Attenuation imaging as a new ultrasonographic application for identifying placental haematoma

2021 ◽  
Vol 14 (3) ◽  
pp. e239287
Author(s):  
Masahiro Yamaguchi ◽  
Takeshi Umazume ◽  
Kiwamu Noshiro ◽  
Hidemichi Watari
Keyword(s):  
Diagnostic Accuracy ◽  
Placental Abruption ◽  
Imaging Modality ◽  
Clinical Findings ◽  
Attenuation Imaging

We present a case in which attenuation imaging (ATI), a recently developed ultrasonographic application, facilitated the diagnosis of preplacental and postplacental haematoma. Placental abruption is a serious condition that affects the prognosis of infants and is difficult to diagnose. Ultrasonography is the primary imaging modality that complements the clinical findings in the diagnosis; however, its sensitivity is low, and improved diagnostic accuracy is desired. Here, we found that placental haematomas on the placental fetal surface observed at 19 weeks of gestation were indistinct from placental parenchyma in B-mode ultrasonographic imaging. In ATI, the placental parenchyma was colour-mapped, but the haematoma portion was not, which helped identify the haematoma. ATI, which also colour-maps uniform tissues, did not colour-map vessels within the placenta. ATI has a breakthrough potential for improving the diagnosis of placental abruption.

scholarly journals Menisco-ligamentous injuries of knee joint: Can ultrasonography serve as an effective screening modality?

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Farooq Mir ◽  
Zahoor Raina ◽  
Omair Shah ◽  
Tariq Gojwari ◽  
Irfan Robbani ◽  
...  
Keyword(s):  
Knee Joint ◽  
Diagnostic Accuracy ◽  
Imaging Modality ◽  
Meniscal Tear ◽  
Clinical Findings ◽  
Ligament Injury ◽  
Effective Screening ◽  
Medial Collateral Ligament Injury ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

The aim is to calculate sensitivity, specificity and diagnostic accuracy of Ultrasonography (USG) as a screening modality in evaluation of Menisco- Ligamentous injuries of knee joint with Magnetic Resonance Imaging (MRI)as gold standard for comparison.Patients with clinically suspected Menisco-Ligamentous injurieswere evaluated by USG initially followed by MRI on the same day. A total of 60 patients (50 males, 10 females) underwent USG and MRI. USG was done using high frequency probe (9-14 Hz) and all the injuries noted. USG of the normal knee was done for comparison. MRI with trauma protocol sequences was done on the same day. The accuracy of USG and MRI in diagnosis of menisco-ligamentous injuries was compared. Majority of the patients (50%) belonged to age group of 21-40 years. Most common injuries seen were medial meniscal tear followed by medial collateral ligament injury. The strength of agreement between USG and MRI was good with Diagnostic accuracy of USG ranging from 83.3% to 95% for different meniscal/ligamentous injuries.USG is an effective imaging modality with high accuracy in diagnosing menisco-ligamentous injuries. USG can act as an effective screening modality in closed knee trauma for evaluation of menisco- ligamentous injuries especially in resource constrained regions owing to its easy availability, portability and lower cost. MRI can be reserved for patients with suspicious USG and clinical findings.

Developmental Hip Dysplasia

2019 ◽  
pp. 297-300
Author(s):  
Dorothy L. Gilbertson-Dahdal
Keyword(s):  
Risk Factors ◽  
Problem Solving ◽  
Imaging Modality ◽  
Treatment Options ◽  
Hip Dislocation ◽  
Clinical Findings ◽  
Developmental Dysplasia ◽  
Developmental Hip Dysplasia ◽  
Hormonal Factors ◽  
Dysplasia Of The Hip

Chapter 112 focuses on developmental dysplasia of the hip, which includes a spectrum of abnormalities ranging from a stable hip with a mildly dysplastic acetabulum to complete hip dislocation. Pathophysiology, clinical findings, and screening studies are explored. The pathophysiology is multifactorial including mechanical, genetic and hormonal factors. Imaging strategies, findings, and treatment options are also discussed. Screening US, which is the imaging modality of choice, is performed on infants with predisposing risk factors. Outcome is quite variable with many cases resolving spontaneously without treatment whereas others stabilize with acetabular dysplasia. Treatment options include immobilization and surgery. MRI is used for problem solving in postoperative patients.

