Journals RSS : Gourt

Osteoid osteoma of the odontoid process of the axis associated with atlanto-axial fusion

Cystic meningioangiomatosis in neurofibromatosis type 2: an MRIpathological study

Multiple gastrointestinal stromal tumours presenting as a haemoperitoneum in a patient with Type 1 neurofibromatosis: MDCT findings

Postural change in ventilation and perfusion secondary to a thoracic scoliosis with complete resolution after surgery

Left-sided gallbladder: a complicated percutaneous cholecystostomy and subsequent hepatic embolisation

Ultrasound and CT findings in hepatic and pancreatic parenchyma in acute schistosomiasis

CT lung cancer screening in the UK

One-dimensional quantitative evaluation of peripheral lung adenocarcinoma with or without ground-glass opacity on thin-section CT images using profile curves

Use of high-resolution MRI of the optic nerve in Graves ophthalmopathy

Three-day regimen improves faecal tagging for minimal preparation CT examination of the colon

Specific hippocampal choline decrease in an animal model of depression

Rheumatoid arthritis: a novel radiographic projection for hand assessment

320-slice CT neuroimaging: initial clinical experience and image quality evaluation

Nephrostomy insertion for patients with bilateral ureteric obstruction caused by prostate cancer

Estimation of organ and effective doses resulting from cone beam CT imaging for radiotherapy treatment planning

Pre-trial quality assurance processes for an intensity-modulated radiation therapy IMRT trial: PARSPORT, a UK multicentre Phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer

Anatomical, clinical and radiological delineation of target volumes in breast cancer radiotherapy planning: individual variability, questions and answers

Bivariate meta-analysis of sensitivity and specificity of radiographers plain radiograph reporting in clinical practice

Liposoluble antioxidants provide an effective radioprotective barrier

Differential diagnosis of hyperintense cerebrospinal fluid on fluid-attenuated inversion recovery images of the brain. Part II: non-pathological conditions

Letter to the editor concerning 320-slice CT neuroimaging: initial clinical experience and image quality evaluation Siebert E et al: Br J Radiol 2009;82:56170

Multidetector Computed Tomography of the Acute Abdomen in the Immunocompromised Host: A Pictorial Review

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 145-155Simon P., Spencer , Niall, Power , Rodney H., ReznekImmunocompromised patients include those receiving chemotherapy for malignant disease, post-transplant patients, patients with acquired immunodeficiency syndrome (AIDS), and those receiving steroids for autoimmune diseases. Advances in transplantation, oncology, and the treatment of AIDS have extended these patients' life expectancies and thereby increased the immunocompromised population. Classical clinical signs of abdominal sepsis may be absent in the immunocompromised host. Consequently, the radiologist is increasingly called on to diagnose specific acute intra-abdominal complications associated with immunodeficiency. This review describes the etiology of the acute abdomen in this heterogeneous group of immunocompromised patients, causes including opportunistic infections, neutropenic enterocolitis, complications of therapy, and...

Positron Emission Tomography/Computed Tomography Potential Pitfalls and Artifacts

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 156-169Xia, Wang , Spencer, KochWith the recent use of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) for tumor staging and treatment response, it is important to recognize many pitfalls, artifacts, and benign uptakes that are commonly encountered. Normal physiology can explain many regions of increased FDG activity, as well as incidental benign tumors and benign metabolic conditions. Recognition of characterization of benign causes and physiologic variants for FDG uptake are discussed to avoid improper characterization as a malignancy. A basic understanding of PET/computed tomographic physics is also discussed, in relation to attenuation correction artifacts caused by metallic implants and contrast agents in the gastrointestinal tract,...

Diagnosis and Management of Pseudoaneurysms: An Update

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 170-188Baljendra S., Kapoor , Heather L., Haddad , Souheil, Saddekni , Mark E., Lockhart“Pseudoaneurysm” is a term that describes disruption of an artery with patent flow in a defined space beyond the confines of the vessels. A pseudoaneurysm can involve any vascular bed and is usually associated with direct arterial injury or erosion of an artery by an adjacent tumor or inflammation. In this article, we discuss different clinical settings and various imaging modalities such as ultrasound, computerized tomography, magnetic resonance imaging, as well as conventional angiography used for the diagnosis of pseudoaneurysms. We also describe the role of newer endovascular, percutaneous, and traditional surgical approaches for the treatment of visceral and peripheral...

The Great Mimicker: Fat Necrosis of the Breast—Magnetic Resonance Mammography Approach

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 189-197Sergi, Ganau , Lidia, Tortajada , Fernanda, Escribano , Xavier, Andreu , Melcior, SentísFat necrosis of the breast is a common benign inflammatory process resulting from injury to breast fat. The pathogenesis of fat necrosis helps to explain its imaging features, which range from benign to malignant-appearing findings. This article reviews the role of magnetic resonance mammography and other conventional imaging techniques in the differential diagnosis of fat necrosis.

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Page IBCM., De la Sen

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Page OBC[No author name available]

Multidetector Computed Tomography of the Acute Abdomen in the Immunocompromised Host: A Pictorial Review

Positron Emission Tomography/Computed Tomography Potential Pitfalls and Artifacts

Diagnosis and Management of Pseudoaneurysms: An Update

The Great Mimicker: Fat Necrosis of the Breast—Magnetic Resonance Mammography Approach

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Page OBC[No author name available]

Computed Tomographic Appearance of Chest Ports and Catheters: A Pictorial Review for Noninterventional Radiologists

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 99-110Maria Lourdes, Díaz , Alberto, Villanueva , Maria Jose, Herraiz , Jose Juan, Noguera , Alberto, Alonso-Burgos , ...Medical practice has expanded the need for long-term central venous catheterization. Chest ports play an important role in the management of oncology patients who need frequent blood products, chemotherapy, and other intravenous drugs. Imaging-guided placement of chest ports and catheters (CR) is a safe and efficacious procedure. Moreover, many cases of catheter-induced central thrombosis go unrecognized, but the incidence of pulmonary embolism in this group may be as high as 12%. Multi-detector computed tomography represents the main imaging method in the follow-up of oncologic patients. We review the radiologic features, mainly on multi-detector computed tomography, of CR commonly used for...

Ultrasound of Wrist Pain

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 111-125Srinivasan, Harish , John, O'Neill , Karen, Finlay , Erik, Jurriaans , Lawrence, FriedmanUltrasound is a valuable imaging modality for evaluation of patients presenting with wrist pain. An important advantage is the ability to correlate the site of pain or discomfort with the underlying sonographic appearance. The capacity to dynamically assess the wrist and use the contralateral asymptomatic wrist for comparison purposes are strengths of ultrasound as a diagnostic tool. This pictorial review deals with the sonographic assessment of the commonly encountered wrist pathologies.

Magnetic Resonance Imaging of the Liver and Biliary Tree in Children

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 126-134Pedro A.B., Albuquerque , D. Alicia, Morales Ramos , Ricardo, FaingoldMagnetic resonance imaging (MRI) is a great modality for the assessment of the liver and biliary tree in the pediatric population. In this review, we illustrate and discuss MRI technique and a variety of congenital abnormalities and acquired conditions including infectious, inflammatory, metabolic, benign, and malignant processes. The role of magnetic resonance angiography and magnetic resonance venography is discussed in hepatic tumors and portal hypertension. Magnetic resonance cholangiopancreatography protocol is also addressed. Although ultrasound remains a screening tool and computer tomography is readily available, MRI accurately depicts the pathology, leading to a better understanding of the disease process with optimal...

Radiofrequency and Microwave Ablation of the Liver, Lung, Kidney, and Bone: What Are the Differences?

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 135-143Christopher L., BraceRadiofrequency (RF) ablation is becoming an accepted treatment modality for many tumors of the liver and is being explored for tumors in the lung, kidney, and bone. While RF energy is the most familiar heat source for tissue ablation, it has certain limitations that may hamper its efficacy in these new organ systems. Microwave energy may be a better source for tissue ablation but has technical hurdles that must be overcome as well. This article outlines the physics behind RF and microwave heating, discusses relevant properties of the liver, lung, kidney, and bone for thermal ablation and examines the roles...

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Page OBC[No author name available]

Technical Essentials of Hepatic Doppler Sonography

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 53-60Min Ju, Kim , Kyoung Won, Kim , So Yeon, Kim , Jeong Kon, Kim , Hyung Jin, Won , ...Doppler ultrasound is an important diagnostic tool for detecting hepatic vascular abnormalities, especially following liver transplantation. Doppler ultrasound has an advantage over computed tomography or other imaging modalities in that it is noninvasive, can be used intraoperatively or immediately postoperatively at the patient's bedside, and is free from radiation hazard. Doppler ultrasound is also sensitive to very slow flow and is not limited by an optimal temporal window because it is a real-time examination. However, this examination is highly operator-dependent. For a proper evaluation of patient hemodynamic status, optimization of Doppler parameters and liberal use of spectral analysis will help...

Microwave Ablation Technology: What Every User Should Know

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 61-67Christopher L., BraceMicrowave ablation is a relatively new technology under development and testing to treat the same types of cancer that can be treated with radiofrequency ablation. Microwave energy has several possible benefits over radiofrequency energy for tumor ablation but, because clinical microwave ablation systems are not widespread, the underlying principles and technologies may not be as familiar. The basic microwave ablation system contains many of the same components as a radiofrequency ablation system: a generator, a power distribution system, and an interstitial applicator. This article attempts to provide an overview of each of these components, outline their functions and roles, and...

Practical Applications of Nuclear Medicine in Imaging Breast Cancer

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 68-83Ba.D., Nguyen , Michael C., Roarke , Patricia J., Karstaedt , Christian J., Ingui , Panol C., RamThe rise in incidence, morbidity, and mortality of breast cancer has triggered multiple imaging efforts to detect this malignancy early, stage it accurately, and monitor it with precision in the posttherapeutic course. Among different imaging modalities, nuclear medicine provides an important contribution to the clinical management of breast cancer. This article discusses four practical applications based on the use of radionuclides in the evaluation of breast malignancy, focusing on scintimammography, preoperative tumor localization procedure using radioactive seeds, sentinel nodal scintigraphy, and F-18 fluorodeoxyglucose positron emission tomography/computed tomography.

Multidetector Computed Tomography of the Mesocolon: Review of Anatomy and Pathology

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 84-90Iswaran, Ramachandran , Peter, Rodgers , Moshier, Elabassy , Rakesh, SinhaThe anatomy of the mesocolon can be seen on multidetector computed tomography (MDCT) scans, and its most important anatomic landmarks are the mesocolic vessels. The high spatial resolution of the current generation scanner coupled with the ability to generate high quality multiplanar images is very helpful in the delineation of the mesocolon. These vessels include the ileocolic and right colic vessels for the ascending mesocolon, the middle colic vessels for the transverse mesocolon, and the inferior mesenteric vein for the sigmoid and descending mesocolon. Knowledge of the anatomic landmarks of the mesocolon can help the radiologist identify the pathways for...

