Showing papers in "Imaging in 2014"
TL;DR: The lymph node anatomy in the mediastinum, common pathways and stations are discussed, which are an important step in diagnosis of benign and malignant disease.
Abstract: Mediastinal lymphadenopathy can be caused by benign and malignant disease.Understanding of the lymph node anatomy and stations is important for diagnosis, treatment and disease monitoring.Various imaging techniques can be used for the assessment of the mediastinum:■ Chest radiography.■ CT and fludeoxyglucose–positron emission tomography CT imaging.■ Mediastinoscopy and mediastinotomy.■ Endoscopic ultrasound (EUS).■ Endobronchial ultrasound (EBUS).■ MRI.Lymph node sampling is an important step in diagnosis of benign and malignant disease.More frequently, less invasive techniques such as EUS and EBUS are preferred to more invasive surgical techniques such as mediastinotomy, as they achieve similar results with fewer complications.Mediastinal lymphadenopathy can have important implications, yet, it is not an uncommon finding in routine imaging work. Causes for lymphadenopathy range from benign infections to malignant processes. In this review, we discuss the lymph node anatomy in the mediastinum, common path...
4 citations
TL;DR: This review aims to provide an overview of the recent advances in imaging of the temporal bone and to discuss problematic and currently topical pathology.
Abstract: • CT is the initial imaging of choice in the investigation of middle ear disease• MRI is used in evaluating the inner ear in patients presenting with sensorineural deafness, tinnitus and vertigo It has an increasingly important role in the detection of post-operative cholesteatoma recurrence• Nuclear medicine and cone beam CT have limited rolesInterpretation of temporal bone imaging is challenging for most general radiologists, as the temporal bone is an anatomically highly complex region This review aims to provide an overview of the recent advances in imaging of the temporal bone and to discuss problematic and currently topical pathology
2 citations
TL;DR: CT remains the workhorse for initial diagnostic imaging in lung cancer; however, the uses for positron emission tomography (PET)-CT are ever increasing with greater sensitivity and specificity for staging.
Abstract: Initial data from North America shows reduction in lung cancer-related mortality following the use of CT screening.Staging with TNM 7 has replaced TNM 6 based on evidence-based outcomes reflecting advances in diagnosis and treatment.CT remains the workhorse for initial diagnostic imaging in lung cancer; however, the uses for positron emission tomography (PET)-CT are ever increasing with greater sensitivity and specificity for staging.Endoscopic ultrasound-guided nodal sampling via the airways and oesophagus is replacing the need for surgical mediastinal sampling and preventing unnecessary thoracotomies.Ultrasound-guided sampling of neck nodes should be considered in those patients with mediastinal adenopathy.Knowledge of potential surgical procedures and their imaging features is vital for reporting radiologists in order to recognize the potential complications.Stereotactic body radiotherapy-associated changes include ground-glass opacity, consolidation and fibrosis. PET-CT is a helpful adjunct in the fol...
2 citations
TL;DR: Pneumocystis jiroveci pneumonia should be the main diagnosis when ground-glass attenuation is seen in patients with human immunodeficiency virus with CD4+ <200 cells per cubic millimetre.
Abstract: • Bacterial pneumonias have similar radiographic patterns in immunocompetent and immunosuppressed patients. Chest radiographs and CT show consolidation, which may be focal (segmental or lobar), patchy or diffuse.• Tuberculosis in immunocompetent patients most frequently manifests as the reactivation (secondary) pattern, whereas immunosuppressed patients present the primary pattern of the disease.• If a neutropenic febrile patient presents with pulmonary nodules or consolidation surrounded by ground-glass opacities (“halo sign”), angioinvasive fungal infection must be the first diagnosis.• Pneumocystis jiroveci pneumonia should be the main diagnosis when ground-glass attenuation is seen in patients with human immunodeficiency virus with CD4+ <200 cells per cubic millimetre.• High-resolution CT features in viral infections are similar and show small poorly defined centrilobular nodules and consolidation foci and/or ground-glass attenuation with peribronchial distribution, and are multifocal and often bilate...
1 citations
TL;DR: Renal masses are commonly encountered in adult radiological practice, with a range of appearances from entirely cystic to solid, to which the now considerably refined Bosniak classification has been applied.
Abstract: • Renal masses are a common, often incidental finding on cross-sectional imaging.• Ultrasound can readily characterize a mass as solid or cystic.• The Bosniak classification is based on CT but can equally well be applied to MRI or contrast-enhanced ultrasound.• CT is the main method for staging renal cell carcinoma (RCC), with MRI used in specific indications, such as to assess the extent of venous involvement.• Most solid renal masses are assumed to be RCC, although approximately 20% of masses under 3 cm will be benign.• The seventh edition of the American Joint Committee on Cancer TNM staging for renal cancer has been presented.• An overview of the therapeutic options for renal cancer is discussed.Renal masses are commonly encountered in adult radiological practice, with a range of appearances from entirely cystic to solid. Characterization of more complex cystic masses is a challenge, to which the now considerably refined Bosniak classification has been applied. The Bosniak classification will be discu...
