Radiographics最新文献_第5页

Interventional Radiology for Bleeding Ectopic Varices: Individualized Approach Based on Vascular Anatomy. 异位静脉曲张出血的介入放射学：基于血管解剖的个性化方法。

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.230140

Hyo-Cheol Kim, Shiro Miyayama, Edward Wolfgang Lee, David Yurui Lim, Jin Wook Chung, Hwan Jun Jae, Jin Woo Choi

{"title":"Interventional Radiology for Bleeding Ectopic Varices: Individualized Approach Based on Vascular Anatomy.","authors":"Hyo-Cheol Kim, Shiro Miyayama, Edward Wolfgang Lee, David Yurui Lim, Jin Wook Chung, Hwan Jun Jae, Jin Woo Choi","doi":"10.1148/rg.230140","DOIUrl":"10.1148/rg.230140","url":null,"abstract":"Ectopic varices are rare but potentially life-threatening conditions usually resulting from a combination of global portal hypertension and local occlusive components. As imaging, innovative devices, and interventional radiologic techniques evolve and are more widely adopted, interventional radiology is becoming essential in the management of ectopic varices. The interventional radiologist starts by diagnosing the underlying causes of portal hypertension and evaluating the afferent and efferent veins of ectopic varices with CT. If decompensated portal hypertension is causing ectopic varices, placement of a transjugular intrahepatic portosystemic shunt is considered the first-line treatment, although this treatment alone may not be effective in managing ectopic variceal bleeding because it may not sufficiently resolve focal mesenteric venous obstruction causing ectopic varices. Therefore, additional variceal embolization should be considered after placement of a transjugular intrahepatic portosystemic shunt. Retrograde transvenous obliteration can serve as a definitive treatment when the efferent vein connected to the systemic vein is accessible. Antegrade transvenous obliteration is a vital component of interventional radiologic management of ectopic varices because ectopic varices often exhibit complex anatomy and commonly lack catheterizable portosystemic shunts. Superficial veins of the portal venous system such as recanalized umbilical veins may provide safe access for antegrade transvenous obliteration. Given the absence of consensus and guidelines, a multidisciplinary team approach is essential for the individualized management of ectopic varices. Interventional radiologists must be knowledgeable about the anatomy and hemodynamic characteristics of ectopic varices based on CT images and be prepared to consider appropriate options for each specific situation. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 8","pages":"e230140"},"PeriodicalIF":5.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592105","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

Ovarian Fibromatosis. 卵巢纤维瘤病

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.240044

Michael Enea, Parisa Khoshpouri, Augusto Lio da Mota Goncalves Filho, Kaitlin M Zaki-Metias, Pouria Rouzrokh

引用次数: 0

Early Postoperative Gastrointestinal Tract Evaluation: Expected Findings and Complications. 术后早期胃肠道评估：预期结果和并发症。

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.230198

Daniel B Montel, Louise L C Bronzeado, Igor R C Oliveira, Gustavo V Araújo, Bruna B M Carvalho, Bárbara C Santos, Daniel M V Lima, Daniel A Rangel, Sudhakar K Venkatesh, Kamila S Albuquerque, Fabio Lewin

引用次数: 0

Muscle Healing in Sports Injuries: MRI Findings and Proposed Classification Based on a Single Institutional Experience and Clinical Observation. 运动损伤的肌肉愈合：基于单一机构经验和临床观察的核磁共振成像结果和拟议分类。

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.230147

Jaime Isern-Kebschull, Sandra Mechó, Carles Pedret, Ricard Pruna, Xavier Alomar, Ara Kassarjian, Antonio Luna, Javier Martínez, Xavier Tomas, Gil Rodas

