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  1. Prediction of peak pressure from clinical and radiological measurements in patients with diabetes

    PubMed Central

    Guldemond, Nick A; Leffers, Pieter; Walenkamp, Geert HIM; Schaper, Nicolaas C; Sanders, Antal P; Nieman, Fred HM; van Rhijn, Lodewijk W

    2008-01-01

    Background Various structural and functional factors of foot function have been associated with high local plantar pressures. The therapist focuses on these features which are thought to be responsible for plantar ulceration in patients with diabetes. Risk assessment of the diabetic foot would be made easier if locally elevated plantar pressure could be indicated with a minimum set of clinical measures. Methods Ninety three patients were evaluated through vascular, orthopaedic, neurological and radiological assessment. A pressure platform was used to quantify the barefoot peak pressure for six forefoot regions: big toe (BT) and metatarsals one (MT-1) to five (MT-5). Stepwise regression modelling was performed to determine which set of the clinical and radiological measures explained most variability in local barefoot plantar peak pressure in each of the six forefoot regions. Comprehensive models were computed with independent variables from the clinical and radiological measurements. The difference between the actual plantar pressure and the predicted value was examined through Bland-Altman analysis. Results Forefoot pressures were significant higher in patients with neuropathy, compared to patients without neuropathy for the whole forefoot, the MT-1 region and the MT-5 region (respectively 138 kPa, 173 kPa and 88 kPa higher: mean difference). The clinical models explained up to 39 percent of the variance in local peak pressures. Callus formation and toe deformity were identified as relevant clinical predictors for all forefoot regions. Regression models with radiological variables explained about 26 percent of the variance in local peak pressures. For most regions the combination of clinical and radiological variables resulted in a higher explained variance. The Bland and Altman analysis showed a major discrepancy between the predicted and the actual peak pressure values. Conclusion At best, clinical and radiological measurements could only explain about 34

  2. Comparing a Supine Radiologic Versus Standing Clinical Measurement of Kyphosis in Older Women: The Fracture Intervention Trial

    PubMed Central

    Kado, Deborah M.; Christianson, Lisa; Palermo, Lisa; Smith-Bindman, Rebecca; Cummings, Steven R.; Greendale, Gail A.

    2013-01-01

    Study Design A study of agreement between different measures of kyphosis, a clinical standing measure (Debrunner kyphometer; Protek AG, Bern, Switzerland) versus a supine radiologic measure (Cobb angle). Objectives To determine whether a supine radiologic measure of kyphosis in older women is a reasonable estimate of clinical kyphosis determined in the standing position, and to investigate a computerized assessment of the Cobb angle. Summary of Background Data Few studies have investigated kyphosis measurement agreement involving older adults. Methods Using data from the Fracture Intervention Trial, we randomly selected 120 women, aged 55– 80 years, who had a Debrunner kyphometer measure of kyphosis and supine lateral spine radiographs from which we measured the Cobb angle (either manually or by digitization). We calculated the intraclass correlation coefficient (ICC) from repeated measures analysis of variance to assess the agreement among the: (1) manual Cobb angle and Debrunner kyphometer, (2) digitized Cobb angle and Debrunner kyphometer, and (3) manual and digitized Cobb angle. Results The mean of both the manual and digitized Cobb angle was 45° (range 18°– 83°), and the mean Debrunner kyphometer reading was 48° (range 17°– 83°). The ICC between either of the 2 measures of the Cobb angle and Debrunner measurement was 0.68, indicating reasonable agreement. The ICC between the manual and digitized Cobb angle was 0.99, indicating excellent agreement. Conclusions There is reasonable agreement between a supine radiologic and standing clinical measurement of kyphosis in older women. PMID:16481959

  3. Objective structured clinical examination in radiology

    PubMed Central

    Agarwal, Anurag; Batra, Bipin; Sood, AK; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, IK

    2010-01-01

    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed “key-list” that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as “manned” or “unmanned” stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations. PMID:20607015

  4. Exogenous lipoid pneumonia. Clinical and radiological manifestations.

    PubMed

    Marchiori, Edson; Zanetti, Gláucia; Mano, Claudia Mauro; Hochhegger, Bruno

    2011-05-01

    Lipoid pneumonia results from the pulmonary accumulation of endogenous or exogenous lipids. Host tissue reactions to the inhaled substances differ according to their chemical characteristics. Symptoms can vary significantly among individuals, ranging from asymptomatic to severe, life-threatening disease. Acute, sometimes fatal, cases can occur, but the disease is usually indolent. Possible complications include superinfection by nontuberculous mycobacteria, pulmonary fibrosis, respiratory insufficiency, cor pulmonale, and hypercalcemia. The radiological findings are nonspecific, and the disease presents with variable patterns and distribution. For this reason, lipoid pneumonia may mimic many other diseases. The diagnosis of exogenous lipoid pneumonia is based on a history of exposure to oil, characteristic radiological findings, and the presence of lipid-laden macrophages on sputum or BAL analysis. High-resolution computed tomography (HRCT) is the best imaging modality for the diagnosis of lipoid pneumonia. The most characteristic CT finding in LP is the presence of negative attenuation values within areas of consolidation. There are currently no studies in the literature that define the best therapeutic option. However, there is a consensus that the key measure is identifying and discontinuing exposure to the offending agent. Treatment in patients without clinical symptoms remains controversial, but in patients with diffuse pulmonary damage, aggressive therapies have been reported. They include whole lung lavage, systemic corticosteroids, and thoracoscopy with surgical debridement. PMID:21185165

  5. Telemetry of Aerial Radiological Measurements

    SciTech Connect

    H. W. Clark, Jr.

    2002-10-01

    Telemetry has been added to National Nuclear Security Administration's (NNSA's) Aerial Measuring System (AMS) Incident Response aircraft to accelerate availability of aerial radiological mapping data. Rapid aerial radiological mapping is promptly performed by AMS Incident Response aircraft in the event of a major radiological dispersal. The AMS airplane flies the entire potentially affected area, plus a generous margin, to provide a quick look at the extent and severity of the event. The primary result of the AMS Incident Response over flight is a map of estimated exposure rate on the ground along the flight path. Formerly, it was necessary to wait for the airplane to land before the map could be seen. Now, while the flight is still in progress, data are relayed via satellite directly from the aircraft to an operations center, where they are displayed and disseminated. This permits more timely utilization of results by decision makers and redirection of the mission to optimize its value. The current telemetry capability can cover all of North America. Extension to a global capability is under consideration.

  6. Clinical relevance of radiologic examination of the skeleton and bone density measurements in osteoporosis of old age

    SciTech Connect

    Kuester, W.; Seidl, G.; Linkesch, W.; Kotscher, E.; Kovarik, J.; Willvonseder, R.; Kovarik, J.; Willvonseder, R.; Dorda, W.

    1981-10-01

    For the diagnosis of primary osteoporosis, various semiquantitative radiologic methods were compared in 149 unselected patients, aged over 50 years. Crush fracture syndrome (CFS), lumbar spine index (LSI), and Singh Index (SI) were assessed by three radiologists and after reevaluation, the intra- and interobserver errors were calculated. The reliability of the subjective grading was improved by joint and repeated reading of the radiographs. Additionally, the peripheral trabecular bone content was measured by photon absorption densitometry (PAD). To test the value of the various semiquantitative methods. LSI, Si, and PAD have been compared with sex-matching before and after separation into age in decades in CFS-positive and CFS-negative patients. In an attempt to differentiate osteoporotics and non-osteoporotics by CFS, our results indicate that CFS-positive and CFS-negative males cannot be separated by LSI, Si, and PAD, whereas in females these methods can discriminate irrespective of the age in decades. However, in age related groups, only SI can discriminate significantly between CFS-positive and CFS-negative females. Correlation of the semiquantitative methods, regardless of the diagnosis of a CFS, revealed a significant correlation-between SI and PAD, but no correlation between LSI and SI, and LSI and PAD, respectively.

  7. Joubert syndrome: the clinical and radiological findings.

    PubMed

    Karakas, Ekrem; Cullu, Nesat; Karakas, Omer; Calik, Mustafa; Boyaci, Fatima Nurefsan; Yildiz, Sema; Cece, Hasan; Akal, Ali

    2014-01-01

    Joubert syndrome is a rare disease characterised by clinical and radiological findings. Among the classic clinical findings of JS are hypotonia, ataxia, mental-motor retardation, respiratory and opthalmological findings. The paediatric cases included in the study comprised nine patients. There was familial consanguinty in seven cases. Clinically, all cases had mental-motor retardation and hypotonia. Episodic hyperpnoea attacks were observed in one case. Facial dysmorphism was the most common additional systemic anomaly and four cases had additional opthalmic findings. Brain MRI examination revealed that all cases had molar tooth sign, bat-wing appearance and vermian cleft. The majority of cases also had vermian hypoplasia. Cerebellar folial disorganisation was observed in approxiamtely half of the cases. Three cases had corpus callosum anomaly and atretic occipital encephalocoele. No pathology was determined in other organs. This study aimed to evaluate the clinical and radiological findings of 9 patients diagnosed with Joubert syndrome. PMID:24605724

  8. Hand dose measurements in interventional radiology

    SciTech Connect

    Felmlee, J.P.; McGough, P.F.; Morin, R.L.; Classic, K.L. )

    1991-02-01

    Measurements of radiation dose to the hand were conducted using TLD ring badges for individual interventional radiology cases. Results from over 30 examinations (including transhepatic cholangiograms and biliary and nephrostomy procedures) conducted by four radiologists using identical equipment show an average hand dose of 1.5 mGy (150 mrad) per procedure. Hand dose varied inversely with distance from the patient. Due to variable hand positions during clinical examinations, fluoroscopic time was not found to be a good indicator of hand dose.

  9. Hand dose measurements in interventional radiology.

    PubMed

    Felmlee, J P; McGough, P F; Morin, R L; Classic, K L

    1991-02-01

    Measurements of radiation dose to the hand were conducted using TLD ring badges for individual interventional radiology cases. Results from over 30 examinations (including transhepatic cholangiograms and biliary and nephrostomy procedures) conducted by four radiologists using identical equipment show an average hand dose of 1.5 mGy (150 mrad) per procedure. Hand dose varied inversely with distance from the patient. Due to variable hand positions during clinical examinations, fluoroscopic time was not found to be a good indicator of hand dose. PMID:1989948

  10. Pediatric Stroke: Clinical Findings and Radiological Approach

    PubMed Central

    Lanni, Giuseppe; Catalucci, Alessia; Conti, Laura; Di Sibio, Alessandra; Paonessa, Amalia; Gallucci, Massimo

    2011-01-01

    This paper focuses on radiological approach in pediatric stroke including both ischemic stroke (Arterial Ischemic Stroke and Cerebral Sinovenous Thrombosis) and hemorrhagic stroke. Etiopathology and main clinical findings are examined as well. Magnetic Resonance Imaging could be considered as the first-choice diagnostic exam, offering a complete diagnostic set of information both in the discrimination between ischemic/hemorrhagic stroke and in the identification of underlying causes. In addition, Magnetic Resonance vascular techniques supply further information about cerebral arterial and venous circulation. Computed Tomography, for its limits and radiation exposure, should be used only when Magnetic Resonance is not available and on unstable patients. PMID:21603166

  11. Chiari I malformations: clinical and radiologic reappraisal.

    PubMed

    Elster, A D; Chen, M Y

    1992-05-01

    Clinical findings and magnetic resonance (MR) images in 68 patients with Chiari I malformations were retrospectively analyzed to identify those radiologic features that correlated best with clinical symptoms. A statistically significant (P = .03) female predominance of the malformation was observed, with a female: male ratio of approximately 3:2. Associated skeletal anomalies were seen in 24% of patients. Syringomyelia was detected in 40% of patients, most commonly between the C-4 and C-6 levels. Of the 25 patients who presented with spinal symptoms, 23 (92%) proved to have a syrinx at MR imaging. When the syrinx extended into the medulla (n = 3), however, brain stem symptoms predominated. Patients with objective brain stem or cerebellar signs had the largest mean tonsillar herniations. Patients with tonsillar herniations greater than 12 mm were invariably symptomatic, but approximately 30% of patients with tonsils herniating 5-10 mm below the foramen magnum were asymptomatic at MR imaging. "Incidental" Chiari I malformations are thus much more common than previously recognized, and careful clinical assessment remains the cornerstone for proper diagnosis and management. PMID:1561334

  12. [Caudal regression sequence: clinical-radiological case].

    PubMed

    Zepeda T, Juan; García M, Mirna; Morales S, Jorge; Pantoja H, Miguel A; Espinoza G, Aníbal

    2015-01-01

    Caudal regression syndrome is an uncommon congenital malformation that includes a wide spectrum of clinical presentations. Characterised by caudal musculoskeletal compromise, it can be associated to neurological, gastrointestinal, renal and genitourinary defects. Although the specific aetiology has not been clarified, it has been associated with the presence of maternal diabetes and mutations in homeobox gene HBLX9. Its diagnosis is based on a good prenatal ultrasound detection, detailed physical examination, and post-natal imaging study using radiography and magnetic resonance. Caudal regression syndrome requires multidisciplinary management, and it seems that good metabolic control of gestational diabetes constitutes the best preventive measure available. We present the clinical case and images of a male term newborn, born to a pregestational diabetic mother with poor metabolic control and a prenatal ultrasound diagnosis of lumbar spine, iliac bones and lower limbs malformation. Born in good conditions, the diagnosis was confirmed using X-rays and magnetic resonance. PMID:26455704

  13. Measuring radiology's value in time saved.

    PubMed

    Lee, Christoph I; Enzmann, Dieter R

    2012-10-01

    Because radiology has historically not measured its added value to patient care and thus not communicated it in easily understood terms to all stakeholders, the specialty must correct this to prepare for the eventual transition from the current fee-for-service payment schedule to new value-based reimbursement systems. Given the increasing risk for marginalization, radiologists need to engage clinicians and managers to map the processes and associated costs of episodes of patient care to identify areas for providing and improving integrated diagnostic information and to measure the value thereof. In such time-driven, activity-based costing practices, radiologists should highlight how proper investments in the information generated by imaging and how radiologists' associated consultative and coordination of services can save greater resources downstream, especially in the nonrenewable resource of physician time, an increasingly scarce health care resource. Using physician time in the most efficient way will be a key element for decreasing health care costs at the aggregate level. Therefore, expressing radiology's contribution in terms of downstream physician time saved is a metric that can be easily understood by all stakeholders. In a conceptual framework centered on value, the specialty of radiology must focus more on its most important product, actionable information, rather than on imaging technologies themselves. Information, unlike imaging technologies, does not depreciate with time but rather increases in value the more it is used. PMID:23025865

  14. Validation, clinical trial, and evaluation of a radiology expert system.

    PubMed

    Kahn, C E

    1991-10-01

    The PHOENIX Radiology Consultant is a rule-based expert system which assists physicians in planning radiological work-up strategies. This article describes the methods used to create and validate the system's knowledge base. The feasibility and acceptability of PHOENIX were tested for two years in a clinical trial. During this period, the system was used 1,421 times, an average of 13.7 times per week, primarily by medical students and nonradiologist physicians. Much of the system's use occurred at night and on weekends, when the radiology department was not fully staffed. Several physicians were enlisted to further evaluate the utility of the system. The results of their evaluation indicate that an expert system that helps physicians select diagnostic-imaging studies can serve as a useful and informative component of a radiology information system, and is particularly useful for medical students and physicians in training. PMID:1762580

  15. Integrating Preclinical and Clinical Oral Diagnosis and Radiology.

    ERIC Educational Resources Information Center

    Rhodus, Nelson L.; Brand, John W.

    1988-01-01

    A program providing second-year dental students with early experience in direct patient contact in an oral diagnosis/oral radiology clinic was well received by both students and faculty and was found to develop desirable skills and qualities in the students participating. (MSE)

  16. Diffuse Infiltrative Lesion of the Breast: Clinical and Radiologic Features

    PubMed Central

    An, Yeong Yi; Cha, Eun Suk; Kim, Hyeon Sook; Kang, Bong Joo; Park, Chang Suk; Jung, Na Young; Whang, In Yong; Yoon, Soo Kyung

    2011-01-01

    The purpose of this paper is to show the clinical and radiologic features of a variety of diffuse, infiltrative breast lesions, as well to review the relevant literature. Radiologists must be familiar with the various conditions that can diffusely involve the breast, including normal physiologic changes, benign disease and malignant neoplasm. PMID:21228947

  17. The Radiology Resident iPad Toolbox: an educational and clinical tool for radiology residents.

    PubMed

    Sharpe, Emerson E; Kendrick, Michael; Strickland, Colin; Dodd, Gerald D

    2013-07-01

    Tablet computing and mobile resources are the hot topics in technology today, with that interest spilling into the medical field. To improve resident education, a fully configured iPad, referred to as the "Radiology Resident iPad Toolbox," was created and implemented at the University of Colorado. The goal was to create a portable device with comprehensive educational, clinical, and communication tools that would contain all necessary resources for an entire 4-year radiology residency. The device was distributed to a total of 34 radiology residents (8 first-year residents, 8 second-year residents, 9 third-year residents, and 9 fourth-year residents). This article describes the process used to develop and deploy the device, provides a distillation of useful applications and resources decided upon after extensive evaluation, and assesses the impact this device had on resident education. The Radiology Resident iPad Toolbox is a cost-effective, portable, educational instrument that has increased studying efficiency; improved access to study materials such as books, radiology cases, lectures, and web-based resources; and increased interactivity in educational conferences and lectures through the use of audience-response software, with questions geared toward the new ABR board format. This preconfigured tablet fully embraces the technology shift into mobile computing and represents a paradigm shift in educational strategy. PMID:23647869

  18. Clinical and radiological findings of a bilateral coronoid hyperplasia case

    PubMed Central

    Torenek, Kubra; Duman, Suayip Burak; Bayrakdar, Ibrahim Sevki; Miloglu, Ozkan

    2015-01-01

    Coronoid hyperplasia (CH) is an infrequent condition that can be defined as an abnormal bony elongation of histologically normal bone. Progressive and painless difficulty in opening the mouth is the main clinical finding of CH. In this case report, the clinical and radiological findings for a 23-year-old male patient with bilateral CH are presented. When plain radiographies are not sufficient for diagnosis and evaluation of the CH, cone-beam computed tomography can be used. PMID:25713499

  19. Chondrosarcoma in Childhood: The Radiologic and Clinical Conundrum

    PubMed Central

    Mosier, Susan M.; Patel, Tanvi; Strenge, Karen; Mosier, Andrew D.

    2012-01-01

    Less than 10% of chondrosarcomas occur in children. In addition, as little as 0.5% of low-grade chondrosarcomas arise secondarily from benign chondroid lesions. The presence of focal pain is often used to crudely distinguish a chondrosarcoma (which is usually managed with wide surgical excision), from a benign chondroid lesion (which can be followed by clinical exams and imaging surveillance). Given the difficulty of localizing pain in the pediatric population, initial radiology findings and short-interval follow-up, both imaging and clinical, are critical to accurately differentiate a chondrosarcoma from a benign chondroid lesion. To our knowledge, no case in the literature discusses a chondrosarcoma possibly arising secondarily from an enchondroma in a pediatric patient. We present a clinicopathologic and radiology review of conventional chondrosarcomas. We also attempt to further the understanding of how to manage a chondroid lesion in the pediatric patient with only vague or bilateral complaints of pain. PMID:23365701

  20. Chondrosarcoma in childhood: the radiologic and clinical conundrum.

    PubMed

    Mosier, Susan M; Patel, Tanvi; Strenge, Karen; Mosier, Andrew D

    2012-12-01

    Less than 10% of chondrosarcomas occur in children. In addition, as little as 0.5% of low-grade chondrosarcomas arise secondarily from benign chondroid lesions. The presence of focal pain is often used to crudely distinguish a chondrosarcoma (which is usually managed with wide surgical excision), from a benign chondroid lesion (which can be followed by clinical exams and imaging surveillance). Given the difficulty of localizing pain in the pediatric population, initial radiology findings and short-interval follow-up, both imaging and clinical, are critical to accurately differentiate a chondrosarcoma from a benign chondroid lesion. To our knowledge, no case in the literature discusses a chondrosarcoma possibly arising secondarily from an enchondroma in a pediatric patient. We present a clinicopathologic and radiology review of conventional chondrosarcomas. We also attempt to further the understanding of how to manage a chondroid lesion in the pediatric patient with only vague or bilateral complaints of pain. PMID:23365701

  1. Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations

    PubMed Central

    Sharma, Raju; Madhusudhan, Kumble S; Ahuja, Vineet

    2016-01-01

    Intestinal tuberculosis is a common clinical problem in India. The clinical features of this disease are nonspecific and can be very similar to Crohn's disease. Radiological evaluation of the small bowel has undergone a paradigm shift in the last decade. This long tubular organ that has traditionally been difficult to evaluate can now be well-visualized by some innovative imaging and endoscopic techniques. This article highlights the state-of-the-art evaluation of ulceroconstrictive diseases of the bowel and provides recommendations for the differentiation of intestinal tuberculosis from Crohn's disease. PMID:27413261

  2. Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations.

    PubMed

    Sharma, Raju; Madhusudhan, Kumble S; Ahuja, Vineet

    2016-01-01

    Intestinal tuberculosis is a common clinical problem in India. The clinical features of this disease are nonspecific and can be very similar to Crohn's disease. Radiological evaluation of the small bowel has undergone a paradigm shift in the last decade. This long tubular organ that has traditionally been difficult to evaluate can now be well-visualized by some innovative imaging and endoscopic techniques. This article highlights the state-of-the-art evaluation of ulceroconstrictive diseases of the bowel and provides recommendations for the differentiation of intestinal tuberculosis from Crohn's disease. PMID:27413261

  3. Nonurgent aortic disease: clinical-radiological diagnosis of aortitis.

    PubMed

    Cabero Moyano, J; Andreu Magarolas, M; Castañer González, E; Gallardo Cistaré, X; Belmonte Castan, E

    2013-01-01

    Aortitis is a pathological term designating inflammation of the aortic wall, regardless of its cause. The clinical presentation of aortitis is nonspecific and variable. Symptoms include abdominal pain, fever, and weight loss; acute phase reactants may also be elevated. Aortitis can be caused by a wide spectrum of entities, including from infectious processes to autoimmune diseases (Takayasu arteritis and giant cell arteritis are among the most common of these causing aortitis), and the prognosis and treatment of these entities vary widely. Various imaging techniques can be used to evaluate the lumen and wall of the aorta (such as multidetector computed tomography, magnetic resonance imaging, angiography, or PET-CT). This review focuses on the most common diseases that cause aortitis and on the clinical and radiological findings that are most useful for diagnosing and treating this condition appropriately. PMID:23891316

  4. Presumed Perinatal Stroke: Risk Factors, Clinical and Radiological Findings.

    PubMed

    Ilves, Pilvi; Laugesaar, Rael; Loorits, Dagmar; Kolk, Anneli; Tomberg, Tiiu; Lõo, Silva; Talvik, Inga; Kahre, Tiina; Talvik, Tiina

    2016-04-01

    It is unknown why some infants with perinatal stroke present clinical symptoms late during infancy and will be identified as infants with presumed perinatal stroke. The risk factors and clinical and radiological data of 42 infants with presumed perinatal stroke (69% with periventricular venous infarction and 31% with arterial ischemic stroke) from the Estonian Pediatric Stroke Database were reviewed. Children with presumed perinatal stroke were born at term in 95% of the cases and had had no risk factors during pregnancy in 43% of the cases. Children with periventricular venous infarction were born significantly more often (82%) vaginally (P = .0213) compared to children with arterial stroke (42%); nor did they require resuscitation (P = .0212) or had any neurological symptoms after birth (P = .0249). Periventricular venous infarction is the most common type of lesion among infants with the presumed perinatal stroke. Data suggest that the disease is of prenatal origin. PMID:26446909

  5. [Modern clinical and radiological approach to diagnostics of odontogenic sinusitis].

    PubMed

    Khomutova, E Yu; Ignat'ev, Yu T; Demyanchuk, A N; Demyanchuk, A B

    2015-01-01

    Inflammatory diseases of the maxillary sinuses affect up to 70% of the adult population. Odontogenic maxillary sinusitis represents 13-86% of the inflammatory processes of maxillofacial area, with the incidence range being explained rather by varying diagnosis criteria than the true incidence difference of odontogenic lesions. The aim of the study was to summarize the clinical and radiological characteristics of odontogenic sinusitis according to patients records in the Department of Maxillofacial Surgery of Omsk Clinical Hospital No11 and the oral surgery department of BUZ GKSP No1 in 2009-2014. A total of 948 records of patient (aged 17 to 68 years) with maxillary sinusitis were identified. X-ray examinations were performed by CT PISASSO TRIO ("KoYo", South Korea) and MSCT Brillians 6 and Brillians 64 ((Philips HealthCare), Netherlands). Images were obtained in axial projection with slice thickness of 0.2-0.6 mm with multiplanar reconstructions (MPR) in a variety of direct and oblique projections. Altogether 664 patients were diagnosed with foreign bodies in the maxillary sinuses (filling material in 569 cases, roots or root fragments? implants, rubber drains, fragments of endodontic instruments in 95 cases). In 284 persons odontogenic cysts were found. Almost every fifth case was complicated by mycotic infection. Analysis of the results showed that only a multidisciplinary approach including dentists, maxillofacial surgeons, otolaryngologists and radiologists, as well as dental volumetric tomography or multislice CT can ensure the correct clinical and radiological approaches to determine the tactics of treatment in patients with sinusitis, reduce the incidence of relapses and chronic inflammatory processes in the maxillary sinuses. PMID:26953424

  6. Clinical and Radiologic Disease in Smokers With Normal Spirometry

    PubMed Central

    Regan, Elizabeth A.; Lynch, David A.; Curran-Everett, Douglas; Curtis, Jeffrey L.; Austin, John H. M.; Grenier, Philippe A.; Kauczor, Hans-Ulrich; Bailey, William C.; DeMeo, Dawn L.; Casaburi, Richard H.; Friedman, Paul; Van Beek, Edwin J. R.; Hokanson, John E.; Bowler, Russell P.; Beaty, Terri H.; Washko, George R.; Han, MeiLan K.; Kim, Victor; Kim, Song Soo; Yagihashi, Kunihiro; Washington, Lacey; McEvoy, Charlene E.; Tanner, Clint; Mannino, David M.; Make, Barry J.; Silverman, Edwin K.; Crapo, James D.

    2015-01-01

    IMPORTANCE Airflow obstruction on spirometry is universally used to define chronic obstructive pulmonary disease (COPD), and current or former smokers without airflow obstruction may assume that they are disease free. OBJECTIVE To identify clinical and radiologic evidence of smoking-related disease in a cohort of current and former smokers who did not meet spirometric criteria for COPD, for whom we adopted the discarded label of Global Initiative for Obstructive Lung Disease (GOLD) 0. DESIGN, SETTING, AND PARTICIPANTS Individuals from the Genetic Epidemiology of COPD (COPDGene) cross-sectional observational study completed spirometry, chest computed tomography (CT) scans, a 6-minute walk, and questionnaires. Participants were recruited from local communities at 21 sites across the United States. The GOLD 0 group (n = 4388) (ratio of forced expiratory volume in the first second of expiration [FEV1] to forced vital capacity >0.7 and FEV1 ≥80% predicted) from the COPDGene study was compared with a GOLD 1 group (n = 794), COPD groups (n = 3690), and a group of never smokers (n = 108). Recruitment began in January 2008 and ended in July 2011. MAIN OUTCOMES AND MEASURES Physical function impairments, respiratory symptoms, CT abnormalities, use of respiratory medications, and reduced respiratory-specific quality of life. RESULTS One or more respiratory-related impairments were found in 54.1% (2375 of 4388) of the GOLD 0 group. The GOLD 0 group had worse quality of life (mean [SD] St George’s Respiratory Questionnaire total score, 17.0 [18.0] vs 3.8 [6.8] for the never smokers; P < .001) and a lower 6-minute walk distance, and 42.3% (127 of 300) of the GOLD 0 group had CT evidence of emphysema or airway thickening. The FEV1 percent predicted distribution and mean for the GOLD 0 group were lower but still within the normal range for the population. Current smoking was associated with more respiratory symptoms, but former smokers had greater emphysema and gas trapping

  7. [Anterior cervical fusion with tantalum interbody implants. Clinical and radiological results in a prospective study].

    PubMed

    Vicario, C; Lopez-Oliva, F; Sánchez-Lorente, T; Zimmermann, M; Asenjo-Siguero, J J; Ladero, F; Ibarzábal, A

    2006-04-01

    Anterior cervical discectomy and interbody fusion (ACDF) is a widely accepted surgical technique in the treatment of cervical disc disease. Tantalum cages have been recently introduced in spine surgery for interbody fusion because of the advantages of their mechanical properties. We present the results of a prospective clinical and radiological study on 24 consecutive patients who underwent an ACDF with tantalum cages. Clinical evaluation was assessed preoperatively and after surgery by a questionnaire that included a Visual Analogic Scale (VAS) of neck and arm pain, the Oswestry Disability Index and the Zung Depression Scale. Results were classified by Odom's criteria. Radiological evaluation included flexion-extension X-rays, and changes in distance between spinous processes and Cobb angle were measured. Postoperatively patients were reviewed 3 and 12 months after surgery. A statistical significative improvement in all clinical data was reported. According to Odom's criteria in 75% of patients the results were considered like excellent or good. Only one case of radiological and clinical pseudoarthrosis was confirmed. No significative differences were reported 3 and 12 months after surgery. Tantalum cages are a very promising and usefull alternative among implants available for ACDF. Compatibility with MRI postoperative studies and the unnecessariness of autograft are some of their advantages. PMID:16721480

  8. Chordoid glioma: a rare radiologically, histologically, and clinically mystifying lesion.

    PubMed

    Bongetta, Daniele; Risso, Andrea; Morbini, Patrizia; Butti, Giorgio; Gaetani, Paolo

    2015-01-01

    Chordoid glioma (CG) is a rare central nervous system neoplasm (WHO grade II) of uncertain origin whose typical localization is in the anterior part of the third ventricle. Its clinical, radiological, and histological features may vary and furthermore mimic other kind of benign lesions usually associated with a better outcome. We report a case of a 43-year-old female who underwent gross total removal of a lesion of the third ventricle causing hydrocephalus. The imaging studies and the intraoperative examination led at first to a hypothesis of meningioma. Early surgical and neurological outcomes were good. The patient underwent multiple complications related to hypothalamic dysfunctions and thrombohemorragic issues and eventually died because of systemic infections. Definitive examination was of chordoid glioma of the third ventricle. Reviewing literature, we evaluated possible pitfalls in radiological and histological diagnosis as well as in surgical and medical treatment of CGs. Despite their benign presentation, a high incidence of multiple possible severe complications is reported. Early alertness and combined treatment strategies could improve overall CGs treatment strategies. PMID:26018908

  9. Radiological dosimetry measurements in Costa Rica

    NASA Astrophysics Data System (ADS)

    León, M.; Santos, F.

    2016-07-01

    The main cause of human exposure to artificial radiation corresponds to medical applications, so it is essential to reduce the dose to patients, workers and consequently the entire population [1]. Although there is no dose limit for patients, is necessary to reduce it to a minimum possible while still getting all the necessary diagnostic information, taking economic and social factors into account [2]. Based on this proposal, agencies such as the International Atomic Energy Agency has been dedicated to providing guidelines levels, whose function is to serve as standards for the optimization of the medical exposure [3]. This research was created as a preliminary survey with the claim of eventually determine the guidance levels in Costa Rica for three different studies of general radiology: Lumbar Spine-AP, Chest - PA and Thoracic Spine - AP (for screens with speeds of 400 and 800), and cranio-caudal study in mammography, applied to Costa Rica's adult population, perform properly in the institutions of Caja Costarricense del Seguro Social (CCSS).

  10. Clinical and Radiological Presentations of Late-Onset Spondyloarthritis

    PubMed Central

    Hmamouchi, Ihsane; Bahiri, Rachid; Hajjaj-Hassouni, Najia

    2011-01-01

    The last few years have witnessed considerable progress in the diagnosis and treatment of spondyloarthritis (SpA). Tools are now available for establishing the diagnosis at an early stage, when appropriate treatment may be able to control the inflammatory process, limit the functional impairments, and improve quality of life. Late-onset SpA after the age of 50 years is uncommon. All the spondyloarthritis subgroups are represented in the elderly. Thus, late onset spondyloarthritis is underdiagnosed in favour of other inflammatory disorders that are more frequently observed in the elderly because the clinical or radiological presentations of late-onset spondyloarthritis are modified in the elderly. They deserve further attention because age population is increasing and new criteria for axial SpA including sacroiliitis detected by MRI may help the clinician with diagnosis. Specific studies evaluating the benefit/risk ratio of TNFα-blocking agents in late onset SpA patients are required. PMID:23509636

  11. Radiological Disaster Simulators for Field and Aerial Measurements

    SciTech Connect

    H. W. Clark, Jr

    2002-11-01

    Simulators have been developed to dramatically improve the fidelity of play for field monitors and aircraft participating in radiological disaster drills and exercises. Simulated radiological measurements for the current Global Positioning System (GPS) location are derived from realistic models of radiological consequences for accidents and malicious acts. The aerial version outputs analog pulses corresponding to the signal that would be produced by various NaI (Tl) detectors at that location. The field monitor version reports the reading for any make/model of survey instrument selected. Position simulation modes are included in the aerial and field versions. The aerial version can generate a flight path based on input parameters or import an externally generated sequence of latitude and longitude coordinates. The field version utilizes a map-based point and click/drag interface to generate individual or a sequence of evenly spaced instrument measurements.

  12. Radiological findings and the clinical importance of megacalycosis

    PubMed Central

    Kalaitzis, Christos; Patris, Emmanuel; Deligeorgiou, Evangelia; Sountoulides, Petros; Bantis, Athanasios; Giannakopoulos, Stilianos; Touloupidis, Stavros

    2015-01-01

    Objective To describe the radiological findings and the clinical importance of megacalycosis. Materials and methods On the basis of a case report and literature review, diagnostic criteria and clinical significance of megacalycosis are presented. Result Megacalycosis is mostly asymptomatic and is usually discovered either accidentally or as a result of its complications, such as stone formation, flank pain, hematuria, infection, and fever. The renal pelvis, infundibulum, and ureter are not dilated. Calyces have a semilunar configuration rather than the conventional triangular or conical form. The tip of each pyramid is flat, and the calyces possess neither fornix nor papillae impressions. The number of calyces is increased compared to the healthy condition, typically from 20–25. The renal parenchyma has a normal width but with a slight narrowing of the renal medulla. The kidney exhibits normal function, in particular with respect to its ability to concentrate the urine. Conclusion Megacalycosis is a rare, usually unilateral dilatation of the kidney calyces in the presence of a normal, undilated renal pelvis and ureter. Its pathological significance lies in the occurrence of complications. PMID:26528455

  13. Performance evaluation of diagnostic radiology dosimeters in clinical and calibration x-ray beams.

    PubMed

    Hourdakis, Costantine John; Boziari, Argyro; Manetou, Aggeliki

    2010-05-01

    Diagnostic radiology dosimeters should comply with International Electrotechnical Commission (IEC) 61674 standard in order to perform measurements with sufficient accuracy and reliability. The calibration of a dosimeter is performed under, and pertains to, reference conditions. However, in most cases, dosimeters are used for clinical measurements under non-reference conditions. The performance, in terms of accuracy of dose measurements, of six commercial diagnostic radiology dosimeters was tested at reference calibration and at clinical non-reference conditions. The results showed that all dosimeters being tested exhibited limits of variation within the +/-5% IEC limits. Depending on the detector's physical and operational properties, the dosimeters' energy dependence of response values varied from -4.7% to +4.2%. To address this variation of response, calibration at three radiation qualities (RQR 3, RQR 5, and RQR 9), at least, is recommended. Different irradiation conditions such as air kerma rate, x-ray tube design, x-ray system, and dosimeter operational modes affect the dosimeters' response by less than 3%. A dosimeter that complies with IEC standards and operates according to its specifications could be used at typical clinical irradiation conditions taking into account only corrections for the energy dependence of response. In this case, the error in dose accuracy is expected to be less than 3%. PMID:20386200

  14. Intraorbital foreign body: clinical presentation, radiological appearance and management.

    PubMed

    Al-Mujaini, Abdullah; Al-Senawi, Rana; Ganesh, Anuradha; Al-Zuhaibi, Sana; Al-Dhuhli, Humoud

    2008-03-01

    Intraorbital foreign bodies usually occur after a high velocity injury such as gunshot or industrial accidents; more rarely they occur following trivial trauma. A retained foreign body can give rise to serious complications, the most devastating of which is loss of the eye. This retrospective, interventional case report reviews the clinical features, radiological appearance and surgical management of two patients who presented at Sultan Qaboos University Hospital, Oman with intraorbital foreign bodies. Details of ocular history, preoperative ocular examination findings including visual acuity, surgical procedure and subsequent management were noted. The two patients, aged 10 years and 9 years old respectively, sustained orbital trauma with sharp objects. Both patients were found to have intraorbital foreign bodies that were documented clearly by computed tomography (CT) scans of the orbit. The first patient presented straight after injury, had no ocular involvement, underwent immediate surgical exploration and ended up with full recovery. The second patient presented to us after a delay of 4 days, and was found to have endophthalmitis. This patient ultimately lost all visual function in the affected eye. A CT scan is the modality of choice for orbital foreign body detection and localization. Early surgical exploration and foreign body extraction greatly influence the visual prognosis and final outcome. PMID:21654960

  15. Clinical, radiological, histological, and molecular characteristics of paediatric epithelioid glioblastoma

    PubMed Central

    Broniscer, Alberto; Tatevossian, Ruth G.; Sabin, Noah D.; Klimo, Paul; Dalton, James; Lee, Ryan; Gajjar, Amar; Ellison, David W.