Magnetic Resonance Arthrography of Superior Labrum Anterior-Posterior Lesions: A Practical Approach to Interpretation

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 91-97Eugene, LinSuperior labrum anterior and posterior (SLAP) lesions are well-evaluated with magnetic resonance (MR) arthography. This article discusses a practical approach to interpretation of MR arthrography exams for the evaluation of suspected SLAP lesions.

Issues in Imaging Malignant Neoplasms of the Female Reproductive System

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 1-16Nagaraj-Setty, Holalkere , Avinash M., Katur , Susanna I., LeeRadiological evaluation of malignant neoplasms of the female reproductive system is invaluable in the initial diagnosis, staging, treatment planning, and follow-up management. Radiologists serving as consultants for the general primary care internist, gynecologists, and specialists in gynecologic oncology should be familiar with the strengths and limitations of various modalities used to evaluate gynecologic cancer patients. This article discusses the most common female reproductive tract neoplasms (ie, cervical, endometrial, and ovarian cancers) and the role of ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography in their diagnosis and management. Imaging features that impact on clinical diagnostic or treatment algorithms...

Pharyngeal Dysphagia: What the Radiologist Needs to Know

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 17-32Patrick D., Grant , Desiree E., Morgan , Francis J., Scholz , Cheri L., CanonDysphagia is defined as difficulty in swallowing. Oropharyngeal dysphagia is defined as difficulty in moving the bolus from the mouth to the esophagus. The best initial evaluation of suspected oropharyngeal dysphagia is a barium study which can evaluate motility of the oropharynx and hypopharynx and provide double-contrast views that may identify structural or mucosal abnormalities. Pharyngeal diverticula, Zenker's and Killian–Jamieson diverticula, and pharyngeal pouches are readily identified on these studies. Zenker's diverticula are the commonest diverticulum implicated in pharyngeal dysphagia and typically occur in the setting of cricopharyngeal dysfunction. The radiologist must not only diagnose these diverticula but also understand...

Vascular Closure Devices: A Comparative Overview

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 33-43Lye-Quen, Hon , Arul, Ganeshan , Steven Mark, Thomas , Dinuke, Warakaulle , Jagalpathy, Jagdish , ...The use of closure devices is widespread and becoming more common. Radiologists performing arterial access procedures should be aware of when and how to use them, as well as the advantages and disadvantages of various devices, and any complications that may occur. This review intends to provide an overview of these devices, focusing on how they work, their efficacy in achieving hemostasis, any risks associated with their use, and our view as to which should be used for particular indications. There are three main categories of vascular closure devices: collagen based, suture based, and staples and clips. Newer generation devices...

Radiofrequency Ablation of Lung Lesions: Practical Applications and Tips

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 44-52A. Molly, Roy , Clare, Bent , Tim, FotheringhamRadiofrequency ablation (RFA) therapy is a minimally invasive technique that can be used in the management of inoperable non-small-cell lung cancer and for palliation in selected patients with pulmonary metastases. Surgical resection remains the gold standard of treatment; however, many patients are ineligible due to comorbidities or poor cardiopulmonary reserve. Others may simply decline radical surgical intervention. Alternative treatment options are limited mainly to chemotherapy and external beam radiation. With the development of RFA, a new promising technique has evolved that can be offered to many, as an alternative choice or as part of combination therapy. The published results of...

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Page OBC[No author name available]

Magnetic Resonance Imaging Features of the Discrete Epiphyseal Radiolucency: A Problem-Solving Approach to Differential Diagnosis

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 6, November-December 2008, Pages 243-261José M., Mellado , Jenny T., Bencardino , Laura, Pérez del PalomarDiscrete radiolucencies in the epiphysis of the long bones may be a major radiographic finding in many arthropathies and synovial-based processes, and also in various osteolytic tumors and tumor-like lesions. In addition, a number of miscellaneous bone disorders, particularly infection and avascular necrosis, may present as discrete epiphyseal radiolucencies. Magnetic resonance imaging is frequently used in the diagnostic workup of these lesions. Our purpose was to review and illustrate, in a problem-solving approach, the potential contributions of magnetic resonance imaging in the characterization of discrete epiphyseal radiolucent lesions.

Computed Tomography and Magnetic Resonance Imaging Features of Lesions of the Renal Medulla and Sinus

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 6, November-December 2008, Pages 262-278Paul, Nikolaidis , Helena, Gabriel , Kathleen, Khong , Michael, Brusco , Nancy, Hammond , ...The kidneys can harbor a wide variety of lesions, many of which can be visualized by computed tomography and magnetic resonance imaging. In this article, the pertinent renal anatomic relationships as well as the histologic composition and function of the renal medulla and sinus are reviewed. Additionally, computed tomography and magnetic resonance imaging features of renal sinus and medullary lesions in adult patients are presented. This article reviews the salient imaging features of various malignant, benign neoplastic, and nonneoplastic lesions of the sinus and medulla.

Computed Tomographic Enterography and Enteroclysis: Pearls and Pitfalls

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 6, November-December 2008, Pages 279-287Hetal, Dave-Verma , Scott, Moore , Ajay, Singh , Noel, Martins , John, ZawackiComputed tomographic (CT) enterography and enteroclysis improve visualization of the small bowel mucosa and wall in comparison with traditional CT and fluoroscopic studies by distending the small bowel through enteric hyperhydration with a negative contrast agent. Although CT enterography is performed with oral hyperhydration, CT enteroclysis requires the placement of an enteroclysis tube, often in patients who are unable to orally consume the amount of liquid. When tolerated, CT enterography is often preferred due to its lack of invasiveness. Magnetic resonance enterography and enteroclysis are other modalities that are still being studied and show promise in the imaging of small...

Editorial Board

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page IFC[No author name available]

Information for Readers

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page i[No author name available]

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page ii[No author name available]

More Than Just Stones: A Pictorial Review of Common and Less Common Gallbladder Pathologies

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 189-202Janice, Ash-Miles , Huw, Roach , Jim, Virjee , Mark, CallawayAlthough stone disease is by far the most commonly encountered pathology of the gallbladder, there are several other important disease processes affecting it. These include adenomyomatosis, cholesterolosis, polyps, porcelain gallbladder, acalculous cholecystitis, xanthogranulomatous cholecystitis, emphysematous cholecystitis, gallbladder cancer, and gallbladder hemorrhage. The purpose of this article was to review the different gallbladder pathologies encountered in everyday radiological practice and to describe their features in the standard imaging modalities.

Ultrasound-Guided Therapeutic Procedures in the Musculoskeletal System

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 203-218Jose Luis, del CuraUltrasound allows the exploration of most of the musculoskeletal system, including lytic bone lesions. Its flexibility, availability, and low cost make it the best tool to guide interventional therapeutic procedures in any musculoskeletal system lesion visible on ultrasound. These techniques include drainages of abscesses, bursitis, hematomas or muscular strains, treatment of cystic lesions (ganglions, Baker's cysts), arthrocentesis, injection of substances in joints and soft tissues, and aspiration of calcific tendinitis. Although the puncture of joints for arthrocentesis and injection of substances are performed by clinicians using palpation, the use of ultrasound guidance improves the effectiveness of the technique especially for...

Ultrasound of Muscle

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 219-230Marianna, Vlychou , James, TehThis pictorial review illustrates the ultrasound appearances of pathological conditions affecting muscle with particular emphasis on extended field-of-view imaging.

Magnetic Resonance Imaging Findings of Golf-Related Injuries

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 231-241Joseph, Sutcliffe , Justin Q., Ly , Amy, Kirby , Douglas P., BeallInjuries related to participation in golf are becoming more common given the increasing popularity of the sport itself. Golf is considered to be an activity associated with a moderate risk for sports injuries. Golf injuries are usually attributable to overuse or traumatic mechanisms and primarily occur at the elbow, wrist, shoulder, and lumbar spine. None of these injuries are unique to golf, but each of these injuries represent the most common injuries associated with golfing. This article reviews a wide range of injuries that are encountered in golfers and describes the magnetic resonance imaging findings of each of these injuries.

Upcoming Articles

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page IBC[No author name available]

In Recent Issues

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page OBC[No author name available]

Editorial Board

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Page IFC[No author name available]

Information for Readers

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Page i[No author name available]

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Page ii[No author name available]

Magnetic Resonance Imaging of Cystic Adnexal Lesions During Pregnancy

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Pages 139-144Aytekin, Oto , Randy, Ernst , Mary K., Jesse , George, SaadeManagement of cystic adnexal lesions diagnosed during pregnancy is a challenging issue for obstetricians. The range of treatment options changes from immediate surgery to close follow-up. This pictorial essay illustrates the magnetic resonance imaging findings of various cystic adnexal lesions in pregnant patients. Magnetic resonance imaging may help in better characterization of some of the cystic adnexal lesions diagnosed during pregnancy without exposing the fetus to ionizing radiation.

Uncommon Tumors and Pseudotumoral Lesions of the Pancreas

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Pages 145-164Carmen, de Juan , Marcelo, Sanchez , Rosa, Miquel , Mario, Pages , Juan Ramon, Ayuso , ...Ductal adenocarcinoma is the most common tumor of the pancreas, accounting for about 80% of all pancreatic tumors. The other 20% of pancreatic tumors is represented by a heterogeneous group of pancreatic neoplasms that includes cystic pancreatic neoplasms, islet cell tumors, and the so-called rare pancreatic tumors. In addition, the pancreatic gland may present a variety of inflammatory and pseudotumoral lesions that may mimic a primary pancreatic neoplasm. These uncommon tumors and pseudotumoral lesions present a wide spectrum of imaging findings and they are often poorly understood by the radiologist, becoming a diagnostic challenge. Some of these lesions may show...

Imaging Evaluation of Complications at Optical Colonoscopy

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Pages 165-177David H., Kim , Perry J., Pickhardt , Andrew J., Taylor , Christine O., MeniasOptical colonoscopy (OC) is an essential component of colorectal cancer screening. In addition to favorable polyp detection capabilities, OC has a unique therapeutic role with the ability to remove identified polyps. However, this procedure carries a low but real risk for morbidity and mortality. OC requires physical intubation of the length of the colon and manipulation of the instrument. In addition, the performance of therapeutic polyp removal increases risk. Inherent to this procedure are several pathways for potential adverse events. Complications can be divided into several major categories including perforation, hemorrhage, postpolypectomy syndromes, and issues related to sedation. The imaging...

Fluorine-18-Deoxyglucose–Positron Emission Tomography Imaging with Magnetic Resonance and Computed Tomographic Correlation in the Evaluation of Bone and Soft-Tissue Sarcomas: A Pictorial Essay

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Pages 178-188Joanna N., Tewfik , Gary S., GreenePositron emission tomography (PET) imaging has a growing role as an imaging modality to be used in conjunction with magnetic resonance and computed tomographic imaging in the detection, staging, and management of many sarcomas and carcinomas. Since PET is a relatively new modality and the incidence of sarcomas is low, it has not yet been approved for use in all bone and soft-tissue sarcomas. The purpose of this article is to pictorially evaluate soft-tissue and bone sarcomas, including malignant peripheral nerve sheath tumor, synovial sarcoma, osteosarcoma, liposarcoma, rhabdomyosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and myxofibrosarcoma. This pictorial essay illustrates and describes...

