Cross-sectional imaging assessment of renal masses with emphasis on MRI

2021 ◽  
pp. 028418512110529
Author(s):  
Athina C Tsili ◽  
Lia-Angela Moulopoulos ◽  
Ioannis Μ Varakarakis ◽  
Maria I Argyropoulou
Keyword(s):  
Renal Tumors ◽  
Renal Masses ◽  
Cross Sectional ◽  
Post Contrast ◽  
Diffusion Weighted Images ◽  
Imaging Tool ◽  
Weighted Sequence ◽  
Phase Images ◽  
Increased Sensitivity ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI) is a useful complementary imaging tool for the diagnosis and characterization of renal masses, as it provides both morphologic and functional information. A core MRI protocol for renal imaging should include a T1-weighted sequence with in- and opposed-phase images (or, alternatively with DIXON technique), T2-weighted and diffusion-weighted images as well as a dynamic contrast-enhanced sequence with subtraction images, followed by a delayed post-contrast T1-weighted sequence. The main advantages of MRI over computed tomography include increased sensitivity for contrast enhancement, less sensitivity for detection of calcifications, absence of pseudoenhancement, and lack of radiation exposure. MRI may be applied for renal cystic lesion characterization, differentiation of renal cell carcinoma (RCC) from benign solid renal tumors, RCC histologic grading, staging, post-treatment follow-up, and active surveillance of patients with treated or untreated RCC.

scholarly journals Comparison of Echocardiography and Computed Tomography/Magnetic Resonance Imaging for Assessing of Pulmonary Vein Stenosis in Children

2020 ◽  
pp. 75-79
Author(s):  
Y. Mykychak ◽  
D. Kozhokar ◽  
I. Yusifli ◽  
A. Morkovkina ◽  
R. Tammo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Pulmonary Vein Stenosis ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Imaging Tool ◽  
Magnetic Resonance Imaging Mri

Pulmonary vein (PV) stenosis is a rare disease with high recurrence and mortality rates. Objective. This study was aimed to evaluate the diagnostic accuracy of echocardiography versus cross-sectional modalities. Material and methods. Our study includes 11 consecutive patients who underwent a comprehensive PV anatomy assessment between April 2018 and June 2019 at Ukrainian Children’s Cardiac Center, Kyiv. Echocardiographic studies of each pulmonary vein followed by computed tomography (CT) or magnetic resonance imaging (MRI) were performed in all patients. A total of 27 CT/MRI studies were performed. Results. There were four patients whose echocardiography findings were completely confirmed by CT/MRI method. In some patients significant stenosis was underestimated by echocardiography. Sensitivity and specificity were 86.4 and 88.9 for echo, as well as 100 and 94.4 for CT/MRI, respectively. Conclusion. This study recognizes the limitations of echocardiography as an imaging tool for pulmonary veins morphology assessment. Cross-sectional studies overcome these limitations and provide excellent morphological as well as functional (MRI) evaluation of pulmonary veins.

scholarly journals The Role of Surveillance in the Management of Small Renal Masses

2007 ◽  
Vol 7 ◽  
pp. 860-868 ◽  
Author(s):  
Alessandro Volpe
Keyword(s):  
Natural History ◽  
Active Treatment ◽  
Initial Period ◽  
Renal Tumors ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Cross Sectional ◽  
Slow Growth Rate ◽  
History Of

Incidentally detected, small renal masses (SRMs) have been increasing significantly in recent years due to the widespread use of improved cross-sectional imaging. A significant number of incidental SRMs are diagnosed in elderly patients who are more likely to undergo imaging for other medical issues. The natural history of SRMs has not been historically well understood because most masses are surgically removed soon after diagnosis.Several reports of surveillance of SRMs have been published in the last few years. When followed conservatively with serial imaging, SRMs have variable growth rates with an average of 0.28 cm/year, according to a recent meta-analysis. Larger series with longer follow-up are needed, but a significant number of small tumors seem to have an indolent behavior with a slow growth rate and a limited tendency to progress. The standard of care for enhancing SRMs is surgery. Up to one-third of surgically removed, <4-cm tumors are histologically benign. The outcomes of current surgical treatment of histologically confirmed, <4-cm, renal cell carcinomas are excellent, but this has not led to a decrease in mortality. Based on these considerations and on the available data on the natural history of SRMs, it seems reasonable to consider that we may be overtreating these lesions. This is especially true for elderly or unfit patients who have a decreased life expectancy. In these selected patients and in patients who refuse active treatment, it seems reasonable to propose an initial period of active surveillance for incidental SRMs, with delayed intervention for those tumors that will exhibit fast growth during follow-up. Percutaneous needle biopsies of renal tumors can be safely performed with the use of modern techniques and have the potential to characterize SRMs at histologically diagnosis, thereby allowing a better selection of the conservative or active treatment that is best suited for each individual patient.

