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Journal articles on the topic 'B-scan examinations'
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1
Merkel, Daniel, Ebaa Albarri, Masuod Yousefzada, Marko Boehm, Michael Gottwald, and Christoph Schneider. "Differences in the B-mode imaging quality of ultrasound devices in the mid-price segment." Medical Ultrasonography 25, no. 3 (2023): 288. http://dx.doi.org/10.11152/mu-4063.
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Aims: A meaningful sonographic examination is decisively dependent on the B-scan quality of the ultrasound device. When selecting a suitable ultrasound device, B-scan quality should be an important purchase criterion. Although there is no generally accepted method to measure B-scan quality, we tried to evaluate comparable sonography devices from different manufacturers regarding B-scan quality.Material and methods: We systematically assessed the B-scan quality in ultrasound devices of seven different manufacturers from the mid-price segment. All 7 ultrasound units tested had comparable equipment features and the purchase value of approximately $20,000. We recorded video sequences and compared B-mode image quality. We used both physiological sectional images and pathological findings from abdominal ultrasound.Results: We identified three ultrasound units that scored significantly better in measuring the B-scan quality than the other devices. The Canon Xario 200, the General Electric Logiq P7 and the Mindray DC70 (in alphabetical order) were the units that outperformed all others.The differences identified were found to be statistically significant. A subgroup analysis showed that the contrasts in quality were more pronounced in near-field examinations than in examinations with greater penetration depth.Conclusions: There are considerable qualitative discrepancies in B-scan ultrasound devices despite being similar in terms of equipment and price. Our findings show that these differences are statistically detectable and likely clinically relevant.
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Hua, Meiping. "Analyzing the Application Value and Detection Rate of Combined Abdominal and Vaginal B-Scan Ultrasound in Diagnosing Acute Abdomen in Obstetrics and Gynecology." Advances in Obstetrics and Gynecology Research 1, no. 2 (2023): 44–50. http://dx.doi.org/10.26689/aogr.v1i2.5405.
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Objective: To analyze the diagnostic value of combined abdominal and vaginal B-scan ultrasound in obstetricsand gynecology acute abdomen. Methods: A total of 80 patients with suspected obstetric and gynecological acute abdomen admitted from February 2021 to October 2023 were recruited. All patients underwent abdominal and vaginal B-scan ultrasound examinations, and the pathological results were compared to explore the joint diagnostic value. Results: Obstetric and gynecological acute abdomen was confirmed in 68 cases through pathology, 53 cases through abdominal B-scan ultrasound, 60 cases through vaginal B-scan ultrasound, and 67 cases through combined abdominal and vaginal B-scan ultrasound. The combined abdominal and vaginal B-scan ultrasound had significantly higher diagnostic efficiency than that of abdominal B-scan ultrasound alone and vaginal B-scan ultrasound alone (P < 0.05). The accuracy of combined abdominal and vaginal B-scan ultrasound in diagnosing obstetric and gynecological acute abdomen is higher than that ofabdominal B-scan ultrasound alone and vaginal B-scan ultrasound alone (P < 0.05). Conclusion: The diagnosis of acute abdomen in obstetrics and gynecology by combined abdominal and vaginal B-scan ultrasound may improve the diagnostic efficiency, enhance the accuracy of acute abdomen classification in obstetrics and gynecology, and have high consistency with pathological results.
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Ngweme, Georgette, M. T. Ngoyi Bambi, Longo Flavien Lutete, et al. "Ophthalmic Ultrasonography in Sub-Saharan Africa—A Kinshasa Experience." Diagnostics 11, no. 11 (2021): 2009. http://dx.doi.org/10.3390/diagnostics11112009.
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The aim of this study was to analyze the use of the diagnostic B-scan ultrasound. Should it be made accessible to all surgical centers in Sub-Saharan Africa in order to (i) avoid unnecessary cataract surgery and (ii) evaluate extraocular pathology? This study was conducted in Kinshasa from 2006 to 2019. Three hundred and twenty-three patients were included and separated into two groups. Group 1 included 262 patients with dense cataract. Group 2 consisted of 61 patients with pathologies of the ocular adnexa, and all were examined with a B-scan ultrasound. In group 1, there were 437 systematically screened eyes. Three hundred and ninety-eight eyes (91.08%) showed no abnormalities, 13 (2.97%) retinal detachments were identified, and 15 (3.43%) demonstrated a detached posterior hyaloid membrane. In the second group, 61 patients were examined (group 2). In 20 of them, surgery was performed for biopsy, tumor excision, mucoceles drainage, and palliative treatment. The need for routine B-scan examinations in dense cataract patients seems to be limited and can most likely be replaced by a thorough application of locally available examination techniques. B-scan application is recommended to manage orbital patients in the most cost-effective way.
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Merkel, Daniel, Hannah Stahlheber, Victoria Chupina, and Christoph Schneider. "Comparison of the quality of B-scan ultrasound in modern high-end devices." Zeitschrift für Gastroenterologie 56, no. 12 (2018): 1491–98. http://dx.doi.org/10.1055/a-0710-5461.
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Abstract Purpose The quality of an ultrasound device’s B-scan mode is decisive in obtaining clear and informative images. High demands are placed upon ultrasound devices, particularly in cases where evidence of small lesions of parenchymal organs is being gathered. Methods We tested the quality of the B-scan mode in ultrasound devices of 7 different manufacturers. We performed ultrasound examinations of 3 predefined abdominal sections on 4 healthy subjects with 7 different ultrasound devices. Documentation was compiled digitally by recording video sequences. Any characteristics identifying the manufacturer were removed. Subsequently, the sequences were organized into corresponding pairs. The resulting 252 video pairs were shown side by side to a panel of 10 experienced ultrasound examiners who evaluated the quality of the scans by way of direct visual comparison. Results Two of the 7 devices were clearly judged to be of higher quality. In part, the differences in the overall evaluation and within the subgroups reached levels of statistical significance. The ranking of the tested devices did not correlate with their suggested retail prices. Conclusion There are relevant differences in the quality of the B-scan mode of modern high-end devices. The suggested retail prices do not correlate with the B-scan quality of the ultrasound devices.
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Hsieh, Yi-Chia, Wei-Jen Yao, Nan-Tsing Chiu, Wen-Horng Yang, and Ho-Shiang Huang. "Pre-Hydration and a Forced Diuresis Protocol for 18F-FDG PET/CT Yielded an Optimal Effect on Primary Pelvic Malignancies." Journal of Clinical Medicine 13, no. 20 (2024): 6090. http://dx.doi.org/10.3390/jcm13206090.
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Background: Positron emission tomography (PET) with 18F-FDG is being used more frequently to evaluate primary pelvic tumors (PTs). However, a standardized hydration protocol is essential for an optimal diuretic effect and constant results. Methods: We reviewed 109 patients with PTs who had undergone 18F-FDG PET/CT examinations between November 2006 and April 2013. Four different protocols were used: (a) no hydration (group 1); (b) oral hydration (800 mL) after an early scan (group 2); (c) intravenous (IV) hydration (500 mL) during an early scan followed by oral hydration (800 mL) and IV furosemide (20 mg) after an early scan (group 3); and (d) oral hydration (800 mL) before an FDG injection followed by the protocol from group 3 (group 4). The maximum standardized uptake (SUVmax) of the urinary bladder (UB) and PTs and the PT/UB SUVmax ratios were examined. Results: The UB SUVmax of group 4 was significantly lower in the early scan compared to that in the other three groups. Group 4 had a significantly higher PT/UB SUVmax ratio in the early scan than the other three groups, and it also had a 52.5% positivity rate for PTs. Conclusions: The pre-hydration plus forced diuresis protocol yielded the optimal effect of UB radiotracer washout and had the best PT/UB SUVmax ratio in both scans.
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Chevallier, Olivier, Nan Zhou, Jian He, Romaric Loffroy, and Yì Xiáng J. Wáng. "Removal of evidential motion-contaminated and poorly fitted image data improves IVIM diffusion MRI parameter scan–rescan reproducibility." Acta Radiologica 59, no. 10 (2018): 1157–67. http://dx.doi.org/10.1177/0284185118756949.
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Background It has been reported that intravoxel incoherent motion (IVIM) diffusion magnetic resonance imaging (MRI) scan–rescan reproducibility is unsatisfactory. Purpose To study IVIM MRI parameter reproducibility for liver parenchyma after the removal of motion-contaminated and/or poorly fitted image data. Material and Methods Eighteen healthy volunteers had liver scans twice in the same session to assess scan–rescan repeatability, and again in another session after an average interval of 13 days to assess reproducibility. Diffusion-weighted images were acquired with a 3-T scanner using respiratory-triggered echo-planar sequence and 16 b-values (0–800 s/mm2). Measurement was performed on the right liver with segment-unconstrained least square fitting. Image series with evidential anatomical mismatch, apparent artifacts, and poorly fitted signal intensity vs. b-value curve were excluded. A minimum of three slices was deemed necessary for IVIM parameter estimation. Results With a total 54 examinations, six did not satisfy inclusion criteria, leading to a success rate of 89%, and 14 volunteers were finally included for the repeatability/reproducibility study. A total of 3–10 slices per examination (mean = 5.3 slices, median = 5 slices) were utilized for analysis. Using threshold b-value = 80 s/mm2, the coefficient of variation and within-subject coefficient of variation for repeatability were 2.86% and 3.36% for Dslow, 3.81% and 4.24% for perfusion fraction (PF), 18.16% and 24.88% for Dfast; and those for reproducibility were 2.48% and 3.24% for Dslow, 4.91% and 5.38% for PF, and 21.18% and 30.89% for Dfast. Conclusion Removal of motion-contaminated and/or poorly fitted image data improves IVIM parameter reproducibility.
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Knipper, Anne, Katharina Kuhn, Ralph G. Luthardt, and Sigmar Schnutenhaus. "Accuracy of Dental Implant Placement with Dynamic Navigation—Investigation of the Influence of Two Different Optical Reference Systems: A Randomized Clinical Trial." Bioengineering 11, no. 2 (2024): 155. http://dx.doi.org/10.3390/bioengineering11020155.
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This randomized prospective clinical study aims to analyze the differences between the computer-assisted planned implant position and the clinically realized implant position using dynamic navigation. In the randomized prospective clinical study, 30 patients were recruited, of whom 27 could receive an implant (BLT, Straumann Institut AG, Basel, Switzerland) using a dynamic computer-assisted approach. Patients with at least six teeth in their jaws to be implanted were included in the study. Digital planning was performed using cone beam tomography imaging, and the visualization of the actual situation was carried out using an intraoral scan. Two different workflows with differently prepared reference markers were performed with 15 patients per group. The actual clinically achieved implant position was recorded with scan bodies fixed to the implants and an intraoral scan. The deviations between the planned and realized implant positions were recorded using evaluation software. The clinical examinations revealed no significant differences between procedures A and B in the mesiodistal, buccolingual and apicocoronal directions. For the mean angular deviation, group B showed a significantly more accurate value of 2.7° (95% CI 1.6–3.9°) than group A, with a value of 6.3° (95% CI 4.0–8.7°). The mean 3D deviation at the implant shoulder was 2.35 mm for workflow A (95% CI 1.92–2.78 mm) and 1.62 mm for workflow B (95% CI 1.2–2.05 mm). Workflow B also showed significantly higher accuracy in this respect. Similar values were determined at the implant apex. The clinical examination shows that sufficiently accurate implant placement is possible with the dynamic navigation system used here. The use of different workflows sometimes resulted in significantly different accuracy results. The data of the present study are comparable with the published findings of other static and dynamic navigation procedures.