{"title":"Muscle Healing in Sports Injuries: MRI Findings and Proposed Classification Based on a Single Institutional Experience and Clinical Observation.","authors":"Jaime Isern-Kebschull, Sandra Mechó, Carles Pedret, Ricard Pruna, Xavier Alomar, Ara Kassarjian, Antonio Luna, Javier Martínez, Xavier Tomas, Gil Rodas","doi":"10.1148/rg.230147","DOIUrl":"10.1148/rg.230147","url":null,"abstract":"MRI plays a crucial role in assessment of patients with muscle injuries. The healing process of these injuries has been studied in depth from the pathophysiologic and histologic points of view and divided into destruction, repair, and remodeling phases, but the MRI findings of these phases have not been fully described, to our knowledge. On the basis of results from 310 MRI studies, including both basal and follow-up studies, in 128 athletes with muscle tears including their clinical evolution, the authors review MRI findings in muscle healing and propose a practical imaging classification based on morphology and signal intensity that correlates with histologic changes. The proposed phases, which can overlap, are destruction (phase 1), showing myoconnective tissue discontinuity and featherlike edema; repair (phase 2), showing filling in of the connective tissue gaps by a hypertrophic immature scar; and remodeling (phase 3), showing scar maturation and regression of the edema. A final healed stage can be identified with MRI, which is characterized by persistence of a slight fusiform thickening of the connective tissue. This information can be obtained from a truncated MRI protocol with three acquisitions, preferably performed with a 3-T magnet. During MRI follow-up of muscle injuries, other important features to be assessed are changes in muscle edema and specific warning signs, such as persistent intermuscular edema, new connective tear, and scar rupture. An understanding of the MRI appearance of normal and abnormal muscle healing and warning signs, along with cooperation with a multidisciplinary team, enable optimization of return to play for the injured athlete. ©RSNA, 2024 See the invited commentary by Flores in this issue.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 8","pages":"e230147"},"PeriodicalIF":5.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762664","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

RadioGraphics Update: Parathyroid CT and Primary Hyperparathyroidism. RadioGraphics更新：甲状旁腺CT和原发性甲状旁腺功能亢进症。

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.240129

Karol L Cardenas, Aakshit Goyal, Michael J Dietzen, Jeffrey R Sachs, Megan E Lipford, Matthew A Gorris, Reese W Randle, Hillary R Kelly, Paul M Bunch

引用次数: 0

Imaging Features of Uncommon Entities That Manifest with Torsion. 表现为扭转的不常见实体的成像特征。

IF 5.2 1区医学

Radiographics Pub Date : 2024-07-01 DOI: 10.1148/rg.230101

Akihiro Nakamata, Mitsuru Matsuki, Yuriko Watanabe, Ryoma Kobayashi, Nana Fujii, Naoki Kunitomo, Yuko Otake, Hiroyuki Fujii, Kohei Hamamoto, Harushi Mori

{"title":"Imaging Features of Uncommon Entities That Manifest with Torsion.","authors":"Akihiro Nakamata, Mitsuru Matsuki, Yuriko Watanabe, Ryoma Kobayashi, Nana Fujii, Naoki Kunitomo, Yuko Otake, Hiroyuki Fujii, Kohei Hamamoto, Harushi Mori","doi":"10.1148/rg.230101","DOIUrl":"10.1148/rg.230101","url":null,"abstract":"Torsion is the twisting of an object along the axis, and various structures (organs and tumors) in the body can twist. Torsion causes initial lymphatic and venous outflow obstruction, leading to congestive edema, enlargement, venous hemorrhagic infarction, and surrounding edema. It can also cause subsequent arterial obstruction depending on the degree of torsion, leading to ischemia, infarction, necrosis, gangrene, and surrounding inflammation. Therefore, in several cases of torsion, immediate surgical intervention is required to improve blood flow and prevent serious complications. Clinical manifestations of torsion are often nonspecific and can affect individuals of varying ages and sex. Imaging plays an important role in the early diagnosis and management of torsion. Multiple imaging modalities, including US, radiography, CT, and MRI, are used to evaluate torsion, and each modality has its specific characteristics. The imaging findings reflect the pathophysiologic mechanism: a twisted pedicle (whirlpool sign), enlargement of the torsed structures, reduced blood flow, internal heterogeneity, and surrounding reactive changes. The whirlpool sign is a definitive characteristic of torsion. In some cases, despite poor internal enhancement, capsular enhancement is observed on contrast-enhanced CT and MR images and is considered to be associated with preserved capsular arterial flow or capsular neovascularization due to inflammation. Radiologists should be familiar with the pathophysiologic mechanisms, clinical characteristics, and imaging characteristics of torsion in various structures in the body. Since other articles about common organ torsions already exist, the authors of this article focus on the uncommon entities that manifest with torsion. ©RSNA, 2024.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 7","pages":"e230101"},"PeriodicalIF":5.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319027","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

Conventional and Contrast-enhanced US of the Lung: From Performance to Diagnosis. 肺部常规和对比增强 US：从性能到诊断。

IF 5.2 1区医学

Radiographics Pub Date : 2024-07-01 DOI: 10.1148/rg.230171

Sergio Jiménez-Serrano, Alfredo Páez-Carpio, Blanca Doménech-Ximenos, Lluria Cornellas, Marcelo Sánchez, Margarita V Revzin, Ivan Vollmer

