Radiographics最新文献_第10页

Noninvasive Quantitative CT for Diffuse Liver Diseases: Steatosis, Iron Overload, and Fibrosis. 弥漫性肝病的无创定量 CT：脂肪变性、铁超载和纤维化。

IF 5.2 1区医学

Radiographics Pub Date : 2025-01-01 DOI: 10.1148/rg.240176

Perry J Pickhardt, Meghan G Lubner

{"title":"Noninvasive Quantitative CT for Diffuse Liver Diseases: Steatosis, Iron Overload, and Fibrosis.","authors":"Perry J Pickhardt, Meghan G Lubner","doi":"10.1148/rg.240176","DOIUrl":"10.1148/rg.240176","url":null,"abstract":"Chronic diffuse liver disease continues to increase in prevalence and represents a global health concern. Noninvasive detection and quantification of hepatic steatosis, iron overload, and fibrosis are critical, especially given the many relative disadvantages and potential risks of invasive liver biopsy. Although MRI techniques have emerged as the preferred reference standard for quantification of liver fat, iron, and fibrosis, CT can play an important role in opportunistic detection of unsuspected disease and is performed at much higher volumes. For hepatic steatosis, noncontrast CT provides a close approximation to MRI-based proton-density fat fraction (PDFF) quantification, with liver attenuation values less than or equal to 40 HU signifying at least moderate steatosis. Liver fat quantification with postcontrast CT is less precise but can generally provide categorical assessment (eg, mild vs moderate steatosis). Noncontrast CT can also trigger appropriate assessment for iron overload when increased parenchymal attenuation values are observed (eg, >75 HU). A variety of morphologic and functional CT features indicate the presence of underlying hepatic fibrosis and cirrhosis. Beyond subjective assessment, quantitative CT methods for staging fibrosis can provide comparable performance to that of elastography. Furthermore, quantitative CT assessment can be performed retrospectively, since prospective techniques are not required. Many of these CT quantitative measures are now fully automated via artificial intelligence (AI) deep learning algorithms. These retrospective and automated advantages have important implications for longitudinal clinical care and research. Ultimately, regardless of the indication for CT, opportunistic detection of steatosis, iron overload, and fibrosis can result in appropriate clinical awareness and management. ©RSNA, 2024 See the invited commentary by Yeh in this issue.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"45 1","pages":"e240176"},"PeriodicalIF":5.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radiologist's Guide to the Scapula. 放射医师肩胛骨指南》。

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240139

Wilfred Manzano, Kathryn J Stevens

引用次数: 0

Improving Diagnosis of Acute Cholecystitis with US: New Paradigms. 用 US 改善急性胆囊炎的诊断：新范例。

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240032

Richa Patel, Justin R Tse, Luyao Shen, David B Bingham, Aya Kamaya

{"title":"Improving Diagnosis of Acute Cholecystitis with US: New Paradigms.","authors":"Richa Patel, Justin R Tse, Luyao Shen, David B Bingham, Aya Kamaya","doi":"10.1148/rg.240032","DOIUrl":"10.1148/rg.240032","url":null,"abstract":"Acute cholecystitis is an inflammatory condition of the gallbladder typically incited by mechanical obstruction. Accurate diagnosis of this common clinical condition is challenging due to variable imaging appearances as well as overlapping clinical manifestations with biliary colic, acute hepatitis, pancreatitis, and cholangiopathies. In acute cholecystitis, increased dilatation and high intraluminal pressures lead to gallbladder inflammation and may progress to gangrenous changes, focal wall necrosis, and subsequent perforation. In acute calculous cholecystitis, gallstones are the cause of obstruction and are often impacted in the gallbladder neck or cystic duct, leading to gallbladder inflammation. In acalculous cholecystitis, patients are typically critically ill, often with hypotensive episodes and prolonged gallbladder stasis, which lead to obstruction, gallbladder ischemia, and inflammation. Helpful sonographic findings of acute cholecystitis include a dilated gallbladder; increased intraluminal pressures in the gallbladder, resulting in a bulging fundus (tensile fundus sign); intraluminal sludge in the setting of right upper quadrant pain; wall hyperemia, which may be quantified by elevated cystic artery velocities or hepatic artery velocities; mucosal ischemic changes, characterized by loss of mucosal echogenicity; pericholecystic inflammation, characterized by hyperechoic pericholecystic fat; and mucosal discontinuity. Extruded complex fluid next to a wall defect is definitive for gallbladder wall perforation, and further evaluation with CT or MRI allows evaluation of the full extent of perforation and other potential complications. The sonographic Murphy sign, while helpful if positive, is relatively insensitive for accurate diagnosis of acute cholecystitis. Thus, overreliance on the sonographic Murphy sign results in surprisingly low diagnostic accuracy in practice.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 12","pages":"e240032"},"PeriodicalIF":5.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uterine Leiomyoma with Intravascular Leiomyomatosis. 子宫纵隔肌瘤伴血管内纵隔肌瘤病