    2014-01-01

    Aims A few case series in adults have described the characteristics of epithelioid glioblastoma (e-GB), one of the rarest variants of this cancer. We evaluated clinical, radiological, histological, and molecular characteristics in the largest series to date of paediatric e-GB. Methods Review of clinical characteristics and therapy, imaging studies, and histology was performed in patients younger than 22 years with e-GB seen at our institution over 15 years. Sequencing of hotspot mutations and FISH of relevant genes were undertaken. Results Median age at diagnosis of six patients was 7.6 years. Tumours originated in the cerebral cortex (n=2) or diencephalon (n=4). Three patients presented with acute, massive haemorrhage and three had leptomeningeal dissemination at diagnosis. Paediatric e-GB had the typical histological characteristics seen in adult tumours. Universal immunoreactivity for INI1 and lack of diverse protein expression were seen in all cases. One tumour had a chromosome 22q loss. Three tumours (50%) harboured a BRAF: p.V600E. One thalamic tumour had an H3F3A p.K27M. All patients received radiation therapy with (n=3) or without chemotherapy (n=3). All patients experienced tumour progression with a median survival of 169 days. One patient with non-metastatic disease had early leptomeningeal progression. Two patients had symptomatic tumour spread outside the central nervous system (CNS) through a ventriculo-peritoneal shunt. One additional patient had widespread metastases outside the CNS identified at autopsy. Conclusions Paediatric e-GBs are rare cancers with an aggressive behaviour that share histological and genetic characteristics with their adult counterparts. BRAF inhibition is a potential treatment for these tumours. PMID:24127995

  16. [Radiologic medical desktop conferences--clinical evaluation of the KAMEDIN teleradiology system in routine practice of a radiologic institute].

    PubMed

    Bolte, R; Lehmann, K J; Walz, M; Loose, R; Lütgemeier, J; Seibert, F; Busch, C; Schinkmann, M; Georgi, M

    1996-07-01

    KAMEDIN is a teleradiology project of "Deutsche Telekom". ISDN based image transfer, visualisation and online-presentation of digital radiological images is performed. In this study the suitability of the KAMEDIN-system has been tested in a clinical environment. The software has been adapted to the requirements of radiological image visualisation. During 6 months over 50 conferences took place with an average of 36 CT-slices per patient. The amount of time was approximately 10 min for conference preparation, 20 min for image transfer and 8 min for conferencing. Software problems occurred and were solved. Image quality on the monitor as well as online presentation including "simultaneous cursors" showed high performance and achieved high acceptance by the clinicians. Thus KAMEDIN is a useful teleradiology system, especially if the system is adapted to the requirements of radiology departments. PMID:8924455

  17. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    PubMed

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta. PMID:26858185

  18. Overview and future direction for x-radiology measurements

    SciTech Connect

    Graber, H.C.

    1993-12-31

    This paper provides a general overview of methodology and associated imaging measurement requirements required by current published codes and standards and also an insight as to the considerations being addressed in development of new standards. Beginning in the mid 1980`s and continuing into the 1990`s, the use of electronic imaging has increased significantly. As a result, those involved in developing new standards had difficulty with terminology since the term ``radiographic`` was commonly used, however, depending on its use, could have a completely different technical meaning. As a result, ASTM initiated a new term ``Radiology`` for industrial imaging applications. The new term radiology more appropriately addresses both electronic imaging and film imaging and is technically correct. As a result of the increased use of electronic imaging technology, it presents a challenge to address the problems unique to electronic imaging and how these problems are resolved through new code and standard requirements.

  19. Citizenship in radiology: defining a concept and proposing its measure.

    PubMed

    Lee, Christoph I; Herrington, William T; Donner, E Michael; Bluth, Edward I

    2013-06-01

    Merely suggesting that radiologists answer the call to bolster and secure the future of their own specialty has not resulted in increased activism. Therefore, the ACR Commission on Human Resources has developed a definition for the concept of citizenship in radiology and explicit descriptions of the activities associated with it. Furthermore, the authors introduce a methodology for the measurement and valuation of individual radiologists' contributions to group practices and to the specialty as a whole. These measures can in turn be used to promote, acknowledge, recognize, and incentivize citizenship activity among radiologists at the local, regional, and national levels. PMID:23583084

  20. Clinical routine operation of a filmless radiology department: three years experience

    NASA Astrophysics Data System (ADS)

    Mosser, Hans M.; Paertan, Gerald; Hruby, Walter

    1995-05-01

    This paper communicates the operational implementation of filmless digital radiology in clinical routine, its feasibility and its effect on the radiology profession, based on the three years clinical experience from the filmless digital radiology department of the Danube Hospital, a major teaching hospital in Vienna, Austria, with currently 850 acute-care beds. Since April 1992 all radiological modalities are reported from the monitors of 16 reporting consoles in the radiology department. Images and reports are distributed by the hospital-wide network (Sienet, Siemens Medical Systems, Erlangen), and can be viewed on 60 display consoles throughout the hospital. Filmless radiology primarily is an efficient hospital-wide infrastructure to deliver radiological services along with other medical information, providing safe and fast access to this information anytime and anywhere, necessary for the conduct of the diagnostic and therapeutic task of patient care. In a comparative study of the Danube Hospital with the film based Rudolfstiftung Hospital in Vienna, we found a significant decrease of the mean patient length of hospital stay (1.99 to 3.72 days) that partially might be attributed to the implementation of filmless radiology.

  1. Radiology Quality Measure Compliance Reporting: an Automated Approach.

    PubMed

    Kohli, Marc; Schonlau, Duane

    2016-06-01

    As part of its ongoing effort to improve healthcare quality, the Center of Medicare and Medicaid Services (CMS) has transitioned from monetary rewards to reimbursement penalties for noncompliance or nonparticipation with its quality measurement initiatives. More specifically, eligible providers who bill for CMS patient care, such as radiologists, will face a 2 % negative payment adjustment, if they fail to report adequate participation and compliance with sufficient CMS quality measures in 2015. Although several methods exist to report participation and compliance, each method requires the gathering of relevant studies and assessing the reports for compliance. To aid in this data gathering and to prevent reduced reimbursements, radiology groups should consider implementing automated processes to monitor compliance with these quality measure standards. This article describes one method of creating an automated report scanner, utilizing an open source interface engine called Mirth Connect, that may facilitate the data gathering and monitoring related to reporting compliance with CMS standard #195 Stenosis measurement in Ultrasound Carotid Imaging Reports. The process described in this article is currently utilized by a large multi-institutional radiology group to assess for report compliance and offers the user near real time surveillance of compliance with the quality measure. PMID:26510752

  2. Clinical and Radiological Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations

    SciTech Connect

    Andersen, Poul Erik Kjeldsen, Anette D.

    2006-02-15

    The purpose was to evaluate the clinical and radiological long-term results of embolization of pulmonary arteriovenous malformations (PAVMs) and to assess the quality of life after treatment. A clinical follow-up was undertaken after 67 months (mean) in 35 consecutive patients with 106 PAVMs. Outcome parameters at follow-up were PaO{sub 2} and patients' satisfaction. During follow-up, the patients had a clinical examination, measurement of arterial blood gases, chest X-ray, and contrast echocardiography performed and were asked to fill in a questionnaire exploring experience of the treatment and subjective effect of treatment on physical and social functioning. A significant rise in oxygenation of the blood after embolization was measured. In 77% of the patients symptoms improved, and 71% felt better performance. In eight patients, one of the PAVMs was found insufficiently embolized or recanalized at follow-up angiography and therefore were re-embolized. Endovascular embolization for PAVMs is effective. Clinical parameters and quality of life improved significantly. Regular clinical controls after therapy are necessary to discover insufficiently embolized, recanalized or new PAVMs.

  3. Joint Probability Models of Radiology Images and Clinical Annotations

    ERIC Educational Resources Information Center

    Arnold, Corey Wells

    2009-01-01

    Radiology data, in the form of images and reports, is growing at a high rate due to the introduction of new imaging modalities, new uses of existing modalities, and the growing importance of objective image information in the diagnosis and treatment of patients. This increase has resulted in an enormous set of image data that is richly annotated…

  4. Clinical radiology of the spine and spinal cord

    SciTech Connect

    Banna, M.

    1985-01-01

    This book is a source of information about aspects of radiology of the spine and spinal column. It presents coverage of both normal and abnormal conditions. Contents: Spinal fractures and dislocations. Degenerative diseases of the spine. Gross anatomy of the spinal cord and meninges. Intraspinal mass lesions. Spinal dysraphism. Congenital anomalies. Tumors of the vertebral column, and more.

  5. Natural Language Processing Technologies in Radiology Research and Clinical Applications.

    PubMed

    Cai, Tianrun; Giannopoulos, Andreas A; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K; Rybicki, Frank J; Mitsouras, Dimitrios

    2016-01-01

    The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively "mine" these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. "Intelligent" search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. PMID:26761536

  6. Clinical diagnostic radiology and radiation therapy. Special listing

    SciTech Connect

    Not Available

    1981-08-01

    This Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Radiologic methods in cancer diagnosis; Radiotherapy methods in cancer treatment; Radiotherapy of specific body sites; Radiation injury and pathology; Radiation dosimetry and dose fractionation studies; Broad cancer radiotherapy programs.

  7. My approach to interstitial lung disease using clinical, radiological and histopathological patterns

    PubMed Central

    Leslie, K O

    2009-01-01

    The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting. The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis. A pattern-based histopathological approach to interstitial lung disease provides a “map” for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation. PMID:19398592

  8. Can clinical and radiological findings predict surgery for lumbar disc herniation? A systematic literature review

    PubMed Central

    White, Andrew P.; Harrop, James; Dettori, Joseph R.

    2012-01-01

    Study design: Systematic review. Objective or clinical question: What clinical and radiological findings in patients with lumbar-herniated nucleus pulposus can serve as predictors of surgical intervention? Methods: Articles published between January 1975 and August 2011 were systematically reviewed using Pubmed, Cochrane, National Guideline Clearinghouse Databases, and bibliographies of key articles. Each article was subject to quality rating and was analyzed by two independent reviewers. Results: From 123 citations, 21 underwent full-text review. Four studies met inclusion criteria. Only baseline disability as measured by the Roland Disability Index (RDI) or the Oswestry Disability Index (ODI) was consistently associated with a greater likelihood of having discectomy surgery across multiple studies. With the current literature, we were not able to find an association between surgery and several characteristics including smoking status, body mass index, neurological deficit, positive straight leg testing, and level of herniation. Conclusions: From the limited data available, it appears that individual radiographic and clinical features are not able to predict the likelihood of surgical intervention. Higher baseline disability measurements (Oswestry and Roland) did correlate, however, with surgical treatment. PMID:23236305

  9. Radiology.

    PubMed

    Patel, Ketan; Wallace, Roxanne; Busconi, Brian D

    2011-04-01

    Hip and groin pain are a common complaint among athletes of all ages, and may result from an acute injury or from chronic, repetitive trauma. Hip injuries can be intraarticular, extraarticular, or both. Labral abnormalities may occur in asymptomatic patients as well as in those with incapacitating symptoms and signs. Athletic hip injury leading to disabling intraarticular hip pain most commonly involves labral tear. The extraarticular causes are usually the result of overuse activity, leading to inflammation, tendonitis, or bursitis. In clinical practice, the term athletic pubalgia is used to describe exertional pubic or groin pain. PMID:21419955

  10. Biomimetic hydroxyapatite used in the treatment of periodontal intrabony pockets: clinical and radiological analysis

    PubMed Central

    Figliuzzi, Michele Mario; Giudice, Amerigo; Pileggi, Settimia; Scordamaglia, Francesco; Marrelli, Massimo; Tatullo, Marco; Fortunato, Leonzio

    2016-01-01

    Summary Aim Hydroxyapatite (PA) has a chemical composition and physical structure very similar to natural bone and therefore it has been considered to be the ideal biomaterial able to ensure a biomimetic scaffold to use in bone tissue engineering. The aim of this study is to clinically test hydroxyapatite used as osteoconductive biomaterial in the treatment of periodontal bone defects. Clinical and radiological evaluations were conducted at 6, 12 and 18 months after the surgery. Materials and methods Forty patients with 2- and 3-wall intrabony pockets were enrolled in this study. PPD, CAL, radiographic depth (RD) and angular defects were preoperatively measured. After surgery, patients were re-evaluated every 6 months for 18 months. Statistical analyses were also performed to investigate any differences between preoperative and postoperative measurements. Results Paired t-test samples conducted on the data obtained at baseline and 18 months after, showed significant (p<0.01) differences in each measurement performed. The role of preoperative RD was demonstrated to be a significant key factor (p<0.01). A relevant correlation between preoperative PPD and CAL gain was also found. Conclusions Within the limitations of this study, the absence of anatomical variables, except the morphology of the bone defect, emphasizes the importance of the proper surgical approach and the graft material used. PMID:27486507

  11. Clinical compliance of viewing conditions in radiology reporting environments against current guidelines and standards

    NASA Astrophysics Data System (ADS)

    Daly, S.; Rainford, L.; Butler, M. L.

    2014-03-01

    Several studies have demonstrated the importance of environmental conditions in the radiology reporting environment, with many indicating that incorrect parameters could lead to error and misinterpretation. Literature is available with recommendations as to the levels that should be achieved in clinical practice, but evidence of adherence to these guidelines in radiology reporting environments is absent. This study audited the reporting environments of four teleradiologist and eight hospital based radiology reporting areas. This audit aimed to quantify adherence to guidelines and identify differences in the locations with respect to layout and design, monitor distance and angle as well as the ambient factors of the reporting environments. In line with international recommendations, an audit tool was designed to enquire in relation to the layout and design of reporting environments, monitor angle and distances used by radiologists when reporting, as well as the ambient factors such as noise, light and temperature. The review of conditions were carried out by the same independent auditor for consistency. The results obtained were compared against international standards and current research. Each radiology environment was given an overall compliance score to establish whether or not their environments were in line with recommended guidelines. Poor compliance to international recommendations and standards among radiology reporting environments was identified. Teleradiology reporting environments demonstrated greater compliance than hospital environments. The findings of this study identified a need for greater awareness of environmental and perceptual issues in the clinical setting. Further work involving a larger number of clinical centres is recommended.

  12. Radiologic and Clinical Bronchiectasis Associated with Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Moua, Teng; Zand, Ladan; Hartman, Robert P.; Hartman, Thomas E.; Qin, Dingxin; Peikert, Tobias; Qian, Qi

    2014-01-01

    Background Polycystin 1 and 2, the protein abnormalities associated with autosomal dominant polycystic kidney disease (ADPKD), are also found in airway cilia and smooth muscle cells. There is evidence of increased radiologic bronchiectasis associated with ADPKD, though the clinical and functional implications of this association are unknown. We hypothesized an increased prevalence of both radiologic and clinical bronchiectasis is associated with APDKD as compared to non-ADPKD chronic kidney disease (CKD) controls. Materials and Methods A retrospective case-control study was performed at our institution involving consecutive ADPKD and non-ADPKD chronic kidney disease (CKD) patients seen over a 13 year period with both chest CT and PFT. CTs were independently reviewed by two blinded thoracic radiologists. Manually collected clinical data included symptoms, smoker status, transplant history, and PFT findings. Results Ninety-two ADPKD and 95 non-ADPKD CKD control patients were compared. Increased prevalence of radiologic bronchiectasis, predominantly mild lower lobe disease, was found in ADPKD patients compared to CKD control (19 vs. 9%, P = 0.032, OR 2.49 (CI 1.1–5.8)). After adjustment for covariates, ADPKD was associated with increased risk of radiologic bronchiectasis (OR 2.78 (CI 1.16–7.12)). Symptomatic bronchiectasis occurred in approximately a third of ADPKD patients with radiologic disease. Smoking was associated with increased radiologic bronchiectasis in ADPKD patients (OR 3.59, CI 1.23–12.1). Conclusions Radiological bronchiectasis is increased in patients with ADPKD particularly those with smoking history as compared to non-ADPKD CKD controls. A third of such patients have symptomatic disease. Bronchiectasis should be considered in the differential in ADPKD patients with respiratory symptoms and smoking history. PMID:24747723

  13. Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

    SciTech Connect

    Casimiro de Deus Cardoso, Cejana; Giordani, Adelmo Jose; Borri Wolosker, Angela Maria; Souhami, Luis; Gois Manso, Paulo; Souza Dias, Rodrigo; Comodo Segreto, Helena Regina; Araujo Segreto, Roberto

    2012-03-01

    Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.

  14. Cerebro-costo-mandibular syndrome: Clinical, radiological, and genetic findings.

    PubMed

    Tooley, Madeleine; Lynch, Danielle; Bernier, Francois; Parboosingh, Jillian; Bhoj, Elizabeth; Zackai, Elaine; Calder, Alistair; Itasaki, Nobue; Wakeling, Emma; Scott, Richard; Lees, Melissa; Clayton-Smith, Jill; Blyth, Moira; Morton, Jenny; Shears, Debbie; Kini, Usha; Homfray, Tessa; Clarke, Angus; Barnicoat, Angela; Wallis, Colin; Hewitson, Rebecca; Offiah, Amaka; Saunders, Michael; Langton-Hewer, Simon; Hilliard, Tom; Davis, Peter; Smithson, Sarah

    2016-05-01

    Cerebro-Costo-Mandibular syndrome (CCMS) is a rare autosomal dominant condition comprising branchial arch-derivative malformations with striking rib-gaps. Affected patients often have respiratory difficulties, associated with upper airway obstruction, reduced thoracic capacity, and scoliosis. We describe a series of 12 sporadic and 4 familial patients including 13 infants/children and 3 adults. Severe micrognathia and reduced numbers of ribs with gaps are consistent findings. Cleft palate, feeding difficulties, respiratory distress, tracheostomy requirement, and scoliosis are common. Additional malformations such as horseshoe kidney, hypospadias, and septal heart defect may occur. Microcephaly and significant developmental delay are present in a small minority of patients. Key radiological findings are of a narrow thorax, multiple posterior rib gaps and abnormal costo-transverse articulation. A novel finding in 2 patients is bilateral accessory ossicles arising from the hyoid bone. Recently, specific mutations in SNRPB, which encodes components of the major spliceosome, have been found to cause CCMS. These mutations cluster in an alternatively spliced regulatory exon and result in altered SNRPB expression. DNA was available from 14 patients and SNRPB mutations were identified in 12 (4 previously reported). Eleven had recurrent mutations previously described in patients with CCMS and one had a novel mutation in the alternative exon. These results confirm the specificity of SNRPB mutations in CCMS and provide further evidence for the role of spliceosomal proteins in craniofacial and thoracic development. © 2016 Wiley Periodicals, Inc. PMID:26971886

  15. Hashimoto encephalopathy: A study of the clinical profile, radiological and electrophysiological correlation in a Tertiary Care Center in South India

    PubMed Central

    Sharma, Pattanagere Manjunatha Suryanarayana; Javali, Mahendra; Mahale, Rohan; Madhusudhan, Byadarahalli Kempegowda; Majeed, Anas Abdul; Srinivasa, Rangasetty

    2015-01-01

    Background: Hashimoto encephalopathy (HE) is a poorly understood and often misdiagnosed entity with variable clinical spectrum. There are many uncertainties that still remain about this condition and the pathological significance of thyroid peroxidase (TPO) antibody. Objective: To characterize the clinical, laboratory and radiologic findings in patients with HE. Design: Retrospective analysis of clinical features and diagnostic test data. Main Outcome Measures: Clinical features, laboratory, radiologic, electroencephalography (EEG) findings associated with HE and therapeutic outcome. Results: Thirteen consecutive patients were identified as having HE. The median age at onset was 48.5 years (range, 19–62 years). There was a female preponderance (76.9%). Clinical manifestations were cognitive impairment and behavioral changes in 10 (76.9%), sleep disturbance in 9 (69.2%), seizures in 6 (46.1%), headache in 4 (30.8%), psychosis or paranoia in 5 (38.5%), transient symptoms in 6 (46.1%), myoclonus in 4 (30.8%), ataxia or gait disorder in 4 (30.8%). The most frequent laboratory abnormalities were increased TPO (n = 13) in all cases, increased thyroid stimulating hormone levels (n = 6), and increased erythrocyte sedimentation rate (n = 5). The cerebrospinal fluid protein level was elevated in 8 of 9 patients (88.8%). Magnetic resonance imaging abnormalities were present in 2 patients (15.4%). EEG changes were seen in 7 patients (53.8%). All but two patients showed significant therapeutic benefit with steroids. Conclusions: HE has a wide range of clinical, laboratory, and radiologic findings. All patients with an unexplained encephalopathy should be screened for this condition as treatment response is excellent. To the best of our knowledge, this is the largest single center clinical series of HE from the Indian subcontinent. PMID:26167010

  16. Extracting numeric measurements and temporal coordinates from Japanese radiological reports

    NASA Astrophysics Data System (ADS)

    Imai, Takeshi; Onogi, Yuzo

    2004-04-01

    Medical records are written mainly, in natural language. The focus of this study is narrative radiological reports written in natural Japanese. These reports cannot be used for advanced retrieval, data mining, and so on, unless they are stored, using a structured format such as DICOM-SR. The goal is to structure narrative reports progressively, using natural language processing (NLP). Structure has many different levels, for example, DICOM-SR has three established levels -- basic text, enhanced and comprehensive. At the enhanced level, it is necessary to use numerical measurements and spatial & temporal coordinates. In this study, the wording used in the reports was first standardized, dictionaries were organized, and morphological analysis performed. Next, numerical measurements and temporal coordinates were extracted, and the objects to which they referred, analyzed. 10,000 CT and MR reports were separated into 82,122 sentences, and 34,269 of the 36,444 numerical descriptions were tagged. Periods, slashes, hyphens, and parentheses are ambiguously used in the description of enumerated lists, dates, image numbers, and anatomical names, as well as at the end of sentences; to resolve this ambiguity, descriptions were processed, according to the order -- date, size, unit, enumerated list, and abbreviation -- then, the tagged reports were separated into sentences.

  17. [CADASIL: a case with clinical, radiological, histological and genetic diagnoses].

    PubMed

    Posada, I J; García-Morales, I; Martínez, M A; Hoenicka, J; Bermejo, F

    2003-05-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare inherited cerebrovascular disease. The onset of clinical symptoms occurs with migraine with aura, transient ischemic attacks, recurrent subcortical ischemic infarcts, neuropsychiatric changes reaching subcortical dementia. Brain magnetic resonance images show multiple deep cerebral infarcts in white matter and basal ganglia and diffuse leukoencephalopathy. Neuropathologic hallmark consists of deposition of small electron dense granular patches related to the basement membrane of vascular smooth muscle cells with degeneration of smooth muscle cells and media and luminal obliteration. Recently, the genetic characteristics of this disorder have been reported. Missense mutations in notch3 gene localized in chromosome 19 are involved in its pathogenesis. Only three families from Spain have been reported. Here we describe a patient with typical clinical symptoms, neuroimaging and pathology of CADASIL. C406T (Arg110Cys) mutation in notch3 gene was found. We comment on the clinical symptoms of different members of the patient's family. PMID:12721871

  18. Castleman Disease of the Thorax: Clinical, Radiologic, and Pathologic Correlation: From the Radiologic Pathology Archives.

    PubMed

    Kligerman, Seth J; Auerbach, Aaron; Franks, Teri J; Galvin, Jeffrey R

    2016-01-01

    Castleman disease is a complex lymphoproliferative disease pathologically divided into two subtypes, the hyaline vascular variant (HVV) and the plasma cell variant (PCV). The HVV is the most common, is thought to represent a benign neoplasm of lymph node stromal cells, and is treated with surgical resection. It is most commonly found in the mediastinum, where it classically appears as a unicentric, avidly enhancing mass at computed tomography (CT) and magnetic resonance imaging. This appearance can mimic other avidly enhancing mediastinal masses, and location, clinical history, laboratory data, and nuclear medicine single photon emission CT (SPECT) and positron emission tomography (PET) studies can help narrow the differential diagnosis. Multicentric Castleman disease (MCD), which in the majority of cases is composed of the PCV, is an aggressive lymphoproliferative disorder associated with human herpesvirus infection, interleukin 6 dysregulation, and other systemic disorders. While it can be difficult to differentiate MCD from lymphoma, the presence of avidly enhancing lymph nodes can suggest the diagnosis. The purpose of this article is to review the clinical, immunologic, and pathologic findings associated with both unicentric Castleman disease and MCD and discuss how the imaging findings correlate with the pathophysiology of the disease. PMID:27618318

  19. Nonspecific Interstitial Pneumonia/Fibrosis: Clinical Manifestations, Histologic and Radiologic Features

    PubMed Central

    Park, Choon Sik; Jeon, Jin Woo; Park, Sung Woo; Lim, Gune-Il; Jeong, Seong Hwan; Uh, Soo-Taek; Park, Jai Soung; Choi, Deuk Lin; Jin, So Young; Kang, Chang Hee

    1996-01-01

    Objectives Customarily used classification of IPF did not satisfy a sizable group of patients with IPF that in the past had been lumped with UIP and now currently has begun to be recognized as nonspecific interstitial pneumonia/fibrosis (NIP). There are few reports about the clinical features of NIP. Methods The pathologic slides of 66 patients having open lung biopsy (OLB) for the differential diagnosis of interstitial lung diseases (ILD) from 1984 to 1995 were reviewed. Seven cases were confirmed as NIP. The clinical record, pulmonay function tests (PFT), chest PA and HRCT were reviewed and analysed retrospectively. Results Six patients with NIP were female. The median age was 56 years. Mean duration of symptoms was 4 months. Five patients had systemic flu-like symptoms. the most common respiratory symptom was gradual dyspnea Two patients revealed a mild degree of anemia Four cases had leukocytois of more than 10,000/mm3. ESR and CRP O.K. elevated in all measured cases. Anti-nuclear antibody (ANA) was positive in three of six patients and ds-DNA antibody was positive in one of six patients Restrictive pattern of PFT was predominant. Diffusion capacity of carbonmonoxide (DLCO) decreased markedly. In bronchoalveolar lavage (BAL), total cell counts elevated about three times of normal value. On differntial counts of BAL cells, lymphocytes, neutrophils and eosinophils were higher than those of normal controls. The prominent finding of chest radiology was bilaterally patchy opacifications in parenchyme of lower lung zones. On HRCT, bilaterally patchy areas of ground-glass attenuation and/or areas of alveolar consolidation were commonly shown. The number of pathologic type was one case of group I, four cases of group II and two cases of group III. The average period from diagnosis to the last follow-up was 24.8 months. Five patients were clinically recovered to the previously well-being state. Conclusion Patients with NIP had different clinical features from UIP, AIP

  20. Clinical and Radiologic Characteristics of Inferior Rectus Muscle Sheath Entrapment in Orbital Blowout Fracture.

    PubMed

    Bagheri, Abbas; Tavakoli, Mehdi; Khosravifard, Keivan; Yazdani, Shahin

    2015-10-01

    Blowout fracture is a common condition in the oculoplastics clinic. One of the indications for its repair is entrapment of the inferior rectus muscle within the fracture site. Herein, the authors present 3 patients of inferior rectus muscle sheath entrapment without entrapment of the muscle itself. The outcome of treatment was excellent in all patients. The aim of this report is to present the special clinical and radiologic findings in such patients. PMID:26413961

  1. Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation.

    PubMed

    Rubinstein, Tal J; Clemett, John; Birnbach, Charles D; LauKaitis, Steven J; Sires, Bryan S

    2016-01-01

    A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material. PMID:27413562

  2. Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation

    PubMed Central

    Rubinstein, Tal J.; Clemett, John; Birnbach, Charles D.; LauKaitis, Steven J.; Sires, Bryan S.

    2016-01-01

    A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material. PMID:27413562

  3. Pineal cyst: a review of clinical and radiological features.

    PubMed

    Choy, Winward; Kim, Won; Spasic, Marko; Voth, Brittany; Yew, Andrew; Yang, Isaac

    2011-07-01

    Pineal cysts (PCs) are benign and often asymptomatic lesions of the pineal region that are typically small and do not change in size over time. PCs appear as small, well circumscribed, unilocular masses that either reside within or completely replace the pineal gland. This article reviews and discusses the characteristic features of PCs-clinical, histological, and identifiable by various imaging modalities-which assist clinicians in narrowing the differential diagnosis for pineal lesions. PMID:21801982

  4. Magnetoencephalography: Fundamentals and Established and Emerging Clinical Applications in Radiology

    PubMed Central

    2013-01-01

    Magnetoencephalography is a noninvasive, fast, and patient friendly technique for recording brain activity. It is increasingly available and is regarded as one of the most modern imaging tools available to radiologists. The dominant clinical use of this technology currently centers on two, partly overlapping areas, namely, localizing the regions from which epileptic seizures originate, and identifying regions of normal brain function in patients preparing to undergo brain surgery. As a consequence, many radiologists may not yet be familiar with this technique. This review provides an introduction to magnetoencephalography, discusses relevant analytical techniques, and presents recent developments in established and emerging clinical applications such as pervasive developmental disorders. Although the role of magnetoencephalography in diagnosis, prognosis, and patient treatment is still limited, it is argued that this technology is exquisitely capable of contributing indispensable information about brain dynamics not easily obtained with other modalities. This, it is believed, will make this technology an important clinical tool for a wide range of disorders in the future. PMID:24967282

  5. Liliequist membrane: radiological evaluation, clinical and therapeutic implications*

    PubMed Central

    Dias, Daniel Aguiar; Castro, Fábio Luiz Onuki; Yared, James Henrique; Lucas Júnior, Ademar; Ferreira Filho, Luiz Alves; Ferreira, Nelson Fortes Paes Diniz

    2014-01-01

    In a simplistic and succinct way, Liliequist membrane may be understood as a projection formed by an arachnoid membrane extending from the dorsum sellae to the mammillary bodies. In spite of being well known to neurosurgeons, many radiologists neither know this anatomical structure nor give importance to its study. The imaging evaluation of this membrane is feasible and may be interesting for a better preoperative planning; postoperative evaluation of third ventriculostomies; and understanding of suprasellar arachnoid cysts and perimesencephalic hemorrhage. The present article illustrates the anatomy of the membrane, with emphasis on imaging findings, besides describing its possible clinical and surgical implications. PMID:25741076

  6. [Familial cerebellar ataxia: clinical, radiological and electrophysiological findings].

    PubMed

    Gajkowski, K; Rysz, A; Walecki, J; Bojakowski, J

    1988-01-01

    A family with cerebellar ataxia of late onset occurring in four generations was observed. Neurological abnormalities included signs of cerebellar ataxia, pyramidal tract damage and damage to the peripheral motor neuron. Computerized tomography demonstrated in five out of six studied patients an image suggesting olivo-ponto-cerebellar atrophy. In the cerebellar structures, brainstem and cerebral hemispheres evidence of atrophy was detected. No correlation was demonstrated between the intensity of the clinical signs and the progression of changes in CT image. Electrophysiological investigations demonstrated changes compatible with damage to the motor and sensory fibres in the peripheral nerves and signs suggesting damage to the spinal motor neurons and pyramidal tract. These observations confirm the multilevel development of the process. The use of similar diagnostic methods will permit a more accurate classification of cerebellar ataxia and obtaining of better information for prognostication of individual cases. PMID:3164096

  7. The cervical spine in patients with psoriatic arthritis: a clinical, radiological and immunogenetic study.

    PubMed Central

    Salvarani, C; Macchioni, P; Cremonesi, T; Mantovani, W; Battistel, B; Rossi, F; Capozzoli, N; Baricchi, R; Portioli, I

    1992-01-01

    The radiological changes of the cervical spine were evaluated in 57 patients with psoriatic arthritis and were correlated with clinical, radiological, and immunogenetic features of the disease. Forty patients (70%) showed radiological evidence of the cervical spine being affected by the disease. Two patterns of cervical spine abnormalities were noted. Fifteen patients (26%) had erosive and/or subluxing cervical rheumatoid like lesions; 25 patients (44%) had a more frequently reported pattern similar to ankylosing spondylitis. Although subaxial subluxations were the most frequently observed cervical abnormalities (53%) in the inflammatory subgroup, none of the patients studied had cord compression. Ankylosing cervical spine disease was the only form of axial involvement in nine (36%) of 25 patients with the ankylosing form of psoriatic arthritis. All of these patients had peripheral disease and were B27 negative. Predictors of cervical spine disease patterns were considered using clinical, demographic, and radiological features and HLA antigens. The results of a multivariate analysis showed that the best predictors of inflammatory cervical spine disease are the presence of HLA-B39 and HLA-DR4 antigens, radiocarpal erosions, and the absence of the HLA-DR5 antigen. PMID:1540041

  8. Epidermoids involving the temporal bone: clinical, radiological and pathological aspects.

    PubMed

    Nager, G T

    1975-12-01

    Epidermoids or congenital cholesteatomas arise from aberrant epithelial remnants and are, therefore, considerd blastomatous malformations. Their predilective sites are the intracranial cavity, the diploe of the skull and the spinal canal. In the base of the skull the temporal bone is the most frequent site. Epidermoids account for about 0.2-1.5 percent of all intracranial tumors. The majority originate in the cerebello-pontine angle where they account for 6-7 percent of all tumors. Their age incidence reveals a great scatter from birth to 80 years. The majority are recognized during the third and fourth decades with the onset of clinical symptoms occurring much earlier. They affect males more frequently than females. Their delicate capsule with a whitish mother-of-pearl sheen lends them a typical appearance. Epidermoids are generally slow growing lesions which may remain asymptomatic for years. The irritative effect of their content, however, can produce symptoms of dysfunction and intense inflammation. Malignant changes occur infrequently. Diploic epidermoids are easily recognized, whereas, intradural epidermoids are more difficult to identify. Epidermoids may arise in the vicinity, on the outer aspect or within the temporal bone. Epidermoids originating in any of these locations have certain characteristic features which may arouse suspicion of their presence. Examples of an epidermoid with origin in the typical locations within the temporal bone and cerebello-pontine angle are discussed to portray their individual characteristics. PMID:1207346

  9. Non-compressive myelopathy: clinical and radiological study.

    PubMed

    Prabhakar, S; Syal, P; Singh, P; Lal, V; Khandelwal, N; Das, C P

    1999-12-01

    Fifty seven patients (42 males and 15 females) with non-compressive myelopathy were studied from 1997 to 1999. Acute transverse myelitis (ATM) was the commonest (31) followed by Vit B12 deficiency myelopathy (8), primary progressive multiple sclerosis (5), hereditary spastic paraplegia (3), tropical spastic paraplegia (2), subacute necrotising myelitis (1), radiation myelitis (1), syphilitic myelitis (1) and herpes zoster myelitis (1). 4 cases remained unclassified. In the ATM group, mean age was 30.35 years, antecedent event was observed in 41.9% case, 25 cases had symmetrical involvement and most of the cases had severe deficit at onset. CSF study carried out in 23 patients of ATM revealed rise in proteins (mean 147.95mg%, range 20-1200 mg/dL) and pleocytosis (mean 20.78/cumm, range 0-200 mm3). Oligoclonal band (OCB) was present in 28% of cases of ATM. The most common abnormality detected was a multisegment hyperintense lesion on T2W images, that occupied the central area on cross section. In 6 patients hyperintense signal was eccentric in location. MRI was normal in 4 cases of ATM. Thus ATM is the leading cause of non-compressive myelopathy. Clinical features combined with MRI findings are helpful in defining the cause of ATM. PMID:10625902

  10. LETTER TO THE EDITOR: Response to 'Patient dose measurements in radiological practices'

    NASA Astrophysics Data System (ADS)

    Zoetelief, J.; Wambersie, A.

    2006-06-01

    A lack of suitable dosimetric quantities for application in diagnostic radiology is noted by Dr Moores. It is concluded by Dr Moores that it is not possible to adhere to the basic principles of the International Commission on Radiation Units and Measurements (ICRU) regarding patient dosimetry in diagnostic radiology due to the extremely wide variety of quantities and units employed. The conclusion of the ICRU on similar observations, however, was that there is a need for harmonization of quantities and terminology for dosimetry in diagnostic and interventional radiology and they established a Report Committee with the aim of formulating an ICRU report on 'dosimetric procedures in diagnostic radiology'. The report produced by this committee entitled 'Patient dosimetry for x rays used in medical imaging' was accepted for publication in December 2005 and is currently at press, and may serve to improve the current situation with regard to patient dose measurement in diagnostic and interventional radiology.

  11. Atypical presentation of posterior reversible encephalopathy syndrome: Clinical and radiological characteristics in eclamptic patients.

