Clinical Imaging最新文献

{"title":"Comprehensive multimodality imaging review of reproductive interventions and their complications","authors":"Michelle Lee, Kira Melamud, Robert Petrocelli, Chrystia Slywotzky, Vinay Prabhu","doi":"10.1016/j.clinimag.2024.110312","DOIUrl":"10.1016/j.clinimag.2024.110312","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110312"},"PeriodicalIF":1.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512344","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":"Heart lung axis in acute pulmonary embolism: Role of CT in risk stratification","authors":"Renee S. Friedman ,&nbsp;Linda B. Haramati ,&nbsp;Timothy F. Christian ,&nbsp;Seth I. Sokol ,&nbsp;Jonathan Alis","doi":"10.1016/j.clinimag.2024.110311","DOIUrl":"10.1016/j.clinimag.2024.110311","url":null,"abstract":"<div><div>Pulmonary embolism (PE) remains a significant cause of mortality requiring prompt diagnosis and risk stratification. This review focuses on the role of computed tomography (CT) in the risk stratification of acute PE, highlighting its impact on patient management. We will explore basic pathophysiology of pulmonary embolism (PE) and review current guidelines, which will help radiologists interpret images within a broader clinical context. This review covers key CT findings which can be used for risk stratification including indicators of right ventricular (RV) dysfunction, clot burden, clot location and left atrial volume. We will discuss the measurement of RV/LV diameter ratio as a key indicator of RV dysfunction and its limitations and challenges within various patient populations. While these parameters should be included in a radiologist's report, their predictive value for mortality depends on the patient's existing cardiopulmonary reserve and should not be interpreted in isolation.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110311"},"PeriodicalIF":1.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442271","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":"Anne C. Roberts, MD, FSIR, FACR, FCIRSE: Pioneer, innovator and leader","authors":"Naomi Isaac ,&nbsp;Julie Bykowski","doi":"10.1016/j.clinimag.2024.110309","DOIUrl":"10.1016/j.clinimag.2024.110309","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"117 ","pages":"Article 110309"},"PeriodicalIF":1.8,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644940","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":"Factors affecting mammogram breast cancer surveillance effectiveness in the ipsilateral and contralateral breast","authors":"Julie Liana Hamzah ,&nbsp;Jasmine Kai Sing Phua ,&nbsp;Wei Ting Chan ,&nbsp;Sze Yiun Teo ,&nbsp;Veronique Kiak-Mien Tan ,&nbsp;Geok Hoon Lim ,&nbsp;Benita Kiat Tee Tan ,&nbsp;Swee Ho Lim ,&nbsp;Puay Hoon Tan ,&nbsp;John Carson Allen ,&nbsp;Lester Chee Hao Leong","doi":"10.1016/j.clinimag.2024.110308","DOIUrl":"10.1016/j.clinimag.2024.110308","url":null,"abstract":"<div><h3>Aim</h3><div>Mammography is the mainstay of imaging surveillance after breast cancer (BC) treatment, but false negatives can occur. The objective of the study was to determine the factors that can predict poorer second breast cancer (SBC) mammogram detection of the ipsilateral and contralateral breast separately.</div></div><div><h3>Methods</h3><div>A multicentre retrospective review was performed on female patients with a previous history of treated BC who developed a second breast cancer (SBC) in the ipsilateral (ISBC) or contralateral breast (CSBC) within 10 years from the first BC. SBC cases that occurred between January 2006 and October 2017 were included from the institutional database. The ISBC and CSBC mammogram-occult (MO) rates were correlated with mammographic breast density as well as various clinical, radiological and histological characteristics of the first BC.</div></div><div><h3>Results</h3><div>274 cases of SBC were evaluated. 39.4 % (108/274) of cases were ISBC and 60.6 % (166/274) were CSBC. 35 (32.4 %) of the ISBCs and 42 (25.3 %) of the CSBCs were MO (<em>p</em> = 0.218). On multivariate analysis, symptomatic first BC (<em>p</em> = 0.041), prevailing dense breast tissue at the time of SBC diagnosis (<em>p</em> = 0.003) and trabecular thickening on surveillance mammograms (<em>p</em> = 0.017) were associated with MO ISBC. MO first BC (<em>p</em> &lt; 0.001) was the only factor found to correlate with MO CSBC.