scholarly journals Incidental Monotypic (Fat-Poor) Renal Angiomyolipoma Diagnosed by Core Needle Biopsy

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Verena Kufer ◽  
Siegfried A. Schwab ◽  
Maike Büttner ◽  
Abbas Agaimy ◽  
Michael Uder ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Renal Tumors ◽  
Renal Lesion ◽  
Renal Angiomyolipoma ◽  
Cross Sectional ◽  
Core Needle ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

We present the case of a 55-year-old patient with a history of chemotherapy and bone marrow transplantation because of acute myeloid leukaemia. An incidental 4 × 3 cm measuring renal mass was detected while performing a magnetic resonance imaging (MRI) for lumbago. The lesion was suspected to be either a renal cell carcinoma (RCC) or a leukemic infiltration. To decide about further treatment a percutaneous core needle biopsy was performed. Histology showed a monotypic angiomyolipoma, a relatively rare benign renal lesion. Interestingly, in cross-sectional imaging, angiomyolipoma was not taken into differential diagnostic account because of lack of a fatty component. Due to bleeding after biopsy the feeding artery of the tumor was occluded by microcoils. This case demonstrates the utility of biopsy of renal tumors, in particular when small tumor-like lesions are incidentally detected to decide about the right treatment and thereby avoiding nephrectomy.

scholarly journals Role of multi detector computed tomography (MDCT) in evaluation of renal masses

2018 ◽  
Vol 6 (3) ◽  
pp. 974
Author(s):  
M. A. Karthikeyan ◽  
Poonam Vohra
Keyword(s):  
Computed Tomography ◽  
Renal Mass ◽  
Early Stage ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Clinical Signs ◽  
Simple Cyst ◽  
Renal Masses ◽  
Cross Sectional ◽  
Post Contrast

Background: Due to rapid pace in development of imaging techniques and increasing number of investigations being done, more number of renal masses are discovered incidentally during evaluation of unrelated or unspecific symptoms. Hence it is vital to differentiate neoplastic and non-neoplastic masses. Among the neoplastic masses, there is a need to differentiate benign and malignant masses so that appropriate treatment strategies like nephron sparing surgery, radio frequency ablation etc. can be planned at an early stage and avoiding unnecessary radical treatments for improved patients survival.Methods: A Cross-sectional Observational study was done in 35 patients. Patients of either sex in any age group who had presented with suspected renal mass by clinical signs and symptoms (palpable renal angle mass, renal angle pain, hematuria) confirmed on USG examination or an incidental Renal mass diagnosed on USG/CT examination were included in our study.Results: Ultrasound is the initial imaging modality of choice since it is inexpensive, easy to perform and no radiation exposure. On USG, the renal lesions are classified as solid or cystic. Anechoic, thin walled cyst without any septations or solid components is usually Bosniak I cyst (simple cyst) and does not need any further evaluation. Rest of the cystic and solid lesions cannot be characterized by ultrasound and hence need further evaluation.Conclusions: Multidetector Computed Tomography is the imaging modality of choice for further evaluation and characterization. CT is done in four phases viz., unenhanced, corticomedullary, nephrographic and excretory phase especially in cases of malignancy while in benign conditions like angiomyolipoma and abscess, evaluation with unenhanced and single phase post contrast in portovenous phase is sufficient.

scholarly journals Magnetic resonance imaging template to standardize reporting of anal fistulas

2021 ◽  
Author(s):  
I. Sudoł-Szopińska ◽  
G. A. Santoro ◽  
M. Kołodziejczak ◽  
A. Wiaczek ◽  
U. Grossi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Treatment Strategies ◽  
Cross Sectional Study ◽  
Resonance Imaging ◽  
Anal Fistulas ◽  
Cross Sectional ◽  
Radiology Reports ◽  
Colorectal Surgeons ◽  
Magnetic Resonance Imaging Mri

AbstractAnal fistula (AF) is a common referral to colorectal surgeons. Management remains challenging and sometimes controversial. Magnetic resonance imaging (MRI) is commonly performed in initial workup for AF. However, reports often lack key information for guiding treatment strategies. It has been shown that with structured radiology reports, there is less missing information. We present a structured MRI template report including 8 key descriptors of anal fistulas, whose effectiveness and acceptability are being assessed in a cross-sectional study (NCT04541238).

scholarly journals Comparison of swept-source versus spectral-domain optical coherence tomography angiography for detection of macular neovascularization