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Stefanovic, Ivan, Bojana Dacic, Sasa Novak, et al. "Topographic localization of an intraocular foreign body by B-scan echography." Vojnosanitetski pregled 67, no. 3 (2010): 213–15. http://dx.doi.org/10.2298/vsp1003213s.
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Background/Aim. In cases of blurred optic media the ultrasound diagnostics offers useful data about eventual presence of intraocular foreign body as well as about its precise localization in the eye. The aim of this study was to retrospectively analyze echographic findings in patients with the diagnosis of intraocular foreign body with a special interest in localizations of a intraocular foreign body in the eye and the presence of an eventual infection - endophthalmitis. The aim of this study was also to confirm the localization of intraocular foreign body by echography and to test the precision of this method. Methods. We performed analysis of all cases that had been referred to the ultrasound diagnostices, in which the presence of intraocular foreign body had been confirmed in the period of one year. All examinations were done with B-scan and were confirmed during the surgery - vitrectomy. Results. In the one-year period we were contacted by 27 patients with intraocular foreign body. In one injured eye the intraocular foreign body was in the lens (3.7%), in 10 injured eyes (37.03%) intraocular foreign body was in the vitreal body. In 15 patients (55.5%) intraocular foreign body was fixed in the retina. In one patient (3.7%) there was a perforating injury, intraocular foreign body was found in the retrobulbar part of the orbit. In 7 injured eyes (25.9%), with the presence of intraocular foreign body, we found signs of endophthalmitis (organized blurring in vitreal space, thickened choroid). Other accompanying echographic findings were: blood in vitreal space, haemophthalmus in 12 cases (44.4%), retinal detachment in 5 cases (18.5%) and subretinal hemorrhagies in 4 cases (14.8%). Conclusion. Ultrasound diagnostics can very precisely show the localization of intraocular foreign body in the eye that is very important in the choice of approach and timing of surgical treatment. Also the echographic diagnostics may find an accompanying endophthalmitis in the posterior segment of the eye, that is very important for an urgent therapeutic approach.
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Wakabayashi, Hiroshi, Kenichi Nakajima, Atsushi Mizokami, et al. "A new parameter of bone scintigraphy: Relation between bone scan index and bone metabolic markers in prostate cancer patients with bone metastases." Journal of Clinical Oncology 31, no. 15_suppl (2013): e16072-e16072. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e16072.
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e16072 Background: A computer-aided diagnosis system for bone scan with semiquantitative index of Bone Scan Index (BSI) may be used to quantify the spread of bone metastases. This retrospective study aimed to examine associations between BSI, bone metabolic markers, and prostate specific antigen (PSA) in prostate cancer patients with bone metastases. Methods: A total of 158 scintigraphy of 52 patients (mean examinations/person 3, range 1-8; mean age 71 years, range 46 to 86) were studied. The intervals between bone scan and blood examinations were 0 to 16 days (median 0 day). Subjects were divided into 4 groups according to BSI; Group A: 0 - <2, Group B: 2 - <4, Group C: 4 - <8, and Group D: 8<. The markers of PSA, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (1-CTP), bone alkaline phosphatase (BAP), and tartate resistant acid phosphatase-5b (TRAP-5b) were examined. As the values of PSA, BAP, and TRAP-5b covered a large range of scales, we also used the logarithms of the variables. BSI, which corresponded amount of metastatic lesions, was automatically calculated by BONENAVI software (FUJIFILM RIPharma, Co. Ltd., Tokyo, Japan; Exini Bone, Exini Diagnostics, Sweden). Results: All scans showed increased uptake at bone metastases. BSI correlated significantly with 1-CTP, BAP, logBAP, TRAP-5b, logTRAP-5b, and logPSA (r=0.39, 0.66, 0.71, 0.69, 0.61 and 0.41, respectively). Statistical F value was 11 in 1-CTP, 31 in BAP, 29 in logBAP, 19 in TRAP-5b, 14 in logTRAP-5b, 3 in PSA, and 9 in logPSA by ANOVA, respectively. Comparison by Dunnett’s test showed significantly higher values in Group D for all bone metabolic markers and logPSA, Group C for BAP, logBAP, TRAP-5b, and logTRAP-5b, and Group B for logTRAP-5b compared with Group A, respectively. However, PSA did not correlate significantly with extent of bone metastases as assessed by BSI. Conclusions: The changes in BSI showed close relationship with all bone metabolic markers but not with PSA. The BSI reflected the activity and extent of bone metastases, and might be used as an imaging biomarker.
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Ilmah, Ilmah, Puranto Budi, and P. Ariawan. "An Optic Nerve Avulsion Due to A Gun Shot Injury: A Case Report." Oftalmologi: Jurnal Kesehatan Mata Indonesia 3, no. 2 (2021): 29–32. http://dx.doi.org/10.11594/ojkmi.v3i2.17.
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Purpose: To present a rare case of optic nerve avulsion due to gun shot injury. Case Report: A 30-year-old man presented with sudden visual loss on the Right Eye (RE) after a gun shot on his left frontal bone. On examination of the RE, he had periorbital hematoma and edema, and also conjunctival chemosis. There was no light perception of the RE, and his pupil was dilated and nonreactive to light. There’s also an eye movement resistance. On the examination of the Left Eye, he had periorbital hematoma and edema, visual acuity was 1.0 and other examinations was within normal limit. B-scan USG of the RE showed a hyperechoic image on the retinal projection in front of the optic nerve. CT-scan showed multiple metal density fractions in the subcortical cortical left frontal lobe and right retrobulbar. On funduscopic examination, there was bleeding in the inferior vitreous originating from the optic nerve papilae. The patient underwent craniotomy, debridement, and corpus alienum extraction by neurosurgeon and plastic surgeon. The patient was treated with high dose steroid (methyl prednisolone 4 x 250 mg iv). After a week of therapy, there was no improvement of his RE visual acuity. Conclusion: Optic nerve avulsion is a rare case with devastating results because there’s still no definite therapy to improve the outcome.
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Lutsenko, N. S., O. A. Isakova, O. A. Rudycheva, and T. S. Kyrylova. "A rare finding on the fundus or “dancing” retina: a clinical case." Modern medical technology 17, no. 1 (2025): 67–72. https://doi.org/10.14739/mmt.2025.1.319453.
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Aim. To attract the attention of ophthalmologists to the possibilities of optic coherence tomography (OCT) in the differential diagnosis of the retinal peripheral mass by detecting its pulsation. Materials and methods. A 47-year-old female patient has been under observation since 2021 for primary open-angle glaucoma (stage 1a, left eye) and moderate myopia in both eyes. She has been wearing glasses since childhood and receives preservative-free latanoprost for intraocular pressure control. Regular examinations every six months include tonometry, ophthalmoscopy, perimetry, and OCT / OCT angiography (OCTA) imaging for monitoring glaucoma progression and retinal health. The Cross Line mode was used for B-scans focused on vortex vein ampullae, with video recordings capturing dynamic retinal and choroidal changes. Results. The patient complained of “lightning” and a floating spot in front of the left eye, and a thorough examination of the central and peripheral retina was performed. The OCT and OCTA examinations of the central retina revealed thinning of the ganglion cell layer and peripapillary nerve fiber layer in the upper-temporal sector, a decrease in the density of blood vessels, which corresponds to the initial signs of glaucoma. The OCT-B scan of the peripheral area at the level of the ophthalmoscopic grayish radiating focus revealed a convex change in the retinal profile, a homogeneous hyporeflective cavity with clear borders in the choroid, without changes in the retinal layers and subretinal fluid. Rhythmic retinal pulsations synchronized with the heart rate were observed. The differential diagnosis included choroidal metastases, melanoma, lymphoma, hemangioma, nevus, and varicose dilation of the vortex vein ampulla, the latter diagnosis being confirmed. Conclusions. Varicose dilation of the vortex vein ampulla is a rare condition that mimics benign and malignant retinal diseases, requiring differential diagnosis, where OCT is useful for identifying morphological and dynamic changes, with recognition of retinal fluctuation as the final diagnostic criterion.
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Kiseleva, T. N., E. K. Eliseeva, and M. N. Zakharova. "The case of posterior ischemic optic neuropathy in patient with multiple sclerosis." POINT OF VIEW. EAST – WEST, no. 1 (April 20, 2021): 107–10. http://dx.doi.org/10.25276/2410-1257-2021-1-107-110.
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A case of posterior ischemic optic neuropathy (PION) in a 41-year-woman with 19 years remission of multiple sclerosisis presented.She had complaints of acute unilateral loss of vision and underwent complex clinical and instrumental examination including B-scan of orbit, color duplex sonography (CDS) of orbital vessels and brachiocephalic arteries, magnetic resonance imaging (MRI). The significant stenosis of internal carotid artery due to its dissection was detected on the affected eye side. The results of ultrasound examinations and MRI excluded demyelinative retrobulbar neuritis (RBN) and determined the signs of blood flow impairment in vessels of orbital part of the optic nerve. Differential diagnostics of PION and RBN required the investigations of blood flow in orbital vessels and brachiocephalic arteries. Key words: posterior ischemic optic neuropathy, multiple sclerosis, retrobulbar neuritis, color duplex sonography, internal carotid artery.
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Graur, Florin, Emil Mois, and Nadim Al Hajjar. "Primary Pure Squamous Cell Carcinoma of the Duodenum: a Case Report." Journal of Gastrointestinal and Liver Diseases 23, no. 3 (2014): 329–32. http://dx.doi.org/10.15403/jgld.2014.1121.233.nahj3.
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Primary pure squamous cell carcinoma of the duodenum is a very rare type of duodenal neoplasm and is more likely to be presented as a metastatic tumor. The literature offers little information on this subject and includes very few articles and case reports. Laboratory tests, CT and ultrasound examinations, x-rays and immunohistochemical markers assisted us in making this rare diagnosis of primary squamous cell carcinoma of the duodenum in a 47 year old female patient, who presented with weight loss and melena. The 8 cm duodenal tumor with pancreas invasion was resected by a cephalic duodenopancreatectomy. The pathology examination revealed a primary duodenal squamous cell carcinoma moderately differentiated (G2), invasive in the head of the pancreas, with keratinization, stage II B (pT4N0MxL0V0R0). Positive outcome after surgery was highlighted, no recurrence being registered at the 6 month CT scan follow-up.
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Summaiyya, Umme, Nikita Sharma, and Harpreet K. Narde. "Case Report: Choroidal osteoma: Bone in the eye." Indian Journal of Ophthalmology - Case Reports 4, no. 2 (2024): 522–26. http://dx.doi.org/10.4103/ijo.ijo_3069_23.
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We share a case of a 16-year-old girl who presented with blurring of vision in her left eye since 1 year, with fundus examination suggestive of choroidal osteoma. The detailed clinical, complimentary examinations, and multimodal imaging – fundus photo, optical coherence tomography, fundus fluorescein angiography, and B-scan ultrasonography – of the case are discussed. Choroidal osteoma is a rare benign ossifying tumor of unknown etiology characterized by mature bone replacing choroid, more commonly unilateral and predominantly affecting young females, typically manifesting in the teenage years or in the early 20s. Although choroidal osteoma is a rare benign tumor, accurate diagnosis is important because it is similar to amelanotic choroidal melanoma and metastatic choroidal carcinoma which require treatment and it is important to keep patients under observation for early detection of treatable choroidal neovascularization and other complications.
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Mustafa, Abdullateef A., Abdulameer A. Al-Mosawi, Wasan K. Kammona, and Samer F. Hassan. "Accuracy of ultrasound versus computed tomography in diagnosis of maxillary sinusitis." Journal of the Faculty of Medicine Baghdad 56, no. 1 (2014): 36–39. http://dx.doi.org/10.32007/jfacmedbagdad.561422.