{"title":"Conventional and Contrast-enhanced US of the Lung: From Performance to Diagnosis.","authors":"Sergio Jiménez-Serrano, Alfredo Páez-Carpio, Blanca Doménech-Ximenos, Lluria Cornellas, Marcelo Sánchez, Margarita V Revzin, Ivan Vollmer","doi":"10.1148/rg.230171","DOIUrl":"10.1148/rg.230171","url":null,"abstract":"In recent years, lung US has evolved from a marginal tool to an integral component of diagnostic chest imaging. Contrast-enhanced US (CEUS) can improve routine gray-scale imaging of the lung and chest, particularly in diagnosis of peripheral lung diseases (PLDs). Although an underused tool in many centers, and despite inherent limitations in evaluation of central lung disease caused by high acoustic impedance between air and soft tissues, lung CEUS has emerged as a valuable tool in diagnosis of PLDs. Owing to the dual arterial supply to the lungs via pulmonary and bronchial (systemic) arteries, different enhancement patterns can be observed at lung CEUS, thereby enabling accurate differential diagnoses in various PLDs. Lung CEUS also assists in identifying patients who may benefit from complementary diagnostic tests, including image-guided percutaneous biopsy. Moreover, lung CEUS-guided percutaneous biopsy has shown feasibility in accessible subpleural lesions, enabling higher histopathologic performance without significantly increasing either imaging time or expenses compared with conventional US. The authors discuss the technique of and basic normal and pathologic findings at conventional lung US, followed by a more detailed discussion of lung CEUS applications, emphasizing specific aspects of pulmonary physiology, basic concepts in lung US enhancement, and the most commonly encountered enhancement patterns of different PLDs. Finally, they discuss the benefits of lung CEUS in planning and guidance of US-guided lung biopsy. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 7","pages":"e230171"},"PeriodicalIF":5.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472645","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

Imaging of Antepartum and Postpartum Hemorrhage: Contemporary Classification of Placenta Previa. 产前和产后出血的成像：前置胎盘的当代分类。

IF 5.2 1区医学

Radiographics Pub Date : 2024-07-01 DOI: 10.1148/rg.240127

Yinka Oyelese

引用次数: 0

Cesarean Scar Ectopic Pregnancy: A Do-Not-Miss Diagnosis. 剖腹产瘢痕宫外孕：不容错过的诊断。

IF 5.2 1区医学

Radiographics Pub Date : 2024-07-01 DOI: 10.1148/rg.230199

Anne Kennedy, Michelle Debbink, April Griffith, Jennifer Kaiser, Paula Woodward

{"title":"Cesarean Scar Ectopic Pregnancy: A Do-Not-Miss Diagnosis.","authors":"Anne Kennedy, Michelle Debbink, April Griffith, Jennifer Kaiser, Paula Woodward","doi":"10.1148/rg.230199","DOIUrl":"10.1148/rg.230199","url":null,"abstract":"The rate of cesarean section (CS) for delivery has increased internationally, reaching 50% in some countries. Abnormal implantation of a new pregnancy at the site of the prior hysterotomy is an important complication because of the risks of hemorrhage, uterine rupture, and progression to placenta accreta spectrum (PAS), a condition with high morbidity with potential for catastrophic obstetric hemorrhage, maternal and fetal mortality, and loss of fertility. Cesarean scar ectopic pregnancy (CSEP) is the recommended term to describe these pregnancies, which are recognized on the basis of the sac implantation site, growth pattern, and associated abnormal perfusion. The true incidence of CSEP is unknown because the condition is likely underdiagnosed and underreported. The 2022 Society for Maternal-Fetal Medicine consult series notes that severe maternal morbidity and mortality are linked to difficulty in making the diagnosis of CSEP. The authors review the signs of CSEP at imaging, some pitfalls that may lead to delayed or missed diagnosis, and the consequences thereof. CSEPs must be differentiated from low implantation of a normal pregnancy, cervical ectopic pregnancy, and evolving pregnancy loss. Early recognition allows prompt and safe treatment that is usually surgical. Early treatment results in decreased health care costs, a shorter hospital stay, preservation of fertility, and prevention of iatrogenic preterm delivery, which is typical in cases that progress to PAS. Hysterectomy has serious negative psychologic consequences for patients of childbearing age; early diagnosis and prompt treatment of CSEP can prevent this often-ignored complication. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 7","pages":"e230199"},"PeriodicalIF":5.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285436","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

Invited Commentary: Understanding and Addressing Cognitive Biases in Radiology. 特邀评论：了解和解决放射学中的认知偏差。

IF 5.2 1区医学

Radiographics Pub Date : 2024-07-01 DOI: 10.1148/rg.230244

David B Larson

引用次数: 0