    PubMed

    Aracki-Trenkić, Aleksandra; Stojanov, Dragan; Trenkić, Milan; Radovanović, Zoran; Ignjatović, Jelena; Ristić, Saša; Trenkić-Bozinović, Marija

    2016-08-01

    Posterior reversible encephalopathy syndrome (PRES) is an obstetric emergency frequently occurring in a pregnant or puerperal woman, manifested with an acute headache, consciousness impairment, seizures, and visual deficits and is associated with white matter changes predominantly affecting the posterior parietal and occipital lobes of the brain. Apart from the above-described typical location of the changes, the most common atypical location involves the brain stem and basal ganglia. Since magnetic resonance imaging (MRI) is more sensitive and specific imaging technique compared to computerized tomography, establishing the diagnosis and follow-up in patients with PRES is based mainly on MRI findings. It is particularly important not to exclude PRES as a possible diagnosis when we have the appropriate clinical presentation accompanied by the atypical radiological findings, since this clinical-radiological syndrome can often be manifested with an atypical MRI image. PMID:27322924

  12. Atypical presentation of posterior reversible encephalopathy syndrome: Clinical and radiological characteristics in eclamptic patients.

    PubMed

    Aracki-Trenkić, Aleksandra; Stojanov, Dragan; Trenkić, Milan; Radovanović, Zoran; Ignjatović, Jelena; Ristić, Saša; Trenkić-Bozinović, Marija

    2016-08-01

    Posterior reversible encephalopathy syndrome (PRES) is an obstetric emergency frequently occurring in a pregnant or puerperal woman, manifested with an acute headache, consciousness impairment, seizures, and visual deficits and is associated with white matter changes predominantly affecting the posterior parietal and occipital lobes of the brain. Apart from the above-described typical location of the changes, the most common atypical location involves the brain stem and basal ganglia. Since magnetic resonance imaging (MRI) is more sensitive and specific imaging technique compared to computerized tomography, establishing the diagnosis and follow-up in patients with PRES is based mainly on MRI findings. It is particularly important not to exclude PRES as a possible diagnosis when we have the appropriate clinical presentation accompanied by the atypical radiological findings, since this clinical-radiological syndrome can often be manifested with an atypical MRI image. PMID:27483175

  13. Atypical presentation of posterior reversible encephalopathy syndrome: Clinical and radiological characteristics in eclamptic patients

    PubMed Central

    Aracki-Trenkić, Aleksandra; Stojanov, Dragan; Trenkić, Milan; Radovanović, Zoran; Ignjatović, Jelena; Ristić, Saša; Trenkić-Bozinović, Marija

    2016-01-01

    Posterior reversible encephalopathy syndrome (PRES) is an obstetric emergency frequently occurring in a pregnant or puerperal woman, manifested with an acute headache, consciousness impairment, seizures, and visual deficits and is associated with white matter changes predominantly affecting the posterior parietal and occipital lobes of the brain. Apart from the above-described typical location of the changes, the most common atypical location involves the brain stem and basal ganglia. Since magnetic resonance imaging (MRI) is more sensitive and specific imaging technique compared to computerized tomography, establishing the diagnosis and follow-up in patients with PRES is based mainly on MRI findings. It is particularly important not to exclude PRES as a possible diagnosis when we have the appropriate clinical presentation accompanied by the atypical radiological findings, since this clinical-radiological syndrome can often be manifested with an atypical MRI image.

  14. A clinical audit programme for diagnostic radiology: the approach adopted by the International Atomic Energy Agency.

    PubMed

    Faulkner, K; Järvinen, H; Butler, P; McLean, I D; Pentecost, M; Rickard, M; Abdullah, B

    2010-01-01

    The International Atomic Energy Agency (IAEA) has a mandate to assist member states in areas of human health and particularly in the use of radiation for diagnosis and treatment. Clinical audit is seen as an essential tool to assist in assuring the quality of radiation medicine, particularly in the instance of multidisciplinary audit of diagnostic radiology. Consequently, an external clinical audit programme has been developed by the IAEA to examine the structure and processes existent at a clinical site, with the basic objectives of: (1) improvement in the quality of patient care; (2) promotion of the effective use of resources; (3) enhancement of the provision and organisation of clinical services; (4) further professional education and training. These objectives apply in four general areas of service delivery, namely quality management and infrastructure, patient procedures, technical procedures and education, training and research. In the IAEA approach, the audit process is initiated by a request from the centre seeking the audit. A three-member team, comprising a radiologist, medical physicist and radiographer, subsequently undertakes a 5-d audit visit to the clinical site to perform the audit and write the formal audit report. Preparation for the audit visit is crucial and involves the local clinical centre completing a form, which provides the audit team with information on the clinical centre. While all main aspects of clinical structure and process are examined, particular attention is paid to radiation-related activities as described in the relevant documents such as the IAEA Basic Safety Standards, the Code of Practice for Dosimetry in Diagnostic Radiology and related equipment and quality assurance documentation. It should be stressed, however, that the clinical audit does not have any regulatory function. The main purpose of the IAEA approach to clinical audit is one of promoting quality improvement and learning. This paper describes the background to

  15. Dentigerous Cyst or Adenomatoid Odontogenic Tumor: Clinical Radiological and Histopathological Dilemma

    PubMed Central

    Acharya, Shivesh; Goyal, Ashima; Rattan, Vidya; Vaiphei, Kim; Kaur Bhatia, Sarabjot

    2014-01-01

    Adenomatoid odontogenic tumor (AOT) is a well-recognised slow growing benign tumor derived from complex system of dental lamina or its remnants. This lesion is categorised into three variants of which the more common variant is follicular type which is often mistaken for dentigerous cyst. We present a case of AOT in a 14-year-old male who was misdiagnosed as dentigerous cyst. Clinical radiological and therapeutic characteristics of the case are commented on in detail. PMID:25097553

  16. Clinical, Bronchographic, Radiological, and Physiological Observations in Ten Cases of Asbestosis

    PubMed Central

    Leathart, G. L.

    1960-01-01

    Ten cases of asbestosis (eight male, two female), aged 45-65 years have been kept under observation for periods of up to eight years. Bronchiectasis was demonstrated bronchographically in six cases. Clubbing of the fingers and coarse crepitations appeared to be signs of bronchiectasis rather than of uncomplicated asbestosis. It is suggested that the prevalence of bronchiectasis is higher than has been reported previously because the patients survived longer. The radiological findings are tabulated and compared with previous descriptions. In these subjects there was no relationship between radiological and clinical state. Nine patients eventually showed clinical deterioration and it often proceeded rapidly. The radiograph however, usually remained unaltered. Pulmonary function tests, including diffusing capacity, arterial blood analysis and estimation of mechanical properties of the lung, were carried out in these 10 cases, and in 11 asbestos workers (aged 35-64 years) without radiological abnormality. The steady state diffusing capacity for carbon monoxide (Dco) at rest was lower in asbestosis than in the control subjects. The pulmonary compliance was remarkably low in asbestosis and related fairly closely to the vital capacity. The maximum voluntary ventilation was also low and was related to increased pulmonary resistance but it cannot be said whether this is in the airways or in the lung tissue. Indirect evidence of inequalities of ventilation/perfusion ratio was obtained in most cases. There is no convincing evidence that pulmonary fibrosis occurs without radiological abnormality, but a defect of diffusion may occur. There is no test of pulmonary function which is diagnostic, but a low pulmonary compliance, especially if combined with a low diffusing capacity, is confirmatory. It is suggested that the demonstration of a progressive decline in vital capacity, or in diffusing capacity, may enable a diagnosis of asbestosis to be made before radiological

  17. Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

    SciTech Connect

    Safari, M. J.; Wong, J. H. D.; Ng, K. H.; Jong, W. L.; Cutajar, D. L.; Rosenfeld, A. B.

    2015-05-15

    Purpose: The MOSkin is a MOSFET detector designed especially for skin dose measurements. This detector has been characterized for various factors affecting its response for megavoltage photon beams and has been used for patient dose measurements during radiotherapy procedures. However, the characteristics of this detector in kilovoltage photon beams and low dose ranges have not been studied. The purpose of this study was to characterize the MOSkin detector to determine its suitability for in vivo entrance skin dose measurements during interventional radiology procedures. Methods: The calibration and reproducibility of the MOSkin detector and its dependency on different radiation beam qualities were carried out using RQR standard radiation qualities in free-in-air geometry. Studies of the other characterization parameters, such as the dose linearity and dependency on exposure angle, field size, frame rate, depth-dose, and source-to-surface distance (SSD), were carried out using a solid water phantom under a clinical x-ray unit. Results: The MOSkin detector showed good reproducibility (94%) and dose linearity (99%) for the dose range of 2 to 213 cGy. The sensitivity did not significantly change with the variation of SSD (±1%), field size (±1%), frame rate (±3%), or beam energy (±5%). The detector angular dependence was within ±5% over 360° and the dose recorded by the MOSkin detector in different depths of a solid water phantom was in good agreement with the Markus parallel plate ionization chamber to within ±3%. Conclusions: The MOSkin detector proved to be reliable when exposed to different field sizes, SSDs, depths in solid water, dose rates, frame rates, and radiation incident angles within a clinical x-ray beam. The MOSkin detector with water equivalent depth equal to 0.07 mm is a suitable detector for in vivo skin dosimetry during interventional radiology procedures.

  18. Diagnostic accuracy of tests based on radiologic measurements of dogs and cats: a systematic review.

    PubMed

    Lamb, Christopher R; Nelson, Justin R

    2015-01-01

    A systematic review of diagnostic tests based on radiologic measurements of structures in dogs and cats was done in order to reach generalizable conclusions about the value of making such measurements. Literature search was done using the ISI Web of Knowledge(SM) for studies in the subject category Veterinary sciences. Studies were eligible for inclusion that employed length, angle, area or volume measurements from radiographic, ultrasonographic, CT or MR images of dogs or cats as a diagnostic test for a naturally occurring condition, compared the results of imaging with a reference standard, included at least 10 subjects, and sufficient data that a 2 × 2 table of results could be constructed. Quality of studies was assessed using the QUADAS-2 tool. Twenty-six studies were found describing 40 tests that satisfied the inclusion criteria. Tests were radiographic in 22 (55%) instances and ultrasonographic in 18 (45%). Quality of studies was generally low, with a risk of bias in patient selection in 92% studies, performance of the index test in 73% studies, and patient flow in 42% studies. Median (range) number of subjects was 64 (20-305), sensitivity was 77% (38-99%), specificity was 82% (50-99%), positive likelihood ratio was 4.1 (1-103), and negative likelihood ratio was 0.29 (0.01-1). Two studies that compared accuracy of radiographic measurements to subjective image interpretation alone found no difference. Evidence is weak that radiologic measurements of structures in dogs and cats are useful for diagnosis, hence measurements should not be emphasized as a basis for diagnosis in either teaching or clinical imaging reports. PMID:25339347

  19. Clinical, physiological, and radiological features of asthma–chronic obstructive pulmonary disease overlap syndrome

    PubMed Central

    Suzuki, Toshio; Tada, Yuji; Kawata, Naoko; Matsuura, Yukiko; Ikari, Jun; Kasahara, Yasunori; Tatsumi, Koichiro

    2015-01-01

    Background Asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is associated with rapid decline in lung function, poorer health-related quality-of-life outcomes, and frequent exacerbations, compared to COPD alone. Although the numbers of patients with ACOS have increased, there is little established evidence regarding diagnostic criteria and treatment options. Thus, the aim of our study was to clarify the clinical, physiological, and radiological features of patients with ACOS. Methods We examined a total of 100 patients with COPD and 40 patients with ACOS, who were selected based on clinical criteria. All patients underwent baseline testing, including a COPD assessment test, pulmonary function tests, and multidetector row computed tomography imaging. Percentage of low attenuation volume, percentage of wall area, and percentage of total cross-sectional area of pulmonary vessels less than 5 mm2 (%CSA <5) were determined using multidetector row computed tomography. ACOS patients were administered a fixed dose of budesonide/formoterol (160/4.5 μg, two inhalations; twice daily) for 12 weeks, after which the ACOS patients underwent multidetector row computed tomography to measure the same parameters. Results At baseline, the ACOS patients and COPD patients had a similar degree of airflow limitation, vital capacity, and residual volume. ACOS patients had higher COPD assessment test scores, percentage of wall area, and %CSA <5 than COPD patients. Compared to baseline, budesonide/formoterol treatment significantly increased the forced expiratory volume in 1 second and decreased the degree of airway wall thickness (percentage of wall area) as well as pulmonary microvascular density (%CSA <5) in ACOS patients. Conclusion Our results suggest that ACOS is characterized by an airway lesion–dominant phenotype, in contrast to COPD. Higher %CSA <5 might be a characteristic feature of ACOS. PMID:26028967

  20. Evolution of the clinical review station for enterprise-wide multimedia radiology reporting

    NASA Astrophysics Data System (ADS)

    Hanlon, William B.; Valtchinov, Vladimir I.; Davis, Scott D.; Lester, James; Khorasani, Ramin; Carrino, John A.; Benfield, Andrew

    2000-05-01

    Efforts to develop Picture Archiving and Communications Systems (PACS) for the last ten years have concentrated mainly on developing systems for primary interpretation of digital radiological images. Much less attention has been paid to the clinical aspects of the radiology process. Clinical radiology services are an important component of the overall care delivery process, providing information and consultation services to referring physicians, the customers of radiology, in a timely fashion to aid in care decisions. Information management systems (IMS) are playing an increasingly central role in the care delivery process. No suitable commercial PACS or IMS products were available that could effectively provide for the requirements of the clinicians. We endeavored to fill this void at our institution by developing a system to deliver images and text reports electronically on-demand to the referring physicians. This system has evolved substantially since initial deployment eight years ago. As new technologies become available they are evaluated and integrated as appropriate to improve system performance and manageability. Not surprisingly, the internet and World Wide Web (WWW) technology has had the greatest impact on system design in recent years. Additional features have been added over time to provide services for teleradiology, teaching, and research needs. We also discovered that these value-added services give us a competitive edge in attracting new business to our department. Commercial web-based products are now becoming available which do a satisfactory job of providing many of these clinical services. These products are evaluated for integration into our system as they mature. The result is a system that impacts positively on patient care.

  1. Bridging the gap between basic and clinical sciences: A description of a radiological anatomy course.

    PubMed

    Torres, Anna; Staśkiewicz, Grzegorz J; Lisiecka, Justyna; Pietrzyk, Łukasz; Czekajlo, Michael; Arancibia, Carlos U; Maciejewski, Ryszard; Torres, Kamil

    2016-05-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images requires the practitioner to not only hone certain technical skills, but to command an excellent knowledge of sectional anatomy and an understanding of the pathophysiology of the examined areas as well. Yet throughout many medical curricula there is often a large gap between traditional anatomy coursework and clinical training in imaging techniques. The authors present a radiological anatomy course developed to teach sectional anatomy with particular emphasis on ultrasonography and computed tomography, while incorporating elements of medical simulation. To assess students' overall opinions about the course and to examine its impact on their self-perceived improvement in their knowledge of radiological anatomy, anonymous evaluation questionnaires were provided to the students. The questionnaires were prepared using standard survey methods. A five-point Likert scale was applied to evaluate agreement with statements regarding the learning experience. The majority of students considered the course very useful and beneficial in terms of improving three-dimensional and cross-sectional knowledge of anatomy, as well as for developing practical skills in ultrasonography and computed tomography. The authors found that a small-group, hands-on teaching model in radiological anatomy was perceived as useful both by the students and the clinical teachers involved in their clinical education. In addition, the model was introduced using relatively few resources and only two faculty members. Anat Sci Educ 9: 295-303. © 2015 American Association of Anatomists. PMID:26599321

  2. Clinical and radiological repercussions of plexiform neurofibroma in the pelvic region.

    PubMed

    Slaibi, Érica Bertolace; Daher, João Gabriel Lima; da Fonseca, Gustavo Guida Godinho; Daher, Carlos Magno; Geller, Mauro; Ribeiro, Márcia Gonçalves

    2014-01-01

    The authors report the case of a plexiform neurofibroma located in the pelvis, affecting the bladder, prostate and spine (lumbar/sacral), followed-up for three years and six months. Surgical removal was contraindicated and the patient underwent biannual clinical and radiological follow-up that did not demonstrate any tumor increase. The clinical manifestations of neurofibromatosis type 1 are variable, and the medical team should be attentive to further investigations, considering possible unexpected rare findings. Large pelvic masses may correspond to plexiform neurofibromas, so the diagnostic hypothesis of neurofibromatosis should be taken into consideration. PMID:25741110

  3. Key Performance Indicators in Radiology: You Can't Manage What You Can't Measure.

    PubMed

    Harvey, H Benjamin; Hassanzadeh, Elmira; Aran, Shima; Rosenthal, Daniel I; Thrall, James H; Abujudeh, Hani H

    2016-01-01

    Quality assurance (QA) is a fundamental component of every successful radiology operation. A radiology QA program must be able to efficiently and effectively monitor and respond to quality problems. However, as radiology QA has expanded into the depths of radiology operations, the task of defining and measuring quality has become more difficult. Key performance indicators (KPIs) are highly valuable data points and measurement tools that can be used to monitor and evaluate the quality of services provided by a radiology operation. As such, KPIs empower a radiology QA program to bridge normative understandings of health care quality with on-the-ground quality management. This review introduces the importance of KPIs in health care QA, a framework for structuring KPIs, a method to identify and tailor KPIs, and strategies to analyze and communicate KPI data that would drive process improvement. Adopting a KPI-driven QA program is both good for patient care and allows a radiology operation to demonstrate measurable value to other health care stakeholders. PMID:26323653

  4. Decision support systems for clinical radiological practice — towards the next generation

    PubMed Central

    Stivaros, S M; Gledson, A; Nenadic, G; Zeng, X-J; Keane, J; Jackson, A

    2010-01-01

    The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully. PMID:20965900

  5. Radiological protection in ion beam radiotherapy: practical guidance for clinical use of new technology.

    PubMed

    Yonekura, Y; Tsujii, H; Hopewell, J W; Ortiz López, P; Cosset, J-M; Paganetti, H; Montelius, A; Schardt, D; Jones, B; Nakamura, T

    2016-06-01

    Recently introduced technologies in radiotherapy have significantly improved the clinical outcome for patients. Ion beam radiotherapy, involving proton and carbon ion beams, provides excellent dose distributions in targeted tumours, with reduced doses to the surrounding normal tissues. However, careful treatment planning is required in order to maximise the treatment efficiency and minimise the dose to normal tissues. Radiation exposure from secondary neutrons and photons, particle fragments, and photons from activated materials should also be considered for radiological protection of the patient and medical staff. Appropriate maintenance is needed for the equipment and air in the treatment room, which may be activated by the particle beam and its secondary radiation. This new treatment requires complex procedures and careful adjustment of parameters for each patient. Therefore, education and training for the personnel involved in the procedure are essential for both effective treatment and patient protection. The International Commission on Radiological Protection (ICRP) has provided recommendations for radiological protection in ion beam radiotherapy in Publication 127 Medical staff should be aware of the possible risks resulting from inappropriate use and control of the equipment. They should also consider the necessary procedures for patient protection when new technologies are introduced into clinical practice. PMID:26980799

  6. Virtual anthropology: useful radiological tools for age assessment in clinical forensic medicine and thanatology.

    PubMed

    Dedouit, Fabrice; Saint-Martin, Pauline; Mokrane, Fatima-Zohra; Savall, Frédéric; Rousseau, Hervé; Crubézy, Eric; Rougé, Daniel; Telmon, Norbert

    2015-09-01

    Virtual anthropology consists of the introduction of modern slice imaging to biological and forensic anthropology. Thanks to this non-invasive scientific revolution, some classifications and staging systems, first based on dry bone analysis, can be applied to cadavers with no need for specific preparation, as well as to living persons. Estimation of bone and dental age is one of the possibilities offered by radiology. Biological age can be estimated in clinical forensic medicine as well as in living persons. Virtual anthropology may also help the forensic pathologist to estimate a deceased person's age at death, which together with sex, geographical origin and stature, is one of the important features determining a biological profile used in reconstructive identification. For this forensic purpose, the radiological tools used are multislice computed tomography and, more recently, X-ray free imaging techniques such as magnetic resonance imaging and ultrasound investigations. We present and discuss the value of these investigations for age estimation in anthropology. PMID:25735613

  7. A Clinical Update and Radiologic Review of Pediatric Orbital and Ocular Tumors

    PubMed Central

    Rao, Ajay A.; Naheedy, John H.; Chen, James Y.-Y.; Robbins, Shira L.; Ramkumar, Hema L.

    2013-01-01

    While pediatric orbital tumors are most often managed in tertiary care centers, clinicians should be aware of the signs of intraocular and orbital neoplasms. In the pediatric population, a delay in diagnosis of orbital and intraocular lesions, even if benign, can lead to vision loss and deformity. Intraocular lesions reviewed are retinoblastoma, medulloepithelioma, and retinal astrocytic hamartoma. Orbital neoplasms reviewed are rhabdomyosarcoma, neuroblastoma metastases, optic pathway glioma, plexiform neurofibroma, leukemia, lymphoprolipherative disease, orbital inflammatory syndrome, dermoid and epidermoid inclusion cysts, and Langerhans' cell histiocytosis. Vascular lesions reviewed are infantile hemangioma and venous lymphatic malformation. In conjunction with clinical examination, high-resolution ophthalmic imaging and radiologic imaging play an important role in making a diagnosis and differentiating between benign and likely malignant processes. The radiologic imaging characteristics of these lesions will be discussed to facilitate prompt diagnosis and treatment. The current treatment modalities and management of tumors will also be reviewed. PMID:23577029

  8. Clinical and Radiological Comparison of Semirigid (WavefleX) and Rigid System for the Lumbar Spine

    PubMed Central

    Kim, Do-Keun; Lim, Hyunkeun; Oh, Chang Hyun

    2016-01-01

    Objective Spinal fusion operation is an effective treatment in the spinal pathology, but it could change the physiological distribution of load at the instrumented and adjacent segments. This retrospective study compared the radiological and clinical outcomes of patients undergoing lumbar fusion with semirigid rods versus rigid rods system. Methods Using transpedicular fixation and posterior lumbar interbody fusion at the level of L4/L5, 20 patients were treated with semirigid rods (WavefleX, SR group), and 20 patients with rigid rods (titanium, RR group). Clinical and radiological outcomes were evaluated, including visual analog score for lower back pain and leg pain, Prolo functional and economic scores, statues of implanted instruments, fusion rate, and complications during 24-month follow-up. Results Clinical scores were significantly improved until postoperative 24-month follow-up as compared with preoperative scores in both groups (p<0.05), with similar levels of improvement observed at the same time points postoperatively between the 2 groups. Prolo economic scores were significantly improved in SR group compared to RR until 12 months, but this improvement became similar after 18 months. The overall fusion rate was 94.1% until the 24-month follow-up for both groups. No significant complication was observed in both groups. Conclusion The results of the present study indicate that semirigid rods system with posterior lumbar interbody fusion showed similar clinical and radiological result with rigid rods system until 2 years after instrumentation. The WavefleX rods system, as a semirigid rods with unique characteristics, may be an effective alternative treatment for patients in lumbar fusion. PMID:27437014

  9. Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review

    PubMed Central

    Garewal, Devinder; Evans, Mathew; Taylor, David; Hoy, Gregory A.; Barwood, Shane; Connell, David

    2013-01-01

    Background To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability. Methods Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography. Results Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p < 0.01) and 10° (p < 0.001), respectively. Subjective shoulder function was good. Mean (SD) scores on the WOSI, MISS and l'Insalata scales were 78.0 (19.7), 75.8 (11.5) and 89.3 (9.9), respectively. No loss of subscapularis strength was identified (p > 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm2 reconstituted surgically by a bone block of 225.4 (73.8) mm2. Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p < 0.05). Conclusions The Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy.

  10. Paradoxical Lung Function Response to Beta2-agonists: Radiologic Correlates and Clinical Implications

    PubMed Central

    Bhatt, Surya P.; Wells, James M.; Kim, Victor; Criner, Gerard J.; Hersh, Craig P.; Hardin, Megan; Bailey, William C.; Nath, Hrudaya; il-Kim, Young; Foreman, Marilyn G.; Stinson, Douglas S.; Wilson, Carla G.; Rennard, Stephen I.; Silverman, Edwin K.; Make, Barry J.; Dransfield, Mark T.

    2014-01-01

    Background Bronchodilator response is seen in a significant proportion of patients with chronic obstructive pulmonary disease (COPD). However, there are also reports of a paradoxical response (PR) to beta2-agonists, resulting in bronchoconstriction. Asymptomatic bronchoconstriction is likely far more common but there has been no systematic study of this phenomenon.We assessed theprevalence of PR in current and former smokers with and without COPD, and its radiologic correlates and clinical implications. Methods Subjects from a large multicenter study (COPDGene) were categorized into two groups based on PR defined as at least a 12% and 200mLreduction in FEV1 and/or FVC after administration of a short-acting beta2-agonist (180ucg albuterol). Predictors of PR and associations with respiratory morbidity and computed tomographic measures of emphysema and airway disease were assessed. Findings 9986 subjects were included. PR was seen in 4.54% and the frequency was similar in those with COPD and smokers without airflow obstruction. Compared to Caucasians, PR was twice as common in African-Americans (6.9% vs. 3.4%;p <0.001). On multivariate analyses, African- American race (adjusted OR 1.89, 95%CI 1.50 to 2.39), lesspercent emphysema (OR 0.96, 95%CI 0.92 to 0.99) and increased wall-area% of segmental airways (OR 1.04,95%CI 1.01 to 1.08) were independently associated with PR.PR was independently associated with worse dyspnea, lower six-minute-walk distance, higher BODE index, and a greater frequency of exacerbations(increased by a factor of 1.35, 95%CI 1.003 to 1.81). Interpretation Paradoxical response to beta2-agonists is associated with respiratory morbidity and is more common in African Americans. PMID:25217076

  11. The clinical display of radiologic information as an interactive multimedia report.

    PubMed

    Maloney, K; Hamlet, C T

    1999-05-01

    We regard the delivery of radiological information as an interactive multimedia report. We use a multimedia report model based on Extensible Markup Language (XML), rather than a traditional workstation model. Others have suggested a similar document-based approach. This display presentation includes image-related and text-based information and may contain interactive components (e.g., window, level and zoom). Using XML as a foundation for this multimedia presentation, we achieve flexibility and platform independence at a lower cost. XML allows for the separation of content and form. Content information, defined as elements (e.g., images, radiologic reports, and demographic information), is treated as independent information objects. The behavior of the elements can be changed for different users and tasks. In addition, by separating format detail from content, the appearance of the elements within the report can be modified. XML does not replace existing standards (i.e., Digital Imaging and Communications in Medicine [DICOM], Transmission Control Protocol/Internet Protocol [TCP/IP]). Instead, it provides a powerful framework that is used in combination with existing standards to allow system designers to modify display characteristics based on user need. We describe our application of XML to the clinical display of radiologic information. PMID:10342186

  12. Homozygous N540K hypochondroplasia--first report: radiological and clinical features.

    PubMed

    De Rosa, M Laura Garcia; Fano, Virginia; Araoz, H Verónica; Chertkoff, Lilien; Obregon, M Gabriela

    2014-07-01

    We describe a 16-month-old male with N540K homozygous mutation in the FGFR3 gene who showed a more severe phenotype than hypochondroplasia (HCH). To our knowledge, a homozygous state for this mutation causing HCH has not been reported before. The clinical and radiological characteristics of our patient represent an intermediate condition between achondroplasia and achondroplasia/hypochondroplasia compound heterozygosity. This case represents a new expression of FGFR3 spectrum and it is of considerable importance for the genetic counseling in cases where both parents are affected with HCH. PMID:24715719

  13. T1- Thresholds in Black Holes Increase Clinical-Radiological Correlation in Multiple Sclerosis Patients

    PubMed Central

    Thaler, Christian; Faizy, Tobias; Sedlacik, Jan; Holst, Brigitte; Stellmann, Jan-Patrick; Young, Kim Lea; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

    2015-01-01

    Background Magnetic Resonance Imaging (MRI) is an established tool in diagnosing and evaluating disease activity in Multiple Sclerosis (MS). While clinical-radiological correlations are limited in general, hypointense T1 lesions (also known as Black Holes (BH)) have shown some promising results. The definition of BHs is very heterogeneous and depends on subjective visual evaluation. Objective We aimed to improve clinical-radiological correlations by defining BHs using T1 relaxation time (T1-RT) thresholds to achieve best possible correlation between BH lesion volume and clinical disability. Method 40 patients with mainly relapsing-remitting MS underwent MRI including 3-dimensional fluid attenuated inversion recovery (FLAIR), magnetization-prepared rapid gradient echo (MPRAGE) before and after Gadolinium (GD) injection and double inversion-contrast magnetization-prepared rapid gradient echo (MP2RAGE) sequences. BHs (BHvis) were marked by two raters on native T1-weighted (T1w)-MPRAGE, contrast-enhancing lesions (CE lesions) on T1w-MPRAGE after GD and FLAIR lesions (total-FLAIR lesions) were detected separately. BHvis and total-FLAIR lesion maps were registered to MP2RAGE images, and the mean T1-RT were calculated for all lesion ROIs. Mean T1 values of the cortex (CTX) were calculated for each patient. Subsequently, Spearman rank correlations between clinical scores (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite) and lesion volume were determined for different T1-RT thresholds. Results Significant differences in T1-RT were obtained between all different lesion types with highest T1 values in visually marked BHs (BHvis: 1453.3±213.4 ms, total-FLAIR lesions: 1394.33±187.38 ms, CTX: 1305.6±35.8 ms; p<0.05). Significant correlations between BHvis/total-FLAIR lesion volume and clinical disability were obtained for a wide range of T1-RT thresholds. The highest correlation for BHvis and total-FLAIR lesion masks were found at T1-RT>1500 ms

  14. Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports

    PubMed Central

    Andersen, Jack Gunnar; Stokke, Mali Victoria; Tennstrand, Anne Lise; Aamodt, Rolf; Heggelund, Thomas; Dahl, Fredrik A; Sandbæk, Gunnar; Hurlen, Petter

    2016-01-01

    Background Misinterpretation of radiological examinations is an important contributing factor to diagnostic errors. Consultant radiologists in Norwegian hospitals frequently request second reads by colleagues in real time. Our objective was to estimate the frequency of clinically important changes to radiology reports produced by these prospectively obtained double readings. Methods We retrospectively compared the preliminary and final reports from 1071 consecutive double-read abdominal CT examinations of surgical patients at five public hospitals in Norway. Experienced gastrointestinal surgeons rated the clinical importance of changes from the preliminary to final report. The severity of the radiological findings in clinically important changes was classified as increased, unchanged or decreased. Results Changes were classified as clinically important in 146 of 1071 reports (14%). Changes to 3 reports (0.3%) were critical (demanding immediate action), 35 (3%) were major (implying a change in treatment) and 108 (10%) were intermediate (requiring further investigations). The severity of the radiological findings was increased in 118 (81%) of the clinically important changes. Important changes were made less frequently when abdominal radiologists were first readers, more frequently when they were second readers, and more frequently to urgent examinations. Conclusion A 14% rate of clinically important changes made during double reading may justify quality assurance of radiological interpretation. Using expert second readers and a targeted selection of urgent cases and radiologists reading outside their specialty may increase the yield of discrepant cases. PMID:27013638

  15. Measurements of entrance surface dose using a fiber-optic dosimeter in diagnostic radiology

    NASA Astrophysics Data System (ADS)

    Yoo, Wook Jae; Seo, Jeong Ki; Shin, Sang Hun; Han, Ki-Tek; Jeon, Dayeong; Jang, Kyoung Won; Sim, Hyeok In; Lee, Bongsoo; Park, Jang-Yeon

    2013-03-01

    In this study, a fiber-optic dosimeter (FOD) was developed to measure entrance surface dose (ESD) in diagnostic radiology. We measured the scintillating lights in order to obtain ESDs, which changed with the various exposure parameters of a digital radiography (DR) system, such as tube potential, current-time product, focus-surface distance (FSD), and field size, using the fabricated FOD system. From the experimental results, the output light signals of the FOD were similar to the ESDs of the conventional semiconductor dosimeter. In conclusion, we characterized the measured ESDs as functions of exposure parameters by using two different types of dosimeters and demonstrated that the proposed FOD using a plastic scintillating fiber and a plastic optical fiber (POF) makes it possible to measure ESDs in the energy range of diagnostic radiology. From the results of this study, it is anticipated that the FOD will be a useful dosimeter in low-energy photon applications including diagnostic radiology.

  16. Congenital spinal dermal tract: how accurate is clinical and radiological evaluation?

    PubMed

    Tisdall, Martin M; Hayward, Richard D; Thompson, Dominic N P

    2015-06-01

    OBJECT A dermal sinus tract is a common form of occult spinal dysraphism. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. Clinical and radiological features can appear innocuous, leading to delayed diagnosis and failure to appreciate the implications or extent of the abnormality. If it is left untreated, complications can include meningitis, spinal abscess, and inclusion cyst formation. The authors present their experience in 74 pediatric cases of spinal dermal tract in an attempt to identify which clinical and radiological factors are associated with an infective presentation and to assess the reliability of MRI in evaluating this entity. METHODS Consecutive cases of spinal dermal tract treated with resection between 1998 and 2010 were identified from the departmental surgical database. Demographics, clinical history, and radiological and operative findings were collected from the patient records. The presence or absence of active infection (abscess, meningitis) at the time of neurosurgical presentation and any history of local sinus discharge or infection was assessed. Magnetic resonance images were reviewed to evaluate the extent of the sinus tract and determine the presence of an inclusion cyst. Radiological and operative findings were compared. RESULTS The surgical course was uncomplicated in 90% of 74 cases eligible for analysis. Magnetic resonance imaging underreported the presence of both an intradural tract (MRI 46%, operative finding 86%) and an intraspinal inclusion cyst (MRI 15%, operative finding 24%). A history of sinus discharge (OR 12.8, p = 0.0003) and the intraoperative identification of intraspinal inclusion cysts (OR 5.6, p = 0.023) were associated with an infective presentation. There was no significant association between the presence of an intradural tract discovered at surgery and an infective presentation. CONCLUSIONS Surgery for the treatment of

  17. Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

    SciTech Connect

    Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.; Lee, Michael J.

    2000-07-15

    Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived from a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are

  18. An autopsy study of combined pulmonary fibrosis and emphysema: correlations among clinical, radiological, and pathological features

    PubMed Central

    2014-01-01

    Background Clinical evaluation to differentiate the characteristic features of pulmonary fibrosis and emphysema is often difficult in patients with combined pulmonary fibrosis and emphysema (CPFE), but diagnosis of pulmonary fibrosis is important for evaluating treatment options and the risk of acute exacerbation of interstitial pneumonia of such patients. As far as we know, it is the first report describing a correlation among clinical, radiological, and whole-lung pathological features in an autopsy cases of CPFE patients. Methods Experts retrospectively reviewed the clinical charts and examined chest computed tomography (CT) images and pathological findings of an autopsy series of 22 CPFE patients, and compared these with findings from 8 idiopathic pulmonary fibrosis (IPF) patients and 17 emphysema-alone patients. Results All patients had a history of heavy smoking. Forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC%) was significantly lower in the emphysema-alone group than the CPFE and IPF-alone groups. The percent predicted diffusing capacity of the lung for carbon monoxide (DLCO%) was significantly lower in the CPFE group than the IPF- and emphysema-alone groups. Usual interstitial pneumonia (UIP) pattern was observed radiologically in 15 (68.2%) CPFE and 8 (100%) IPF-alone patients and was pathologically observed in all patients from both groups. Pathologically thick-cystic lesions involving one or more acini with dense wall fibrosis and occasional fibroblastic foci surrounded by honeycombing and normal alveoli were confirmed by post-mortem observation as thick-walled cystic lesions (TWCLs). Emphysematous destruction and enlargement of membranous and respiratory bronchioles with fibrosis were observed in the TWCLs. The cystic lesions were always larger than the cysts of honeycombing. The prevalence of both radiological and pathological TWCLs was 72.7% among CPFE patients, but no such lesions were observed in patients with IPF or emphysema

  19. Metabolic disorders with clinical and radiologic features of sporadic Creutzfeldt-Jakob disease

    PubMed Central

    Rosenbloom, Michael H.; Tartaglia, M. Carmela; Forner, Sven A.; Wong, Katherine K.; Kuo, Amy; Johnson, David Y.; Colacurcio, Valerie; Andrews, Bret D.; Miller, Bruce L.; DeArmond, Stephen J.

    2015-01-01

    Summary Two patients with metabolic disorders presented with clinical and radiologic features suggestive of sporadic Creutzfeldt-Jakob disease (sCJD). Case 1 was a 50-year-old man with rapid decline in cognitive, behavioral, and motor function following new-onset seizures. MRI was read as consistent with CJD, and he was referred for a treatment trial, but it was determined that he recently experienced rapid correction of hyponatremia resulting in extrapontine myelinolysis. Case 2 was a 66-year-old woman with poorly controlled diabetes mellitus who was found unconscious after a suspected insulin overdose. Examination showed altered mental status and neuroimaging was remarkable for cortical/striatal hyperintensities suggestive of sCJD. On autopsy, she had hypoglycemic/hypoxic nerve cell loss. Although characteristic MRI findings have high sensitivity and specificity for sCJD, potentially reversible metabolic disorders sometimes present rapidly and can resemble sCJD both clinically and radiologically. These cases highlight the importance of establishing a broad differential diagnosis when evaluating a patient with suspected sCJD. PMID:26137419

  20. [Congenital lacrimonasal duct cyst: Do not forget this radiological and clinical entity].