2021 ◽  
Author(s):  
Anna Lentzsch ◽  
Laura Schöllhorn ◽  
Christel Schnorr ◽  
Robert Siggel ◽  
Sandra Liakopoulos
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
En Face ◽  
Increased Sensitivity ◽  
Sensitivity Specificity ◽  
Subretinal Hyperreflective Material

Abstract Purpose To compare swept-source (SS) versus spectral-domain (SD) optical coherence tomography angiography (OCTA) for the detection of macular neovascularization (MNV). Methods In this prospective cohort study, 72 eyes of 54 patients with subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye were included. OCTA scans were acquired using two devices, the PLEX Elite 9000 SS-OCTA and the Spectralis SD-OCTA. Fluorescein angiography (FA) was used as reference. Two graders independently evaluated en face OCTA images using a preset slab as well as a manually modified slab, followed by a combination of en face and cross-sectional OCTA. Results Sensitivity (specificity) for the automated slabs was 51.7% (93.0%) for SS-OCTA versus 58.6% (95.3%) for SD-OCTA. Manual modification of segmentation increased sensitivity to 79.3% for SS-OCTA but not for SD-OCTA (58.6%). The combination of en face OCTA with cross-sectional OCTA reached highest sensitivity values (SS-OCTA: 82.8%, SD-OCTA: 86.2%), and lowest number of cases with discrepancies between SS-OCTA and SD-OCTA (4.2%). Fleiss kappa as measure of concordance between FA, SS-OCTA, and SD-OCTA was 0.56 for the automated slabs, 0.60 for the manual slabs, and 0.73 (good agreement) for the combination of en face OCTA with cross-sectional OCTA. Concordance to FA was moderate for the automated slabs and good for manual slabs and combination with cross-sectional OCTA of both devices. Conclusion Both devices reached comparable results regarding the detection of MNV on OCTA. Sensitivity for MNV detection and agreement between devices was best when evaluating a combination of en face and cross-sectional OCTA.

scholarly journals Cross-sectional analysis of follow-up chest MRI and chest CT scans in patients previously affected by COVID-19

2021 ◽  
Author(s):  
Martina Pecoraro ◽  
Stefano Cipollari ◽  
Livia Marchitelli ◽  
Emanuele Messina ◽  
Maurizio Del Monte ◽  
...  
Keyword(s):  
Chest Ct ◽  
Ct Scans ◽  
Imaging Biomarker ◽  
Cross Sectional ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Sectional Analysis ◽  
Ct And Mri ◽  
Interlobular Septal Thickening

Abstract Purpose The aim of the study was to prospectively evaluate the agreement between chest magnetic resonance imaging (MRI) and computed tomography (CT) and to assess the diagnostic performance of chest MRI relative to that of CT during the follow-up of patients recovered from coronavirus disease 2019. Materials and methods Fifty-two patients underwent both follow-up chest CT and MRI scans, evaluated for ground-glass opacities (GGOs), consolidation, interlobular septal thickening, fibrosis, pleural indentation, vessel enlargement, bronchiolar ectasia, and changes compared to prior CT scans. DWI/ADC was evaluated for signal abnormalities suspicious for inflammation. Agreement between CT and MRI was assessed with Cohen’s k and weighted k. Measures of diagnostic accuracy of MRI were calculated. Results The agreement between CT and MRI was almost perfect for consolidation (k = 1.00) and change from prior CT (k = 0.857); substantial for predominant pattern (k = 0.764) and interlobular septal thickening (k = 0.734); and poor for GGOs (k = 0.339), fibrosis (k = 0.224), pleural indentation (k = 0.231), and vessel enlargement (k = 0.339). Meanwhile, the sensitivity of MRI was high for GGOs (1.00), interlobular septal thickening (1.00), and consolidation (1.00) but poor for fibrotic changes (0.18), pleural indentation (0.23), and vessel enlargement (0.50) and the specificity was overall high. DWI was positive in 46.0% of cases. Conclusions The agreement between MRI and CT was overall good. MRI was very sensitive for GGOs, consolidation and interlobular septal thickening and overall specific for most findings. DWI could be a reputable imaging biomarker of inflammatory activity.

scholarly journals Relationship between abnormalities detected by magnetic resonance imaging and knee symptoms in early knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Osteoarthritis ◽  
Cartilage Damage ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Radiographic Evidence ◽  
Cross Sectional ◽  
Meniscal Lesions ◽  
Magnetic Resonance Imaging Mri

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.

scholarly journals Actionable and incidental neuroradiological findings in twins with neurodevelopmental disorders