scholarly journals P1302 B-cell lymphoma presenting as an ejection systolic murmur

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Constantinides ◽  
M Ioannides ◽  
K Yiagou ◽  
P Avraamides
Keyword(s):  
B Cell ◽  
Transthoracic Echocardiography ◽  
Cell Lymphoma ◽  
Imaging Modality ◽  
Pulmonary Stenosis ◽  
B Cell Lymphoma ◽  
Large Mass ◽  
Clinical Findings ◽  
Ct Guided ◽  
Mediastinal Masses

Abstract OnBehalf Nicosia General Hospital We present the case of a young patient with large B-cell lymphoma causing severe extrinsic pulmonary stenosis. This patient presented to the emergency department with chest discomfort ,fatigue and dyspnea on minimal exertion. A loud ejection mid-systolic crescendo-decrescendo murmur with widely split S2 located in 2nd left parasternal border, raised the suspicion of pulmonary stenosis and patient underwent immediate transthoracic echocardiography as the first imaging modality of choice.On transthoracic echocardiography a large mass was seen, causing severe extrinsic pulmonary stenosis, and was further diagnosed as B-cell lymphoma after CT-guided biopsy. We discuss the high index of lymphoma suspicion in cases of pulmonary stenosis findings such as loud ejection murmur in pulmonic valve auscultation area, in otherwise healthy patients, with no history of congenital heart disease. Lymphoma and other mediastinal masses represent the most common aetiology of acquired pulmonary stenosis and should be suspected in otherwise healthy patients who present with clinical findings of pulmonary stenosis and vice-versa, pulmonary stenosis should be suspected in the presence of symptomatic mediastinal masses. Abstract P1302 Figure. Lymphoma PSAX

scholarly journals MLTI-17. DIFFERENTIATION OF RADIATION INJURY FROM RECURRENT BRAIN METASTASIS USING COMBINED FET PET/MRI RADIOMICS

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i17-i18
Author(s):  
Philipp Lohmann ◽  
Martin Kocher ◽  
Garry Ceccon ◽  
Elena Bauer ◽  
Gabriele Stoffels ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Diagnostic Accuracy ◽  
Radiation Injury ◽  
Imaging Modality ◽  
Feature Analysis ◽  
Textural Features ◽  
Textural Feature ◽  
Fet Pet ◽  
Mri Features

Abstract BACKGROUND: The aim of this study was to investigate the potential of combined radiomics textural feature analysis of contrast-enhanced MRI (CE MRI) and static O-(2-[18F]fluoroethyl)-L-tyrosine(FET) PET for the differentiation of recurrent brain metastasis from radiation injury. PATIENTS AND METHODS: Fifty-two patients with newly diagnosed or progressive contrast-enhancing brain lesions on MRI after radiotherapy (predominantly radiosurgery, 84% of patients) of brain metastases were additionally investigated using FET PET. Based on histology (n=19) or clinicoradiological follow-up (n=33), local recurrent brain metastases were diagnosed in 21 patients (40%) and radiation injury in 31 patients (60%). Forty-two features (shape-based, first and second order features) were calculated on both unfiltered and filtered CE MRI and summed FET PET images (20–40 min p.i). After feature selection, logistic regression models using a maximum of five features to avoid overfitting were calculated for each imaging modality separately and for the combined FET PET/MRI features. The resulting models were validated using cross-validation. Diagnostic accuracies were calculated for each imaging modality separately as well as for the combined model. RESULTS: For differentiation between radiation injury and brain metastasis recurrence, textural features extracted from CE MRI had a diagnostic accuracy of 81%. FET PET textural features revealed a slightly higher diagnostic accuracy of 83%. However, the highest diagnostic accuracy was obtained when combining CE MRI and FET PET features (accuracy, 89%). CONCLUSION: Our findings suggest that combined FET PET/MRI radiomics using textural feature analysis offers a great potential to contribute significantly to the management of patients with brain metastases. SUPPORT: This work was supported by the Wilhelm-Sander Stiftung, Germany

scholarly journals Evaluation of Diagnostic Accuracy of Anal Fistula by 360° Endoanal Ultrasound

