Transperineal Ultrasonography in Perianal Crohn Disease: A Valuable Imaging Modality

Aims of treatment for Crohn disease have moved beyond the resolution of clinical symptoms to objective end points including endoscopic and radiological normality. Regular re-evaluation of disease status to safely, readily and reliably detect the presence of inflammation and complications is paramount. Improvements in sonographic technology over recent years have facilitated a growing enthusiasm among radiologists and gastroenterologists in the use of ultrasound for the assessment of inflammatory bowel disease. Transabdominal intestinal ultrasound is accurate, affordable and safe for the assessment of lumi-nal inflammation and complications in Crohn disease, and can be performed with or without the use of intravenous contrast enhancement. Perianal fistulizing disease is a common, complex and often treatment-refractory complication of Crohn disease, which requires regular radiological monitoring. Endoanal ultrasound is invasive, uncomfortable and yields limited assessment of the perineal region. Although magnetic resonance imaging of the pelvis is established, timely access may be a problem. Transperineal ultrasound has been described in small studies, and is an accurate, painless and cost-effective method for documenting perianal fluid collections, fistulas and sinus tracts. In the present article, the authors review the literature regarding perineal ultrasound for the assessment of perianal Crohn disease and use case examples to illustrate its clinical utility.

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A novel use of contrast-enhanced ultrasound in uterine artery embolization

American Journal of Interventional Radiology ◽

10.25259/ajir_3_2020 ◽

2020 ◽

Vol 4 ◽

pp. 8

Author(s):

Jemianne Bautista Jia ◽

Eric Mastrolonardo ◽

Mateen Soleman ◽

Ilya Lekht

Keyword(s):

Uterine Artery Embolization ◽

Uterine Artery ◽

Imaging Modality ◽

Cost Effective ◽

Contrast Enhanced Ultrasound ◽

Artery Embolization ◽

Non Invasive ◽

Contrast Enhanced

Contrast-enhanced ultrasound (CEUS) is a cost-effective, quick, and non-invasive imaging modality that has yet to be incorporated in uterine artery embolization (UAE). We present two cases that demonstrate the utility of CEUS in UAE for the identification of uterine-ovarian collaterals which otherwise can result in ineffective fibroid treatment and non-target embolization.

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953 Role of Routine Preoperative Echocardiograms in Adolescent Idiopathic Scoliosis Patients undergoing Deformity Correction Surgery

British Journal of Surgery ◽

10.1093/bjs/znab134.339 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A Hassan ◽

S Shah ◽

M Patel

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Clinical Assessment ◽

Clinical Symptoms ◽

Deformity Correction ◽

Cost Effective ◽

Cardiovascular Complications ◽

Anterior Correction ◽

Perioperative Complication ◽

Clinical Records

Abstract Introduction Patients with Adolescent Idiopathic Scoliosis (AIS) are often noted to have routine preoperative Echocardiograms (ECHO). The prevalence of ECHO abnormalities and their impact on perioperative outcome is not clear, especially balancing against its costs. The study aims at identifying the significance of routine preoperative ECHO for AIS patients. Methodology Clinical records of 295 adolescent AIS patients, >10years age (mean 15.64years), who underwent primary posterior corrective surgery in a tertiary spinal centre, between 2015-2020, were reviewed. Patients with revision surgery, anterior correction, syndromic/neuromuscular scoliosis and/or pre-existent known cardiac comorbidities were excluded. Results 139(47%) patients had preoperative ECHO. 21(15%) patients showed echocardiographic abnormalities (11 trivial valvular abnormalities, 5 mild root dilatation, 3 mild pericardial effusion and 2 septal defects). None of these patients showed any clinical symptoms/signs or required Cardiology assessment; and none had perioperative cardiovascular complications. Conversely, four(1.36%) patients demonstrated auscultatory murmurs on preoperative clinical assessment. None reported any perioperative complication. The average known cost of an echocardiogram was noted to be £363. Conclusions Routine preoperative Echocardiogram for all AIS patients is not recommended or deemed cost-effective. Positive clinical assessment finding could be used as a screening tool for performing ECHO in AIS patients.

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Imaging Findings of Knee Trauma on Magnetic Resonance Imaging

Annals of International medical and Dental Research ◽

10.53339/aimdr.2022.8.1.3 ◽

2022 ◽

Vol 8 (1) ◽

pp. 12-23

Author(s):

Poonam Ohri ◽

Shreeji Goya ◽

Niveditha C ◽

Manasi Kohli

Keyword(s):