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lynnea Myers ◽  
Mai-Lan Ho ◽  
Elodie Cauvet ◽  
Karl Lundin ◽  
Torkel Carlsson ◽  
...  
Keyword(s):  
Neurodevelopmental Disorders ◽  
Copy Number Variants ◽  
Cross Sectional Study ◽  
Autism Spectrum ◽  
Molecular Signaling ◽  
Mri Findings ◽  
Cross Sectional ◽  
Increased Risk ◽  
Magnetic Resonance Imaging Mri ◽  
Morphological Variants

AbstractWhile previous research has investigated neuroradiological findings in autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), the entire range of neurodevelopmental disorders (NDDs) has not yet been well-studied using magnetic resonance imaging (MRI). Considering the overlap among NDDs and simultaneous development of the brain and face, guided by molecular signaling, we examined the relationship of actionable and incidental (non-actionable) MRI findings and NDD diagnoses together with facial morphological variants and genetic copy number variants (CNVs). A cross-sectional study was conducted with a twin cohort 8–36 years of age (57% monozygotic, 40% dizygotic), including 372 subjects (46% with NDDs; 47% female) imaged by MRI, 280 with data for facial morphological variants, and 183 for CNVs. Fifty-one percent of participants had MRI findings. Males had a statistically significantly higher percentage of MRI findings (57.7%) compared with females (43.8%, p = 0.03). Twin zygosity was not statistically significantly correlated with incidence or severity of specific MRI findings. No statistically significant association was found between MRI findings and any NDD diagnosis or facial morphological variants; however, MRI findings were statistically significantly associated with the number of CNVs (OR 1.20, 95% CI 1.00–1.44, p = 0.05, adjusted OR for sex 1.24, 95% CI 1.03–1.50, p = 0.02). When combining the presence of MRI findings, facial morphological variants, and CNVs, statistically significant relationships were found with ASD and ADHD diagnoses (p = 0.0006 and p = 0.002, respectively). The results of this study demonstrate that the ability to identify NDDs from combined radiology, morphology, and CNV assessments may be possible. Additionally, twins do not appear to be at increased risk for neuroradiological variants.

scholarly journals How one treats lateral epicondylitis – a survey among Brazilian orthopedists

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rafael Fuchs Lazarini ◽  
Renato Arouca Zan ◽  
João Carlos Belloti ◽  
Ildeu Afonso de Almeida Filho ◽  
Luiz Fernando Sartori Centenaro ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Hand Surgery ◽  
Initial Therapy ◽  
Cross Sectional Study ◽  
Imaging Method ◽  
Cross Sectional ◽  
Imaging Tool ◽  
Management Protocol

Abstract Background Lateral epicondylitis (LE), also known as tennis elbow, is the most common painful elbow condition. It affects approximately 1–3% of adults. There are various possible treatments described in the literature, but evidence to support a gold standard management protocol is lacking. Therefore, the objective of this study was to evaluate how Brazilian orthopaedists diagnose and treat lateral epicondylitis and compare these results with the available evidence. Methods This is an observational, analytical, cross-sectional study. A questionnaire was prepared to obtain information from the participants with eight specific questions (2 on diagnosis and 6 on treatment). These questions were answered voluntarily by participants at 3 major congresses of orthopaedists in Brazil in 2018. The results were analysed in accordance with the overall number of responses and were evaluated among groups according to subspecialty. Results We obtained a total of 501 questionnaires. Of these, 33 were excluded. The mean age was 38.67 years. The majority of respondents (91%) were male. We obtained 26.7% from specialists in hand surgery (Hand group), 36.5% from subspecialists in shoulder and elbow (Shoulder and Elbow group), and 36.8% from generalists in orthopaedics or from other subspecialties (General Orthopaedists group). For diagnosis, 24.4% did not initially request any imaging method. The most requested exam was ultrasonography (54.9%). The most prominent indication for initial treatment was physical therapy. For refractory cases, 78.3% of the respondents preferred doing a local infiltration. The most commonly used substance for local infiltrations was corticosteroids (89.6%). With respect to the surgical treatment option, 75.8% of those who recommend it prefer open techniques, and 24.2% prefer arthroscopic treatment. Of the total respondents, 12.8% did not recommend surgical treatment for LE. Conclusion Among Brazilian orthopaedists, the Cozen test is most frequently chosen, and ultrasound is the most commonly used imaging tool. Nonsurgically, oral nonsteroidal anti-inflammatory drugs (NSAIDs) plus physiotherapy is the most popular initial therapy, and corticosteroids are the most popular type of infiltration agent. Most surgeons recommended surgery after 6 months of nonsurgical treatment, and 75.8% preferred the open technique.

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