Complications of Caesarean delivery part 2: Non-pregnant and pregnancy-related complications

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110387
Author(s):  
Eelin Tan ◽  
Timothy Shao Ern Tan ◽  
Harvey Eu Leong Teo ◽  
Li Ching Lau
Keyword(s):  
Patient Outcomes ◽  
Caesarean Delivery ◽  
Abnormal Placentation ◽  
First Line ◽  
Cross Sectional ◽  
Scar Endometriosis ◽  
Caesarean Scar ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Uterine Dehiscence

Introduction With the rise in Caesarean deliveries, complications related to the procedure are increasingly encountered. Sonography has an indispensable role in the assessment of these complications and is often the first-line investigation of choice. Topic description: Part 2 of this pictorial review summarises the non-pregnant and pregnancy-related complications of Caesarean deliveries. Discussion Non-pregnant complications include Caesarean scar defects, scar endometriosis and malpositioned intrauterine devices. Complications related to future gestations include scar ectopic pregnancy, abnormal placentation and intrapartum uterine dehiscence or rupture. Key sonographic features of these conditions are illustrated. Pitfalls, mimics, limitations and indications for cross-sectional imaging are discussed. Conclusion Sound knowledge of the sonographic features of common non-pregnant and pregnancy-related complications of Caesarean delivery will facilitate accurate diagnosis, timely management and improved patient outcomes.

Complications of Caesarean delivery part 1: Early complications

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110385
Author(s):  
Eelin Tan ◽  
Timothy Shao Ern Tan ◽  
Harvey Eu Leong Teo ◽  
Li Ching Lau
Keyword(s):  
Caesarean Delivery ◽  
Vascular Complications ◽  
Early Complications ◽  
First Line ◽  
Cross Sectional ◽  
Pictorial Review ◽  
Products Of Conception ◽  
Cross Sectional Imaging ◽  
Infective Complications ◽  
Uterine Dehiscence

Introduction With the rise in Caesarean deliveries, complications related to the procedure are increasingly encountered. Sonography has an indispensable role in the assessment of these complications and is often the first-line investigation of choice. Topic Description: Part 1 of this pictorial review summarises the early complications unique to and associated with Caesarean deliveries. Discussion Acute haemorrhagic complications include retained products of conception, subfascial and bladder flap haematomas and, rarely, postpartum uterine dehiscence or rupture and iatrogenic vascular complications. Infective complications include puerperal and wound infections. Key sonographic features of these conditions are illustrated. Pitfalls, mimics, limitations and indications for cross-sectional imaging are discussed. Conclusion Sound knowledge of the sonographic features of common early complications of Caesarean delivery will facilitate accurate diagnosis, timely management and improved patient outcomes.

Periaortic air in native and post-operative aorta on computed tomography

2021 ◽  
Author(s):  
Mansi Verma ◽  
Amit Ajit Deshpande ◽  
Niraj Nirmal Pandey ◽  
Sanjeev Kumar
Keyword(s):  
Computed Tomography ◽  
Clinical Laboratory ◽  
Radical Surgery ◽  
Imaging Finding ◽  
Radiological Findings ◽  
Catastrophic Event ◽  
Cross Sectional ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Indispensable Tool

Periaortic air can be seen in various conditions which can be a benign imaging finding or harbinger of a catastrophic event. The causes vary in native aorta and post-operative aorta. A radiologist has an important part in the management process of these patients, as the treatment varies from conservative to radical surgery based on the aetiology. The presence of periaortic air seen in the light of various clinical, laboratory and radiological findings can guide the radiologist towards a particular aetiology. Cross-sectional imaging, mainly computed tomography, is an indispensable tool in recognising ectopic periaortic air and to identify the associated findings and eventually make an accurate diagnosis. We present a pictorial review of various causes of the periaortic air in native and postoperative aorta, the salient features and management of the described conditions.

scholarly journals Comprehensive Radiological Assessment of Sub-axial Spinal Injury

2019 ◽  
Vol 2 (1) ◽  
pp. 181-187
Author(s):  
Jawad Naqvi ◽  
Syed I Ali ◽  
Vinay Parmar ◽  
Chooi Oh ◽  
Simon Beardmore ◽  
...  
Keyword(s):  
Mechanical Stability ◽  
Spinal Injury ◽  
Image Interpretation ◽  
Neurological Status ◽  
Classification Systems ◽  
Unstable Fracture ◽  
Cross Sectional ◽  
Pictorial Review ◽  
Thoracolumbar Injury ◽  
Cross Sectional Imaging

Radiologists frequently interpret cross-sectional imaging of the spine in the setting of trauma. Mechanical stability of the traumatised spine is the single most important factor which guides further management. Several classification systems have been developed over the past to assist radiologists to judge the potentially unstable injuries. The radiologists are arguably most familiar with Denis system of classification which is based on injury morphology and mechanism. This system has been criticised for being too simple, not prognostically valuable and lack of consideration of patients' neurological status. AO (Arbeitsgemeinschaft für Osteosynthesefragen) and TLICS (Thoracolumbar Injury Classification and Severity Score ) classification systems are the next major evolutions which highlight the importance of the posterior ligamentous complex (PLC) and neurological status of the patients in predicting the potentially unstable fracture. The aim of this pictorial review is to familiarise radiologists with newer classification systems to improve their image interpretation skills and promote efficient communication with spinal surgeons. The pictorial examples are intended to illustrate the various injury types and how to classify them according to the aforementioned classification systems.

