound. PID usually concomitantly affects the cervix or uterus along with the tubes because these are ascending infections; hence, treating only the tubal pathology without treating the ovarian/uterine pathology would not be beneficial. Although it was a retrospective study, it would have been interesting if the authors had commented on the outcome of the patients diagnosed with various pathologies on HSG, whether they underwent further investigation or laparoscopy or surgery, and whether these findings on HSG were also seen in other procedures. Without a gold standard, the results of a study could be fallacious.
{"title":"In response to the article “The relationship between hysterosalpingography findings and female infertility in a Nigerian population”. Pol J Radiol 2020; 85: e188-e195","authors":"Ankita Aggarwal, Neha Bagri","doi":"10.5114/pjr.2022.115153","DOIUrl":"https://doi.org/10.5114/pjr.2022.115153","url":null,"abstract":"Being budding gynaecoradiologist, we read the article “The relationship between hysterosalpingography findings and female infertility in a Nigerian population” authored by Adedigba et al. with great interest [1]. In the current era of highly sophisticated imaging modalities like magnetic resonance imaging, bringing out the importance of a simple conventional imaging modality like hysterosalpingography (HSG), which is easy, cheap, and fairly informative, is worth appreciating. We commend the authors for their work. However, we have made a few observations that we would like to bring to the notice of the readers of this article. The authors observed tubal block to be the predominant cause of infertility in females, with cornual block being the commonest site. As the authors themselves state, due to unsafe abortions there is higher risk of pelvic infections in their population. Pelvic inflammatory disease usually affects the ampullary region, and hence this observation is contradictory. A possible explanation for this observation is the presence of cornual spasm or excessive cornual plugging. A study by Sulak et al. also observed that two-thirds of the resected tubes for cornual block did not reveal any tubal pathology and were probably due to cornual spasm or mucous plugging [2]. Another observation that the authors made was that tubal pathology was more common than other pathologies in infertile patients. This could partly be explained by the fact that HSG is inherently less sensitive in detecting ovarian, uterine, or cervical pathologies [3]. Hence one cannot draw conclusions based on the findings of HSG, and it should be confirmed with a cheap and simple investigation like transvaginal ultrasound. PID usually concomitantly affects the cervix or uterus along with the tubes because these are ascending infections; hence, treating only the tubal pathology without treating the ovarian/uterine pathology would not be beneficial. Although it was a retrospective study, it would have been interesting if the authors had commented on the outcome of the patients diagnosed with various pathologies on HSG, whether they underwent further investigation or laparoscopy or surgery, and whether these findings on HSG were also seen in other procedures. Without a gold standard, the results of a study could be fallacious.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e194 - e194"},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46383184","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}
S. Salerno, M. Terranova, M. Anzelmo, A. Vinci, F. Vernuccio, G. Collura, M. Marrale, G. Re
Purpose The primary objective was to assess the frequency of appropriateness of computed tomography (CT) for acute abdominal pain (AAP) in the emergency department; the secondary aim was to compare the diagnostic accuracy of ultra-sound (US) and CT in the diagnosis of the aetiology of AAP for diseases that can be diagnosed by US; and the third objective was to assess extent to which inappropriate CT examinations for AAP result in ionizing radiation exposure. Material and methods In this retrospective single-centre study, we included patients aged between 15 and 46 years referred to the emergency department for AAP in 2016 and submitted to abdominal CT scans, collecting a total of 586 patients. In 152 patients with the more frequent pathologies, we compared the referral reason and current guidelines of the European Society of Radiology (ESR) IGUIDE®. Then we measured and compared the sensitivity of US and CT for the identification of the aetiology of AAP for diseases whose diagnosis can be reached by US. We also recorded the mean computed tomography dose index (CTDIvol), dose length product (DLP) and its standard deviation, and we calculated the effective dose (ED) using CT-Expo® software. Results According to IGUIDE and based on the clinical suspicion of CT requests, CT examination was considered crucial in 264 (45.05%) patients. 322 patients had a referral reason for CT scan that could be considered “possibly appropriate” according Iguide criteria (4, 5, 6 scoring). Of these, 135 had an inappropriate CT request according to image findings. Conclusions A better clinical framing and a correct interpretation of the reference guidelines could reduce unjustified exposure to ionizing radiation.