2019 ◽  
Vol 10 (2) ◽  
pp. 66-69
Author(s):  
Jawhar Lal Singha ◽  
Sami Ahmad ◽  
Nadim Ahmed ◽  
SM Zulker Nayeem ◽  
Ferdoush Rayhan ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Anal Fistula ◽  
Imaging Modality ◽  
Endoanal Ultrasound ◽  
Internal Opening ◽  
Surgical Results ◽  
Anal Fistulas ◽  
Imaging Tool ◽  
Endoanal Sonography ◽  
Noninvasive Imaging Modality

Introduction: 360° endoanal ultrasound (EAUS) has become an effective imaging tool to diagnose anal fistulas for last three decades. Objectives: To assess the diagnostic accuracy of 360° endoanal ultrasound imaging comparing pre and peroperative diagnosis in anal fistulas. Methods: Between Jauary 2015 and June 2018, 240 patients with clinical anal fistula underwent endoanal sonographic assessment using a 360° endoanal transducer (7–15 MHz The sonographic findings, including the fistulas and other inflammatory lesions, were correlated with surgical results. The types of fistulas on endoanal sonography based on classification of Park and the internal opening of the fistula, both pre and peroperative, were compared to those of other studies. Results: The 240 patients studied included 165 male and 75 female patients. Endoanal sonography was able to show and track hypoechoic lesions, their locations, and internal openings of the fistulas. Compared with surgical results, endoanal sonography had sensitivity of 94.6%, specificity of 100%, and accuracy of 94.1% for the diagnosis of perianal fistulas. Also, endoanal sonography had accuracy of 86.1% for determining fistula types based on the Parks classification and 92.8% for identifying internal openings of the fistulas. Conclusions: Endoanal ultrasound is an accurate and noninvasive imaging modality for evaluation of fistulas. It is a very useful tool for preoperative management and surgical planning by providing precise and detailed information on fistulas. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 66-69

scholarly journals Diagnostic accuracy of ultrasonography with laparoscopy for assessment of benign adnexal masses

2019 ◽  
Vol 9 (1) ◽  
pp. 283
Author(s):  
Vinita Sarbhai ◽  
Medha Yadav
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Ovarian Cyst ◽  
Imaging Modality ◽  
Age Groups ◽  
Serous Cystadenoma ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Adnexal Pathology ◽  
Rule Out

Background: Adnexal masses are one of the most common pathologies among women of all age groups. Objective of this study was to assess efficacy of ultrasonography in diagnosing adnexal pathology, rule out malignancy and its comparison with laparoscopy and pathology results.Methods: A total 32 women with benign adnexal mass were evaluated by clinical examination, ultrasonography and laparoscopy. Findings of ultrasound were compared with laparoscopy and histopathology reports and diagnostic accuracy was calculated.Results: Sensitivity of USG in diagnosing simple ovarian cyst is 20% and specificity is 88.9% while laparoscopy has sensitivity of 100% and specificity of 94.4%. USG versus laparoscopy has sensitivity of 50% versus 100% and specificity of 94.1% versus 100% in diagnosing endometrioma. Sensitivity of USG in diagnosing dermoid cyst is 66.7% and specificity is 95% while laparoscopy has both sensitivity and specificity of 100%. USG and laparoscopy, both have 100% sensitivity and specificity in diagnosing ectopic pregnancy, para-ovarian cyst and TO abscess. Benign serous cystadenoma is a histopathological diagnosis and is missed by both laparoscopy and ultrasonography.Conclusions: Ultrasonography should be the primary imaging modality used to identify and characterize adnexal masses, as it is readily available, and noninvasive.

scholarly journals Ultrasonography of the Lung

2019 ◽  
Vol 191 (10) ◽  
pp. 909-923 ◽  
Author(s):  
Maija Radzina ◽  
Jürgen Biederer
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Emergency Room ◽  
Imaging Modality ◽  
Outpatient Setting ◽  
Chronic Obstructive ◽  
Free Text ◽  
Medical Subject Headings ◽  
High Diagnostic Accuracy ◽  
Valuable Adjunct