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Background: ultrasound offers non-invasive, rapid and simple method for confirming the clinical diagnosis of maxillary sinus pathologies.Objective: to evaluate the accuracy of real time ultrasound compared with the computed tomography in evaluation of maxillary sinusitis.Patients and materials: This comparative cross-sectional study was done on 42 patients referred for computed tomography examination of paranasal sinuses in Al-Yarmook Teaching Hospital-Baghdad, from October 2012 to February 2013 with patients clinically suggesting an underlying maxillary sinusitis. Ultrasound and computed tomography examinations were carried out on the same day, the ultrasound being the first investigation. The sample of this study consisted of 26 men and 16 women. The age of patients ranged between 20-60 years, mean age equal to 38 years. Our patients were randomly selected.Results: The results are based on the data analysis of total forty two [84 sinuses] patients with symptoms and/or signs of maxillary sinus diseases. In this study, real time B-mode ultrasonography of maxillary compared with computed tomography had a 81.8% sensitivity, 100 % specificity and 90.4% accuracy. The present study showed that total opacity of the maxillary sinus on computed tomography frequently gave a positive full sinus scan [77.7%] while the rest shows partial sinus scan [22.3%]. All patients with positive full sinus scan on ultrasound of maxillary sinuses have total opacity on computed tomography. Conclusion: Ultrasound can help as one of primary investigations of maxillary sinusitis. A positive full sinus scan appeared specific for total opacity of the maxillary sinus on computed tomography. A postural adjustment of the patient slightly bent foreword reduces the false negative results.
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El Hachimi, Rim, Rida EL Hadiri, Latifa Sbai, et al. "Rhino-Orbito-Cerebral Mucormycosis: An Infection Still Fatal: A Case Report." Journal of Advances in Medicine and Medical Research 35, no. 12 (2023): 1–6. http://dx.doi.org/10.9734/jammr/2023/v35i125030.
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We report a case of a 54-year-old patient, an unbalanced diabetic, who presented rhino-orbito-cerebral mucormycosis with orbital involvement as circumstance of discovery. The aims are to highlight the importance of making an early diagnosis to improve prognosis of this infectious pathology. Early diagnosis requires clinical suspicion of infection in all immunocompromised patients, particularly in diabetics with ketoacidosis and clinical research of typical necrotic plaques on the eyelid, palate or sinus level. Histopathological analysis makes diagnosis. Angiography-MRA and angiography-CT scan remain complementary examinations to assess the extension and guide treatment. The management must be multidisciplinary. Association of intravenous antifungal treatment (especially amphotericin B) and localized or radical surgical debridement is the treatment of choice. Local treatment with amphotericin B increases tissue penetration.
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Uppal, Athar Adnan, Saira Zaman, Ayesha Shahbaz, and Sadia Iram. "Olfactory neuroblastoma: a rare sinonasal malignancy." Journal of the Pakistan Medical Association 74, no. 7 (2024): 1370–73. http://dx.doi.org/10.47391/jpma.10735.
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Olfactory neuroblastoma is a rare malignant tumour arising from the olfactory nerve and extending into the nasal cavity. In this case report, the case of a 42-year-old male is presented. The patient had a two-month history of progressive nasal blockage and episodes of epistaxis. No complaint of anosmia or facial pain was reported. All the necessary examinations were performed. Upon investigation, the CT scan and MRI showed a polypoid mass involving the right maxillary sinus, eroding the medial wall and expanding into the osteo-meatal complex. The diagnosis of olfactory neuroblastoma was confirmed through histopathological examination and further validated by immunohistochemistry as it was positive for synaptophysin, chromogranin, gamma enolase, and neurofilament. On staging, the tumour was Kadish B. The mass was excised by lateral rhinotomy. The patient was kept on radiotherapy and was free from recurrence upon follow-up 10 months later. ---Continue
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Venkatram, Sindhaghatta, Sara Bughio, and Gilda Diaz-Fuentes. "Clinical Brain Death with False Positive Radionuclide Cerebral Perfusion Scans." Case Reports in Critical Care 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/630430.
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Practice guidelines from the American Academy of Neurology for the determination of brain death in adults define brain death as “the irreversible loss of function of the brain, including the brainstem.” Neurological determination of brain death is primarily based on clinical examination; if clinical criteria are met, a definitive confirmatory test is indicated. The apnea test remains the gold standard for confirmation. In patients with factors that confound the clinical determination or when apnea tests cannot safely be performed, an ancillary test is required to confirm brain death. Confirmatory ancillary tests for brain death include (a) tests of electrical activity (electroencephalography (EEG) and somatosensory evoked potentials) and (b) radiologic examinations of blood flow (contrast angiography, transcranial Doppler ultrasound (TCD), and radionuclide methods). Of these, however, radionuclide studies are used most commonly. Here we present data from two patients with a false positive Radionuclide Cerebral Perfusion Scan (RCPS).
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Facchinelli, Davide, Enrico Boninsegna, Marco Barillari, Giancarlo Mansueto, Mauro Krampera, and Dino Veneri. "Primary sphenoid lymphoma: Focus on imaging." Tumori Journal 104, no. 6 (2018): NP42—NP45. http://dx.doi.org/10.1177/0300891618803501.
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Primary lymphoma of the sphenoid is an extremely rare pathology, therefore it is difficult to hypothesize and the imaging characteristics are not well-known. Here we report the imaging features in computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scan of a 44-year-old patient who presented with severe headache. CT and MRI showed a sphenoid sinus mass that suggested rhinopharyngeal lesion or a chordoma. However, biopsy from the mass histologically proved it to be Diffuse large B-cell lymphoma and PET examinations revealed increased fluorodeoxyglucose uptake around the sphenoid bone and multiple spinal lesions.
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Zulfariska, Nony, Pande Putu Yuli Anandasari, Ni Nyoman Margiani, Firman Parulian Sitanggang, Putu Patriawan, and I. Gde Raka Widiana. "Correlation between Head Computed Tomography Scan Examination and Cranial Index Measurement in Pediatric Hydrocephalus." Mutiara Medika: Jurnal Kedokteran dan Kesehatan 22, no. 1 (2022): 20–27. http://dx.doi.org/10.18196/mmjkk.v22i1.12464.
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Hydrocephalus in children can inhibit child growth. However, if treated immediately, the patient will develop normal intelligence. In radiology, the most important problem is to detect hydrocephalus early. Currently, radiology examinations can detect hydrocephalus accurately with a CT scan to identify the presence of blockages and assess the degree. Skull radiography is used to assess the presence of advanced hydrocephalus. A comparison is carried out and assesses the relationship between hydrocephalus measurement on the ventricular and cranial index by scanogram. The study used a cross-sectional analytics design, using Picture Archiving and Communication System (PACS) data. There were 68 samples taken using consecutive sampling, obtaining ventricular index measurement results above 0.30, and patients under 12 years old. Spearman rank test showed a correlation between the ventricular index measurements and cranial index, with Spearman’s Rho (r) = 0.856 and p0.001 with linear equation Y= 2.973 + 0.005X. It revealed that the constant 2.973 indicated that if there is no B coefficient value, the participation value will be 2.973. Furthermore, regression coefficient X of 0.005 indicated that the participation value grows by 0.005 for every 1 addition of the B coefficient value with R2= 0.340.
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Mamot, Christoph, Dirk Klingbiel, Felicitas Hitz, et al. "Final Results of a Prospective Evaluation of the Predictive Value of Interim Positron Emission Tomography in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP-14 (SAKK 38/07)." Journal of Clinical Oncology 33, no. 23 (2015): 2523–29. http://dx.doi.org/10.1200/jco.2014.58.9846.
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Purpose Our main objective was to prospectively determine the prognostic value of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) after two cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone given every 14 days (R-CHOP-14) under standardized treatment and PET evaluation criteria. Patients and Methods Patients with any stage of diffuse large B-cell lymphoma were treated with six cycles of R-CHOP-14 followed by two cycles of rituximab. PET/CT examinations were performed at baseline, after two cycles (and after four cycles if the patient was PET-positive after two cycles), and at the end of treatment. PET/CT examinations were evaluated locally and by central review. The primary end point was event-free survival at 2 years (2-year EFS). Results Median age of the 138 evaluable patients was 58.5 years with a WHO performance status of 0, 1, or 2 in 56%, 36%, or 8% of the patients, respectively. By local assessment, 83 PET/CT scans (60%) were reported as positive and 55 (40%) as negative after two cycles of R-CHOP-14. Two-year EFS was significantly shorter for PET-positive compared with PET-negative patients (48% v 74%; P = .004). Overall survival at 2 years was not significantly different, with 88% for PET-positive versus 91% for PET-negative patients (P = .46). By using central review and the Deauville criteria, 2-year EFS was 41% versus 76% (P < .001) for patients who had interim PET/CT scans after two cycles of R-CHOP-14 and 24% versus 72% (P < .001) for patients who had PET/CT scans at the end of treatment. Conclusion Our results confirmed that an interim PET/CT scan has limited prognostic value in patients with diffuse large B-cell lymphoma homogeneously treated with six cycles of R-CHOP-14 in a large prospective trial. At this point, interim PET/CT scanning is not ready for clinical use to guide treatment decisions in individual patients.
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Hashem, Abbas A. A., Ahmad S. Khalil, Sherif A. Dabour, and Wael M. El-Haig. "Diagnostic accuracy of clinical examination, ultrasonography, and computed tomography in detecting and localizing posterior segment intraocular foreign bodies: a surgical correlation study." Journal of the Egyptian Ophthalmological Society 118, no. 3 (2025): 296–301. https://doi.org/10.4103/ejos.ejos_33_25.
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Background Open globe injuries with retained intraocular foreign bodies (IOFBs) are a major cause of ocular morbidity, particularly among young adults. Management requires a carefully planned sequence of steps, including accurate detection and localization of IOFBs to ensure their safe removal and better prognosis. Purpose To assess the detection sensitivity and localization performance of clinical examination, B-scan ultrasonography, and computed tomography (CT) for posterior segment IOFBs, using intraoperative findings during pars plana vitrectomy as the reference standard. Patients and methods This retrospective study included 60 patients with surgically confirmed posterior segment IOFBs who underwent pars plana vitrectomy. Preoperative data from clinical examinations, ocular ultrasonography, and CT imaging were reviewed and compared with the surgical findings in terms of IOFB detection and localization. A three-point scoring system was used to quantify localization accuracy based on anatomical zone and clock-hour position, and the localization performance was evaluated using three complementary measures: mean localization score, localization accuracy, and sensitivity of localization Results The sensitivity for IOFB detection was 38.3% for clinical examination, 73.3% for ultrasonography, and 95% for CT (P<0.001). CT also demonstrated the highest localization performance, with 75.4% localization accuracy, a mean localization score of 1.65±0.67, and localization sensitivity of 71.7%. Ultrasonography showed moderate localization accuracy (47.7% localization accuracy, mean localization score of 1.27±0.79, localization sensitivity 35%), while clinical examination had the lowest performance (34.8% localization accuracy, score 1.08±0.79, localization sensitivity 13.3%). The differences between modalities were all statistically significant (P<0.001). Conclusion CT scan demonstrated superior diagnostic accuracy in both detecting and localizing IOFBs, making it the most reliable preoperative modality. Ocular ultrasonography remains a useful alternative and is superior in detecting associated vitreoretinal complications, while clinical examination alone is insufficient. These findings support the complementary use of imaging modalities in the surgical planning for posterior segment trauma.
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Kim, Seong-Min, Yeun-ju Kim, Seong-Min Choi, and Ki Baek Lee. "Device Application to Improve Patient Safety and Image Quality during Chest CT Examination of Unconscious Patients." Korean Society of Computed Tomographic Technology 25, no. 1 (2023): 11–19. http://dx.doi.org/10.31320/jksct.2023.25.1.11.
