Radiographics最新文献_第6页

Multisystem Imaging Manifestations of Kidney Failure. 肾衰竭的多系统影像表现。

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.230124

Prabhakar Shantha Rajiah, Garima Suman, Kanupriya Vijay, Nitin Venugopal, Bahar Mansoori, Majid Chalian, Amit Kumar Agarwal

{"title":"Multisystem Imaging Manifestations of Kidney Failure.","authors":"Prabhakar Shantha Rajiah, Garima Suman, Kanupriya Vijay, Nitin Venugopal, Bahar Mansoori, Majid Chalian, Amit Kumar Agarwal","doi":"10.1148/rg.230124","DOIUrl":"10.1148/rg.230124","url":null,"abstract":"Kidney failure (KF) refers to a progressive decline in glomerular filtration rate to below 15 ml/min per 1.73 m2, necessitating renal replacement therapy with dialysis or renal transplant. The hemodynamic and metabolic alterations in KF combined with a proinflammatory and coagulopathic state leads to complex multisystemic complications. The imaging hallmark of systemic manifestations of KF is bone resorption caused by secondary hyperparathyroidism. Other musculoskeletal complications include brown tumor, osteosclerosis, calcinosis, soft-tissue calcification, and amyloid arthropathy. Cardiovascular complications and infections are the leading causes of death in KF. Cardiovascular complications include accelerated atherosclerosis, cardiomyopathy, pericarditis, myocardial calcinosis, and venous thromboembolism. Neurologic complications such as encephalopathy, osmotic demyelination, cerebrovascular disease, and opportunistic infections are also frequently encountered. Pulmonary complications include edema and calcifications. Radiography and CT are used in assessing musculoskeletal and thoracic complications, while MRI plays a key role in assessing neurologic and cardiovascular complications. CT iodinated contrast material is generally avoided in patients with KF except in situations where the benefit of contrast-enhanced CT outweighs the risks and in patients already undergoing maintenance dialysis. At MRI, group II gadolinium-based contrast material can be safely administered in patients with KF. The authors discuss the extrarenal systemic manifestations of KF, the choice of imaging modality in their assessment, and imaging findings of complications. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 8","pages":"e230124"},"PeriodicalIF":5.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762663","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

Malignant Rhabdoid Tumor and Related Pediatric Tumors: Multimodality Imaging Review with Pathologic Correlation. 恶性横纹肌瘤及相关儿科肿瘤：多模态成像回顾与病理学相关性。

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.240015

Maria Clara Lorca, Jessie Huang, Kristian Schafernak, Deepa Biyyam, A Luana Stanescu, Nathan C Hull, Philip J Katzman, Shehanaz Ellika, Apeksha Chaturvedi

{"title":"Malignant Rhabdoid Tumor and Related Pediatric Tumors: Multimodality Imaging Review with Pathologic Correlation.","authors":"Maria Clara Lorca, Jessie Huang, Kristian Schafernak, Deepa Biyyam, A Luana Stanescu, Nathan C Hull, Philip J Katzman, Shehanaz Ellika, Apeksha Chaturvedi","doi":"10.1148/rg.240015","DOIUrl":"10.1148/rg.240015","url":null,"abstract":"Malignant rhabdoid tumors (MRTs) are rare but lethal solid neoplasms that overwhelmingly affect infants and young children. While the central nervous system is the most common site of occurrence, tumors can develop at other sites, including the kidneys and soft tissues throughout the body. The anatomic site of involvement dictates tumor nomenclature and nosology. While the clinical and imaging manifestations of MRTs and other more common entities may overlap, there are some site-specific distinctive imaging characteristics. Irrespective of the site of occurrence, somatic and germline mutations in SMARCB1, and rarely in SMARCA4, underlie the entire spectrum of rhabdoid tumors. MRTs have a simple and remarkably stable genome but can demonstrate considerable molecular and biologic heterogeneity. Related neoplasms encompass an expanding category of phenotypically dissimilar (nonrhabdoid tumors driven by SMARC-related alterations) entities. US, CT, MRI, and fluorodeoxyglucose PET/CT or PET/MRI facilitate diagnosis, initial staging, and follow-up, thus informing therapeutic decision making. Multifocal synchronous or metachronous rhabdoid tumors occur predominantly in the context of underlying rhabdoid tumor predisposition syndromes (RTPSs). These autosomal dominant disorders are driven in most cases by pathogenic variants in SMARCB1 (RTPS type 1) and rarely by pathogenic variants in SMARCA4 (RTPS type 2). Genetic testing and counseling are imperative in RTPS. Guidelines for imaging surveillance in cases of RTPS are based on age at diagnosis. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 8","pages":"e240015"},"PeriodicalIF":5.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876690","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

The Peritoneum: Anatomy, Pathologic Findings, and Patterns of Disease Spread. 腹膜：腹膜：解剖、病理发现和疾病扩散模式》（Peritoneum: Anatomy, Pathologic Findings, and Patterns of Disease Spreads）。

IF 5.2 1区医学

Radiographics Pub Date : 2024-08-01 DOI: 10.1148/rg.230216

Ayman H Gaballah, Maged Algazzar, Irfan A Kazi, Mohamed Badawy, Nicholas Philip Guys, Eslam Adel Shehata Mohamed, Jennifer Sammon, Khaled M Elsayes, Peter S Liu, Matthew Heller

{"title":"The Peritoneum: Anatomy, Pathologic Findings, and Patterns of Disease Spread.","authors":"Ayman H Gaballah, Maged Algazzar, Irfan A Kazi, Mohamed Badawy, Nicholas Philip Guys, Eslam Adel Shehata Mohamed, Jennifer Sammon, Khaled M Elsayes, Peter S Liu, Matthew Heller","doi":"10.1148/rg.230216","DOIUrl":"10.1148/rg.230216","url":null,"abstract":"Disease spread in the abdomen and pelvis generally occurs in a predictable pattern in relation to anatomic landmarks and fascial planes. Anatomically, the abdominopelvic cavity is subdivided into several smaller spaces or compartments by key ligaments and fascial planes. The abdominal cavity has been traditionally divided into peritoneal, retroperitoneal, and pelvic extraperitoneal spaces. Recently, more clinically relevant classifications have evolved. Many pathologic conditions affect the abdominal cavity, including traumatic, inflammatory, infectious, and neoplastic processes. These abnormalities can extend beyond their sites of origin through various pathways. Identifying the origin of a disease process is the first step in formulating a differential diagnosis and ultimately reaching a final diagnosis. Pathologic conditions differ in terms of pathways of disease spread. For example, simple fluid tracks along fascial planes, respecting anatomic boundaries, while fluid from acute necrotizing pancreatitis can destroy fascial planes, resulting in transfascial spread without regard for anatomic landmarks. Furthermore, neoplastic processes can spread through multiple pathways, with a propensity for spread to noncontiguous sites. When the origin of a disease process is not readily apparent, recognizing the spread pattern can allow the radiologist to work backward and ultimately arrive at the site or source of pathogenesis. As such, a cohesive understanding of the peritoneal anatomy, the typical organ or site of origin for a disease process, and the corresponding pattern of disease spread is critical not only for initial diagnosis but also for establishing a road map for staging, anticipating further disease spread, guiding search patterns and report checklists, determining prognosis, and tailoring appropriate follow-up imaging studies. ©RSNA, 2024 Supplemental material is available for this article.","PeriodicalId":54512,"journal":{"name":"Radiographics","volume":"44 8","pages":"e230216"},"PeriodicalIF":5.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876691","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

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