Radiology of acute mastoiditis and its complications: a pictorial review and interpretation checklist

2019 ◽  
Vol 133 (10) ◽  
pp. 856-861
Author(s):  
M W Mather ◽  
P D Yates ◽  
J Powell ◽  
I Zammit-Maempel
Keyword(s):  
Head And Neck ◽  
Surgical Planning ◽  
Systematic Approach ◽  
Acute Mastoiditis ◽  
Cross Sectional ◽  
Imaging Technology ◽  
Radiological Features ◽  
Pictorial Review ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

AbstractBackgroundMastoiditis is an otological emergency, and cross-sectional imaging has a role in the diagnosis of complications and surgical planning. Advances in imaging technology are becoming increasingly sophisticated and, by the same token, the ability to accurately interpret findings is essential.MethodsThis paper reviews common and rare complications of mastoiditis using case-led examples. A radiologist-derived systematic checklist is proposed, to assist the ENT surgeon with interpreting cross-sectional imaging in emergency mastoiditis cases when the opinion of a head and neck radiologist may be difficult to obtain.ResultsA 16-point checklist (the ‘mastoid 16’) was used on a case-led basis to review the radiological features of both common and rare complications of mastoiditis; this is complemented with imaging examples.ConclusionAcute mastoiditis has a range of serious complications that may be amenable to treatment, once diagnosed using appropriate imaging. The proposed checklist provides a systematic approach to identifying complications of mastoiditis.

scholarly journals Rhino-orbito-cerebral Mucormycosis: Pictorial Review

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Vivek Pai ◽  
Rima Sansi ◽  
Ritesh Kharche ◽  
Sridevi Chaitanya Bandili ◽  
Bhujang Pai
Keyword(s):  
Risk Factors ◽  
Elevated Serum ◽  
Metabolic Factors ◽  
Clinical Form ◽  
Complex Interplay ◽  
Cross Sectional ◽  
Pictorial Review ◽  
Adjacent Structures ◽  
Pictorial Essay ◽  
Cross Sectional Imaging

AbstractMucormycosis (MCR) is a fulminant, potentially lethal, opportunistic fungal infection. Diabetes, immunocompromised states and elevated serum iron levels are the most important risk factors for contracting MCR infection. Recently, MCR co-infections have been observed in patients with COVID-19 disease owing to a complex interplay of metabolic factors and corticosteroid therapy. Rhino-orbito-cerebral mucormycosis (ROCM) is the most common clinical form of MCR infection and refers to infection of the nasal cavities, paranasal sinuses, neck spaces, orbits and intracranial structures. Sinonasal inoculation is typically the primary site of infection; the necrotising and angioinvasive properties of the fungus facilitate its spread into adjacent structures. In this review, we discuss the pertinent mycology and risk factors of MCR infection. The review also aims to acquaint the reader with the cross-sectional imaging appearances of ROCM and its complications. All the cases discussed in this pictorial essay are microbiologically and/or histopathologically proven cases of ROCM with concomitant COVID-19 infection.

scholarly journals Developmental anomalies of the superior vena cava and its tributaries: What the radiologist needs to know?

2020 ◽  
pp. 20200856
Author(s):  
Mansi Verma ◽  
Niraj Nirmal Pandey ◽  
Vineeta Ojha ◽  
Sanjeev Kumar ◽  
Sivasubramaniam Ramakrishnan
Keyword(s):  
Superior Vena Cava ◽  
Imaging Techniques ◽  
Superior Vena ◽  
Vena Cava ◽  
Clinical Importance ◽  
Cross Sectional ◽  
Developmental Anomalies ◽  
Ct Venography ◽  
Pictorial Review ◽  
Cross Sectional Imaging

Deviations from the normal process of embryogenesis can result in various developmental anomalies of the superior vena cava (SVC). While these anomalies are often asymptomatic, they assume clinical importance during interventions such as central venous catheterisations and pacemaker implantations and during cardiothoracic surgeries while instituting cardiopulmonary bypass and for creation of cavo-pulmonary connections. Role of imaging in identifying these anomalies is indispensable. Cross-sectional imaging techniques like CT venography and magnetic resonance (MR) venography allow direct visualisation and consequently increased detection of anomalies. CT venography plays an important role in detection of SVC anomalies as it is readily available, has excellent spatial resolution, short acquisition times and potential for reconstruction of images in multiple planes. This pictorial review focuses on the developmental anomalies of the SVC and its tributaries highlighting their embryological basis, imaging appearances on CT venography and potential clinical implications, where relevant.

