role of contrast enhanced spectral mammography in assessment of focal breast asymmetry

Abstract Background The term adrenal incidentaloma (AI), by definition, is an adrenal mass that is unexpectedly detected through an imaging procedure performed for reasons unrelated to adrenal dysfunction or suspected dysfunction. Despite their frequent appearance, the challenge remains in recognizing and treating the small percentage of AI that poses a significant risk, either because of their hormonal activity or because of their malignant histology. The aim of this study is to study the role of MRI, specifically chemical shift imaging (CSI), against various MDCT scans (non-enhanced, enhanced, and delayed) in the characterization of incidentally discovered adrenal masses to offer a way for the patients to avoid unnecessary time and money-wasting imaging modalities used to reach a diagnosis of their incidentally discovered adrenal lesions. We examined a total number of 20 patients with total of 22 adrenal lesions. The mean age was 51.1 ± 15.27. Results In our study, we found that among CT parameters, APW and RPW showed the highest sensitivity and specificity for detection of lipid-rich adenomas. CSI has also proven to be the best MR technique. However, there is no statistically significant difference in the diagnostic capability of CSI versus the CT washout technique. Both modalities could be conducted, according to specific patient preferences and/or limitations, with comparable highly accurate outcomes. Conclusion This study demonstrates that a similar diagnostic outcome is obtained from contrast-enhanced CT (CECT) and MRI with CSI of adrenal lesions.

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Role of MSCT in the diagnosis of perforated gall bladder (a retrospective study)

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0128-2 ◽

2020 ◽

Vol 51 (1) ◽

Cited By ~ 1

Author(s):

Mohamed M. Harraz ◽

Ahmed H. Abouissa

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Gall Bladder ◽

Acute Cholecystitis ◽

Acute Diverticulitis ◽

Wall Thickening ◽

Free Fluid ◽

Iodinated Contrast ◽

Contrast Enhanced

Abstract Background Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP. Results It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP. Conclusion GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.

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Role of texture analysis and dynamic contrast-enhanced magnetic resonance imaging quantitative parameters based on different regions of interest in glioma grading

Asian Journal of Surgery ◽

10.1016/j.asjsur.2021.05.023 ◽

2021 ◽

Author(s):

Peng-fei Zhao ◽

Sheng-hui Xie ◽

Peng-fei Qiao ◽

Yang Gao

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Texture Analysis ◽

Regions Of Interest ◽

Resonance Imaging ◽

Dynamic Contrast Enhanced ◽

Quantitative Parameters ◽

Glioma Grading ◽

Contrast Enhanced

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Role of CEUS in Vascular Pathology

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1403-2400 ◽

2021 ◽

Author(s):

Vito Cantisani ◽

Nicola Di Leo ◽

Emanuele David ◽

Dirk-André Clevert

Keyword(s):

Research Field ◽

Arterial System ◽

Qualitative Assessment ◽

Vascular Pathology ◽

New Horizons ◽

Contrast Enhanced ◽

Inflammatory Infiltrates ◽

Time Evaluation

AbstractIn recent years, the implementation of contrast-enhanced ultrasound (CEUS) in clinical practice has opened new horizons in the arterial pathologies research field, since this technique is able to supply new sets of data that can be crucial in patient management. The main applications of CEUS in the arterial system are the detection, characterization, and follow-up of carotid plaques and endoleaks after EVAR. Other situations in which CEUS was demonstrated to be a useful tool are large vessel vasculitis, dissections, and untreated aneurysms. In carotid atherosclerosis CEUS is not only able to acquire quantitative data about stenosis but also to perform a qualitative assessment of the plaque. The most important plaque features that CEUS is able to depict are ulceration, neovascularization, and the presence of inflammatory infiltrates. All of these factors contribute to plaque vulnerability. Thus, CEUS is crucial in order to allow better risk stratification and management of patients. In follow-up after EVAR, CEUS shows sensitivity and specificity values similar to CTA while ensuring several advantages, such as lower cost and the absence of ionizing radiation and nephrotoxic agents. Moreover, CEUS is able to offer real-time evaluation of endoleaks and thus is a useful tool in cases that are ambiguous on CTA. Most limitations are patient-related and are the same as in all other ultrasound techniques, such as high BMI and meteorism.