Upcoming Articles

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Page IBC[No author name available]

In Recent Issues

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 4, July-August 2008, Page OBC[No author name available]

CT "invisible" lesion of the major salivary glands a diagnostic pitfall of contrast-enhanced CT.

Related Articles CT "invisible" lesion of the major salivary glands a diagnostic pitfall of contrast-enhanced CT. Clin Radiol. 2009 Jul;64(7):744-6 Authors: Kei PL, Tan TY PMID: 19520223 [PubMed - in process]

Unusual unilateral breast (131)I uptake related to breastfeeding practice.

Related Articles Unusual unilateral breast (131)I uptake related to breastfeeding practice. Clin Radiol. 2009 Jul;64(7):743-4 Authors: Basu S, Moghe SH PMID: 19520222 [PubMed - in process]

Re: Imaging appearances and endovascular management of uncommon pseudoaneurysms.

Related Articles Re: Imaging appearances and endovascular management of uncommon pseudoaneurysms. Clin Radiol. 2009 Jul;64(7):742-3 Authors: Ward E, Killeen RP, Doody O, Torreggiani WC PMID: 19520221 [PubMed - in process]

Radiology in the gross health context: need for prevention?

Related Articles Radiology in the gross health context: need for prevention? Clin Radiol. 2009 Jul;64(7):741-2 Authors: Vehmas T PMID: 19520220 [PubMed - in process]

Case report: a case of subclavius posticus muscle mimicking a mass on mammogram.

Related Articles Case report: a case of subclavius posticus muscle mimicking a mass on mammogram. Clin Radiol. 2009 Jul;64(7):738-40 Authors: Kolpattil S, Harland R, Temperley D PMID: 19520219 [PubMed - in process]

Case report: ectopic pancreas with pseudocyst and pseudoaneurysm formation.

Related Articles Case report: ectopic pancreas with pseudocyst and pseudoaneurysm formation. Clin Radiol. 2009 Jul;64(7):734-7 Authors: Surov A, Hainz M, Hinz L, Holzhausen HJ, Finke R, Spielmann RP, Kunze C Ectopic pancreas is a rare congenital anomaly. It is usually asymptomatic, or presents with non specific gastrointestinal symptoms. We describe here a case of ectopic pancreas in the gastric antrum, with pseudocyst and pseudoaneurysm formation. This entity has not been reported previously in the literature. PMID: 19520218 [PubMed - in process]

Imaging of the gastrointestinal complications of systemic chemotherapy.

Related Articles Imaging of the gastrointestinal complications of systemic chemotherapy. Clin Radiol. 2009 Jul;64(7):724-33 Authors: Cronin CG, O'Connor M, Lohan DG, Keane M, Roche C, Bruzzi JF, Murphy JM Gastrointestinal complications of chemotherapy may be serious and potentially life-threatening. Familiarity with and awareness of the potential complications associated with various chemotherapeutic agents/regimens is paramount to enable accurate and timely diagnosis. In this article we review the radiological manifestations of the most notable gastrointestinal complications associated with chemotherapeutic administration. PMID: 19520217 [PubMed - in process]

Pancreas transplants.

Related Articles Pancreas transplants. Clin Radiol. 2009 Jul;64(7):714-23 Authors: Chandra J, Phillips RR, Boardman P, Gleeson FV, Anderson EM Cadaveric, whole pancreas transplantation has proved an effective therapy in the treatment of long-standing type 1 diabetes mellitus and is capable of achieving an insulin-independent eugyclaemic state. As a result, this procedure is being increasingly performed. However, the surgical procedure is complex and unfamiliar to many radiologists. Imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gives excellent results and can be used confidently to diagnose vascular, enteric, and immune-mediated complications. We present a review of the normal post-transplantation appearance and the features of early and late complications. PMID: 19520216 [PubMed - in process]

Evaluation of the incidence of nephrogenic systemic fibrosis in patients with moderate renal insufficiency administered gadobenate dimeglumine for MRI.

Related Articles Evaluation of the incidence of nephrogenic systemic fibrosis in patients with moderate renal insufficiency administered gadobenate dimeglumine for MRI. Clin Radiol. 2009 Jul;64(7):706-13 Authors: Bryant BJ, Im K, Broome DR AIM: To determine the incidence of nephrogenic systemic fibrosis (NSF) in stage 3 chronic kidney disease patients following intravenous exposure to gadobenate dimeglumine. MATERIALS AND METHODS: A prospective study was performed on 168 consecutive patients at a single institution with stage 3 chronic kidney disease who underwent clinically-indicated contrast-enhanced magnetic resonance imaging (MRI) examinations with gadobenate dimeglumine from January 2007 to March 2008. All patients were contacted by phone by investigators 3 months after MRI to verify the presence or absence of NSF signs or symptoms. If signs or symptoms suggestive of NSF developed, dermatologic referral was made and confirmatory skin biopsy performed if indicated. RESULTS: One hundred and eighty contrast-enhanced MRI examinations with gadobenate dimeglumine were performed on the 168 patients. Twenty patients were lost to follow-up, but 160 incidents of contrast medium exposure were followed up for 3-months and 105 incidents were followed up for 6 months. The mean contrast medium dose per weight was 0.093 mmol/kg (range 0.042-0.153 mmol/kg). The mean estimated creatinine clearance was 50.4 ml/min/1.73 m(2) (range from 30-59 ml/min/1.73 m(2)). Ten patients developed skin rashes during the 3-month follow-up period, but none were confirmed to represent NSF (0% prevalence rate). No other signs or symptoms of NSF were reported. CONCLUSION: Based on this limited study, NSF does not appear to occur in patients with stage 3 chronic kidney disease exposed to intravenous gadobenate dimeglumine for MRI at standard dosing of approximately 0.1 mmol/kg. PMID: 19520215 [PubMed - in process]

Impact of integrated PET/CT in the staging of oesophageal cancer: a UK population-based cohort study.

Related Articles Impact of integrated PET/CT in the staging of oesophageal cancer: a UK population-based cohort study. Clin Radiol. 2009 Jul;64(7):699-705 Authors: Noble F, Bailey D, , Tung K, Byrne JP AIM: To document the impact of integrated positron-emission tomography and computed tomography (PET/CT) on the management of a cohort of UK patients undergoing PET/CT as part of their staging investigations for potentially curable oesophageal cancer. MATERIALS AND METHODS: A multicentre, prospective study of newly diagnosed patients with oesophageal cancer undergoing PET/CT was set up across five cancer networks covering a total population of 6.6 million. Data were prospectively collected for cases diagnosed between 1 November 2006 and 31 October 2007. RESULTS: One hundred and ninety-one patients underwent PET/CT, with 31 (16%) positive for possible metastatic disease. Amongst the 31 positive examinations, 18 (9.4%) were confirmed to have metastatic disease, and 13 (6.5%) patients had no subsequent evidence of metastatic disease, although in three (1.6%) of these a second previously unsuspected pathology was diagnosed. Two patients had false-negative PET/CT and were found to have metastatic disease. The results of the PET/CT examination down-staged 10 (5%) patients thought to have coeliac/M1a node involvement on CT. Fifteen of 110 (13%) patients with stage 3 or 4 disease at CT and endoscopic ultrasound (EUS) had confirmed metastatic disease at PET/CT, compared with none of 18 with stage 2b, three of 52 (6%) with stage 2a, and none of 10 with stage 1 disease. CONCLUSION: This study confirms the role of PET/CT in a multicentre UK setting in the management of patients with potentially curable carcinoma of the oesophagus, improving the accuracy of pre-treatment staging compared with CT and EUS alone. Early tumours infrequently show evidence of metastasis on PET/CT, although further data are required to confidently determine the stage of tumours where PET/CT has no additional value. PMID: 19520214 [PubMed - in process]

Are UK radiologists satisfied with the training and support received in suspected child abuse?

Related Articles Are UK radiologists satisfied with the training and support received in suspected child abuse? Clin Radiol. 2009 Jul;64(7):690-8 Authors: Leung RS, Nwachuckwu C, Pervaiz A, Wallace C, Landes C, Offiah AC AIM: To determine current practice and perceptions of the adequacy of training and support received for the reporting of skeletal surveys in suspected physical child abuse. MATERIALS AND METHODS: A list of telephone numbers of UK hospitals with a radiology department was obtained from the Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An 18-item questionnaire was successfully administered to consultant radiologists from 84 departments. RESULTS: Sixty-one percent of departments had a named radiologist to report their skeletal surveys, 16% assigned surveys to a random radiologist, and 23% referred them elsewhere. Only 52% of departments had a dedicated paediatric radiologist, thus in a significant proportion of departments (25%) initial reports on skeletal surveys for physical abuse were provided by non-paediatric radiologists. Fifteen percent did not have ready access to a paediatric radiology opinion. Sixty-one percent thought that the service could be improved. Expert evidence was provided by 5% of respondents. Seventy-three percent would never consider providing expert evidence, even if given adequate radiology and/or legal training. CONCLUSION: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service and education strategies should be implemented. PMID: 19520213 [PubMed - in process]

A simple method to approximate liver size on cross-sectional images using living liver models.

Related Articles A simple method to approximate liver size on cross-sectional images using living liver models. Clin Radiol. 2009 Jul;64(7):682-9 Authors: Muggli D, Müller MA, Karlo C, Fornaro J, Marincek B, Frauenfelder T AIM: To assess whether a simple. diameter-based formula applicable to cross-sectional images can be used to calculate the total liver volume. MATERIALS AND METHODS: On 119 cross-sectional examinations (62 computed tomography and 57 magnetic resonance imaging) a simple, formula-based method to approximate the liver volume was evaluated. The total liver volume was approximated measuring the largest craniocaudal (cc), ventrodorsal (vd), and coronal (cor) diameters by two readers and implementing the equation: Vol(estimated)=cc x vd x cor x 0.31. Inter-rater reliability, agreement, and correlation between liver volume calculation and virtual liver volumetry were analysed. RESULTS: No significant disagreement between the two readers was found. The formula correlated significantly with the volumetric data (r>0.85, p<0.0001). In 81% of cases the error of the approximated volume was <10% and in 92% of cases <15% compared to the volumetric data. CONCLUSION: Total liver volume can be accurately estimated on cross-sectional images using a simple, diameter-based equation. PMID: 19520212 [PubMed - in process]

Sarcoid-like reaction to malignancy on whole-body integrated (18)F-FDG PET/CT: prevalence and disease pattern.