</div></div><div><h3>Conclusion</h3><div>The study found various clinical, radiological and pathological factors associated with mammogram surveillance failure for the ipsilateral and contralateral breast. This information can provide additional guidance in the planning of a personalised surveillance program using adjunct imaging screening.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110308"},"PeriodicalIF":1.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445526","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 experience on the limited role of ultrasound for breast cancer screening in BRCA1 and BRCA2 mutations carriers aged 30–39 years","authors":"Hila Bufman ,&nbsp;Vera Sorin ,&nbsp;Renata Faermann ,&nbsp;Rinat Bernstein-Molho ,&nbsp;Eitan Friedman ,&nbsp;Yiftach Barash ,&nbsp;Nora Balint Lahat ,&nbsp;Miri Sklair-Levy","doi":"10.1016/j.clinimag.2024.110310","DOIUrl":"10.1016/j.clinimag.2024.110310","url":null,"abstract":"<div><h3>Purpose</h3><div>In BRCA germline pathogenic sequence variants (PSV) carriers aged 30–39 years imaging is recommended at six-month intervals. The European society for medical oncology recommendation of the use of 6-monthly MRI six-monthly MRI screening is being considered at our institution, particularly for younger carriers under the age of 35, although it is not mandatory. If 6-monthly MRI is unavailable, annual MRI may be supplemented by ultrasound (with or without mammography). The aim of this study was to evaluate the utility of ultrasound screening added to mammography, as a 6-month supplement to annual MRI in BRCA PSV carriers aged 30–39 years.</div></div><div><h3>Materials and methods</h3><div>This IRB approved retrospective study included BRCA PSV carriers aged 30–39 years, who underwent breast cancer screening at our institution between January 2015 and March 2023. Participants were divided into two groups, those who had supplemental whole-breast US and mammography at six months and underwent screening before March 2019, and those who had only mammography without supplemental US and enrolled in screening after March 2019. Patient characteristics, cancer detection rates and cancer characteristics were compared between the two groups.</div></div><div><h3>Results</h3><div>Overall, 200 asymptomatic BRCA1/2 PSV carriers undergoing screening in our institution were included in the study. Mean age was 35.7 ± 3.5 years, and mean follow-up time was 37.4 ± 38.0 months. There were 118 (59 %) women screened with supplemental US, and 82 (41 %) women without. Eight cancers were diagnosed during the study period, four in women with supplemental US and four in women without. The sensitivity of whole-breast screening US was 25 % (1/4), specificity 85.7 % (222/259), PPV 2.6 % (1/38), and NPV 98.7 % (222/225). Of the four cancers detected in women screened with supplemental US, one was diagnosed by whole-breast US, two by MRI, and one by mammography. Of eight cancers included in this study, two were not detectable by targeted second-look US. All eight cancers were detectable by MRI.</div></div><div><h3>Conclusion</h3><div>The addition of whole-breast ultrasound to mammography and MRI screening in BRCA PSV carriers aged 30–39 years offered limited incremental benefit. MRI with 6 months supplemental mammography without US detected all cancer cases.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"116 ","pages":"Article 110310"},"PeriodicalIF":1.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407170","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":"Low-field MRI lung opacity severity associated with decreased DLCO in post-acute Covid-19 patients","authors":"Lea Azour ,&nbsp;Leopoldo N. Segal ,&nbsp;Rany Condos ,&nbsp;William H. Moore ,&nbsp;Nicholas Landini ,&nbsp;Destiny Collazo ,&nbsp;Daniel H. Sterman ,&nbsp;Isabel Young ,&nbsp;Jane Ko ,&nbsp;Shari Brosnahan ,&nbsp;James Babb ,&nbsp;Hersh Chandarana","doi":"10.1016/j.clinimag.2024.110307","DOIUrl":"10.1016/j.clinimag.2024.110307","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the clinical significance of low-field MRI lung opacity severity.