{"title":"Are we overusing abdominal computed tomography scans in young patients referred in an emergency for acute abdominal pain?","authors":"S. Salerno, M. Terranova, M. Anzelmo, A. Vinci, F. Vernuccio, G. Collura, M. Marrale, G. Re","doi":"10.5114/pjr.2022.115126","DOIUrl":"https://doi.org/10.5114/pjr.2022.115126","url":null,"abstract":"Purpose The primary objective was to assess the frequency of appropriateness of computed tomography (CT) for acute abdominal pain (AAP) in the emergency department; the secondary aim was to compare the diagnostic accuracy of ultra-sound (US) and CT in the diagnosis of the aetiology of AAP for diseases that can be diagnosed by US; and the third objective was to assess extent to which inappropriate CT examinations for AAP result in ionizing radiation exposure. Material and methods In this retrospective single-centre study, we included patients aged between 15 and 46 years referred to the emergency department for AAP in 2016 and submitted to abdominal CT scans, collecting a total of 586 patients. In 152 patients with the more frequent pathologies, we compared the referral reason and current guidelines of the European Society of Radiology (ESR) IGUIDE®. Then we measured and compared the sensitivity of US and CT for the identification of the aetiology of AAP for diseases whose diagnosis can be reached by US. We also recorded the mean computed tomography dose index (CTDIvol), dose length product (DLP) and its standard deviation, and we calculated the effective dose (ED) using CT-Expo® software. Results According to IGUIDE and based on the clinical suspicion of CT requests, CT examination was considered crucial in 264 (45.05%) patients. 322 patients had a referral reason for CT scan that could be considered “possibly appropriate” according Iguide criteria (4, 5, 6 scoring). Of these, 135 had an inappropriate CT request according to image findings. Conclusions A better clinical framing and a correct interpretation of the reference guidelines could reduce unjustified exposure to ionizing radiation.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e187 - e193"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43309906","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}
We read with interest the article entitled “The spectrum of imaging findings in pulmonary hydatid disease and the additive value of T2-weighted magnetic resonance imaging in its diagnosis” by Naseer et al. [1]. The authors described the spectrum of imaging findings in pulmonary echinococcosis and studied the additive value of T2-weighted magnetic resonance imaging (MRI) in the characterisation of pulmonary hydatid disease. They concluded that “Most of the pulmonary hydatid cysts can be diagnosed on computed tomography (CT); however, sometimes the findings may be indeterminate or atypical, leading to a diagnostic dilemma. MRI, owing to its ability to demonstrate hypointense endocyst, can act as a useful adjunct to correctly diagnose hydatid cyst or suggest an alternative diagnosis”. We wish to highlight that recent publications have highlighted the potential role of MRI as a radiationfree alternative to multidetector computed tomography (MDCT) for imaging in children, particularly those with different kinds of pulmonary infections and compromised immune systems [2-7]. Technological advances in MRI and faster acquisition sequences help in high-quality MRI of the lung [2-7]. Lung MRI has been reported to have higher diagnostic accuracy and sensitivity in the detection of pulmonary hydatids than computed tomography [2,3]. Sodhi et al. [2] prospectively investigated the diagnostic accuracy and added value of fast MRI in 28 children (5-17 years) for evaluating pulmonary hydatid disease by comparing MRI findings with MDCT findings. The combined total scanning time for all 4 MRI sequences used in this study was approximately 2-5 minutes only. The accuracy of fast MRI and MDCT for detecting pulmonary hydatid cysts was found to be 92.86%. There was no difference between fast MRI and MDCT for accurately detecting pulmonary hydatid cysts (p < 0.001). Internal membranes were detected in 11 of 28 patients (39.28%) with fast MRI, and in 3 of 28 patients (10.71%) with MDCT. Almost perfect interobserver agreement was present between the 2 independent reviewers (κ = 1). They concluded that fast MRI without intravenous contrast is comparable to MDCT for accurately detecting lung cysts in paediatric patients with pulmonary hydatid disease. However, fast MRI provided a 28.6% increase in added diagnostic value by showing internal membranes of cysts, which are specific to pulmonary hydatid disease. Therefore, fast MRI should be considered in lieu of MDCT as a primary problem-solving radiation-free imaging modality after initial chest radiography in paediatric patients with clinically suspected pulmonary hydatid disease.