Anterior Cruciate Ligament ◽

Imaging Modality ◽

Cruciate Ligament ◽

Age Groups ◽

Lateral Collateral Ligament ◽

Cost Effective ◽

Collateral Ligament ◽

Imaging Evaluation ◽

Young Males ◽

Anterior Cruciate

Background: Knee is one of the major joints involved in kinesis. With increasing involvement in sports related activities especially in young people, Trauma related knee pathologies have increased. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non-operative treatment. Methods:This prospective study included total of 82 cases. The patients were referred to the department of Radiodiagnosis from indoor and outdoor departments of Guru Nanak Dev Hospital, Amritsar with suspicion of internal derangement of the knee and with history of knee trauma.Results:The most common age group involved was young males between 15-34 years. In all age groups most of the patients were males. Most common ligament to be injured was Anterior Cruciate Ligament (ACL). Partial tears were more common than complete tears. Posterior Cruciate Ligament (PCL) tears were less common. Medial Collateral Ligament (MCL) tears outnumbered Lateral Collateral Ligament (LCL) tears and grade 2 tears were more common in both. Among the meniscal injuries Medial Meniscus (MM) tears were more common than LM and grade 3 signal was more common in both. Most of the patellar retinaculum injuries were associated with Anterior Cruciate Ligament ACL tears.Conclusions:Post-traumatic pre-arthroscopic MR imaging evaluation has proved to be cost-effective. MRI is an accurate imaging modality complementing the clinical evaluation and providing a global intra-articular and extra-articular assessment of the knee.

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Utility of intravascular ultrasound in intracranial and extracranial neurointerventions: experience at University at Buffalo Neurosurgery–Millard Fillmore Gates Circle Hospital

Neurosurgical FOCUS ◽

10.3171/2011.10.focus11242 ◽

2012 ◽

Vol 32 (1) ◽

pp. E6 ◽

Cited By ~ 11

Author(s):

Peter Kan ◽

Maxim Mokin ◽

Adib A. Abla ◽

Jorge L. Eller ◽

Travis M. Dumont ◽

...

Keyword(s):

Intravascular Ultrasound ◽

Imaging Modality ◽

Interventional Cardiology ◽

Plaque Composition ◽

Intraluminal Thrombus ◽

Conventional Angiography ◽

Cross Sectional ◽

Case Examples ◽

Vessel Stenosis ◽

Wide Range

Intravascular ultrasound (IVUS) generates high-resolution cross-sectional images and sagittal reconstructions of the vessel wall and lumen. As a result, this imaging modality can provide accurate measurements of the degree of vessel stenosis, allow the detection of intraluminal thrombus, and analyze the plaque composition. The IVUS modality is widely used in interventional cardiology, and its use in neurointerventions has gradually increased. With case examples, the authors illustrate the utility of IVUS as an adjunct to conventional angiography for a wide range of intracranial and extracranial neurointerventions.

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Medical Therapy for Crohn Disease

10.2310/gastro.5416 ◽

2015 ◽

Author(s):

Jessica R Allegretti ◽

Joshua R. Korzenik

Keyword(s):

Disease Activity ◽

Crohn Disease ◽

Clinical Symptoms ◽

Activity Index ◽

Severe Disease ◽

Treatment Options ◽

Injection Site Reaction ◽

Perianal Fistula ◽

Perianal Disease ◽

Aminosalicylic Acid

Crohn disease (CD) is an inflammatory condition that can affect any portion of the gastrointestinal tract from the mouth to the perianal area. The resulting transmural inflammation can lead to a spectrum of clinical presentations depending on disease location and severity. The treatment of CD depends on the severity of the disease, phenotype, presence of perianal disease, and response to previous therapies. This review examines the goals of therapy for CD, clinical symptoms and disease activity, treatment of disease based on mild to moderate to severe stages, treatment of refractory disease, perianal disease, postoperative CD, and noninflammatory treatment options. Figures show adalimumab injection-site reaction and perianal fistula with seton placement. Tables list the Crohn Disease Activity Index (CDAI), the Harvey Bradshaw Index, 5-aminosalicylic acid formulations, standard dosing of CD medications for moderate to severe disease, and rates of clinical response and remission in patients receiving anti–tumor necrosis factor agents versus placebo, by trial. This review contains 2 highly rendered figures, 5 tables, and 85 references.

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Novel 15-mm-long lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections located ≥10 mm from the luminal wall

Endoscopy ◽

10.1055/a-1682-7095 ◽

2021 ◽

Author(s):

Linda Y. Zhang ◽

Rastislav Kunda ◽

Maridi Aerts ◽

Nouredin Messaoudi ◽

Rishi Pawa ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Clinical Symptoms ◽