scholarly journals Poor ‘Real-Life’ Negative Predictive Value of Cross-Sectional Imaging in Obstructive Jaundice

2014 ◽  
Vol 28 (7) ◽  
pp. 385-390
Author(s):  
Brian A Brunson ◽  
Robert Hawes ◽  
Brenda Hoffman ◽  
Stacie Vela ◽  
Joseph Romagnuolo
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Predictive Value ◽  
Resonance Imaging ◽  
First Line ◽  
Cross Sectional ◽  
Post Test ◽  
Cross Sectional Imaging ◽  
Line Test ◽  
Sectional Imaging

BACKGROUND: Cross-sectional imaging remains the first-line test for obstructive jaundice despite high miss rates for pancreatobiliary tumours. Improvements in resolution and slice thickness of spiral computed tomography/magnetic resonance imaging/magnetic resonance cholangiopancreatography promised to increase accuracy.OBJECTIVE: To assess whether the post-test probability of neoplasm is truly altered by the presence or absence of a mass on computed tomography/magnetic resonance imaging in obstructive jaundice.METHODS: The institutional endoscopic ultrasound (EUS) database was retrospectively reviewed to stratify patients presenting to EUS over a two-year period for obstructive jaundice (suspicious for malignancy) according to their pre-EUS imaging results. The primary analysis involved the calculation of the positive predictive value and negative predictive value (NPV) of imaging with 95% binomial CIs. Test performance of EUS/fine-needle aspiration (FNA) was also calculated. Final diagnosis was determined by positive cytology/histology; negative EUS was supplemented by clinical follow-up.RESULTS: The positive predictive value (n=51) and NPV (n=53) of pre-EUS imaging was 98% (95% CI 90% to 100%) and 9% (95% CI 3% to 21%), respectively (accuracy 53%), with post-test suspicion of malignancy similar between imaging-positive and -negative groups. EUS demonstrated a mass in 96% of imaging-positive cases versus 85% in imaging-negative cases (exact P=0.09). Malignant or suspicious FNA cytology was obtained with EUS in 92% of the imaging-positive group, and 62% of the imaging-negative group (75% of subgroup with FNA) (P<0.001).CONCLUSION: Lack of a definite mass on pre-EUS imaging had low NPV, and was clearly not sufficiently accurate or reassuring in this clinical setting. In suspicious obstructive jaundice, EUS with FNA has a high diagnostic yield regardless of the findings of pre-EUS cross-sectional imaging and, as such, EUS may be a more reasonable first-line test in this high-suspicion setting.

scholarly journals National survey of imaging practice for suspected or confirmed plasma cell malignancies

2018 ◽  
Vol 91 (1092) ◽  
pp. 20180462
Author(s):  
Olwen Amy Westerland ◽  
Guy Pratt ◽  
Majid Kazmi ◽  
Inas El-Najjar ◽  
Matthew Streetly ◽  
...  
Keyword(s):  
Plasma Cell ◽  
Best Practice ◽  
Skeletal Survey ◽  
British Society ◽  
First Line ◽  
Cross Sectional ◽  
Imaging Test ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Line Imaging

Objective: Cross-sectional imaging is now recommended by the National Institute for Health and Care Excellence (NICE) for patients with suspected and newly diagnosed myeloma instead of skeletal survey. The objectives of this study were: (1) To evaluate compliance of current UK imaging practice with reference to National Institute for Health and Care Excellence best-practice clinical guidelines for plasma cell malignancies. (2) To identify factors which may influence diagnostic imaging choices. Methods: We conducted a national online survey to assess compliance with guidelines and to identify challenges to implementation (endorsed by Myeloma UK, UK Myeloma Forum and the British Society of Skeletal Radiologists). Results: Responses were received from 31 district general and 28 teaching hospitals. For suspected and confirmed myeloma, skeletal survey remained the most frequent first-line imaging test (suspected myeloma 44.3%, confirmed myeloma 37.7%). Only 9.8 % of responders offered first-line whole body MRI. Conclusion: Significant challenges remain to standardisation of imaging practice in accordance with national best-practice guidelines. Advances in knowledge: This is the first publication to date evaluating current UK imaging practice for assessing myeloma since the publication of new guidelines recommending use of advanced cross-sectional imaging techniques. Skeletal survey remains the most commonly performed first-line imaging test in patients with suspected or confirmed myeloma and this is largely due to resource limitations within radiology departments.

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