Diagnostic and Interventional Radiology最新文献

{"title":"Pulmonary infarctions as the cause of bilateral cavitations in a patient with COVID-19.","authors":"Edson Marchiori, Luiz Felipe Nobre, Bruno Hochhegger, Gláucia Zanetti","doi":"10.5152/dir.2020.20865","DOIUrl":"https://doi.org/10.5152/dir.2020.20865","url":null,"abstract":"We read with interest a Letter to the Editor by Xu et al. (1), in which they described no previous reported cavitation in patients with COVID-19 pneumonia to date, indicating the need to consider associated causes other than the virus infection determining the cavitary lesions. However, they reported the case of a 27-year-old man with confirmed COVID-19 infection who presented with a CT cavitation in the right lung. An extensive search revealed no secondary infectious agent, including tuberculosis. Even so, the patient was treated with multiple antimicrobial drugs, but after 5 days the symptoms improved, and the cavity enlarged. Henceforth, the patient was mainly treated with antiviral drugs, and the cavity gradually disappeared. Therefore, the authors suggested that the cavity was caused by COVID-19, although there was no pathological confirmation of that evidence. The literature reflects consensus that lung injuries caused by COVID-19 do not cavitate, and that the finding of cavitation should direct the search for alternative diagnoses, or even overlap with other diseases, especially associated secondary infections (2). Recent studies have demonstrated that pulmonary co-infection by other agents is not uncommon in the COVID-19 context. Complications such as necrotizing pneumonia and subsequent cavitation of lung lesions may occur, and their imaging presentations are considered to be atypical of COVID-19 (3, 4). None of the published cases demonstrate adequately that the pulmonary cavitation is attributable to COVID-19 pneumonia. We would like to report the case of a 66-year-old man admitted to the emergency room with COVID-19 pneumonia, requiring high FiO2. D-dimer level was 980 ng/mL (normal <500 ng/mL). The patient developed respiratory failure and his condition progressed slowly, with no oximetric improvement. A new D-dimer test showed values 10 times greater than normal. Angio-CT performed 23 days after the first examination demonstrated extensive pulmonary thromboembolism, with the simultaneous appearance of two cavitated lung lesions, with different morphological aspects, compatible with the evolutionary stages of pulmonary infarction cavitation (Fig.). The patient had an excellent evolution after full anticoagulation therapy. Lung cavitation following pulmonary embolism and infarction is an uncommon finding, described in patients with diseases other than COVID-19 (5). The two types of cavitary pulmonary infarction are bland infarction, caused by aseptic necrosis in the absence of infection, and septic infarction, caused by the superinfection of dead lung tissue. Infected pulmonary infarctions lead to cavitation more rapidly than do bland infarctions with aseptic necrosis, and infectious cavitary infarction has a higher mortality rate and requires an aggressive approach to improve the outcome (5). Our patient had two cavitated lesions with different morphological characteristics (one with thick and irregular walls, the other with thin wal","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"690-691"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2020.20865","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38733740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of transjugular intrahepatic portosystemic shunt on transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis.","authors":"Xi Chen,&nbsp;Zhen-Kang Qiu,&nbsp;Guo-Bao Wang,&nbsp;Xin-Lin Chen,&nbsp;Fu-Jun Zhang,&nbsp;Fei Gao","doi":"10.5152/dir.2021.20358","DOIUrl":"https://doi.org/10.5152/dir.2021.20358","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatocellular carcinoma (HCC) usually occurs accompanied by portal hypertension. Transcatheter arterial chemoembolization (TACE) is recommended as an effective treatment in HCC. Recent studies had conflicting results regarding the effectiveness and safety of TACE for HCC in patients with transjugular intrahepatic portosystemic shunt (TIPS). This meta-analysis aimed to evaluate the influence of TIPS on the effectiveness and safety of TACE for patients with HCC.</p><p><strong>Methods: </strong>A comprehensive search of studies among PubMed, Web of Science and Cochrane Library was conducted, from the earliest publishing date to January 27th, 2020. Statistical analyses were all performed using the Stata 13.0 software. I2 index statistic was used to assess heterogeneity.