    PubMed

    Braun, J-J; Debry, C; Donato, L; Riehm, S

    2016-02-01

    Although obstruction of the lacrimonasal duct is a fairly common finding in newborns, development of a dacryocystocele (nasolacrimal duct cyst) is uncommon and is caused by stenosis in the proximal and distal area of the nasolacrimal duct leading to a cystic dilatation. Its diagnosis remains difficult for the pediatrician, the ENT specialist, the ophthalmologist, and the radiologist. The study of six cases of dacryocystocele and the review of the literature led the authors to describe the clinical and radiological features of this uncommon entity. The symptomatology includes nasal obstruction and, when bilateral, significant respiratory distress in the newborn (obligate nose-breather) and dilatation of the lacrimal duct with blue cystic swelling inferior to the medial canthus or with an inflammatory aspect of the lacrimal duct in case of infection. A careful endoscopic examination of the nasal cavities and CT or MRI imaging reveals a cystic tumor, which arises in the inferior meatus, inferolateral to the inferior turbinate, and can partly or completely obstruct the endonasal space, uni- or bilaterally. CT and MRI are equally sensitive in detecting dacryocystocele and are also useful for differential diagnosis for other cystic or tumoral nasal lesions such as meningoencephalocele, dermoid cyst, and glioma. To avoid the risk of potential complications (respiratory distress or even sudden infant death, infectious ophthalmologic complications), this radiological and clinical entity should not be forgotten. Endoscopic marsupialization leads to immediate and definitive healing recovery. PMID:26724215

  1. Clinical and Radiological Classification of the Jawbone Anatomy in Endosseous Dental Implant Treatment

    PubMed Central

    Kubilius, Marius

    2013-01-01

    ABSTRACT Objectives The purpose of present article was to review the classifications suggested for assessment of the jawbone anatomy, to evaluate the diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone, as well as to suggest new classification system of the jawbone anatomy in endosseous dental implant treatment. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandible; mandibular canal; alveolar nerve, inferior; anatomy, cross-sectional; dental implants; classification. The search was restricted to English language articles, published from 1972 to March 2013. Additionally, a manual search in the major anatomy and oral surgery books were performed. The publications there selected by including clinical and human anatomy studies. Results In total 109 literature sources were obtained and reviewed. The classifications suggested for assessment of the jawbone anatomy, diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone were discussed. New classification system of the jawbone anatomy in endosseous dental implant treatment based on anatomical and radiologic findings and literature review results was suggested. Conclusions The classification system proposed here based on anatomical and radiological jawbone quantity and quality evaluation is a helpful tool for planning of treatment strategy and collaboration among specialists. Further clinical studies should be conducted for new classification validation and reliability evaluation. PMID:24422030

  2. Tuberculous meningitis with multiple intracranial tuberculomas mimicking neurocysticercosis clinical and radiological findings.

    PubMed

    Oncul, Oral; Baylan, Orhan; Mutlu, Hakan; Cavuslu, Saban; Doganci, Levent

    2005-12-01

    Central nervous system (CNS) tuberculosis (TB), the most dangerous form of TB, remains a public health problem, particularly in developing countries. In the differential diagnosis of intracranial tuberculomas (ICTs), images on radiological findings should be differentiated from other causes of space-occupying lesions. These lesions include malignant diseases such as glioma or lymphoma, pyogenic abscess, toxoplasmosis, neurocysticercosis (NC), sarcoidosis, hydatidosis and late syphilitic involvement of CNS. We present a case with multiple ICTs mimicking NC with similar clinical and imaging manifestations in a young immunocompetent patient. The diagnosis was based on brain magnetic resonance imaging findings. The definitive diagnosis was confirmed mycobacteriologically in cerebrospinal fluid and sputum specimens. Adequate response to anti-TB chemotherapy was achieved while multiple ICTs in the brain disappeared slowly. In the absence of appropriate therapy, these pathologies might be fatal; the possibilities of differential diagnosis would be of great clinical importance, particularly because of the different treatment protocols required for the NC and ICTs. PMID:16377875

  3. Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects

    PubMed Central

    Szwedowski, Dawid; Walecki, Jerzy

    2014-01-01

    Summary The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or lumbar spine. Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. Underlying degenerative changes, including spondylosis or spinal canal stenosis, are typically present in adult patients. The level of spinal cord injury corresponds to the location of these changes. With recent advances in neuroimaging techniques, especially in magnetic resonance imaging, and with increasing availability of MRI as a diagnostic tool, the overall detection rate of SCIWORA has significantly improved. PMID:25505497

  4. Percutaneous Stabilization System Osseofix® for Treatment of Osteoporotic Vertebral Compression Fractures - Clinical and Radiological Results after 12 Months

    PubMed Central

    Ender, Stephan Albrecht; Wetterau, Elmar; Ender, Michaela; Kühn, Jens-Peter; Merk, Harry Rudolf; Kayser, Ralph

    2013-01-01

    Study Design A prospective consecutive cohort study (follow-up study). Objective Our study investigated whether implantation of an expandable titanium mesh cage (Osseofix®) is a successful and safe minimally invasive therapy for osteoporotic vertebral compression fractures (VCF). Our experiences, clinical and radiological findings after 12 months follow-up are presented. Kypho- and vertebroplasty are well-established minimally invasive procedures for the treatment of osteoporotic VCF. The main complications associated with both procedures are uncontrolled bone cement leakage. Therefore a suitable alternative has been investigated. Methods During June 2010 to May 2011 24 patients were included with 32 osteoporotic VCF (T6 to L4). All of them were stabilized with the Osseofix® system. Preinterventionally we performed X-ray, MRI, and bone density measurements (DXA). Clinical and radiological results were evaluated preop., postop. and after 12 months postop. based on the Oswestry Disability Index (ODI) and the Visual Analogue Scale (VAS), X-ray (Beck Index, Cobb-angle) and CT. Results There was a significant improvement in the mean ODI (70,6% to 30,1%) as well as a significant reduction in pain intensity (VAS) (7,7 to 1,4) after 12 month. The mean kyphotic angle according to Cobb showed significant improvements (11,7° to 10,4°) after 12 months. Postinterventional imaging showed only one case of loss of height in a stabilized vertebral body (3.1%). We saw no changes in posterior vertebral wall or adjacent fractures. Except for one pronounced postoperative hematoma we saw no surgical complications including no cement leakage. Conclusions Stabilization of symptomatic osteoporotic VCF with Osseofix® system is a safe and effective procedure, even in fractures with posterior wall involvement. The clinical mid-term results are good at a very low complication rate. The Osseofix® system is an interesting alternative to the established procedures of cement augmentation

  5. Informatics in radiology: improving clinical work flow through an AIM database: a sample web-based lesion tracking application.

    PubMed

    Abajian, Aaron C; Levy, Mia; Rubin, Daniel L

    2012-01-01

    Quantitative assessments on images are crucial to clinical decision making, especially in cancer patients, in whom measurements of lesions are tracked over time. However, the potential value of quantitative approaches to imaging is impeded by the difficulty and time-intensive nature of compiling this information from prior studies and reporting corresponding information on current studies. The authors believe that the quantitative imaging work flow can be automated by making temporal data computationally accessible. In this article, they demonstrate the utility of the Annotation and Image Markup standard in a World Wide Web-based application that was developed to automatically summarize prior and current quantitative imaging measurements. The system calculates the Response Evaluation Criteria in Solid Tumors metric, along with several alternative indicators of cancer treatment response, by using the data stored in the annotation files. The application also allows the user to overlay the recorded metrics on the original images for visual inspection. Clinical evaluation of the system demonstrates its potential utility in accelerating the standard radiology work flow and in providing a means to evaluate alternative response metrics that are difficult to compute by hand. The system, which illustrates the utility of capturing quantitative information in a standard format and linking it to the image from which it was derived, could enhance quantitative imaging in clinical practice without adversely affecting the current work flow. PMID:22745220

  6. Clinical and Radiologic Outcomes among Bipolar Hemiarthroplasty, Compression Hip Screw and Proximal Femur Nail Antirotation in Treating Comminuted Intertrochanteric Fractures

    PubMed Central

    Suh, You-Sung; Nho, Jae-Hwi; Kim, Seong-Min; Hong, Sijohn; Choi, Hyung-Suk

    2015-01-01

    Purpose In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23]) Materials and Methods We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening). Results There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000). Conclusion There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH

  7. Critical evaluation of the radiological and clinical features of adenomatoid odontogenic tumour

    PubMed Central

    Becker, T; Buchner, A; Kaffe, I

    2012-01-01

    Objectives The aim of this study was to evaluate the radiological and clinical features of adenomatoid odontogenic tumours (AOTs). Methods A total of 272 cases (267 from the English-language literature and 5 new cases) were analysed with special emphasis on their radiological features. Results The patients' ages at time of diagnosis ranged from 3 years to 82 years (mean 18.4 years). The maxilla-to-mandible ratio was 1.7:1. Mandibular lesions were significantly more frequent among patients older than 16 years (p = 0.032). Expansion of the cortex was significantly more prominent among patients older than 16 years (p = 0.045). There was a positive correlation between the size of the lesion and the age of the patient at the time of diagnosis (p = 0.016). The size was also associated with increased root resorption (p < 0.001), ill-defined borders (p < 0.001), expansion (p < 0.001) and perforation of the cortex (p < 0.001). Small opacities were present in 77% of lesions and were associated with expansion of the cortex (p = 0.043). The significant radiological features in patients aged 30 years and above were root resorption (p = 0.013) and lesions crossing the midline (p = 0.019). Conclusions The size of an AOT is influenced by the patient's age. It is also associated with root resorption, ill-defined borders, expansion and perforation of the cortex, but it cannot be ruled out that those changes reflect a longer duration of the lesion. PMID:22752319

  8. Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach

    PubMed Central

    Park, Woong Bae; Lee, Sang Won; Sung, Jae Hoon; Yang, Seung Ho; Kim, IL Sub

    2016-01-01

    Objective To compare the clinical and radiological outcome of both sides using the unilateral approach. Methods Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index (ODI), the visual analog scale (VAS) pain score to evaluate symptoms in both legs, and the radiological morphometric index to calculate the anteriorposterior diameter and midcanal width. The incidence of complications from this approach was then evaluated. Results The mean follow-up time was 12.2 months. The mean ODI was 48.4 preoperatively and 14.2 postoperatively. The mean dural sac widening of the ipsilateral side (187.0%) was significantly larger (p<0.01) than that of the the contralateral side (145.6%). The VAS improvement ratio ([preoperative VAS score-postoperative VAS score]/[preoperative VAS score]×100) for the pain in each leg was 75.4%(ipsilateral side) and 73.7%(contralateral side). While the VAS improvement ratio for pain in each side was significantly reduced, the difference in the VAS ratio between sides was statistically insignificant (p=0.64). There were 2 cases (5.1%) of dural tearing during the procedure, 1 case (2.6%) of transient paresthesia of nerve roots, and 2 cases (5.1%) of transient paresthesia of the contralateral nerve root. The transient paresthesias of nerve roots never lasted more than 2 weeks. Conclusion This technique allows for significant decompression of the contralateral canal and excellent clinical outcomes without troublesome complications. Although ipsilateral the dural sac widening was significantly larger than contralateral side, the difference in the clinical outcome between sides was statistically insignificant. PMID:27437011

  9. Clinical measures and treatment needs.

    PubMed

    Marcus, M; Reifel, N M; Nakazono, T T

    1997-05-01

    Clinically evaluated oral health outcome variables from the ICS-II USA data set were examined in the diverse ethnic groups, for two adult age cohorts (35-44 and 65-74 years). These measures were derived from epidemiological examinations and include the DMFT components, loss of attachment, and an indicator of treatment need--the ratio of decayed teeth over decayed and filled teeth. The ratio of decayed over decayed and filled teeth was used in multivariate analysis, since this measure represents an area where public policy could have an impact if determinants were understood. The most important independent variables were race-ethnicity, educational attainment, no fear of dental visits because of pain, and oral hygiene practices. Having a usual source of dental care and visiting the dentist within the past 12 months did not appear to be as important in predicting unmet needs as these other variables. To bridge the gap between the oral health status of majority and minority populations, health educators in minority communities need to become more accessible, have a pro-active interest in oral health, and also be cognizant of the various socio-cultural issues influencing oral health. The problems regarding Native American adults are more complex and require more careful study. PMID:9549992

  10. Intermediate clinical and radiological results of cervical TDR (Mobi-C®) with up to 2 years of follow-up

    PubMed Central

    Beaurain, J.; Bernard, P.; Dufour, T.; Fuentes, J. M.; Hovorka, I.; Huppert, J.; Steib, J. P.; Vital, J. M.; Aubourg, L.

    2009-01-01

    The interest in cervical total disc replacement (TDR) as an alternative to the so-far gold standard in the surgical treatment of degenerative disc disease (DDD), e.g anterior cervical discectomy and fusion (ACDF), is growing very rapidly. Many authors have established the fact that ACDF may result in progressive degeneration in adjacent segments. On the contrary, but still theoretically, preservation of motion with TDR at the surgically treated level may potentially reduce the occurrence of adjacent-level degeneration (ALD). The authors report the intermediate results of an undergoing multicentre prospective study of TDR with Mobi-C® prosthesis. The aim of the study was to assess the safety and efficacy of the device in the treatment of DDD and secondary to evaluate the radiological status of adjacent levels and the occurrence of ossifications, at 2-year follow-up (FU). 76 patients have performed their 2-year FU visit and have been analyzed clinically and radiologically. Clinical outcomes (NDI, VAS, SF-36) and ROM measurements were analyzed pre-operatively and at the different post-operative time-points. Complications and re-operations were also assessed. Occurrences of heterotopic ossifications (HOs) and of adjacent disc degeneration radiographic changes have been analyzed from 2-year FU X-rays. The mean NDI and VAS scores for arm and neck are reduced significantly at each post-operative time-point compared to pre-operative condition. Motion is preserved over the time at index levels (mean ROM = 9° at 2 years) and 85.5% of the segments are mobile at 2 years. HOs are responsible for the fusion of 6/76 levels at 2 years. However, presence of HO does not alter the clinical outcomes. The occurrence rate of radiological signs of ALD is very low at 2 years (9.1%). There has been no subsidence, no expulsion and no sub-luxation of the implant. Finally, after 2 years, 91% of the patients assume that they would undergo the procedure again. These intermediate

  11. Electronic Healthcare Record and clinical research in cardiovascular radiology. HL7 CDA and CDISC ODM interoperability.

    PubMed

    El Fadly, A; Daniel, C; Bousquet, C; Dart, T; Lastic, P-Y; Degoulet, P

    2007-01-01

    Integrating clinical research data entry with patient care data entry is a challenging issue. At the G. Pompidou European Hospital (HEGP), cardiovascular radiology reports are captured twice, first in the Electronic Health Record (EHR) and then in a national clinical research server. Informatics standards are different for EHR (HL7 CDA) and clinical research (CDISC ODM). The objective of this work is to feed both the EHR and a Clinical Research Data Management System (CDMS) from a single multipurpose form. We adopted and compared two approaches. First approach consists in implementing the single "care-research" form within the EHR and aligning XML structures of HL7 CDA document and CDISC ODM message to export relevant data from EHR to CDMS. Second approach consists in displaying a single "care-research" XForms form within the EHR and generating both HL7 CDA document and CDISC message to feed both EHR and CDMS. The solution based on XForms avoids overloading both EHR and CDMS with irrelevant information. Beyond syntactic interoperability, a perspective is to address the issue of semantic interoperability between both domains. PMID:18693829

  12. Recurrent Wernicke's Encephalopathy in a 16-Year-Old Girl with Atypical Clinical and Radiological Features

    PubMed Central

    Lamdhade, S.; Almulla, A.; Alroughani, R.

    2014-01-01

    Background. Wernicke's Encephalopathy (WE) is a clinical diagnosis with serious neurological consequences. Its occurrence is underestimated in nonalcoholics and is uncommon in adolescents. We aim to draw the attention to a rare case, which had additional clinical and radiological features. Case. A 16-year-old girl presented with three-week history of vomiting secondary to intestinal obstruction. She developed diplopia soon after hospitalization. Neurological evaluation revealed restriction of bilateral lateral recti with horizontal nystagmus, and bilateral limb dysmetria. Brain MRI was normal. She had prompt improvement to thiamine. Four months later, she presented with headache, bilateral severe deafness, and tinnitus. Clinically, she had severe sensorineural hearing loss, bilateral lateral recti paresis, and gait ataxia. CT head showed bilateral caudate nucleus hypodensities. MRI brain revealed gadolinium enhancement of mamillary bodies and vermis. She had significant improvement after IV thiamine. Headache completely resolved while the ocular movements, hearing, and tinnitus improved partially in 72 hours. Conclusions. Recurrent WE in adolescence is uncommon. Headache, tinnitus, and deafness are rare clinical features. Although MRI study shows typical features of WE, the presence of bilateral caudate nuclei hypodensities on CT scan is uncommon. Prompt treatment with thiamine is warranted in suspected cases to prevent permanent neurological sequelae. PMID:24790762

  13. [Pseudotumoral medullary syndrome manifesting a probably beginning multiple sclerosis. Clinical, radiological and neuropathological correlations].

    PubMed

    Reznik, M; Franck, G; Flandroy, P; Lenelle, J

    1994-01-01

    A 19-y old sportsman was admitted because he complained of ascending paresthesia since two weeks, muscular strength diminution in both arms, then respiratory difficulties without fever. Clinical examination confirmed an asymmetric bilateral pyramidal syndrome affecting the four limbs, a hyposensitive level up to C5, without meningeal symptoms. MRI detected a widening of the cervical (C2-C5) spinal cord, with gadolinium enhancement. CSF demonstrated lymphocytic pleocytosis and total protein of 530 mg/l with an oligoclonal IgG pattern. With a diagnosis of multiple sclerosis, a corticoid therapy was started but without clinical improvement. Six weeks later, a new MRI revealed an increased enlargement of the cervical spinal cord suggesting a tumoral process. No tumor could be detected at neurosurgery. Biopsy specimen (from C3-C4) demonstrated an inflammatory demyelinating disease with astrocytic hypertrophy. Electron microscopy confirmed the active demyelinating disorder with persistently denuded axons. Several macrophages were observed, but no lymphocytic invasion. Astrocytes were prominent in some areas with "en plaque" gliosis. MRI failed to discover any other demyelinating lesions. Further clinical evaluation was inconspicuous, the patient regaining full activities after 6 months. MRI after 9 months demonstrated no spinal cord lesion. This observation contributes to suggest the influence of the blood-brain barrier breakdown on the occurrence of clinical and radiological signs of new lesions in suspected multiple sclerosis. PMID:8140889

  14. Orthopaedic radiology

    SciTech Connect

    Park, W.M.; Hughes, S.P.F.

    1987-01-01

    This book is an account of the principles of modern diagnostic imaging techniques and their applications in orthopedics. The aim is to show radiology as a dynamic subject. Orthopaedic Radiology is divided into two sections with the first part focusing on the principles of diagnostic imaging and interpretation and the second applying this information to practical clinical problems.

  15. Radioactivity: Recommendations of the International Commission on Radiological Units and Measurements (1962), (ICRU) Report 10 c.

    ERIC Educational Resources Information Center

    National Bureau of Standards (DOC), Washington, DC.

    This handbook presents recommendations agreed upon at the meeting of the International Commission on Radiological Units and Measurements (ICRU) held in Montreux, Switzerland, in April 1962. It is written in a report form with a preface including symbols, abbreviations and definitions of terms used in the report. The report consists of four…

  16. Differential Diagnoses of Overgrowth Syndromes: The Most Important Clinical and Radiological Disease Manifestations

    PubMed Central

    Lacerda, Letícia da Silva; Alves, Úrsula David; Zanier, José Fernando Cardona; Machado, Dequitier Carvalho; Camilo, Gustavo Bittencourt; Lopes, Agnaldo José

    2014-01-01

    Overgrowth syndromes comprise a heterogeneous group of diseases that are characterized by excessive tissue development. Some of these syndromes may be associated with dysfunction in the receptor tyrosine kinase (RTK)/PI3K/AKT pathway, which results in an increased expression of the insulin receptor. In the current review, four overgrowth syndromes were characterized (Proteus syndrome, Klippel-Trenaunay-Weber syndrome, Madelung's disease, and neurofibromatosis type I) and illustrated using cases from our institution. Because these syndromes have overlapping clinical manifestations and have no established genetic tests for their diagnosis, radiological methods are important contributors to the diagnosis of many of these syndromes. The correlation of genetic discoveries and molecular pathways that may contribute to the phenotypic expression is also of interest, as this may lead to potential therapeutic interventions. PMID:25009745

  17. Clinical, radiologic and arthroscopic assessment and treatment of bilateral discoid lateral meniscus.

    PubMed

    Rao, Sharath K; Sripathi Rao, P

    2007-05-01

    The purpose of the study is to evaluate clinical, radiologic and arthroscopic features of bilateral discoid lateral meniscus and to assess the outcome of arthroscopic meniscectomy. Among the 177 arthroscopies performed for discoid lateral meniscus between January 1993 and January 2004, 12 were bilateral. The clinical and radiologic evaluation was done from the records. The type of discoid meniscus, the type of tear was assessed arthroscopically. All patients underwent arthroscopic meniscectomy. Patients were followed up for a minimum period of 2 years. All patients had pain as presenting symptom. Eight patients presented with bilateral knee pain and four patients developed pain in the opposite knee after the affected knee was treated. The classically described thud was present in 11 knees. The widening of the joint space was found in 13 knee radiographs; 14 knees had complete type, nine had incomplete type and one had ring type of discoid lateral meniscus on arthroscopic evaluation; 20 knees involving 10 complete types, all incomplete types and ring type of discoid lateral meniscus showed obvious meniscal tears. The remaining four meniscus showed softening of a portion of the meniscus. Underlying intra-substance tear was visualized arthroscopically in the softened areas on saucerisation. All but one discoid menisci underwent arthroscopic partial central meniscectomy. When followed up for an average period of 32.6 months 19 knees showed excellent results and 5 knees good results. Possibility of bilaterality should be suspected in discoid lateral meniscus. Softening of meniscus denotes underlying intra-substance tear. This finding has not been described in the literature so far. Arthroscopic partial meniscectomy gives good results in symptomatic bilateral discoid meniscus. This to our knowledge is the largest series of bilateral discoid lateral menisci. PMID:17225177

  18. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

    PubMed Central

    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results. PMID:27027054

  19. A clinical and radiological profile of neuromyelitis optica and spectrum disorders in an Indian cohort

    PubMed Central

    Barhate, Kavita Sohan; Ganeshan, Malti; Singhal, Bhim Sen

    2014-01-01

    Background: There is insufficient data on the clinical and radiological features of neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD) from India. Objective: The objective of the following study is to examine the clinico-radiological features of NMO and NMOSD in an Indian cohort. Materials and Methods: This retrospective study included 44 consecutive patients who (1) satisfied the 2006 Wingerchuk criteria for NMO (16 seropositive and 7 seronegative); or (2) had isolated or recurrent optic neuritis (ON) with seropositivity (n = 4); or (3) had isolated or recurrent myelitis with seropositivity (n = 17). Results: The female:male ratio was 7.8:1 with median age of onset 26.5 (range 8-72). Annualized relapse rate (ARR) was comparable across all groups (F [3, 40] = 0.938 and P = 0.431). Various presentations other than ON and myelitis were noted. All 40 patients with myelitis had spinal cord lesions involving ≥3 vertebral segments during the course of the disease. Cervicomedullary involvement was seen in 32.5% (13/40) patients. Brain magnetic resonance imaging was available for 40 patients; eight of these (20%) had brain lesions in locations described in multiple sclerosis (MS), 27.5% (11/40) had lesions at sites unusual for MS and 52.5% (21/40) had normal brain imaging. Conclusion: NMO and NMOSD patients in this cohort have comparable ARR regardless of clinical presentation, supporting the emerging trend of treating all patients with immunotherapeutic agents at an early stage. Varied presentations seen in NMO and NMOSD highlight the need for a high index of suspicion for NMO in demyelinating episodes not classical for MS. PMID:24753665

  20. Attitudes of Radiologic Science Students, Technologists, and Clinical Instructors Regarding Their Experiential Learning and Career Capacity

    ERIC Educational Resources Information Center

    Burns, Caroline

    2012-01-01

    Radiologic science is an essential part of the healthcare continuum and preparing radiologic science students with experiential learning is essential. It is from this experience working with the patient that students begin to prepare for entry-level practice. The purpose of the study was to examine the attitudes of current radiologic science…

  1. Infantile hemangioendothelioma of the liver: a radiologic-pathologic-clinical correlation

    SciTech Connect

    Dachman, A.H.; Lichtenstein, J.E.; Friedman, A.C.; Hartman, D.S.

    1983-06-01

    Infantile hemangioendothelioma is the most common symptomatic vascular liver tumor of infancy. It is considered a benign tumor; however, aggressive behavior is occasionally seen microscopically, and rarely distant metastases have been reported. The exact incidence of infantile hemangioendothelioma is difficult to determine because often it has been either misdiagnosed or mislabeled as cavernous hemangioma in the literature. Cavernous hemangioma is the most common primary liver tumor in older age groups but is rarely found in infants as a clinically significant tumor. Levick and Rubie were the first to recognize an association between hemangioendothelioma of the liver and congestive heart failure, and there were subsequent reports substantiating this association. However, it is our impression and the finding of others that congestive heart failure is distinctly less common than abdominal mass or hepatomegaly as the presenting sign in infantile hemangioendothelioma. Congestive heart failure is rarely a feature of cavernous hemangioma. Because of the errors in terminology and questions regarding clinical presentation, a radiologic-pathologic-clinical correlation study of infantile hemangioendothelioma and review of the literature was undertaken.

  2. Enchondroma versus Low-Grade Chondrosarcoma in Appendicular Skeleton: Clinical and Radiological Criteria

    PubMed Central

    Ferrer-Santacreu, Eugenio M.; Ortiz-Cruz, Eduardo J.; González-López, José Manuel; Pérez Fernández, Elia

    2012-01-01

    Objectives. To determine the validity of clinical and radiological features of enchondroma and low grade chondrosarcoma, and contrast the biopsy results with the clinical diagnosis based on the history and imaging. Material and Method. The study included 96 patients with cartilage type lesions suggestive of an enchondroma (E) or an low grade chondrosarcoma (LGC) according to the clinical and imaging data. The hypotheses were contrasted with the biopsy. Results. Of the 82 patients studied completely, 56 were considered E (68.29%), 8 as LGC (8.33%) and in 18 (18.75%) were doubtful cases and considered as suspected LGC. Of these, the biopsy showed 4 E (25%), 10 LGC (50%) and 4 were not definitive. On the other hand, of the 56 cases diagnosed as E, 15 were biopsied, 5 of these biopsies turned out to be LGC (33.3%). The 8 cases diagnosed as LGC, were also biopsied and only 4 biopsies (50%) confirmed the initial diagnosis. Features analyzed in the study showed no statistically significant difference. Correlation analysis between the diagnosis issued initially and the biopsy result gave a value of 0.69 (kappa coefficient), which was considered a good correlation. Conclusion. Features analyzed did not have any statistical significance. However, there was a good correlation between initial diagnosis and biopsy's result. PMID:22593766

  3. A guide for effluent radiological measurements at DOE installations

    NASA Astrophysics Data System (ADS)

    Corley, J. P.; Corbit, C. D.

    1983-07-01

    Effluent monitoring and reporting programs are maintained at all US Department of Energy (DOE) facilities that may: (1) discharge significant concentrations of radioactivity in relation to applicable standards, or (2) discharge quantities of radioactivity that have potential health and safety or other environmental significance. This Guide is intended to provide supplemental guidance to DOE Orders on methods, procedures, and performance criteria to bring more comparable rationale to DOE facility effluent measurement programs and promote compliance with applicable standards and provide the DOE Office of Operational Safety (OOS) and Operations Offices with an additional tool for evaluating effluent measurement programs at DOE facilities.

  4. Liver Masses: A Clinical, Radiological and Pathological Perspective For: Perspectives in Clinical Gastroenterology and Hepatology

    PubMed Central

    Venkatesh, Sudhakar K.; Chandan, Vishal; Roberts, Lewis R.

    2013-01-01

    Liver masses present a relatively common clinical dilemma, particularly with the increasing use of various imaging modalities in the diagnosis of abdominal and other symptoms. The accurate and reliable determination of the nature of the liver mass is critical, not only to reassure individuals with benign lesions but also, and perhaps more importantly, to ensure that malignant lesions are diagnosed correctly. This avoids the devastating consequences of missed diagnosis and the delayed treatment of malignancy or the unnecessary treatment of benign lesions With appropriate interpretation of the clinical history and physical examination, and the judicious use of laboratory and imaging studies, the majority of liver masses can be characterized noninvasively. Accurate characterization of liver masses by cross-sectional imaging is particularly dependent on an understanding of the unique phasic vascular perfusion of the liver and the characteristic behaviors of different lesions during multiphasic contrast imaging. When non-invasive characterization is indeterminate, a liver biopsy may be necessary for definitive diagnosis. Standard histologic examination is usually complemented by immunohistochemical analysis of protein biomarkers. Accurate diagnosis allows the appropriate selection of optimal management, which is frequently reassurance or intermittent follow up for benign masses. For malignant lesions or those at risk of malignant transformation, management depends on the tumor staging, the functional status of the uninvolved liver and technical surgical considerations. Unresectable metastatic masses require oncologic consultation and therapy. The efficient characterization and management of liver masses therefore requires a multidisciplinary collaboration between the gastroenterologist/hepatologist, radiologist, pathologist, hepatobiliary or transplant surgeon, and medical oncologist. PMID:24055987

  5. Invited review: study design considerations for clinical research in veterinary radiology and radiation oncology.

    PubMed

    Scrivani, Peter V; Erb, Hollis N

    2013-01-01

    High quality clinical research is essential for advancing knowledge in the areas of veterinary radiology and radiation oncology. Types of clinical research studies may include experimental studies, method-comparison studies, and patient-based studies. Experimental studies explore issues relative to pathophysiology, patient safety, and treatment efficacy. Method-comparison studies evaluate agreement between techniques or between observers. Patient-based studies investigate naturally acquired disease and focus on questions asked in clinical practice that relate to individuals or populations (e.g., risk, accuracy, or prognosis). Careful preplanning and study design are essential in order to achieve valid results. A key point to planning studies is ensuring that the design is tailored to the study objectives. Good design includes a comprehensive literature review, asking suitable questions, selecting the proper sample population, collecting the appropriate data, performing the correct statistical analyses, and drawing conclusions supported by the available evidence. Most study designs are classified by whether they are experimental or observational, longitudinal or cross-sectional, and prospective or retrospective. Additional features (e.g., controlled, randomized, or blinded) may be described that address bias. Two related challenging aspects of study design are defining an important research question and selecting an appropriate sample population. The sample population should represent the target population as much as possible. Furthermore, when comparing groups, it is important that the groups are as alike to each other as possible except for the variables of interest. Medical images are well suited for clinical research because imaging signs are categorical or numerical variables that might be predictors or outcomes of diseases or treatments. PMID:23578318

  6. Multiparametric MRI of the anterior prostate gland: clinical-radiological-histopathological correlation.

    PubMed

    Moosavi, B; Flood, T A; Al-Dandan, O; Breau, R H; Cagiannos, I; Morash, C; Malone, S C; Schieda, N

    2016-05-01

    Anterior prostate cancer (APC) is defined as a tumour in which more than half of malignant tissue is located anterior to the urethra. APCs are increasingly recognized as clinically important, particularly in patients undergoing active surveillance and for patients with negative non-targeted systematic transrectal ultrasound (TRUS)-guided biopsies but with persistent clinical suspicion of cancer. Multiparametric (mp) MRI has a crucial role for the diagnosis of anterior tumours, eventual histological sampling of suspicious lesions using image-guided targeted biopsy techniques, and potentially, to improve local staging of disease. mpMRI is accurate for the detection of APC and for differentiation of tumour from other anterior prostatic structures including benign prostatic hyperplasia (BPH) and the anterior fibromuscular stroma (AFMS). Characterization and reporting of APC should rely on the recently revised Prostate Imaging and Data Reporting System (PI-RADS) version 2.0 document. T2-weighted (T2W) imaging is emphasized as the determining sequence for assessment of the anterior prostate and specific features for APC on T2W imaging include: ill-defined/spiculated margin, lenticular shape, anterior/inferior location, and growth pattern (invasion of urethra or AFMS and crossing midline). Functional imaging, mainly with diffusion-weighted imaging, is also contributory and improves the sensitivity for detection of APC compared to T2W imaging alone. APCs commonly show positive surgical margins after radical prostatectomy and staging of disease extent using conventional clinical parameters is limited. mpMRI may have a future role to improve local staging of APC. This review illustrates the importance of mpMRI in APC using a clinical-radiological-histopathological approach. PMID:26888762

  7. Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation

    SciTech Connect

    Sy, W.M.; Seo, I.S.; Vieira, J.; Zaman, M.

    1985-05-01

    Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases.

  8. Clinical Experience With A High Resolution Digital Imaging System For Gastro-Intestinal Radiology

    NASA Astrophysics Data System (ADS)

    Edmonds, E. W.; Rowlands, J. A.; Hynes, D. M.; Toth, B. D.; Porter, A. J.

    1987-01-01

    In our department, it is planned that the gastro-intestinal fluoroscopic area will be equipped entirely with digital imaging systems. The use of the 1024 X 1024 pixel frame store, backed by a hard disc for rapid image transfer, and the production of hard copy on a laser imager has reached the point where clinical efficacy and acceptance are assured. The further addition of facilities for annotation and the application of digital post-processing techniques are being explored both at the clinical site and at the research laboratorieS. The use of laser imaging has produced a further improvement in image quality and some of the practical problems related to this apparatus will be described. The availability of larger capacity laser disc image storage enables the local area network or "mini-PACS" system for fluoroscopy areas to become a concept worthy of investigation. We present our experience over a number of years with these systems, together with our latest investigations into potential applications of laser technology to the practice of radiology in a busy imaging centre.

  9. Pathophysiology, clinical features and radiological findings of differentiation syndrome/all-trans-retinoic acid syndrome.

    PubMed

    Cardinale, Luciano; Asteggiano, Francesco; Moretti, Federica; Torre, Federico; Ulisciani, Stefano; Fava, Carmen; Rege-Cambrin, Giovanna

    2014-08-28

    In acute promyelocytic leukemia, differentiation therapy based on all-trans-retinoic acid can be complicated by the development of a differentiation syndrome (DS). DS is a life-threatening complication, characterized by respiratory distress, unexplained fever, weight gain, interstitial lung infiltrates, pleural or pericardial effusions, hypotension and acute renal failure. The diagnosis of DS is made on clinical grounds and has proven to be difficult, because none of the symptoms is pathognomonic for the syndrome without any definitive diagnostic criteria. As DS can have subtle signs and symptoms at presentation but progress rapidly, end-stage DS clinical picture resembles the acute respiratory distress syndrome with extremely poor prognosis; so it is of absolute importance to be conscious of these complications and initiate therapy as soon as it was suspected. The radiologic appearance resembles the typical features of cardiogenic pulmonary edema. Diagnosis of DS remains a great skill for radiologists and haematologist but it is of an utmost importance the cooperation in suspect DS, detect the early signs of DS, examine the patients' behaviour and rapidly detect the complications. PMID:25170395

  10. A comparative analysis of patients with mesiodenses: a clinical and radiological study

    PubMed Central

    Lee, Sung-Suk; Oh, Ji-Su; You, Jae-Seek; Jeong, Kyung-In; Kim, Young-Kyun; Lee, Sang-Ho; Lee, Nan-Young

    2015-01-01

    Objectives A mesiodens appears most commonly as a supernumerary tooth impacted in the anterior maxilla. The purpose of this study is analyze mesiodens clinically. Materials and Methods Gender, crown form, direction of impaction, relation to permanent incisors, and chief complaints of patients with extracted mesiodens were analyzed. Results Patients were analyzed for motivation to visit the hospital; 85.4% of the patients were referred from other hospitals. Mesiodens was more common in males than in females (3.7:1), and 70.1% of patients had only one mesiodens, while 29.6% had two mesiodenses. Of the mesiodenses, 61.4% were of the aconical form, and the most common direction was upward (62.4%), followed by the normal position (26.0%) and the horizontal position (11.6%). The mesiodenses caused orthodontic problems with the permanent incisors in 46.3% of cases. Mesiodens associated with dentigerous cyst was rarely observed in our patient group. Conclusion Mesiodens is more common in males than in females and often affects the permanent incisors. Thus, careful clinical and radiological evaluations of mesiodenses are important. PMID:26339577

  11. Clinical, hormonal and radiological profile of 46XY disorders of sexual development

    PubMed Central

    Vasundhera, Chauhan; Jyotsna, Viveka P.; Kandasamy, Devasenathipathy; Gupta, Nandita

    2016-01-01

    Background and Objectives: 46 XY disorders of sexual development (DSD) cover a wide spectrum of phenotypes ranging from unambiguous female genitalia to ambiguous male genitalia with hypospadias or dysgenetic gonads. Management of these patients depends on the cause of DSD, degree of feminization, age at presentation, and gender orientation. The aim of this study was to evaluate the presentation and management of patients with 46XY DSD at our center. Patients and Methods: All new and old patients of 46XY DSD attending the endocrine OPD in a period of 16 months were included in this study. Clinical, cytogenetic, hormonal, and radiological evaluation were done to identify the cause of DSD. Results: Among 19 patients, eight were diagnosed with disorders of gonadal development (one with complete gonadal dysgenesis, four with partial gonadal dysgenesis, two with congenital bilateral anorchia, and one with ovotesticular DSD) and eight with disorders of androgen synthesis and action (one with complete androgen insensitivity syndrome [AIS], three with partial AIS and four with 5α reductase deficiency). In three patients, a definitive diagnosis could not be made. Conclusions: Management of patients with DSD depends on etiology, gender assignment, gender orientation, hormonal treatment, genital surgery, and consequent psychosocial implications. Due to the overlapping clinical and biochemical parameters in different subsets of DSD, only a preliminary etiological diagnosis can be made in some cases. Genetic studies with long-term follow-up are required for an accurate diagnosis. PMID:27186544

  12. Atypical clinical and radiological course of a patient with Canavan disease.

    PubMed

    Sarret, Catherine; Boespflug-Tanguy, Odile; Rodriguez, Diana

    2016-04-01

    Canavan disease (CD) is a rare metabolic disorder caused by aspartoacylase (ASPA) deficiency. It leads to severe neurological degeneration with spongiform brain degeneration. Accumulation of N-acetylaspartate (NAA) in brain and urine is specific to the disease and guides diagnosis. Magnetic resonance imaging (MRI) usually shows diffuse white matter abnormalities with involvement of the basal ganglia. Mild forms of the disease with a more favorable clinical course and radiological involvement of the basal ganglia without white matter abnormalities have also been reported. Here we report an atypical case of a girl aged nine years with CD. The disease started at the classical age of five months. Classical elevation of NAA in brain and urine was present and genetic analysis identified mutations in the ASPA gene. However, clinical evolution was milder than typical CD, with partial motor impairment and relatively well-preserved cognitive skills. MRI was also atypical with low white matter involvement and unusual topography and evolution of abnormalities in the basal ganglia. PMID:26586007

  13. How to Develop, Validate, and Compare Clinical Prediction Models Involving Radiological Parameters: Study Design and Statistical Methods.