{"title":"Lung magnetic resonance imaging in pulmonary hydatid in children","authors":"K. Sodhi, A. Bhatia, A. Saxena","doi":"10.5114/pjr.2022.115123","DOIUrl":"https://doi.org/10.5114/pjr.2022.115123","url":null,"abstract":"We read with interest the article entitled “The spectrum of imaging findings in pulmonary hydatid disease and the additive value of T2-weighted magnetic resonance imaging in its diagnosis” by Naseer et al. [1]. The authors described the spectrum of imaging findings in pulmonary echinococcosis and studied the additive value of T2-weighted magnetic resonance imaging (MRI) in the characterisation of pulmonary hydatid disease. They concluded that “Most of the pulmonary hydatid cysts can be diagnosed on computed tomography (CT); however, sometimes the findings may be indeterminate or atypical, leading to a diagnostic dilemma. MRI, owing to its ability to demonstrate hypointense endocyst, can act as a useful adjunct to correctly diagnose hydatid cyst or suggest an alternative diagnosis”. We wish to highlight that recent publications have highlighted the potential role of MRI as a radiationfree alternative to multidetector computed tomography (MDCT) for imaging in children, particularly those with different kinds of pulmonary infections and compromised immune systems [2-7]. Technological advances in MRI and faster acquisition sequences help in high-quality MRI of the lung [2-7]. Lung MRI has been reported to have higher diagnostic accuracy and sensitivity in the detection of pulmonary hydatids than computed tomography [2,3]. Sodhi et al. [2] prospectively investigated the diagnostic accuracy and added value of fast MRI in 28 children (5-17 years) for evaluating pulmonary hydatid disease by comparing MRI findings with MDCT findings. The combined total scanning time for all 4 MRI sequences used in this study was approximately 2-5 minutes only. The accuracy of fast MRI and MDCT for detecting pulmonary hydatid cysts was found to be 92.86%. There was no difference between fast MRI and MDCT for accurately detecting pulmonary hydatid cysts (p < 0.001). Internal membranes were detected in 11 of 28 patients (39.28%) with fast MRI, and in 3 of 28 patients (10.71%) with MDCT. Almost perfect interobserver agreement was present between the 2 independent reviewers (κ = 1). They concluded that fast MRI without intravenous contrast is comparable to MDCT for accurately detecting lung cysts in paediatric patients with pulmonary hydatid disease. However, fast MRI provided a 28.6% increase in added diagnostic value by showing internal membranes of cysts, which are specific to pulmonary hydatid disease. Therefore, fast MRI should be considered in lieu of MDCT as a primary problem-solving radiation-free imaging modality after initial chest radiography in paediatric patients with clinically suspected pulmonary hydatid disease.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e186 - e186"},"PeriodicalIF":0.0,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46463551","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}
Dyssynergic defecation (DD) is defined as paradoxical contraction or inadequate relaxation of the pelvic floor muscles during defecation, which causes functional constipation. Along with the anal manometry and balloon expulsion tests, magnetic resonance (MR) defecography is widely used to diagnose or rule out pelvic dyssynergia. Besides the functional abnormality, structural pathologies like rectocele, rectal intussusception, or rectal prolapse accompanying DD can also be well demonstrated by MR defecography. This examination can be an uncomfortable experience for the patient, so the imaging method and the importance of patient cooperation must be explained in detail. The defecatory phase of the examination is indispensable for evaluation, and inadequate effort should be ruled out before diagnosing DD. MR defecography provides important data for the diagnosis of DD, but optimal imaging criteria should be applied. Further tests can be suggested if patient co-operation is not sufficient or MR defecography findings are irrelevant.
{"title":"Magnetic resonance defecography findings of dyssynergic defecation","authors":"N. Haliloğlu, A. Erden","doi":"10.5114/pjr.2022.114866","DOIUrl":"https://doi.org/10.5114/pjr.2022.114866","url":null,"abstract":"Dyssynergic defecation (DD) is defined as paradoxical contraction or inadequate relaxation of the pelvic floor muscles during defecation, which causes functional constipation. Along with the anal manometry and balloon expulsion tests, magnetic resonance (MR) defecography is widely used to diagnose or rule out pelvic dyssynergia. Besides the functional abnormality, structural pathologies like rectocele, rectal intussusception, or rectal prolapse accompanying DD can also be well demonstrated by MR defecography. This examination can be an uncomfortable experience for the patient, so the imaging method and the importance of patient cooperation must be explained in detail. The defecatory phase of the examination is indispensable for evaluation, and inadequate effort should be ruled out before diagnosing DD. MR defecography provides important data for the diagnosis of DD, but optimal imaging criteria should be applied. Further tests can be suggested if patient co-operation is not sufficient or MR defecography findings are irrelevant.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e181 - e185"},"PeriodicalIF":0.0,"publicationDate":"2022-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49477396","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}
Takuya Mori, Hidenori Mitani, Keigo Chosa, W. Fukumoto, Y. Baba, K. Awai
Purpose Computed tomography (CT)-guided percutaneous drainage has been used to address pelvic abscesses because it is safe and minimally invasive. However, CT-guided drainage has the limitation that the puncture route should be on the same axial slice. A technique for puncturing in the cranio-caudal direction under CT fluoroscopy is needed. Case report An 82-year-old man with an abscess due to rectal cancer was scheduled for CT-guided drainage to improve his general condition before radical surgery. Drainage was performed via a perineal approach to localize the drainage tract in the resection area to avoid dissemination of cancer cells. To perform a puncture in the cranio-caudal direction we controlled the needle like a joystick and advanced it under CT fluoroscopy while moving the CT gantry cranially to follow the needle tip throughout the puncture. Our unique technique yielded successful CT-guided puncture in the cranio-caudal direction. Conclusions Our unique technique overcomes the limitations of CT-guided cranio-caudal puncture and may allow the drainage of abscesses whose treatment was heretofore difficult.