</p><p><strong>Results: </strong>Six studies with a total of 536 patients with HCC were included in the analysis. The pooled response rate was 51% (95% CI: 25% to 77%) with a significant heterogeneity (I2=93.3%, p < 0.001). The TACE + TIPS group had an inferior response rate than the non-TIPS group, but the difference had no statistical significance (p = 0.171) and heterogeneity was low (I2=0.00%, p = 0.490). Pooled hepatic failure rate was 8.8% (95% CI: 5.2% to 12.4%) with low heterogeneity (I2=0.0%, p = 0.747). But the pooled hepatic failure rate increased to 12.7% (95% CI: 5.7% to 19.7%) with low heterogeneity (I2=11.5%, p = 0.323) if the patients who received TIPS after TACE were excluded.</p><p><strong>Conclusion: </strong>TIPS does not influence the effectiveness of TACE, but attention should be paid to the risk of hepatic failure.</p>","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"671-676"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480950/pdf/dir-27-5-671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39235117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral tilt during IVC filter placement does not predict the need for advanced filter retrieval techniques.","authors":"Peter White,&nbsp;Younes Jahangiri,&nbsp;Khashayar Farsad,&nbsp;John Kaufman,&nbsp;Ramsey Al-Hakim","doi":"10.5152/dir.2021.19411","DOIUrl":"https://doi.org/10.5152/dir.2021.19411","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to determine if lateral inferior vena cava (IVC) filter tilt at placement predicts the need for subsequent advanced retrieval techniques.</p><p><strong>Methods: </strong>A retrospective chart review was performed of all Gunther Tulip IVC filter placements with subsequent retrievals between February 2015 and October 2017. Chart and imaging review was performed for patient, filter placement, and filter retrieval demographics/characteristics. Degree of agreement between two measurement sets was evaluated with the intraclass correlation (ICC) analysis. Categorical variables were compared with chi-square or Fisher exact test, as appropriate. Kendall rank correlation was used to measure correlation between categorical variables.</p><p><strong>Results: </strong>There was poor agreement between filter tilt angle at the time of placement and retrieval (ICC coefficient, 0.54). Mean difference ± standard deviation between tilt angle at the time of placement and retrieval was 4.6°±4.3° (p = 0.35). Among patient- or procedure-related factors, a common femoral vein access on placement (regression coefficient, -2.90; p = 0.039) was associated with a lower difference between placement and retrieval filter tilt angles compared to internal jugular vein access. Higher filter tilt angle measured at the time of retrieval (OR: 1.19, p = 0.025), hook embedment (OR: 77.3, p < 0.001), and a longer dwell time (OR: 1.25, p = 0.002) were associated with the need for advanced retrieval techniques. However, in univariate and multivariate analysis filter tilt angle at the time of placement was not associated with the subsequent need for advanced retrieval technique (p = 0.16).</p><p><strong>Conclusion: </strong>Lateral tilt at the time of placement is poorly associated with lateral tilt at the time of retrieval and does not correlate with the need for advanced retrieval technique.</p>","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"644-648"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480951/pdf/dir-27-5-644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39445574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI and CT in the follow-up after irreversible electroporation of small renal masses.","authors":"Mara Buijs,&nbsp;Daniel M de Bruin,&nbsp;Peter Gk Wagstaff,&nbsp;Patricia J Zondervan,&nbsp;Matthijs JV Scheltema,&nbsp;Marc W Engelbrecht,&nbsp;Maria P Laguna,&nbsp;Krijn P van Lienden","doi":"10.5152/dir.2021.19575","DOIUrl":"https://doi.org/10.5152/dir.2021.19575","url":null,"abstract":"<p><strong>Purpose: </strong>Ablation plays a growing role in the treatment of small renal masses (SRMs) due to its nephron sparing properties and low invasiveness. Irreversible electroporation (IRE) has the potential, although still experimental, to overcome current limitations of thermal ablation. No prospective imaging studies exist of the ablation zone in the follow up after renal IRE in humans. Objectives are to assess computed tomography (CT) and magnetic resonance imaging (MRI) on the ablation zone volume (AZV), enhancement and imaging characteristics after renal IRE.