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This study was to analyze the effect on patient safety and image quality improvement by lowering the arm and applying a self-made device during chest CT examinations of unconscious patients. From April 1 to September 30, 2022, 78 patients (male: 42, female: 36, mean age: 67 years old) among intensive care unit patients who underwent chest CT scan were retrospectively reviewed. The patients were classified into three positions as follows: both arms raised (A position), both arms straight out using the self-made device (B position), and both arms straight out to the side (C position). For radiation dose comparison, dose length product (DLP) values were measured and compared to each other. For image quality evaluation, image noise, signal to noise ratio (SNR), contrast to noise ratio (CNR), and contrast to dose ratio (CNRDR) values were compared, and qualitative evaluation was also performed. The average DLP value of the B position was significantly lower than that of the C position, and it was relatively higher than that of the A position, but there was no significant difference statistically.(p=0.051) In the quantitative evaluation, it was evaluated that the B position maintains a quality quite similar to that of the A position despite the lowering of the both arms. In addition, in the qualitative evaluation, an average score was obtained between A and C. In conclusion, it was confirmed that the use of the self-made device for rapid and safe chest CT examination of unconscious patients is useful in improving patient dose and image quality.
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Wang, Wenyan, Huaicong Long, and Zhiying Zhao. "A Patient with a Right Atrium Mass and Congenital Heart Disease: A Challenging Diagnosis of a Stubborn Disease." Case Reports in Cardiology 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/6810961.
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Cardiac lymphoma is extremely rare. An intracardiac mass has rarely been reported to be the cardiac involvement of extranodal lymphoma. It is difficult to establish a final diagnosis via routine examinations. The ability of an echocardiogram to characterize tissue is limited; systemic (18)F-FDG PET/CT scans provide important information for both staging and response assessment in patients with lymphoma. A 68-year-old Chinese male with a second patent foramen ovale (PFO) and an interventricular septal defect presented at our institute with persistent fever, shortness of breath, repeated paroxysmal supraventricular tachycardia (PSVT) attack, and rapidly progressing superior vena cava syndrome. The patient also presented with a mass located in the upper right atrium and superior vena cava which was detected by echocardiogram. (18)F-FDG PET/CT scan revealed a pathological increase of (18)F-FDG uptake in the atrial mass and several other extracardiac lymph nodes. Lymph node biopsy was positive for large B-cell lymphoma. Immunohistochemistry revealed intense and diffuse expression of CD20, CD10, BCL-6, and Ki-67. The patient died without any chemotherapy 18 days after hospital discharge.
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Shao, Yi, and Zhao-Yang Wang. "Guidelines for preoperative visual function and imaging examination standards in vitreoretinal surgery (2025)." International Journal of Ophthalmology 18, no. 5 (2025): 813–31. https://doi.org/10.18240/ijo.2025.05.06.
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This guideline seeks to thoroughly investigate the standardized operational procedures for visual function and imaging examinations prior to vitreoretinal surgery. Preoperative assessments can greatly assist clinicians in determining surgical indications, assessing patient conditions, and offering valuable assistance in formulating surgical strategies and predicting outcomes. Developed by a collaborative team of experts from the Ophthalmic Imaging and Intelligent Medicine Branch of the Chinese Medical Education Association, in conjunction with the Ophthalmic Imaging and Intelligent Medicine Branch of the Chinese Medical Education Association, these guidelines have been formulated through extensive research and evaluation, incorporating the latest technological advancements and studies on a global and domestic scale in vitreoretinal surgery. After extensive deliberations and incorporation of up-to-date clinical data, these guidelines have been developed to assist in standardizing preoperative examinations for vitreoretinal surgery. The overarching goals include improving medical quality, maximizing resource allocation, offering decision-making assistance, and safeguarding patient rights. This document provides a comprehensive analysis of preoperative assessments for vitreoretinal procedures, covering principles, methodologies, and precautions related to a range of diagnostic techniques including ultra-wide-angle fundus imaging, fluorescein angiography, indocyanine green angiography, ophthalmic B-ultrasound examinations, ultrasound biomicroscopy, optical coherence tomography, optical coherence tomography angiography, orbital CT scan, orbital MRI, and ophthalmic electrophysiology tests such as electroretinograms, visually evoked potentials, and visual field testing.
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Djajapranata, Kenneth Martino, and Ummi Maimunah. "The Role of Histopathology in Patients with Hepatitis C Leading to Hepatocellular Carcinoma." Journal of Medical and Health Studies 4, no. 3 (2023): 09–17. http://dx.doi.org/10.32996/jmhs.2023.4.3.2.
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Hepatocellular carcinoma (HCC) is a primary malignant tumor of the liver, where 90% of cases of primary liver tumors are caused by this tumor. About 85% of HCC tumor cases also have cirrhosis of the liver. Currently, HCC is the fifth most malignant tumor in the world. Other than that, San HCC's survival is scanty. A patient at Dr. Soetomo complained of an enlarged stomach 5 months ago. The patient was first diagnosed with Hepatitis C 3 months ago but has not been treated for hepatitis C. The patient underwent several examinations in January, March and May 2022. Supportive testing of normal AFP and anti-HCV levels was performed with a positive result for HCV RNA >11.00. When considering liver function tests to assess liver disease severity using the CTP score, the score is 7 (CTP B). X-ray examination, CT scan and tumor size 11.2 x 6.7 cm were obtained, fed from the right a. hepatica, and there was no thrombosis in v. porta/hepatica. In these patients, there was no arterial enhancement, venous phase washout, and pseudocysts. The liver tumor of the aorta to the aorta, the largest size 7.3 x 11.3 x 15.9 cm, is equal to VTh11-VL3. The link expands to ±6.8 inches. Since the AFP test was normal and the CT scan did not show these results, this patient will be followed up with a biopsy. The biopsy method was performed with FNAB considering the safety of the procedure and the patient profile. Atypical FNAB results but favorable histochemistry for HCC, where CK, glypican-3, and AFP are positive. Based on the results of the examination, it was stated that the patient had Hepatoocellular Carcinoma (HCC) accompanied by cirrhosis of the liver due to chronic hepatitis C infection.
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Brunese, Luca, Antonio Romeo, Sergio Iorio, et al. "Thyroid B-flow twinkling sign: a new feature of papillary cancer." European Journal of Endocrinology 159, no. 4 (2008): 447–51. http://dx.doi.org/10.1530/eje-07-0891.
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BackgroundMicrocalcifications (aggregated with psammoma bodies), detected by ultrasound (US), are the most specific feature of papillary thyroid cancer (PTC). Using B-flow imaging (BFI), we identified a new sign (the twinkling sign; BFI-TS) in ‘suspect’ PTC nodules, which appeared to be generated by microcalcifications.ObjectiveTo evaluate whether the BFI-TS was predictive of malignancy, we correlated the BFI-TS with the results of fine needle aspiration cytology and histology.DesignCross-sectional cohort study from September 2006 to April 2008.SettingDepartment of Radiology and Endocrinology, University of Naples Federico II, and Department of Endocrinology, Second University of Naples.PatientsA total of 306 consecutive patients with 539 thyroid nodules >8 mm in diameter.Main outcome measureUS and BFI examinations were performed with the Logiq 9 system (General Electric Company, Milan, Italy); all patients underwent cytological examination.ResultsCytology revealed 455 (84.4%) benign nodules and 84 (15.6%) malignant nodules; the latter were confirmed by postsurgical histological examination (76 cases of PTC, 7 follicular carcinoma, and 1 Hürthle cell carcinoma). All suspect nodules, namely, nodules with potential predictors of thyroid malignancy (e.g., microcalcifications and intra-nodal vascularity), were analyzed by cytology or histology (or both). Of 84, 68 (80.9%) of malignant nodules had ≥4 or more BFI-TSs in at least one scan versus only 12 of 455 (2.6%) of benign lesions.ConclusionsOur results indicate that the BFI-TS could be a reliable diagnostic technique in the management of suspect thyroid nodules.
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Cüneyitoğlu Özkul, Mine, Ünal Erkan Mumcuoğlu, and İbrahim Tanzer Sancak. "Single-image Bayesian Restoration and Multi-image Super-resolution Restoration for B-mode Ultrasound Using an Accurate System Model Involving Correlated Nature of the Speckle Noise." Ultrasonic Imaging 41, no. 6 (2019): 368–86. http://dx.doi.org/10.1177/0161734619865961.
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B-mode ultrasound is an essential part of radiological examinations due to its low cost, safety, and portability, but has the drawbacks of the speckle noise and output of most systems is two-dimensional (2D) cross sections. Image restoration techniques, using mathematical models for image degradation and noise, can be used to boost resolution (deconvolution) as well as to reduce the speckle. In this study, new single-image Bayesian restoration (BR) and multi-image super-resolution restoration (BSRR) methods are proposed for in-plane B-mode ultrasound images. The spatially correlated nature of the speckle was modeled, allowing for examination of two different models for BR and BSRR for uncorrelated Gaussian (BR-UG, BSRR-UG) and correlated Gaussian (BR-CG, BSRR-CG). The performances of these models were compared with common image restoration methods (Wiener filter, bilateral filtering, and anisotropic diffusion). Well-recognized metrics (peak signal-to-noise ratio, contrast-to-noise ratio, and normalized information density) were used for algorithm free-parameter estimation and objective evaluations. The methods were tested using superficial tissue (2D scan data collected from volunteers, tissue-mimicking resolutions, and breast phantoms). Improvement in image quality was assessed by experts using visual grading analysis. In general, BSRR-CG performed better than all other methods. A potential downside of BSRR-CG is increased computation time, which can be addressed by the use of high-performance graphics processing units (GPUs).
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Derzsi, Zoltán, Zsolt Bara, Emőke Horváth, et al. "Successful Laparoscopy-Assisted Extirpation of Burkitt’s Lymphoma Causing Intestinal Obstruction in a 17-Year-Old Boy." Journal of Clinical Medicine 13, no. 24 (2024): 7834. https://doi.org/10.3390/jcm13247834.
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Background: Childhood extranodal B-cell non-Hodgkin’s lymphomas are often caused by Burkitt’s lymphoma (BL). Treatment usually involves intensive polychemotherapy, and recent prospective trials show significantly improved outcomes. Surgery primarily involves conducting biopsies; ablative interventions are not recommended. However, in cases of severe presentation, such as an acute abdomen, emergency surgery may be necessary. Methods: We present the case of a 17-year-old boy who underwent emergency surgery due to intestinal obstruction caused by a tumor mass. An exploratory laparoscopy was performed due to abdominal wall infiltrates, and a large intraabdominal mass was discovered in the ileocaecal region. The tumor and tumor infiltrates were successfully removed en bloc in a minimally invasive laparoscopy-assisted fashion. Results: The postoperative course was favorable, and chemotherapy was started. Histopathology confirmed the diagnosis of BL. Follow-up examinations, including a positron emission tomography (PET) scan, showed no tumor recurrence. More than two years later, the patient remains asymptomatic with negative PET scans. Conclusions: Laparoscopy-assisted removal can be useful for pediatric solid abdominal tumors with abdominal wall infiltrates that cause obstruction. Surgeons must assess indications and procedures based on imaging and findings during emergency interventions. The role of ablative MIS in pediatric BL is limited.
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Stankovic-Babic, Gordana, Ana Oros, Sonja Cekic, Milena Vujanovic, and Rade Babic. "Unilateral optic nerve aplasia associated with microphthalmos." Vojnosanitetski pregled 69, no. 3 (2012): 286–90. http://dx.doi.org/10.2298/vsp1203286s.