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240204

Maria M Rodrigues, Pedro D Poças, Raquel V Portugal, Ciléin Kearns, Alfredo Páez-Carpio

引用次数: 0

Congenital and Infantile Masses of the Head and Neck. 先天性和婴儿头颈部肿块。

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240059

Alexandra M Foust, Rekha Krishnasarma, Caroline D Robson, Elizabeth Snyder, Dann Martin, Katharyn D Cassella, Lindsey Johnstone, Joanne Rispoli, Sumit Pruthi, Asha Sarma

引用次数: 0

Quality Improvement Report: The Sliding Sign Initiative-Facilitating Earlier Detection of Deep Endometriosis in an Academic US Department. 质量改进报告：滑动标志倡议--促进美国学术部门更早地发现深部子宫内膜异位症。

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240082

Emily H T Pang, Caroline E Lee, Abigail Lee, Esraa A Khalifa

{"title":"Quality Improvement Report: The Sliding Sign Initiative-Facilitating Earlier Detection of Deep Endometriosis in an Academic US Department.","authors":"Emily H T Pang, Caroline E Lee, Abigail Lee, Esraa A Khalifa","doi":"10.1148/rg.240082","DOIUrl":"10.1148/rg.240082","url":null,"abstract":"A delayed diagnosis of endometriosis can significantly impact a patient's quality of life. To facilitate an earlier diagnosis, we implemented a modified pelvic US protocol that included use of the dynamic sliding sign (SS) maneuver to screen at-risk populations. The aim of this initiative was to improve both SS maneuver performance and SS reporting consistency to 80% and determine the number of new endometriosis cases identified after US. A quality improvement framework based on the plan-do-study-act (PDSA) methodology was used to develop and evaluate interventions. Eligible pelvic US studies were reviewed at regular intervals to track SS maneuver performance and SS reporting, with control charts used to detect intervention-related variation. A chart review of all abnormal SS cases was also performed. The project initiation (PDSA cycle 1) included protocol development and educational sessions. Reminder posters were placed during cycle 2 and revised in cycle 3, and the eligibility criteria were revised. Cycles 4 and 5 consisted of in-person discussions, distribution of a reference guide, and creation of a dictation software macro. In terms of results, sonographers performed the SS maneuver correctly in 52.1% of eligible patients after cycle 1, increasing to 83.9% by cycle 5. In the cases in which the SS maneuver was performed by the sonographer, after PDSA cycle 1, the SS was reported by the radiologist in 69% of cases (including both correct and incorrect interpretations), and both reported and interpreted correctly in 59% of cases, reaching 79.5% by cycle 3, and plateauing thereafter. Thirty-seven patients were newly diagnosed with endometriosis after undergoing US of the SS. The objectives of our SS initiative were met, with improved SS US performance, improved SS reporting and interpretation, and a number of new endometriosis cases diagnosed. ©RSNA, 2024 Supplemental material is available for this article. See the invited commentary by Jha and VanBuren in this issue.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 12","pages":"e240082"},"PeriodicalIF":5.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neonatal Liver Imaging: Techniques, Role of Imaging, and Indications. 新生儿肝脏成像：新生儿肝脏成像：技术、成像作用和适应症。

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240034

Fatemeh Hadian, Caroline Rutten, Iram Siddiqui, Christopher Tomlinson, Govind B Chavhan

{"title":"Neonatal Liver Imaging: Techniques, Role of Imaging, and Indications.","authors":"Fatemeh Hadian, Caroline Rutten, Iram Siddiqui, Christopher Tomlinson, Govind B Chavhan","doi":"10.1148/rg.240034","DOIUrl":"10.1148/rg.240034","url":null,"abstract":"The neonatal liver may be affected by a variety of congenital and acquired diseases. Imaging has an important role in the workup and management of many neonatal hepatic abnormalities. Some aspects of imaging the liver and imaging findings are specific to neonatal patients when compared with those in older children. Therefore, selecting and tailoring the imaging technique for each indication in the neonate is important for optimal care, with minimal invasiveness. Common indications for imaging include incidental focal lesions, neonatal liver failure, cholestasis, and sepsis. US is the primary imaging modality, and for most conditions it is the only imaging modality required. MRI is the next modality after US for neonatal liver assessment and is especially required for complete assessment and staging of neoplasms, vascular abnormalities, and diagnosis of neonatal hemochromatosis. CT can be used when MRI is not available and should be used sparingly and in patients with acute conditions such as intra-abdominal bleeding. The authors emphasize imaging modalities that can be used for assessment of neonatal liver abnormalities, the imaging appearances of normal and changing structures in the neonatal liver, and indications for imaging. Abnormalities that are described include neonatal liver failure, infections, hepatic calcifications, umbilical venous catheter-related complications, and vascular abnormalities. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 12","pages":"e240034"},"PeriodicalIF":5.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing the Radiology Readout Experience. 优化放射学读出体验。