</p><p><strong>Methods: </strong>Prospective phase 2 study of IRE in nine patients with ten SRMs. MRI imaging was performed pre-IRE, 1 week, 3 months, 6 months and 12 months after IRE. CT was performed pre-IRE, perioperatively (direct after ablation), 3 months, 6 months and 12 months after IRE. AZVs were assessed by two independent observers. Observer variation was analyzed. Evolution of AZVs, and relation between the needle configuration volume (NCV; planned AZV) and CT- and MRI volumes were evaluated.</p><p><strong>Results: </strong>Eight SRMs were clear cell renal cell carcinomas, one SRM was a papillary renal cell carcinoma and one patient had a non-diagnostic biopsy. On CT, median AZV increased perioperatively until 3 months post-IRE (respectively, 16.8 cm3 and 6.2 cm3) compared to the NCV (4.8 cm3). On MRI, median AZV increased 1-week post-IRE until 3 months post-IRE (respectively, 14.5 cm3 and 4.6 cm3) compared to the NCV (4.8 cm3). At 6 months the AZV starts decreasing (CT 4.8 cm3; MRI 3.0 cm3), continuing at 12 months (CT 4.2 cm3, MRI 1.1 cm3). Strong correlation was demonstrated between the planning and the post-treatment volumes. Inter-observer agreement between observers was excellent (CT 95% CI 0.82-0.95, MRI 95% CI 0.86-0.96). All SRMs appeared non-enhanced immediately after ablation, except for one residual tumour. Subtraction images confirmed non-enhancement on MRI in unclear enhancement cases (3/9). Directly after IRE, gas bubbles, perinephric stranding and edema were observed in all cases.</p><p><strong>Conclusion: </strong>The AZV increases immediately on CT until 3 months after IRE. On MRI, the AZV increases at 1 week until 3 months post-IRE. At 6 months the AZV starts decreasing until 12 months post-IRE on both CT and MRI. Enhancement was absent post-IRE, except for one residual tumour. Gas bubbles, perinephric stranding and edema are normal findings directly post-IRE.</p>","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"654-663"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480958/pdf/dir-27-5-654.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39445575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of ablation and embolization for intermediate-sized liver metastases from colorectal cancer: what can we learn from treating primary liver cancer?","authors":"Matthew J Seager,&nbsp;Tobias F Jakobs,&nbsp;Ricky A Sharma,&nbsp;Steve Bandula","doi":"10.5152/dir.2021.20520","DOIUrl":"https://doi.org/10.5152/dir.2021.20520","url":null,"abstract":"<p><p>Colorectal cancer liver metastases (CRLMs) are common. Treating CRLMs with thermal ablation can prolong survival, but compared to lesions smaller than 3 cm, local control rates and overall survival are relatively worse with larger, intermediate (3-5 cm) lesions. Local recurrence rates range between 1.7%-20.2% and 6.7%-68.9% for CRLMs less than 3 cm and greater than 3 cm, respectively. Worse outcomes are also present when ablating intermediate size hepatocellular carcinoma (HCC) and there are some pathological similarities with CRLMs, namely the presence of micrometastatic disease. Combining ablation with transarterial chemoembolization is more effective in treating intermediate-size HCC than ablation alone. A meta-analysis of robust randomized controlled trials demonstrated long-term improved survival with combination therapy compared to ablation alone (odds ratio at 1, 3 and 5 years of 2.74, 2.77 and 5.23, respectively). There is, however, minimal evidence for combination therapy in CRLMs, limited to a handful of studies that are predominantly retrospective and have heterogeneous inclusion criteria. Given the difficulty in successfully treating intermediate CRLMs, the strong evidence for combination therapy in intermediate HCC and potential pathological similarities, formal evaluation of combination treatment in CRLM is merited. This review highlights existing evidence for treatment of intermediate-size liver lesions and highlights where trials in CRLMs should focus.</p>","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"677-683"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480946/pdf/dir-27-5-677.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39235116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid progression of COVID-19 pneumonia to extensive fibrosis assessed with 3D volumetric CT.","authors":"Serkan Guneyli,&nbsp;Ilhan Hekimsoy,&nbsp;Emre Altinmakas,&nbsp;Recep Savas","doi":"10.5152/dir.2021.21105","DOIUrl":"https://doi.org/10.5152/dir.2021.21105","url":null,"abstract":"","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"692-693"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480959/pdf/dir-27-5-692.