</div></div><div><h3>Methods</h3><div>Retrospective cross-sectional analysis of post-acute Covid-19 patients imaged with low-field MRI from 9/2020 through 9/2022, and within 1 month of pulmonary function tests (PFTs), 6-min walk test (6mWT), and symptom inventory (SI), and/or within 3 months of St. George Respiratory Questionnaire (SGRQ) was performed.</div><div>Univariate and correlative analyses were performed with Wilcoxon, Chi-square, and Spearman tests. The association between disease and demographic factors and MR opacity severity, PFTs, 6mWT, SI, and SGRQ, and association between MR opacity severity with functional and patient-reported outcomes (PROs), was evaluated with mixed model analysis of variance, covariance and generalized estimating equations. Two-sided 5 % significance level was used, with Bonferroni multiple comparison correction.</div></div><div><h3>Results</h3><div>81 MRI exams in 62 post-acute Covid-19 patients (median age 57, IQR 41–64; 25 women) were included. Exams were a median of 8 months from initial illness. Univariate analysis showed lung opacity severity was associated with decreased %DLCO (ρ = −0.55, <em>P</em> = .0125), and lung opacity severity quartile was associated with decreased %DLCO, predicted TLC, FVC, and increased FEV1/FVC.</div><div>Multivariable analysis adjusting for sex, initial disease severity, and interval from Covid-19 diagnosis showed MR lung opacity severity was associated with decreased %DLCO (<em>P</em> &lt; .001). Lung opacity severity was not associated with PROs.</div></div><div><h3>Conclusion</h3><div>Low-field MRI lung opacity severity correlated with decreased %DLCO in post-acute Covid-19 patients, but was not associated with PROs.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110307"},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394953","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":"The prognostic relevance of pleural effusion in patients with COVID-19 - A German multicenter study","authors":"Andreas Michael Bucher ,&nbsp;Julia Dietz ,&nbsp;Constantin Ehrengut ,&nbsp;Lukas Müller ,&nbsp;Dominik Schramm ,&nbsp;Alena Akinina ,&nbsp;Michelle Drechsel ,&nbsp;Roman Kloeckner ,&nbsp;Malte Sieren ,&nbsp;Peter Isfort ,&nbsp;Marwin-Jonathan Sähn ,&nbsp;Matthias A. Fink ,&nbsp;Dorottya Móré ,&nbsp;Bohdan Melekh ,&nbsp;Felix G. Meinel ,&nbsp;Hanna Schön ,&nbsp;Matthias Stefan May ,&nbsp;Lisa Siegler ,&nbsp;Hanna Münzfeld ,&nbsp;Richard Ruppel ,&nbsp;Alexey Surov","doi":"10.1016/j.clinimag.2024.110303","DOIUrl":"10.1016/j.clinimag.2024.110303","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes.</div></div><div><h3>Methods</h3><div>In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation.</div></div><div><h3>Results</h3><div>PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, <em>p</em> &lt; 0.001), with a hazard ratio of 2.22 (95 % CI 1.65–2.99, p &lt; 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %.</div></div><div><h3>Conclusion</h3><div>Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"117 ","pages":"Article 110303"},"PeriodicalIF":1.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631867","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":"Review of neuroimaging findings of intracranial angioinvasive fungal infections","authors":"Jay Acharya ,&nbsp;Anthony R. Zamary ,&nbsp;Ahmad Alach ,&nbsp;Joseph Kang ,&nbsp;Anandh G. Rajamohan ,&nbsp;Mark D. Mamlouk ,&nbsp;Fernando Torres","doi":"10.1016/j.clinimag.2024.110306","DOIUrl":"10.1016/j.clinimag.2024.110306","url":null,"abstract":"<div><div>With increasing use of broad-spectrum antibiotics, advances in organ and stem-cell transplant therapy, and the continued diabetes mellitus II epidemic, as well as other risk factors, reports of fungal infections of the CNS have been increasing. The most lethal subset is the angioinvasive fungal infection. <em>Aspergillus fumigatus</em>, <em>Mucor</em>, and <em>Fusarium</em> tend to affect immunocompromised individuals depending on their risk factors<em>. Exserohilum rostratum</em> and <em>Cladophialaphora</em> species tend to infect immunocompetent individuals. Early diagnosis and treatment are imperative for improved outcomes and reduced morbidity and mortality. Clinical presentation is often nonspecific, while