Spinal disorders mimicking infection

AbstractSpinal infections are very commonly encountered by radiologists in their routine clinical practice. In case of typical MRI features, the diagnosis is relatively easy to interpret, all the more so if the clinical and laboratory findings are in agreement with the radiological findings. In many cases, the radiologist is able to make the right diagnosis, thereby avoiding a disco-vertebral biopsy, which is technically challenging and associated with a risk of negative results. However, several diseases mimic similar patterns, such as degenerative changes (Modic) and crystal-induced discopathy. Differentiation between these diagnoses relies on imaging changes in endplate contours as well as in disc signal. This review sought to illustrate the imaging pattern of spinal diseases mimicking an infection and to define characteristic MRI and CT patterns allowing to distinguish between these different disco-vertebral disorders. The contribution of advanced techniques, such as DWI and dual-energy CT (DECT) is also discussed.

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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT

Journal of Visualized Experiments ◽

10.3791/56526 ◽

2018 ◽

Author(s):

Bowen Shi ◽

Huimin Lin ◽

Miao Zhang ◽

Wei Lu ◽

Ying Qu ◽

...

Keyword(s):

Gastric Cancer ◽

Gene Regulation ◽

Targeted Therapy ◽

Peritoneal Metastasis ◽

Dual Energy ◽

Dual Energy Ct ◽

Radiological Findings ◽

Pet Ct

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Cerebral contrast staining mimicking parenchymal haemorrhage in a stroke patient

BMJ Case Reports ◽

10.1136/bcr-2020-236400 ◽

2020 ◽

Vol 13 (12) ◽

pp. e236400

Author(s):

Elvin Yuan Ting Lim ◽

Saravana Kumar Swaminathan

Keyword(s):

Ct Scan ◽

Middle Cerebral Artery ◽

Signs And Symptoms ◽

Dual Energy ◽

Dual Energy Ct ◽

Iodinated Contrast ◽

Acute Infarct ◽

The Right ◽

The Brain

A 75-year-old female patient presented with signs and symptoms of a right hemispheric syndrome. A CT scan of the brain with angiogram showed an acute infarct in the right middle cerebral artery (MCA) territory secondary to thromb-occlusion of the M1 segment of the right MCA. A follow-up CT scan 2 weeks later showed a large hyperdense region in the infarcted area. With the aid of a dual-energy CT scan, this was eventually shown to be due to contrast staining from an earlier administration of iodinated contrast on the same day, rather than frank haemorrhagic conversion of the recent right MCA infarct.

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Combined use of iterative reconstruction and monochromatic imaging in spinal fusion CT images

Acta Radiologica ◽

10.1177/0284185116631182 ◽

2016 ◽

Vol 58 (1) ◽

pp. 62-69 ◽

Cited By ~ 11

Author(s):

Fengdan Wang ◽

Yan Zhang ◽

Huadan Xue ◽

Wei Han ◽

Xianda Yang ◽

...

Keyword(s):

Image Quality ◽

Spinal Fusion ◽

Iterative Reconstruction ◽

Dual Energy ◽

Image Noise ◽

Dual Energy Ct ◽

Spinal Diseases ◽

Metal Artifacts ◽

Monochromatic Imaging ◽

Combined Use

Background Spinal fusion surgery is an important procedure for treating spinal diseases and computed tomography (CT) is a critical tool for postoperative evaluation. However, CT image quality is considerably impaired by metal artifacts and image noise. Purpose To explore whether metal artifacts and image noise can be reduced by combining two technologies, adaptive statistical iterative reconstruction (ASIR) and monochromatic imaging generated by gemstone spectral imaging (GSI) dual-energy CT. Material and Methods A total of 51 patients with 318 spinal pedicle screws were prospectively scanned by dual-energy CT using fast kV-switching GSI between 80 and 140 kVp. Monochromatic GSI images at 110 keV were reconstructed either without or with various levels of ASIR (30%, 50%, 70%, and 100%). The quality of five sets of images was objectively and subjectively assessed. Results With objective image quality assessment, metal artifacts decreased when increasing levels of ASIR were applied ( P < 0.001). Moreover, adding ASIR to GSI also decreased image noise ( P < 0.001) and improved the signal-to-noise ratio ( P < 0.001). The subjective image quality analysis showed good inter-reader concordance, with intra-class correlation coefficients between 0.89 and 0.99. The visualization of peri-implant soft tissue was improved at higher ASIR levels ( P < 0.001). Conclusion Combined use of ASIR and GSI decreased image noise and improved image quality in post-spinal fusion CT scans. Optimal results were achieved with ASIR levels ≥70%.

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Transitional cell carcinoma of the renal pelvis masquerading as renal tuberculosis

International Surgery Journal ◽

10.18203/2349-2902.isj20201015 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1313

Author(s):

Samuel Lalhruaizela ◽

Zothansanga Zadeng ◽

Lal Hruaitluanga

Keyword(s):

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Pelvis ◽

Histopathological Examination ◽

Transitional Cell ◽

Radiological Findings ◽

Negative Results ◽

Renal Tuberculosis ◽

The Right ◽

Exploratory Surgery

We report a case of transitional cell carcinoma of the right renal pelvis mimicking the signs, symptoms and radiological findings of renal tuberculosis (TB). She had been diagnosed initially for urinary tract infection and radiological diagnosis initially was more towards renal TB and urine cytology and cultures were normal. Specific investigations for tuberculosis all showed negative results. But as neoplasia could not be ruled out by ureterorenoscopy due to presence of multiple ureteric strictures, decision was taken for an exploratory surgery. During surgery it was found that there was a tumour in the upper pole of kidney involving the renal pelvis and was found to be papillary transitional cell carcinoma on histopathological examination.

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