Related Articles Sarcoid-like reaction to malignancy on whole-body integrated (18)F-FDG PET/CT: prevalence and disease pattern. Clin Radiol. 2009 Jul;64(7):675-81 Authors: Chowdhury FU, Sheerin F, Bradley KM, Gleeson FV AIM: To evaluate the prevalence of sarcoid-like reaction to malignancy detected using integrated 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography and computed tomography (PET/CT) in patients undergoing staging or restaging of solid-organ malignancy. MATERIALS AND METHODS: A systematic search was performed using the institutional radiology information system of 2048 consecutive PET/CT examinations performed in cancer patients at a tertiary-referral centre. Cases that were considered suspicious for sarcoid-like reaction were identified from the initial radiological report and were retrospectively reviewed by three experienced PET/CT reporters. RESULTS: Sarcoid-like reaction was initially suspected in 23 of the 2048 (1.1%) FDG PET/CT examinations, with the diagnosis confirmed histologically or by clinico-radiological follow-up in 13 of the 23 cases (57%). Sarcoid-like reaction was more commonly seen in patients undergoing FDG PET/CT for restaging of suspected recurrence rather than for primary tumour staging (77% versus 23%; p=0.05). The mean maximum standardized uptake value (SUV(max)) of confirmed hilar and mediastinal sarcoid-like reaction was 7.3 (range 3.1-13.6). Symmetric hilar uptake was demonstrated in 11 of the 13 (85%) and all 13 had additional mediastinal nodal uptake. Pulmonary uptake was seen in seven of the 13 cases (54%). Extra-thoracic involvement was present in eight of the 13 (61.5%), including nodal, splenic, and hepatic lesions. CONCLUSION: Sarcoid-like reaction was suspected in 1.1% of cancer patients at FDG PET/CT examination, with confirmation of the diagnosis in 0.6%. With the increasing use of FDG PET/CT in cancer patients, it is important to be aware of the prevalence of this uncommon, but important, disease entity and to consider this diagnosis in appropriate cases in order to avoid a false-positive interpretation of metastatic disease. PMID: 19520211 [PubMed - in process]

The transjugular intrahepatic portosystemic shunt (TIPS).

Related Articles The transjugular intrahepatic portosystemic shunt (TIPS). Clin Radiol. 2009 Jul;64(7):664-74 Authors: Owen AR, Stanley AJ, Vijayananthan A, Moss JG The creation of an intrahepatic portosystemic shunt via a transjugular approach (TIPS) is an interventional radiological procedure used to treat the complications of portal hypertension. TIPS insertion is principally indicated to prevent or arrest variceal bleeding when medical or endoscopic treatments fail, and in the management refractory ascites. This review discusses the development and execution of the technique, with focus on its clinical efficacy. Patient selection, imaging surveillance, revision techniques, and complications are also discussed. PMID: 19520210 [PubMed - in process]

The use of sedation in the radiology department.

Related Articles The use of sedation in the radiology department. Clin Radiol. 2009 Jul;64(7):655-63 Authors: Patatas K, Koukkoulli A The use of intravenous sedation and analgesia in patients undergoing interventional diagnostic and therapeutic procedures is increasing. Sedation by non-anaesthetists is considered to be safe, provided that they have received adequate training and have the necessary equipment, facilities, and personnel. This article aims to increase awareness of the safe use of sedative drugs in radiology and provide a practical guideline for minimal and moderate sedation. PMID: 19520209 [PubMed - in process]

Three-dimensional Electrocardiographically Gated Variable Flip Angle FSE Imaging for MR Angiography of the Hands at 3.0 T: Initial Experience.

Related Articles Three-dimensional Electrocardiographically Gated Variable Flip Angle FSE Imaging for MR Angiography of the Hands at 3.0 T: Initial Experience. Radiology. 2009 Jun 30; Authors: Lim RP, Storey P, Atanasova IP, Xu J, Hecht EM, Babb JS, Stoffel DR, Chang H, McGorty K, Chen Q, Rusinek H, Belmont HM, Lee VS After institutional review board approval and informed consent were obtained for this HIPAA-compliant investigation, a three-dimensional electrocardiographically gated variable flip angle (VFA) fast spin-echo magnetic resonance (MR) angiography technique was evaluated as an unenhanced method for imaging hand arteries in 13 subjects (including four patients) at 3.0 T; this included evaluation of vessel visualization with warming and cooling in seven subjects. Examinations were evaluated for image quality and vessel conspicuity. Clear separation of arteries from veins was achieved in all subjects, with excellent vessel conspicuity and depiction of stenoses. Warming improved vessel visualization in healthy volunteers. VFA MR angiography is a high-spatial-resolution technique that enables the assessment of vascular reactivity in response to temperature challenge. (c) RSNA, 2009. PMID: 19567653 [PubMed - as supplied by publisher]

Idiopathic Syringomyelia: Phase-Contrast MR of Cerebrospinal Fluid Flow Dynamics at Level of Foramen Magnum.

Related Articles Idiopathic Syringomyelia: Phase-Contrast MR of Cerebrospinal Fluid Flow Dynamics at Level of Foramen Magnum. Radiology. 2009 Jun 30; Authors: Struck AF, Haughton VM Purpose: To measure cerebrospinal fluid (CSF) flow velocities in the foramen magnum in patients with idiopathic syringomyelia (IS). Materials and Methods: Patient consent for this retrospective study was waived by the institutional review board within the guidelines of HIPAA. The authors reviewed the medical records of a neurosurgery specialty clinic to identify patients with IS-that is, syringomyelia without evidence of Chiari malformation, tumor, or substantial spine trauma. Patients without syringomyelia or Chiari malformation identified from the review served as control subjects. The data of patients and control subjects who had undergone phase-contrast magnetic resonance (MR) imaging were included in the study. MR flow images were inspected for evidence of synchronous bidirectional CSF flow and heterogeneous spatial and temporal flow patterns. Peak CSF flow velocities in the IS and control groups were calculated, and differences were tested for statistical significance by using the Wilcoxon rank sum test. Results: Eight patients who met the criteria for IS and six who met the criteria to serve as control subjects were identified. The phase-contrast MR images obtained in five of the eight patients with IS and in none of the control subjects depicted synchronous bidirectional flow and/or large flow jets. Mean peak systolic (caudal) CSF flow velocities were 6.7 cm/sec in the IS group and 3.6 cm/sec in the control group; the difference was significant (P < .01). Mean peak diastolic (cephalic) velocities were 3.9 and 3.4 cm/sec in the IS and control groups, respectively; the difference was not significant (P = .36). Conclusion: Some patients with IS have increased peak systolic CSF flow velocities. (c) RSNA, 2009. PMID: 19567652 [PubMed - as supplied by publisher]

Coagulation Disorders in Patients with Cancer: Nontunneled Central Venous Catheter Placement with US Guidance--A Single-Institution Retrospective Analysis.

Related Articles Coagulation Disorders in Patients with Cancer: Nontunneled Central Venous Catheter Placement with US Guidance--A Single-Institution Retrospective Analysis. Radiology. 2009 Jun 30; Authors: Della Vigna P, Monfardini L, Bonomo G, Curigliano G, Agazzi A, Bellomi M, Orsi F Purpose: To assess the feasibility and safety of ultrasonographic (US) guidance in the placement of nontunneled central venous catheters (CVCs) in patients with cancer who had altered coagulation profiles. Materials and Methods: The study was approved by the institutional review board; informed consent was obtained. Medical charts of all patients with cancer who underwent nontunneled CVC placement at the European Institute of Oncology, Milan, from September 2001 to August 2008 were retrospectively reviewed. Patients were considered to have coagulation disorders or risk of bleeding when they had the following: prothrombin time more than 1.2 times normal or activated partial thromboplastin time more than 1.2 times normal and/or platelet count less than 150 x 10(9)/L. Patients with a prothrombin time and partial thromboplastin time more than 2.2 times normal and/or a platelet count less than 50 000/mm(3) were considered to be at high risk for bleeding. Two hundred thirty-nine nontunneled CVCs were placed with US guidance in 157 patients. Results: One hundred twenty-two (51%) of 239 nontunneled CVCs were inserted in patients with cancer who had hemostasic disorders. Forty-five (37%) of 122 nontunneled CVCs were implanted in patients considered to be at high risk for bleeding. All catheters were successfully placed at the first needle pass with no major complications such as bleeding or pneumothorax. Two hundred thirty-three (97%) nontunneled CVCs were placed in the subclavian vein, and six (3%) were placed in the internal jugular vein. No patient underwent any correction for an abnormal coagulation profile. Conclusion: In patients with cancer who had coagulation disorders, nontunneled CVC placement with US guidance was feasible and safe and did not require correction of coagulation parameters. (c) RSNA, 2009. PMID: 19567651 [PubMed - as supplied by publisher]

Noninvasive Assessment of Acute Ureteral Obstruction with Diffusion-weighted MR Imaging: A Prospective Study.

Related Articles Noninvasive Assessment of Acute Ureteral Obstruction with Diffusion-weighted MR Imaging: A Prospective Study. Radiology. 2009 Jun 30; Authors: Thoeny HC, Binser T, Roth B, Kessler TM, Vermathen P Purpose: To prospectively assess the potential of noninvasive diffusion-weighted magnetic resonance (MR) imaging to depict changes in microperfusion and diffusion in patients with acute unilateral ureteral obstruction. Materials and Methods: The local ethics committee approved the study protocol. Informed consent was obtained. Diffusion-weighted MR imaging was performed in 21 patients (two women, 19 men; mean age, 43 years +/- 10 [standard deviation]) with acute unilateral ureteral obstruction due to a calculus diagnosed at unenhanced computed tomography. A control group (one woman, 15 men; mean age, 44 years +/- 12) underwent the same MR protocol. Standard processing yielded an apparent diffusion coefficient (ADC) ADC(T); the separation of microperfusion and diffusion contributions yielded the perfusion fraction F(P) and the pure diffusion coefficient ADC(D). ADC(T), ADC(D), and F(P) were compared between obstructed and contralateral unobstructed kidneys and with control values. For statistical analysis, nonparametric rank tests were used. A P value of less than .05 was considered significant. Results: No significant differences were observed between the ADC(T) of the medulla or cortex of the obstructed and unobstructed kidneys. Compared with control kidneys, only medullary ADC(T) was slightly increased in the obstructed kidney (P < .04). However, the ADC(D) in the medulla of the obstructed and unobstructed kidneys was significantly higher than that in control subjects (201 x 10(-5)mm(2)/sec +/- 16 and 199 x 10(-5)mm(2)/sec +/- 20 vs 189 x 10(-5)mm(2)/sec +/- 12; P < .008 and P < .03, respectively). F(P) of the cortex of the obstructed kidney was significantly lower than that in the unobstructed kidney (20.2% +/- 4.8 vs 24.0% +/- 5.8; P < .002); F(P) of the medulla was slightly lower in the obstructed kidney than in the unobstructed kidney (18.3% +/- 5.9 vs 20.7% +/- 6.4; P = .05). Conclusion: Diffusion-weighted MR imaging allows noninvasive detection of changes in renal perfusion and diffusion during acute unilateral ureteral obstruction, as exemplified in patients with a ureteral calculus. (c) RSNA, 2009. PMID: 19567650 [PubMed - as supplied by publisher]

Osteochondral Lesions of the Talus: Retrograde Drilling with High-Field-Strength MR Guidance.

