Iranian Journal of Radiology最新文献

{"title":"Can Diffusion-Weighted Imaging be a Gold Standard Method for Acute Appendicitis? A Comparative Study","authors":"Serdar Serinsoz, Remzi Akturk","doi":"10.5812/iranjradiol.113603","DOIUrl":"https://doi.org/10.5812/iranjradiol.113603","url":null,"abstract":"Background: Diagnosis of an inflamed appendix is commonly based on clinical, laboratory, and diagnostic imaging data. Ultrasonography (US) is the leading diagnostic modality for these patients. However, an inconclusive US examination suggests the application of non-enhanced computed tomography (NECT). Objectives: This study aimed to compare US, NECT, and diffusion-weighted magnetic resonance imaging (DW-MRI) examinations for an accurate diagnosis of acute appendicitis with the rate of proven appendicitis by surgery. Patients and Methods: This retrospective study was performed on 70 patients, diagnosed with acute appendicitis between February 2018 and January 2020. The diagnostic accuracy of US, CT, and DW-MRI for acute appendicitis was examined in relation to the demographic and clinical variables. Results: Age and gender were not significantly associated with surgically proven appendicitis. However, the appendix diameter had a significant association with surgically proven appendicitis. All DW-MRI–positive patients with acute abdominal symptoms were surgically diagnosed with acute/subacute appendicitis (even those with < 6 mm in diameter). Based on the ROC curve analysis, the sensitivity and specificity of DW-MRI in predicting acute appendicitis was 100% and 90.90%, respectively. Conclusion: The appendix diameter was an important factor in diagnosing acute appendicitis. However, DW-MRI is an advanced technique that may exclude the need for the appendix diameter measurements.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47629320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Diffusion Tensor Imaging in Obstructive Nephropathy","authors":"Hua-jian Xu, Han-wen Zhang, Juan Yu, F. Lin, Y. Lei","doi":"10.5812/IRANJRADIOL.114832","DOIUrl":"https://doi.org/10.5812/IRANJRADIOL.114832","url":null,"abstract":"Background: Obstructive nephropathy is a common clinical disease. Objectives: To explore the value of diffusion tensor imaging (DTI) in obstructive nephropathy. Methods: Forty healthy Sprague-Dawley (SD) rats were examined in this study. Thirty-two animals underwent complete obstruction of the left ureter, while eight animals underwent a sham surgery. Magnetic resonance imaging (MRI) was performed before surgery and within different intervals after surgery. Eight rats from the experimental group and two rats from the sham group were used in each interval. Following MRI, the animals were sacrificed and sent for medical examinations. The scanning sequences included positioning, transverse T2-weighted (T2W), coronal, and coronal DTI sequences. Image postprocessing was performed after DTI to measure DTI parameters, including apparent diffusion coefficient (ADC) and fractional anisotropy (FA), and to reconstruct DTI fiber traces. One-way analysis of variance was used to compare the parameters between the cortex and medulla and between different intervals. Results: The fiber tracing showed that the obstructed renal fiber bundles were sparse and disordered. The ADC and FA values of the renal cortex, extrarenal medulla, and inner medulla decreased with prolonged hydrops and were negatively correlated with the expression of alpha-smooth muscle actin (α-SMA) and the renal tubulointerstitial lesion grade (r < 0, P < 0.001). Comparison of the cortex, extrarenal medulla, and inner medulla showed the following trends for the ADC and FA values: cortex > extrarenal medulla > inner medulla and cortex < extrarenal medulla < inner medulla, respectively. Conclusions: DTI in obstructive nephropathy not only can reflect the degree of renal interstitial fibrosis and accurately indicate the renal function, but also can provide information regarding renal blood perfusion, water metabolism, and ultrastructural changes.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41502002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-Oral Ultrasonography of Young Adult Mandibular Foramen: A Reliable Method","authors":"M. Mehdizadeh, Negar Baharlouei, H. Taheri","doi":"10.5812/iranjradiol.111237","DOIUrl":"https://doi.org/10.5812/iranjradiol.111237","url":null,"abstract":"Background: The inferior alveolar nerve (IAN) block is the most commonly used mandibular injection method for local anesthesia in restorative and surgical procedures. Ultrasound images can provide more accurate information about the location of the inferior alveolar neurovascular bundle. Objectives: This study aimed to evaluate the ultrasound images of patients to determine the location of the mandibular foramen (MF) relative to the adjacent landmarks. Patients and Methods: In this cross-sectional