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39235122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-atrial right coronary artery on dual-source CT: prevalence and characteristics.","authors":"Kartik P Ganga,&nbsp;Vineeta Ojha,&nbsp;Aayush Goyal,&nbsp;Siddharthan Deepti,&nbsp;Sanjeev Kumar","doi":"10.5152/dir.2021.20340","DOIUrl":"https://doi.org/10.5152/dir.2021.20340","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to determine the prevalence rate and radiological characteristics of intra-atrial right coronary artery (IARCA) in an adult population undergoing computed tomography coronary angiography (CTCA) on a dual-source CT scanner.</p><p><strong>Methods: </strong>Overall, 7114 consecutive CTCAs acquired using a dual-source CT scanner in a high-volume, specialized cardiac care facility were retrospectively analyzed for the presence of IARCA. We scrutinized the CTCA datasets to determine the prevalence rate of IARCA and also to characterize its various imaging features including its length, depth from right atrial wall, segment involved, and presence and absence of atherosclerosis within the involved segment and in the rest of the right coronary artery (RCA).</p><p><strong>Results: </strong>The prevalence of IARCA was 0.29% (21/7114) in our study population. The mean length and depth of the intra-atrial segment was 14.85 mm and 2.57 mm, respectively. The mid-RCA was the most common segment to be involved, and no significant atherosclerosis was noted either in the intra-atrial segment or the rest of the RCA.</p><p><strong>Conclusion: </strong>The prevalence rate of the incidental IARCA in the adult subjects undergoing CTCA is higher than previously reported for anatomical series, as seen in our study using a dual-source scanner. This under-reported anomaly must be explicitly assessed in patients undergoing ablative and other electrophysiological procedures, where it can have important implications.</p>","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"595-598"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480945/pdf/dir-27-5-595.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39229406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeat angiography in patients undergoing conventional catheter-directed thrombolysis for submassive pulmonary embolism: a large single-center experience.","authors":"Adam Schmitz,&nbsp;Michael Schacht,&nbsp;Sabah Butty","doi":"10.5152/dir.2021.20573","DOIUrl":"https://doi.org/10.5152/dir.2021.20573","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies have examined conventional catheter directed thrombolysis (CDT) for the treatment of submassive pulmonary embolism (PE). Moreover, angiographic resolution of thrombus burden following CDT has infrequently been characterized. This study describes a single-center experience treating submassive PE with CDT while utilizing repeat angiography to determine treatment efficacy.</p><p><strong>Methods: </strong>A retrospective analysis of 140 consecutive patients who underwent CDT for submassive PE from December 2012 to June 2019 was performed. Angiographic resolution of thrombus burden after CDT was reported as high (>75%), moderate (51-75%), low (26-50%), or insignificant (≤25%). All angiograms were reviewed by two interventional radiologists. Secondary endpoints included reduction in pulmonary artery pressure (PAP) and clinical outcomes. Bleeding events were classified according to the Society of Interventional Radiology (SIR) adverse event criteria.</p><p><strong>Results: </strong>CDT was performed in 140 patients with a mean rtPA dose of 25.3 mg and a mean treatment time of 26.0 hours. Angiographic resolution of thrombus burden was high in 70.0%, moderate in 19.3%, low in 5.7%, and insignificant in 3.6%; in 2 patients (1.4%) repeat angiography was not performed. Systolic PAP was reduced (47 vs. 35 mmHg, p < 0.001), mean PAP was reduced (25 vs 21 mmHg, p < 0.001), and 129 patients (92.1%) improved clinically. Patients with high or moderate resolution of thrombus burden had a clinical improvement rate of 95.2%, while patients with low or insignificant thrombus burden resolution had a clinical improvement rate of 76.9% (p=0.011). Ten patients (7.1%) had hemodynamic or respiratory decompensation requiring mechanical ventilation, systemic thrombolysis, cardiopulmonary resuscitation, or surgical intervention. Seven patients (5.0%) experienced moderate bleeding events and one patient (0.7%) with metastatic disease developed severe gastrointestinal bleeding that resulted in death. Thirty-day mortality was 1.4%.</p><p><strong>Conclusion: </strong>In patients with submassive PE undergoing CDT, angiographic resolution of thrombus burden is a safe and directly observable metric that can be used to determine procedural success. In this study, CDT with repeat angiography was associated with a 5.7% bleeding event rate and thirty-day mortality of 1.4%.