Related Articles Osteochondral Lesions of the Talus: Retrograde Drilling with High-Field-Strength MR Guidance. Radiology. 2009 Jun 30; Authors: Seebauer CJ, Bail HJ, Wichlas F, Jung T, Papanikolaou IS, van der Voort I, Rump JC, Schilling R, Winkelmann A, Walther T, Chopra SS, Teichgräber UK The institutional review board approved the use of cadaveric specimens, and informed consent was obtained from all volunteers. The authors performed and assessed a magnetic resonance (MR)-assisted navigation method for minimally invasive retrograde drilling of talar osteochondral lesions. For this method, a single imaging plane is sufficient for navigation during intervention. To accomplish this objective, a passive MR navigation device was used to evaluate 16 cadaveric ankle joints. Use of this interactive MR-assisted navigation method in combination with a passive aiming device allowed precise and rapid retrograde drilling of talar osteochondral lesions. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2523081981/DC1 (c) RSNA, 2009. PMID: 19567649 [PubMed - as supplied by publisher]

Ornithine Transcarbamylase Deficiency with Persistent Abnormality in Cerebral Glutamate Metabolism in Adults.

Related Articles Ornithine Transcarbamylase Deficiency with Persistent Abnormality in Cerebral Glutamate Metabolism in Adults. Radiology. 2009 Jun 30; Authors: Gropman AL, Sailasuta N, Harris KC, Abulseoud O, Ross BD Purpose: To determine cerebral glutamate turnover rate in partial-ornithine transcarbamylase deficiency (OTCD) patients by using carbon 13 ((13)C) magnetic resonance (MR) spectroscopy. Materials and Methods: The study was performed with approval of the institutional review board, in compliance with HIPAA regulations, and with written informed consent of the subjects. MR imaging, hydrogen 1 ((1)H) MR spectroscopy, and (13)C MR spectroscopy were performed at 1.5 T in 10 subjects, six patients with OTCD and four healthy control subjects, who were in stable condition. Each received intravenous (13)C-glucose (0.2 g/kg), C1 or C2 position, as a 15-minute bolus. Cerebral metabolites were determined with proton decoupling in a parieto-occipital region (n = 9) and without proton decoupling in a frontal region (n = 1) during 60-120 minutes. Results: Uptake and removal of cerebral glucose ([1-(13)C]-glucose or [2-(13)C]-glucose) were comparable in healthy control subjects and subjects with OTCD (P = .1). Glucose C1 was metabolized to glutamate C4 and glucose C2 was metabolized to glutamate C5 at comparable rates, both of which were significantly reduced in OTCD (combined, P = .04). No significant differences in glutamine formation were found in subjects with OTCD (P = .1). [2-(13)C]-glucose and its metabolic products were observed in anterior cingulate gyrus without proton decoupling in one subject with OTCD. Conclusion: Treatments that improve cerebral glucose metabolism and glutamate neurotransmission may improve neurologic outcome in patients with OTCD, in whom prevention and treatment of hyperammonemic episodes appear to be insufficient. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2523081878/DC1 (c) RSNA, 2009. PMID: 19567648 [PubMed - as supplied by publisher]

Small Hepatocellular Carcinoma: Is Radiofrequency Ablation Combined with Transcatheter Arterial Chemoembolization More Effective than Radiofrequency Ablation Alone for Treatment?

Related Articles Small Hepatocellular Carcinoma: Is Radiofrequency Ablation Combined with Transcatheter Arterial Chemoembolization More Effective than Radiofrequency Ablation Alone for Treatment? Radiology. 2009 Jun 30; Authors: Shibata T, Isoda H, Hirokawa Y, Arizono S, Shimada K, Togashi K Purpose: To prospectively compare combined radiofrequency ablation and transcatheter arterial chemoembolization (TACE) with radiofrequency ablation alone for the treatment of small (

Diffusion-Tensor Imaging Implicates Prefrontal Axonal Injury in Executive Function Impairment Following Very Mild Traumatic Brain Injury.

Related Articles Diffusion-Tensor Imaging Implicates Prefrontal Axonal Injury in Executive Function Impairment Following Very Mild Traumatic Brain Injury. Radiology. 2009 Jun 30; Authors: Lipton ML, Gulko E, Zimmerman ME, Friedman BW, Kim M, Gellella E, Gold T, Shifteh K, Ardekani BA, Branch CA Purpose: To determine whether frontal white matter diffusion abnormalities can help predict acute executive function impairment after mild traumatic brain injury (mTBI). Materials and Methods: This study had institutional review board approval, included written informed consent, and complied with HIPAA. Diffusion-tensor imaging and standardized neuropsychologic assessments were performed in 20 patients with mTBI within 2 weeks of injury and 20 matched control subjects. Fractional anisotropy (FA) and mean diffusivity (MD) images (imaging parameters: 3.0 T, 25 directions, b = 1000 sec/mm(2)) were compared by using whole-brain voxelwise analysis. Spearman correlation analyses were performed to evaluate associations between diffusion measures and executive function. Results: Multiple clusters of lower frontal white matter FA, including the dorsolateral prefrontal cortex (DLPFC), were present in patients (P < .005), with several clusters also demonstrating higher MD (P < .005). Patients performed worse on tests of executive function. Lower DLPFC FA was significantly correlated with worse executive function performance in patients (P < .05). Conclusion: Impaired executive function following mTBI is associated with axonal injury involving the DLPFC. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2523081584/DC1 (c) RSNA, 2009. PMID: 19567646 [PubMed - as supplied by publisher]

Chronic Recurrent Multifocal Osteomyelitis: Comparison of Whole-Body MR Imaging with Radiography and Correlation with Clinical and Laboratory Data.

Related Articles Chronic Recurrent Multifocal Osteomyelitis: Comparison of Whole-Body MR Imaging with Radiography and Correlation with Clinical and Laboratory Data. Radiology. 2009 Jun 30; Authors: Fritz J, Tzaribatchev N, Claussen CD, Carrino JA, Horger MS Purpose: To describe whole-body magnetic resonance (MR) imaging appearance of chronic recurrent multifocal osteomyelitis (CRMO) and assess the role of MR imaging versus radiography in diagnosis of disease and correlation with clinical findings and laboratory data. Materials and Methods: Institutional review board approved this retrospective HIPAA-compliant study; informed consent was waived. T1-weighted, short inversion time inversion-recovery, and contrast material-enhanced T1-weighted whole-body MR imaging was performed and two-plane radiographs, clinical findings, and laboratory data were reviewed in 13 children (median age, 13 years) with CRMO. Lesion depiction, location, and characterization and extraskeletal abnormalities were evaluated. MR imaging findings were compared with clinical and laboratory data and radiographic results. Data analysis was performed, and diagnostic performance statistics of radiography, physical examination results, and serum inflammatory markers were calculated. General multilevel linear modeling framework was used. Odds ratios were calculated to estimate effect of age, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level on reliabilities. Associations of ESR and CRP level with total number of lesions were assessed (chi(2) test). Results: MR imaging depicted 101 ill-defined edemalike osseous lesions. Most frequent anatomic sites were distal femur (21%, 21 of 101), proximal tibia (17%, 17 of 101), and distal tibia and fibula (14% each, 14 of 101). In tubular bones (70 anatomic sites), metaphysis (86%, 60 of 70) and epiphysis (67%, 47 of 70) were involved. Contiguous physeal relationship (89%, 66 of 74), periosteal reaction (48%, 48 of 101), and symmetric involvement (85%, 11 of 13) were present. MR imaging demonstrated multifocality in all patients. There were no extraskeletal abnormalities and no relationship between serum inflammatory markers and number of symptomatic anatomic sites (P = .472). Sensitivity for radiography was 0.13 (70 of 119); physical examination, 0.31 (52 of 299); and serum inflammatory markers, 0.15 (two of 13). Conclusion: Whole-body MR imaging is useful for detection of CRMO, particularly in indeterminate cases, because it is more likely to show abnormalities. (c) RSNA, 2009. PMID: 19567645 [PubMed - as supplied by publisher]

Breast Imaging Reporting and Data System Lexicon for US: Interobserver Agreement for Assessment of Breast Masses.

Related Articles Breast Imaging Reporting and Data System Lexicon for US: Interobserver Agreement for Assessment of Breast Masses. Radiology. 2009 Jun 30; Authors: Abdullah N, Mesurolle B, El-Khoury M, Kao E Purpose: To retrospectively evaluate the interobserver agreement of radiologists who used the Breast Imaging Reporting and Data System (BI-RADS) lexicon to characterize and categorize ultrasonographic (US) features of breast masses. Materials and Methods: No institutional review board approval or patient consent was required. Five breast radiologists retrospectively independently evaluated 267 breast masses (113 benign and 154 malignant masses in 267 patients) by using the BI-RADS US lexicon. Reviewers were blinded to mammographic images, medical history, and pathologic findings. Interobserver agreement was assessed with the Aickin revised kappa statistic. Results: Interobserver agreement varied from fair for evaluation of mass margins (kappa = 0.36) to moderate for evaluation of lesion boundary (kappa = 0.48), echo pattern (kappa = 0.58), and posterior acoustic features (kappa = 0.47) to substantial for evaluation of mass orientation (kappa = 0.70) and shape (kappa = 0.64). For small (

Re: "frequency and spectrum of errors in final radiology reports generated with automatic speech recognition technology".

Related Articles Re: "frequency and spectrum of errors in final radiology reports generated with automatic speech recognition technology". J Am Coll Radiol. 2009 Jul;6(7):536; reply 536-7 Authors: Janower ML PMID: 19560078 [PubMed - in process]

Re: "frequency and spectrum of errors in final radiology reports generated with automatic speech recognition technology".

Related Articles Re: "frequency and spectrum of errors in final radiology reports generated with automatic speech recognition technology". J Am Coll Radiol. 2009 Jul;6(7):535-6; reply 536-7 Authors: Branstetter BF, Shrestha RB PMID: 19560076 [PubMed - in process]

The maxfield family.

Related Articles The maxfield family. J Am Coll Radiol. 2009 Jul;6(7):533-4 Authors: Linton O PMID: 19560075 [PubMed - in process]

Laws and sausages.

Related Articles Laws and sausages. J Am Coll Radiol. 2009 Jul;6(7):531-2 Authors: Krishnaraj A PMID: 19560074 [PubMed - in process]

Percutaneous image-guided ablation of renal tumors.

Related Articles Percutaneous image-guided ablation of renal tumors. J Am Coll Radiol. 2009 Jul;6(7):527-30 Authors: Miller JC, Gervais DA, McGovern FJ, Thrall JH, Uppot RN PMID: 19560073 [PubMed - in process]

Multiparametric magnetic resonance imaging of breast cancer.

Related Articles Multiparametric magnetic resonance imaging of breast cancer. J Am Coll Radiol. 2009 Jul;6(7):523-6 Authors: Jacobs MA PMID: 19560072 [PubMed - in process]

Leading in a crisis, part 1.

Related Articles Leading in a crisis, part 1. J Am Coll Radiol. 2009 Jul;6(7):521-2 Authors: Lexa FJ PMID: 19560071 [PubMed - in process]

Why planes crash: lessons for radiology.

