Treat, follow-up, or discharge? An aid in sonographic decisions for the borderline centered neonatal/infantile hips.

Aim: To investigate whether linear measurements or ratios on the Graf's "standard plane" ultrasound images of the neonatal/infantile hip, can support the clinically important differentiation between type I and type II hips.

Material And Methods: A total of 60 Graf type II hips and 124 randomly selected Graf type I hips, matched to the gestational age at delivery, birth weight, delivery mode, and age at the time of the examination, were identified through our hip screening service, during a period of two years. The images were diagnostically suitable, following anatomical identification and usability check, according to Graf.

Current Imaging Diagnosis of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade.

Pyogenic Liver Abscess Complicating Acute Cholecystitis: Different Management Options.

Acute cholecystitis, which is usually associated with gallstones is one of the most common surgical causes of emergency hospital admission and may be further complicated by mural necrosis, perforation and abscess formation. Perforation of the gallbladder is a relatively uncommon complication of acute cholecystitis (0.8-3.

Local and Regional Therapies for Hepatocellular Carcinoma and Future Combinations.

Background: Hepatocellular carcinoma (HCC) can be treated by local and regional methods of percutaneous interventional radiological techniques. Indications depend on tumor size, type and stage, as well as patient's condition, liver function and co-morbidities. According to international classification systems such as Barcelona Clinic Liver Cancer (BCLC) classification, very early, early or intermediate staged tumors can be treated either with ablative methods or with transarterial chemoembolization (TACE), depending on tumor characteristics.

Haemoptysis in Pulmonary Arterial Hypertension Associated with Congenital Heart Disease: Insights on Pathophysiology, Diagnosis and Management.

Haemoptysis represents one of the most severe major bleeding manifestations in the clinical course of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD). Accumulating evidence indicates that dysfunction of the pulmonary vascular bed in the setting of PAH predisposes patients to increased hemorrhagic diathesis, resulting in mild to massive and life-threatening episodes of haemoptysis. Despite major advances in PAH targeted treatment strategies, haemoptysis is still correlated with substantial morbidity and impaired quality of life, requiring a multidisciplinary approach by adult CHD experts in tertiary centres.

Diagnosing a Patient with Erdheim-Chester Disease during the COVID-19 Pandemic.

: Erdheim-Chester disease (ECD) is a rare hematopoietic neoplasm of histiocytic origin characterized by an insidious course. The coronavirus disease 2019 (COVID-19) pandemic has put an enormous strain on healthcare systems worldwide both directly and indirectly, resulting in the disruption of healthcare services to prevent, diagnose and manage non-COVID-19 disease. : We describe the case of a 58-year-old male patient with sporadic episodes of self-resolving mild fever and anemia of chronic disease with onset two years before the current presentation.

Institutional Diagnostic Reference Levels and Peak Skin Doses in selected diagnostic and therapeutic interventional radiology procedures.

Purpose: Institutional (local) Diagnostic Reference Levels for Cerebral Angiography (CA), Percutaneous Transhepatic Cholangiography (PTC), Transarterial Chemoembolization (TACE) and Percutaneous Transhepatic Biliary Drainage (PTBD) are reported in this study.

Materials And Methods: Data for air kerma-area product (P), air kerma at the patient entrance reference point (K), fluoroscopy time (FT) and number of images (NI) as well as estimates of Peak Skin Dose (PSD) were collected for 142 patients. Therapeutic procedure complexity was also evaluated, in an attempt to incorporate it into the DRL analysis.

CIRSE Standards of Practice on Percutaneous Transhepatic Cholangiography, Biliary Drainage and Stenting.

This CIRSE Standards of Practice document is aimed at interventional radiologists and provides best practices for performing percutaneous transhepatic cholangiography, biliary drainage and stenting. It has been developed by an expert writing group established by the CIRSE Standards of Practice Committee.

Cerebral CT Perfusion in Acute Stroke: The Effect of Lowering the Tube Load and Sampling Rate on the Reproducibility of Parametric Maps.

The aim of this study was to define lower dose parameters (tube load and temporal sampling) for CT perfusion that still preserve the diagnostic efficiency of the derived parametric maps. Ninety stroke CT examinations from four clinical sites with 1 s temporal sampling and a range of tube loads (mAs) (100-180) were studied. Realistic CT noise was retrospectively added to simulate a CT perfusion protocol, with a maximum reduction of 40% tube load (mAs) combined with increased sampling intervals (up to 3 s).

CT liver perfusion in patients with hepatocellular carcinoma: can we modify acquisition protocol to reduce patient exposure?

Objectives: To investigate the potential of decreasing the number of scans and associated radiation exposure involved in CT liver perfusion (CTLP) dynamic studies for hepatocellular carcinoma (HCC) assessment.

Methods: Twenty-four CTLP image datasets of patients with HCC were retrospectively analyzed. All examinations were performed on a modern CT system using a standard acquisition protocol involving 35 scans with 1.

Effect of scan projection radiography coverage on tube current modulation in pediatric and adult chest CT.

Purpose: To investigate the effect of scan projection radiography (SPR) coverage on tube current modulation in pediatric and adult thoracic CT examinations.

Methods: Sixty pediatric and 60 adult chest CT examinations were retrospectively studied to determine the incidence rate of examinations involving SPRs that did not include the entire image volume (IV) or the entire primarily exposed body volume (PEBV). The routine chest CT acquisition procedure on a modern 64-slice CT system was imitated on five anthropomorphic phantoms of different size.

Curative embolization of iatrogenic inferior mesenteric arteriovenous fistula 14 years after right hemicolectomy.