</p>","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"664-670"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480944/pdf/dir-27-5-664.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39445576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Rings of Saturn\" appearance: a unique finding in a case of COVID-19 pneumonitis.","authors":"Ramezan Jafari,&nbsp;Patrick M Colletti,&nbsp;Amin Saburi","doi":"10.5152/dir.2020.20266","DOIUrl":"https://doi.org/10.5152/dir.2020.20266","url":null,"abstract":"Since March 2019 when the severe respiratory syndrome of coronavirus disease 2019 (COVID-19) was announced, many radiologic manifestations of COVID-19 have been reported (1). Bilateral ground glass opacities (GGOs) predominantly at lower and posterior segments, mixed pattern of GGOs and consolidation and septal thickening are the most common features. Halo sign, nodular pattern, pleural effusion, and even completely normal findings are less frequently reported. We have encountered a unique CT appearance of COVID-19 pneumonitis in a 24-year-old man. This finding is not a halo or reverse halo sign as might be expected in these organizing pneumonias. Figure demonstrates focal core opacity and two ring-like opacities immediately around it as in the “rings of Saturn”. From a pathologic perspective, initially the virus enters the alveoli, followed by viral proliferation and local and generalized immune system response with cytokine storm by immunological modulators. This is most commonly followed by a recovery phase with pulmonary parenchymal tissue repair processes (2). CT may initially demonstrate localized GGOs, followed by more widespread GGOs, typically combined with consolidation, crazy paving, and the formation of fibrotic strips (3, 4). Concurrent invasion and resolving phases are due to immunity response in multiple phases as seen in organizing pneumonia. The most prominent differences between organizing pneumonia and resolving focal GGOs of COVID-19 include faster and less severe local reaction, with faster recovery and less fibrotic changes of simple resolving GGOs. Focal necrosis with surrounding hemorrhage is the main pathology of the halo sign typical of organizing pneumonia, which is not expected in COVID-19. The pathological distribution of organizing pneumonia is in both alveoli and terminal bronchioles. Bronchiolar involvement can be due to thick alveolar exudates and inflammatory bronchial wall thickening. Similarly, our presented feature appears to be due to bronchiole interstitial spreading and vascular impairment as a part of the cytokine storm with interstitial pneumonitis and focal organizing pneumonia with step-by-step veno-lymphatic spreading. This is the first report of this particular finding and needs to be supported by additional observations and studies.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"154"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2020.20266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38166231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI in patients with urethral stricture: a systematic review.","authors":"Mikolaj Frankiewicz,&nbsp;Karolina Markiet,&nbsp;Jakub Krukowski,&nbsp;Edyta Szurowska,&nbsp;Marcin Matuszewski","doi":"10.5152/dir.2020.19515","DOIUrl":"https://doi.org/10.5152/dir.2020.19515","url":null,"abstract":"<p><p>Magnetic resonance imaging (MRI) is gaining acceptance as a diagnostic tool in urethral stricture disease. Numerous publications emphasize on the advantages of MRI including its ability to determine periurethral spongiofibrosis, thus overcoming the main limitation of retrograde urethrography (RUG). It is also becoming an alternative for sonourethrography (SUG), which is a highly subjective examination. Magnetic resonance urethrography (MRU) has become an increasingly appreciated tool for diagnosing patients with urethral stricture disease. Obtained data provides radiologists and urethral reconstructive surgeons with additional information regarding anatomical relationships and periurethral tissue details, facilitating further treatment planning. Considering the great prevalence of urethral stricture disease and necessity of using accurate, and acceptable diagnostic method, this review was designed to provide radiologists and clinicians with a systematic review of the literature on the use of MRI in the urethral stricture disease.</p>","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":" ","pages":"134-146"},"PeriodicalIF":2.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/dir.2020.19515","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38631844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}