Related Articles Why planes crash: lessons for radiology. J Am Coll Radiol. 2009 Jul;6(7):518-20 Authors: Gunderman RB, Cohen MD PMID: 19560070 [PubMed - in process]

Analysis of treatment planning time among systems and planners for intensity-modulated radiation therapy.

Related Articles Analysis of treatment planning time among systems and planners for intensity-modulated radiation therapy. J Am Coll Radiol. 2009 Jul;6(7):514-7 Authors: Das IJ, Moskvin V, Johnstone PA Radiation oncology is a technologically advanced health care specialty in which numerous innovations, such as intensity-modulated radiation therapy (IMRT), require significant manpower and resources. For 3 main disease sites (prostate, head and neck, and lung), the authors investigated IMRT planning time across the United States among commonly used treatment planning systems (TPS). Treatment planning time was investigated in different components of IMRT: data transfer, contouring, beam arrangements, optimization, dose calculation, and phantom plans. The results showed significant variability among the TPS depending on the functionality and efficiency of the TPS algorithm. This study provides a road map to quantify the manpower needed and the selection of proper tools for IMRT planning and could be a model for any health care task. PMID: 19560069 [PubMed - in process]

MR-guided focused ultrasound: a potentially disruptive technology.

Related Articles MR-guided focused ultrasound: a potentially disruptive technology. J Am Coll Radiol. 2009 Jul;6(7):510-3 Authors: Bradley WG A disruptive technology is a technological innovation that overturns the existing dominant technologies in a market. Magnetic resonance (MR)-guided focused ultrasound (MRgFUS) is a noninvasive procedure based on the combination of real-time MR anatomic guidance, MR thermometry, and high-intensity focused ultrasound. Several hundred transducer elements become convergent at a point under MR guidance, leading to heating and coagulation necrosis. Outside the focal point, there is no significant heating. There is no need to break the skin for procedures in the body or to perform a craniotomy for procedures in the brain. This lack of invasiveness is what makes MRgFUS so disruptive compared with surgery. At present, MRgFUS has been used for the ablation of uterine fibroids, breast tumors, painful bony metastases, and liver tumors. In the brain, it has been used for the ablation of glioblastomas and for functional neurosurgery. Phantom and animal studies suggest future applications for prostate cancer and acute stroke treatment. PMID: 19560068 [PubMed - in process]

Endovascular repair vs open surgical repair of abdominal aortic aneurysms: comparative utilization trends from 2001 to 2006.

Related Articles Endovascular repair vs open surgical repair of abdominal aortic aneurysms: comparative utilization trends from 2001 to 2006. J Am Coll Radiol. 2009 Jul;6(7):506-9 Authors: Levin DC, Rao VM, Parker L, Frangos AJ, Sunshine JH PURPOSE: Within the past few years, endovascular aneurysm repair (EVAR) has come into use for the treatment of abdominal aortic aneurysms (AAAs). In many cases, EVAR has the potential to replace traditional open surgical repair (OSR), which is more invasive, risky, and expensive. The aim of this study was to determine to what extent EVAR is replacing OSR, whether the frequency of treatment is increasing with the advent of the less invasive approach, and which specialties are performing the procedures. MATERIALS AND METHODS: The Medicare Part B data sets for 2001 through 2006 were studied. Procedure volume and utilization rates per 100,000 Medicare beneficiaries were determined for the 7 Current Procedural Terminology, fourth edition, procedure codes that describe EVAR and the 4 codes that describe OSR for AAA. Medicare's physician specialty codes were used to ascertain the specialties of the physician providers. RESULTS: A total of 31,965 OSRs for AAA were performed in Medicare beneficiaries in 2001, dropping to 15,665 by 2006 (-51%). In contrast, EVAR was carried out in 11,028 instances in 2001, increasing to 28,937 by 2006 (+162%). The utilization rate per 100,000 for OSR dropped from 90 to 42 (a rate decrease of 48) during the study period, while the rate for EVAR increased from 31 to 77 (a rate increase of 46). The combined utilization rate per 100,000 of the two types of interventions for AAA (EVAR and OSR) decreased from 121 in 2001 to 119 in 2006. In performing EVAR, procedure volume and market share in 2006 by specialty were 1) 22,003 procedures by surgeons, a 76% share; 2) 3,287 procedures by radiologists, an 11% share; 3) 1,915 procedures by cardiologists, a 7% share; and 4) 1,732 procedures by all other physicians, a 6% share. CONCLUSIONS: Treatment for AAA seems to be an example of the responsible use of new technology by physicians. The newer, less invasive, and less risky procedure (EVAR) is replacing the older and more invasive procedure (OSR) to a considerable degree. However, the overall combined utilization rate of both types of AAA treatment has remained stable in the Medicare population. There is thus no evidence to suggest that the introduction of the newer approach has led to the overtreatment of patients. Although radiologists do have a role in EVAR, surgeons strongly predominate. PMID: 19560067 [PubMed - in process]

An evaluation of MRI safety and compatibility of a silver-impregnated antimicrobial wound dressing.

Related Articles An evaluation of MRI safety and compatibility of a silver-impregnated antimicrobial wound dressing. J Am Coll Radiol. 2009 Jul;6(7):500-5 Authors: Nyenhuis J, Duan L PURPOSE: Wound infections can slow healing, increase pain, and have negative effects on a patient's quality of life. The recent emergence of antibiotic-resistant bacterial strains has led wound care specialists to revisit alternative topical agents such as silver to control wound bioburden. Aquacel Ag is an ionic silver-containing barrier dressing that is able to absorb large amounts of wound exudate. The aim of this study was to assess the magnetic resonance (MR) safety and compatibility of this dressing, according to the standard requirements of the American Society for Testing and Materials (ASTM). METHODS: Radiofrequency-induced temperature changes associated with the test dressing were assessed using an ASTM phantom at 123 and 64 MHz. Whether the dressing caused any image distortion or magnetic deflection or if the electric resistance of the hydrated dressing differed significantly from that of tissue was also investigated. RESULTS: Similar radiofrequency-induced temperature changes were observed during 123 MHz (nominal 3 T) MR imaging of the phantom material alone (1.3 degrees C) and when the dressing was added (1.8 degrees C-2.0 degrees C). Similar increases in temperature were also observed at 64 MHz (1.5 T) in the phantom material alone (1.4 degrees C-1.9 degrees C) and with the dressing (1.6 degrees C-1.7 degrees C). The test dressing did not cause any discernible image distortion or magnetic deflection and had similar electric resistance to human body tissues. CONCLUSION: The wound dressing impregnated with ionic silver evaluated in this study has similar magnetic and electric characteristics to human tissues and is MR safe as defined in ASTM standard F2503-05. Therefore, the dressings can be left in place when a patient is undergoing MR imaging. PMID: 19560066 [PubMed - in process]

Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

Related Articles Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices. J Am Coll Radiol. 2009 Jul;6(7):491-9 Authors: Steele JR, Schomer DF Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors. PMID: 19560065 [PubMed - in process]

Automating quality assurance for digital radiography.

Related Articles Automating quality assurance for digital radiography. J Am Coll Radiol. 2009 Jul;6(7):486-90 Authors: Reiner BI The existing practice of quality assurance (QA) in medical imaging is problematic because of the subjective manner in which it is performed, the lack of community and industry-wide QA standards, a paucity of supporting technology, and an overall lack of accountability. The solution for optimizing QA lies in the creation of objective and reproducible QA metrics, whose analysis can be automated through the creation of computerized QA software algorithms. The QA data derived from these computerized programs would in turn create the infrastructure for a comprehensive QA database, which can serve as a valuable resource for QA education and training, research, decision support, and technology innovation. The ability to objectively track and analyze QA practice across the wide spectrum of imaging providers creates a mechanism for the creation and refinement of objective QA standards and "best practice" guidelines. PMID: 19560064 [PubMed - in process]

Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior.

Related Articles Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior. J Am Coll Radiol. 2009 Jul;6(7):479-85 Authors: Brown SD, Goske MJ, Johnson CM Disruptive physician behavior may diminish productivity, lead to medical errors, and compromise patient safety. The purpose of this paper is to review how common psychological conditions such as depression, stress, and burnout may drive disruptive behavior in the workplace and result in impaired patterns of professional conduct similar to what is seen with substance abuse. Problems related to these psychological morbidities may be more effectively managed with improved understanding of the conditions and behaviors, their associated risk factors, and the barriers that exist to reporting them. Further research and educational programs are warranted to address how these conditions might affect radiology. PMID: 19560063 [PubMed - in process]

P4P: pragmatic for practice.

Related Articles P4P: pragmatic for practice. J Am Coll Radiol. 2009 Jul;6(7):477-8 Authors: Duszak R PMID: 19560062 [PubMed - in process]

www.X-rayRisk.com: an online calculator for cancer risk.

Related Articles www.X-rayRisk.com: an online calculator for cancer risk. J Am Coll Radiol. 2009 Jul;6(7):475-6 Authors: Hanley M, Koonce JD, Bradshaw ML PMID: 19560061 [PubMed - in process]

The myriad faces of imaging today (and implications for tomorrow).

Related Articles The myriad faces of imaging today (and implications for tomorrow). J Am Coll Radiol. 2009 Jul;6(7):472-4 Authors: Wilner EM PMID: 19560060 [PubMed - in process]

The goose that lays the golden eggs.

Related Articles The goose that lays the golden eggs. J Am Coll Radiol. 2009 Jul;6(7):471 Authors: Hillman BJ PMID: 19560059 [PubMed - in process]

Technological Innovations Impact All Aspects of AMCLC 2009.

Related Articles Technological Innovations Impact All Aspects of AMCLC 2009. J Am Coll Radiol. 2009 Jul;6(7):469-70 Authors: Thrall JH PMID: 19560058 [PubMed - in process]

Editorial Board

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Page i[No author name available]

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Page iii[No author name available]

Introduction

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 201-202Timothy, Clark

Portal Anatomic Variants Relevant to Transjugular Intrahepatic Portosystemic Shunt

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 203-207Nael, Saad , Michael, Darcy , Wael, SaadTransjugular intrahepatic portosystemic shunt (TIPS) creation is an accepted treatment for portal hypertension. TIPS creation remains a challenging procedure because it involves the successful passage of a needle from a point of origin (hepatic vein) to a target point (portal vein) through the liver substance. An understanding of the anatomy of these two vascular beds facilitates overcoming the challenge of the spatial relationship between these two points. In this article the authors review the vascular and parenchymal anatomic variations, both congenital and acquired that impact the success of TIPS creation.

Stepwise Placement of a Transjugular Intrahepatic Portosystemic Shunt Endograft

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 208-211Timothy W.I., ClarkEndografts continue to evolve the role of transjugular intrahepatic portosystemic shunts for patients with complications of portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) created with bare stents, although associated with high rates of short-term portal decompression, are plagued by shunt stenosis and thrombosis over the long term. In contrast, TIPS created with endografts achieve durable, sustained patency in most patients with portal hypertension. The technique of successful endograft placement does have technical nuances that differ from TIPS creation with bare stents. This article provides a step-by-step approach for the interventional radiologist for placement of the via Torr device, which is...