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Incremental Role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in detection of recurrence of carcinoma cervix

10.1055/s-0039-1685260 ◽

2016 ◽

Author(s):

S. Dash ◽

A. Goel ◽

S. Sogani

Keyword(s):

Fdg Pet ◽

Carcinoma Cervix ◽

Histopathological Correlation ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Radiologic Imaging ◽

18F Fdg

Purpose: To evaluate the role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in early detection of recurrence in follow up patients of carcinoma cervix. Methods: Patients with histopathologically proven carcinoma cervix who underwent chemotherapy, radiotherapy and/or surgery and on follow up were recruited in the study. Fifty-two patients underwent 18F-FDG PET-CECT for detection of recurrence. The median age was 51.5 (average = 53.4) years. PET-CECT studies were evaluated and analyzed separately by an experienced nuclear medicine physician and a radiologist independently. The physicians were blinded for the patient history. PET-CECT results were validated with histopathological correlation, conventional radiologic imaging/follow up PET-CECT study and clinical follow up. Results: Out of 52 patients, 34 patients were reported as positive for recurrence, 17 of these were having active local recurrence and 31 patients had regional lymph nodal metastases, 14 patients had distant metastases (out of them 6 patients had distant lymph node metastases, 6 had pulmonary metastases, 4 had skeletal metastases and two had liver metastases). Remaining 18 patients were reported as negative for recurrence. The lung was the most common site for distant metastasis. Patient were then further evaluated based on histopathological correlation, conventional radiologic imaging and follow up PET-CECT scan and five were found to be false positive and one patient was identified as false negative. The sensitivity, specificity, positive and negative predictive value were derived to be 96.7%, 77.3%, 85.3% and 94.4%, respectively. Accuracy was calculated to be 88.5%. Conclusions: 18F-FDG PET-CECT is a very useful non-invasive modality for the early detection of recurrence and metastatic workup in patients with carcinoma cervix with a very high sensitivity and negative predictive value. It is also useful in targeting biopsy sites in suspected cases of recurrence.

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How Can We Manage Gallbladder Lesions by Transabdominal Ultrasound?

Diagnostics ◽

10.3390/diagnostics11050784 ◽

2021 ◽

Vol 11 (5) ◽

pp. 784

Author(s):

Shinji Okaniwa

Keyword(s):

High Frequency ◽

Layer Structure ◽

Wall Layer ◽

Pancreaticobiliary Maljunction ◽

Doppler Imaging ◽

Wall Thickening ◽

Contrast Enhanced ◽

Postural Changes ◽

Venous Phase

The most important role of ultrasound (US) in the management of gallbladder (GB) lesions is to detect lesions earlier and differentiate them from GB carcinoma (GBC). To avoid overlooking lesions, postural changes and high-frequency transducers with magnified images should be employed. GB lesions are divided into polypoid lesions (GPLs) and wall thickening (GWT). For GPLs, classification into pedunculated and sessile types should be done first. This classification is useful not only for the differential diagnosis but also for the depth diagnosis, as pedunculated carcinomas are confined to the mucosa. Both rapid GB wall blood flow (GWBF) and the irregularity of color signal patterns on Doppler imaging, and heterogeneous enhancement in the venous phase on contrast-enhanced ultrasound (CEUS) suggest GBC. Since GWT occurs in various conditions, subdividing into diffuse and focal forms is important. Unlike diffuse GWT, focal GWT is specific for GB and has a higher incidence of GBC. The discontinuity and irregularity of the innermost hyperechoic layer and irregular or disrupted GB wall layer structure suggest GBC. Rapid GWBF is also useful for the diagnosis of wall-thickened type GBC and pancreaticobiliary maljunction. Detailed B-mode evaluation using high-frequency transducers, combined with Doppler imaging and CEUS, enables a more accurate diagnosis.

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