{"title":"Cranio-caudal puncture with computed tomography-guided drainage of a deep pelvic abscess","authors":"Takuya Mori, Hidenori Mitani, Keigo Chosa, W. Fukumoto, Y. Baba, K. Awai","doi":"10.5114/pjr.2022.114864","DOIUrl":"https://doi.org/10.5114/pjr.2022.114864","url":null,"abstract":"Purpose Computed tomography (CT)-guided percutaneous drainage has been used to address pelvic abscesses because it is safe and minimally invasive. However, CT-guided drainage has the limitation that the puncture route should be on the same axial slice. A technique for puncturing in the cranio-caudal direction under CT fluoroscopy is needed. Case report An 82-year-old man with an abscess due to rectal cancer was scheduled for CT-guided drainage to improve his general condition before radical surgery. Drainage was performed via a perineal approach to localize the drainage tract in the resection area to avoid dissemination of cancer cells. To perform a puncture in the cranio-caudal direction we controlled the needle like a joystick and advanced it under CT fluoroscopy while moving the CT gantry cranially to follow the needle tip throughout the puncture. Our unique technique yielded successful CT-guided puncture in the cranio-caudal direction. Conclusions Our unique technique overcomes the limitations of CT-guided cranio-caudal puncture and may allow the drainage of abscesses whose treatment was heretofore difficult.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e177 - e180"},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46721079","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}
S. Shalini, V. Arunachalam, R. Varatharajaperumal, P. Mehta, T. S., M. Cherian
Purpose The aim of our study was to prospectively evaluate the role of third-generation, dual-source, dual-energy computed tomography (DECT) in the characterization of renal calculi, with ex vivo renal stone evaluation using Fourier transform infrared spectroscopy (IS) as the reference standard. Material and methods In our study 50 patients with history suggestive of renal calculi were subjected to DECT using 100 kVp and Sn150 kVp. With DECT, renal stone attenuation at low and high kVp was attained, and the attenuation ratios were measured. The result of DECT was compared with IS to identify the chemical composition of the extracted renal stones. IBM SPSS version 22 was used for statistical analysis. Results In our study, the mean attenuation ratio of the renal stone was 1.57 ± 0.25. Out of 50 patients, the stones of 39 patients were predicted as calcium-containing stones, in 4 patients as cystine stones, and in 7 as uric acid stones on DECT. In IS analysis, 43 patients had calcium-containing stones, and 7 patients had uric acid stones. The accuracy rate of DECT for detecting calcium and uric acid stones in our study were 90% and 100%, respectively. The positive predictive value for the DECT to assess the chemical composition of renal calculi was found to be 92%. Conclusions Third-generation DECT scan had 100% accuracy in differentiating uric acid stones from non-uric acid stones in our study. Because the treatment is different for different chemical compositions of stones, identification of specific chemical components is very important, and it can be accurately done by DECT.
{"title":"The role of third-generation dual-source dual-energy computed tomography in characterizing the composition of renal stones with infrared spectroscopy as the reference standard","authors":"S. Shalini, V. Arunachalam, R. Varatharajaperumal, P. Mehta, T. S., M. Cherian","doi":"10.5114/pjr.2022.114841","DOIUrl":"https://doi.org/10.5114/pjr.2022.114841","url":null,"abstract":"Purpose The aim of our study was to prospectively evaluate the role of third-generation, dual-source, dual-energy computed tomography (DECT) in the characterization of renal calculi, with ex vivo renal stone evaluation using Fourier transform infrared spectroscopy (IS) as the reference standard. Material and methods In our study 50 patients with history suggestive of renal calculi were subjected to DECT using 100 kVp and Sn150 kVp. With DECT, renal stone attenuation at low and high kVp was attained, and the attenuation ratios were measured. The result of DECT was compared with IS to identify the chemical composition of the extracted renal stones. IBM SPSS version 22 was used for statistical analysis. Results In our study, the mean attenuation ratio of the renal stone was 1.57 ± 0.25. Out of 50 patients, the stones of 39 patients were predicted as calcium-containing stones, in 4 patients as cystine stones, and in 7 as uric acid stones on DECT. In IS analysis, 43 patients had calcium-containing stones, and 7 patients had uric acid stones. The accuracy rate of DECT for detecting calcium and uric acid stones in our study were 90% and 100%, respectively. The positive predictive value for the DECT to assess the chemical composition of renal calculi was found to be 92%. Conclusions Third-generation DECT scan had 100% accuracy in differentiating uric acid stones from non-uric acid stones in our study. Because the treatment is different for different chemical compositions of stones, identification of specific chemical components is very important, and it can be accurately done by DECT.","PeriodicalId":94174,"journal":{"name":"Polish journal of radiology","volume":"87 1","pages":"e172 - e176"},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48569531","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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