1 citations
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TL;DR: Doppler ultrasound and dynamic-enhanced MRI are the most sensitive imaging tools for diagnosing and monitoring synovitis in inflammatory arthropathies.
Abstract: • MR or CT is advocated in the assessment of radiographically occult fractures.• The intrinsic ligaments of the wrist are better visualized at 3.0-T MRI than at 1.5-T MRI; however, MR or multidetector CT arthrography is the most sensitive at detecting intrinsic ligament and triangular fibrocartilage complex (TFCC) tears.• MR is more sensitive at detecting scapholunate ligament tears than lunotriquetral ligament tears.• TFCC tears can be divided into traumatic or degenerative tears, the latter being related to ulnar impaction syndrome.• Chronic wrist pain as a result of trauma may be secondary to scaphoid avascular necrosis, malunion, non-union, scapholunate advanced collapse and scaphoid non-union advanced collapse wrist or chronic regional pain syndrome.• Specific ulnar-sided wrist pain has its own unique causes that are optimally imaged with MR.• Doppler ultrasound and dynamic-enhanced MRI are the most sensitive imaging tools for diagnosing and monitoring synovitis in inflammatory arthropathies.• Most m...
TL;DR: There is a fracture through the waist of the scaphoid associated with a perilunate dislocation consistent with a trans-scaphoid perilunates dislocation, which has been treated by open reduction and fixation with Kirschner wires across the lunotriquetral interval and a Herbert compression screw across the trans-Scaphoid fracture.
Abstract: There is a fracture through the waist of the scaphoid associated with a perilunate dislocation consistent with a trans-scaphoid perilunate dislocation. This has been treated by open reduction and fixation with Kirschner wires across the lunotriquetral interval and a Herbert compression screw across the trans-scaphoid fracture. These are extremely important injuries, 25% are missed at initial presentation and may lead to serious complications. They can occur following high-energy trauma, such as road traffic accidents or sporting injuries, causing hyperextension of the wrist. 26% of injuries are associated with polytrauma. Perilunate dislocations occur in a sequence of events involving either ligament and/or bony disruption. This injury pattern typically starts on the radial side and destabilizes either through the body of the scaphoid or through the scapholunate interval. Mayfield et al described the ligamentous sequence of events:
TL;DR: One of the most common is generally (although not universally) accepted to involve shaking; this article will concentrate on this type of injury and will therefore include AHT that refocused on shaking.
Abstract: • A shaking event is a common mechanism in abusive head trauma (AHT).• AHT is associated with greater morbidity and mortality than accidental (usually impact) head trauma.• AHT gives rise to different patterns of subdural haemorrhage (SDH) and parenchymal brain injury from impact head trauma.• Multifocal SDH is best regarded as a marker of a mechanism of injury but does not itself cause symptoms and signs.• Associated parenchymal brain injury leads to symptoms and signs and relates to outcome.• Published standards for the radiological investigation of AHT are available and should be followed.Abusive head trauma (AHT) is best defined as a head injury occurring to a child as a result of an act by a carer that may be negligent, reckless or deliberate. Whilst there are a number of different potential mechanisms involved in AHT, one of the most common is generally (although not universally) accepted to involve shaking; this article will concentrate on this type of injury and will therefore include AHT that ref...
TL;DR: Brain imaging cannot diagnose dementia but can suggest the most likely underlying neuropathology in a demented patient, and there are no currently available disease-modifying treatments for dementia.
Abstract: • Structural brain imaging is recommended in patients with dementia by all current guidelines.• Brain imaging cannot diagnose dementia but can suggest the most likely underlying neuropathology in a demented patient.• Alzheimer's disease is the commonest cause of dementia and usually co-exists with other pathologies, most often cerebrovascular disease.• Frontotemporal dementias are a heterogeneous group of neuropathologies that typically cause asymmetric frontal, anterior temporal and/or insular atrophy.• Dementia with Lewy bodies is caused by the same pathology as Parkinson's disease, and there is clinical overlap.• Cerebrovascular disease is associated with vascular risk factors, increases linearly with age and, typically, is manifest as white matter ischaemic change and/or lacunar infarcts.• There are no currently available disease-modifying treatments for dementia.• The prevalence of dementia is doubling every 20 years, as people live longer and health and social care resources will soon become insuffi...