analytical study, 50 patients were subjected to intra-oral ultrasonography of the right and left sides of the mandible. An Alpinion ultrasound system (Seoul, South Korea) was used for detecting the MF, as well as its distance from different landmarks. Results: In all patients, the MF was found using color Doppler ultrasonography. The probability of detecting MF in conventional ultrasonography was estimated at 36% and 18% for the right and left sides of the mandible without using the Doppler technique, respectively. The mean MF distance from the anterior border of the ramus was 14.6 ± 2.1 and 16.1 ± 2.1 mm on the right and left sides, respectively. Also, the vertical distance of MF from the occlusal plane was 7.5 ± 1.1 mm on the right side and 8.7 ± 1.2 mm on the left side of the mandible. In all studied patients, the MF was above the occlusal plane. Conclusion: The results of this study showed that ultrasonography is not only a suitable option for intra-oral imaging due to its non-ionizing beams, but is also appropriate for localization of the MF and its related landmarks.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42950240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the Relationship Between the Degree of Peritumoral Brain Edema and Pathological Features of Glioma Before Surgery","authors":"Zhenhua Wang, Xinlan Xiao","doi":"10.5812/iranjradiol.109181","DOIUrl":"https://doi.org/10.5812/iranjradiol.109181","url":null,"abstract":"Background: Gliomas are the most common malignant tumors of the central nervous system (CNS). Preoperative grading and prediction of the malignancy grade of gliomas are of particular importance. These tumors are often accompanied by peritumoral brain edema (PTBE). Previous studies have suggested that the degree of PTBE is an independent indicator of the prognosis of gliomas. Objectives: This study aimed to investigate the relationships between the degree of PTBE and the grade of glioma, isocitrate dehydrogenase 1 (IDH1) mutation status, and Ki-67 expression level in gliomas. Patients and Methods: In this retrospective cross-sectional study, a total of 82 patients were enrolled, according to the 2016 World Health Organization (WHO) classification of CNS tumors. Overall, 29 tumors were pathologically confirmed as low-grade gliomas (LGGs , grade I-II), whereas the remaining 53 tumors were classified as high-grade gliomas (HGGs grade III-IV). The IDH1 mutations, Ki-67 expression, and magnetic resonance imaging (MRI) findings were retrospectively analyzed. The tumor and tumor + PTBE volumes were also measured, and the tumor edema index (EI) was calculated for each patient. Edema was then graded and correlated with the pathological parameters. Results: The degree of EI was higher in the HGG group compared to the LGG group, and the difference was statistically significant (z = -7.018, P < 0.05). Besides, the degree of EI was higher in the IDH1 wild-type and mutant groups (z = -4.116, P < 0.05). The degree of EI significantly increased with Ki-67 expression and patient’s age (P < 0.05), whereas there was no significant association between the degree of EI and gender (z = -0.497, P = 0.619). The Spearman’s correlation test revealed that the EI degree was positively correlated with the Ki-67 expression level and age, with correlation coefficients of 0.740 and 0.466, respectively. Moreover, the multivariate regression analysis indicated that EI and IDH1 had significant effects on differentiating LGGs from HGGs (P < 0.05 for both). The receiver operating characteristic (ROC) curve analysis showed that EI was an optimal index for differentiating LGGs from HGGs, with an AUC of 0.822 (cutoff value: 1.722, sensitivity: 95.8%, specificity: 70.0%, 95% CI: 0.718 - 0.899). Conclusion: The degree of PTBE was found to be a valuable index for the differential diagnosis of LGGs from HGGs. The degree of PTBE was positively correlated with the patient’s age, grade of glioma, and Ki-67 level and negatively correlated with the IDH1 mutation status.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45168245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Size Measurements with Breast Magnetic Resonance Imaging (MRI) in Elderly Patients with Breast Cancer: A Comparison of Breast MRI with Mammography and Ultrasound","authors":"J. An, J. Woo, Ji Ye Lee, B. Lee","doi":"10.5812/iranjradiol.110817","DOIUrl":"https://doi.org/10.5812/iranjradiol.110817","url":null,"abstract":"Background: With a rapid increase in the aging population around the world, there has been a surge in the number of elderly breast cancer patients. Magnetic resonance imaging (MRI) is commonly used in preoperative assessments for elderly patients. However, there has been no consensus on the accuracy of tumor size measurements by MRI. Objectives: To compare the accuracy of MRI versus conventional imaging methods, namely, mammography (MG) and