    PubMed

    Han, Kyunghwa; Song, Kijun; Choi, Byoung Wook

    2016-01-01

    Clinical prediction models are developed to calculate estimates of the probability of the presence/occurrence or future course of a particular prognostic or diagnostic outcome from multiple clinical or non-clinical parameters. Radiologic imaging techniques are being developed for accurate detection and early diagnosis of disease, which will eventually affect patient outcomes. Hence, results obtained by radiological means, especially diagnostic imaging, are frequently incorporated into a clinical prediction model as important predictive parameters, and the performance of the prediction model may improve in both diagnostic and prognostic settings. This article explains in a conceptual manner the overall process of developing and validating a clinical prediction model involving radiological parameters in relation to the study design and statistical methods. Collection of a raw dataset; selection of an appropriate statistical model; predictor selection; evaluation of model performance using a calibration plot, Hosmer-Lemeshow test and c-index; internal and external validation; comparison of different models using c-index, net reclassification improvement, and integrated discrimination improvement; and a method to create an easy-to-use prediction score system will be addressed. This article may serve as a practical methodological reference for clinical researchers. PMID:27134523

  14. How to Develop, Validate, and Compare Clinical Prediction Models Involving Radiological Parameters: Study Design and Statistical Methods

    PubMed Central

    Han, Kyunghwa; Choi, Byoung Wook

    2016-01-01

    Clinical prediction models are developed to calculate estimates of the probability of the presence/occurrence or future course of a particular prognostic or diagnostic outcome from multiple clinical or non-clinical parameters. Radiologic imaging techniques are being developed for accurate detection and early diagnosis of disease, which will eventually affect patient outcomes. Hence, results obtained by radiological means, especially diagnostic imaging, are frequently incorporated into a clinical prediction model as important predictive parameters, and the performance of the prediction model may improve in both diagnostic and prognostic settings. This article explains in a conceptual manner the overall process of developing and validating a clinical prediction model involving radiological parameters in relation to the study design and statistical methods. Collection of a raw dataset; selection of an appropriate statistical model; predictor selection; evaluation of model performance using a calibration plot, Hosmer-Lemeshow test and c-index; internal and external validation; comparison of different models using c-index, net reclassification improvement, and integrated discrimination improvement; and a method to create an easy-to-use prediction score system will be addressed. This article may serve as a practical methodological reference for clinical researchers. PMID:27134523

  15. Late-onset ankylosing spondylitis and related spondylarthropathies: clinical and radiological characteristics and pharmacological treatment options.

    PubMed

    Toussirot, Eric; Wendling, Daniel

    2005-01-01

    Ankylosing spondylitis is the prototype of related diseases commonly called spondylarthropathies which include reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel diseases (enteropathic arthritis) and undifferentiated spondylarthropathies. Ankylosing spondylitis and spondylarthropathies are generally observed in young patients but can be observed later in life or in persons >50 years of age. All the spondylarthropathy subgroups are represented in the elderly with some features particular to this age group. Indeed, radiological aspects of ankylosing spondylitis may be difficult to interpret because of the radiological changes induced by aging. Late-onset peripheral spondylarthropathies are characterised by severe disease, marked elevation of laboratory parameters of inflammation, oligoarthritis involving the lower limbs and oedema of the extremities. Psoriatic arthritis is more severe in the elderly and is associated with worse outcomes than in young patients. The clinical presentation of undifferentiated spondylarthropathy is as varied in the elderly as in young and middle-aged adults. Reactive arthritis and enteropathic arthritis are observed in the elderly more rarely. The effects of aging on drug metabolism and pharmacokinetics, together with the existence of co-morbidities and polypharmacy, are responsible for difficulties in the therapeutic management of late-onset ankylosing spondylitis or spondylarthropathies. Indeed, NSAIDs should be used with caution in older patients because of the high risk of serious gastrointestinal complications. Sulfasalazine and methotrexate have been used as disease-controlling drugs but did not prove very effective. Pamidronate and tumour necrosis factor (TNF)-alpha antagonists offer a therapeutic alternative but have not been specifically tested in the elderly. Pamidronate has been tested in young-onset ankylosing spondylitis and spondylarthropathies with conflicting results but can be used in

  16. Spinous Process splitting Laminectomy: Clinical outcome and Radiological analysis of extent of decompression

    PubMed Central

    Srikantha, Umesh

    2015-01-01

    Introduction Spinous process splitting laminectomy (SPSL) is a useful technique in achieving adequate decompression for lumbar canal stenosis, has the advantage of simultaneously decompressing multiple levels and minimising injury to the paraspinal muscles. Some concern has been expressed over the efficacy of this technique in decompressing lateral recesses. This study was undertaken to assess the clinical outcome of SPSL technique and radiologically assess the extent of decompression. Patients and Methods Thirty-nine consecutive patients treated by SPSL for degenerative lumbar spinal stenosis were methodically assessed for demographic data, clinical findings, Pre- and post-op VAS, JOA scores and spinal canal dimensions on imaging. Surgical technique for SPSL is described. Results The mean age of the patients was 66.9 yrs. The mean follow-up was 7.3 months. The mean pre- and post-operative VAS scores were 7.8 and 3.7, respectively. The mean pre- and post-operative JOA scores were 6.3 and 11.2, respectively. The mean JOA recovery rate was 57.3%. 77% of the patients were in the ‘good’ or ‘excellent’ McNab's grades at follow-up. Radiologic results were assessed separately at the 118 levels decompressed by the SPSL technique. The ratio increase for the spinal canal dimensions on post-operative images were as follows – Interfacet distance–116.6%; Effective AP distance–67.6%; Right lateral recess depth–165.1%; Right lateral recess angle–145.5%; Left lateral recess depth–149.3%; Left lateral recess angle–133.6%; Cross-sectional spinal canal area–163.8%. There was no worsening of pre-existing degenerative listhesis or scoliosis in any case. Conclusion SPSL achieves effective central and lateral recess decompression, at the same time minimising injury to the paraspinal muscles thus reducing post-operative pain and aiding in quicker mobilisation and recovery. It is an effective tool to treat multiple level spinal stenosis, especially in elderly

  17. Rigid Bronchoscopy in Airway Foreign Bodies: Value of the Clinical and Radiological Signs

    PubMed Central

    Acharya, Kunjan

    2016-01-01

    Introduction  Foreign body in airway is a common emergency in ENT practice. As we know, Rigid Bronchoscopy is the method of choice for removing it, although at times it leads to specialists performing unnecessary bronchoscopy, exposing patients to hazards of general anesthesia. Objective  The objective of my study is to calculate sensitivity, specificity, positive predictive value, odds ratio from the clinical and radiological signs, comparing with the gold standard, the rigid bronchoscope procedure. Method  This is a prospective analytical study designed at University Teaching Hospital and conducted over a period of 18 months, from March 2011 to August 2012. Data collection was broadly classified into three different categories: (1) Symptomatology, such as presence or absence of choking, cyanosis, and difficulty in breathing; (2) Clinical signs, such as the presence or absence of air entry, crackles, and rhonchi 3. Chest X-ray findings were suggestive of a foreign body. Results  There were a total of 40 rigid bronchoscopies performed under general anesthesia for the diagnosis and therapeutic reasons. Among 40 patients who underwent rigid bronchoscopy, 32 (80%) were found to have varieties of foreign bodies in their airway while 8 patients (20%) had negative bronchoscopy. The history of choking is the only clinical symptoms which came out to be statistically Significant (p = 0.043) with odds ratio of 5. Conclusion  Rigid bronchoscopy is the gold standard technique for diagnosis and procedure of choice to remove FB from airway. Regardless, it still presents a small chance of negative result, especially when there is no history of aspiration. PMID:27413398

  18. CLINICAL AND RADIOLOGICAL EVALUATION ON DEVELOPMENTAL HIP DYSPLASIA AFTER SALTER AND OMBRÉDANNE PROCEDURE

    PubMed Central

    da Rocha, Válney Luiz; Thomé, André Luiz Coelho; da Silva Castro, Daniel Labres; de Oliveira, Leandro Zica; de Moraes, Frederico Barra

    2015-01-01

    Objective: To evaluate the clinical and radiological medium-term results from surgical treatment of developmental hip dysplasia through Salter innominate bone osteotomy and Ombrédanne femoral shortening. Methods: Fourteen patients were evaluated, with surgical treatment on 18 hips (seven right-side hips and eleven left-side hips) using the proposal technique, performed between 1998 and 2008. The Dutoit and Severin criteria were used respectively for clinical and radiographic evaluations. Results: The average preoperative index for the seven right-side hips was 43.3° (40° to 50°), and this was corrected through surgery to an average of 31.57° (24° to 42°). The average preoperative index for the eleven left-side hips was 42.1° (36° to 56°), and this was corrected through surgery to an average of 30.36° (20° to 44°). There was a statistically significant difference between the preoperative and postoperative acetabular indexes, with P > 0.05. The clinical evaluation showed that there were seven excellent hips (38.9%), eight good ones (44.4%), three fair hips (16.7%) and no poor ones (0%). By grouping the hips rated good and excellent as satisfactory and those rated poor and fair as unsatisfactory, 83.3% of the results were seen to be favorable. There were no statistically significant correlations between occurrences of complications and patient age at the time of surgery or between complications and the preoperative acetabular index (p > 0.05). The complications observed consisted of one case each of subluxation, osteonecrosis and osteonecrosis together with subluxation. Conclusion: The combined procedure of Salter and Ombrédanne is a viable option for treating developmental hip dysplasia after patients have started to walk. PMID:27027068

  19. Experimental measurement of radiological penumbra associated with intermediate energy x-rays (1 MV) and small radiosurgery field sizes

    SciTech Connect

    Keller, Brian M.; Beachey, David J.; Pignol, Jean-Philippe

    2007-10-15

    Stereotactic radiosurgery is used to treat intracranial lesions with a high degree of accuracy. At the present time, x-ray energies at or above Co-60 gamma rays are used. Previous Monte Carlo simulations have demonstrated that intermediate energy x-ray photons or IEPs (defined to be photons in the energy range of 0.2-1.2 MeV), combined with small field sizes, produce a reduced radiological penumbra leading to a sharper dose gradient, improved dose homogeneity and sparing of critical anatomy adjacent to the target volume. This hypothesis is based on the fact that, for small x-ray fields, a dose outside the treatment volume is dictated mainly by the range of electrons set into motion by x-ray photons. The purpose of this work is: (1) to produce intermediate energy x rays using a detuned medical linear accelerator (2) to characterize the energy of this beam (3) to measure the radiological penumbra for IEPs and small fields to compare with that produced by 6 MV x rays or Co-60, and (4) to compare these experimental measurements with Monte Carlo computer simulations. The maximum photon energy of our IEP x-ray spectrum was measured to be 1.2 MeV. Gafchromic EBT films (ISP Technologies, Wayne, NJ) were irradiated and read using a novel digital microscopy imaging system with high spatial resolution. Under identical irradiation conditions the measured radiological penumbra widths (80%-20% distance), for field sizes ranging from 0.3x0.3 to 4.0x4.0 cm{sup 2}, varied from 0.3-0.77 mm (1.2 MV) and from 1.1-2.1 mm (6 MV). Even more dramatic were the differences found when comparing the 90%-10% or the 95%-5% widths, which are in fact more significant in radiotherapy. Monte Carlo simulations agreed well with the experimental findings. The reduction in radiological penumbra could be substantial for specific clinical situations such as in the treatment of an ocular melanoma abutting the macula or for the treatment of functional disorders such as trigeminal neuralgia (a nonlethal

  20. Characterization of optically stimulated luminescence dosemeters to measure organ doses in diagnostic radiology

    PubMed Central

    Endo, A; Katoh, T; Kobayashi, I; Joshi, R; Sur, J; Okano, T

    2012-01-01

    Objective The aim of this study was to assess the characteristics of an optically stimulated luminescence dosemeter (OSLD) for use in diagnostic radiology and to apply the OSLD in measuring the organ doses by panoramic radiography. Methods The dose linearity, energy dependency and angular dependency of aluminium oxide-based OSLDs were examined using an X-ray generator to simulate various exposure settings in diagnostic radiology. The organ doses were then measured by inserting the dosemeters into an anthropomorphic phantom while using three panoramic machines. Results The dosemeters demonstrated consistent dose linearity (coefficient of variation<1.5%) and no significant energy dependency (coefficient of variation<1.5%) under the applied exposure conditions. They also exhibited negligible angular dependency (≤10%). The organ doses of the X-ray as a result of panoramic imaging by three machines were calculated using the dosemeters. Conclusion OSLDs can be utilized to measure the organ doses in diagnostic radiology. The availability of these dosemeters in strip form proves to be reliably advantageous. PMID:22116136

  1. Clinical and Radiological Evaluation after Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique

    PubMed Central

    Lee, Kwang Won; Bae, Kyoung Wan; Choy, Won Sik

    2013-01-01

    Background We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA). Methods Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up period was 27.4 months. Clinical and functional outcomes were assessed using range of motion, Korean shoulder score, Constant score, and UCLA score. Radiological outcome was evaluated with preoperative and follow-up MRA. Potential predictive factors that influenced cuff retear, such as age, gender, geometric patterns of tear, size of cuff tear, acromioplasty, fatty degeneration, atrophy of cuff muscle, retraction of supraspinatus, involved muscles of cuff and osteolysis around the suture anchor were evaluated. Results Thirty cases (48.4%) revealed retear on MRA. In univariable analysis, retear was significantly more frequent in over 60 years age group (62.5%) than under 60 years age group (39.5%; p = 0.043), and also in medium to large-sized tear than small-sized tear (p = 0.003). There was significant difference in geometric pattern of tear (p = 0.015). In multivariable analysis, only age (p = 0.036) and size of tear (p = 0.030) revealed a significant difference. The mean active range of motion for forward flexion, abduction, external rotation at the side and internal rotation at the side were significantly improved at follow-up (p < 0.05). The mean Korean shoulder score, Constant score, and UCLA score increased significantly at follow-up (p < 0.01). The range of motion, Korean shoulder score, Constant score, and UCLA score did not differ significantly between the groups with retear and intact repairs (p > 0.05). The locations of retear were insertion site in 10 cases (33.3%) and

  2. Informatics in radiology: IHE teaching file and clinical trial export integration profile: functional examples.

    PubMed

    Kamauu, Aaron W C; Whipple, Jeffrey J; DuVall, Scott L; Siddiqui, Khan M; Siegel, Eliot L; Avrin, David

    2008-01-01

    The digital revolution in radiology introduced the need for electronic export of medical images. However, the current export process is complicated and time consuming. In response to this continued difficulty, the Integrating the Healthcare Enterprise (IHE) initiative published the Teaching File and Clinical Trial Export (TCE) integration profile. The IHE TCE profile describes a method for using existing standards to simplify the export of key medical images for education, research, and publication. This article reviews the authors' experience in implementing the TCE profile in the following three processes: (a) the retrieval of images for a typical teaching file application within a TCE-compliant picture archiving and communication system (PACS); (b) the export of images, independent of TCE compliance of the PACS, to a typical teaching file application; and (c) the TCE-compliant transfer of images for publication. These examples demonstrate methods with which the TCE profile can be implemented to ease the burden of collecting key medical images from the PACS. PMID:18635622

  3. Clinical and Radiological Outcome in Cases of Posterolateral Fusion with Instrumentation for Lumbar Spondylolisthesis

    PubMed Central

    Sannegowda, Raghavendra Bakki

    2015-01-01

    Introduction Lumbar Spondylolisthesis as a cause of low back pain and lower limb radiculopathy has been treated using varied surgical options. The role of laminectomy for decompression of neural elements and stabilization using instrumentation in the form of pedicle screws and rod construct has been a well-established and time tested treatment modality. Aim and Objectives This study analyses the role of laminectomy and instrumentation in obtaining clinical and radiologically favourable outcome. Materials and Methods Data was analysed from the case records for the duration from January 2010 to March 2014. The study analyses the influence of lumbar decompression (laminectomy) and transpedicular instrumentation using titanium pedicle screws and intertransverse process iliac crest graft on patients with degenerative lumbar spondylolisthesis and spinal stenosis. Conclusion Decompression primarily relieves radicular symptoms and neurogenic claudication whereas fusion primarily relieves back pain by elimination of instability. The addition of posterolateral instrumentation (pedicle screws) enhances the ability to obtain a solid arthrodesis. Posterolateral instrumentation enables improved functional outcome, better patient satisfaction and less back and lower limb symptomatology. This is irrespective of bony arthrodesis or pseudoarthrosis, at least in the short term follow-up. PMID:26266162

  4. Kudo total elbow arthroplasty in rheumatoid arthritis. Clinical and radiological results.

    PubMed

    Rauhaniemi, J; Tiusanen, H; Kyrö, A

    2006-04-01

    We have analysed the results of 28 total elbow replacements in 27 patients. The replacements were made using the Kudo unconstrained, unlinked, total elbow prosthesis. The elbows were all affected by rheumatoid arthritis. The follow-up time was from 3 to 7 years, with a mean follow-up of 58 months. Our results with this prosthesis in rheumatoid arthritis appear promising and only few complications were noticed. In one case, a radiological loosening of the ulnar component was observed at the 5-year visit but without any clinical symptoms and no operations were needed. In two other cases, an open reduction was performed within the first 3 months to correct a subluxation. A triceps tendon was re-inserted for a fourth patient 55 months postoperatively. In general, the range of motion became statistically significantly better with the prosthesis and there was also a high rate of relief of pain in patients in whom the elbow was severely affected by rheumatoid arthritis. PMID:16137809

  5. Keratocystic odontogenic tumour in a Hong Kong community: the clinical and radiological features

    PubMed Central

    MacDonald-Jankowski, D S; Li, T K

    2010-01-01

    Objectives The aim of this study was to evaluate the clinical and conventional radiological features of a consecutive series of cases of “keratocystic odontogenic tumour” (KCOT) affecting a Hong Kong Chinese community and to determine their outcome by follow-up. Methods All cases were accompanied by appropriate radiography and were histopathologically confirmed. Results 33 consecutive KCOTs were reviewed. 18 patients were male. The mean age at first presentation was 30.6 years. Swelling was the most frequent presenting symptom. Those patients first presenting with pain were significantly older, whereas those first presenting with a maxillary lesion were significantly younger. The maxilla and mandible were affected in 13 and 20 cases, respectively. KCOTs were most frequently confined to the posterior sextants of both jaws. KCOTs affecting the maxilla were mainly unilocular, whereas those affecting the mandible were multilocular. Patients with multilocular KCOTs were significantly older. Patients with KCOTs associated with root resorption were significantly older, whereas patients associated with unerupted teeth were significantly younger. 69% displaced teeth, 41% resorbed them and 56% were associated with unerupted teeth. All but two were followed up for at least 2 years. Three lesions recurred. Conclusions KCOTs in this community displayed some differences from those reported in the literature. PMID:20203279

  6. Tubercular meningitis in children: Clinical, pathological, and radiological profile and factors associated with mortality

    PubMed Central

    Israni, Anil V.; Dave, Divya A.; Mandal, Anirban; Singh, Amitabh; Sahi, Puneet K.; Das, Rashmi Ranjan; Shah, Arpita

    2016-01-01

    Context: Childhood tuberculosis is a major public health problem in developing countries with tubercular meningitis being a serious complication with high mortality and morbidity. Aim: To study the clinicopathological as well as radiological profile of childhood tuberculous meningitis (TBM) cases. Settings and Design: Prospective, observational study including children <14 years of age with TBM admitted in a tertiary care hospital from Western India. Subjects and Methods: TBM was diagnosed based on predefined criteria. Glassgow coma scale (GCS) and intracranial pressure (ICP) was recorded. Staging was done as per British Medical Council Staging System. Mantoux test, chest X-ray, cerebrospinal fluid (CSF) examination, neuroimaging, and other investigations were done to confirm TB. Statistical Analysis Used: STATA software (version 9.0) was used for data analysis. Various risk factors were determined using Chi-square tests, and a P< 0.05 was considered significant. Results: Forty-seven children were included, of which 11 (24.3%) died. Fever was the most common presenting symptom, and meningismus was the most common sign. Twenty-nine (62%) children presented with Stage III disease. Stage III disease, low GCS, and raised ICP were predictors of mortality. Findings on neuroimaging or CSF examination did not predict mortality. Conclusions: Childhood TBM presents with nonspecific clinical features. Stage III disease, low GCS, lack of Bacillus Calmette–Guérin vaccination at birth and raised ICP seem to the most important adverse prognostic factors. PMID:27365958

  7. Clinical and radiological factors affecting progressive collapse of acute osteoporotic compression spinal fractures.

    PubMed

    Goldstein, Sergei; Smorgick, Yossi; Mirovsky, Yigal; Anekstein, Yoram; Blecher, Ronen; Tal, Sigal

    2016-09-01

    Osteoporotic compression spine fractures have a different clinical course and outcomes when compared to spinal fractures occurring in the younger population. Only a few studies have investigated the risk factors for progressive osteoporotic compression spine fractures. The purpose of this study was to investigate clinical and radiological factors related to progressive collapse following acute osteoporotic compression spine fractures. We retrospectively identified all patients treated for thoracolumbar fractures in our institution between January 2008 and July 2013. Included cases were examined by plain radiographs and CT scans. For each patient we classified the fracture according to the AOSpine Thoracolumbar Spine Injury Classification System. The difference between initial and final height loss and initial and final local kyphosis was documented as height loss difference and kyphotic angle difference. The presence of old fractures and intravertebral cleft were also documented. The study included 153 patients, comprising 102 women and 51 men. The mean patient age was 68.9years. The mean length of follow up was 15months. A statistically significant correlation was found between patient age, final height loss, height loss difference and kyphotic angle difference. Height loss difference and kyphotic angle difference were significantly correlated to type of fracture according to the AO classification system. The height loss difference was 18.1% in A1 type fractures, 27.1% in A2 type fractures, 24.2% in A3 type fractures and 25.7% in A4 type fractures. During a minimum 3-month follow up of conservative treatment for acute osteoporotic vertebral compression fractures, age and the AOSpine Thoracolumbar Spine Injury Classification System were predictive factors for progressive collapse. PMID:27387197

  8. Etiological, clinical, and radiological features of longitudinally extensive myelopathy in Chinese patients.

    PubMed

    Zhang, Weihe; Jiao, Yujuan; Cui, Lei; Liu, Lei; Zhang, Linwei; Jiao, Jinsong

    2016-10-01

    Longitudinally extensive myelopathy (LEM) is a rare spinal syndrome, and was mostly assessed in western populations. In order to investigate the etiological, clinical, and radiological features of LEM in Chinese patients, we retrospectively analyzed eighty-nine (40 men and 49 women, median age 45.9±15.7years) patients with LEM hospitalized in China-Japan Friendship Hospital. LEM comprised autoimmune inflammatory myelitis (n=53), metabolic and compressive disorders (n=13), vascular diseases (n=10), neoplastic diseases (n=7), infectious diseases (n=4), and syringomyelia (n=2). Neuromyelitis optica spectrum disorders (NMOSD) was the most common cause of transverse myelopathy identified in LEM (38/89 [42.7%]) characterized by intractable vomiting and hiccups and painful tonic spasms. Subacute combined degeneration and anterior spinal artery syndrome accounted for the largest non-transverse LEM, which selectively affected the spinal dorsal and/or lateral columns and the spinal anterior region, respectively. Radicular pain was common in anterior spinal artery syndrome. Postrema (n=15, 39.5%) and cervical (n=31, 81.6%) lesions were significantly increased in NMOSD versus non-NMOSD (n=7, 13.7% and n=34, 66.7%, respectively, p<0.05]. Axial T2-weighted MRI indicated that 46 (51.7%) patients exhibited complete lesions; 43 (48.3%) patients exhibited non-transverse lesions, mainly unilateral or symmetrical tract lesions. Twenty-four (51.1%) LEM patients exhibited distinct gadolinium contrast enhancement. In this Chinese cohort, LEM was primarily attributed to NMOSD. While the etiological distribution in the non-NMOSD group was different from western populations, clinical and imaging features may facilitate a differential diagnosis. PMID:27526974

  9. Somatosensory evoked potentials in cervical spondylosis. Correlation of median, ulnar and posterior tibial nerve responses with clinical and radiological findings.

    PubMed

    Yu, Y L; Jones, S J

    1985-06-01

    Somatosensory evoked potentials (SEPs) following median, ulnar and tibial nerve stimulation were recorded from sites over the shoulders, neck and scalp in 34 patients with cervical spondylosis. Twenty control subjects were matched for sex and age. Detailed clinical and radiological data were assembled, with particular attention to the sensory modalities impaired and the locus and severity of cord compression. The patients were divided clinically into 4 groups: combined myelopathy and radiculopathy (6 cases), myelopathy alone (15), radiculopathy (6) and neck pain (7). Four cases are described in detail. SEP abnormalities were strongly correlated with clinical myelopathy, but not with radiculopathy. Median and ulnar nerve responses were less often affected than tibial, even with myelopathy above C6 level. Tibial nerve SEP abnormalities were strongly correlated with posterior column signs on the same side of the body, but not with anterolateral column sensory signs. In myelopathy cases, the SEP examination appeared to be more sensitive to sensory pathway involvement than clinical sensory testing. SEP abnormalities were infrequent in cases of radiculopathy and neck pain, bearing no relation to the clinical locus of root lesions. Abnormal SEPs consistent with subclinical posterior column involvement, however, were recorded in 1 patient with radiculopathy and 2 with neck pain. Follow-up recordings made postoperatively in 7 myelopathy cases reflected the clinical course (improvement, deterioration or no change) in 4, but failed to reflect improvement in 3. The correlation of SEP findings with radiological data was generally poor. SEP abnormalities were detected in 6 out of 8 patients with clinical myelopathy but no radiological evidence of posterior cord compression, suggesting that impairment of the blood supply may be an important factor contributing to cord damage. An application for SEPs in the clinical management of cervical spondylosis may lie in the detection of

  10. Outcome Measures for Clinical Trials in Interstitial Lung Diseases

    PubMed Central

    Lammi, Matthew R.; Baughman, Robert P.; Birring, Surinder S.; Russell, Anne-Marie; Ryu, Jay H.; Scholand, Marybeth; Distler, Oliver; LeSage, Daphne; Sarver, Catherine; Antoniou, Katerina; Highland, Kristin B.; Kowal-Bielecka, Otylia; Lasky, Joseph A.; Wells, Athol U.; Saketkoo, Lesley Ann

    2015-01-01

    The chronic fibrosing idiopathic interstitial pneumonias (IIPs) are a group of heterogeneous pulmonary parenchymal disorders described by radiologic and histological patterns termed usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP). These include idiopathic pulmonary fibrosis (IPF) and those related to connective tissue disease (CTD) and are associated with substantial morbidity and mortality. Beyond the importance of establishing an appropriate diagnosis, designing optimal clinical trials for IIPs has been fraught with difficulties in consistency of clinical endpoints making power analyses, and the establishment of efficacy and interpretation of results across trials challenging. Preliminary recommendations, developed by rigorous consensus methods, proposed a minimum set of outcome measures, a ‘core set’, to be incorporated into future clinical trials (Saketkoo et al, THORAX. 2014.). This paper sets out to examine the candidate instruments for each domain (Dyspnea, Cough, Health Related Quality of Life, Imaging, Lung Physiology and Function, Mortality). Candidate measures that were not selected as well as measures that were not available for examination at the time of the consensus process will also be discussed. PMID:27019654

  11. Congenital intestinal malrotation in adolescent and adult patients: a 12-year clinical and radiological survey.

    PubMed

    Husberg, Britt; Salehi, Karin; Peters, Trevor; Gunnarsson, Ulf; Michanek, Margareta; Nordenskjöld, Agneta; Strigård, Karin

    2016-01-01

    Congenital intestinal malrotation is mainly detected in childhood and caused by incomplete rotation and fixation of the intestines providing the prerequisites for life-threatening volvulus of the midgut. The objective of this study was to evaluate a large cohort of adult patients with intestinal malrotation. Thirty-nine patients, 15-67 years, were diagnosed and admitted to a university setting with congenital intestinal malrotation 2002-2013. The patients were divided into three age groups for stratified evaluation. Medical charts were scrutinized, and clinical outcome of surgery was reviewed. Twelve patients presented as emergency cases, whereas 27 were admitted as elective cases. Diagnosis was established in 33 patients who underwent radiological investigation and in the remaining 6 during surgery. A Ladd's operation was performed in 31 symptomatic patients; a conservative strategy was chosen in eight cases. Volvulus was more common in the younger age group. Twenty-six surgically treated patients were available for telephone interview, 1-12 years after surgery. All patients, except one, regarded their general condition improved to a high degree (n = 18) or with some reservation (n = 7). Twelve patients suffered remaining abdominal pain of a chronic and diffuse character. Due to recurrence of malrotation six patients were reoperated. Symptomatic malrotation occurs in both children and the adult population. Improved awareness and an accurately performed CT scan can reveal the malformation and enable surgical treatment. A Ladd's procedure relieved most patients from their severe complaints even when a history of several years of suffering existed. PMID:27026938

  12. Association of chronic rhinosinusitis with nasal polyps and asthma: clinical and radiological features, allergy and inflammation markers.

    PubMed

    Staikūniene, Jūrate; Vaitkus, Saulius; Japertiene, Lidija Marija; Ryskiene, Silvija

    2008-01-01

    Chronic rhinosinusitis (CRS) with and without nasal polyps represent different stages of one chronic inflammatory disease of the mucosa of the nasal cavity and paranasal sinuses. Coexistence of chronic rhinosinusitis with nasal polyps and asthma and rather similar characteristics of inflammation support assumption that chronic rhinosinusitis and nasal polyps and asthma may be, at least in part, the same disease process. We therefore aimed to evaluate the differences of sinus radiologic findings, systemic inflammation and allergy markers, pulmonary function of chronic rhinosinusitis associated with nasal polyps and asthma. A total of 121 patients with chronic rhinosinusitis referred to tertiary center were evaluated; 23 healthy persons served as controls. Sinus CT scans and nasal endoscopy were performed. Allergic rhinitis was diagnosed according to history and positive skin prick tests to common inhalant allergens. Asthma was diagnosed according to GINA by history and pulmonary function tests. Aspirin intolerance was assessed by history. Total IgE, Aspergillus fumigatus-specific IgE levels, leukocyte and eosinophil count in the peripheral blood were measured. Nasal polyps were detected in 84 patients (69.4%), asthma diagnosed in 48 patients (39.6%), associated with nasal polyps (91.7%) and allergic rhinitis in 45.5% of patients. Forty-four patients with chronic rhinosinusitis and having nasal polyps and asthma were characterized by older age (P<0.01), greater duration of nasal symptoms (P<0.001), higher number previous surgeries (P<0.01), more severe sinus disease on CT scan (P<0.001), greater blood leukocyte and eosinophil count, total IgE level (P<0.01), bronchial obstruction (P<0.05), incidence of allergic rhinitis (P<0.01), and sensitivity to house dust mite D. pteronyssinus (47.7%, P<0.01) and mold allergens (29.5%, P<0.01) comparing to the patients with isolated chronic rhinosinusitis. The extent of sinus CT changes was greater in asthmatics and correlated

  13. Clinical improvement and radiological progression in a girl with early onset scoliosis (EOS) treated conservatively – a case report

    PubMed Central

    Weiss, Hans-Rudolf

    2006-01-01

    . However, the weight the patient gained cannot explain the cosmetical improvement in this case. Conservative treatment with a certain standard of quality seems a viable alternative for patients with Cobb angles of > 60° when surgical treatment is refused. Specialists in scoliosis management should be aware of the fact that curve progression can occur even if the clinical measurements show an improvement. PMID:16872503

  14. Solid variant of aneurysmal bone cyst presenting as a giant cervical mass: A clinical, radiological, histopathological dilemma

    PubMed Central

    Savardekar, Amey R.; Patra, Deviprasad; Chatterjee, Debajyoti; Ahuja, Chirag K.; Salunke, Pravin

    2015-01-01

    Background: Typical aneurysmal bone cysts (ABCs) are osteolytic, multicystic lesions with parietal sclerosis and blood-filled cysts. In rare instances, the cystic components may be completely absent. Such solid variants in ABC (s-ABC) exhibit a solid architecture; making the clinical, radiological, and histological differentiation from other solid bone tumors like osteosarcoma (especially giant cell rich osteosarcoma) and giant cell tumor, a difficult task. Case Report: We report the case of a 45–year-old male presenting with a giant solid cervical spine lesion. Histopathology revealed solid variant of ABC, even though the radiological and fine needle aspiration cytology studies pointed toward a giant cell tumor. Conclusion: We aim to discuss the clinical, radiological, and histological findings of solid ABC (a rare benign entity) vis-à-vis the common neoplastic entities of osteosarcoma and giant cell tumor. The histopathological nuisances in making the diagnosis of s-ABC are put forth, along with its impact on management of such giant bony spinal lesions. PMID:26005581

  15. Deposition Measurements From the Full-Scale Radiological Dispersal Device Field Trials.

    PubMed

    Erhardt, Lorne; Lebel, Luke; Korpach, Ed; Berg, Rodney; Inrig, Elizabeth; Watson, Ian; Liu, Chuanlei; Gilhuly, Colleen; Quayle, Debora

    2016-05-01

    In 2012, Defence Research and Development Canada led a series of experiments, titled the Full-Scale Radiological Dispersal Device Field Trials, in which short-lived radioactive material was explosively dispersed and the resulting plume and deposition were characterized through a variety of methods. Presented here are the results of a number of measurements that were taken to characterize the radioactive ground deposition. These included in situ gamma measurements, deposition filter samples, and witness plate measurements that were taken in situ with handheld beta survey meters. The results from the different measurement techniques are compared to each other and to a simple deposition model. Results showed that approximately 3% of the original source activity was deposited in the immediate vicinity of ground zero, and an additional 15-30% of the original activity was deposited within 450 m of ground zero. Implications of these results for emergency response are discussed. PMID:27023032

  16. Clinical and radiological signs of ABPA associated with airways infection with Aspergillus in the absence of specific IgE.

    PubMed

    Sunzini, F; Barbato, C; Canofari, C; Lugari, L; Perricone, R; Bergamini, A

    2016-09-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus that mainly affects patients with asthma. For diagnosis, elevated serum IgE level are needed according to Greenberger and Patterson criteria. We report a case of 43 years-old woman who developed ABPA with productive cough, fever and radiological findings of multiple confluent areas of consolidation in both upper lobes. Laboratory tests showed elevated peripheral eosinophil counts (9.3 x 10(3)/ml). In bronchial washing A. galactomannans and A. Fumigatus were isolated, although we found normal levels of serum IgE, and the absence of serum IgG and IgE antibodies to Aspergillus and A. galactomannans. In conclusion, clinical and radiological signs of ABPA can be associated with Aspergillus infection also in the absence of a specific serum antibody reaction. PMID:27608478

  17. infoRAD: computers for clinical practice and education in radiology. Teleradiology: fundamental considerations and clinical applications.