neuroimaging can be helpful for accurate diagnosis. CT of the head and/or the maxillofacial structures is the primary imaging modality. Once the infection begins to proliferate, areas of vasogenic and cytotoxic edema, with regional mass effect and shift of the midline structures may be seen. These findings, however, are often nonspecific and may also be seen in underlying neoplasm, inflammatory processes, and other intracranial infections. Characteristic findings on T1, T2, diffusion-weighted imaging (DWI), and gradient echo sequences (GRE) may help to further narrow the differential diagnoses. We present a review of neuroimaging findings that will aid the neuroradiologist in distinguishing intracranial angioinvasive fungal infections and lead to improved patient outcomes.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110306"},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367310","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":"Diffuse unilateral MRI breast entities","authors":"Rebecca T. Sivarajah ,&nbsp;Trevor R. Bean ,&nbsp;Alison L. Chetlen","doi":"10.1016/j.clinimag.2024.110305","DOIUrl":"10.1016/j.clinimag.2024.110305","url":null,"abstract":"<div><div>Many benign and malignant breast entities can present with diffuse unilateral magnetic resonance imaging (MRI) findings. The unilateral breast findings can be broken down into three broad categories including asymmetric diffuse masses/non-mass enhancement (NME), diffuse unilateral skin thickening, and diffuse asymmetric background enhancement. Although correlation with clinical history is always necessary, biopsy is often needed to make a definitive diagnosis. There are some findings on MRI which can help narrow the differential including morphology, distribution, T2W signal, enhancement kinetics, and associated skin thickening. Malignant entities which will be discussed in this review include ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, Paget disease, inflammatory breast cancer, and locally advanced breast cancer. Benign entities which will be discussed in this review include idiopathic granulomatous mastitis (IGM), infectious mastitis, pseudoangiomatous stromal hyperplasia, giant fibroadenoma, early and late radiation changes, unilateral breast feeding, and central venous obstruction, all which have varied MRI appearances. It is important for radiologists to be familiar with the common entities that can present with diffuse asymmetric unilateral MRI breast findings to ensure the correct diagnosis and management is undertaken.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110305"},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331747","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":"CTA and DSA findings in carotid blowout syndrome: An overview and approach to imaging diagnosis","authors":"Stephen J. Sozio ,&nbsp;Arevik Abramyan ,&nbsp;Andrew Soliman ,&nbsp;Gaurav Gupta ,&nbsp;Hai Sun ,&nbsp;Emad Nourollah-Zadeh ,&nbsp;Sudipta Roychowdhury ,&nbsp;Sri Hari Sundararajan","doi":"10.1016/j.clinimag.2024.110304","DOIUrl":"10.1016/j.clinimag.2024.110304","url":null,"abstract":"<div><div>Carotid blowout syndrome (CBS) is a potentially life-threatening complication in patients suffering head and neck cancer, in which rupture of the carotid artery and/or its branches can rapidly lead to life-threatening hemorrhage, shock, and death. CBS is categorized into three subtypes, which are characterized by extent of disease as evidenced by clinical presentation, physical exam findings, and imaging characteristics. Given the high morbidity and mortality associated with CBS, prompt recognition and treatment remains pivotal, as early intervention is associated with longer survival and lower complication rates. In turn, we present an overview of the hallmark imaging findings of CBS through a retrospective review of our institution's findings of these characteristic imaging findings in all patients who underwent evaluation and management of CBS at our facility across a 10-year period.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"115 ","pages":"Article 110304"},"PeriodicalIF":1.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378518","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}