ultrasound (US), in tumor size measurements in elderly patients and to determine the predictors of measurement accuracy. Patients and Methods: This study was conducted on 134 patients, aged 50 years or above (137 breasts with invasive cancer). The tumor size and T stage were assessed using MG, US, and MRI, and the results were compared with pathological findings. The tumor size differences between the imaging and pathological findings were classified as ≤ 0.5 cm or > 0.5 cm. Differences in tumor size and T stage were also analyzed based on age group (≥ 60 years vs. < 60 years), using chi-square test, Fisher’s exact test, and Cohen’s kappa coefficient. The diagnostic sensitivity, specificity, and accuracy were also measured. Besides, a multivariate logistic regression analysis was performed to evaluate the predictors of tumor size differences. Results: Tumor size differences ≤ 0.5 cm, T-stage agreement, and diagnostic performance of MRI for T stages ≥ 2 were higher in the elderly group compared to the younger group. The T-stage agreement with the histopathological results was higher on MRI compared to conventional imaging methods. For diagnosis of T stages ≥ 2, MRI showed the highest sensitivity, while US showed the highest specificity. The calcification type, dense breasts, and histological grade 3 were predictors of tumor size differences > 0.5 cm. Conclusion: The accuracy of tumor size measurements on MRI was higher in elderly patients aged ≥ 60 years. The diagnostic accuracy also increased in elderly patients with non-dense breasts and mass-type lesions. In T-stage analysis, MRI showed the highest sensitivity, while US showed the highest specificity.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45216718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Assessment Using Early Quantitative Chest CT Parameters for the Severity of COVID-19","authors":"Xun Ding, Jia Xu, Haibo Xu, Jun Zhou, Qing-yun Long","doi":"10.5812/iranjradiol.109439","DOIUrl":"https://doi.org/10.5812/iranjradiol.109439","url":null,"abstract":"Background: Today, the outbreak of coronavirus disease 2019 (COVID-19) is known as a public health emergency by the World Health Organization (WHO). Therefore, risk assessment is necessary for making a correct decision in disease management. Objectives: This study aimed to assess the risk of progression to the critical stage in COVID-19 patients, based on the early quantitative chest computed tomography (CT) parameters. Patients and Methods: In this case-control study, 39 laboratory-confirmed critical or expired COVID-19 cases (critical group), as well as 117 laboratory-confirmed COVID-19 patients including mild, moderate, and severe cases (non-critical group), were enrolled. Seven quantitative CT parameters, representing the lung volume percentages at different density intervals, were automatically calculated, using the artificial intelligence (AI) algorithms. Multivariable-adjusted logistic regression models, based on the quantitative CT parameters, were established to predict the adverse outcomes (critical vs. non-critical). The predictive performance was estimated using the receiver operating characteristic (ROC) curve analysis and by measuring the area under the ROC curve (AUC). The quantitative CT parameters in different stages were compared between the two groups. Results: No significant differences were found between the two groups regarding the lung volume percentages at different density intervals within 0 - 4 days (P = 0.596-0.938); however, this difference began to become significant within 5 - 9 days and persisted even after one month. Overall, the quantitative CT parameters could well predict the severity of COVID-19. The lung volume percentage of -7 Hounsfield units (-7 HUs) had the largest crude odds ratio (OR: 1.999; 95% CI, 1.453 ~ 2.750; P < 0.001) and adjusted OR (adjusted OR: 1.768; 95% CI, 1.114 ~ 2.808; P = 0.016). The lung volume percentage of -6 HU showed the best predictive performance with the largest AUC of 0.808; the cutoff value of 5.93% showed 71.79% sensitivity and 84.62% specificity. Conclusion: Early quantitative chest CT parameters can be measured to assess the risk of progression to the critical stage of COVID-19; this is of critical importance in the clinical management of this disease.