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240141

Rouzbeh Mashayekhi, Farhad Pishgar, Maria Lucia Brun-Vergara, Julia Niemierko

引用次数: 0

Contrast-enhanced CT Lymphangiography for Various Central Lymphatic Disorders. 对比增强 CT 淋巴管造影术治疗各种中央淋巴系统疾病

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240058

Yura Ahn, Hyun Jung Koo, Jooae Choe, Jong Eun Lee, Dong Hyun Yang, Joon-Won Kang, Ji Hoon Shin

{"title":"Contrast-enhanced CT Lymphangiography for Various Central Lymphatic Disorders.","authors":"Yura Ahn, Hyun Jung Koo, Jooae Choe, Jong Eun Lee, Dong Hyun Yang, Joon-Won Kang, Ji Hoon Shin","doi":"10.1148/rg.240058","DOIUrl":"10.1148/rg.240058","url":null,"abstract":"Lymphatic leakage, manifesting as chylothorax or chylous ascites, arises from traumatic or nontraumatic causes and poses severe risks such as malnutrition and increased infection susceptibility. Accurate diagnosis and an effective treatment strategy necessitate comprehensive lymphatic imaging. Conventional lymphangiography and dynamic contrast-enhanced MR lymphangiography (DCMRL) have been widely used and studied as effective lymphatic imaging methods. Recently, CT lymphangiography (CTL) has been successfully implemented in animal studies and some patients, and the authors' institution now prioritizes CTL over DCMRL. Contrast-enhanced CTL offers a promising alternative, with advantages such as better accessibility and faster imaging. These advantages of CTL over traditional methods highlight its superior accessibility and fast acquisition time. Moreover, to reduce and optimize radiation dose, the stepwise propagation scanning method in CTL could be used, which is especially beneficial in pediatric patients. In this review, the authors suggest the protocol for CTL and interpretation methods for evaluation and therapeutic planning of central lymphatic disorders, focusing on the condition of lymphatic leakage. ©RSNA, 2024 The slide presentation from the RSNA Annual Meeting is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 12","pages":"e240058"},"PeriodicalIF":5.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

US of Acute Tendon Tears. 急性肌腱撕裂的美国。

IF 5.2 1区医学

Radiographics Pub Date : 2024-12-01 DOI: 10.1148/rg.240060

Lisa M Billone, Sarah J Allred, Dyan V Flores

{"title":"US of Acute Tendon Tears.","authors":"Lisa M Billone, Sarah J Allred, Dyan V Flores","doi":"10.1148/rg.240060","DOIUrl":"10.1148/rg.240060","url":null,"abstract":"US is an effective tool for appraising acute tendon injury, allowing rapid evaluation of symptoms at bedside and paving the way for prompt diagnosis and treatment selection. It offers three main advantages in the acute or emergent setting. First, it is more sensitive and specific than physical examination. This is beneficial in tendons such as the distal triceps wherein incomplete and complete tears may manifest with similar clinical presentations. Tendon injury may also be clinically innocuous because bruising or a palpable defect is not always present and swelling may mask palpation of the tendon gap. Second, US provides important descriptors that may affect treatment selection, such as injury site, injury extent, and length of retraction. Pectoralis major tears at the tendon or musculotendinous junction warrant operative referral and are readily illustrated at US. A torn distal biceps tendon with significant retraction may require additional graft augmentation rather than reattachment to the insertion alone. Soleus and gastrocnemius strains may mimic each other clinically. Although both are managed conservatively, distinction between the two facilitates formulation of a specific rehabilitation regimen. Finally, US can narrow the differential diagnosis and rule out mimics of musculoskeletal abnormalities. Nonmusculoskeletal conditions, such as deep venous thrombosis and a ruptured Baker cyst, can manifest with the same clinical presentation as acute calf injuries and must be considered in a patient presenting with sudden calf, posterior leg, or ankle pain. The authors review the anatomic features, US techniques, and imaging findings of acute tendon injuries to aid in meaningful reporting and timely treatment selection. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 12","pages":"e240060"},"PeriodicalIF":5.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0