    PubMed

    Barnes, G T; Morin, R L; Staab, E V

    1993-05-01

    Teleradiology, the practice of radiology from a distance, involves transmission of images between two locations. Radiologists off site can be consulted easily and quickly whenever critical questions arise. Similarly, long-distance, real-time radiologic monitoring of patients is possible. Second opinions can be obtained from specialists in difficult cases. The result is improved and more efficient delivery of patient care. The large number of teleradiology products and features often confuses radiologists who are considering the incorporation of teleradiology into their practices. It is important that practice patterns and needs be evaluated prior to specification and acquisition of a teleradiology system. PMID:8316673

  18. iPad-based patient briefing for radiological examinations-a clinical trial.

    PubMed

    Schlechtweg, Philipp M; Hammon, Matthias; Giese, David; Heberlein, Christian; Uder, Michael; Schwab, Siegfried A

    2014-08-01

    To analyze if an iPad-based patient briefing can serve as a digital alternative to conventional documentations prior to radiological examinations. One hundred one patients referred for routine MRI were randomized into two groups, who underwent iPad-based and classic written briefing in opposite order. For each briefing completion time, completeness and correctness were noted. Patient's knowledge about the content of either briefing modality was subsequently tested. The influence of patient-related factors on the performance of the electronic briefing (EB) was analyzed. Finally, the patient's subjective impression of the EB was assessed. The mean durations were 4.4 ± 2.2 min for EB and 1.7 ± 1.3 min for the classic briefing (p < 0.01). All iPad briefings were returned entirely filled out, whereas 11 % of the classic forms were returned with missing data. No significant differences in memorization of the briefing's information were objectified. There was a positive correlation between the duration of EB and age (r = 0.53; p < 0.01), whereas a negative correlation was found between computer skills and patient's age (r = -0.55; p < 0.01) or duration of EB (r = -0.62; p < 0.01). More than half of the study patients would prefer EB in the future; another 29 % had no preference at all. Patient briefing on iPads transfers the information for the patients equally well compared to the classic written approach. Although iPad briefing took patients longer to perform, the majority would prefer it to written consent briefings in the future. Nevertheless, measures have to be undertaken to improve the overall acceptance and performance. PMID:24687643

  19. Bridging the Gap between Basic and Clinical Sciences: A Description of a Radiological Anatomy Course

    ERIC Educational Resources Information Center

    Torres, Anna; Staskiewicz, Grzegorz J.; Lisiecka, Justyna; Pietrzyk, Lukasz; Czekajlo, Michael; Arancibia, Carlos U.; Maciejewski, Ryszard; Torres, Kamil

    2016-01-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images…

  20. Radiology/Imaging. Clinical Rotation. Instructor's Packet and Student Study Packet.

    ERIC Educational Resources Information Center

    Texas Univ., Austin. Extension Instruction and Materials Center.

    The instructor's packet, the first of two packets, is one of a series of materials designed to help students who are investigating the activities within a radiology department or considering any of the imaging technologies as a career. The material is designed to relate training experience to information studied in the classroom. This packet…

  1. Clinical and Radiological Results of Microsurgical Posterior Lumbar Interbody Fusion and Decompression without Posterior Instrumentation for Lateral Recess Stenosis

    PubMed Central

    Şişman, Lokman; Türkmen, Faik; Efe, Duran; Pekince, Oğuzhan; Göncü, Recep Gani; Sever, Cem

    2015-01-01

    Study Design A single-center, retrospective patient review of clinical and radiological outcomes of microsurgical posterior lumbar interbody fusion and decompression, without posterior instrumentation, for the treatment of lateral recess stenosis. Purpose This study documented the clinical and radiological results of microsurgical posterior lumbar interbody fusion and decompression of the lateral recess using interbody cages without posterior instrumentation for the treatment of lateral recess stenosis. Overview of Literature Although microsurgery has some advantages, various complications have been reported following microsurgical decompression, including cage migration, pseudoarthrosis, neurologic deficits, and persistent pain. Methods A total of 34 patients (13 men, 21 women), with a mean age of 56.65±9.1 years (range, 40-77 years) confirmed spinal stability, and preoperative radiological findings of lateral recess stenosis, were included in the study. Interbody polyetheretherketone cages and auto grafts were used in all patients. Posterior instrumentation was not used because of limited resection of the posterior lumbar structures. Preoperative and postoperative radiographs, computed tomography scans, and magnetic resonance imaging were assessed and compared to images taken at the final follow-up. Functional recovery was also evaluated according to the Macnab criteria at the final follow-up. Results The average follow-up time was 35.05±8.65 months (range, 24-46 months). The clinical results, operative time, intraoperative blood loss, and duration of hospital stay were similar to previously published results; the fusion rate (85.2%) was decreased and the migration rate (5.8%) was increased, compared with prior reports. Conclusions Although microsurgery has some advantages, migration and pseudoarthrosis remain challenges to achieving adequate lumbar interbody fusion. PMID:26435789

  2. Guide for radiological characterization and measurements for decommissioning of US Department of Energy surplus facilities

    SciTech Connect

    Denahm, D. H.; Barnes, M. G.; Jaquish, R. E.; Corley, J. P.; Gilbert, R. O.; Hoenes, G. R.; Jamison, J. D.; McMurray, B. J.; Watson, E. C.

    1983-08-01

    This Guide describes the elements of radiological characterization at DOE excess facilities in preparation for, during, and subsequent to decommissioning operations. It is the intent of this Guide and accompanying appendices to provide the reader (user) with sufficient information to carry out that task with a minimum of confusion and to provide a uniform basis for evaluating site conditions and verifying that decommissioning operations are conducted according to a specific plan. Some areas of particular interest in this Guide are: the need to involve appropriate staff from the affected states in the early planning stages of decommissioning; the need for and suggested methods of radiological site characterization to complete a decommissioning project, including: historical surveys, environmental pathway analyses, statistical sampling design, and choosing appropriate instrumentation and measurements; the need for and emphasis on quality assurance, documentation and records retention; the establishment of a Design Objective approach to applying site-specific contamination limits based on the ALARA philosophy; the establishment of a ''de minimis'' or minimum dose level of concern for decommissioning operations based on existing standards, experience and ALARA considerations.

  3. Pathogenesis, clinical course and neuro-radiological signs of Proprionibacterium acnes cerebritis: Case report and literature review.

    PubMed

    Yakhkind, Aleksandra; Yacoub, Hussam A; Grove, Jacqueline; Varrato, Jay D; Castaldo, John E

    2015-01-01

    The clinical and neuroimaging characteristics of brain infections related to Propionibacterium acnes are not well-characterized, making early diagnosis and treatment a challenge. More recently, life-threatening central nervous system infections with P. acnes are being reported with increasing frequency as complications of neurointerventional procedures. We present a rare case of P. acnes cerebritis that occurred as a sequela of bare platinum aneurysm coiling and a contaminant of percutaneous angiographic intervention. We include an extensive review of the literature describing the pathogenesis of P. acnes and neuro-radiological signs of brain infections related to this pathogen. PMID:25762004

  4. Dynamic Cervical Implant versus Anterior Cervical Diskectomy and Fusion: A Prospective Study of Clinical and Radiologic Outcome.

    PubMed

    Richter, Heiko; Seule, Martin; Hildebrandt, Gerhard; Fournier, Jean-Yves

    2016-07-01

    Objective To evaluate clinical and radiologic outcome in patients treated with a dynamic cervical implant (DCI) or anterior cervical diskectomy and fusion (ACDF). Study Design A prospective comparative cohort study. Methods The study included 60 patients with one- or two-level cervical degenerative disk disease (DDD) undergoing treatment with either DCI (n = 30) or ACDF (n = 30). Clinical and radiologic outcomes were assessed 3 and 12 months after surgery. Clinical scoring systems included the Visual Analog Scale for Neck (VAS-N) and Arm pain (VAS-A), the Neck Pain and Disability Scale (NPAD), and the European Quality of Life Scale (EQ-5D). Results Both the DCI and ACDF group showed significant clinical improvement 12 months after surgery using the VAS-N (p = 0.034 and p < 0.001, respectively), VAS-A (p < 0.001 and p < 0.001, respectively), NPAD (p < 0.001 and p < 0.001, respectively), and EQ-5D (p < 0.001 and p < 0.001, respectively). There were no significant differences in clinical outcome comparing both groups at the 3- and 12-month follow-up. The fusion rate at 12 months after surgery was 39.4% and 80.0% in the DCI and ACDF groups, respectively. Radiolucency was found in 90.9% in the DCI group at 12-month follow-up. Conclusion The clinical results for DCI treatment are equivalent to those for ACDF in the treatment of one- and two-level cervical DDD at 12 months after surgery. Further studies are necessary to investigate the high rates of radiolucency and fusion associated with DCI treatment. PMID:27088592

  5. Clinical outcome measures for Cutaneous Lupus Erythematosus

    PubMed Central

    Albrecht, Joerg; Werth, Victoria P.

    2011-01-01

    Cutaneous lupus erythematosus is a clinically heterogeneous group of rare skin diseases that only rarely have been subjected to controlled clinical trials. This may be have been partly due to a lack of suitable validated outcome instruments. Recently the FDA mandated that organ specific trials for lupus erythematosus need to use a combination of different outcome measures. The patient’s condition needs to be assessed in terms of quality of life, the patient’s global response and organ specific instruments that measure activity of the disease as well as damage due to the disease. For the skin the only formally validated and published instrument is currently the Cutaneous Lupus Erythematosis Disease Area and Severity Index (CLASI). This paper discusses the background of the development of the CLASI as well as issues related to its use and interpretation in the context of clinical research of CLE. PMID:20693208

  6. Mobile computing for radiology.

    PubMed

    Auffermann, William F; Chetlen, Alison L; Sharma, Arjun; Colucci, Andrew T; DeQuesada, Ivan M; Grajo, Joseph R; Kung, Justin W; Loehfelm, Thomas W; Sherry, Steven J

    2013-12-01

    The rapid advances in mobile computing technology have the potential to change the way radiology and medicine as a whole are practiced. Several mobile computing advances have not yet found application to the practice of radiology, while others have already been applied to radiology but are not in widespread clinical use. This review addresses several areas where radiology and medicine in general may benefit from adoption of the latest mobile computing technologies and speculates on potential future applications. PMID:24200475

  7. Clinical evaluation of using semantic searching engine for radiological imaging services in RIS-integrated PACS

    NASA Astrophysics Data System (ADS)

    Ling, Tonghui; Zhang, Kai; Yang, Yuanyuan; Hua, Yanqing; Zhang, Jianguo

    2015-03-01

    We had designed a semantic searching engine (SSE) for radiological imaging to search both reports and images in RIS-integrated PACS environment. In this presentation, we present evaluation results of this SSE about how it impacting the radiologists' behaviors in reporting for different kinds of examinations, and how it improving the performance of retrieval and usage of historical images in RIS-integrated PACS.

  8. Quality initiatives: anatomy and pathophysiology of errors occurring in clinical radiology practice.

    PubMed

    Brook, Olga R; O'Connell, Anna Marie; Thornton, Eavan; Eisenberg, Ronald L; Mendiratta-Lala, Mishal; Kruskal, Jonathan B

    2010-09-01

    The Joint Commission requires development of comprehensive error detection systems that incorporate root cause analyses for all sentinel events. To prevent medical errors from occurring, there is a need for a readily available and easy-to-implement system for detecting, classifying, and managing mistakes. The wide spectrum of interrelated contributing factors makes the classification of errors difficult. Contributors to and causes of radiologic errors can be classified under latent and active failures. Latent failures include technical and system-related failures, with a radiology-specific subgroup of communication failures that includes documentation, inaccurate or incomplete information, and communication loop failures. Active failures may be ascribed to human failures (more specifically failure of execution of a task, inadequate planning, or behavior-related failures), patient-based failures, and external failures. Classification of an error should also include the impact of the error on the patient, staff, other customers, and radiology practice. Further considerations should include nonmedical impact of the error, including legal, social, and economic effects on both the patient and the system. Rather than focusing the investigation on blaming individuals for active failures, the primary effort should be to discover latent system failures that can be remedied at a departmental level. Such an error classification system will decrease the likelihood of future errors and diminish their adverse impact. PMID:20622192

  9. Measuring Mortality Information in Clinical Data Warehouses

    PubMed Central

    Jones, Barrett; Vawdrey, David K.

    2015-01-01

    The ability to track and report long-term outcomes, especially mortality, is essential for advancing clinical research. The purpose of this study was to present a framework for assessing the quality of mortality information in clinical research databases. Using the clinical data warehouse (CDW) at Columbia University Medical Center as a case study, we measured: 1) agreement in vital status between our institution’s patient registration system and the U.S. Social Security Administration’s Death Master File (DMF), 2) the proportion of patients marked as deceased according to the DMF records who had subsequent visits to our institution, and 3) the proportion of patients still living according to Columbia’s CDW who were over 100 and 120 years of age. Of 33,295 deaths recorded in our institution’s patient registration system, 13,167 (39.5%) did not exist in the DMF. Of 315,037 patients in our CDW who marked as deceased according to the DMF, 2.1% had a subsequent clinical encounter at our institution. The proportion of patients still living according to Columbia’s CDW who were over 100 and 120 years of age was 43.6% and 43.1%, respectively. These measures may be useful to other clinical research investigators seeking to assess the quality of mortality data (1–4). PMID:26306284

  10. Measuring Mortality Information in Clinical Data Warehouses.

    PubMed

    Jones, Barrett; Vawdrey, David K

    2015-01-01

    The ability to track and report long-term outcomes, especially mortality, is essential for advancing clinical research. The purpose of this study was to present a framework for assessing the quality of mortality information in clinical research databases. Using the clinical data warehouse (CDW) at Columbia University Medical Center as a case study, we measured: 1) agreement in vital status between our institution's patient registration system and the U.S. Social Security Administration's Death Master File (DMF), 2) the proportion of patients marked as deceased according to the DMF records who had subsequent visits to our institution, and 3) the proportion of patients still living according to Columbia's CDW who were over 100 and 120 years of age. Of 33,295 deaths recorded in our institution's patient registration system, 13,167 (39.5%) did not exist in the DMF. Of 315,037 patients in our CDW who marked as deceased according to the DMF, 2.1% had a subsequent clinical encounter at our institution. The proportion of patients still living according to Columbia's CDW who were over 100 and 120 years of age was 43.6% and 43.1%, respectively. These measures may be useful to other clinical research investigators seeking to assess the quality of mortality data (1-4). PMID:26306284

  11. Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study

    PubMed Central

    VASCELLARI, ALBERTO; SCHIAVETTI, STEFANO; BATTISTELLA, GIUSEPPE; REBUZZI, ENRICO; COLETTI, NICOLÒ

    2015-01-01

    Purpose the purpose of this retrospective study was to present the outcomes of three different techniques for the treatment of type III acromioclavicular joint dislocations: arthroscopic TightRope (TR), arthroscopic GraftRope (GR), and open reconstruction of the coracoclavicular (CC) ligament using the Ligament Augmentation and Reconstruction System (LARS). Methods eighteen patients underwent clinical and radiological evaluations after a mean follow-up time of 43 months. The following clinical outcome measures were considered: the Disability of the Arm, Shoulder and Hand outcome measure (DASH), the Nottingham Clavicle Score (NCS), and the Constant score (CS). On X-rays, the CC distance was measured. Results the median DASH score at follow-up was 12.5 in the TR group, 5 in the GR group, and 4.2 in the LARS group. The median NCS value was 88 in the TR group, 88 in the GR group, and 91 in the LARS group. The median CS was 100 in the TR group, 95 in the GR group, and 94.5 in the LARS group. The mean CC distance was 10.3 mm in the TR group, 13.8 in the GR group, and 16.6 in the LARS group. Conclusions all three techniques proved to be reliable in providing good clinical outcomes, although none of the studied techniques demonstrated reliability in maintaining anatomical reduction after surgery. Level of evidence Level III, retrospective comparative study. PMID:26605251

  12. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification.

    PubMed

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  13. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification

    PubMed Central

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  14. Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Çiloğlu, Osman; Çiçek, Hakan; Yılmaz, Ahmet; Özalay, Metin; Söker, Gökhan; Leblebici, Berrin

    2014-01-01

    Objectives: We investigated the effects anatomic or nonanatomic femoral tunnel positions and tunnel fixation methods obtained using two different surgery methods on tunnel widening and clinical results in anterior cruciate ligament (ACL) reconstructions. Methods: Patients with isolated anterior cruciate ligament rupture are included to study who don’t have intra-and extra-articular additional pathology of the knee, without previously a history of operations of both knees. 2 groups were created. Group 1 Aperfix implant were used which can be able to perform non anatomical femoral tunnel and intra tunnel fixation with transtibial technique. In Group 2 Endobutton CL implant were used which can make fixation from outside the cortex with anatomic femoral tunnel in use of anteromedial portal techniques. 27 patients (average age 29,33, range 18 to 55 years) in group 1 and 27 patients (average age 27,51, range 16 to 45 years) in group 2 totally 54 patients were performed surgery. All patients were assessed using the IKDC (International knee documentation committee), Tegner Activity Scala and Lysholm II Functional Scores. Muscle strength measurements in both groups compared to intact knee was measured with an isokinetic dynamometer Biodex System 3 Pro. The location of the femoral tunnel aperture and tunnel widening were imaged with 3D reconstructive computed tomography. All measurements were performed using the same software application by the same radiologist. Results: The two groups were similar with respect to age and sex distribution, operated side, the size of the tunnel created, and follow-up period (p>0.05). After surgery in both groups, the clinical scores showed significant improvement compared to preoperative (p=0,0001). However, postoperative clinical outcomes in the two groups did not show a difference significantly (p>0,005). Isokinetic muscle strength study showed significant differences between the two groups (p=0,0001). Location of femoral tunnel aperture

  15. Retrospective Comparison of Radiological and Clinical Outcomes of PLIF and TLIF Techniques in Patients Who Underwent Lumbar Spinal Posterior Stabilization

    PubMed Central

    Asil, Kiyasettin; Yaldiz, Can

    2016-01-01

    Abstract Degenerative disc disease and spinal stenosis lead to various symptoms. Degeneration of facet joints is added to this degenerative process with aging. Seventy-four patients who were admitted to the Spinal Column Outpatient Clinic of the Neurosurgery Department with a diagnosis of degenerative narrow spinal canal and lumbar spondylolisthesis between 2011 and 2013 and who underwent surgery were included in the study. Our study was conducted with 74 patients of whom 73.0% (n = 54) were female and 27.0% (n = 20) were male. Mean age was 54.86 ± 7.87 years (range 34–74). Although we did not detect a difference between the two surgical methods with regard to clinical improvement, transforaminal lumbar interbody fusion (TLIF) is preferred due to radiological advantages observed one year later, ease of application, and the development of fewer complications. PMID:27124016

  16. Clinical and Radiological Characteristics of Lumbosacral Lateral Disc Herniation in Comparison With Those of Medial Disc Herniation

    PubMed Central

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-01-01

    Abstract Lateral disc herniation (foraminal and extra foraminal) has clinical characteristics that are different from those of medial disc herniation (central and subarticular), including older age, more frequent radicular pain, and neurologic deficits. This is supposedly because lateral disc herniation mechanically irritates or compresses the exiting nerve root or dorsal root ganglion inside of a narrow canal more directly than medial disc herniation. The purpose of this study was to investigate clinical and radiological characteristics of lateral disc herniation in comparison with medial disc herniation. The 352 subjects diagnosed with localized lumbosacral disc herniation and followed up for at least 12 months after completion of treatment were included and divided into medial and lateral disc herniation groups, according to the anatomical location of the herniated disc in axial plain of magnetic resonance image. Clinical and radiological data were obtained and compared between the two groups. The lateral group included 74 (21%) patients and the medial group included 278 (79%). Mean age of the lateral group was significantly higher than that in the medial group. The lateral group showed a significantly larger proportion of patients with radiating leg pain and multiple levels of disc herniations than the medial group. No significant differences were found in terms of gender, duration of pain, pretreatment numeric rating scale, severity of disc herniation (protrusion and extrusion), and presence of weakness in leg muscles. The proportion of patients who underwent surgery was not significantly different between the 2 groups. However, the proportion of patients who accomplished successful pain reduction after treatment was significantly smaller in the lateral than in the medial group. In conclusion, patients with lateral disc herniation were older and had larger proportion of radiating leg pain than those with medial disc herniation. Lateral disc herniation was more

  17. Clinical and Radiological Characteristics of Lumbosacral Lateral Disc Herniation in Comparison With Those of Medial Disc Herniation.

    PubMed

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-02-01

    Lateral disc herniation (foraminal and extra foraminal) has clinical characteristics that are different from those of medial disc herniation (central and subarticular), including older age, more frequent radicular pain, and neurologic deficits. This is supposedly because lateral disc herniation mechanically irritates or compresses the exiting nerve root or dorsal root ganglion inside of a narrow canal more directly than medial disc herniation. The purpose of this study was to investigate clinical and radiological characteristics of lateral disc herniation in comparison with medial disc herniation. The 352 subjects diagnosed with localized lumbosacral disc herniation and followed up for at least 12 months after completion of treatment were included and divided into medial and lateral disc herniation groups, according to the anatomical location of the herniated disc in axial plain of magnetic resonance image. Clinical and radiological data were obtained and compared between the two groups. The lateral group included 74 (21%) patients and the medial group included 278 (79%). Mean age of the lateral group was significantly higher than that in the medial group. The lateral group showed a significantly larger proportion of patients with radiating leg pain and multiple levels of disc herniations than the medial group. No significant differences were found in terms of gender, duration of pain, pretreatment numeric rating scale, severity of disc herniation (protrusion and extrusion), and presence of weakness in leg muscles. The proportion of patients who underwent surgery was not significantly different between the 2 groups. However, the proportion of patients who accomplished successful pain reduction after treatment was significantly smaller in the lateral than in the medial group. In conclusion, patients with lateral disc herniation were older and had larger proportion of radiating leg pain than those with medial disc herniation. Lateral disc herniation was more

  18. Radiological and Clinical Pneumonitis After Stereotactic Lung Radiotherapy: A Matched Analysis of Three-Dimensional Conformal and Volumetric-modulated Arc Therapy Techniques

    SciTech Connect

    Palma, David A.; Senan, Suresh; Haasbeek, Cornelis J.A.; Verbakel, Wilko F.A.R.; Vincent, Andrew; Lagerwaard, Frank

    2011-06-01

    Purpose: Lung fibrosis is common after stereotactic body radiotherapy (SBRT) for lung tumors, but the influence of treatment technique on rates of clinical and radiological pneumonitis is not well described. After implementing volumetric modulated arc therapy (RapidArc [RA]; Varian Medical Systems, Palo Alto, CA) for SBRT, we scored the early pulmonary changes seen with arc and conventional three-dimensional SBRT (3D-CRT). Methods and Materials: Twenty-five SBRT patients treated with RA were matched 1:2 with 50 SBRT patients treated with 3D-CRT. Dose fractionations were based on a risk-adapted strategy. Clinical pneumonitis was scored using Common Terminology Criteria for Adverse Events version 3.0. Acute radiological changes 3 months posttreatment were scored by three blinded observers. Relationships among treatment type, baseline factors, and outcomes were assessed using Spearman's correlation, Cochran-Mantel-Haenszel tests, and logistic regression. Results: The RA and 3D-CRT groups were well matched. Forty-three patients (57%) had radiological pneumonitis 3 months after treatment. Twenty-eight patients (37%) had computed tomography (CT) findings of patchy or diffuse consolidation, and 15 patients (20%) had ground-glass opacities only. Clinical pneumonitis was uncommon, and no differences were seen between 3D-CRT vs. RA patients in rates of grade 2/3 clinical pneumonitis (6% vs. 4%, respectively; p = 0.99), moderate/severe radiological changes (24% vs. 36%, respectively, p = 0.28), or patterns of CT changes (p = 0.47). Radiological severity scores were associated with larger planning target volumes (p = 0.09) and extended fractionation (p = 0.03). Conclusions: Radiological changes after lung SBRT are common with both approaches, but no differences in early clinical or radiological findings were observed after RA. Longer follow-up will be required to exclude late changes.

  19. The relationship of anthropometric measures to radiological features of the breast in premenopausal women.

    PubMed Central

    Boyd, N. F.; Lockwood, G. A.; Byng, J. W.; Little, L. E.; Yaffe, M. J.; Tritchler, D. L.

    1998-01-01

    We studied 273 premenopausal women recruited from mammography units who had different degrees of density of the breast parenchyma on mammography, in whom we measured height, weight and skinfold thicknesses. Mammograms were digitized to high spatial resolution by a scanning densitometer and images analysed to measure the area of dense tissue and the total area of the breast. Per cent density and the area of non-dense tissue were calculated from these measurements. We found that the mammographic measures had different associations with body size. Weight and the Quetelet index of obesity were strongly and positively associated with the area of non-dense tissue and with the total area of the breast, but less strongly and negatively correlated with the area of dense tissue. We also found a strong inverse relationship between the areas of radiologically dense and non-dense breast tissue. Statistical models containing anthropometric variables explained up to 8% of the variance in dense area, but explained up to 49% of the variance in non-dense area and 43% of variance in total area. These results suggest that aetiological studies in breast cancer that use mammographic density should consider dense and non-dense tissues separately. In addition to per cent density, methods should be examined that combine information from these two tissues. Images Figure 1 PMID:9820186

  20. Yttrium-90 hepatic radioembolization: clinical review and current techniques in interventional radiology and personalized dosimetry.

    PubMed

    Tong, Aaron K T; Kao, Yung Hsiang; Too, Chow Wei; Chin, Kenneth F W; Ng, David C E; Chow, Pierce K H

    2016-06-01

    In recent years, yttrium-90 ((90)Y) microsphere radioembolization has been establishing itself as a safe and efficacious treatment for both primary and metastatic liver cancers. This extends to both first-line therapies as well as in the salvage setting. In addition, radioembolization appears efficacious for patients with portal vein thrombosis, which is currently a contraindication for surgery, transplantation and transarterial chemoembolization. This article reviews the efficacy and expanding use of (90)Y microsphere radioembolization with an added emphasis on recent advances in personalized dosimetry and interventional radiology techniques. Directions for future research into combination therapies with radioembolization and expansion into sites other than the liver are also explored. PMID:26943239

  1. Combining Radiography and Passive Measurements for Radiological Threat Localization in Cargo

    SciTech Connect

    Miller, Erin A.; White, Timothy A.; Jarman, Kenneth D.; Kouzes, Richard T.; Kulisek, Jonathan A.; Robinson, Sean M.; Wittman, Richard A.

    2015-10-01

    Detecting shielded special nuclear material (SNM) in a cargo container is a difficult problem, since shielding reduces the amount of radiation escaping the container. Radiography provides information that is complementary to that provided by passive gamma-ray detection systems: while not directly sensitive to radiological materials, radiography can reveal highly shielded regions that may mask a passive radiological signal. Combining these measurements has the potential to improve SNM detection, either through improved sensitivity or by providing a solution to the inverse problem to estimate source properties (strength and location). We present a data-fusion method that uses a radiograph to provide an estimate of the radiation-transport environment for gamma rays from potential sources. This approach makes quantitative use of radiographic images without relying on image interpretation, and results in a probabilistic description of likely source locations and strengths. We present results for this method for a modeled test case of a cargo container passing through a plastic-scintillator-based radiation portal monitor and a transmission-radiography system. We find that a radiograph-based inversion scheme allows for localization of a low-noise source placed randomly within the test container to within 40 cm, compared to 70 cm for triangulation alone, while strength estimation accuracy is improved by a factor of six. Improvements are seen in regions of both high and low shielding, but are most pronounced in highly shielded regions. The approach proposed here combines transmission and emission data in a manner that has not been explored in the cargo-screening literature, advancing the ability to accurately describe a hidden source based on currently-available instrumentation.

  2. Results of radiological measurements taken in the Niagara Falls, New York, area (NF002)

    SciTech Connect

    Williams, J.K.; Berven, B.A.

    1986-11-01

    The results of a radiological survey of 100 elevated gamma radiation anomalies in the Niagara Falls, New York, area are presented. These radiation anomalies were identified by a mobile gamma scanning survey during the period October 3-16, 1984, and were recommended for an onsite survey to determine if the elevated levels of radiation may be related to the transportation of radioactive waste material to the Lake Ontario Ordnance Works for storage. In this survey, radiological measurements included outdoor gamma exposure rates at 1 m above the surface; outdoor gamma exposure rates at the surface, range of gamma exposure rates during scan; and uranium, radium, and thorium concentrations in biased surface soil samples. The results show 38 anomalies (35 located along Pletcher Road and 3 associated with other unreleated locations) were found to exceed Formerly Utilized Sites Remedial Action Program (FUSRAP) remedial action guidelines and were recommended for formal characterization surveys. (Since the time of this survey, remedial actions have been conducted on the 38 anomalies identified as exceeding FUSRAP guidelines, and the radioactive material above guidelines has been removed.) The remaining 62 anomalies are associated with asphalt driveways and parking lots, which used a phosphate slag material (previously identified as cyclowollastonite, synthetic CaSiO/sub 3/). This rocky-slag waste material was used for bedding under asphalt surfaces and in general gravel applications. Most of the contaminated soil and rock samples collected at the latter anomalies had approximately equal concentrations of /sup 226/Ra and /sup 238/U and, therefore, are not related to materials connected with the Niagara Falls Storage Site (NFSS), including material that was transported to the NFSS. 13 refs., 7 figs., 14 tabs.

  3. Clinical measurements using fiber optic sensors

    SciTech Connect

    Roe, J.N.

    1987-09-01

    The use of fiber optics in clinical measurements for illumination and imaging is widespread, but a more advanced sensing concept can be realized. The attachment of species specific fiber terminations at the distal end of the fiber optic so that in-situ analysis can be made is discussed along with measurement instrumentation. These terminations are called optrodes (optical electrodes), and a group of optrodes are presently under development for the in-vivo and in-vitro identification and quantification of species of interest to the clinician. The current development includes pH, carbon dioxide, potassium, and anti-cancer drugs. 6 refs., 8 figs.

  4. [Measurement of the Dose Rate Using Dosimeters in Interventional Radiology and Its Difficulty].

    PubMed

    Yoshida, Hidenori; Takahashi, Chiharu; Narita, Nobuhiro; Mizusawa, Yasuhiko; Sekiya, Masaru; Ohkubo, Masaki

    2016-01-01

    In equipment used for interventional radiology (IVR), automatic exposure control (AEC) is incorporated to obtain the X-ray output suitable for the treatment of targeted lesions. For the AEC, users select a region as the signal sensing region (measuring field, MF) in the flat panel detector; MFs with various sizes and shapes were pre-defined and prepared in the system. The aim of this study was to examine the change of measured dose rate with the selection of MFs, the type of dosimeters (the ionization chamber dosimeter and the semiconductor dosimeter), and the dosimeter placement relative to the direction of X-ray tube (from cathode to anode). The IVR equipment was Allura Xper FD20/10 (Philips Medical Systems), and six kinds of built-in MFs were used. It was found that dose rate measured by the ionization chamber dosimeter showed a variation of -2 mGy/min with the MFs and the ionization chamber dosimeter placement. The dose rate measured by the semiconductor dosimeter showed more variation than the ionization chamber dosimeter. The change of dose rate with the dosimeter placement would be caused by the MF overlapping the dosimeter which would affect the AEC (the X-ray output). Also, the change of dose rate with the dosimeter placement was considered to be related to the heel effect of the X-ray beam. When performing dose rate measurements, we should notice that the selection of MFs, the type of dosimeters, and the dosimeter placement would affect the measured values. PMID:26796935

  5. Metatarsal leiomyosarcoma masquerading as acute osteomyelitis - A diagnostic trap unveiled by vigilant clinical, radiologic and pathologic analysis.

    PubMed

    Chow, Louis Tsun Cheung

    2016-06-01

    Due to overlapping clinical and radiological features, the differentiation between osteomyelitis and bone tumor can be challenging. A 48-year-old lady presented with intermittent left foot pain for a few months. Plain radiographs showed an osteolytic lesion affecting the proximal diaphysis of the left fourth metatarsal bone, with thinning and irregularities of the cortex and focal periosteal reaction. Ultrasonography revealed diffuse subcutaneous edema in the dorsum of the left foot, cortical irregularities along the mid-shaft of the left fourth metatarsal bone, and surrounding periosteal collection. Computed tomography showed medullary expansion along the shaft and base of the left fourth metatarsal bone with cortical irregularities and defects suggestive of cloaca, and focal mild periosteal new bone formation. The clinico-radiologic diagnosis was acute osteomyelitis with periosteal collection. During open biopsy, the finding of intramedullary fleshy tissue in the absence of significant inflammatory edema and purulent discharge, and subsequent negative culture result prompted a review of the histologic slides which was initially reported as benign fibroblastic tissue proliferation. Careful analysis of the histomorphology disclosed a spindle cell sarcoma for which ray amputation of the fourth and fifth metatarsal was performed. The final diagnosis was grade 1 leiomyosarcoma and the patient remained well 33 months after the operation. PMID:26802815

  6. Measuring pacemaker dose: A clinical perspective

    SciTech Connect

    Studenski, Matthew T.; Xiao Ying; Harrison, Amy S.

    2012-07-01

    Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.

  7. Measuring pacemaker dose: a clinical perspective.

    PubMed

    Studenski, Matthew T; Xiao, Ying; Harrison, Amy S

    2012-01-01

    Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired. PMID:21875785

  8. Characterisation of an anthropomorphic chest phantom for dose measurements in radiology beams

    NASA Astrophysics Data System (ADS)

    Henriques, L. M. S.; Cerqueira, R. A. D.; Santos, W. S.; Pereira, A. J. S.; Rodrigues, T. M. A.; Carvalho Júnior, A. B.; Maia, A. F.

    2014-02-01

    The objective of this study was to characterise an anthropomorphic chest phantom for dosimetric measurements of conventional radiology beams. This phantom was developed by a previous research project at the Federal University of Sergipe for image quality control tests. As the phantom consists of tissue-equivalent material, it is possible to characterise it for dosimetric studies. For comparison, a geometric chest phantom, consisting of PMMA (polymethylmethacrylate) with dimensions of 30×30×15 cm³ was used. Measurements of incident air kerma (Ki) and entrance surface dose (ESD) were performed using ionisation chambers. From the results, backscatter factors (BSFs) of the two phantoms were determined and compared with values estimated by CALDose_X software, based on a Monte Carlo simulation. For the technical parameters evaluated in this study, the ESD and BSF values obtained experimentally showed a good similarity between the two phantoms, with minimum and maximum difference of 0.2% and 7.0%, respectively, and showed good agreement with the results published in the literature. Organ doses and effective doses for the anthropomorphic phantom were also estimated by the determination of conversion coefficients (CCs) using the visual Monte Carlo (VMC) code. Therefore, the results of this study prove that the anthropomorphic thorax phantom proposed is a good tool to use in dosimetry and can be used for risk evaluation of X-ray diagnostic procedures.

  9. Liposarcoma or invasive lipomatosis in flower horn fish, hybrid cichlid: clinical, radiological, ultrasonographical and histopathological study.

    PubMed

    Rahmati-Holasoo, H; Shokrpoor, S; Tavakkoli, A; Vajhi, A; Ebrahimzadeh Mousavi, H

    2016-03-01

    Liposarcoma or invasive lipomatosis affecting three indoor aquarium fish (flower horn fish, hybrid cichlid) is characterized, by the presence of mature adipocytes of variable sizes and by an invasive behaviour, which affected internal organs and eyes of all cases. Detailed macroscopic, radiological, ultrasonographical and histopathological features are presented. All fish had bilateral exophthalmia with some masses around the eyes. Ultrasonography confirmed the presence of hyperechoic masses in the eyes. Histopathology of all cases described the presence of variable-sized adipose cells in the eyes. The suggested diagnosis is well-differentiated liposarcoma or invasive lipomatosis. This is the first report of liposarcoma or invasive lipomatosis in flower horn fish, hybrid cichlid. PMID:25753688

  10. Novel Somatic Mutations in Primary Hyperaldosteronism are related to the Clinical, Radiological and Pathological Phenotype

    PubMed Central

    Scholl, Ute I.; Healy, James M.; Thiel, Anne; Fonseca, Annabelle L.; Brown, Taylor C.; Kunstman, John W.; Horne, Matthew J.; Dietrich, Dimo; Riemer, Jasmin; Kücükköylü, Seher; Reimer, Esther N.; Reis, Anna-Carinna; Goh, Gerald; Kristiansen, Glen; Mahajan, Amit; Korah, Reju; Lifton, Richard P.; Prasad, Manju L.; Carling, Tobias

    2016-01-01

    Summary Aldosterone-producing adenomas (APAs) and bilateral adrenal hyperplasia are important causes of secondary hypertension. Somatic mutations in KCNJ5, CACNA1D, ATP1A1, ATP2B3 and CTNNB1 have been described in APAs. Objective To characterize clinical-pathological features in APAs and unilateral adrenal hyperplasia, and correlate them with genotypes. Design Retrospective study. Subjects and Measurements Clinical and pathological characteristics of 90 APAs and 7 diffusely or focally hyperplastic adrenal glands were reviewed, and samples were examined for mutations in known disease genes by Sanger or exome sequencing. Results Mutation frequencies were: KCNJ5, 37.1%; CACNA1D, 10.3%; ATP1A1, 8.2%; ATP2B3, 3.1%; CTNNB1, 2.1%. Previously unidentified mutations included I157K, F154C and 2 insertions (I150_G151insM and I144_E145insAI) in KCNJ5, all close to the selectivity filter, V426G_V427Q_A428_L433del in ATP2B3, and A39Efs*3 in CTNNB1. Mutations in KCNJ5 were associated with female, and other mutations with male gender (p=0.007). On computed tomography, KCNJ5-mutant tumors displayed significantly greater diameter (p=0.023), calculated area (p=0.002) and lower pre-contrast Hounsfield Units (p=0.0002) vs. tumors with mutations in other genes. Accordingly, KCNJ5-mutant tumors were predominantly comprised of lipid-rich fasciculata-like clear cells, whereas other tumors were heterogeneous (p=5×10−6 vs. non-KCNJ5 mutant and p=0.0003 vs. wild type tumors, respectively). CACNA1D mutations were present in two samples with hyperplasia without adenoma. Conclusions KCNJ5 mutant tumors appear to be associated with fasciculata-like clear cell predominant histology and tend to be larger with a characteristic imaging phenotype. Novel somatic KCNJ5 variants likely cause adenomas by loss of potassium selectivity, similar to previously described mutations. PMID:26252618

  11. [Clinical and radiological study on tissue regeneration after alveolar bone augmentation with various osteoplastic materials and membranes].