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44849151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Intra-arterial Chemoradiotherapy and Neoadjuvant Chemoradiotherapy Followed by Surgery for Maxillary Sinus Squamous Cell Carcinoma","authors":"Daisuke Yunaiyama, K. Tsukahara, Mitsuro Okubo, Kazuhiro Saito","doi":"10.5812/iranjradiol.108875","DOIUrl":"https://doi.org/10.5812/iranjradiol.108875","url":null,"abstract":"Background: Although intra-arterial chemoradiotherapy (CRT) followed by surgery has been the standard of care for patients with advanced maxillary sinus squamous cell carcinoma (MSSCC), concurrent intra-arterial chemotherapy and high-dose radiotherapy without surgery has emerged as a promising alternative. Objectives: This study aimed to evaluate the ability of intra-arterial CRT alone to increase the overall survival (OS) of patients with MSSCC. Patients and Methods: Forty patients with histologically confirmed MSSCC, who were treated at Tokyo Medical University Hospital (Tokyo, Japan) between February 1999 and June 2015, were enrolled in this study. Twenty-seven patients were treated with intra-arterial CRT (median dose of 60 Gy) without surgery (CRT group), whereas 13 patients were treated with neoadjuvant intra-arterial CRT (median dose of 40 Gy), followed by surgery (S group). The association of OS with age, performance status, T factor (mean tumor size according to the tumor-node-metastasis [TNM] grading system), N factor (mean lymph node involvement according to the TNM grading system), and treatment method was assessed. Results: The median follow-up duration was 36.0 months. There were no significant differences regarding the patients’ characteristics between the two groups. The treatment method was the only significant prognostic factor for OS. The five-year OS rates were 92% and 55% in the CRT and S groups, respectively (P = 0.01). Conclusion: The intra-arterial CRT (60 Gy) without surgery yielded improved survival outcomes in patients with advanced MSSCC as compared to the neoadjuvant intra-arterial CRT (40 Gy) followed by surgery.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44447925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Dynamic Changes of Chest CT Findings and Therapeutic Response of COVID-19: A Multicenter Experience in Shanghai, China","authors":"Jing-qi Zhu, Cuisong Tang, Yuxin Shi, Songhua Zhan, Shuai Wang, Litao Song, Zhihong Shao, Guang-shan Tang, Lin Zhang","doi":"10.5812/IRANJRADIOL.108734","DOIUrl":"https://doi.org/10.5812/IRANJRADIOL.108734","url":null,"abstract":"Background: The novel coronavirus disease 2019 (COVID-19) has become a global public health emergency. Computed tomography (CT) offers valuable clues to the diagnosis of COVID-19. However, little is known about the correlation between dynamic changes of CT scores and therapeutic response in the course of COVID-19. Objectives: To describe the temporal changes of CT findings and characterize the time window of disease progression on the follow-up CT scans of patients with COVID-19. Patients and Methods: In this historical cohort study performed in Shanghai, China, the follow-up chest CT images of 91 patients with COVID-19 with different therapeutic responses were reviewed in multiple centers, with an emphasis on characterizing the changing trend of CT scores for lung lesions at 13 - 15 days after the symptom onset and thereafter. The CT score curve patterns were categorized into type 1 (characterized by an increase to the peak level, followed by a decrease), type 2 (characterized by a steady change without an obvious peak), and type 3 (characterized by a progressive increase). Results: The CT scores of the progression group (n = 9) with a longer time to the peak were significantly higher than those of the non-progression group (n = 82) on the first day and days 13 - 15 (P < 0.05), except for the median CT scores before days 13 - 15. The CT curve type 1 and type 2 were commonly observed in the non-progression group (63.4% and 36.6%, respectively), while type 3 was more common in the progression group (88.9%). Conclusion: Most patients with COVID-19 show favorable responses to clinical treatments in Shanghai. Thirteen to fifteen days after the symptom onset can be considered as a turning point for the therapeutic response. The CT curve type 3 usually represents a poor response. The CT scores of patients with different therapeutic responses may overlap before days 13 - 15. The changing trend of longitudinal CT scores may contribute to the prediction of disease progression.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46266182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Cone-Beam Computed Tomography (CBCT) for Targeting the Portal Vein in Transjugular Intrahepatic Portosystemic Shunt (TIPS) Procedures: Comparison of Low-Dose with Standard-Dose CBCT","authors":"Arne Estler, J. Herrmann, C. Artzner, R. Hoffmann, K. Nikolaou, Tobias Hepp, U. Grosse, U. Schempf, F. Seith, G. Groezinger","doi":"10.5812/iranjradiol.111704","DOIUrl":"https://doi.org/10.5812/iranjradiol.111704","url":null,"abstract":"Background: A transjugular intrahepatic portosystemic shunt (TIPS) is a common treatment for patients with portal hypertension. In these patients, the portal vein can be punctured under the guidance of cone-beam computed tomography (CBCT). Objectives: To compare standard-dose (SD) CBCT with low-dose (LD) CBCT, as three-dimensional (3D) intraprocedural guidance for transhepatic puncture in TIPS placement, in