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Intraduction. Optic nerve aplasia is a rare developmental anomaly characterised by the congenital absence of the optic nerve, central retinal vessels and retinal ganglion cells that is seen most often in a unilaterally malformed eye. Case report. We reported a girl with a very rare anomaly of the eye, unilateral aplasia of the optic nerve and microphthalmia. We carried out a complete ophthalmological examination, A- and Bscan ultrasonography, magnetic resonance imaging (MRI) of the orbit and brain, pediatrician, neurological examinations and karyotype determination. The examined child was a third child from the third regular pregnancy, born at term (39 GS, BM 3100 g). Family ocular history was negative. The right corneal diameter was 7.5 mm and left 10 mm. On dilated fundus examination, the right eye showed the absence of optic nerve and central retinal vessels. B-scan echography showed a small right globe (axial length 13.80 mm), normal size left globe (axial length 18.30 mm) and the absence of optic nerve on the right eye. Physical and neurological findings and karyotype was normal. MRI of the orbits and brain marked asymmetry of globe size and unilateral absence of the optic nerve. The patient is under the control of a competent ophthalmologist and prosthetic. Conclusion. Further aesthetic and functional development of a young person is the primary goal in tracking this rare congenital optic nerve anomalies in the malformed eye.
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Sheikhghomi, Sima, Mahboubeh Shafaat, and Hamidreza Hasani. "Eyelid Schwannoma. A Case Report." Czech and Slovak Ophthalmology 79, no. 6 (2023): 325–28. http://dx.doi.org/10.31348/2023/34.
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In this case report, we describe a 53-year-old woman who presented with a slow-growing lower lid mass in her right eye. On gross examination, a remarkable lower lid bulging was noted. On palpation, a subcutaneous oval-shaped mass with a firm consistency, measuring about 2cm, was noted. The uncorrected visual acuities of the patient were 20/20 (by Snellen chart) bilaterally, and the examinations of the anterior and posterior segments of both eyes were unremarkable. On the orbital Computed Tomography scan of the patient, a solitary and homogenous solid globular mass with the same density of the brain tissue was obvious. The patient underwent surgical excision. Microscopic assessment of the lesion revealed a biphasic hypercellular area (Antoni A) and myxoid hypocellular areas (Antoni B), containing slender cells with tapered ends, interspersed with collagen fibers, consistent with a diagnosis of schwannoma. In addition, some foci of nuclear palisading around the fibrillary process (Verocay bodies) could frequently be found throughout the highly cellular regions. Schwannomas rarely occur in the eyelids, but have clinical and paraclinical indicators which indicate the probable diagnosis. In conclusion, we suggest that eyelid schwannoma be considered as an element of the differential diagnoses list for subcutaneous lesions of the eyelid.
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Zimna, Katarzyna, Małgorzata Sobiecka, Jacek Wakuliński, et al. "Lung Ultrasonography in the Evaluation of Late Sequelae of COVID-19 Pneumonia—A Comparison with Chest Computed Tomography: A Prospective Study." Viruses 16, no. 6 (2024): 905. http://dx.doi.org/10.3390/v16060905.
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The onset of the COVID-19 pandemic allowed physicians to gain experience in lung ultrasound (LUS) during the acute phase of the disease. However, limited data are available on LUS findings during the recovery phase. The aim of this study was to evaluate the utility of LUS to assess lung involvement in patients with post-COVID-19 syndrome. This study prospectively enrolled 72 patients who underwent paired LUS and chest CT scans (112 pairs including follow-up). The most frequent CT findings were ground glass opacities (83.3%), subpleural lines (72.2%), traction bronchiectasis (37.5%), and consolidations (31.9%). LUS revealed irregular pleural lines as a common abnormality initially (56.9%), along with subpleural consolidation >2.5 mm ≤10 mm (26.5%) and B-lines (26.5%). A strong correlation was found between LUS score, calculated by artificial intelligence percentage involvement in ground glass opacities described in CT (r = 0.702, p < 0.05). LUS score was significantly higher in the group with fibrotic changes compared to the non-fibrotic group with a mean value of 19.4 ± 5.7 to 11 ± 6.6, respectively (p < 0.0001). LUS might be considered valuable for examining patients with persistent symptoms after recovering from COVID-19 pneumonia. Abnormalities identified through LUS align with CT scan findings; thus, LUS might potentially reduce the need for frequent chest CT examinations.
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Gohmann, Robin F., Philipp Lauten, Patrick Seitz, et al. "Combined Coronary CT-Angiography and TAVI-Planning: A Contrast-Neutral Routine Approach for Ruling-Out Significant Coronary Artery Disease." Journal of Clinical Medicine 9, no. 6 (2020): 1623. http://dx.doi.org/10.3390/jcm9061623.
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Background: Significant coronary artery disease (CAD) is a common finding in patients undergoing transcatheter aortic valve implantation (TAVI). Assessment of CAD prior to TAVI is recommended by current guidelines and is mainly performed via invasive coronary angiography (ICA). In this study we analyzed the ability of coronary CT-angiography (cCTA) to rule out significant CAD (stenosis ≥ 50%) during routine pre-TAVI evaluation in patients with high pre-test probability for CAD. Methods: In total, 460 consecutive patients undergoing pre-TAVI CT (mean age 79.6 ± 7.4 years) were included. All patients were examined with a retrospectively ECG-gated CT-scan of the heart, followed by a high-pitch-scan of the vascular access route utilizing a single intravenous bolus of 70 mL iodinated contrast medium. Images were evaluated for image quality, calcifications, and significant CAD; CT-examinations in which CAD could not be ruled out were defined as positive (CAD+). Routinely, patients received ICA (388/460; 84.3%; Group A), which was omitted if renal function was impaired and CAD was ruled out on cCTA (Group B). Following TAVI, clinical events were documented during the hospital stay. Results: cCTA was negative for CAD in 40.2% (188/460). Sensitivity, specificity, PPV, and NPV in Group A were 97.8%, 45.2%, 49.6%, and 97.4%, respectively. Median coronary artery calcium score (CAC) was higher in CAD+-patients but did not have predictive value for correct classification of patients with cCTA. There were no significant differences in clinical events between Group A and B. Conclusion: cCTA can be incorporated into pre-TAVI CT-evaluation with no need for additional contrast medium. cCTA may exclude significant CAD in a relatively high percentage of these high-risk patients. Thereby, cCTA may have the potential to reduce the need for ICA and total amount of contrast medium applied, possibly making pre-procedural evaluation for TAVI safer and faster.
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Čmelo, Jozef. "Carotid-Cavernous Fistula from the Perspective of an Ophthalmologist. A Review." Czech and Slovak Ophthalmology 76, no. 5 (2019): 203–10. http://dx.doi.org/10.31348/2020/8.
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Carotid-cavernous fistula (CCF) is an abnormal communication - vascular connection between arteries and veins in the cavernous sinus. Classification according to etiology is traumatic vs spontaneous. According to blood flow rate per high flow vs low flow fistula. According to anatomy of direct vs indirect: Direct (direct) CCF arises through direct communication between the internal carotid artery (ICA) and the cavernous sinus. Indirect CCF originates through indirect communication through the meningeal branches of ICA, external carotid artery and cavernous sinus (not directly with ICA) and Barrow type A, B, C, D division. Patient‘s subjective complaints depend on the type of CCF. Most often it is pulsating tinnitus, synchronous with blood pulse. Typical findings include protrusion and pulsation of the eyeball, corkscrew vessels - arterialization of conjunctival and episleral vessels, increased intraocular pressure, not responding to local antiglaucomatous therapy, keratopathy a lagophthalmo, corneal ulcers. In the later untreated stages of CCF, secondary, venous stasis or central retinal vein occlusion can occur. Diagnostic procedures include B-scan and color Doppler ultrasonography, digital ophthamodynamometry, computer tomography, nuclear magnetic resonance and digital subtraction angiography. CCF can simulate orbitopathy, conjunctivitis symptoms, carotid occlusion, scleritis or cavernous sinus thrombosis. The ophthalmologist should recognize and indicate the necessary examinations in a timely manner. The therapy is ophthalmological, neuroradiological, sterotactic, surgical and conservative.
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Hajdukovic, Zoran, Snezana Kuzmic-Jankovic, Tamara Kljakovic-Avramovic, Leposava Sekulovic, and Ljiljana Tukic. "Orbital lymphoma associated with Graves’ disease: A case report." Vojnosanitetski pregled 71, no. 5 (2014): 510–14. http://dx.doi.org/10.2298/vsp1405510h.
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Introduction. The presence of bilateral exophthalmos and palpebral, periorbital edema associated with hyperthyroidism is most often considered as an initial sign of Graves? ophthalmopathy. However, in up to 20% of cases, Graves? ophthalmopathy might precede the occurrence of hyperthyroidism, which is very important to be considered in the differential diagnosis, especially if it is stated as unilateral. Among other less common causes of non-thyroid-related orbitopathy, orbital lymphoma represents rare conditions. We presented of a patient with Graves? disease, initially manifested as bilateral orbitopathy and progressive unilateral exophthalmos caused by the marginal zone B-cell non-Hodgkin lymphoma of the orbit. Case report. A 64-yearold man with the 3-year history of bilateral Graves? orbitopathy and hyperthyroidism underwent the left orbital decompression surgery due to the predominantly left, unilateral worsening of exophthalmos resistant to the previously applied glucocorticoid therapy. A year after the surgical treatment, a substantial exophthalmos of the left eye was again observed, signifying that other non-thyroid pathology could be involved. Orbital ultrasound was suggestive of primary orbital lymphoma, what was confirmed by orbital CT scan and the biopsy of the tumor tissue. Detailed examinations indicated that the marginal zone B-cell non-Hodgkin lymphoma extended to IV - B-b CS, IPI 3 (bone marrow infiltration: m+ orbit+). Upon the completion of the polychemiotherapy and the radiation treatment, a complete remission of the disease was achieved. Conclusion. Even when elements clearly indicate the presence of thyroid-related ophthalmopathy, disease deteriorating should raise a suspicion and always lead to imaging procedures to exclude malignancy.
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Basu, S., G. Li, G. Bural, and A. Alavi. "Fluorodeoxyglucose positron emission tomography (FDG-PET) and PET/computed tomography imaging characteristics of thyroid lymphoma and their potential clinical utility." Acta Radiologica 50, no. 2 (2009): 201–4. http://dx.doi.org/10.1080/02841850802620689.
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Background: A relative paucity of data exists in the literature with regard to the utility of fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in the clinical management of patients with primary lymphoma of the thyroid gland (PTL). Purpose: To explore the FDG-PET imaging characteristics and their potential role in PTL, and to compare the results with anatomical imaging modalities. Material and Methods: Patients with thyroid lymphoma who had undergone whole-body FDG-PET or PET/computed tomography (CT) during their course of the disease were identified by examination of case records. PET scans were reevaluated, and maximum standardized uptake value (SUVmax) was calculated and used as the semiquantitative measure of FDG uptake for this analysis. CT and/or magnetic resonance imaging (MRI) studies carried out within 1 week of FDG-PET scan and without any therapeutic intervention between the two studies were considered for the purpose of comparison. A total of six patients with 20 studies (14 FDG-PET and six PET/CT examinations) were identified following the criteria. All patients were female (age 16–83 years). Among these, five were proven to have PTL. Two patients had localized PTL (stage IE), two patients had associated regional nodal involvement (IIE), and one patient had associated nodal involvement on both sides of the diaphragm (IIIE) at presentation. Except for one patient with follicular B-cell lymphoma, all others were diffuse large-B-cell lymphoma (DLBCL) subtype. Results: Avid FDG uptake was observed in both cases of untreated PTL, with SUVmax of 23 and 7.6, respectively. One patient showed focal FDG uptake (SUVmax 6.7) in the thyroid in the setting of a responding abdominal non-Hodgkin lymphoma (NHL) and was subsequently proven as adenomatous nodule with Hurthle cell changes. Following successful therapy, SUVmax declined consistently with improvement in disease status. In one patient, complete response was noted earlier by FDG-PET compared to CT. Disease recurrence was detected earlier by FDG-PET compared to CT in two patients with increased FDG activity in both thyroid lobes without any corresponding CT abnormality. Conclusion: FDG-PET is a useful and sensitive modality for assessing disease activity in thyroid lymphoma. Its ability to detect disease recurrence was found to be superior compared to CT in two patients.