    PubMed

    Mikhaĭlovskiĭ, A A; Kulakov, A A; Korolev, V M; Vinnichenko, O Iu

    2014-01-01

    The aim of the study was to compare the efficiency of alveolar bone augmentation using a variety of osteoplastic materials and collagen membrane and healing under a clot. The study included patients undergoing the extraction of symmetric teeth. After extraction one of the sockets were filled with osteoplastic materials while symmetrically located socket with no bone grafting served as a control. In group 1 augmentation was performed using Bio-Oss Collagen Bio-Gide membrane, in group 2 - Osteodent-M and Collost membranes, in group 3 - BIOPLAST-dent and BIOPLAST-dent-MK membranes. Clinical and radiological evaluation revealed positive impact of bioplastic materials on the bone tissue healing and recovery rates. The best results showed Bio-Oss Collagen with barrier bioresorbable membrane Bio-Gide allowing the creation of the most favorable conditions for delayed implantation. PMID:25377579

  12. Histopathological study of the outer membrane of the dura mater in chronic sub dural hematoma: Its clinical and radiological correlation

    PubMed Central

    Bokka, Sriharsha; Trivedi, Adarsh

    2016-01-01

    Background: A chronic subdural hematoma is an old clot of blood on the surface of the brain between dura and arachnoid membranes. These liquefied clots most often occur in patients aged 60 and older with brain atrophy. When the brain shrinks inside the skull over time, minor head trauma can cause tearing of blood vessels over the brain surface, resulting in a slow accumulation of blood over several days to weeks. Aim of the Study: To evaluate the role of membrane in hematoma evaluation and to correlate its histopathology with clinic-radiological aspects of the condition and overall prognosis of patients. Material and Methods: The study incorporated all cases of chronic SDH admitted to the Neurosurgery department of JLN Hospital and Research Centre, Bhilai, between November 2011 and November 2013. All such cases were analyzed clinically, radiologically like site, size, thickness in computed tomography, the attenuation value, midline shift and histopathological features were recorded. Criteria for Inclusion: All cases of chronic subdural haematoma irrespective of age and sex were incorporated into the study. Criteria for Exclusion: All cases of acute subdural haematoma and cases of chronic sub dural hematoma which were managed conservatively irrespective of age and sex were excluded from the study Results: In our series of cases, the most common histopathological type of membrane was the inflammatory membrane (Type II) seen in 42.30% of cases followed by hemorrhagic inflammatory membrane (Type III) seen in 34.62% of cases while scar inflammatory type of membrane (Type IV) was seen in 23.08% of cases. No case with noninflammatory type (Type I) was encountered. PMID:26889276

  13. Comparison of clinical and radiological outcomes after automated open lumbar discectomy and conventional microdiscectomy: a prospective randomized trial

    PubMed Central

    Lee, Sang-Ho; Bae, Jun Seok

    2015-01-01

    Objective: Microdiscectomy (MD) is the gold standard for surgical discectomy. As a minimally invasive discectomy, automated open lumbar discectomy (AOLD) is designed to preserve annular integrity and disc height as well as effectively remove herniated disc and degenerated disc material. However, there have been no prospective clinical studies comparing their effectiveness. The study was designed to compare clinical and radiological outcomes after AOLD with those of MD. Methods: Seventy-eight patients were evaluated for unilateral leg pain with the presence of disc herniation on magnetic resonance imaging (MRI) scans at a single attributable level. Sixty-two patients were enrolled; 33 patients (53%) were randomly assigned to the AOLD group and the remaining 29 patients (47%) were assigned to the MD group. Follow-up assessment was performed for 19 of the AOLD patients and 17 of the MD patients. The average follow-up period was 20 months. Clinical and functional outcomes were assessed using VAS and ODI scores. Change of disc height (DH), instability, and disc degeneration were assessed from radiographs, while Modic change and reherniation were assessed using MRI scans. Results: Postoperative VAS scores for leg pain and ODI scores for function were significantly improved in both groups. Postoperative VAS for back pain tended to decrease in the MD group but the decrease was statistically insignificant (P = 0.081). The postoperative VAS for back pain was significantly reduced in the AOLD group (P = 0.012). Patients from the MD group showed greater DH reduction than the AOLD group (P = 0.049). The MD group experienced greater disc degeneration and Modic change than the AOLD group. Follow-up MRI revealed 2 cases of reherniation in the AOLD group; 1 case was symptomatic, the other was asymptomatic. Conclusions: AOLD showed comparable clinical and radiological outcomes to conventional MD. AOLD preserves the central disc and removes only the loose degenerative disc fragments

  14. Benefits of hospital-wide PACS networks: a survey of clinical users of radiology services

    NASA Astrophysics Data System (ADS)

    Bryan, Stirling; Weatherburn, Gwyneth C.; Watkins, Jessamy; Buxton, Martin J.

    1998-07-01

    An independent evaluation of PACS has been carried out at Hammersmith Hospital. This paper describes one element: the use of a questionnaire instrument to assess radiology service user's views on the quality of the service being provided; major causes of dissatisfaction with the service; the extent to which images are unavailable; and the consequences of images unavailability. The objective was to investigate some of the key claims made for the PACS technology. The principal research design was a 'before and after' comparison at Hammersmith Hospital. A number of other, comparator, hospitals were included in this survey in order to allow inferences to be made about the any observed changes at Hammersmith. The questionnaire was distributed on three occasions before PACS was operational at Hammersmith and on one occasion afterwards. Across all data collection rounds and all sites, very high levels of satisfaction with image quality were reported. When asked about satisfaction with the written reporting service, a larger proportion of respondents across all sites and rounds indicated their discontent Following the introduction of PACS, the proportion of respondents indicating that lost ward or outpatient images was a problem was significantly lower and the rate of re-examination was lower.

  15. Work Productivity in Rheumatoid Arthritis: Relationship with Clinical and Radiological Features

    PubMed Central

    Chaparro del Moral, Rafael; Rillo, Oscar Luis; Casalla, Luciana; Morón, Carolina Bru; Citera, Gustavo; Cocco, José A. Maldonado; Correa, María de los Ángeles; Buschiazzo, Emilio; Tamborenea, Natalia; Mysler, Eduardo; Tate, Guillermo; Baños, Andrea; Herscovich, Natalia

    2012-01-01

    Objective. To assess the relationship between work productivity with disease activity, functional capacity, life quality and radiological damage in patients with rheumatoid arthritis (RA). Methods. The study included consecutive employed patients with RA (ACR'87), aged over 18. Demographic, disease-related, and work-related variables were determined. The reduction of work productivity was assessed by WPAI-RA. Results. 90 patients were evaluated, 71% women. Age average is 50 years old, DAS28 4, and RAQoL 12. Median SENS is 18 and HAQ-A 0.87. Mean absenteeism was of 14%, presenting an average of 6.30 work hours wasted weekly. The reduction in performance at work or assistance was of 38.4% and the waste of productivity was of 45%. Assistance correlated with DAS28 (r = 0.446; P < 0.001), HAQ-A (r = 0.545; P < 0.001) and RAQoL (r = 0.475; P < 0.001). Lower total productivity was noticed in higher levels of activity and functional disability. Patients with SENS > 18 showed lower work productivity than those with SENS < 18 (50 versus 34; P = 0.04). In multiple regression analysis, variables associated with reduction of total work productivity were HAQ-A and RAQoL. Conclusion. RA patients with higher disease severity showed higher work productivity compromise. PMID:23320166

  16. Justification in clinical radiological practice: a survey among staff of five London hospitals.

    PubMed

    Koutalonis, M; Horrocks, J

    2012-04-01

    This study represents a survey performed among staff who, according to the Ionising Radiation (Medical Exposures) Regulations of 2000 (IRMER), are responsible for justifying radiological examinations in the UK. The aim of the survey is to map the current situation regarding knowledge of risks from X-ray exposures and the criteria used for their justification. An anonymous electronic questionnaire was emailed to 219 radiologists and radiographers of five National Health Service hospitals. The questions were designed to investigate the way the sample group defines/assesses risk and benefit when justifying medical exposures, and to test their knowledge on radiation doses, risk communication, and on relevant national legislation. The majority of the respondents are aware of the relevant legislation/guidelines. Patient's medical condition, age and sex, and alternative techniques using less or no ionising radiation are the main criteria used for justification. However, when estimating the effective dose of various examinations in chest radiograph equivalents, the majority of the responses were incorrect. Although there is good knowledge of legislation around justification of medical exposures, there seems to be a lack of knowledge on radiation doses and risks among IRMER practitioners. PMID:21576178

  17. Radiologically Defined Ecological Dynamics and Clinical Outcomes in Glioblastoma Multiforme: Preliminary Results1

    PubMed Central

    Zhou, Mu; Hall, Lawrence; Goldgof, Dmitry; Russo, Robin; Balagurunathan, Yoganand; Gillies, Robert; Gatenby, Robert

    2014-01-01

    MATERIALS AND METHODS: We examined pretreatment magnetic resonance imaging (MRI) examinations from 32 patients with glioblastoma multiforme (GBM) enrolled in The Cancer Genome Atlas (TCGA). Spatial variations in T1 post-gadolinium and either T2-weighted or fluid attenuated inversion recovery sequences from each tumor MRI study were used to characterize each small region of the tumor by its local contrast enhancement and edema/cellularity (“habitat”). The patient cohort was divided into group 1 (survival < 400 days, n = 16) and group 2 (survival > 400 days, n = 16). RESULTS: Histograms of relative values in each sequence demonstrated that the tumor regions were consistently divided into high and low blood contrast enhancement, each of which could be subdivided into regions of high, low, and intermediate cell density/interstitial edema. Group 1 tumors contained greater volumes of habitats with low contrast enhancement but intermediate and high cell density (not fully necrotic) than group 2. Both leave-one-out and 10-fold cross-validation schemes demonstrated that individual patients could be correctly assigned to the short or long survival group with 81.25% accuracy. CONCLUSION: We demonstrate that novel image analytic techniques can characterize regional habitat variations in GBMs using combinations of MRI sequences. A preliminary study of 32 patients from the TCGA database found that the distribution of MRI-defined habitats varied significantly among the different survival groups. Radiologically defined ecological tumor analysis may provide valuable prognostic and predictive biomarkers in GBM and other tumors. PMID:24772202

  18. Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event

    PubMed Central

    Okuda, Darin T.; Siva, Aksel; Kantarci, Orhun; Inglese, Matilde; Katz, Ilana; Tutuncu, Melih; Keegan, B. Mark; Donlon, Stacy; Hua, Le H.; Vidal-Jordana, Angela; Montalban, Xavier; Rovira, Alex; Tintoré, Mar; Amato, Maria Pia; Brochet, Bruno; de Seze, Jérôme; Brassat, David; Vermersch, Patrick; De Stefano, Nicola

    2014-01-01

    Objective To report the 5-year risk and to identify risk factors for the development of a seminal acute or progressive clinical event in a multi-national cohort of asymptomatic subjects meeting 2009 RIS Criteria. Methods Retrospectively identified RIS subjects from 22 databases within 5 countries were evaluated. Time to the first clinical event related to demyelination (acute or 12-month progression of neurological deficits) was compared across different groups by univariate and multivariate analyses utilizing a Cox regression model. Results Data were available in 451 RIS subjects (F: 354 (78.5%)). The mean age at from the time of the first brain MRI revealing anomalies suggestive of MS was 37.2 years (y) (median: 37.1 y, range: 11–74 y) with mean clinical follow-up time of 4.4 y (median: 2.8 y, range: 0.01–21.1 y). Clinical events were identified in 34% (standard error = 3%) of individuals within a 5-year period from the first brain MRI study. Of those who developed symptoms, 9.6% fulfilled criteria for primary progressive MS. In the multivariate model, age [hazard ratio (HR): 0.98 (95% CI: 0.96–0.99); p = 0.03], sex (male) [HR: 1.93 (1.24–2.99); p = 0.004], and lesions within the cervical or thoracic spinal cord [HR: 3.08 (2.06–4.62); p = <0.001] were identified as significant predictors for the development of a first clinical event. Interpretation These data provide supportive evidence that a meaningful number of RIS subjects evolve to a first clinical symptom. An age <37 y, male sex, and spinal cord involvement appear to be the most important independent predictors of symptom onset. PMID:24598783

  19. Impact on Patient Safety and Satisfaction of Implementation of an Outpatient Clinic in Interventional Radiology (IPSIPOLI-Study): A Quasi-Experimental Prospective Study

    SciTech Connect

    Lutjeboer, Jacob Burgmans, Mark Christiaan E-mail: mburgmans@hotmail.com; Chung, Kaman Erkel, Arian Robert van

    2015-06-15

    PurposeInterventional radiology (IR) procedures are associated with high rates of preparation and planning errors. In many centers, pre-procedural consultation and screening of patients is performed by referring physicians. Interventional radiologists have better knowledge about procedure details and risks, but often only get acquainted with the patient in the procedure room. We hypothesized that patient safety (PS) and patient satisfaction (PSAT) in elective IR procedures would improve by implementation of a pre-procedural visit to an outpatient IR clinic.Material and MethodsIRB approval was obtained and informed consent was waived. PS and PSAT were measured in patients undergoing elective IR procedures before (control group; n = 110) and after (experimental group; n = 110) implementation of an outpatient IR clinic. PS was measured as the number of process deviations. PSAT was assessed using a questionnaire measuring Likert scores of three dimensions: interpersonal care aspects, information/communication, and patient participation. Differences in PS and PSAT between the two groups were compared using an independent t test.ResultsThe average number of process deviations per patient was 0.39 in the control group compared to 0.06 in the experimental group (p < 0.001). In 9.1 % patients in the control group, no legal informed consent was obtained compared to 0 % in the experimental group. The mean overall Likert score was significantly higher in the experimental group compared to the control group: 2.68 (SD 0.314) versus 2.48 (SD 0.381) (p < 0.001).ConclusionPS and PSAT improve significantly if patients receive consultation and screening in an IR outpatient clinic prior to elective IR procedures.

  20. Sclerosing bone dysplasias: genetic, clinical and radiology update of hereditary and non-hereditary disorders.

    PubMed

    Boulet, Cedric; Madani, Hardi; Lenchik, Leon; Vanhoenacker, Filip; Amalnath, Deepak S; de Mey, Johan; De Maeseneer, Michel

    2016-06-01

    There is a wide variety of hereditary and non-hereditary bone dysplasias, many with unique radiographic findings. Hereditary bony dysplasias include osteopoikilosis, osteopathia striata, osteopetrosis, progressive diaphyseal dysplasia, hereditary multiple diaphyseal sclerosis and pyknodysostosis. Non-hereditary dysplasias include melorheostosis, intramedullary osteosclerosis and overlap syndromes. Although many of these dysplasias are uncommon, radiologists should be familiar with their genetic, clinical and imaging findings to allow for differentiation from acquired causes of bony sclerosis. We present an overview of hereditary and non-hereditary bony dysplasias with focus on the pathogenesis, clinical and radiographic findings of each disorder. PMID:26898950

  1. Synovial Chondromatosis of the Ankle Joint: Clinical, Radiological, and Intraoperative Findings

    PubMed Central

    Sedeek, Sedeek Mohamed; Choudry, Q.; Garg, S.

    2015-01-01

    Synovial chondromatosis, also termed synovial osteochondromatosis, is a rare benign disorder characterized by the presence of cartilaginous nodules in the synovium of the joints, tendon sheaths, and bursae. It most commonly involves large joints, such as the knee, hip, and shoulder, but its presence in smaller joints has also been reported. Nevertheless, ankle involvement is unusual. The diagnosis is commonly made following a thorough history, clinical, physical, and radiographic examination. We report a case of a young patient with primary synovial chondromatosis of the ankle joint and present the clinical, radiographic, and intraoperative findings. PMID:26177002

  2. Synovial Chondromatosis of the Ankle Joint: Clinical, Radiological, and Intraoperative Findings.

    PubMed

    Sedeek, Sedeek Mohamed; Choudry, Q; Garg, S

    2015-01-01

    Synovial chondromatosis, also termed synovial osteochondromatosis, is a rare benign disorder characterized by the presence of cartilaginous nodules in the synovium of the joints, tendon sheaths, and bursae. It most commonly involves large joints, such as the knee, hip, and shoulder, but its presence in smaller joints has also been reported. Nevertheless, ankle involvement is unusual. The diagnosis is commonly made following a thorough history, clinical, physical, and radiographic examination. We report a case of a young patient with primary synovial chondromatosis of the ankle joint and present the clinical, radiographic, and intraoperative findings. PMID:26177002

  3. Radiologically isolated syndrome: an uncommon finding at a university clinic in a high-prevalence region for multiple sclerosis

    PubMed Central

    Granberg, Tobias; Martola, Juha; Aspelin, Peter; Kristoffersen-Wiberg, Maria; Fredrikson, Sten

    2013-01-01

    Objective The improved availability of MRI in medicine has led to an increase in incidental findings. Unexpected brain MRI findings suggestive of multiple sclerosis (MS) without typical symptoms of MS were recently defined as radiologically isolated syndrome (RIS). The prevalence of RIS is uncertain. The aim of this study was to determine the prevalence of RIS at a university hospital in a region with a high prevalence for MS and describe the long-term prognosis of the identified patients. Design Retrospective cohort study conducted in 2012. Setting All brain MRI examinations performed at Karolinska University Hospital in Huddinge, Stockholm, Sweden during 2001 were retrospectively screened by a single rater for findings fulfilling the Okuda criteria. The sample year was chosen in order to establish the long-term prognosis of the patients identified. The examinations of interest were re-evaluated according to the Barkhof criteria by a neuroradiologist with long experience in MS. Participants In total 2105 individuals were included in the study. Ages ranged from 0 to 90 years with a median age of 48 years. Only one patient with RIS was identified, equivalent to a prevalence of 0.05% in the studied population, or 0.15% among patients aged 15–40 years. The patient with RIS developed symptoms consistent with MS within 3 months accompanied with radiological progression and was diagnosed with MS. Conclusions RIS, according to present criteria, is an uncommon finding in a tertiary hospital setting in a high-prevalence region for MS where awareness and clinical suspicion of MS is common. In order to study the prognosis of RIS, multicentre studies, or case–control studies are recommended. PMID:24189079

  4. Lipoprotein (a) measurements for clinical application.

    PubMed

    Marcovina, Santica M; Albers, John J

    2016-04-01

    The high degree of size heterogeneity of apo(a), the distinct protein component of lipoprotein (a) [Lp(a)], renders the development and selection of specific antibodies directed to apo(a) more difficult and poses significant challenges to the development of immunoassays to measure its concentration in plasma or serum samples. Apo(a) is extremely variable in size not only between but also within individuals because of the presence of two different, genetically determined apo(a) isoform sizes. Therefore, the antigenic determinants per particle available to interact with the antibodies will vary in the samples and the calibrators, thus contributing to apo(a) size-dependent inaccuracy of different methods. The lack of rigorous validation of the immunoassays and common means of expressing Lp(a) concentrations hinder the harmonization of results obtained by different studies and contribute to the lack of common cut points for identification of individuals at risk for coronary artery disease or for interventions aimed at reducing Lp(a) levels. The aim of our review is to present and critically evaluate the issues surrounding the measurements of Lp(a), their impact on the clinical interpretation of the data, and the obstacles we need to overcome to achieve the standardization of Lp(a) measurements. PMID:26637278

  5. The National Institutes of Health Clinical Center Digital Imaging Network, Picture Archival and Communication System, and Radiology Information System.

    PubMed

    Goldszal, A F; Brown, G K; McDonald, H J; Vucich, J J; Staab, E V

    2001-06-01

    In this work, we describe the digital imaging network (DIN), picture archival and communication system (PACS), and radiology information system (RIS) currently being implemented at the Clinical Center, National Institutes of Health (NIH). These systems are presently in clinical operation. The DIN is a redundant meshed network designed to address gigabit density and expected high bandwidth requirements for image transfer and server aggregation. The PACS projected workload is 5.0 TB of new imaging data per year. Its architecture consists of a central, high-throughput Digital Imaging and Communications in Medicine (DICOM) data repository and distributed redundant array of inexpensive disks (RAID) servers employing fiber-channel technology for immediate delivery of imaging data. On demand distribution of images and reports to clinicians and researchers is accomplished via a clustered web server. The RIS follows a client-server model and provides tools to order exams, schedule resources, retrieve and review results, and generate management reports. The RIS-hospital information system (HIS) interfaces include admissions, discharges, and transfers (ATDs)/demographics, orders, appointment notifications, doctors update, and results. PMID:11442088

  6. [The aging heart and its pathology. An epidemiological study of 229 cases based on a clinical and radiological classification].

    PubMed

    Tamburrini, L R; Di Monte, M; Gerometta, R; Ponte, E; Cherubini, M

    1989-12-01

    The paper studies epidemiological distribution of the aging heart and its pathology in a sample of 229 subjects (101 male and 128 female) on the basis of a clinical and radiological classification into cardiological phenotypes. This study involved the use of mathematical statistical procedures following a standard method using SIR database (Scientific Information Retrieval) software implemented on the CDC Cyber 170/730 mainframe in the Trieste University Computing Center that is connected with the Chair of Geriatric Pathology. Using this software it was possible to assess the epidemiological significance of the usual clinical parameters, and show that the most representative cardiopathy is the 3rd type, i.e. the hypertrophic-ischemic cardiopathy belonging to the large aortic heart. Its natural pathogenesis is independent of risk factors and relates to the aging of muscular and connective tissues in which the coronary circulation is involved in the deterioration of the cardiovascular system and is therefore different from the primary ischemias of adults. PMID:2622569

  7. Radioanalytical Data Quality Objectives and Measurement Quality Objectives during a Federal Radiological Monitoring and Assessment Center Response

    SciTech Connect

    E. C. Nielsen

    2006-01-01

    During the early and intermediate phases of a nuclear or radiological incident, the Federal Radiological Monitoring and Assessment Center (FRMAC) collects environmental samples that are analyzed by organizations with radioanalytical capability. Resources dedicated to quality assurance (QA) activities must be sufficient to assure that appropriate radioanalytical measurement quality objectives (MQOs) and assessment data quality objectives (DQOs) are met. As the emergency stabilizes, QA activities will evolve commensurate with the need to reach appropriate DQOs. The MQOs represent a compromise between precise analytical determinations and the timeliness necessary for emergency response activities. Minimum detectable concentration (MDC), lower limit of detection, and critical level tests can all serve as measurements reflecting the MQOs. The relationship among protective action guides (PAGs), derived response levels (DRLs), and laboratory detection limits is described. The rationale used to determine the appropriate laboratory detection limit is described.

  8. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution.

    PubMed

    Godzik, Jakub; Ravindra, Vijay M; Ray, Wilson Z; Schmidt, Meic H; Bisson, Erica F; Dailey, Andrew T

    2015-08-01

    OBJECT The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. METHODS The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1-2 and C2-7 lordotic angles, C2-7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. RESULTS At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1-108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. CONCLUSIONS The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated with

  9. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution

    PubMed Central

    Godzik, Jakub; Ravindra, Vijay M.; Ray, Wilson Z.; Schmidt, Meic H.; Bisson, Erica F.; Dailey, Andrew T.

    2016-01-01

    Object The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. Methods The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1–2 and C2–7 lordotic angles, C2–7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. Results At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1–108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. Conclusions The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated

  10. Burkitt's lymphoma: a child's case presenting in the maxilla. Clinical and radiological aspects.

    PubMed

    Valenzuela-Salas, Borja; Dean-Ferrer, Alicia; Alamillos-Granados, Francisco-Jesús

    2010-05-01

    Burkitt's lymphoma (BL) is a neoplasm which, despite its very aggressive behaviour is potentially curable. It typically affects the paediatric population. BL belongs to the non-Hodgkin lymphomas group, and is the first human tumour undoubtedly related to a viral origin (Epstein-Barr virus). Two main clinical subtypes are recognized: endemic or African type, and sporadic type; HIV associated BL constitutes a third type. Although common in endemic BL, maxillary involvement is rare in sporadic cases. This, together with the clinical lack of specificity associated to this location, makes diagnosis difficult. New chemotherapeutic protocols achieve a high survival rate. Most important prognostic factors are location and tumour stage. We report a paediatric case of BL presenting in the maxilla, with a review and a description of the characteristics of the disease. PMID:20038882

  11. Nevoid Basal Cell Carcinoma Syndrome - Clinical and Radiological Findings of Three Cases

    PubMed Central

    Ali, Ibrahim K; Karjodkar, Freny R; Sansare, Kaustubh; Salve, Prashant; Goyal, Shikha

    2016-01-01

    Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder, characterized by skeletal anomalies and multiple keratocystic odontogenic tumors of the jaws. The skeletal anomalies of this syndrome are mandibular prognathism, bossing of frontal and parietal bones, high-arched palate, and bifid rib. We report three cases with NBCCS, emphasizing the clinical and radiographic findings, the importance of the early diagnosis of NBCCS, and a preventive multidisciplinary approach in the management of NBCCS.

  12. Clinical and radiological features of brain neurotoxicity caused by antitumor and immunosuppressant treatments.

    PubMed

    Erbetta, Alessandra; Salmaggi, Andrea; Sghirlanzoni, Angelo; Silvani, Antonio; Potepan, Paolo; Botturi, Andrea; Ciceri, Elisa; Bruzzone, Maria Grazia

    2008-06-01

    Antitumor and immunosuppressant treatment-related neurotoxicity can determine nonspecific clinical syndromes. Exclusion of other possible causes, among which tumor progression, appearance of paraneoplastic disease, renal or hepatic failure, diabetes or hypertension, is relevant. We report clinical and neuroradiological features in five patients with neurotoxic syndromes due to chemotherapy/radiotherapy or immunosuppression in the context of neoplastic disease/organ transplantation. Acute neurological syndrome developed in three patients after methotrexate (MTX), cyclosporine A, and L-asparaginase therapy, respectively. MRI showed posterior reversible encephalopathy in two cases and venous thrombosis with intraparenchymal hematoma in the third patient. Late onset clinical syndrome occurred in the last two patients, treated with MTX or radiation therapy for breast cancer metastasis and pituitary adenoma. Neuroimaging showed brain diffuse abnormalities. Patients affected by tumors suffer from increased risk for treatment-related toxicities. Appearance or worsening of neurological signs and symptoms challenge the clinician to discriminate between CNS involvement by the tumor, toxicity of drugs, parane-oplastic disease and infections. MRI has a key role in differential diagnosis. Close interaction between the neurologist, the oncologist and the neuroradiologist leads to the optimal management of patients. PMID:18612759

  13. Use of Fisiograft in Intrabony Defects- A Clinical and Radiological Study

    PubMed Central

    Pandey, Ruchi; Madhumala, R.; Saranyan, R.; Sreekanth, P.

    2013-01-01

    Aim: To evaluate the efficacy of Polylactic Acid/Polygycolic Acid (PLA/PGA -Fisiograft®) with Open Flap Debridement (OFD) and OFD alone in the treatment of intrabony defects over a period of 9 months. Material and Methods: Twenty Nine systemically healthy subjects with total of 30 defects were included in the present, randomized, controlled and two arm parallel study. Tests were treated with OFD along with Fisiograft® and controls with OFD alone. Results: On intra-group comparison, clinical parameters at 6 and 9 months showed statistically significant results. On comparing between the two groups, the reduction in Defect Specific Bleeding Score (DSBS), Defect Specific Plaque Score (DSPS), Probing Depth (PD) and gain in Clinical Attachment Level (CAL) revealed no statistical significances other than Recession Depth (REC) which was more in controls. The mean radiographic parameters at 9 months post-operatively in both the groups were statistically significant. However, the inter-group comparison revealed no statistically significant values. Conclusions: The overall results at the end study proved that the adjunctive use of Fisiograft® was not beneficial when compared with OFD alone. Clinical Significance: Synthetic bone replacement graft materials are commonly used for periodontal regeneration. The present study was conducted by using PLA/PGA reveals no additional benefit over OFD alone in treatment of intrabony defects. PMID:24298530

  14. Jackson-Weiss syndrome: Clinical and radiological findings in a large kindred and exclusion of the gene from 7p21 and 5qter

    SciTech Connect

    Ades, L.C.; Haan, E.A.; Mulley, J.C.; Senga, I.P.; Morris, L.L.; David, D.J.

    1994-06-01

    We describe the clinical and radiological manifestations of the Jackson-Weiss syndrome (JWS) in a large South Australian kindred. Radiological abnormalities not previously described in the hands include coned epiphyses, distal and middle phalangeal hypoplasia, and carpal bone malsegmentation. New radiological findings in the feet include coned epiphyses, hallux valgus, phalangeal, tarso-navicular and calcaneo-navicular fusions, and uniform absence of metatarsal fusions. Absence of linkage to eight markers along the short arm of chromosome 7 excluded allelian between JWS and Saethre-Chotzen syndrome at 7p21. No linkage was detected to D5S211, excluding allelism to another recently described cephalosyndactyly syndrome mapping to 5qter. 35 refs., 5 figs., 4 tabs.

  15. Clinical and radiologic features and their relationships with neurofunctional scores in patients with acute cerebellar infarct

    PubMed Central

    Kozak, Hasan Hüseyin; Uca, Ali Ulvi; Poyraz, Necdet; Anliaçık, Süleyman Ömer; Tokgöz, Osman Serhat

    2016-01-01

    Background: Cerebellar infarct is a rare condition with very nonspecific clinical features. The aim of this study was to assess the full spectrum of the clinical characteristics, neuroimaging findings and neurofunctional analyses of cerebellar infarction, and the relationship between them. Materials and Methods: Data were collected from 59 patients admitted to our department during an 8-year period. We retrospectively analyzed the relationship between demographic characteristics, clinical symptomatology, etiological factors, functional condition, vascular distribution, frequency of subcortical white matter lesions (WMLs), and concomitant lesion outside the cerebellum in patients with acute cerebellar infarct (ACI) at time of admission. Results: The mean age in our series was 65.2 years, with most being male (57.6%). The posterior inferior cerebellar (PICA) artery was the most commonly affected territory at 62.7%. There was concomitant lesion outside the cerebellum in 45.7%. The main etiology in PICA was cardioembolism. While mean National Institutes of Health Stroke Scale on admission was 2.08 ± 1.67 in study group, modified Rankin Scale (mRS) on admission was detected to be mRS1 (n: 44, 74.5%) and mRS2 (n: 12, 20.3%) most frequently. Fourteen (35%) patients were detected to be in Fazekas stage 0; 11 (27.5%) patients in Fazekas stage 1; 6 (15%) patients in Fazekas stage 2; and 9 (22.5%) patients in Fazekas stage 3. Conclusion: Cerebellar infarct is very heterogeneous. The other cerebral area infarcts which accompany ACI negatively affect neurologic functional scores. Although it is difficult to detect the relationship between WMLs and neurologic functional severity, timely detection of risk factors and their modulation may be associated with prevention and treatability of WMLs, and this may be one of the important points for prevention of stroke-related disability. PMID:27293332

  16. Papillary tumor of the pineal region with extended clinical and radiologic follow-up

    PubMed Central

    Shakir, Hakeem J.; Qiu, Jingxin; Prasad, Dheerendra; Mechtler, Laszlo L.; Fenstermaker, Robert A.

    2015-01-01

    Background: Papillary tumor of the pineal region (PTPR) is a rare neoplasm with only anecdotal data to guide the treatment. Results of treatment with surgery, radiation therapy, and chemotherapy have been reported to have varying degrees of success. Here we report a patient with a PTPR, who underwent subtotal resection, gamma knife stereotactic radiosurgery, and adjuvant temozolomide chemotherapy. Case Description: During 9 years of clinical and radiographic follow-up, the patient has had regression of residual tumor and remains asymptomatic. Conclusion: When gross total resection of a PTPR is not possible, treatment with gamma knife stereotactic radiosurgery and temozolomide chemotherapy may provide long-term tumor control. PMID:26539320

  17. Hepatolithiasis and the syndrome of recurrent pyogenic cholangitis: clinical, radiologic, and pathologic features.

    PubMed

    Tsui, Wilson Man-shan; Chan, Yiu-kay; Wong, Chi-tat; Lo, Yan-fai; Yeung, Yat-wah; Lee, Yat-wing

    2011-02-01

    Primary hepatothiasis (HL) and recurrent pyogenic cholangitis (RPC) are two terms describing the different aspects of the same disease, with HL emphasizing the pathologic changes and RPC emphasizing the clinical presentation and suppurative inflammation. It is predominantly a disease of the Far East. In the 1960s, it was the third most common cause of emergency abdominal surgery at a university hospital in Hong Kong. Thereafter, its incidence has decreased considerably, possibly due to improved standards of living and Westernized diet. Clinically, patients may present acutely with recurrent bacterial cholangitis and its possible complications, such as liver abscess and septicemic shock, or with chronic complications, such as cholangiocarcinoma. Pathologically, it is characterized by pigmented calcium bilirubinate stones within dilated intrahepatic bile ducts featuring chronic inflammation, mural fibrosis, and proliferation of peribiliary glands, without extrahepatic biliary obstruction. Episodes of suppurative inflammation cumulate in sclerosing cholangitis of peripheral ducts and parenchymal fibrosis resulting from collapse and scarring. Mass-forming inflammatory pseudotumor and neoplasms like intraductal papillary neoplasms and cholangiocarcinoma are increasingly recognized complications. Modern imaging techniques allow definitive diagnosis, accurate assessment for treatment planning, and detection of complications. A multidisciplinary team approach (interventional endoscopist, interventional radiologist, hepatobiliary surgeon, and intensivists) is important for optimal patient outcome. PMID:21344349

  18. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    PubMed

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes. PMID:20067999

  19. Clinical Signs of Radiologic Pneumonia in Under-Five Hypokalemic Diarrheal Children Admitted to an Urban Hospital in Bangladesh

    PubMed Central

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ashraf, Hasan; Faruque, Abu S. G.; Bardhan, Pradip Kumar; Das, Sumon Kumar; Shahunja, K. M.; Shahid, Abu S. M. S. B.; Ahmed, Tahmeed

    2013-01-01

    Background Clinical signs of pneumonia are often veiled in under-five diarrheal children presenting with hypokalemia, making clinical diagnosis of pneumonia very difficult in such population. However, there is no published report that describes the influences of hypokalemia on the clinical signs of pneumonia in diarrheal children. Our objective was to assess the influences of hypokalemia, and their outcome in such children. Methods We prospectively enrolled all under-five diarrheal children (n = 180) admitted to the Special Care Ward of the Dhaka Hospital of icddr,b from September-December 2007 with radiological pneumonia who also had their serum potassium estimated. We compared the clinical features and outcome of the diarrheal children having pneumonia with (cases = 55) and without hypokalemia (controls = 125). Results The case-fatality among the cases was 2 times higher compared to the controls, but the difference was not statistically significant (p = 0.202). In logistic regression analysis, after adjusting for potential confounders such as age of the patient, clinical dehydration, severe wasting, abnormally sleepy, lower chest wall in-drawing, nasal flaring and inability to drink on admission, under-five diarrheal children with pneumonia who presented with nutritional edema had 3 times more risk to have hypokalemia compared to those without nutritional edema (OR = 2.76, 95% CI = 1.01–7.51) and these hypokalemic children were 64% less likely to present with fast breathing (OR = 0.36, 95% CI = 0.17–0.74). Conclusion and significance The results of our analysis are simple but may have great public health implications and underscore the importance of diligent assessment for pneumonia in under-five diarrheal children having risk of hypokalemia as in children with nutritional edema even in absence of fast breathing, a useful sign of pneumonia. This may help for early initiation of first dose of parental antibiotics along with

  20. Clinical-radiological evaluation of sequelae of stereotactic radiosurgery for intracranial arteriovenous malformations

    SciTech Connect

    Levy, R.P.; Fabrikant, J.I.; Frankel, K.A.; Phillips, M.H.; Steinberg, G.K.; Marks, M.P.; DeLaPaz, R.L.; Chuang, F.Y.S.