terms of image quality, radiation dose, technical success, and complications. Materials and Methods: A total of 44 patients were retrospectively enrolled in this study. Eighteen patients underwent LD-CBCT, while 26 patients underwent SD-CBCT for guiding the portal vein puncture. A quantitative assessment of image quality was performed by calculating the contrast-to-noise ratio (CNR) of the hepatic portal vein. This analysis was based on a five-point vascular visualization scale (VVS), ranging from optimal (score = 1) to non-diagnostic (score = 5), while a three-point Likert scale was used for motion artifacts (1 = no motion artifacts, 3 = blurred). Image streak artifacts were also rated from one to three, based on the image quality results. Technical success was also investigated, including the number of puncture attempts, time to successful portal vein access, and radiation dose of the TIPS procedure. Results: Based on the results, TIPS could be placed successfully in all cases. Neither VVS (LD-CBCT VVS: 2.78, SD-CBCT VVS: 2.54; P = 0.467), nor the procedure time showed any significant differences between the groups (LD-CBCT: 48.3 min, SD-CBCT: 40.2 min; P = 0.45). Moreover, the objective evaluation of image quality indicated the lower quality of LD-CBCT images; however, the difference was not statistically significant (LD-CBCT CNR: 1.1 ± 0.76, SD-CBCT CNR: 1.3 ± 1.1; P = 0.5). The median number of puncture attempts was the same for SD-CBCT and LD-CBCT (n = 3; range: 1 - 6). Also, the mean dose area product (DAP) was significantly lower in LD-CBCT as compared to SD-CBCT (LD-CBCT: 2733 ± 848 µGm2, SD-CBCT: 6119 ± 1677 µGm2; P < 0.0001). The total DAP was significantly lower using LD-CBCT (LD-CBCT: 14831 ± 9299 µGm2, SD-CBCT: 20985 ± 10127 µGm2; P = 0.047). Conclusion: Both SD-CBCT and LD-CBCT provided successful 3D guidance for portal vein puncture during TIPS creation. Although these methods did not differ significantly in terms of image quality, complications, or number of puncture attempts, LD-CBCT significantly reduced the radiation dose.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45542757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of Quantitative Contrast-Enhanced Ultrasonography in Distinguishing Asymptomatic Subacute Thyroiditis from Papillary Thyroid Carcinoma","authors":"Na Wang, Hongguang Sun, Qi Tingyue, Haiyan Cao, Li Nianfen, Linhai Zhu, Yongling Ding","doi":"10.5812/IRANJRADIOL.107225","DOIUrl":"https://doi.org/10.5812/IRANJRADIOL.107225","url":null,"abstract":"Background: Asymptomatic subacute thyroiditis (aSAT) without inflammatory features is often difficult to distinguish from papillary thyroid carcinoma (PTC), even with ultrasonography. Under certain circumstances, a fine-needle aspiration biopsy (FNAB) is performed, which is known to increase the patient’s physical pain. Objectives: To investigate the value of quantitative contrast-enhanced ultrasonography (CEUS) in discriminating aSAT from PTC nodules. Methods: A total of 30 aSAT and 23 PTC patients were systematically reviewed. Quantitative CEUS parameters, including the rise time (RT), time to peak (TTP), maximum intensity (IMAX), as well as their extension indicators (ΔRT and ΔTTP), were determined in various nodule areas (total, central, peripheral, and control regions of nodules). Chi-square test and independent-samples t-test were performed to compare significant differences between PTC and aSAT. A receiver operating characteristics (ROC) curve analysis was also performed to assess the diagnostic efficacy of each parameter, as well as diagnostic efficacy indices, including sensitivity and specificity, in discriminating aSAT from PTC nodules. Results: Compared to the PTC group, patients with aSAT had a longer ∆RT1 (RT of the control area − RT of the whole area; 0.12 ± 0.69 vs. -0.2 ± 0.57, P = 0.03) and ∆RT3 (RT of the control area − RT of the central area; 0.43 ± 0.72 vs. 0.04 ± 0.94, P = 0.049). Besides, compared to the PTC group, the aSAT group had a shorter RT in the total area (RT1: 4.05 ± 1.56 vs. 4.91 ± 2.09, P = 0.045); a shorter TTP in the total (TTP1: 4.91 ± 1.76 vs. 7.30 ± 3.92, P = 0.005), peripheral (TTP2: 5.06 ± 1.97 vs. 7.00 ± 3.48, P = 0.01), and central (TTP3: 4.90 ± 1.68 vs. 7.57 ± 4.41, P = 0.004) areas; and a lower IMAX in the peripheral area (IMAX2: 0.74 ± 0.36 vs. 1.09 ± 0.57, P = 0.009). Based on the ROC curve analysis, the area under the curve was significantly larger for TTP1 as compared to RT1 (P = 0.027). Conclusion: Conventional ultrasound and CEUS examinations were inadequate in distinguishing PTC from aSAT. Overall, a quantitative analysis may indicate more biological characteristics of nodules, which can be helpful in the differential diagnosis.","PeriodicalId":50273,"journal":{"name":"Iranian Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46931629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}