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Plateroti, Andrea Maria, Rocco Plateroti, Roberto Mollo, Aloisa Librando, Maria Teresa Contestabile, and Vito Fenicia. "Sturge-Weber Syndrome Associated with Monolateral Ocular Melanocytosis, Iris Mammillations, and Diffuse Choroidal Haemangioma." Case Reports in Ophthalmology 8, no. 2 (2017): 375–84. http://dx.doi.org/10.1159/000477612.
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We present the case of a 12-year-old boy with Sturge-Weber syndrome and ocular melanocytosis who presented with bilateral naevus flammeus of the face and hyperpigmentation of the right iris associated with ipsilateral iris mammillations. The patient had glaucoma and a diffuse choroidal haemangioma of the right eye. Optical coherence tomography of the anterior segment confirmed iris hyper-pigmentation and did not show abnormalities of the chamber angle structures. B-scan ultrasonography and enhanced depth imaging optical coherence tomography were performed and showed a marked difference in thickness and reflectance between the right and left choroid. Visual field examinations with perimetry showed early defects in the right eye. Peripapillary optical coherence imaging showed borderline values of retinal nerve fibre layer thickness reduction in the right eye. Sturge-Weber syndrome associated with ocular melanocytosis and iris mammillations is an extremely rare condition. This paper highlights the role of multi-imaging methods in the enhanced evaluation of rare diseases towards choosing the most appropriate management strategies and improving the follow-up of patients over time.
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Yakovlev, R. A., N. Yu Gorbunova, A. A. Voskresenskaya, and N. А. Pozdeyeva. "FIRST EXPERIENCE WITH COMBINED CYCLOPHOTOCOAGULATION TECHNIQUE USING TRANSILLUMINATION." Bulletin of Pirogov National Medical & Surgical Center 19, no. 4 (2024): 133–35. http://dx.doi.org/10.25881/20728255_2024_19_4_s1_133.
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Relevance: сurrently, micropulse transscleral cyclophotocoagulation is widely used for the treatment of refractory glaucoma. It has a high safety profile and can be applied to eyes with high visual potential. Continuous-wave cyclophotocoagulation has a more pronounced hypotensive effect; however, it is accompanied by a significant number of complications. During transscleral cyclophotocoagulation, it is suggested to use a standard position for the sensor, though the position of the ciliary processes may vary.Purpose: to analyze the effectiveness and safety of the combined cyclophotocoagulation technique using transillumination.Materials and Methods: the study included 22 patients (22 eyes) who underwent combined cyclophotocoagulation with transillumination. The observation period was 6 months, with control examinations conducted at 1, 3, and 6 months. At each visit, refractokeratometry, visual acuity assessment, ultrasound examination (B-scan), tonometry using the Maklakov method were performed. There was one case of postoperative uveitis in the form of iridocyclitisResults: after six months, intraocular pressure decreased by 45% from the baseline level-from 35.5 (34–38.5) mm Hg to 20 (20–21) mm Hg. The number of hypotensive therapy drops was also reduced-from 7 (5.75–7) to 4 (3.25–4) drops per day.Conclusion: combined cyclophotocoagulation with transscleral transillumination demonstrated a stable hypotensive effect over 6 months, with no significant complications such as prolonged hypotony, phthisis bulbi, or persistent refractory uveitis, which are commonly seen with continuous-wave cyclophotocoagulation. Thus, this technique may become an effective alternative to standard methods of cyclophotocoagulation.
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Akici, Fahrinnisa Ferhan, Deniz Tugcu, Gonul Aydogan, et al. "a Pediatric Primary Renal Lymphoma Case Presenting with Acute Renal Failure Findings." Blood 124, no. 21 (2014): 5464. http://dx.doi.org/10.1182/blood.v124.21.5464.5464.
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Abstract Lymphomatous involvement of the kidneys is a common manifestation of systemic non-Hodgkin’s lymphoma (NHL). In contrast, lymphoma originating within the kidneys is a rare event in children. In this study we report a case of primary renal lymphoma presenting with acute renal failure in a 14-years-old boy. According to histopathological and immunohistochemical examinations, the diagnosis of B-cell renal lymphoma was established. A fourteen years old boy presented to our Pediatric Hematology - Oncology Unit, with 4-month history of weakness and anorexia. He had mild abdominal pain. Physical examination revealed no significant abdominal or systemic. The laboratory data were white blood cell count 4100/mm3; hemoglobin level 10.8 g/dL, mean corpuscular volume 107 fL; mean corpuscular hemoglobin concentration 33.6 g/dL); platelet count 179,000/mm3;erytrocyte sedimentation rate 50mm/h; blood urea nitrogen level 142 mg/dL; creatinine level 4.85 mg/dL; lactate dehydrogenase level 465 IU/L. There were no pyuria or hematuria, and urinary culture and stain results were negative. An abdominal ultrasonography revealed an increase in bilateral kidney sizes. Abdomen computed tomography scan showed an increase in thickness of renal parenchyma with hypodense appearance and with bilateral mild ectasia in pelvicalyceal system. An ultrasonography guided renal biopsy demonstrated precursor B-cell lymphoblastic lymphoma. Hematoxylin and eosin section of these renal masses revealed neoplastic lymphoma cells with increased nuclear-cytoplasmic ratio, prominent nucleoli and mitotic figures.The lymphoma cells stained positivie for terminal deoxynucleotydyl transferase and B-lymphocyte marker CD10 and CD20 immuno-histochemical stain. Extrarenal abdominal involvement was excluded by imaging techniques. Bone marrow examination was normal. He was diagnosed as non-Hodgkin’s lymphoma, pre B-cell type and was treated with multidrug chemotherapy (induction regimen of prednisolone, vincristine, daunorubicin and L-asparaginase) and prophlactic intratecal methotrexate according to British-French-Munster (BFM) protocol. After the initial therapy, renal function test were improved rapidly and during consolidation and maintenance chemotherapy, they continud as normal. The patient is still in complete remission and was followed normal renal function with no sign of disease recurrence 5 years later diagnosis..In conclusion, diagnose of PRL is difficult. Percutaneous kidney biopsy is the most expeditious method towards the establishment of an early diagnosis for appropriate chemotheraph. Early diagnosis and urgent therapy, with supporting therapy are necessary for good prognosis. Disclosures No relevant conflicts of interest to declare.
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Dhami, Dana Victoria, Sabina Dhami, Dinesh Kapur, David Coletti, Kurella Sreedevi, and Mandeep Dhami. "Follicular Lymphoma Masquerading As a Neuroendocrine Tumor." Blood 136, Supplement 1 (2020): 18–19. http://dx.doi.org/10.1182/blood-2020-138506.
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A 73 y/o Caucasian female presented with abdominal pain for 2 years, gradually worsening in the recent past. The pain was more severe at night, especially while sleeping on her abdomen. An A/P CT scan showed a mid-abdominal mesenteric mass measuring 8 x 4 cm, which was new since prior examinations. The new mass was accompanied by prominent retro-peritoneal lymph nodes, the largest along the left paraaortic region measuring 1.9 x 1.6 cm. She reported good appetite and denied fever, chills, night sweats or unexplained weight loss. She admitted to a 6-month history of diarrhea consisting of 2-3 loose stools daily. Her clinical presentation was felt to be concerning for Carcinoid tumor. A GA-68 dotatate PET/CT showed uptake within the known mesenteric mass, most likely representing carcinoid tumor. Minimal uptake observed in retroperitoneal lymph nodes felt to represent early metastatic disease. The patient underwent laparotomy, small bowel resection and retroperitoneal lymph node resection. Pertinent laboratory studies - Chromogranin level, pre op - 625 (ref 25 - 140) Chromogranin level post op - 54 Pathology showed grade 2, follicular lymphoma. The neoplastic cells predominantly composed of small, irregular cleaved centrocytes mixed with a minor population of centroblasts (less than 15 per high-power field). Neoplastic follicles were diffusely positive for CD20, PAX5, CD10, BCL6, and BCL2. Ki67 showed 10-20% proliferation index. Cyclin D1 was negative. Flow cytometry identified monoclonal B-cell population positive for CD10, CD19 (dim), and CD20, which expressed dim monotypic lambda light chain. CD5 negative. Discussion: There is evidence that lymphoma cells express somatostatin receptors (SSTR). Octreotide scan (111In-pentetreotide - binds to SSTR2 and SSTR5) uptake has been described in lymphomas with variable degree of avidity. Gallium Dotatate scan (68Ga-Dotatate - binds selectively to SSTR2) uptake has been previously described in a patient with large cell lymphoma. Here we describe a case of follicular lymphoma presenting with symptoms suggestive of carcinoid that showed uptake on Gallium Dotatae scan. This finding therefore warrants recognition by clinicians for potential of lymphoma presenting with positive Gallium Dotatate scan. Ruuska et al* have shown that 62% of various PET positive lymphomas (DLBCL, follicular and Hodgkin's) were also 68Ga-DOTONAC PET/CT positive and there was concordance between SSTR2 positivity by IHC and 68Ga-DOTONAC PET/CT. If this finding is confirmed in further studies, perhaps this may lead to a possible therapeutic application for 177Lu-DOTA-TATE in management of some refractory lymphomas. *Tina Ruuska et al, Acta Oncologica, 2018, vol 57, no. 2. 283-289 Figure Disclosures No relevant conflicts of interest to declare.
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Chung, Kaman, Onno M. Mets, Paul K. Gerke, et al. "Brock malignancy risk calculator for pulmonary nodules: validation outside a lung cancer screening population." Thorax 73, no. 9 (2018): 857–63. http://dx.doi.org/10.1136/thoraxjnl-2017-211372.
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ObjectiveTo assess the performance of the Brock malignancy risk model for pulmonary nodules detected in routine clinical setting.MethodsIn two academic centres in the Netherlands, we established a list of patients aged ≥40 years who received a chest CT scan between 2004 and 2012, resulting in 16 850 and 23 454 eligible subjects. Subsequent diagnosis of lung cancer until the end of 2014 was established through linking with the National Cancer Registry. A nested case–control study was performed (ratio 1:3). Two observers used semiautomated software to annotate the nodules. The Brock model was separately validated on each data set using ROC analysis and compared with a solely size-based model.ResultsAfter the annotation process the final analysis included 177 malignant and 695 benign nodules for centre A, and 264 malignant and 710 benign nodules for centre B. The full Brock model resulted in areas under the curve (AUCs) of 0.90 and 0.91, while the size-only model yielded significantly lower AUCs of 0.88 and 0.87, respectively (p<0.001). At 10% malignancy risk, the threshold suggested by the British Thoracic Society, sensitivity of the full model was 75% and 81%, specificity was 85% and 84%, positive predictive values were 14% and 10% at negative predictive value (NPV) of 99%. The optimal threshold was 6% for centre A and 8% for centre B, with NPVs >99%.DiscussionThe Brock model shows high predictive discrimination of potentially malignant and benign nodules when validated in an unselected, heterogeneous clinical population. The high NPV may be used to decrease the number of nodule follow-up examinations.