Background High diagnostic accuracy, increasing clinical experience and technical improvements are good reasons to consider lung ultrasound (US) for the assessment of pleural and pulmonary diseases. In the emergency room and in intensive care, it is well acknowledged, but application in other settings is rare. The aim of this review is to update potential users in general radiology about the diagnostic scope of lung US and to encourage more frequent use of this generally underestimated lung imaging modality. Method Literature review was done independently by the two authors in MEDLINE (via PubMed) covering a time span from 2002 until 2017 using free text and Medical Subject Headings/MeSH. Article selection for the bibliography was based on consensus according to relevance and evidence. Results and Conclusion The technical prerequisites include a standard ultrasound unit with a suitable transducer. Pleural effusion and pneumothorax, atelectasis, interstitial edema, pneumonia, exacerbated chronic obstructive pulmonary disease/asthma and pulmonary embolism can be distinguished by particular ultrasound signs, artifacts and their combinations. A highly standardized selection of access points and terminology for the description of imaging findings contributes to high diagnostic accuracy even in challenging patients and settings. Besides the assessment of acute respiratory failure in the emergency room, lung US may be used for monitoring interstitial fluid accumulation in volume therapy and for the diagnosis of pneumonia or the assessment of pleural effusion and pleurisy in a routine outpatient setting. Last but not least, the increasing concerns about medical radiation exposure warrant a more extensive use of this sometimes underestimated modality as a cost-, time- and radiation-saving alternative or valuable adjunct to the standard imaging modalities. Key Points:  Citation Format

scholarly journals Optimized Flat-Detector CT in Stroke Imaging: Ready for First-Line Use?

2016 ◽  
Vol 43 (1-2) ◽  
pp. 9-16 ◽  
Author(s):  
Matthias Eckert ◽  
Philipp Gölitz ◽  
Hannes Lücking ◽  
Tobias Struffert ◽  
Frauke Knossalla ◽  
...  
Keyword(s):  
Imaging Modality ◽  
High Sensitivity ◽  
Reconstruction Algorithm ◽  
Clinical Findings ◽  
Rater Agreement ◽  
Flat Detector ◽  
Stroke Imaging ◽  
Imaging Approach ◽  
Ischemic Attack ◽  
Subarachnoid Hemorrhages

Background: Using flat-detector CT (FD-CT) for stroke imaging has the advantage that both diagnostic imaging and endovascular therapy can be performed directly within the Angio Suite without any patient transfer and time delay. Thus, stroke management could be speeded up significantly, and patient outcome might be improved. But as precondition for using FD-CT as primary imaging modality, a reliable exclusion of intracranial hemorrhage (ICH) has to be possible. This study aimed to investigate whether optimized native FD-CT, using a newly implemented reconstruction algorithm, may reliably detect ICH in stroke patients. Additionally, the potential to identify ischemic changes was evaluated. Methods: Cranial FD-CT scans were obtained in 102 patients presenting with acute ischemic stroke (n = 32), ICH (n = 45) or transient ischemic attack (n = 25). All scans were reconstructed with a newly implemented half-scan cone-beam algorithm. Two experienced neuroradiologists, unaware of clinical findings, evaluated independently the FD-CTs screening for hemorrhage or ischemic signs. The findings were correlated to CT, and rater and inter-rater agreement was assessed. Results: FD-CT demonstrated high sensitivity (95-100%) and specificity (100%) in detecting intracerebral and intraventricular hemorrhage (IVH). Overall, interobserver agreement (κ = 0.92) was almost perfect and rater agreement to CT highly significant (r = 0.81). One infratentorial ICH and 10 or 11 of 22 subarachnoid hemorrhages (SAHs) were missed of whom 7 were perimesencephalic. The sensitivity for detecting acute ischemic signs was poor in blinded readings (0 or 25%, respectively). Conclusions: Optimized FD-CT, using a newly implemented reconstruction algorithm, turned out as a reliable tool for detecting supratentorial ICH and IVH. However, detection of infratentorial ICH and perimesencephalic SAH is limited. The potential of FD-CT in detecting ischemic changes is poor in blinded readings. Thus, plain FD-CT seems insufficient as a standalone modality in acute stroke, but within a multimodal imaging approach primarily using the FD technology, native FD-CT seems capable to exclude reliably supratentorial hemorrhage. Currently, FD-CT imaging seems not yet ready for wide adoption, replacing regular CT, and should be reserved for selected patients. Furthermore, prospective evaluations are necessary to validate this approach in the clinical setting.