    1989-12-01

    Stereotactic heavy-charged-particle Bragg peak radiosurgery has been used to treat 322 patients with surgically-inaccessible intracranial vascular malformations. (The clinical results of this method for the treatment of angiographically demonstrable arteriovenous malformations (AVMs) and angiographically occult vascular malformations (AOVMs) of the brain are described in separate reports of this symposium). The great majority of patients have had an uneventful post-treatment course with satisfactory health outcomes. However, several categories of delayed sequelae of stereotactic radiosurgery have been identified, involving the vascular structures essential for the integrity of the brain tissue and the brain parenchyma directly. These categories reflect both reaction to injury and to alterations in regional hemodynamic status, and include vasogenic edema, occlusion of functional vasculature, radiation necrosis, and local or remote effects on cerebral arterial aneurysms. 10 refs., 7 figs., 1 tab.

  1. Clinical and Radiological Findings of Autosomal Dominant Osteopetrosis Type II: A Case Report

    PubMed Central

    Kant, Priyanka; Sharda, Neelkamal; Bhowate, Rahul R.

    2013-01-01

    Osteopetrosis is a rare inherited genetic disease characterized by sclerosis of the skeleton caused by the absence or malfunction of osteoclasts. Three distinct forms of the disease have been recognized, autosomal dominant osteopetrosis being the most common. Autosomal dominant osteopetrosis exhibits a heterogeneous trait with milder symptoms, often at later childhood or adulthood. The aim of this case report is to present the clinical and radiographic features of a 35-year-old female patient with autosomal dominant osteopetrosis type II who exhibited features of chronic generalised periodontitis, and the radiographs revealed generalised osteosclerosis and hallmark radiographic features of ADO type II, that is, “bone-within-bone appearance” and “Erlenmeyer-flask deformity.” PMID:24260721

  2. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients.

    PubMed

    Ducros, Anne; Boukobza, Monique; Porcher, Raphaël; Sarov, Mariana; Valade, Dominique; Bousser, Marie-Germaine

    2007-12-01

    Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by the association of severe headaches with or without additional neurological symptoms and a 'string and beads' appearance on cerebral arteries, which resolves spontaneously in 1-3 months. We present the clinical, neuroimaging and outcome data of 67 consecutive patients prospectively diagnosed over 3 years in our institution with an angiographically confirmed RCVS. There were 43 females and 24 males with a mean age of 42 years (19-70). RCVS was spontaneous in 37% of patients and secondary in the 63% others, to postpartum in 5 and to exposure to various vasoactive substances in 37, mainly cannabis, selective serotonin-recapture inhibitors and nasal decongestants. The main pattern of presentation (94% of patients) was multiple thunderclap headaches recurring over a mean period of 1 week. In 51 patients (76%), headaches resumed the clinical presentation. Various complications were observed, with different time courses. Cortical subarachnoid haemorrhage (cSAH) (22%), intracerebral haemorrhage (6%), seizures (3%) and reversible posterior leukoencephalopathy (9%) were early complications, occurring mainly within the first week. Ischaemic events, including TIAs (16%) and cerebral infarction (4%), occurred significantly later than haemorrhagic events, mainly during the second week. Significant sex differences were observed: women were older, had more frequent single-drug exposure and a higher rate of stroke and cSAH. Sixty-one patients were treated by nimodipine: 36% had recurrent headaches, 7% TIAs and one multiple infarcts. The different time courses of thunderclap headaches, vasoconstriction and strokes suggest that the responsible vasospastic disorder starts distally and progresses towards medium sized and large arteries. No relapse was observed during the 16 +/- 12.4 months of follow-up. Our data suggest that RCVS is more frequent than previously thought, is more often secondary particularly to

  3. Enchondroma versus Chondrosarcoma in Long Bones of Appendicular Skeleton: Clinical and Radiological Criteria—A Follow-Up

    PubMed Central

    Ferrer-Santacreu, Eugenio M.; Ortiz-Cruz, Eduardo J.; Díaz-Almirón, Mariana; Pozo Kreilinger, Jose Juan

    2016-01-01

    As of today two types of cartilage tumors remain a challenge even for the orthopedic oncologist: enchondroma (E), a benign tumor, and chondrosarcoma (LGC), a malignant and low aggressiveness tumor. A prospective study of 133 patients with a cartilaginous tumor of low aggressiveness in the long bones of the appendicular skeleton was done to prove this difficult differential diagnosis. Parameters including medical history and radiological and nuclear imaging were collected and compared to the result of the biopsy. A scale of aggressiveness was applied to each patient according to the number of aggressiveness episodes present. A comparison of the results of the biopsy with the initial diagnosis made by the orthopedic oncologist based solely on clinical data and imaging tests was also made. Finally, a management algorithm for these cases was proposed. A statistical significance for LGC resulted from the parameter as follows: pain on palpation, involvement of cortical in either the CT or MRI, and Tc99 bone scan uptake equal or superior to anterosuperior iliac crest. In our series, a tumor scoring 5 points or higher in the scale of aggressiveness can have 50% more chance of being LGC. When compared with the gold standard (the biopsy), surgeon's initial judgement showed a sensitivity of 73.5% and a specificity of 94.1%. PMID:27034667

  4. Assessment of clinical and radiological response to sorafenib in hepatocellular carcinoma patients

    PubMed Central

    Sacco, Rodolfo; Mismas, Valeria; Romano, Antonio; Bertini, Marco; Bertoni, Michele; Federici, Graziana; Metrangolo, Salvatore; Parisi, Giuseppe; Tumino, Emanuele; Bresci, Giampaolo; Giacomelli, Luca; Marceglia, Sara; Bargellini, Irene

    2015-01-01

    Sorafenib is an effective anti-angiogenic treatment for hepatocellular carcinoma (HCC). The assessment of tumor progression in patients treated with sorafenib is crucial to help identify potentially-resistant patients, avoiding unnecessary toxicities. Traditional methods to assess tumor progression are based on variations in tumor size and provide unreliable results in patients treated with sorafenib. New methods to assess tumor progression such as the modified Response Evaluation Criteria in Solid Tumors or European Association for the Study of Liver criteria are based on imaging to measure the vascularization and tumor volume (viable or necrotic). These however fail especially when the tumor response results in irregular development of necrotic tissue. Newer assessment techniques focus on the evaluation of tumor volume, density or perfusion. Perfusion computed tomography and Dynamic Contrast-Enhanced-UltraSound can measure the vascularization of HCC lesions and help predict tumor response to anti-angiogenic therapies. Mean Transit Time is a possible predictive biomarker to measure tumor response. Volumetric techniques are reliable, reproducible and time-efficient and can help measure minimal changes in viable tumor or necrotic tissue, allowing the prompt identification of non-responders. Volume ratio may be a reproducible biomarker for tumor response. Larger trials are needed to confirm the use of these techniques in the prediction of response to sorafenib. PMID:25624994

  5. Measurements of radiological data of some amino acids in the energy range 0.122-1.330MeV

    NASA Astrophysics Data System (ADS)

    Lokhande, Rajkumar M.; More, Chaitali V.; Surung, Bharat S.; Raut, Siddheshwar D.; Pawar, Pravina P.

    2016-05-01

    Radiological parameters such as μm, σt, σe, Zeff and Neff of amino acids, namely Lysine (C6H15N2O2), Histidine (C6H9N3O2) and Arginine (C6H15N4O2), were measured using NaI (Tl)-based gamma spectrometry. Radioactive sources used in the study are 57Co, 133Ba, 137Cs, 54Mn, 60Co and 22Na. Gamma ray transmission method in a narrow beam good geometry set up was used in the study. The measured data were compared against XCOM-based data. The agreement is within 2%.

  6. Inflammatory bowel disease in children--clinical, endoscopic, radiologic and histopathologic investigation.

    PubMed

    Seo, J K; Yeon, K M; Chi, J G

    1992-09-01

    This paper reviews our five years' clinical experience (1987 to 1991) of 22 patients with inflammatory bowel disease (IBD). There were 12 patients with Crohn's disease and 10 patients with ulcerative colitis. The mean age at diagnosis was 8.7 years (2 to 14 years). Clinical impressions before referral were chronic diarrhea in 11, irritable bowel syndrome in 5, colon polyp in 4, lymphoma in 3, intestinal tuberculosis in 2, amoebic colitis in 2, ulcerative colitis in 2 children and other diseases. The mean interval from the onset of symptoms to the diagnosis of IBD was 18 months. Diagnosis of Crohn's disease was delayed for more than 13 months in 8 (67%), whereas that of ulcerative colitis was delayed for more than 13 months in 4 (40%). Diarrhea (50%), abdominal pain (36%) and rectal bleeding (36%) were the three most frequent presenting complaints of IBD. Moderately severe abdominal pain was a more common chief complaint in Crohn's disease (58%) than in ulcerative colitis (10%). Hematochezia (90% vs 17%) and moderately severe diarrhea (90% vs 75%) were more common gastrointestinal manifestations in ulcerative colitis than in Crohn's disease. The associated extraintestinal manifestations were oral ulcer in 7, arthralgia in 11 and arthritis in 4, skin lesions in 2, eye lesions in 2 and growth failure in 9 patients. Of 12 children with Crohn's disease, granuloma was found in 5, aphthous ulcerations in 8, cobble stone appearance in 8, skip area or asymmetric lesions in 6, transmural involvement in 7, and perianal fistula in 3. Among 10 children with ulcerative Colitis, there were crypt abscess in 8, granularity or friability in 10 and rectosigmoid ulcerations with purulent exudate in 8 children. The main sites of involvement in children with Crohn's disease were both the small and large bowels in 7 (58%), small bowel only in 2 (16%), and colon only in 3 (25%). Terminal ileum involvement was seen in 75% of Crohn's disease cases. The main sites of involvement in children

  7. Combining Radiography and Passive Measurements for Radiological Threat Detection in Cargo

    SciTech Connect

    Miller, Erin A.; White, Timothy A.; Jarman, Kenneth D.; Kouzes, Richard T.; Kulisek, Jonathan A.; Robinson, Sean M.; Scherrer, Charles; Wittman, Richard S.

    2012-12-01

    Abstract Radiography is widely understood to provide information complimentary to passive detection: while not directly sensitive to radiological materials, radiography can reveal highly shielded regions which may mask a passive radiological signal. We present a method for combining radiographic and passive data which uses the radiograph to provide an estimate of scatter and attenuation for possible sources. This approach allows quantitative use of radiographic images without relying on image interpretation, and results in a probabilistic description of likely source locations and strengths. We present first results for this method for a simple modeled test case of a cargo container driving through a PVT portal. With this inversion approach, we address criteria for an integrated passive and radiographic screening system and how detection of SNM threats might be improved in such a system.

  8. Lumbar Transpedicular Implant Failure: A Clinical and Surgical Challenge and Its Radiological Assessment

    PubMed Central

    Ali, Abdel Mohsen Arafa

    2014-01-01

    Study Design It is a multicenter, controlled case study review of a big scale of pedicle-screw procedures from January 2000 to June 2010. The outcomes were compared to those with no implant failure. Purpose The purpose of this study was to review retrospectively the outcome of 100 patients with implant failure in comparison to 100 control-patients, and to study the causes of failure and its prevention. Overview of Literature Transpedicular fixation is associated with risks of hardware failure, such as screw/rod breakage and/or loosening at the screw-rod interface and difficulties in the system assembly, which remain a significant clinical problem. Removal or revision of the spinal hardware is often required. Methods Two hundred patients (88 women, 112 men) were divided into 2 major groups, with 100 patients in group I (implant failure group G1) and 100 patients in group II (successful fusion, control group G2). We subdivided the study groups into two subgroups: subgroup a (single-level instrumented group) and subgroup b (multilevel instrumented group). The implant status was assessed based on intraoperative and follow-up radiographs. Results Implant failure in general was present in 36% in G1a, and in 64% in G1b, and types of implant failure included screw fracture (34%), rod fracture (24%), rod loosening (22%), screw loosening (16%), and failure of both rod and screw (4%). Most of the failures (90%) occurred within 6 months after surgery, with no reported cases 1 year postoperatively. Conclusions We tried to address the problem and study the causes of failure, and proposed solutions for its prevention. PMID:24967042

  9. Cervical Pedicle Screw Fixation: Anatomic Feasibility of Pedicle Morphology and Radiologic Evaluation of the Anatomical Measurements

    PubMed Central

    2014-01-01

    Study Design All parameters were measured manually and with a computed tomography (CT) scanner. For the manual measurements, a Vernier scale instrument was used. Purpose This study evaluates quantitatively pedicles of middle and lower cervical spine (C3 to C7) and to evaluate the possibilities of using these structures as anchors in posterior cervical fusion. Overview of Literature Pedicle screws may be an alternative fixation technique for posterior cervical instrumentation. Methods Twenty-two bony sets of adult cervical spines were studied (110 vertebrae, 220 pedicles) from C3 down to C7. Results CT measurement of cervical pedicles appeared to be accurate and valuable for preoperative planning of cervical pedicle screw instrumentation. The study showed a high correlation between the values obtained by manual and CT measurements of pedicle dimensions. The technical challenge of insertion is the obvious theoretical drawback of the use of cervical pedicle screws. Many technical factors are important to consider, namely, the point of screw entry, the pedicle dimensions, the screw direction according to the pedicle angle and orientation, the screw diameter and length, and the method of screw introduction. Conclusions Transpedicular screw fixation of the cervical spine appears to be promising. Anatomic limitations should be clear to the surgeon. Further clinical and biomechanical studies are needed to settle this technique. PMID:24967041

  10. Image-Guided Cryoablation of the Spine in a Swine Model: Clinical, Radiological, and Pathological Findings with Light and Electron Microscopy

    SciTech Connect

    Freitas, Ricardo Miguel Costa de Andrade, Celi Santos Caldas, José Guilherme Mendes Pereira; Tsunemi, Miriam Harumi; Ferreira, Lorraine Braga Arana-Chavez, Victor Elias; Cury, Patrícia Maluf

    2015-10-15

    PurposeThis study was designed to present the feasibility of an in vivo image-guided percutaneous cryoablation of the porcine vertebral body.MethodsThe institutional animal care committee approved this study. Cone-beam computed tomography (CBCT)-guided vertebral cryoablations (n = 22) were performed in eight pigs with short, 2-min, single or double-freezing protocols. Protective measures to nerves included dioxide carbon (CO{sub 2}) epidural injections and spinal canal temperature monitoring. Clinical, radiological, and pathological data with light (n = 20) or transmission electron (n = 2) microscopic analyses were evaluated after 6 days of clinical follow-up and euthanasia.ResultsCBCT/fluoroscopic-guided transpedicular vertebral body cryoprobe positioning and CO{sub 2} epidural injection were successful in all procedures. No major complications were observed in seven animals (87.5 %, n = 8). A minor complication was observed in one pig (12.5 %, n = 1). Logistic regression model analysis showed the cryoprobe-spinal canal (Cp-Sc) distance as the most efficient parameter to categorize spinal canal temperatures lower than 19 °C (p < 0.004), with a significant Pearson’s correlation test (p < 0.041) between the Cp-Sc distance and the lowest spinal canal temperatures. Ablation zones encompassed pedicles and the posterior wall of the vertebral bodies with an inflammatory rim, although no inflammatory infiltrate was depicted in the surrounding neural structures at light microscopy. Ultrastructural analyses evidenced myelin sheath disruption in some large nerve fibers, although neurological deficits were not observed.ConclusionsCBCT-guided vertebral cryoablation of the porcine spine is feasible under a combination of a short freezing protocol and protective measures to the surrounding nerves. Ultrastructural analyses may be helpful assess the early modifications of the nerve fibers.

  11. The clinical and radiological evaluation of the use of an allograft-prosthesis composite in the treatment of proximal femoral giant cell tumours.

    PubMed

    Malhotra, R; Kiran Kumar, G N; K Digge, V; Kumar, V

    2014-08-01

    Giant cell tumour is the most common aggressive benign tumour of the musculoskeletal system and has a high rate of local recurrence. When it occurs in proximity to the hip, reconstruction of the joint is a challenge. Options for reconstruction after wide resection include the use of a megaprosthesis or an allograft-prosthesis composite. We performed a clinical and radiological study to evaluate the functional results of a proximal femoral allograft-prosthesis composite in the treatment of proximal femoral giant cell tumour after wide resection. This was an observational study, between 2006 and 2012, of 18 patients with a mean age of 32 years (28 to 42) and a mean follow-up of 54 months (18 to 79). We achieved excellent outcomes using Harris Hip Score in 13 patients and a good outcome in five. All allografts united. There were no complications such as infection, failure, fracture or resorption of the graft, or recurrent tumour. Resection and reconstruction of giant cell tumours with proximal femoral allograft-prosthesis composite is a better option than using a prosthesis considering preservation of bone stock and excellent restoration of function. A good result requires demanding bone banking techniques, effective measures to prevent infection and stability at the allograft-host junction. PMID:25086128

  12. Diagnostic radiology

    SciTech Connect

    Leeds, N.E.; Jacobson, H.G.

    1986-10-17

    Developments in the burgeoning field of diagnostic radiology have continued apace. Four areas that represent either subspecialities or technological advances in diagnostic radiology will be considered in this report: ultrasonography, interventional radiology, nuclear radiology, and magnetic resonance. In no sense is the exclusion of other subdisciplines and modalities (eg, pediatric radiology, computed tomography) and indication of their of importance or their failure to include innovative concepts.

  13. Methylmercury poisoning: long-term clinical, radiological, toxicological, and pathological studies of an affected family.

    PubMed

    Davis, L E; Kornfeld, M; Mooney, H S; Fiedler, K J; Haaland, K Y; Orrison, W W; Cernichiari, E; Clarkson, T W

    1994-06-01

    For 3 months in 1969 a family in the United States that included a pregnant mother consumed pork containing methylmercury. Children, aged 20, 13, and 8 years and a neonate, developed severe neurological signs. Twenty-two years later, the 2 oldest had cortical blindness or constricted visual fields, diminished hand proprioception, choreoathetosis, and attentional deficits. Magnetic resonance images showed tissue loss in the calcarine and parietal cortices and cerebellar folia. The youngest had quadriplegia, blindness, and severe mental retardation until their deaths. The brain of the 8-year-old who died at age 30 showed cortical atrophy, neuronal loss, and gliosis, most pronounced in the paracentral and parietooccipital regions. The total mercury level in formalin-fixed, left occipital cortex was 1,974 ng/gm as measured by atomic absorption. Regional brain mercury levels correlated with extent of brain damage. A control patient had 38.5 ng of mercury/gm in the occipital cortex. Systemic organs in the patient and a control subject had comparable mercury levels. In mercury-intoxicated rats, we found that only 5 to 10% of total brain mercury was lost by formalin fixation. Brain inorganic mercury in the patient ranged from 82 to 100%. Since inorganic mercury crosses the blood-brain barrier poorly, biotransformation of methyl to inorganic mercury may have occurred after methylmercury crossed the blood-brain barrier, accounting for its persistence in brain and causing part of the brain damage. PMID:8210224

  14. Machine Learning and Radiology

    PubMed Central

    Wang, Shijun; Summers, Ronald M.

    2012-01-01

    In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. PMID:22465077

  15. The validity of a novel radiological method for measuring femoral stem version on anteroposterior radiographs of the hip after total hip arthroplasty.

    PubMed

    Weber, M; Lechler, P; von Kunow, F; Völlner, F; Keshmiri, A; Hapfelmeier, A; Grifka, J; Renkawitz, T

    2015-03-01

    Femoral stem version has a major influence on impingement and early post-operative stability after total hip arthroplasty (THA). The main objective of this study was to evaluate the validity of a novel radiological method for measuring stem version. Anteroposterior (AP) radiographs and three-dimensional CT scans were obtained for 115 patients (female/male 63/72, mean age 62.5 years (50 to 75)) who had undergone minimally invasive, cementless THA. Stem version was calculated from the AP hip radiograph by rotation-based change in the projected prosthetic neck-shaft (NSA*) angle using the mathematical formula ST = arcos [tan (NSA*) / tan (135)]. We used two independent observers who repeated the analysis after a six-week interval. Radiological measurements were compared with 3D-CT measurements by an independent, blinded external institute. We found a mean difference of 1.2° (sd 6.2) between radiological and 3D-CT measurements of stem version. The correlation between the mean radiological and 3D-CT stem torsion was r = 0.88 (p < 0.001). The intra- (intraclass correlation coefficient ≥ 0.94) and inter-observer agreement (mean concordance correlation coefficient = 0.87) for the radiological measurements were excellent. We found that femoral tilt was associated with the mean radiological measurement error (r = 0.22, p = 0.02). The projected neck-shaft angle is a reliable method for measuring stem version on AP radiographs of the hip after a THA. However, a highly standardised radiological technique is required for its precise measurement. PMID:25737512

  16. The Ability of the United States Federal Radiological Monitoring and Assessment Center to Collect and Disseminate Environmental Measurements during Radiological Emergencies

    SciTech Connect

    Craig Marianno and James Essex

    2007-04-30

    The Federal Radiological Monitoring and Assessment Center (FRMAC) is the United States’ response organization for radiological emergencies. The FRMAC is structured as an operations center and employs the combined resources of several federal agencies to respond to any disaster resulting in the release of radioactivity. The mission of the FRMAC is to support state and local authorities in the gathering of environmental data using an array of survey equipment ranging from alpha probes, beta/gamma probes, and high-purity germanium (HPGe) spectroscopy to the gathering of physical samples. Once collected, the data are projected on maps to assist public officials make protective action decisions. In addition to the accumulation of data, it is the legal obligation of the FRMAC to keep archival records of all data points and their actions. During an event, it is conceivable that hundreds to thousands of sample points will be recorded over a relatively short time. It is in the interest of the federal government and public that the information collected be put to the best use as fast as possible. Toward this end, the Remote Sensing Laboratory, working under the direction of the United States Department of Energy’s National Nuclear Security Administration, is investigating the use of several technologies that will accelerate data flow from field teams to the FRMAC and, finally, distribution of data to decision makers and the public. Not only can finished data products be viewed through the internet, but the actual collection of data via “real-time” telemetry can be viewed using this same method. Data from the field will be transferred directly to the FRMAC using the MCPD (multi-path communication device). This base station receives the survey information from the field teams via Bluetooth and instantly investigates the best communication pathway to transfer data to the FRMAC. Possible paths include standalone radio, commercial cellular networks (GPRS and CDMA) and

  17. Radiology image perception and observer performance: How does expertise and clinical information alter interpretation? Stroke detection explored through eye-tracking

    NASA Astrophysics Data System (ADS)

    Cooper, Lindsey; Gale, Alastair; Darker, Iain; Toms, Andoni; Saada, Janak

    2009-02-01

    Historically, radiology research has been dominated by chest and breast screening. Few studies have examined complex interpretative tasks such as the reading of multidimensional brain CT or MRI scans. Additionally, no studies at the time of writing have explored the interpretation of stroke images; from novices through to experienced practitioners using eye movement analysis. Finally, there appears a lack of evidence on the clinical effects of radiology reports and their influence on image appraisal and clinical diagnosis. A computer-based, eye-tracking study was designed to assess diagnostic accuracy and interpretation in stroke CT and MR imagery. Eight predetermined clinical cases, five images per case, were presented to participants (novices, trainee, and radiologists; n=8). The presence or absence of abnormalities was rated on a five-point Likert scale and their locations reported. Half cases of the cases were accompanied by clinical information; half were not, to assess the impact of information on observer performance. Results highlight differences in visual search patterns amongst novice, trainee and expert observers; the most marked differences occurred between novice readers and experts. Experts spent more time in challenging areas of interest (AOI) than novices and trainee, and were more confident unless a lesion was large and obvious. The time to first AOI fixation differed by size, shape and clarity of lesion. 'Time to lesion' dropped significantly when recognition appeared to occur between slices. The influence of clinical information was minimal.

  18. Glycosylated haemoglobin: measurement and clinical use.

    PubMed Central

    Peacock, I

    1984-01-01

    The discovery, biochemistry, laboratory determination, and clinical application of glycosylated haemoglobins are reviewed. Sources of error are discussed in detail. No single assay method is suitable for all purposes, and in the foreseeable future generally acceptable standards and reference ranges are unlikely to be agreed. Each laboratory must establish its own. Nevertheless, the development of glycosylated haemoglobin assays is an important advance. They offer the best available means of assessing diabetic control. PMID:6381544

  19. Do clinical outcome measures assess consumer-defined recovery?

    PubMed

    Andresen, Retta; Caputi, Peter; Oades, Lindsay G

    2010-05-30

    There is an international call for mental health services to become recovery-oriented, and also to use evidence-based practices. Addressing this call requires recovery-oriented measurement of outcomes and service evaluation. Mental health consumers view recovery as leading as meaningful life, and have criticised traditional clinical measures for being too disability-oriented. This study compares three measures of consumer-defined recovery from enduring mental illness: the Recovery Assessment Scale, the Mental Health Recovery Measure and the Self-Identified Stage of Recovery, with four conventional clinical measures. Correlational analyses supported the convergent validity of the recovery measures, although certain subscales were unrelated to each other. More importantly, little relationship was found between consumer-defined recovery and the clinical measures. Analyses of variance revealed that scores on the recovery measures increased across self-identified stage of recovery, but scores on most clinical measures did not improve consistently across stage of recovery. The findings demonstrate the qualitative difference between the two types of measures, supporting the claim by consumers that clinical measures do not assess important aspects of recovery. There is a need for further research and refinement of recovery measurement, including assessment of stages of recovery, with the aim of including such measures as an adjunct in routine clinical assessment, service evaluation and research. PMID:20227768

  20. A pilot study measuring changes in student impressions before and after clinical training using a questionnaire based on the semantic differential technique.

    PubMed

    Tamura, Naomi; Terashita, Takayoshi; Ogasawara, Katsuhiko

    2013-01-01

    Students with a positive impression of their studies can become more motivated. This study measured the learning impact of clinical training by comparing student impressions before and after clinical training. The study included 32 students of radiological technology in their final year with the Division of Radiological Science and Technology, Department of Health Sciences, School of Medicine, Hokkaido University. To measure student impressions of x-ray examination training, we developed a questionnaire using the semantic differential technique. The resulting factor analysis identified 2 factors that accounted for 44.9% of the 10 bipolar adjective scales. Factor 1 represented a "resistance" impression of x-ray examination training, and factor 2 represented a "responsibility" impression. The differences in factor scores before and after the clinical training suggest that student impressions are affected by clinical training. PMID:23920812

  1. Battlefield radiology

    PubMed Central

    Graham, R N J

    2012-01-01

    With the increasing tempo of military conflicts in the last decade, much has been learnt about imaging battlefield casualties in the acute setting. Ultrasound in the form of focused abdominal sonography in trauma (FAST) has proven invaluable in emergency triage of patients for immediate surgery. Multidetector CT allows accurate determination of battlefield trauma injuries. It permits the surgeons and anaesthetists to plan their interventions more thoroughly and to be made aware of clinically occult injuries. There are common injury patterns associated with blast injury, gunshot wounds and blunt trauma. While this body of knowledge is most applicable to the battlefield, there are parallels with peacetime radiology, particularly in terrorist attacks and industrial accidents. This pictorial review is based on the experiences of a UK radiologist deployed in Afghanistan in 2010. PMID:22806621

  2. Possible clinical outcome measures for clinical trials in patients with multiple sclerosis

    PubMed Central

    Goldman, Myla D.; Motl, Robert W.; Rudick, Richard A.

    2010-01-01

    Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease with both clinical and pathological heterogeneity. The complexity of the MS population has offered challenges to the measurement of MS disease progression in therapeutic trials. The current standard clinical outcome measures are relapse rate, Expanded Disability Severity Scale (EDSS), and the MS Functional Composite (MSFC). These measures each have strengths and some weakness. Two additional measures, the six-minute walk and accelerometry, show promise in augmenting current measures. MS therapeutics is a quickly advancing field which requires sensitive clinical outcome measures that can detect small changes in disability that reliably reflect long-term changes in sustained disease progression in a complex population. A single clinical outcome measure of sustained disease progression may remain elusive. Rather, an integration of current and new outcome measures may be most appropriate and utilization of different measures depending on the MS population and stage of the disease may be preferred. PMID:21179614

  3. Primary hypertrophic osteoarthropathy caused by homozygous deletion in HPGD gene in a family: changing clinical and radiological findings with long-term follow-up.

    PubMed

    Tüysüz, Beyhan; Yılmaz, Saliha; Kasapçopur, Özgür; Erener-Ercan, Tuğba; Ceyhun, Emre; Bilguvar, Kaya; Günel, Murat

    2014-11-01

    Autosomal recessive primary hypertrophic osteoarthropathy1 (PHOAR1) is characterized by delayed closure of the fontanels, digital clubbing, arthropathy and periostosis. Homozygous mutations in hydroxyprostaglandin dehydrogenase (HPGD) gene are the underlying pathology of PHOAR1. The aim of this study was to analyze the HPGD gene and the changing clinical and radiological findings with advancing age of two siblings with the diagnosis of PHOAR1. A novel 2-bp homozygous deletion was found in exon 3 (c.310-311delCT) of HPGD gene in the patients. Clinical and radiological findings of the siblings were evaluated between 4 months and 8 years and 6 months of age. The painful swelling and sweating of the hands and feet, cranial ossification defect and expanded diaphyses were evident at infantile period and gradually showed improvement until 4 years of age. After the age of 4 years, digital clubbing and swelling of knees persisted, palmoplantar hyperkeratosis developed and acro-osteolysis became evident on hand radiographs. In conclusion, we suggest that the clinical findings of the patients with PHOAR1 should be classified in two periods as early and late childhood. We also observed that there was intrafamilial variability of clinical findings. PMID:24816859

  4. How best to measure cough clinically.

    PubMed

    Birring, Surinder S; Spinou, Arietta

    2015-06-01

    It is possible to measure cough by assessing its severity, frequency, intensity, associated urge and its impact on quality of life. Cough severity can simply be assessed with a Visual Analogue Scale. Cough frequency can be assessed objectively with cough frequency monitors. Validated cough monitors include the Leicester Cough Monitor and the VitaloJAK. Cough reflex sensitivity measurement is better used to investigate the mechanisms of action of antitussive medications, rather than assessing efficacy. Health-Related Quality of Life measures are available to assess the impact of cough; they include the validated Leicester Cough Questionnaire and Cough-specific Quality of Life Questionnaire for adult patients. It is best to assess cough with a combination of subjective and objective tools, to capture its wide-ranging impact. PMID:25819594

  5. Basic bone radiology

    SciTech Connect

    Griffiths, H.J.

    1987-01-01

    This clinical book surveys the skeletal system as seen through radiological imaging. It emphasizing abnormalities, disease, and trauma, and includes vital information on bones, bone growth, and the cells involved in bone pathology. It covers many bone diseases and injuries which are rarely covered in medical texts, as well as descriptions of radiologic procedures that specifically relate to the skeleton. This edition includes many illustrations, information on MR imaging and CT scanning, and discussions of osteoporosis, dysplasias, and metabolic bone disease.

  6. Radiomic Profiling of Glioblastoma: Identifying an Imaging Predictor of Patient Survival with Improved Performance over Established Clinical and Radiologic Risk Models.

    PubMed

    Kickingereder, Philipp; Burth, Sina; Wick, Antje; Götz, Michael; Eidel, Oliver; Schlemmer, Heinz-Peter; Maier-Hein, Klaus H; Wick, Wolfgang; Bendszus, Martin; Radbruch, Alexander; Bonekamp, David

    2016-09-01

    Purpose To evaluate whether radiomic feature-based magnetic resonance (MR) imaging signatures allow prediction of survival and stratification of patients with newly diagnosed glioblastoma with improved accuracy compared with that of established clinical and radiologic risk models. Materials and Methods Retrospective evaluation of data was approved by the local ethics committee and informed consent was waived. A total of 119 patients (allocated in a 2:1 ratio to a discovery [n = 79] or validation [n = 40] set) with newly diagnosed glioblastoma were subjected to radiomic feature extraction (12 190 features extracted, including first-order, volume, shape, and texture features) from the multiparametric (contrast material-enhanced T1-weighted and fluid-attenuated inversion-recovery imaging sequences) and multiregional (contrast-enhanced and unenhanced) tumor volumes. Radiomic features of patients in the discovery set were subjected to a supervised principal component (SPC) analysis to predict progression-free survival (PFS) and overall survival (OS) and were validated in the validation set. The performance of a Cox proportional hazards model with the SPC analysis predictor was assessed with C index and integrated Brier scores (IBS, lower scores indicating higher accuracy) and compared with Cox models based on clinical (age and Karnofsky performance score) and radiologic (Gaussian normalized relative cerebral blood volume and apparent diffusion coefficient) parameters. Results SPC analysis allowed stratification based on 11 features of patients in the discovery set into a low- or high-risk group for PFS (hazard ratio [HR], 2.43; P = .002) and OS (HR, 4.33; P < .001), and the results were validated successfully in the validation set for PFS (HR, 2.28; P = .032) and OS (HR, 3.45; P = .004). The performance of the SPC analysis (OS: IBS, 0.149; C index, 0.654; PFS: IBS, 0.138; C index, 0.611) was higher compared with that of the radiologic (OS: IBS, 0.175; C index, 0

  7. Application of radiological protection measures to meet different environmental protection criteria.

    PubMed

    Copplestone, D

    2012-01-01

    The International Commission on Radiological Protection (ICRP) recognises that there is no simple or single universal definition of 'environmental protection', and that the concept differs from country to country and from one circumstance to another. However, there is an increasing need to be able to demonstrate that the environment is protected from radioactive substances released under authorisation for various reasons, such as for wildlife conservation requirements, or wildlife management for commercial reasons, or simply as part of pollution control. The Commission is developing the concept of Representative Organisms, which may be identified from any specific legal requirements or from more general requirements to protect local habitats or ecosystems. Such organisms may be the actual objects of protection or they may be hypothetical, depending on the objectives of the assessment. They may be similar to, or even congruent with, one or more of the Reference Animals and Plants (RAPs). Where this is not the case, attempts can be made to consider the extent to which the Representative Organisms differ from the nearest RAP in terms of known radiation effects upon it, basic biology, radiation dosimetry, and pathways of exposure. This paper discusses the practical implications of such an approach. PMID:23089025

  8. Investigation of an MLE Algorithm for Quantification of Aerial Radiological Measurements

    SciTech Connect

    Reed, Michael; Essex, James

    2012-05-10

    Aerial radiation detection is routinely used by many organizations (DHS, DOE, EPA, etc.) for the purposes of identifying the presence of and quantifying the existence of radiation along the ground. This work involves the search for lost or missing sources, as well as the characterization of large-scale releases such as might occur in a nuclear power plant accident. The standard in aerial radiological surveys involves flying large arrays of sodium-iodide detectors at altitude (15 to 700 meters) to acquire geo-referenced, 1 Hz, 1024-channel spectra. The historical shortfalls of this technology include: • Very low spatial resolution (typical field of view is circle of two-times altitude) • Relatively low detectability associated with large stand-off distances • Fundamental challenges in performing ground-level quantification This work uses modern computational power in conjunction with multi-dimensional deconvolution algorithms in an effort to improve spatial resolution, enhance detectability, and provide a robust framework for quantification.

  9. Radiology practice models: the 2008 ACR Forum.

    PubMed

    Gunderman, Richard B; Weinreb, Jeffrey C; Van Moore, Arl; Hillman, Bruce J; Neiman, Harvey L; Thrall, James H

    2008-09-01

    The 2008 ACR Forum brought together a diverse group of participants from clinical radiology, radiology leadership and practice management, managed care, economics, law, and entrepreneurship in Washington, DC, in January 2008 to discuss current models of radiology practice and anticipate new ones. It addressed what forces shape the practice of radiology, how these forces are changing, and how radiology practices can most effectively respond to them in the future. PMID:18755435

  10. Technology insight: measuring prolactin in clinical samples.

    PubMed

    Smith, Thomas P; Kavanagh, Lucille; Healy, Marie-Louise; McKenna, T Joseph

    2007-03-01

    Measurement of prolactin is one of the most commonly undertaken hormonal investigations in evaluating patients with reproductive disorders. Hyperprolactinemia is found in up to 17% of such cases. Diagnostic evaluation of hyperprolactinemia is difficult but is facilitated by a logical approach where a thorough patient history is obtained, secondary causes of hyperprolactinemia are excluded, and the limitations of current prolactin assays are appreciated. Once hyperprolactinemia has been confirmed, attempts to establish the underlying cause can start. Given current workloads, laboratories rely on automated platforms to measure prolactin, most of which employ two-site immunoassay sandwich methods. Although generally robust and reliable, such immunoassays are susceptible to interference, and good collaboration between clinicians and the laboratory helps to minimize problems. A major challenge facing laboratories is correct differentiation of patients with true hyperprolactinemia from those with macroprolactinemia. Macroprolactin is a high-molecular-mass, biologically inactive form of prolactin that is detected to varying degrees by all prolactin immunoassays. Conservative estimates suggest that the presence of macroprolactin leads to misdiagnosis in as many as 10% of all reported instances of biochemical hyperprolactinemia. In the absence of specific testing, macroprolactin represents a diagnostic pitfall that results in the misdiagnosis and mismanagement of large numbers of patients. PMID:17315036