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Kotrotsos, Athanasios, Constantinos Rouvalis, Anna Geitona, and Vassilis Kostopoulos. "Toughening and Healing of CFRPs by Electrospun Diels–Alder Based Polymers Modified with Carbon Nano-Fillers." Journal of Composites Science 5, no. 9 (2021): 242. http://dx.doi.org/10.3390/jcs5090242.
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In the present investigation, thermo-reversible bonds formed between maleimide and furan groups (Diels–Alder (DA)-based bis-maleimides (BMI)) have been generated to enable high-performance unidirectional (UD) carbon fiber-reinforced plastics (CFRPs) with self-healing (SH) functionality. The incorporation of the SH agent (SHA) was performed locally, only in areas of interest, with the solution electrospinning process (SEP) technique. More precisely, reference and modified CFRPs with (a) pure SHA, (b) SHA modified with multi-walled carbon nano-tubes (MWCNTs) and (c) SHA modified with graphene nano-platelets (GNPs) were fabricated and further tested under Mode I loading conditions. According to experimental results, it was shown that the interlaminar fracture toughness properties of modified CFRPs were considerably enhanced, with GNP-modified ones to exhibit the best toughening performance. After the first fracture and the activation of the healing process, C-scan inspections revealed, macroscopically, a healing efficiency (H.E.) of 100%; however, after repeating the tests, a low recovery of mechanical properties was achieved. Finally, optical microscopy (OM) examinations not only showed that the epoxy matrix at the interface was partly infiltrated by the DA resin, but it also revealed the presence of pulled-out fibers at the fractured surfaces, indicating extended fiber bridging between crack flanks due to the presence of the SHA.
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He, Tiangeng, Caiyun You, Song Chen, Xiangda Meng, Yuanyuan Liu, and Hua Yan. "Secondary Sulcus-Fixed Foldable IOL Implantation with 25-G Infusion in Patients with Previous PPV after Open-Globe Injury." European Journal of Ophthalmology 27, no. 6 (2017): 786–90. http://dx.doi.org/10.5301/ejo.5000963.
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Purpose To evaluate the safety and efficacy of secondary sulcus-fixed foldable intraocular lens (IOL) implantation through a clear corneal incision with 25-G infusion in patients with previous pars plana vitrectomy (PPV) after open-globe injury, and to analyze postoperative outcomes and prognostic factors of treatment. Methods Clinical data of 89 eyes of 89 patients with open-globe injury who underwent secondary sulcus-fixed foldable IOL implantation through a clear corneal incision with 25-G infusion after vitrectomy in our hospital between January 2008 and June 2015 were retrospectively analyzed. The examinations before IOL implantation mainly included visual acuity, slit-lamp examination, direct and indirect ophthalmoscope, visual electrophysiology, corneal endothelium, B scan, ultrasound biomicroscope, and intraocular pressure. Five eyes underwent suturing of peripheral iris and 7 eyes underwent suturing of iris laceration simultaneously. The mean follow-up was 18 months with a range from 6 months to 8 years. Results The mean interval between secondary sulcus-fixed foldable IOL implantation and vitrectomy was 2.8 months with a range from 2 to 6 months. The uncorrected visual acuity improved in all patients with a well-centered IOL ranging from 0.1 to 0.8 with the best-corrected visual acuity from 0.1 to 1.0 after secondary IOL implantation. The postoperative complications mainly included mild anterior chamber exudates in 10 eyes (11%), temporary IOP elevation in 12 eyes (13%), and recurrent retinal detachment in 5 eyes (6%), which were subsequently managed by surgery. Conclusions The interval of 2.8 months between vitrectomy and secondary IOL implantation is an appropriate and safe option to correct aphakia in patients receiving vitrectomy for open-globe injury.
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Pleș, Liana, Cătălin Cîrstoveanu, Romina-Marina Sima, Gabriel-Petre Gorecki, Radu Chicea, and Bashar Haj Hamoud. "Prenatal Diagnosis of Bovine Aortic Arch Anatomic Variant." Diagnostics 12, no. 3 (2022): 624. http://dx.doi.org/10.3390/diagnostics12030624.
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Fetal aortic arch development is an early and complex process that depends on many genetic and environmental factors. The final aortic arch varies greatly; it may take the form of a normal arch, anatomic variant (AAAV) with a common origin to that of the innominate artery and left common carotid artery (formerly known as “bovine aortic arch” (with an incidence of up to 27%)) or one of multiple pathological conditions. The present study aimed to establish the feasibility and impact of prenatal anatomic arch variants’ diagnosis. A retrospective study of 271 fetal second- and third-trimester anomaly scans was performed in our tertiary center. Examinations that evaluated the sagittal aortic arch were included and the branching pattern was assessed. Additionally, a literature data search based on the terms “common origin of innominate artery and left common carotid artery”, “bovine arch”, “bovine aortic” and “aortic arch anomalies” was performed. Results that referred to prenatal AAAV were retained and the papers evaluated. In our study, the AAA incidence was 1.93%, with 4 out of 5 cases being arch type B. All cases had minor associated conditions but a good postnatal outcome. An anatomic aortic variant with a common IA and LCCa prenatal diagnosis was found in a small number of studies; most of the cases described in pediatric and adult series were related to cardiac surgery for stenting, aneurysm or thoracic-associated diseases. The incidence of AAAV varied from 6 to 27% depending on the population studied (highest incidence in African individuals). The variant was highly associated with aortic dissection, pulmonary and cerebral embolism and increased risks of incidents during surgery. Diagnosing AAAV during a routine anatomic scan is feasible and diagnoses can be made when anomaly scans are performed. Awareness of the condition is important for postnatal surgery when other cardiac anomalies are found; this can prevent accidents with simple changes to the patient’s lifestyle, and, in the case of surgery, means we can adopt the correct surgical approach.
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Garderet, Laurent, Driss Kharroubi-Lakouas, Damien roos Weil, et al. "The Role of PET-MRI in Multiple Myeloma Patients." Blood 136, Supplement 1 (2020): 12. http://dx.doi.org/10.1182/blood-2020-141789.
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Introduction Low-dose CT scans and magnetic resonance imaging (MRI) using T2- and T1-weighted contrasted enhanced images are the standard methods of bone staging for newly diagnosed and relapsed multiple myeloma (MM) patients. Fluoro-desoxy-glucose positron emission tomography (18F-FDG PET) is also a validated procedure for the imaging of MM bone lesions and the evaluation of extramedullary plasmacytoma. Furthermore, PET CT is useful to determine the prognosis and to assess the minimal residual disease. A new hybrid technology combining PET and MRI provides metabolic and anatomic information simultaneously. We evaluated the results obtained using this new examination. Materials and Methods Thirty-nine MM patients were prospectively included in this single center observational study. Fifty-one PET-MRI scans were performed in 4 patient populations: 1/ newly diagnosed smoldering MM (NDSMM, n =10); 2/ newly diagnosed symptomatic MM (NDMM, n=18); 3/ MM patients with long term follow-up (FU, n=17); 4/ MM patients with biochemical relapse (Rel, n=6). The imaging protocol consisted of T1-weighted, DIXON and diffusion-weighted (b=50 and b=800) axial sequences from the head to the knees simultaneously acquired by PET, followed by coronal and sagittal T1-weighted and T2-weighted sequences centered on the full spine and basin. MRI was considered to be positive in the case of diffuse bone marrow infiltration (DI), diffuse patchy bone marrow infiltration (DPI), focal bone marrow lesions (FL) or extra-medullary disease (EMD). PET was considered to be positive when FDG-avid focal bone lesions, a diffuse medullary area and/or FDG-avid EMD were observed. Medullary compression was also evaluated using MRI. Results The characteristics of the patients are summarized in Table 1. They were classified according to the ISS scale (I, n=18; II, n=7; III, n=3; missing, n=11) and none had high-risk cytogenetics or extra-medullary disease. The hybrid PET-MRI technique provided good image quality in all cases with no artefacts. No medullary compression was detected by MRI. Among the overall 51 PET-MRI examinations, 38 (74%) were positive for MRI and 27 (53%) for PET. Table 2 summarizes the bone marrow results obtained using MRI and PET in the four groups of patients. EMD was not detected by either MRI or PET. In NDSMM patients, MRI was positive and PET was negative in 30%, while none were positive only for PET. In NDMM, MRI was positive and PET was negative in 22% of cases, while 5% were positive only for PET (Figure 1 shows a negative PET and a positive MRI scan in the same patient). In FU patients, 35% of MRI scans remained positive with PET negative, while 6% were PET-positive and MRI-negative. In the case of relapsed patients, MRI and PET scans were in 100% agreement. Conclusions Using PET-MRI, in addition to a search for medullary compression, MRI can provide additional bone marrow information with respect to PET in about 22 to 30% of cases, particularly in NDSMM and NDMM. In a single examination, PET-MRI can detect bone, as well as potential extra-medullary lesions and medullary compression, without irradiation. The baseline PET examination is useful to evaluate the prognosis. Legend to Figure 1: PET and MRI scans in an asymptomatic myeloma patient. PET is negative but MRI reveals a bone lesion in the left iliac crest (arrow). Disclosures Leblond: Janssen: Honoraria; Lilly: Honoraria; Astra Zeneca: Honoraria; Roche: Honoraria; Amgen: Honoraria; Gilead: Honoraria; Beigene: Honoraria; Beigene: Membership on an entity's Board of Directors or advisory committees; Gilead: Membership on an entity's Board of Directors or advisory committees; AbbVie: Membership on an entity's Board of Directors or advisory committees; Astra Zeneca: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria.
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Askerova, A. N. "Clinical and Radiation Diagnosisof Renal Arteriovenous Malformation." Medical Visualization, no. 3 (June 28, 2017): 53–61. http://dx.doi.org/10.24835/1607-0763-2017-3-53-61.
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Purpose:to analyze the results of preoperative diagnosis and treatment of patients with renal arteriovenous malformation and compare them with the literature data.Materials and methods.5 patients with renal arteriovenous malformations were examined for the period from 2014 to2016 in the FSBI "A.V. Vishnevsky Institute of Surgery» MH RF, where simultaneously there are clinical departments of urology and vascular surgery, 4 of them were treated. All patients were female. The mean age was 31.8 ± 6.7 years (24–41 years). Ultrasound was done to all the patients in B-mode followed by a duplex scan using an abdominal 2–4 MHz convex. MDCT was performed in 4 patients out of 5. Patients underwent multiphase examination on a multidetector CT-scanner Philips Brilliance iCT-256 and Brilliance CT-64 (Philips Medical Systems (Cleveland) with the 120 kV and 100 kV protocols and an intravenous injection of the iodinated contrast agent. Digital subtraction angiography was performed in 3 patients.Results.One-sided lesion occurred in four cases (3 of them (60%) right-sided and 1 (20%) left-sided), in one patient (20%) arteriovenous malformation was bilateral As a result of the analysis of our own material and literature data, the diagnostic criteria of renal arteriovenous malformations according to ultrasound, MDCT and digital subtraction angiography were studied in detail. The results of the examinations of 5 patients with demonstration of ultrasound, MDCT and angiographic images are presented with the visualization of the characteristic features of renal AVM. In addition, the treatment options for such patients with the possibility of preserving the kidney are described.Conclusion.Duplex scanning is an effective method of diagnosis and postoperative follow-up of patients with renal arteriovenous malformations. Preoperative computed tomography and selective digital subtraction angiography provide accurate information about the renal angioarchitectonics and AV-shunts for choosing the treatment tactics and planning the surgical intervention.