Clinical Success ◽

Duodenal Wall ◽

Metal Stents ◽

Pancreatic Fluid Collections ◽

Pancreatic Fluid ◽

Maximal Diameter ◽

International Multicenter Study ◽

Fluid Collections

Abstract Background Endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) by cautery-enhanced lumen-apposing metal stents (LAMS) has largely been limited to collections located < 10 mm from the luminal wall. We present outcomes of the use of a novel 15-mm-long cautery-enhanced LAMS for drainage of PFCs located ≥ 10 mm away. Methods This international, multicenter study analyzed all adults with PFCs located ≥ 10 mm from the luminal wall who were treated by EUS-guided drainage using the 15-mm-long cautery-enhanced LAMS. The primary outcome was technical success. Secondary outcomes included clinical success (decrease in PFC size by ≥ 50 % at 30 days and resolution of clinical symptoms without surgical intervention), complications, and recurrence. Results 35 patients (median age 57 years; interquartile range [IQR] 47–64 years; 49 % male) underwent novel LAMS placement for drainage of PFCs (26 walled-off necrosis, 9 pseudocysts), measuring 85 mm (IQR 64–117) maximal diameter and located 11.8 mm (IQR 10–12.3; range 10–14) from the gastric/duodenal wall. Technical and clinical success were high (both 97 %), with recurrence in one patient (3 %) at a median follow-up of 123 days (58–236). Three complications occurred (9 %; one mild, two moderate). Conclusions The 15-mm-long cautery-enhanced LAMS was feasible and safe for drainage of PFCs located 10–14 mm from the luminal wall.

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Abstract 5817.5: Assessment of Global Left Ventricular Function and Volumes with 320-Slice MSCT: A Comparison with 2D Echocardiography

Circulation ◽

10.1161/circ.118.suppl_18.s_1010 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Fleur R de Graaf ◽

Joanne D Schuijf ◽

Jacob M van Werkhoven ◽

J Wouter Jukema ◽

Gaetano Nucifora ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Function Analysis ◽

Imaging Modality ◽

Linear Regression Analysis ◽

Left Ventricular ◽

Lv Function ◽

Intravenous Contrast ◽

2D Echocardiography ◽

Artery Disease

Background. Multi-slice computed tomography (MSCT) has been demonstrated as a feasible imaging modality for non-invasive assessment of coronary artery disease and left ventricular (LV) function analysis. Recently, 320-slice systems have become available with 16 cm anatomical coverage allowing prospective image acquisition of the entire heart within a single rotation or heart beat. However, limited data are currently available with these systems. The purpose of the present study therefore was to evaluate the accuracy of 320-slice MSCT in the assessment of global LV function as compared to 2-dimensional (2D) echocardiography. Methods. A head-to-head comparison between 320-slice MSCT and 2D echocardiography was performed in 40 patients (24 male; mean age 61 ± 9 years) with known or suspected coronary artery disease (CAD). During intravenous contrast agent administration, the entire heart was imaged in a single heartbeat, using prospective dose modulation (full dose during 65–85% of R-R interval). The following parameters were used: gantry rotation time 350 ms, tube voltage 120 kV, tube current 300–500mA. LV end-diastolic volumes (LVEDV) and LV end-systolic volumes (LVESV) were determined and the LV ejection fraction (LVEF) was derived. Two-dimensional echocardiography served as the gold standard. Results. Average LVEF was 59% ± 8% (range 31%–77%) as determined on 2D-echocardiography, compared with 61% ± 8% (range 33%–78%) on MSCT. Evaluation of LVEF by linear regression analysis showed a good correlation between MSCT and 2D-echocardiography (r = 0.84; p < 0.001). A close correlation between MSCT and 2D-echocardiography was also demonstrated for the assessment of LVEDV (r = 0.81; p < 0.001) and LVESV (r = 0.89; p < 0.001). At Bland-Altman analysis, mean differences (± SD) of 20.88 ml ± 23.07 ml (p < 0.01) and 6.83 ml ± 13.01 ml (p < 0.01) were observed between MSCT and 2D-echocardiography for LVEDV and LVESV respectively. As a result, LVEF was slightly overestimated with MSCT (1.98% ± 4.54%; p < 0.01). Conclusion. Accurate assessment of LV function and volumes is feasible with 320-slice MSCT in patients with known or suspected CAD.

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Changes of Myelin Organization in Patients with Alzheimer’s Disease Shown by q-Space Myelin Map Imaging

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000493937 ◽

2019 ◽

Vol 9 (1) ◽

pp. 24-33 ◽

Cited By ~ 2

Author(s):

Miho Ota ◽

Noriko Sato ◽

Yukio Kimura ◽

Yoko Shigemoto ◽

Hiroshi Kunugi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Healthy Subjects ◽

Clinical Symptoms ◽

Imaging Modality ◽

Significant Negative Correlation ◽

Anterior Cingulate ◽

Resonance Imaging ◽

Duration Of Illness ◽

The Central Nervous System

Background: Recent studies detected the aberrant myelination of the central nervous system (CNS) in Alzheimer’s disease (AD). Here, we compared the change of myelination between patients with AD and controls by a novel magnetic resonance imaging modality, “q-space myelin map (MM) imaging.” Methods: Twenty patients with AD and 18 healthy subjects underwent MM imaging. We compared the MM metric between the 2 groups and examined the relationships between the metric and the clinical symptoms of AD. Results: AD patients showed a significant reduction of MM metric in the hippocampus, insula, precuneus, and anterior cingulate regions. There was also a significant negative correlation between the duration of illness and the MM metric in the temporoparietal region. Conclusion: Our findings suggest that MM imaging could be a clinically proper modality to estimate the myelination changes in AD patients.

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