A Prospective Evaluation of CT in Acutely Paraparetic Chondrodystrophic Dogs

2013 ◽  
Vol 49 (6) ◽  
pp. 363-369 ◽  
Author(s):  
Jennifer Deck Bibevski ◽  
R. Mark Daye ◽  
Todd D. Henrickson ◽  
Todd W. Axlund
Keyword(s):  
Imaging Modality ◽  
Clinical Findings ◽  
Type I ◽  
Prospective Evaluation ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Diagnostic Modality ◽  
Spinal Compression ◽  
Lesion Level

The clinical usefulness of computed tomography (CT) as a sole diagnostic modality in identifying disc lesion(s) in chondrodystrophic breeds presenting with acute signs of intervertebral disc disease (IVDD) is incompletely characterized. CT was used prospectively to determine the validity of this tool. Neurologic examinations and CT scans were performed on all dogs at presentation. Surgical decompression was based on those findings. Clinical follow-up examinations were performed on days 1 and 14 postsurgically. CT detected a lesion consistent with clinical findings in 63 of 69 cases (91%). All 63 dogs with Hansen type I IVDD lesions were identified on CT alone. The surgeon and radiologist agreed on lesion level in 72 of 78 lesions (92%) and lateralization in 71 of 78 lesions (91%). Improvement in neurologic grade was documented in 60 of 69 dogs (87%) by 14 days. CT imaging can be used as a single imaging modality in chondrodystrophic dogs presenting with acute paresis. CT used in this manner is a reliable and noninvasive tool for detecting spinal compression secondary to IVDD in chondrodystrophic dogs.

scholarly journals Physician Receptiveness of Ventilation-Perfusion Imaging in a Randomized Clinical Trial

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Colton Junod, BS ◽  
Alice M. Mitchell, MD, MS
Keyword(s):  
Acute Kidney Injury ◽  
Diagnostic Accuracy ◽  
Chest Radiograph ◽  
Imaging Modality ◽  
Pulmonary Arteries ◽  
Kidney Injury ◽  
Pulmonary Surgery ◽  
Increased Risk ◽  
Patients At Risk ◽  
History Of

Background and Hypothesis: Computed Tomography of the pulmonary arteries (CTPA) is the most common imaging modality for evaluating patients for suspected pulmonary embolism (PE), but carries the risk of acute kidney injury (AKI) from contrast media exposure. In appropriately selected patients, ventilation scintigraphy (VQ) imaging is a diagnostically equivalent alternative. We hypothesized that physician perceptions of diagnostic accuracy and study availability contribute to under-utilization of VQ imaging. Project Methods: Patients with suspected PE at increased risk of acute kidney injury, were randomly selected to undergo VQ instead of CTPA. Patients unable to consent, patients with a history of pulmonary surgery, and those undergoing contrastenhanced imaging for other indications were excluded. A screening chest radiograph was obtained prior to study imaging allocation. All cases were reviewed by a nuclear medicine radiologist blinded to acceptance or refusal of VQ imaging allocation. The primary outcome was defined as the rate of physician-refusal of VQ imaging. The unprompted physician-reported reason for refusal was recorded, in real-time, along with any other general responses. Results: Following exclusions, 42 subjects were enrolled. Notably, chest radiograph findings excluded only 2 subjects. The reviewing nuclear radiologist agreed with all study-selections for VQ appropriateness and there was no instance of nondiagnostic VQ imaging. Treating physicians refused VQ imaging randomization in 48% (20/42). Physicians also believed VQ imaging lacked sufficient diagnostic accuracy in the context of active non-pulmonary malignancy in 29% (12/42) of cases. Although CT did not identify cases not seen on chest radiograph, in 12% (5/42) cases suspected pneumonia was the reason for refusal. Statements such as “VQ is inferior [for PE],” and “VQ takes too long” were characteristic of general responses from treating providers. Conclusion and Potential Impact: VQ imaging remains under-utilized in patients at risk of AKI. Perceived limitations to diagnostic accuracy and study availability are contributors to under-utilization.

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