Inferior mesenteric arteriovenous fistula (IMAVF) is a rare condition with 40 reported cases. It can be of congenital, idiopathic or acquired etiology. Acquired IMAVF occurs after trauma or has an iatrogenic origin due to abdominal interventions, mainly operations involving the left hemi-colon.

CT coronary angiography in asymptomatic male patients with high atherosclerosis risk: Is it justified?

Purpose: To study the necessity of coronary artery screening with computerized tomography coronary angiography (CTCA) in asymptomatic male patients.

Material And Methods: A total of 226 asymptomatic male patients aged over 50 years were included in this prospective study, according to a clinical protocol approved by the Heraklion University Hospital's Ethics Committee. All participants had at least 3 or more known atherosclerosis risk factors.

CT Foot Perfusion Examination for Evaluation of Percutaneous Transluminal Angioplasty Outcome in Patients with Critical Limb Ischemia: A Feasibility Study.

Purpose: To evaluate foot perfusion in patients with critical limb ischemia (CLI) using quantitative perfusion multi-detector-row CT and estimate perfusion parameter changes before and after percutaneous transluminal angioplasty (PTA).

Materials And Methods: This prospective study investigated 13 patients (10 men; median age, 72 y; range, 51-84 y) with CLI who underwent CT foot perfusion examinations with a 128-slice dual-energy CT scanner 1 day before and 1 week after PTA. Key parameters such as permeability surface (PS), blood volume (BV), and blood flow (BF) were analyzed and compared statistically.

Dynamic Computed Tomography Perfusion Imaging: Complementary Diagnostic Tool in Hepatocellular Carcinoma Assessment From Diagnosis to Treatment Follow-up.

Early diagnosis of HCC is of paramount importance in order to enable the application of curative treatments. Among these, radiofrequency ablation (RFA) is actually considered the most effective ablative therapy for early stage hepatocellular carcinoma (HCC) not suitable for surgery. On the other hand, transarterial chemoembolization (TACE) represents the standard of care for intermediate stage HCC and compensated liver function.

Comparison of patient dose from routine multi-phase and dynamic liver perfusion CT studies taking into account the effect of iodinated contrast administration.

Objectives: To accurately determine and compare patient radiation burden from routine multi-phase CT (MPCT) and dynamic CT liver perfusion (CTLP) studies taking into account the effect of iodine uptake of exposed tissues/organs.

Materials And Methods: 40 consecutive MPCT of upper abdomen and 40 consecutive CTLP studies performed on a modern CT scanner were retrospectively studied. Iodine uptake of radiosensitive tissues at the time of acquisition was calculated through the difference of tissues' CT numbers between NECT and CECT images.

Common left carotid bifurcation at C7-Th1 level: a rare anatomical variant.

The left common carotid artery usually bifurcates to the internal and external carotids at or near the superior border of thyroid cartilage. In head and neck surgery, the common carotid arteries are important landmarks, defining the plane of dissection during radical neck surgeries. According to the literature, many variations exist regarding the carotid bifurcation.

Giant internal iliac artery aneurysm successfully treated with endovascular stent-graft placement.

An 88-year-old male patient of high surgical risk was presented with left sciatic pain symptoms and a palpable pulsatile left lower abdominal mass. He was operated 8 years ago for a large infrarenal aortic aneurysm. Computed tomography angiography (CTA) revealed a giant 161 mm left internal iliac aneurysm with multilocular appearance and left sacral bone erosion causing the symptoms.

Does lung perfusion scintigraphy continue to have a role in the clinical management of patients suspected of pulmonary embolism in the CT pulmonary angiography era?

Objective: Acute pulmonary embolism (PE) is a life-threatening disorder with high mortality. A prompt diagnosis and treatment is essential for reducing the mortality rate. The purpose of the study is to evaluate if lung perfusion scintigraphy (LPS) continues to have a role in the clinical management of patients suspected of pulmonary embolism in the CT pulmonary angiography (CTPA) era.

A correlative study between diffusion and perfusion MR imaging parameters on peripheral arterial disease data.

Purpose: The purpose of this study was to correlate diffusion and perfusion quantitative and semi-quantitative MR parameters, on patients with peripheral arterial disease. In addition, we investigated which perfusion model better describes the behavior of the dynamic contrast-enhanced (DCE) MR data signal on ischemic regions of the lower limb.

Methods: Linear and nonlinear least squares algorithms, were incorporated for the quantification of the parameters through a variety of widely used models, able to extract physiological information from each imaging technique.

Perfusion-CT analysis for assessment of hepatocellular carcinoma lesions: diagnostic value of different perfusion maps.

Background: Computed tomography liver perfusion (CTLP) has been improved in recent years, offering a variety of perfusion-parametric maps. A map that better discriminates hepatocellular carcinoma (HCC) is still to be found.

Purpose: To compare different CTLP maps, regarding their ability to differentiate cirrhotic or non-cirrhotic parenchyma from malignant HCC.

What is the underestimation of radiation dose to the pediatric thyroid gland from contrast enhanced CT, if contrast medium uptake is not taken into account?

Purpose: To assess the underestimation of radiation dose to the thyroid of children undergoing contrast enhanced CT if contrast medium uptake is not taken into account.

Methods: 161 pediatric head, head & neck and chest CT examinations were retrospectively studied to identify those involving pre- and post-contrast imaging and thyroid inclusion in imaged volume. CT density of thyroid tissue in HU was measured in non-enhanced (NECT) and corresponding contrast-enhanced CT (CECT) images.