Management of Shunt Dysfunction in the Era of TIPS Endografts

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 212-216Timothy W.I., ClarkSignificantly improved long-term patency can be achieved with transjugular intrahepatic portosystemic shunt (TIPS) endografts compared to conventional bare stents. In the USA, approximately 80% of TIPS procedures are performed using these devices. The phenomenon of early shunt thrombosis with TIPS created with bare stent TIPS, attributed to biliary fistulae, is seldom observed in patients with TIPS endografts. Intrashunt stenoses within the polytetrafluoroethylene-lined conduit are also rare. However, as with shunts created with bare stents, distinct patterns of dysfunction can occur with TIPS endografts. Some of these are inherent to the learning curve of placing these devices and others are secondary...

Portal Vein Imaging and Access for Transjugular Intrahepatic Portosystemic Shunts

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 217-224Timothy, Scanlon , Robert K., Ryu

Balloon-occluded Retrograde Transvenous Occlusion

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 225-229Hector, FerralThe current article describes a patient with acute, massive upper gastrointestinal bleeding from isolated gastric varices. The patient had a large gastrosystemic shunt and was managed with a combination of splenic artery embolization followed by balloon-occluded retrograde transvenous occlusion (BORTO) of the gastric varices. BORTO is a procedure that was recently described in Japan by Dr Kanagawa. This technique is extensively used in Japan as first-line therapy in the management of bleeding gastric varices but has not been popularized in the USA. The purpose of this review is to present the technique used to perform BORTO at our institution and...

Direct Intrahepatic Portocaval Shunt

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 230-234Bryan D., Petersen , Timothy W.I., ClarkThe direct intrahepatic portacaval shunt (DIPS) is a modification of the TIPS procedure, using intravascular ultrasound-guidance, combined with fluoroscopy. The DIPS procedure was initially conceived to increase the durability of shunt patency and extend the spectrum of patients with portal hypertension for whom endovascular portocaval shunting can be performed. The DIPS procedure involves intravascular ultrasound-guided puncture from the inferior vena cava to the portal vein through the caudate lobe of the liver. The shunt is completed with a polytetrafluoroethylene-covered stent graft. This article describes the indications, technique, and outcomes of the DIPS procedure to enable the interventional radiologist currently experienced...

Placement of Transjugular Intrahepatic Portosystemic Shunts in Children

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 4, December 2008, Pages 235-240Jonathan M., LorenzPerformance of transjugular intrahepatic portosystemic shunting (TIPS) in children requires an awareness of the technical challenges posed by pediatric anatomy and physiology. Any interventional radiologist skilled in adult TIPS and contemplating performing their first pediatric TIPS should consider adding a second set of more experienced hands. This article reviews some of the more salient technical considerations for performing TIPS in this unique patient population.

Editorial Board

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Page i[No author name available]

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Page iii[No author name available]

Forthcoming Topics

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Page iv[No author name available]

Introduction

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Page 155Dmitry J., Rabkin

Clinical Surveillance and Monitoring of Arteriovenous Access for Hemodialysis

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Pages 156-166Gary A., GelbfishClinical surveillance and monitoring of arteriovenous access for hemodialysis can best ensure long term access function. The failing access can be identified and referred for intervention prior to complete access failure. This article reviews the basic science of access function and the various techniques for detecting the failing access. These techniques are utilized by the dialysis unit staff and by the physician, often the interventionalist, who takes primary care of the access. A combination of various techniques to detect dysfunction and trend analysis of various parameters is most likely to identify in a timely manner, those patients who need intervention.

Hemodialysis Fistula Interventions: Diagnostic and Treatment Challenges and Technical Considerations

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Pages 167-174Boris, NikolicEnd-stage renal disease is one of the main epidemiologic health problems and dialysis access continues to be the Achilles' heel of its treatment. Consequently, hemodialysis fistula maintenance is of great importance which can best be accomplished by close collaboration between primary care, nephrology, surgery and interventional radiology services, routine access monitoring as well as early intervention in cases of impending access failure. Also, knowledge and application of specific interventional techniques that are additionally described in this article may increase intervention efficiency, decrease the incidence of complications and overcome technical challenges thus improving procedural outcome and maximizing access patency rates.

Endovascular Management of the “Failing to Mature” Arteriovenous Fistula

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Pages 175-180George M., NassarThe “failing to mature” arteriovenous fistula (AVF) is frequently encountered among patients in need of hemodialysis (HD). It is essential that its prompt recognition and management are conducted in a timely manner to allow its use in HD. The physical examination is essential in early identification of the “failing to mature” AVF and helps guide initial endovascular management. In most instances, endovascular evaluation successfully identifies all the lesions that have contributed to AVF derangement and retarded its proper maturation. It is common to find juxta-arterial stenosis as well as venous stenosis in the body of the AVF, or its venous...

Tunneled Dialysis Catheters: Pearls and Pitfalls

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Pages 181-185Jeffrey B., SiegelA review of the issues involved in placement of Tunneled Dialysis Catheter with a suggested scheme for maximizing good catheter placement and function.

Selecting Optimal Hemodialysis Catheters: Material, Design, Advanced Features, and Preferences

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Pages 186-191Michael G., Tal , Nina, NiHemodialysis catheters are a necessary evil. They provide an immediate and effective lifeline for hemodialysis patients, and their use is steadily increasing. This increasingly important role has lead to the development of many generations of dialysis catheters. Some aspects of novel designs have shown potential to reduce complications, while others provide options for physician insertion preference. The two major biomaterials for catheter construction are currently polyurethane and silicone, while copolymers such as carbothane are becoming more widespread. Catheter coatings such as heparin, antibiotics, and silver ion are designed to minimize thrombosis and infection. Finally, many lumen and tip designs are...

Minimally Invasive Outpatient Centers

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Pages 192-194James, McGuckin , Kim, ParkinsonMinimally-invasive medicine has continually progressed from its beginning in the 1960's. Evolution of technology and techniques have led to treatment of new disease states in minimally-invasive therapies. Now the venue of those therapies is shifting outpatient procedures from the hospital and into outpatient centers.

Malfunction of Dialysis Catheters: Management of Fibrin Sheath and Related Problems

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 3, September 2008, Pages 195-200Salao, Faintuch , G.M.M., SalazarSuitable central venous access for hemodialysis is frequently required in patients with end-stage renal disease, whenever an arteriovenous fistula or peritoneal dialysis fails or is not a possibility. Ultimately, long-term dialysis via central access may result in dysfunctional catheter with problems such as malpositioning of catheter tip, fibrin sheath formation, thrombosis, infection, and bleeding. The role of interventional radiology is to deliver appropriate treatment to maintain patent and functional access, while minimizing the risk of venous occlusive disease. This article aims at describing different techniques and approaches for management of fibrin sheath associated with malfunctioning tunneled dialysis catheters, as well...

Editorial Board

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Page i[No author name available]

Forthcoming Topics

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Page iv[No author name available]

Introduction

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Page 73Wael E.A., Saad , Michael D., Darcy

Computed Tomography and Magnetic Resonance Cholangiography

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Pages 74-89Wael E.A., Saad , Daniel, GinatIn patients with biliary obstruction, determining the level and the cause of the obstruction is essential because it can be a key factor for the next step in diagnostic or therapeutic intervention. Noninvasive cholangiography, such as computed tomography (CT) cholangiography or magnetic resonance (MR) cholangiography, allows the diagnosis of cause and level of biliary disease with minimal risk. Traditional magnetic resonance cholangiopancreatography (MRCP) is an established and effective noninvasive diagnostic modality particularly for extrahepatic biliary tract evaluation. Intrahepatic biliary duct evaluation and functional MR, including evaluating for leaks and gallbladder dyskinesia and outlet obstruction, are evolving diagnostic techniques that show...

Unconventional Cholangiography

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Pages 90-101Wael E.A., SaadConventional imaging of the biliary tract includes fluoroscopic cholangiography, oral contrast computed tomography (CT) cholangiography, and magnetic resonance cholangiopancreatography. The latter two are discussed in the prior article of noninvasive cholangiography. Fluoroscopic cholangiography can be divided into endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography (see pages 74-89, this issue). This article discussed a varying group of imaging techniques that can be added as modifiers to some of the above imaging modalities to obtain different, if not clearer, images of the biliary tract in particular clinical scenarios. These techniques, which are collectively called by the author, “unconventional cholangiography,” include (1) distal...

Iatrogenic Bile Duct Injury During Laparoscopic Cholecystectomy

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Pages 102-110Nael, Saad , Michael, DarcyLaparoscopic cholecystectomy has largely replaced open cholecystectomy as the standard of care for gallbladder excision. A major disadvantage of this trend has been the increased incidence of bile duct injuries, which, while uncommon, are significantly higher with laparoscopic cholecystectomy. Most injuries are not recognized at the time of surgery and present in a delayed fashion, leading to significant patient morbidity and a negative impact on the quality of life of patients. Treatment is governed by the time of presentation and the nature of the bile duct injury incurred and requires a multidisciplinary approach. Radiologists play a key role in management,...

Percutaneous Management of Biliary Leaks: Biliary Embosclerosis and Ablation

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Pages 111-119Wael E.A., Saad , Michael D., DarcyBiliary leaks after hepatobiliary surgery are not uncommon. In certain situations minimal invasive percutaneous techniques may result in avoidance or reduction of the extent of surgery. Minimal invasive percutaneous techniques include (1) percutaneous bile collection (biloma) drainage, (2) percutaneous transhepatic biliary drainage, (3) biliary leak site embolization/sclerosis, and (4) leaking biliary segment ablation. There are two clinical applications for biliary ablation. The first is actual bile leak site ablation or embosclerosis to reduce an aperture or ablate a fistula (block a hole). The second is ablating an entire biliary segment to cease bile production and induce hepatic segmental atrophy (cease...

Percutaneous Transhepatic Techniques for Removal of Endoscopically Placed Biliary Plastic Endoprostheses

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Pages 120-132Wael E.A., SaadEndoscopic retrograde cholangiopancreatography-placed plastic biliary endoprostheses can migrate proximally and become impacted (4.9%). Endoscopy is resorted to first and percutaneous transhepatic techniques are resorted to second. Percutaneous transhepatic techniques are resorted to in probably less that 0.5% of all endoscopic retrograde cholangiopancreatography-placed plastic biliary endoprostheses and are rarely reported. The current article reviews the results, various techniques, and potential complications during the percutaneous transhepatic removal of these endoprostheses.

Cholangioscopy

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Pages 133-142Michael, Darcy , Daniel, PicusDirect visualization of the bile ducts and gall bladder via cholangioscopy is very useful both in treatment of complex stone cases and the assessment of indeterminate strictures or masses. It allows use of instruments that cannot be used safely with fluoroscopic guidance alone. It also increases procedural efficiency and decreases radiation doses. Careful selection of access routes is critical to ensuring successful cholangioscopy. Tract dilation to accommodate the access sheath should be deferred for several weeks after the initial drainage procedure. This allows clearance of infected material plus allows the tract to mature. Allowing time for tract maturation decreases the...