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Sande, N. K., V. Lilleby, A. B. Aga, E. Kirkhus, B. Flato, and P. Bøyesen. "POS0762 ASSOCIATIONS BETWEEN POWER DOPPLER ULTRASOUND FINDINGS AND B-MODE SYNOVITIS AND CLINICAL ARTHRITIS IN JUVENILE IDIOPATHIC ARTHRITIS USING A STANDARDIZED SCANNING APPROACH AND SCORING SYSTEM." Annals of the Rheumatic Diseases 82, Suppl 1 (2023): 672.2–673. http://dx.doi.org/10.1136/annrheumdis-2023-eular.1294.
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BackgroundUltrasound is a valuable tool in the evaluation of synovitis in patients with juvenile idiopathic arthritis (JIA). However, interpretation of Doppler signals in children is challenging due to physiologic vascularization that can be misinterpreted as pathologic findings. Definitions for synovitis in children, including B-mode (BM) and Doppler findings, have been developed and emphasize that only Doppler signals within synovial hypertrophy should be considered as synovitis [1]. So far, few studies have implemented this definition in the evaluation of Doppler findings in children.ObjectivesTo describe power Doppler (PD) ultrasound findings in joint regions with BM synovitis in patients with JIA using a standardized scanning protocol and scoring system. Further, to examine associations between PD findings and BM synovitis, clinical arthritis, patient characteristics and disease activity.MethodsIn this cross-sectional study one rheumatologist with broad ultrasound experience, blinded to clinical findings, performed ultrasound examinations in 27 patients with JIA aged 2 to 17 years old with suspected clinical arthritis using the same ultrasound machine with standardized settings. The elbow, wrist, metacarpophalangeal 2-3, proximal interphalangeal 2-3, knee, ankle and metatarsophalangeal 2-3 joints were assessed bilaterally and scored for BM and PD findings using a joint-specific scoring system (grades 0-3) with reference atlas [2]. Pathologic BM and PD findings were defined as grades ≥1. Multilevel mixed-effects ordered logistic regression models were used to explore associations between PD findings and BM synovitis, clinical arthritis, age, sex, JIA subgroup, disease duration and measures of disease activity (Juvenile Arthritis Disease Activity Score (JADAS10), (range 0-40).ResultsOverall, 971 joint regions were evaluated by ultrasound, 129 had BM synovitis and were assessed for PD. PD findings were detected in 45 joint regions (34.9%), most frequently in the lateral parapatellar recess of the knee joint (24.4%) (Figure 1). Increasing PD grades were associated with higher BM grades (OR=5.0, 95% CI: 2.7-9.1, p<0.001) and with the presence of clinical arthritis (OR=7.4, 95% CI: 2.7-21.7, p<0.001). PD findings were not associated with age, sex, JIA subgroups, disease duration or JADAS10.ConclusionIncreasing severity of PD findings were significantly associated with BM synovitis and with the presence of clinical arthritis. These findings suggest that PD signals detected using a standardized ultrasound examination and scoring system can reflect active disease in patients with JIA.References[1]Roth et al. Arthritis Care Res. 2017;69(8):1217-23.[2]Sande et al. RMD Open. 2021;7(2):e001581.Figure 1.Illustration of variations in power Doppler (PD) ultrasound findings in two joint regions of the knee in a 10-year-old child with juvenile idiopathic arthritis (JIA).A: Longitudinal dorsal scan of the knee joint (suprapatellar recess) showing B-mode (BM) synovitis,B: and BM synovitis without abnormal PD signals (grade 0).C: Longitudinal dorsal scan of the knee joint (lateral parapatellar recess) showing BM synovitis, andD: BM synovitis with abnormal PD signals (grade 3).Acknowledgements:NIL.Disclosure of InterestsNina Krafft Sande: None declared, Vibke Lilleby: None declared, Anna-Birgitte Aga Speakers bureau: AbbVie, Eli Lilly, Novartis, Pfizer, Consultant of: AbbVie, Eli Lilly, Novartis, Pfizer, Eva Kirkhus: None declared, Berit Flato: None declared, Pernille Bøyesen: None declared.
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Takayama, Yukihisa, Keisuke Sato, Shinji Tanaka, Ryo Murayama, Nahoko Goto, and Kengo Yoshimitsu. "Deep learning-based magnetic resonance imaging reconstruction for improving the image quality of reduced-field-of-view diffusion-weighted imaging of the pancreas." World Journal of Radiology 15, no. 12 (2023): 338–49. http://dx.doi.org/10.4329/wjr.v15.i12.338.
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BACKGROUND It has been reported that deep learning-based reconstruction (DLR) can reduce image noise and artifacts, thereby improving the signal-to-noise ratio and image sharpness. However, no previous studies have evaluated the efficacy of DLR in improving image quality in reduced-field-of-view (reduced-FOV) diffusion-weighted imaging (DWI) [field-of-view optimized and constrained undistorted single-shot (FOCUS)] of the pancreas. We hypothesized that a combination of these techniques would improve DWI image quality without prolonging the scan time but would influence the apparent diffusion coefficient calculation. AIM To evaluate the efficacy of DLR for image quality improvement of FOCUS of the pancreas. METHODS This was a retrospective study evaluated 37 patients with pancreatic cystic lesions who underwent magnetic resonance imaging between August 2021 and October 2021. We evaluated three types of FOCUS examinations: FOCUS with DLR (FOCUS-DLR+), FOCUS without DLR (FOCUS-DLR−), and conventional FOCUS (FOCUS-conv). The three types of FOCUS and their apparent diffusion coefficient (ADC) maps were compared qualitatively and quantitatively. RESULTS FOCUS-DLR+ (3.62, average score of two radiologists) showed significantly better qualitative scores for image noise than FOCUS-DLR− (2.62) and FOCUS-conv (2.88) (P < 0.05). Furthermore, FOCUS-DLR+ showed the highest contrast ratio (CR) between the pancreatic parenchyma and adjacent fat tissue for b-values of 0 and 600 s/mm2 (0.72 ± 0.08 and 0.68 ± 0.08) and FOCUS-DLR− showed the highest CR between cystic lesions and the pancreatic parenchyma for the b-values of 0 and 600 s/mm2 (0.62 ± 0.21 and 0.62 ± 0.21) (P < 0.05), respectively. FOCUS-DLR+ provided significantly higher ADCs of the pancreas and lesion (1.44 ± 0.24 and 3.00 ± 0.66) compared to FOCUS-DLR− (1.39 ± 0.22 and 2.86 ± 0.61) and significantly lower ADCs compared to FOCUS-conv (1.84 ± 0.45 and 3.32 ± 0.70) (P < 0.05), respectively. CONCLUSION This study evaluated the efficacy of DLR for image quality improvement in reduced-FOV DWI of the pancreas. DLR can significantly denoise images without prolonging the scan time or decreasing the spatial resolution. The denoising level of DWI can be controlled to make the images appear more natural to the human eye. However, this study revealed that DLR did not ameliorate pancreatic distortion. Additionally, physicians should pay attention to the interpretation of ADCs after DLR application because ADCs are significantly changed by DLR.
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Slovak, Marilyn L., Elmon L. Enriquez, Victoria Bedell, et al. "Antibody-Targeted FISH Analysis Improves Detection of Residual Disease in “High Risk” B-Cell Acute Lymphoblastic Leukemia." Blood 110, no. 11 (2007): 3500. http://dx.doi.org/10.1182/blood.v110.11.3500.3500.
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Abstract A number of prognostically important genetic subtypes of acute lymphoblastic leukemia (ALL) has been identified. Most notably, the presence of t(9;22)/BCR-ABL1 or 11q23/MLL rearrangements in B-cell ALL is a poor prognostic indicator and patients with these subtypes of ALL are candidates for allogeneic stem cell transplantation. Consequently, early detection of minimal residual disease (MRD) is critical for appropriate diagnostic and therapeutic decisions. Current methods for MRD measurements are based on morphologic examinations, flow cytometry, quantitative reverse-transcription polymerase chain reaction (Q-RT-PCR) and cytogenetics/fluorescence in situ hybridization (FISH). While high abnormality rates ease disease detection through standard morphologic and cytogenetic analyses, the presence of cytogenetically-aberrant lymphoblasts at low levels post treatment hampers residual disease detection. In this study, we analyzed 126 samples collected from 51 patients using a sequential immunohistochemistry (phenotype)/FISH (genotype) approach to detect B-cells with rearrangements of BCR-ABL1 or 11q23/MLL post treatment in 44 and 7 patients, respectively. Cytospin slides, made from residual bone marrow, were stained with a monoclonal CD19 (clone HD37) antibody and scanned on an image analysis system (BioView Duet™) to target the CD19 positive B-cell population. During the scan, the location of each CD19 positive cell was recorded. The slides were subsequently destained and hybridized with FISH probes specific for the genotypic rearrangements mentioned above, with only antibody-targeted cells analyzed (target FISH or T-FISH). Disease was detected by T-FISH and at least one other method in 50 (39.7%) of the 126 samples tested, a finding comparable to the percentage identified by Q-RT-PCR (39.0%) and/or flow cytometry (23.2%). In samples with positive FISH results, T-FISH outperformed or was comparable to standard FISH in detecting disease in 47 (94%) samples. Importantly, T-FISH detected an abnormal cell population in 14/50 (28%) that standard FISH did not detect (p = 0.0064). Eight (57.1%) of these 14 samples had concurrent positive Q-RT-PCR results. The remaining six samples had MLL rearrangements and PCR studies were not performed. In three (6%) samples, abnormal cells were not CD19 positive and thus not detected until a followup area scan of the entire slide revealed low-level positivity in an apparent subset of CD19 negative progenitor B-cells. This latter finding was not observed in the concurrent negative controls. Only two samples (1.6%) with low level BCR-ABL1 positivity by Q-RT-PCR (>10−5) were negative by T-FISH. Serial dilution experiments of CD19-positive/t(9;22)-positive ALL-1 and CD19-negative/t(9;22)-negative Kasumi-1 cell lines demonstrated that T-FISH identified abnormalities at dilutions as low as 10−5, with consistent and reliable detection at 10−3. These observations suggest that antibody-targeted FISH is an effective way to increase the sensitivity of a slide-based assay in detecting residual “high risk” ALL.
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Emir, Sevde Nur, Fatma Kulali, Ilkay Tosun, and Yasar Bukte. "Predictive intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in the staging of fibrosis in hepatitis B patients." Polish Journal of Radiology 90 (February 7, 2025): 66–73. https://doi.org/10.5114/pjr/199686.
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PurposeOur aim was to evaluate the diagnostic efficacy of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters [D, D*, f, and apparent diffusion coefficient (ADC) values] in the detection and staging of liver fibrosis in patients with hepatitis B virus (HBV).Material and methodsIn this prospective study, a patient group of 64 consecutive patients (with a mean age of 43 years, 30 women and 34 men) with HBV, who scheduled liver biopsy, and a control group of 30 healthy individuals without liver disease underwent IVIM-DWI scan. A total of 94 IVIM-DWI examinations were analysed. IVIM-DWI parameters were measured in the right lobe of the liver. The IVIM-DWI parameters of the patient and control groups were compared by Mann-Whitney U test. The patient group was classified into subgroups according to fibrosis stage of histopathological results. Receiver operating characteristic (ROC) analysis was conducted to assess the sensitivity and specificity of each parameter for detection and staging fibrosis.ResultsD and ADC values were significantly lower in the patient group compared to the control group (p < 0.05), while D* values were significantly higher (p < 0.05). No significant difference was observed in f values between the 2 groups. D* had the highest diagnostic performance, with a sensitivity of 78.1% and specificity of 73.3%, with a cut-off value of 1.4 × 10–3 mm2/s in the differentiation of fibrosis stages.ConclusionsIVIM-DWI, particularly the D, D*, and ADC parameters, is an adjunctive non-invasive alternative to biopsy in the staging of HBV-related liver fibrosis, especially for the prediction of advanced fibrosis.