Percutaneous Management of Postoperative Anastomotic Biliary Strictures

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 2, June 2008, Pages 143-153Wael E.A., SaadPostoperative anastomotic biliary strictures can occur after surgery in bile ducts belonging to transplanted or native (nontransplanted) livers. The majority of postoperative anastomotic strictures encountered by interventional radiologists are most likely in liver transplant recipients due to the large and growing liver transplant recipient population worldwide compared with patients with native livers and biliary enteric anastomoses. They occur after 2.5 to 13% of liver transplantations and they represent at least one-half of biliary strictures encountered after liver transplantation. Anastomotic biliary strictures are considered technical in nature, accentuated by fibrosis and scarring that may be secondary to, if not exacerbated by,...

Editorial Board

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Page i[No author name available]

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Page ii[No author name available]

Forthcoming Topics

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Page iii[No author name available]

Introduction

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Page 1Wael E.A., Saad , Michael D., Darcy

Cholecystostomy and Transcholecystic Biliary Access

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Pages 2-13Daniel, Ginat , Wael E.A., SaadPercutaneous cholecystostomy represents a minimally invasive procedure for providing gallbladder decompression, often in critically ill patient populations. Indications for this procedure include calculous and acalculous cholecystitis, gallbladder perforation, malignant obstruction, percutaneous biliary stone removal, biliary duct drainage, and diagnostic imaging of the gallbladder and biliary ductal system. In addition, gallbladder access provided by percutaneous cholecystostomy may serve to carry additional procedures, such as cholangiograms, gallstone dissolution, and lithotripsy. Review of prior imaging studies including ultrasound, CT, and hepatobiliary scans are essential to planning the procedure, by helping to determine the access route: transhepatic versus transperitoneal. The transhepatic route is preferred...

Percutaneous Transhepatic Biliary Drainage

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Pages 14-20Anne M., Covey , Karen T., BrownOver the past three decades, endoscopic and percutaneous biliary drainage have become readily available in most hospital settings and these minimally invasive techniques have revolutionized the treatment of patients with biliary obstruction. In the past, treatment of biliary obstruction had required surgery under general anesthesia and an extended hospital stay. Currently, the same patient can most often be treated either endoscopically as an outpatient or during a short hospital stay after percutaneous drainage under moderate sedation. This article reviews the indications and technique of percutaneous transhepatic cholangiography and biliary drainage.

Transhepatic Techniques for Accessing the Biliary Tract

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Pages 21-42Wael E.A., SaadGaining access to the biliary tract by minimal invasive image-guided techniques is the forefront procedure for interventionalists to manage biliary disease. The technical know how and learned maneuvers are the fundamental skill sets of an interventional radiologist. This article details the technical maneuvers that can be utilized to gain access to the biliary tract with a needle and/or cathter/wire combinations. These techniques include (1) fluoroscopic-guided needle localization from a percutaneous transhepatic approach, (2) different types of wire access/entry into the biliary system, (3) the use of intrabiliary snares as targets for secondary/additional biliary access, (4) recannulating transhepatic biliary tracts after...

Management of Malignant Biliary Obstruction

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Pages 43-50Karen T., Brown , Anne M., CoveyMalignant bile duct obstruction is not uncommon, particularly in the later stages of disease, and may result in significant deterioration in the patient's quality of life, particularly if the patient becomes pruritic. Patients who have undergone previous intervention such as surgery with bilioenteric bypass, sphincterotomy, or endoscopic retrograde cholangiopancreatography may present with cholangitis. In addition, obstructive jaundice may preclude the use of certain chemotherapeutic agents either because of increased toxicity or because they require hepatic metabolism or excretion. This article discusses the indications for drainage in this patient population, technical considerations that may be unique to this patient population, and...

Biliary Complications after Orthotopic Liver Transplantation

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Pages 51-59David G., Buck , Albert B., ZajkoLiver transplantation has made many advances since its inception in the early 1970s. Despite volumes of basic science and clinical research related to liver transplantation, biliary complications continue to present the interventional radiologist with challenging cases in all transplant centers. Biliary complications can range from minor complications such as contained bile leaks to severe complications such as biliary necrosis resulting from hepatic artery thrombosis. Minor complications may require minimal or no intervention, whereas the more severe complications can require urgent surgery. To treat biliary complications such as anastomotic strictures, nonanastomotic strictures, biliary leaks, sludge or biliary necrosis, an accurate diagnosis...

Management of Bleeding after Percutaneous Transhepatic Cholangiography or Transhepatic Biliary Drain Placement

Publication year: 2008Source: Techniques in Vascular and Interventional Radiology, Volume 11, Issue 1, March 2008, Pages 60-71Wael E.A., Saad , Mark G., Davies , Michael D., DarcyBleeding complications occur in 2 to 3% of percutaneous transhepatic biliary drains. These complications include: hemothorax, hemoperitoneum, subcapsular hepatic bleeding, hemobilia, melena, and bleeding from the percutaneous biliary drain. The bleeding sites can be classified into (1) perihepatic bleed sites (hemothorax, hemoperitoneum, subcapsular hepatic hematoma), (2) gastrointestinal bleeding (hemobilia and/or melena), and (3) bleeding from the percutaenous biliary drain itself, which is the most common clinical presentation. There are several bleeding sources. These include skin-bleeds, intercostal artery, portal vein, hepatic vein, and the hepatic artery. There are a variety of maneuvers that can be utilized in the management of bleeding...

Editorial Board

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Page i[No author name available]

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Page iii[No author name available]

Forthcoming Topics

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Page iv[No author name available]

Introduction

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Page 247Jafar, Golzarian , Ziv, Haskal , Marc, Sapoval

Microspheres and Nonspherical Particles for Embolization

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Pages 248-256A., LaurentLast years, calibrated microspheres have proven their superiority in targeting embolization over non spherical particles in many applications. For the very near future they represent the best tool for controlling drug delivery in chemoembolization, under the two conditions that they would be image detectable and that the “dosimetry” would be tailored to pathological process.

Gelatine Sponge Particles: Handling Characteristics for Endovascular Use

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Pages 257-260Hicham T., Abada , Jafar, GolzarianGelatin sponge particles have been used since the mid 1960's in interventional radiology. It had played an important role as a temporary occlusive agent in the past. Embolization has gained a widespread acceptance in interventional radiology leading to different innovative new agents. This review is aimed to underline the persistent role of Gelfoam along with a better understanding of handling techniques in light of what we have learned from other particles as PVA and Embospheres. The clinical impact of embolization with gelfoam will be also stressed and discussed.

Drug-Eluting Particles for Interventional Pharmacology

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Pages 261-269Eleni, Liapi , Kwang-Hun, Lee , Christos C., Georgiades , Kelvin, Hong , Jean-Francois H., GeschwindChemoembolization with drug-eluting particles has been recently introduced in the field of interventional oncology. In this review, we will describe the pharmacokinetic properties and efficacy of all commercially available or under investigation drug-eluting particles and discuss the potentials and future of this new form of transcatheter arterial therapy for liver cancer.

Hemoptysis Workup Before Embolization: Single-Center Experience with a 15-year Period Follow-Up

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Pages 270-273Miguel A., de Gregorio , Joaquin, Medrano , Alicia, Laborda , Teresa, HigueraThe objective of this work was to present our experience in arterial embolization in the endovascular treatment of massive hemoptysis and remark on the importance of the workup before embolization. We present some clinical aspects to keep in mind before carrying out a bronchial embolization in a patient with severe hemoptysis. The main causes of hemoptysis are presented, as well as diagnosis means and the most important therapeutic procedures aimed to stabilize the patient who will undergo a bronchial arterial embolization. Likewise, we present our own experience with 401 patients with over a 15-year period of follow-up.

Bronchial Artery Embolization: Anatomy and Technique

Publication year: 2007Source: Techniques in Vascular and Interventional Radiology, Volume 10, Issue 4, December 2007, Pages 274-275Jean-Pierre, PelageTranscatheter embolization has become a first-line therapy in the management of hemoptysis. Knowledge of the arterial anatomy and variants is the key to safe and successful procedure.

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Postural change in ventilation and perfusion secondary to a thoracic scoliosis with complete resolution after surgery

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Ultrasound and CT findings in hepatic and pancreatic parenchyma in acute schistosomiasis

CT lung cancer screening in the UK

One-dimensional quantitative evaluation of peripheral lung adenocarcinoma with or without ground-glass opacity on thin-section CT images using profile curves

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320-slice CT neuroimaging: initial clinical experience and image quality evaluation

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Pre-trial quality assurance processes for an intensity-modulated radiation therapy IMRT trial: PARSPORT, a UK multicentre Phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer

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Positron Emission Tomography/Computed Tomography Potential Pitfalls and Artifacts

Diagnosis and Management of Pseudoaneurysms: An Update

The Great Mimicker: Fat Necrosis of the Breast—Magnetic Resonance Mammography Approach

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Multidetector Computed Tomography of the Acute Abdomen in the Immunocompromised Host: A Pictorial Review

Positron Emission Tomography/Computed Tomography Potential Pitfalls and Artifacts

Diagnosis and Management of Pseudoaneurysms: An Update

The Great Mimicker: Fat Necrosis of the Breast—Magnetic Resonance Mammography Approach

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Computed Tomographic Appearance of Chest Ports and Catheters: A Pictorial Review for Noninterventional Radiologists

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Magnetic Resonance Imaging of the Liver and Biliary Tree in Children

Radiofrequency and Microwave Ablation of the Liver, Lung, Kidney, and Bone: What Are the Differences?

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Technical Essentials of Hepatic Doppler Sonography

Microwave Ablation Technology: What Every User Should Know

Practical Applications of Nuclear Medicine in Imaging Breast Cancer

Multidetector Computed Tomography of the Mesocolon: Review of Anatomy and Pathology

Magnetic Resonance Arthrography of Superior Labrum Anterior-Posterior Lesions: A Practical Approach to Interpretation

Issues in Imaging Malignant Neoplasms of the Female Reproductive System

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Magnetic Resonance Imaging Features of the Discrete Epiphyseal Radiolucency: A Problem-Solving Approach to Differential Diagnosis

Computed Tomography and Magnetic Resonance Imaging Features of Lesions of the Renal Medulla and Sinus

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More Than Just Stones: A Pictorial Review of Common and Less Common Gallbladder Pathologies

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Magnetic Resonance Imaging of Cystic Adnexal Lesions During Pregnancy

Uncommon Tumors and Pseudotumoral Lesions of the Pancreas

Imaging Evaluation of Complications at Optical Colonoscopy

Fluorine-18-Deoxyglucose–Positron Emission Tomography Imaging with Magnetic Resonance and Computed Tomographic Correlation in the Evaluation of Bone and Soft-Tissue Sarcomas: A Pictorial Essay

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CT "invisible" lesion of the major salivary glands a diagnostic pitfall of contrast-enhanced CT.

Unusual unilateral breast (131)I uptake related to breastfeeding practice.

Re: Imaging appearances and endovascular management of uncommon pseudoaneurysms.

Radiology in the gross health context: need for prevention?

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Imaging of the gastrointestinal complications of systemic chemotherapy.

Pancreas transplants.